WorldWideScience

Sample records for integrative medicine pim

  1. Saudi Aramco experience towards establishing Pipelines Integrity Management Systems (PIMS)

    Energy Technology Data Exchange (ETDEWEB)

    AlAhmari, Saad A. [Saudi Aramco, Dhahran (Saudi Arabia)

    2009-12-19

    Saudi Aramco pipelines network transports hydrocarbons to export terminals, processing plants and domestic users. This network faced several safety and operational-related challenges that require having a more effective Pipelines Integrity Management System (PIMS). Therefore Saudi Aramco decided to develop its PIMS on the basis of geographical information system (GIS) support through different phases, i.e., establishing the integrity management framework, risk calculation approach, conducting a gap analysis toward the envisioned PIMS, establishing the required scope of work, screening the PIMS applications market, and selecting suitable tools that satisfy expected deliverables, and implement PIMS applications. Saudi Aramco expects great benefits from implementing PIMS, e.g., enhancing safety, enhancing pipeline network robustness, optimizing inspection and maintenance expenditures, and facilitating pipeline management and the decision-making process. Saudi Aramco's new experience in adopting PIMS includes many challenges and lessons-learned associated with all of the PIMS development phases. These challenges include performing the gap analysis, conducting QA/QC sensitivity analysis for the acquired data, establishing the scope of work, selecting the appropriate applications and implementing PIMS. (author)

  2. Saudi Aramco experience towards establishing Pipelines Integrity Management System (PIMS)

    Energy Technology Data Exchange (ETDEWEB)

    Al-Ahmari, Saad A. [Saudi Aramco, Dhahran (Saudi Arabia)

    2009-07-01

    Saudi Aramco pipelines network transports hydrocarbons to export terminals, processing plants and domestic users. This network faced several safety and operational-related challenges that require having a more effective Pipelines Integrity Management System (PIMS). Therefore Saudi Aramco decided to develop its PIMS on the basis of geographical information system (GIS) support through different phases, i.e., establishing the integrity management framework, risk calculation approach, conducting a gap analysis toward the envisioned PIMS, establishing the required scope of work, screening the PIMS applications market, and selecting suitable tools that satisfy expected deliverables, and implement PIMS applications. Saudi Aramco expects great benefits from implementing PIMS, e.g., enhancing safety, enhancing pipeline network robustness, optimizing inspection and maintenance expenditures, and facilitating pipeline management and the decision-making process. Saudi Aramco's new experience in adopting PIMS includes many challenges and lessons-learned associated with all of the PIMS development phases. These challenges include performing the gap analysis, conducting QA/QC sensitivity analysis for the acquired data, establishing the scope of work, selecting the appropriate applications and implementing PIMS. (author)

  3. 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.

  4. M109 Family of Vehicles, Paladin Integrated Management (PIM): Operational Assessment of the Initial Operational Test and Evaluation (IOT and E)

    Science.gov (United States)

    2017-01-01

    Director, Operational Test and Evaluation M109 Family of Vehicles, Paladin Integrated Management (PIM) Operational Assessment of the... operational suitability, test adequacy, and survivability of the M109 Family of Vehicles (FoV), known as Paladin Integrated Management (PIM) Self...prevent the M109A7 SPH-equipped unit from completing its mission. The Paladin Integrated Management (PIM) Initial Operational Test and Evaluation

  5. PIM-Check: development of an international prescription-screening checklist designed by a Delphi method for internal medicine patients.

    Science.gov (United States)

    Desnoyer, Aude; Blanc, Anne-Laure; Pourcher, Valérie; Besson, Marie; Fonzo-Christe, Caroline; Desmeules, Jules; Perrier, Arnaud; Bonnabry, Pascal; Samer, Caroline; Guignard, Bertrand

    2017-07-31

    Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection. Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development. 22 University and general hospitals from Canada, Belgium, France and Switzerland. 40 physicians and 25 clinical pharmacists were involved in the study.Agreement with the checklist statements and their usefulness for healthcare professional training were evaluated using two 6-point Likert scales (ranging from 0 to 5). Agreement and usefulness ratings were defined as: >65% of the experts giving the statement a rating of 4 or 5, during the first Delphi-round and >75% during the second. 166 statements were generated during the first two steps. Mean agreement and usefulness ratings were 4.32/5 (95% CI 4.28 to 4.36) and 4.11/5 (4.07 to 4.15), respectively, during the first Delphi-round and 4.53/5 (4.51 to 4.56) and 4.36/5 (4.33 to 4.39) during the second (pinternal medicine. It is intended to help young healthcare professionals in their clinical practice to detect PIM, to reduce medication errors and to improve patient safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Sudan PIMS

    Data.gov (United States)

    US Agency for International Development — The development of this system was awarded to MSI in May 2013 to design and help USAID/South Sudan manage a web-based PIMS that is customized to USAID/South Sudan's...

  7. Complementary and Integrative Medicine

    Science.gov (United States)

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  8. Integrative Medicine in Preventive Medicine Education

    OpenAIRE

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2015-01-01

    During 2012, the USDHHS?s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center esta...

  9. Integrative Medicine in Preventive Medicine Education

    Science.gov (United States)

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2016-01-01

    During 2012, the USDHHS’s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine’s dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site’s competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees’ work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine

  10. An introduction to the new Productivity Information Management System (PIMS)

    Science.gov (United States)

    Hull, R.

    1982-01-01

    The productivity information management system (PIMS), is described. The main objective of this computerized system is to enable management scientists to interactively explore data concerning DSN operations, maintenance and repairs, to develop and verify models for management planning. The PIMS will provide a powerful set of tools for iteratively manipulating data sets in a wide variety of ways. The initial version of PIMS will be a small scale pilot system. The following topics are discussed: (1) the motivation for developing PIMS; (2) various data sets which will be integrated by PIMS; (3) overall design of PIMS; and (4) how PIMS will be used. A survey of relevant databases concerning DSN operations at Goldstone is also included.

  11. South Africa PIMS

    Data.gov (United States)

    US Agency for International Development — PIMS (SOL-674-12-000037) collects and provides information on activities, results, partners, and staff supported through PEPFAR funding in each sub-district of South...

  12. Integrative holistic medicine in Minnesota.

    Science.gov (United States)

    Torkelson, Carolyn J; Manahan, Bill

    2009-05-01

    Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.

  13. The Pim kinases: new targets for drug development.

    Science.gov (United States)

    Swords, Ronan; Kelly, Kevin; Carew, Jennifer; Nawrocki, Stefan; Mahalingam, Devalingam; Sarantopoulos, John; Bearss, David; Giles, Francis

    2011-12-01

    The three Pim kinases are a small family of serine/threonine kinases regulating several signaling pathways that are fundamental to cancer development and progression. They were first recognized as pro-viral integration sites for the Moloney Murine Leukemia virus. Unlike other kinases, they possess a hinge region which creates a unique binding pocket for ATP. Absence of a regulatory domain means that these proteins are constitutively active once transcribed. Pim kinases are critical downstream effectors of the ABL (ableson), JAK2 (janus kinase 2), and Flt-3 (FMS related tyrosine kinase 1) oncogenes and are required by them to drive tumorigenesis. Recent investigations have established that the Pim kinases function as effective inhibitors of apoptosis and when overexpressed, produce resistance to the mTOR (mammalian target of rapamycin) inhibitor, rapamycin . Overexpression of the PIM kinases has been reported in several hematological and solid tumors (PIM 1), myeloma, lymphoma, leukemia (PIM 2) and adenocarcinomas (PIM 3). As such, the Pim kinases are a very attractive target for pharmacological inhibition in cancer therapy. Novel small molecule inhibitors of the human Pim kinases have been designed and are currently undergoing preclinical evaluation.

  14. Integrative medicine is a future medicine

    International Nuclear Information System (INIS)

    Samosyuk, I.Z.; Chukhraev, N.V.

    2001-01-01

    An analysis is given of the modern integrative medicine basis which is the synthesis of: 1. Theology, philosophy and sociology; 2. Physico-mathematical sciences, cybernetics, chemistry and astrology; 3. Medico-biological and clinical experience; 4. Traditional and scientific medicine; 5. Use of traditional and new medical technologies. Problems of 'holistic' medicine which considers Man as a unity of biological, emotional, psychological and social phenomena are exposed. Advantages in combining the drug therapy with modern physiotherapy and physioacupuncture methods seem to be obvious. All visible effects of a disease can de represented in the following forms of changes: information-energy - biochemical - ultrastructure - tissue - clinical diseases. Self-regulation of functional systems has a multilevel structure and needs application of different methods for body recovery. Short-wave irradiation (lasers, magnetotherapy) can be used for energy restoration in functional systems or meridians, and acupuncture plays the role of a 'trigger' which activises the body recovery. Integration of Western and Oriental medicines is the way for achieving the qualitative new level of health protection

  15. Integrative medicine for cancer treatment

    Science.gov (United States)

    ... gov/ency/patientinstructions/000932.htm Integrative medicine for cancer treatment To use the sharing features on this page, ... help relieve common side effects of cancer or cancer treatment, such as fatigue, anxiety, pain, and nausea. Some ...

  16. Integrative medicine for chronic pain

    Science.gov (United States)

    Saha, Felix J.; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

    2016-01-01

    Abstract Introduction: Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Methods: Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients’ pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. Results: A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction. PMID:27399133

  17. Integrating genomics into evolutionary medicine.

    Science.gov (United States)

    Rodríguez, Juan Antonio; Marigorta, Urko M; Navarro, Arcadi

    2014-12-01

    The application of the principles of evolutionary biology into medicine was suggested long ago and is already providing insight into the ultimate causes of disease. However, a full systematic integration of medical genomics and evolutionary medicine is still missing. Here, we briefly review some cases where the combination of the two fields has proven profitable and highlight two of the main issues hindering the development of evolutionary genomic medicine as a mature field, namely the dissociation between fitness and health and the still considerable difficulties in predicting phenotypes from genotypes. We use publicly available data to illustrate both problems and conclude that new approaches are needed for evolutionary genomic medicine to overcome these obstacles. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. PIM1: A Molecular Target to Modulate Cellular Resistance to Therapy in Prostate Cancer

    Science.gov (United States)

    2008-10-31

    demonstration that quercetagetin in competitive with ATP. A crystal structure of PIM1 in complex with quercetagetin, or with three other flavonoids ...pharmacophore analysis of flavonoid inhibitors of PIM1, has also been published recently (3; see appendix B). We have recently obtained, and begun...describing pharmacophore analysis of flavonoid inhibitors of PIM1, published in March, 2007 issue of Bioorganic and Medicinal Chemistry REPORTABLE OUTCOMES

  19. PIMS-Universal Payload Information Management

    Science.gov (United States)

    Elmore, Ralph; McNair, Ann R. (Technical Monitor)

    2002-01-01

    As the overall manager and integrator of International Space Station (ISS) science payloads and experiments, the Payload Operations Integration Center (POIC) at Marshall Space Flight Center had a critical need to provide an information management system for exchange and management of ISS payload files as well as to coordinate ISS payload related operational changes. The POIC's information management system has a fundamental requirement to provide secure operational access not only to users physically located at the POIC, but also to provide collaborative access to remote experimenters and International Partners. The Payload Information Management System (PIMS) is a ground based electronic document configuration management and workflow system that was built to service that need. Functionally, PIMS provides the following document management related capabilities: 1. File access control, storage and retrieval from a central repository vault. 2. Collect supplemental data about files in the vault. 3. File exchange with a PMS GUI client, or any FTP connection. 4. Files placement into an FTP accessible dropbox for pickup by interfacing facilities, included files transmitted for spacecraft uplink. 5. Transmission of email messages to users notifying them of new version availability. 6. Polling of intermediate facility dropboxes for files that will automatically be processed by PIMS. 7. Provide an API that allows other POIC applications to access PIMS information. Functionally, PIMS provides the following Change Request processing capabilities: 1. Ability to create, view, manipulate, and query information about Operations Change Requests (OCRs). 2. Provides an adaptable workflow approval of OCRs with routing through developers, facility leads, POIC leads, reviewers, and implementers. Email messages can be sent to users either involving them in the workflow process or simply notifying them of OCR approval progress. All PIMS document management and OCR workflow controls are

  20. Ethnoveterinary Medicine: The prospects of integrating medicinal ...

    African Journals Online (AJOL)

    Medicinal plants products are part of the natural products that have been in use in traditional medicine and also a source of novel drugs. Therefore, the use of medicinal plant products would be a rational alternative to synthetic drugs. Ethnobotanical surveys carried out in many parts of Kenya have revealed a lot of plants ...

  1. PIM kinases as potential therapeutic targets in a subset of peripheral T cell lymphoma cases.

    Directory of Open Access Journals (Sweden)

    Esperanza Martín-Sánchez

    Full Text Available Currently, there is no efficient therapy for patients with peripheral T cell lymphoma (PTCL. The Proviral Integration site of Moloney murine leukemia virus (PIM kinases are important mediators of cell survival. We aimed to determine the therapeutic value of PIM kinases because they are overexpressed in PTCL patients, T cell lines and primary tumoral T cells. PIM kinases were inhibited genetically (using small interfering and short hairpin RNAs and pharmacologically (mainly with the pan-PIM inhibitor (PIMi ETP-39010 in a panel of 8 PTCL cell lines. Effects on cell viability, apoptosis, cell cycle, key proteins and gene expression were evaluated. Individual inhibition of each of the PIM genes did not affect PTCL cell survival, partially because of a compensatory mechanism among the three PIM genes. In contrast, pharmacological inhibition of all PIM kinases strongly induced apoptosis in all PTCL cell lines, without cell cycle arrest, in part through the induction of DNA damage. Therefore, pan-PIMi synergized with Cisplatin. Importantly, pharmacological inhibition of PIM reduced primary tumoral T cell viability without affecting normal T cells ex vivo. Since anaplastic large cell lymphoma (ALK+ ALCL cell lines were the most sensitive to the pan-PIMi, we tested the simultaneous inhibition of ALK and PIM kinases and found a strong synergistic effect in ALK+ ALCL cell lines. Our findings suggest that PIM kinase inhibition could be of therapeutic value in a subset of PTCL, especially when combined with ALK inhibitors, and might be clinically beneficial in ALK+ ALCL.

  2. Integrative Medicine: In With the New

    Directory of Open Access Journals (Sweden)

    Tiffany A. Mullen

    2015-11-01

    Full Text Available Integrative medicine is not "alternative," which implies the substitution of conventional medicine with often unproven natural treatments. Rather, integrative medicine is defined as the combination of conventional biomedicine with nontraditional and holistic practices to help patients on their journey to health.

  3. Nuclear PIM1 confers resistance to rapamycin-impaired endothelial proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Walpen, Thomas; Kalus, Ina [Research Unit, Division Internal Medicine, University Hospital Zuerich, 8091 Zuerich (Switzerland); Schwaller, Juerg [Department of Biomedicine, University of Basel, 4031 Basel (Switzerland); Peier, Martin A. [Research Unit, Division Internal Medicine, University Hospital Zuerich, 8091 Zuerich (Switzerland); Battegay, Edouard J. [Research Unit, Division Internal Medicine, University Hospital Zuerich, 8091 Zuerich (Switzerland); Zurich Center for Integrative Human Physiology (ZIHP), 8057 Zuerich (Switzerland); Humar, Rok, E-mail: Rok.Humar@usz.ch [Research Unit, Division Internal Medicine, University Hospital Zuerich, 8091 Zuerich (Switzerland); Zurich Center for Integrative Human Physiology (ZIHP), 8057 Zuerich (Switzerland)

    2012-12-07

    Highlights: Black-Right-Pointing-Pointer Pim1{sup -/-} endothelial cell proliferation displays increased sensitivity to rapamycin. Black-Right-Pointing-Pointer mTOR inhibition by rapamycin enhances PIM1 cytosolic and nuclear protein levels. Black-Right-Pointing-Pointer Truncation of Pim1 beyond serine 276 results in nuclear localization of the kinase. Black-Right-Pointing-Pointer Nuclear PIM1 increases endothelial proliferation independent of rapamycin. -- Abstract: The PIM serine/threonine kinases and the mTOR/AKT pathway integrate growth factor signaling and promote cell proliferation and survival. They both share phosphorylation targets and have overlapping functions, which can partially substitute for each other. In cancer cells PIM kinases have been reported to produce resistance to mTOR inhibition by rapamycin. Tumor growth depends highly on blood vessel infiltration into the malignant tissue and therefore on endothelial cell proliferation. We therefore investigated how the PIM1 kinase modulates growth inhibitory effects of rapamycin in mouse aortic endothelial cells (MAEC). We found that proliferation of MAEC lacking Pim1 was significantly more sensitive to rapamycin inhibition, compared to wildtype cells. Inhibition of mTOR and AKT in normal MAEC resulted in significantly elevated PIM1 protein levels in the cytosol and in the nucleus. We observed that truncation of the C-terminal part of Pim1 beyond Ser 276 resulted in almost exclusive nuclear localization of the protein. Re-expression of this Pim1 deletion mutant significantly increased the proliferation of Pim1{sup -/-} cells when compared to expression of the wildtype Pim1 cDNA. Finally, overexpression of the nuclear localization mutant and the wildtype Pim1 resulted in complete resistance to growth inhibition by rapamycin. Thus, mTOR inhibition-induced nuclear accumulation of PIM1 or expression of a nuclear C-terminal PIM1 truncation mutant is sufficient to increase endothelial cell proliferation

  4. [Holistic integrative medicine: the road to the future of the development of burn medicine].

    Science.gov (United States)

    Fan, D M

    2017-01-20

    Holistic integrative medicine is the road to the future of the development of burn medicine. Not only burn medicine, but also human medicine gradually enters the era of holistic integrative medicine. Holistic integrative medicine is different from translational medicine, evidence-based medicine or precision medicine, which integrates the most advanced knowledge and theories in medicine fields with the most effective practices and experiences in clinical specialties to form a new medical system.

  5. 2D PIM Simulation Based on COMSOL

    DEFF Research Database (Denmark)

    Wang, Xinbo; Cui, Wanzhao; Wang, Jingyu

    2011-01-01

    Passive intermodulation (PIM) is a problematic type of nonlinear distortion en- countered in many communication systems. To analyze the PIM distortion resulting from ma- terial nonlinearity, a 2D PIM simulation method based on COMSOL is proposed in this paper. As an example, a rectangular wavegui...

  6. Integrating biomedical and herbal medicine in Ghana

    DEFF Research Database (Denmark)

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi

    2016-01-01

    Background: Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component...... of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline...... the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system...

  7. Finding a sustainable prototype for integrative medicine

    Directory of Open Access Journals (Sweden)

    Geetha Krishnan Gopalakrishna Pillai

    2014-01-01

    Full Text Available Mainstreaming traditional systems of medicine and integrating them with the established health delivery mechanisms is an important step in accelerating advancement of health sciences to achieve current global health care goals. This paper proposes the "axial-model" of Integrative Medicine (IM. A replicable model, viable across multiple IM possibilities, which are clinically beneficial, supports evidence-based evolution and is socially acceptable. Axial model may be implemented to integrate two or more systems of medicines, provided they are legally regulated and approved for clinical administration. It proposes three consecutively phased clinical processes, named parallel, complementary and protocol, respectively. The model supports translational medicine by mainstreaming beneficial practices of traditional medicine as a part of its process of execution.

  8. Recommended integrative medicine competencies for family medicine residents.

    Science.gov (United States)

    Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

    2013-01-01

    The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

  9. Integrative medicine approach to chronic pain.

    Science.gov (United States)

    Teets, Raymond Y; Dahmer, Stephen; Scott, Emilie

    2010-06-01

    Chronic pain can be a frustrating condition for patient and clinician. The integrative medicine approach to pain can offer hope, adding safe complementary and alternative medical (CAM) therapies to mitigate pain and suffering. Such CAM therapies include nutrition, supplements and herbs, manual medicine, acupuncture, yoga, and mind-body approaches. The evidence is heterogeneous regarding these approaches, but some evidence suggests efficacy and confirms safety. The integrative medicine approach can be beneficial in a patient with chronic pain. Copyright 2010 Elsevier Inc. All rights reserved.

  10. Medicinal electrochemistry: integration of electrochemistry, medicinal chemistry and computational chemistry.

    Science.gov (United States)

    Almeida, M O; Maltarollo, V G; de Toledo, R A; Shim, H; Santos, M C; Honorio, K M

    2014-01-01

    Over the last centuries, there were many important discoveries in medicine that were crucial for gaining a better understanding of several physiological processes. Molecular modelling techniques are powerful tools that have been successfully used to analyse and interface medicinal chemistry studies with electrochemical experimental results. This special combination can help to comprehend medicinal chemistry problems, such as predicting biological activity and understanding drug action mechanisms. Electrochemistry has provided better comprehension of biological reactions and, as a result of many technological improvements, the combination of electrochemical techniques and biosensors has become an appealing choice for pharmaceutical and biomedical analyses. Therefore, this review will briefly outline the present scope and future advances related to the integration of electrochemical and medicinal chemistry approaches based on various applications from recent studies.

  11. Integrative medicine in allergy and immunology.

    Science.gov (United States)

    Chang, Christopher; Gershwin, M Eric

    2013-06-01

    Integrative medicine is a relatively new discipline which attempts to combine allopathic medicine with alternative or complementary medicine, to reap the benefits of both forms of medicine in optimizing the care of patients. Integrative medicine concentrates on treating the patient as a whole, both in body and mind. While the scientific method and "evidence-based" clinical research drives the management and treatment of diseases in conventional Western medicine, alternative or complementary medicine is based on unproven yet potentially beneficial techniques that have been developed throughout history, dating back to the ancient cultures in the Middle East, Africa, and China. In spite of the lack of evidence of most alternative medicine techniques, these methodologies have been practiced for centuries with great acceptance in many countries. It is in the Western world, where "modern" medicine is dictated by the scientific method, that the most controversy in the use of these alternative modes of therapy exists. Since the science behind alternative medicine is incomplete or non-existent, it is difficult for those trained in Western medicine to accept or adopt this approach. But perhaps it is the failure of Western medicine to adequately guarantee our well being and good health that have led to the ongoing debate between the medical profession and the general public as to the benefits of these alternative treatments. In one sense, integrative medicine may be a futile attempt to coin a new term in the hope of legitimizing alternative medicine. On the other hand, there is a wealth of historical experience in the use of the techniques. Studies to evaluate the scientific basis behind ancient medical techniques are ongoing, and it is to be expected that the results will neither be uniformly positive nor negative. Of particular interest is the effect of traditional medicine, herbal formulations, and manipulative techniques on the immune system, and its application in the

  12. Personal Information Management (PIM): an Introduction

    OpenAIRE

    Rasoul Zavaraqi; Michael Safaie

    2012-01-01

    The aim of this paper was to present detailed texts about necessities of personal information management (PIM) and has been written by literature survey. Historical investigation of this new born research area showed PIM is an extension to primary personal information management in offices and other bureaucratic centers. PIM is the result of new ICT developments and its followings as information overload and pollution, which is combination of information retrieval, database management systems...

  13. PIMS: Memristor-Based Processing-in-Memory-and-Storage.

    Energy Technology Data Exchange (ETDEWEB)

    Cook, Jeanine

    2018-02-01

    Continued progress in computing has augmented the quest for higher performance with a new quest for higher energy efficiency. This has led to the re-emergence of Processing-In-Memory (PIM) ar- chitectures that offer higher density and performance with some boost in energy efficiency. Past PIM work either integrated a standard CPU with a conventional DRAM to improve the CPU- memory link, or used a bit-level processor with Single Instruction Multiple Data (SIMD) control, but neither matched the energy consumption of the memory to the computation. We originally proposed to develop a new architecture derived from PIM that more effectively addressed energy efficiency for high performance scientific, data analytics, and neuromorphic applications. We also originally planned to implement a von Neumann architecture with arithmetic/logic units (ALUs) that matched the power consumption of an advanced storage array to maximize energy efficiency. Implementing this architecture in storage was our original idea, since by augmenting storage (in- stead of memory), the system could address both in-memory computation and applications that accessed larger data sets directly from storage, hence Processing-in-Memory-and-Storage (PIMS). However, as our research matured, we discovered several things that changed our original direc- tion, the most important being that a PIM that implements a standard von Neumann-type archi- tecture results in significant energy efficiency improvement, but only about a O(10) performance improvement. In addition to this, the emergence of new memory technologies moved us to propos- ing a non-von Neumann architecture, called Superstrider, implemented not in storage, but in a new DRAM technology called High Bandwidth Memory (HBM). HBM is a stacked DRAM tech- nology that includes a logic layer where an architecture such as Superstrider could potentially be implemented.

  14. Comparative oncology: Integrating human and veterinary medicine ...

    African Journals Online (AJOL)

    Cancer constitutes the major health problem both in human and veterinary medicine. Comparative oncology as an integrative approach offers to learn more about naturally occurring cancers across different species. Canine models have many advantages as they experience spontaneous disease, have many genes similar ...

  15. Integrative medicine and patient-centered care.

    Science.gov (United States)

    Maizes, Victoria; Rakel, David; Niemiec, Catherine

    2009-01-01

    Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies

  16. Integration of Chinese medicine with Western medicine could lead to future medicine: molecular module medicine.

    Science.gov (United States)

    Zhang, Chi; Zhang, Ge; Chen, Ke-ji; Lu, Ai-ping

    2016-04-01

    The development of an effective classification method for human health conditions is essential for precise diagnosis and delivery of tailored therapy to individuals. Contemporary classification of disease systems has properties that limit its information content and usability. Chinese medicine pattern classification has been incorporated with disease classification, and this integrated classification method became more precise because of the increased understanding of the molecular mechanisms. However, we are still facing the complexity of diseases and patterns in the classification of health conditions. With continuing advances in omics methodologies and instrumentation, we are proposing a new classification approach: molecular module classification, which is applying molecular modules to classifying human health status. The initiative would be precisely defining the health status, providing accurate diagnoses, optimizing the therapeutics and improving new drug discovery strategy. Therefore, there would be no current disease diagnosis, no disease pattern classification, and in the future, a new medicine based on this classification, molecular module medicine, could redefine health statuses and reshape the clinical practice.

  17. The PIM kinases in hematological cancers.

    Science.gov (United States)

    Alvarado, Yesid; Giles, Francis J; Swords, Ronan T

    2012-02-01

    The PIM genes represent a family of proto-oncogenes that encode three different serine/threonine protein kinases (PIM1, PIM2 and PIM3) with essential roles in the regulation of signal transduction cascades, which promote cell survival, proliferation and drug resistance. PIM kinases are overexpressed in several hematopoietic tumors and support in vitro and in vivo malignant cell growth and survival, through cell cycle regulation and inhibition of apoptosis. PIM kinases do not have an identified regulatory domain, which means that these proteins are constitutively active once transcribed. They appear to be critical downstream effectors of important oncoproteins and, when overexpressed, can mediate drug resistance to available agents, such as rapamycin. Recent crystallography studies reveal that, unlike other kinases, they possess a hinge region, which creates a unique binding pocket for ATP, offering a target for an increasing number of potent small-molecule PIM kinase inhibitors. Preclinical studies in models of various hematologic cancers indicate that these novel agents show promising activity and some of them are currently being evaluated in a clinical setting. In this review, we profile the PIM kinases as targets for therapeutics in hematologic malignancies.

  18. [Application of holistic integrative medicine in orthodontics].

    Science.gov (United States)

    Wang, L

    2017-08-09

    Holistic integrative medicine (HIM) is a new medical knowledge system, which is formed based on the theory of HIM. HIM treats people as a whole by combining the results of basic medical research, clinical practice and clinical research during the treatment process. The concept of HIM runs through the education and treatment of orthodontics. HIM is the trending norm of both modern medicine and orthodontics. This review is about the concept of HIM and the advantages and disadvantages of specialization. Moreover, this review also discusses the vital role of HIM in orthodontic treatment and development.

  19. Targeting the Pim kinases in multiple myeloma.

    LENUS (Irish Health Repository)

    Keane, N A

    2015-07-17

    Multiple myeloma (MM) is a plasma cell malignancy that remains incurable. Novel treatment strategies to improve survival are urgently required. The Pims are a small family of serine\\/threonine kinases with increased expression across the hematological malignancies. Pim-2 shows highest expression in MM and constitutes a promising therapeutic target. It is upregulated by the bone marrow microenvironment to mediate proliferation and promote MM survival. Pim-2 also has a key role in the bone destruction typically seen in MM. Additional putative roles of the Pim kinases in MM include trafficking of malignant cells, promoting oncogenic signaling in the hypoxic bone marrow microenvironment and mediating resistance to therapy. A number of Pim inhibitors are now under development with lead compounds entering the clinic. The ATP-competitive Pim inhibitor LGH447 has recently been reported to have single agent activity in MM. It is anticipated that Pim inhibition will be of clinical benefit in combination with standard treatments and\\/or with novel drugs targeting other survival pathways in MM.

  20. PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities

    Directory of Open Access Journals (Sweden)

    Baldwin Stephen A

    2011-03-01

    Full Text Available Abstract Background Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. Results The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. Conclusions PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/.

  1. PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities.

    Science.gov (United States)

    Troshin, Peter V; Postis, Vincent Lg; Ashworth, Denise; Baldwin, Stephen A; McPherson, Michael J; Barton, Geoffrey J

    2011-03-07

    Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS) that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/.

  2. Developing and implementing core competencies for integrative medicine fellowships.

    Science.gov (United States)

    Ring, Melinda; Brodsky, Marc; Low Dog, Tieraona; Sierpina, Victor; Bailey, Michelle; Locke, Amy; Kogan, Mikhail; Rindfleisch, James A; Saper, Robert

    2014-03-01

    The Consortium of Academic Health Centers for Integrative Medicine defines integrative medicine as "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing." Over the past three decades, the U.S. public increasingly has sought integrative medicine approaches. In an effort to train medical professionals to adequately counsel patients on the safe and appropriate use of these approaches, medical schools and residencies have developed curricula on integrative medicine for their trainees. In addition, integrative medicine clinical fellowships for postresidency physicians have emerged to provide training for practitioners interested in gaining greater expertise in this emerging field. Currently, 13 clinical fellowships in integrative medicine exist in the United States, and they are predominantly connected to academic medical centers or teaching affiliate hospitals. In 2010, the Consortium of Academic Health Centers for Integrative Medicine, represented by 56 member academic health care institutions with a shared commitment to advance the principles and practices of integrative medicine, convened a two-year task force to draft integrative medicine fellowship core competencies. These competencies would guide fellowship curriculum development and ensure that graduates possessed a common body of knowledge, skills, and attitudes. In this article, the authors discuss the competencies and the task force's process to develop them, as well as associated teaching and assessment methods, faculty development, potential barriers, and future directions.

  3. A pluralist challenge to "integrative medicine": Feyerabend and Popper on the cognitive value of alternative medicine.

    Science.gov (United States)

    Kidd, Ian James

    2013-09-01

    This paper is a critique of 'integrative medicine' as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of 'integrative medicine' defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus' account is then considered in the light of Zuzana Parusnikova's recent criticism of 'integrative medicine' and her distinction between 'cognitive' and 'opportunistic' engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of 'dogmatism' and proposes that one can usefully invoke Karl Popper's 'critical rationalism' as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that 'integrative medicine' can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova's appeal to Popper should be augmented with Paul Feyerabend's emphasis upon the role of 'radical alternatives' in maximising criticism. 'Integrative medicine' fails to maximise criticism because it 'translates' alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable 'radical alternatives'. These claims are then illustrated with a discussion of 'traditional' and 'medical' acupuncture. I conclude that 'integrative medicine' fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Evidence-based integrative medicine in clinical veterinary oncology.

    Science.gov (United States)

    Raditic, Donna M; Bartges, Joseph W

    2014-09-01

    Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology. Published by Elsevier Inc.

  5. Individualized Integrative Cancer Care in Anthroposophic Medicine

    Science.gov (United States)

    Kienle, Gunver S.; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Cancer patients widely seek integrative oncology which embraces a wide variety of treatments and system approaches. Objective. To investigate the concepts, therapeutic goals, procedures, and working conditions of integrative oncology doctors in the field of anthroposophic medicine. Methods. This qualitative study was based on in-depth interviews with 35 highly experienced doctors working in hospitals and office-based practices in Germany and other countries. Structured qualitative content analysis was applied to examine the data. Results. The doctors integrated conventional and holistic cancer concepts. Their treatments aimed at both tumor and symptom control and at strengthening the patient on different levels: living with the disease, overcoming the disease, enabling emotional and cognitive development, and addressing spiritual or transcendental issues according to the patient’s wishes and initiatives. Therapeutic procedures were conventional anticancer and symptom-relieving treatments, herbal and mineral remedies, mistletoe therapy, art therapies, massages and other external applications, nutrition and lifestyle advice, psychological support, and multiple forms of empowerment. The approach emphasised good patient-doctor relationships and sufficient time for patient encounters and decision-making. Individualization appeared in several dimensions and was interwoven with standards and mindlines. The doctors often worked in teams and cooperated with other cancer care–related specialists. Conclusion. Integrative cancer care pursues an individualized and patient-centered approach, encompassing conventional and multimodal complementary interventions, and addressing, along with physical and functional needs, the emotional and spiritual needs of patients. This seems to be important for tumor and symptom control, and addresses major challenges and important goals of modern cancer care. PMID:27151589

  6. Personal Information Management (PIM: an Introduction

    Directory of Open Access Journals (Sweden)

    Rasoul Zavaraqi

    2012-10-01

    Full Text Available The aim of this paper was to present detailed texts about necessities of personal information management (PIM and has been written by literature survey. Historical investigation of this new born research area showed PIM is an extension to primary personal information management in offices and other bureaucratic centers. PIM is the result of new ICT developments and its followings as information overload and pollution, which is combination of information retrieval, database management systems (DBMS, information science, human-computer interaction, cognitive psychology, and artificial intelligence. The research area tries to address to old challenges by new mechanisms. The paper introduced the new born research area and discussed about its appearance, definitions, history, benefits, performance and researches which has been done about it.

  7. Pim Protein Kinase-Levels Correlate with Prostate Tumor Growth and Chemo- Resistance - Potential Mechanism of PIM Action

    National Research Council Canada - National Science Library

    Kraft, Andrew S

    2006-01-01

    .... In this proposal, we will examine whether Pim mimics Akt and TOR or modulates additional biochemical pathways and use knockout mice to dissect how myc and Pim collaborate to induce transformation...

  8. Integrative Medicine A Meeting Of The Minds

    Directory of Open Access Journals (Sweden)

    Stephen J. Healy BA

    2015-08-01

    unable to do. Hypnosis and guided imagery historically have been used in Eastern medicine but looked down upon in the Western sector. Complimentary alternative or Integrative medicine as it is now called has brought the Western world into a new means of healing as well as complimenting conventional Medicine. Hippocrates the father of modern medicine used the bark of the willow tree to treat his patients for pain or other maladies. He was aware of the healing and pain relief this bark brought to patients of his century. This was common practice yet it was centuries before The Bayer Company in Germany developed the first aspirin. The reason for the story is that Salicylates the main ingredient in non steroidal anti- inflammatory drugs i.e. aspirin is derived from the bark of the willow tree developed centuries before and used successfully. a delayed recognition of healing therapies used and proven to have positive effects for a patient borders on negligence in medicine. It is vital when something is used successfully to recognize its validity and importance and bring it to the forefront. Alternative therapies used successfully for centuries in the Eastern world are now in the Western world being used in hospitals and clinics across the country but still not at the status it deserves. Western medicine does not give it more than a complimentary status perhaps out of fear of replacing modern methods. It should be accepted and welcomed as it makes a difference and perhaps could preclude more invasive treatments in the future.These therapies including hypnosis and guided imagery are used throughout the world and are available to patients as complimentary but they need recognition and more importantly a board to regulate the practice of them as they are integrated into modern medicine. There needs to be a certification for practicing hypnosis and hypnotherapy. A board equal to the status of the State Medical Boards empowered to enforce strict adherence to the ethical and

  9. Introduction to Integrative Medicine in the Primary Care Setting.

    Science.gov (United States)

    Ring, Melinda; Mahadevan, Rupa

    2017-06-01

    Integrative Medicine has been described as "healing oriented medicine that takes account of the whole person (body, mind, and spirit) including all aspects of lifestyle. It emphasizes therapeutic relationships and makes use of all appropriate therapies, both conventional and alternative." National surveys consistently report that approximately one-third of adults and 12% of children use complementary and integrative medicine approaches. Although there are barriers to primary care professionals engaging in discussions about lifestyle change and complementary and integrative medicine options, there is also great potential to impact patient well-being. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Mind-Body Practices in Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Niko Kohls

    2012-02-01

    Full Text Available Mind-Body practices have become increasingly popular as components of psychotherapeutic and behavior medicine interventions. They comprise an array of different methods and techniques that use some sort of mental-behavioral training and involve the modulation of states of consciousness in order to influence bodily processes towards greater health, well-being and better functioning. Mind-body practices may thus be interpreted as the salutogenetic mirror image of psychosomatic medicine, where psychophysiological and health consequences of specific psychological states are studied, such as stress arousal, psychological trauma or depression. This contribution examines the empirical evidence of the most common mind-body techniques with regard to their salutogenetic potential. We concisely discuss some aspects of the mind-body problem, before we consider some historical aspects and achievements of psychosomatic medicine. We then turn to some prominent mind-body practices and their application, as well as the empirical database for them.

  11. Integrative medicine: a bridge between biomedicine and alternative medicine fitting the spirit of the age

    NARCIS (Netherlands)

    Hoenders, H.J.R.; Appelo, M.T.; de Jong, J.T.V.M.

    2012-01-01

    Complementary and alternative medicine (CAM) are increasingly used by people in first world countries, almost always in combination with biomedicine. The combination of CAM and biomedicine is now commonly referred to as "integrative medicine" (IM). In Groningen, The Netherlands, we founded a center

  12. Naturopathic physicians: holistic primary care and integrative medicine specialists.

    Science.gov (United States)

    Litchy, Andrew P

    2011-12-01

    The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine.

  13. Integrative methods for analyzing big data in precision medicine.

    Science.gov (United States)

    Gligorijević, Vladimir; Malod-Dognin, Noël; Pržulj, Nataša

    2016-03-01

    We provide an overview of recent developments in big data analyses in the context of precision medicine and health informatics. With the advance in technologies capturing molecular and medical data, we entered the area of "Big Data" in biology and medicine. These data offer many opportunities to advance precision medicine. We outline key challenges in precision medicine and present recent advances in data integration-based methods to uncover personalized information from big data produced by various omics studies. We survey recent integrative methods for disease subtyping, biomarkers discovery, and drug repurposing, and list the tools that are available to domain scientists. Given the ever-growing nature of these big data, we highlight key issues that big data integration methods will face. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Ethics and integrative medicine: moving beyond the biomedical model.

    Science.gov (United States)

    Guinn, D E

    2001-01-01

    For the most part, those who have written on the ethics of complementary and alternative medicine (CAM) and integrative medicine have attempted simply to apply traditional bioethics (in the form of principles of autonomy, beneficence, nonmaleficence, and justice) to this new area of healthcare. In this article I argue that adopting the practices of CAM requires a new ethical understanding that incorporates the values implicit in those practices. The characteristics of CAM and conventional medicine can be translated into the language of healthcare values in a variety of ways. I suggest that they support 5 core values: integrated humanity, ecological integrity, naturalism, relationalism, and spiritualism. Characteristics of both CAM and conventional medicine are present in value. What is now thought of as principlism is, in this understanding, simply a subset within these values.

  15. Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study

    Directory of Open Access Journals (Sweden)

    Schneider Craig

    2007-04-01

    Full Text Available Abstract Background As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs developed for the program. Methods The direct observation (DO and treatment plan (TP evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP. The OSCE I was implemented first in 2005 (n = 6, revised and then implemented with a second class of IFM participants in 2006 (n = 7. OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6. Data from the initial implementation of these tools are described using descriptive statistics. Results Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies. Conclusion As these tools are refined further they will be of value both in improving

  16. Complementary, alternative, integrative, or unconventional medicine?

    Science.gov (United States)

    Penson, R T; Castro, C M; Seiden, M V; Chabner, B A; Lynch, T J

    2001-01-01

    Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Interest in complementary and alternative medicine (CAM) has grown exponentially in the past decade, fueled by Internet marketing, dissatisfaction with mainstream medicine, and a desire for patients to be actively involved in their health care. There is a large discordance between physician estimates and reported prevalence of CAM use. Many patients do not disclose their practices mainly because they believe CAM falls outside the rubric of conventional medicine or because physicians do not ask. Concern about drug interactions and adverse effects are compounded by a lack of Food and Drug Administration regulation. Physicians need to be informed about CAM and be attuned to the psychosocial needs of patients.

  17. Integrative Medicine and Mood, Emotions and Mental Health.

    Science.gov (United States)

    Shah, Anuj K; Becicka, Roman; Talen, Mary R; Edberg, Deborah; Namboodiri, Sreela

    2017-06-01

    An integrative approach to individuals with mood, emotional or mental health concerns involves a comprehensive model of care that is person-centered. Integrative medicine builds on a patient's personal meaning and goals (spiritual aspects) and includes herbal therapies, nutritional support, movement and physical manipulative therapies, mindfulness, relaxation strategies, and psychotherapies. Published by Elsevier Inc.

  18. Integrative Medicine as a Bridge to Physician Wellness.

    Science.gov (United States)

    Nguyen, Chau T

    2018-03-01

    Burnout is increasingly recognized as an issue of major importance affecting physicians of all ages and disciplines and thereby patients, systems, and health care in general. At the 2017 American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting, the scope of burnout in medicine was addressed, along with systematic issues that remain. While changing the culture of medicine and health systems to address this is needed, what strategies can health care providers use in their everyday lives to lessen the impact of burnout? Integrative medicine with its focus on wholeness of patient care, including the emotional, mental, social, and spiritual domains of health, is uniquely positioned in arming physicians with sets of tools to help them navigate patients to better health and healing. These very same methods are invaluable for personal self-care, as we are all potential patients. Integrative medicine is a pathway to improving one's own self-care and, thereby, improving patient care.

  19. Holistic integrative medicine: toward a new era of medical advancement.

    Science.gov (United States)

    Fan, Daiming

    2017-03-01

    Medicine has encountered unprecedented problems associated with changes in nature, society, and environment, as well as with new human quests for survival, longevity, and health. In the meantime, the development of medicine is facing challenges that resulted from the over-division and specialization of disciplines and the fragmentation of medical knowledge. To construct a new medical system that is more suitable for human health and disease treatment, holistic integrative medicine (HIM), which regards the human body as a holistic entity, organically integrates the most advanced knowledge and theories in each medical field and the most effective practices in various clinical specialties to revise and adjust on the basis of social, environmental, and psychological conditions. HIM is the inevitable and necessary direction for the future development of medicine. In this article, we illustrated the connotation of HIM, the differences between HIM and other medical conceptions, and the practice of HIM in recent years.

  20. The model of Western integrative medicine: the role of Chinese medicine.

    Science.gov (United States)

    Dobos, Gustav; Tao, Iven

    2011-01-01

    The basic concept of integrative medicine (IM) is that by combining mainstream (biomedicine) with complementary and alternative medicine (CAM), synergistic therapeutic effects can be attained. When the methods of mind/body medicine (MBM) are added to this combination, as in Western countries, a new concept emerges that drastically changes the approach toward illness.It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples' Republic of China preceded the Western model of IM by almost 50 years. Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM, and Chinese medicine has played and continues to play an important role in advancing IM. However, one of the major differences between the Chinese and the Western models of IM today, besides MBM and some other treatment options, is that Western integrative medicine (WIM) strictly requires its CAM methods to be supported by scientific evidence.The therapeutic methods of IM and their applications are many and varied. However, they are most frequently employed to treat chronic medical conditions, e.g., bronchial asthma, rheumatic disease, chronic inflammatory bowel disorder and chronic pain. Other fields in which IM may be applied are internal medicine (inflammatory bowel diseases and cardiovascular diseases), musculoskeletal disorders, oncology (chemotherapy-induced side effects), obstetrics and gynecology (dysmenorrhea, endometriosis, infertility and menopausal complaints), pediatrics, geriatrics, neurology (migraine and chronic headache), and psychiatry (anxiety and depression).The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.

  1. [To see the future development of burn medicine from the view of holistic integrative medicine].

    Science.gov (United States)

    Hu, D H; Tao, K

    2017-04-20

    The therapeutic methods and effects have been improved greatly in the past few decades for burn care and management with several important advancements which have resulted in more effective patient stabilization and significantly decreased mortality in China. However, the challenges still exist, such as how to further improve the recovery of the patients' appearance and function, and how to advance the treatment of severe deep extensive burn injury, etc. The theory of holistic integrative medicine (HIM) provides a new opportunity for the development of clinical medicine. This article emphasizes the important roles of HIM in exploration of burn medicine, considering the advanced development of modern life sciences and relevant techniques.

  2. Integrating cardiology for nuclear medicine physicians. A guide to nuclear medicine physicians

    International Nuclear Information System (INIS)

    Movahed, Assad; Gnanasegaran, Gopinath; Buscombe, John R.; Hall, Margaret

    2009-01-01

    Nuclear cardiology is no longer a medical discipline residing solely in nuclear medicine. This is the first book to recognize this fact by integrating in-depth information from both the clinical cardiology and nuclear cardiology literature, and acknowledging cardiovascular medicine as the fundamental knowledge base needed for the practice of nuclear cardiology. The book is designed to increase the practitioner's knowledge of cardiovascular medicine, thereby enhancing the quality of interpretations through improved accuracy and clinical relevance.The text is divided into four sections covering all major topics in cardiology and nuclear cardiology: -Basic Sciences and Cardiovascular Diseases; -Conventional Diagnostic Modalities; -Nuclear Cardiology; -Management of Cardiovascular Diseases. (orig.)

  3. Inhibition of PIM1 kinase attenuates inflammation-induced pro-labour mediators in human foetal membranes in vitro.

    Science.gov (United States)

    Lim, Ratana; Barker, Gillian; Lappas, Martha

    2017-06-01

    Does proviral integration site for Moloney murine leukaemic virus (PIM)1 kinase play a role in regulating the inflammatory processes of human labour and delivery? PIM1 kinase plays a critical role in foetal membranes in regulating pro-inflammatory and pro-labour mediators. Infection and inflammation have strong causal links to preterm delivery by stimulating pro-inflammatory cytokines and collagen degrading enzymes, which can lead to rupture of membranes. PIM1 has been shown to have a role in immune regulation and inflammation in non-gestational tissues; however, its role has not been explored in the field of human labour. PIM1 expression was analysed in myometrium and/or foetal membranes obtained at term and preterm (n = 8-9 patients per group). Foetal membranes, freshly isolated amnion cells and primary myometrial cells were used to investigate the effect of PIM1 inhibition on pro-labour mediators (n = 5 patients per treatment group). Foetal membranes, from term and preterm, were obtained from non-labouring and labouring women, and from preterm pre-labour rupture of membranes (PPROM) (n = 9 per group). Amnion was collected from women with and without preterm chorioamnionitis (n = 8 per group). Expression of PIM1 kinase was determined by qRT-PCR and western blotting. To determine the effect of PIM1 kinase inhibition on the expression of pro-inflammatory and pro-labour mediators induced by bacterial products lipopolysaccharide (LPS) (10 μg/ml) and flagellin (1 μg/ml) and pro-inflammatory cytokine tumour necrosis factor (TNF) (10 ng/ml), chemical inhibitors SMI-4a (20 μM) and AZD1208 (50 μM) were used in foetal membrane explants and siRNA against PIM1 was used in primary amnion cells. Statistical significance was set at P membranes after spontaneous term labour compared to no labour at term and in amnion with preterm chorioamnionitis compared to preterm with no chorioamnionitis. There was no change in PIM1 expression with preterm labour or PPROM

  4. An integrated web medicinal materials DNA database: MMDBD (Medicinal Materials DNA Barcode Database

    Directory of Open Access Journals (Sweden)

    But Paul

    2010-06-01

    Full Text Available Abstract Background Thousands of plants and animals possess pharmacological properties and there is an increased interest in using these materials for therapy and health maintenance. Efficacies of the application is critically dependent on the use of genuine materials. For time to time, life-threatening poisoning is found because toxic adulterant or substitute is administered. DNA barcoding provides a definitive means of authentication and for conducting molecular systematics studies. Owing to the reduced cost in DNA authentication, the volume of the DNA barcodes produced for medicinal materials is on the rise and necessitates the development of an integrated DNA database. Description We have developed an integrated DNA barcode multimedia information platform- Medicinal Materials DNA Barcode Database (MMDBD for data retrieval and similarity search. MMDBD contains over 1000 species of medicinal materials listed in the Chinese Pharmacopoeia and American Herbal Pharmacopoeia. MMDBD also contains useful information of the medicinal material, including resources, adulterant information, medical parts, photographs, primers used for obtaining the barcodes and key references. MMDBD can be accessed at http://www.cuhk.edu.hk/icm/mmdbd.htm. Conclusions This work provides a centralized medicinal materials DNA barcode database and bioinformatics tools for data storage, analysis and exchange for promoting the identification of medicinal materials. MMDBD has the largest collection of DNA barcodes of medicinal materials and is a useful resource for researchers in conservation, systematic study, forensic and herbal industry.

  5. Integrative medicine for managing the symptoms of lupus nephritis

    Science.gov (United States)

    Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

    2018-01-01

    Abstract Background: Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. Methods and analyses: The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. Dissemination: This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. Trial registration number: PROSPERO 2018 CRD42018085205 PMID:29595669

  6. Towards an integrated approach to health and medicine in Africa

    African Journals Online (AJOL)

    2016-08-18

    Aug 18, 2016 ... As such, a social approach to health-seeking behaviour questions how decisions ... In conclusion, the paper proposes that medicine and the humanities should engage seriously .... mental questions: What story does the integration or separation .... approach which has taken an interest in traditional healing.

  7. A comparison of two tools to screen potentially inappropriate medication in internal medicine patients.

    Science.gov (United States)

    Blanc, A-L; Spasojevic, S; Leszek, A; Théodoloz, M; Bonnabry, P; Fumeaux, T; Schaad, N

    2018-04-01

    Potentially inappropriate medication (PIM) is an important issue for inpatient management; it has been associated with safety problems, such as increases in adverse drugs events, and with longer hospital stays and higher healthcare costs. To compare two PIM-screening tools-STOPP/START and PIM-Check-applied to internal medicine patients. A second objective was to compare the use of PIMs in readmitted and non-readmitted patients. A retrospective observational study, in the general internal medicine ward of a Swiss non-university hospital. We analysed a random sample of 50 patients, hospitalized in 2013, whose readmission within 30 days of discharge had been potentially preventable, and compared them to a sample of 50 sex- and age-matched patients who were not readmitted. PIMs were screened using the STOPP/START tool, developed for geriatric patients, and the PIM-Check tool, developed for internal medicine patients. The time needed to perform each patient's analysis was measured. A clinical pharmacist counted and evaluated each PIM detected, based on its clinical relevance to the individual patient's case. The rates of screened and validated PIMs involving readmitted and non-readmitted patients were compared. Across the whole population, PIM-Check and STOPP/START detected 1348 and 537 PIMs, respectively, representing 13.5 and 5.4 PIMs/patient. Screening time was substantially shorter with PIM-Check than with STOPP/START (4 vs 10 minutes, respectively). The clinical pharmacist judged that 45% and 42% of the PIMs detected using PIM-Check and STOPP/START, respectively, were clinically relevant to individual patients' cases. No significant differences in the rates of detected and clinically relevant PIM were found between readmitted and non-readmitted patients. Internal medicine patients are frequently prescribed PIMs. PIM-Check's PIM detection rate was three times higher than STOPP/START's, and its screening time was shorter thanks to its electronic interface. Nearly

  8. [Effect of ginsenoside Rg3 on Pim-3 and Bad proteins in human pancreatic cancer cell line PANC-1].

    Science.gov (United States)

    Jian, Jie; Hu, Zhi-Fang; Huang, Yuan

    2009-05-01

    Ginsenoside Rg3 is a traditional Chinese medicine monomer which possesses anticancer effects. This study was to investigate the effects of ginsenoside Rg3 on Pim-3 and phosphorylated Bad (pBad) proteins, pBad (Ser112) and pBad (Ser136) in human pancreatic cancer cell line PANC-1. PANC-1 cells were exposed to 10, 20, 40 and 80 micromol/L ginsenoside Rg3 for 24 h. A short hairpin RNA (shRNA) of Pim-3 was cloned and inserted into a eukaryotic expression vector pSilencer 3.1-H1 Neo to construct pSilencer 3.1-H1 Neo-Pim-3. pSilencer 3.1-H1 Neo-Pim-3 was then transfected into PANC-1 cells. Cell proliferation was measured by MTT assay; cell apoptosis was observed under an invert microscope and measured by flow cytometry with Annexin V/PI staining; protein expressions of Pim-3, Bad, pBad (Ser112) and pBad (Ser136) were measured by Western blot. The inhibitory rates of 10, 20, 40 and 80 micromol/L ginsenoside Rg3 on PANC-1 cells were 20.2%, 33.4%, 52.8% and 65.3%, respectively. Typical morphological changes in apoptosis were induced by ginsenoside Rg3. The apoptotic rate of PANC-1 cells was significantly higher in the ginsenoside Rg3 treatment group (80 micromol/L) than in the control group (12.2% vs. 3.3%, PPANC-1 cells. Compared with the control group, the percentages of early and total apoptotic cells were significantly increased in PANC-1 cells transfected with pim-3-shRNA [(11.5+/-3.7)% vs. (5.8+/-2.2)%,P<0.01;(20.8+/-2.6)% vs.(13.0+/-4.1)%,P<0.05], while the expressions of pim-3 and pBad (Ser112) were both decreased. The anti-tumor effect of ginsenoside Rg3 may be associated with the decrease of Pim-3 and pBad (Ser112).

  9. Innovative use of power integrated modules for DC power supplies

    DEFF Research Database (Denmark)

    Ørndrup Nielsen, Rasmus; Elkiær, Alexander; Munk-Nielsen, Stig

    2013-01-01

    In this article several innovative ways of utilizing Power Integrated Modules (PIM) as switching device in a DC power supply are presented. PIM have advantages in compactness of design, cost and fast prototype due to easier PCB layout. A PIM converter topology is chosen and designed resulting...... in an experimental setup. Results from the setup are presented showing the feasibility of using a PIM module as almost all power semiconductors in a DC power supply....

  10. Systems Approaches: A Global and Historical Perspective on Integrative Medicine

    Science.gov (United States)

    2012-01-01

    The globalization of healing systems is a dance of cultural awareness and cultural dominance that has arisen throughout history. With the development of greater communication and interest in whole-systems approaches to healing, the opportunity for the development of a global perspective on healing has emerged with new life force. The birth of integrative holistic healing systems in the West, such as naturopathic, homeopathic, anthroposophic, integral and functional medicine, and others, echoes the ocean of wisdom present in traditional healing systems, such as traditional Chinese medicine (TCM) and Ayurveda. In working to integrate the lessons from these systems, we see the inextricable link between man and the natural world, we work to understand the root cause of disease, we focus on the whole person to return balance, and we use empiric observation in large populations over time to grasp the interrelationships inherent in the whole-systems view of illness and wellness. PMID:24278794

  11. Integrated omics analysis of specialized metabolism in medicinal plants.

    Science.gov (United States)

    Rai, Amit; Saito, Kazuki; Yamazaki, Mami

    2017-05-01

    Medicinal plants are a rich source of highly diverse specialized metabolites with important pharmacological properties. Until recently, plant biologists were limited in their ability to explore the biosynthetic pathways of these metabolites, mainly due to the scarcity of plant genomics resources. However, recent advances in high-throughput large-scale analytical methods have enabled plant biologists to discover biosynthetic pathways for important plant-based medicinal metabolites. The reduced cost of generating omics datasets and the development of computational tools for their analysis and integration have led to the elucidation of biosynthetic pathways of several bioactive metabolites of plant origin. These discoveries have inspired synthetic biology approaches to develop microbial systems to produce bioactive metabolites originating from plants, an alternative sustainable source of medicinally important chemicals. Since the demand for medicinal compounds are increasing with the world's population, understanding the complete biosynthesis of specialized metabolites becomes important to identify or develop reliable sources in the future. Here, we review the contributions of major omics approaches and their integration to our understanding of the biosynthetic pathways of bioactive metabolites. We briefly discuss different approaches for integrating omics datasets to extract biologically relevant knowledge and the application of omics datasets in the construction and reconstruction of metabolic models. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

  12. Innovative Perspectives of Integrated Chinese Medicine on H. pylori.

    Science.gov (United States)

    Ye, Hui; Shi, Zong-Ming; Chen, Yao; Yu, Jing; Zhang, Xue-Zhi

    2018-06-08

    Helicobacter pylori (H. pylori) treatment requires the development of more effective therapies, mainly owing to the challenges posed by the bacterial resistance to antibiotics. In China, critically high infection and antibiotic resistance rates have limited the application of classic H. pylori eradication therapies. Consequently, researchers are attempting to find new solutions by drawing from traditional medicine. This article reviews basic scientific and clinical progress in the use of integrated Chinese and Western medicine (IM) to treat H. pylori; describes the conflicting results between in vivo and in vitro studies in this regard; discusses the observed clinical effects of IM, with emphasis on traditional patent medicines; and proposes a role for IM in both the diagnosis and treatment of H. pylori, including the use of tongue manifestation as an early diagnostic method and capitalizing on IM's direct and indirect methods for enhancing antibiotic effect.

  13. Linking Ayurveda and Western medicine by integrative analysis

    Directory of Open Access Journals (Sweden)

    Fazlin Mohd Fauzi

    2013-01-01

    Full Text Available In this article, we discuss our recent work in elucidating the mode-of-action of compounds used in traditional medicine including Ayurvedic medicine. Using computational (′in silico′ approach, we predict potential targets for Ayurvedic anti-cancer compounds, obtained from the Indian Plant Anticancer Database given its chemical structure. In our analysis, we observed that: (i the targets predicted can be connected to cancer pathogenesis i.e. steroid-5-alpha reductase 1 and 2 and estrogen receptor-β, and (ii predominantly hormone-dependent cancer targets were predicted for the anti-cancer compounds. Through the use of our in silico target prediction, we conclude that understanding how traditional medicine such as Ayurveda work through linking with the ′western′ understanding of chemistry and protein targets can be a fruitful avenue in addition to bridging the gap between the two different schools of thinking. Given that compounds used in Ayurveda have been tested and used for thousands of years (although not in the same approach as Western medicine, they can potentially be developed into potential new drugs. Hence, to further advance the case of Ayurvedic medicine, we put forward some suggestions namely: (a employing and integrating novel analytical methods given the advancements of ′omics′ and (b sharing experimental data and clinical results on studies done on Ayurvedic compounds in an easy and accessible way.

  14. Linking Ayurveda and Western medicine by integrative analysis.

    Science.gov (United States)

    Fauzi, Fazlin Mohd; Koutsoukas, Alexios; Lowe, Robert; Joshi, Kalpana; Fan, Tai-Ping; Glen, Robert C; Bender, Andreas

    2013-04-01

    In this article, we discuss our recent work in elucidating the mode-of-action of compounds used in traditional medicine including Ayurvedic medicine. Using computational ('in silico') approach, we predict potential targets for Ayurvedic anti-cancer compounds, obtained from the Indian Plant Anticancer Database given its chemical structure. In our analysis, we observed that: (i) the targets predicted can be connected to cancer pathogenesis i.e. steroid-5-alpha reductase 1 and 2 and estrogen receptor-β, and (ii) predominantly hormone-dependent cancer targets were predicted for the anti-cancer compounds. Through the use of our in silico target prediction, we conclude that understanding how traditional medicine such as Ayurveda work through linking with the 'western' understanding of chemistry and protein targets can be a fruitful avenue in addition to bridging the gap between the two different schools of thinking. Given that compounds used in Ayurveda have been tested and used for thousands of years (although not in the same approach as Western medicine), they can potentially be developed into potential new drugs. Hence, to further advance the case of Ayurvedic medicine, we put forward some suggestions namely: (a) employing and integrating novel analytical methods given the advancements of 'omics' and (b) sharing experimental data and clinical results on studies done on Ayurvedic compounds in an easy and accessible way.

  15. The Computer in a Programmable Implantable Medication System (PIMS)

    OpenAIRE

    Sanders, K. H.; Radford, W. E.

    1982-01-01

    The Programmable Implantable Medication System (PIMS) developed at APL can be used in the treatment of diabetes, reproductive hormone dysfunction, hypertension, cancer, chronic pain, thrombosis, and the delivery of growth hormone. The Implantable Programmable Infusion Pump (IPIP) is the implanted element of PIMS. Under control of a microprocessor, the IPIP administers medication and stores data pertaining to its operation. An external unit can read out the stored data, as well as program the ...

  16. Pure- and mixed-gas CO2/CH4 separation properties of PIM-1 and an amidoxime-functionalized PIM-1

    KAUST Repository

    Swaidan, Raja; Ghanem, Bader; Litwiller, Eric; Pinnau, Ingo

    2014-01-01

    to the design and evaluation of PIMs for economical natural gas sweetening is a high and stable CO2/CH4 selectivity under realistic, mixed-gas conditions. Here, amidoxime-functionalized PIM-1 (AO-PIM-1) was prepared and examined for fundamental structure

  17. Integrating addiction medicine training into medical school and residency curricula

    OpenAIRE

    Klimas, Jan; Rieb, Launette; Bury, Gerard; Muench, John; O?Toole, Thomas; Rieckman, Traci; Cullen, Walter

    2015-01-01

    peer-reviewed Background: The Affordable Care Act (2010) brings an opportunity to increase the integration of addiction treatment into the health care system. With the anticipated expansion of addiction care services in primary care, challenges, such as workforce training, can be expected. This presentation discusses challenges and opportunities for addiction medicine training of primary care professionals in Ireland, Canada and Portland, OR. Objectives: To explore ideas for integratin...

  18. Improving the Level and Quality of Ethics Review in Chinese Medicine and Integrative Medicine.

    Science.gov (United States)

    Zhang, Cheng-Bin; Li, En-Chang

    2018-04-01

    Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.

  19. Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

    Science.gov (United States)

    Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

    2015-01-01

    An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

  20. Towards an integrated approach to health and medicine in Africa.

    Science.gov (United States)

    Batisai, Kezia

    2016-12-01

    This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

  1. Integrating family medicine and complementary medicine in cancer care: a cross-cultural perspective.

    Science.gov (United States)

    Ben-Arye, Eran; Israely, Pesi; Baruch, Erez; Dagash, Jamal

    2014-10-01

    In this paper, we describe the case study of a 27 year-old Arab female patient receiving palliative care for advanced breast cancer who was referred to complementary medicine (CM) consultation provided within a conventional oncology department. We explore the impact of the integrative CM practitioners' team of three family physicians and one Chinese medicine practitioner on the patient's well-being and specifically on the alleviation of her debilitating hot flashes and insomnia. This quality of life improvement is also affirmed by comparing the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Well-being (MYCAW) questionnaires administered at the initial and follow-up assessment sessions. In conclusion, we suggest that family physicians trained in evidence-based complementary medicine are optimal integrators of holistic patient-centered supportive care. The inclusion of trained CM practitioners in a multi-disciplinary integrative team may enhance the bio-psycho-social-spiritual perspective, and provide additional practical therapies that improve the quality of life of patients confronting cancer. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Pim kinases are upregulated during Epstein-Barr virus infection and enhance EBNA2 activity

    International Nuclear Information System (INIS)

    Rainio, Eeva-Marja; Ahlfors, Helena; Carter, Kara L.; Ruuska, Marja; Matikainen, Sampsa; Kieff, Elliott; Koskinen, Paeivi J.

    2005-01-01

    Latent Epstein-Barr virus (EBV) infection is strongly associated with B-cell proliferative diseases such as Burkitt's lymphoma. Here we show that the oncogenic serine/threonine kinases Pim-1 and Pim-2 enhance the activity of the viral transcriptional activator EBNA2. During EBV infection of primary B-lymphocytes, the mRNA expression levels of pim genes, especially of pim-2, are upregulated and remain elevated in latently infected B-cell lines. Thus, EBV-induced upregulation of Pim kinases and Pim-stimulated EBNA2 transcriptional activity may contribute to the ability of EBV to immortalize B-cells and predispose them to malignant growth

  3. Space Medicine in the Human System Integration Process

    Science.gov (United States)

    Scheuring, Richard A.

    2010-01-01

    This slide presentation reviews the importance of integration of space medicine in the human system of lunar exploration. There is a review of historical precedence in reference to lunar surface operations. The integration process is reviewed in a chart which shows the steps from research to requirements development, requirements integration, design, verification, operations and using the lessons learned, giving more information and items for research. These steps are reviewed in view of specific space medical issues. Some of the testing of the operations are undertaken in an environment that is an analog to the exploration environment. Some of these analog environments are reviewed, and there is some discussion of the benefits of use of an analog environment in testing the processes that are derived.

  4. [Periodontology from the perspective of holistic integrative medicine].

    Science.gov (United States)

    Luan, Q X

    2017-08-09

    Medical diciplines have been gradually differentiated and specialized during its developement, and problems due to deep specialization have been increasingly apparent. Its performance is as follows: dental specialists tends to focus on a certain narrow area and ignore neither the patients as a whole existence nor the role of the environmental factors. In this article, the author tries to show the holistic integrative medicine (HIM) from the point of view of periodontal specialty. In fact, the pathogenesis, the differential diagnosis and the treatment of periodontal diseases along with the role of preventive dentistry and basic medicine for periodontology must be considered as a whole using the philosophy of HIM. The future development of periodontal specialty should absorb the achievements of other medical and dental diciplines. Periodontist should pay more attention to HIM. The author also gives some thoughts and suggestions on how to practice HIM in the field of periodontics.

  5. Identification of novel inhibitors for Pim-1 kinase using pharmacophore modeling based on a novel method for selecting pharmacophore generation subsets

    Science.gov (United States)

    Shahin, Rand; Swellmeen, Lubna; Shaheen, Omar; Aboalhaija, Nour; Habash, Maha

    2016-01-01

    Targeting Proviral integration-site of murine Moloney leukemia virus 1 kinase, hereafter called Pim-1 kinase, is a promising strategy for treating different kinds of human cancer. Headed for this a total list of 328 formerly reported Pim-1 kinase inhibitors has been explored and divided based on the pharmacophoric features of the most active molecules into 10 subsets projected to represent potential active binding manners accessible to ligands within the binding pocket of Pim-1 kinase. Discovery Studio 4.1 (DS 4.1) was employed to detect potential pharmacophoric active binding manners anticipated by Pim-1 Kinase inhibitors. The pharmacophoric models were then allowed to compete within Quantitative Structure Activity Relationship (QSAR) framework with other 2D descriptors. Accordingly Genetic algorithm and multiple linear regression investigation were engaged to find the finest QSAR equation that has the best predictive power r 262 2 = 0.70, F = 119.14, r LOO 2 = 0.693, r PRESS 2 against 66 external test inhibitors = 0.71 q2 = 0.55. Three different pharmacophores appeared in the successful QSAR equation this represents three different binding modes for inhibitors within the Pim-1 kinase binding pocket. Pharmacophoric models were later used to screen compounds within the National Cancer Institute database. Several low micromolar Pim-1 Kinase inhibitors were captured. The most potent hits show IC50 values of 0.77 and 1.03 µM. Also, upon analyzing the successful QSAR Equation we found that some polycyclic aromatic electron-rich structures namely 6-Chloro-2-methoxy-acridine can be considered as putative hits for Pim-1 kinase inhibition.

  6. The Situation of Complementary and Alternative Medicine / Integrative Medicine in Finland: Genuine Research Is Needed.

    Science.gov (United States)

    Zimmermann, Peter Josef; Aarva, Pauliina; Sorsa, Minna

    The official acceptance of complementary and alternative medicine (CAM) or integrative medicine in the academic discussion and in health policies in Finland is still poor. This is in contradiction to the fact that modern Finnish citizens use CAM as much as any people elsewhere in the European Union, with rates of 28-46% of the general population, or even more. This was one of the reasons for the foundation of the Finnish Forum for Research in Integrative Medicine and Healthcare (SILF) in November 2014. A first challenge for the SILF was to facilitate a research seminar to address the issue of CAM research as a part of the Finnish academic research. The seminar was organized by the Department of Health Sciences of the University of Tampere on November 13, 2015. Almost one third of the more than 400 participants were health professionals, and again one-third out of this group were physicians. As a result of the seminar, a research network was inaugurated. Obviously there is an increasing interest of health professionals in CAM and maybe even a change of attitude towards CAM also in Finland. However, genuine Finnish CAM research is essential in order to open up the academic discussion. © 2017 S. Karger GmbH, Freiburg.

  7. Medicine Delivery Device with Integrated Sterilization and Detection

    Science.gov (United States)

    Shearn, Michael J.; Greer, Harold F.; Manohara, Harish

    2013-01-01

    Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. The application of semiconductor processing techniques and technologies to the problems of fluid manipulation and delivery has enabled the integration of chemical, electrical, and mechanical manipulation of samples all within a single microfluidic device. This approach has been successfully applied at JPL to the automated processing, detection, and analysis of minute quantities (parts per trillion level) of biomaterials to develop instruments for in situ exploration or extraterrestrial bodies. The same nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely high-surface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL's ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization

  8. Prescriptions of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine for allergic rhinitis under the National Health Insurance in Taiwan.

    Science.gov (United States)

    Huang, Sheng-Kang; Ho, Yu-Ling; Chang, Yuan-Shiun

    2015-09-15

    Allergic rhinitis has long been a worldwide health problem with a global growth trend. The use of traditional Chinese medicines alone or integrated Chinese-Western medicines for its treatment is quite common in Taiwan. Respiratory diseases account for the majority of outpatient traditional Chinese medicine treatment, while allergic rhinitis accounts for the majority of respiratory diseases. We hereby conduct a comparative analysis between traditional Chinese medicine treatments and western medicine treatments for allergic rhinitis in Taiwan. The results of the analysis on the prescription difference of traditional Chinese medicine and western medicine treatments would be helpful to clinical guide and health policy decision making of ethnopharmacological therapy. Patients diagnosed as allergic rhinitis with diagnostic code 470-478 (ICD-9-CM) were selected as subjects from 2009-2010 National Health Insurance Research Database based on the claim data from the nationwide National Health Insurance in Taiwan. This retrospective study used Chi-Square test to test the effects of gender and age on visit of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine treatments. A total of 45,804 patients diagnosed as allergic rhinitis with ICD-9-CM 470-478 were identified from 2009-2010 NHIRD. There were 36,874 subjects for western medicine treatment alone, 5829 subjects for traditional Chinese medicine treatment alone, and 3101 subjects for integrated Chinese-Western medicine treatment. Female patients were more than male in three treatments. 0-9 years children had the highest visit frequency in western medicine and integrated Chinese-Western medicine groups, while 10-19 years young-age rank the highest in traditional Chinese medicine group. The Chi-square test of independence showed that the effects of gender and age on visit of three treatments were significant. The prescription drugs of western medicine treatment alone were almost for

  9. Management of chronic pain using complementary and integrative medicine.

    Science.gov (United States)

    Chen, Lucy; Michalsen, Andreas

    2017-04-24

    Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronic pain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action and clinical studies on the efficacy of commonly used CIM modalities such as acupuncture, mind-body system, dietary interventions and fasting, and herbal medicine and nutrients. 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.

  10. Towards an integrated approach to health and medicine in Africa

    Directory of Open Access Journals (Sweden)

    Kezia Batisai

    2016-01-01

    Full Text Available This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine ‘HIV/AIDS patient behaviour’ with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014. The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 167–177. doi:10.1080/17290376.2014.972057; Chavunduka, G. (1998. Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O’Brien, S. & Broom, A. (2014. HIV in (and out of the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 94–104. doi:10.1080/17290376.2014.938102]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS – who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus – often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about ‘when, where and how to seek medical attention’, the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in

  11. Application of PIMS Software in Monthly Planning of Refinery Production

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    This article describes the application of the PIMS software in formulating monthly refining production plan. Application of the PIMS software can help to solve a series of problems related with monthly plan of refining production such as optimized selection of crude and feedstocks, optimized selection of production scale and processing scheme, identification of bottlenecks and their mitigation,optimized selection of turnaround time and optimized selection of operating regime, which have increased the economic benefits of refining enterprises. With the further development and improvement of models the PIMS software will play an increasingly important role in formulating monthly plans of refining operations and production management at refineries. This article also explores the problems existing in refinery monthly planning, and has made recommendations on developing and improving models and reporting system, enhancement of basic data acquisition, model maintenance personnel and staff training.

  12. Remediation of uranium contaminated water and soil by PIMS approach

    International Nuclear Information System (INIS)

    Raicevic, S.; Raicevic, J.; Smiciklas, I. . E-mail address of corresponding author: raich@beotel.yu; Raicevic, S.)

    2005-01-01

    Contamination of soil by uranium (U) represents a permanent threat for food and water resources. For this reason, remediation is a very important measure for protection of the health of the population living in the vicinity of these contaminated sites. Phosphate- Induced Metal Stabilization (PIMS) represents one of the powerful methods for remediation of soil and water contaminated by U, including depleted uranium (DU). By this approach it is possible to stabilize metals in the form of phosphate phases and other low soluble phases that are stable over geological time. PIMS is based on application of a special form of apatite of biological origin, Apatite II, to clean up metal and radionuclide contamination, in situ or ex situ. This biogenic apatite can be emplaced as a down-gradient permeable reactive barrier, mixed into contaminated soil or waste or used as a disposal liner. Here we will briefly describe the PIMS remediation protocol. (author)

  13. Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

    Science.gov (United States)

    Laube, Justin G R; Shapiro, Martin F

    2017-05-01

    Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

  14. [Integrated skills laboratory concept for undergraduate training in internal medicine].

    Science.gov (United States)

    Nikendei, C; Schilling, T; Nawroth, P; Hensel, M; Ho, A D; Schwenger, V; Zeier, M; Herzog, W; Schellberg, D; Katus, H A; Dengler, T; Stremmel, W; Müller, M; Jünger, J

    2005-05-06

    An amendment to the German medical curriculum in April 2002 will place basic practical skills at the centre of medical training. We report here on the implementation and evaluation of an obligatory, tutor-guided, and integrated skills laboratory concept in the field of internal medicine. To test the effectiveness of a skills laboratory training on OSCE performance a pilot study was carried out. The experimental group, of 77 students, participated in seven sessions of communication training, skills laboratory training, and bedside teaching, each lasting one and a half hours. The control group of 66 students had as many sessions but was only offered bedside-teaching. The evaluation of acceptance of skills' training as well as the related increase in individual competence is on-going (summer term 2004: n = 176 students). The integrated skills laboratory concept was rated at 3.5 (SD = 1.2) on a 5-point scale and was acknowledged as practice-oriented (M = 4.2; SD = 1.0) and relevant for doctors' everyday lives (M = 3.6; SD = 1.1). Increased levels of competence according to individual self-evaluations proved to be highly significant (p<.001), and results of the pilot study showed that the experimental group had a significantly better OSCE performance than the control group (p<.001). This pilot study shows that curriculum changes promoting basic clinical skills are effective and lead to an improved practical education of tomorrow's physicians. The integrated skills laboratory concept is well accepted and leads to a relevant increase in competence in the practice of internal medical. The presented skills laboratory concept in internal medicine is proving to be a viable and efficient learning tool.

  15. Exploring in integrated quality evaluation of Chinese herbal medicines: the integrated quality index (IQI) for aconite.

    Science.gov (United States)

    Zhang, Ding-kun; Wang, Jia-bo; Yang, Ming; Peng, Cheng; Xiao, Xiao-he

    2015-07-01

    Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the

  16. Identification of novel oxidized protein substrates and physiological partners of the mitochondrial ATP-dependent Lon-like protease Pim1

    DEFF Research Database (Denmark)

    Bayot, Aurélien; Gareil, Monique; Rogowska-Wrzesinska, Adelina

    2010-01-01

    , yeast cells have been shown to accumulate electron-dense inclusion bodies in the matrix space, to lose integrity of mitochondrial genome, and to be respiration-deficient. Because of the severity of phenotypes associated with the depletion of Pim1, this protease appears to be an essential component...

  17. Expression, purification, crystallization and preliminary crystallographic analysis of human Pim-1 kinase

    International Nuclear Information System (INIS)

    Qian, Kevin C.; Studts, Joey; Wang, Lian; Barringer, Kevin; Kronkaitis, Anthony; Peng, Charline; Baptiste, Alistair; LaFrance, Roger; Mische, Sheenah; Farmer, Bennett

    2004-01-01

    Pim kinases, belong to a distinctive serine/threonine protein-kinase family and are involved in cytokine-induced signal transduction and the development of lymphoid malignancies. Human Pim-1 kinase has been cloned, expressed and crystallized Pim kinases, including Pim-1, Pim-2 and Pim-3, belong to a distinctive serine/threonine protein-kinase family. They are involved in cytokine-induced signal transduction and the development of lymphoid malignancies. Their kinase domains are highly homologous to one another, but share low sequence identity to other kinases. Specifically, there are two proline residues in the conserved hinge-region sequence ERPXPX separated by a residue that is non-conserved among Pim kinases. Full-length human Pim-1 kinase (1–313) was cloned and expressed in Escherichia coli as a GST-fusion protein and truncated to Pim-1 (14–313) by thrombin digestion during purification. The Pim-1 (14–313) protein was purified to high homogeneity and monodispersity. This protein preparation yielded small crystals in the initial screening and large crystals after optimization. The large crystals of apo Pim-1 enzyme diffracted to 2.1 Å resolution and belong to space group P6 5 , with unit-cell parameters a = b = 95.9, c = 80.0 Å, β = 120° and one molecule per asymmetric unit

  18. An Integrated Framework for Gender Equity in Academic Medicine.

    Science.gov (United States)

    Westring, Alyssa; McDonald, Jennifer M; Carr, Phyllis; Grisso, Jeane Ann

    2016-08-01

    In 2008, the National Institutes of Health funded 14 R01 grants to study causal factors that promote and support women's biomedical careers. The Research Partnership on Women in Biomedical Careers, a multi-institutional collaboration of the investigators, is one product of this initiative.A comprehensive framework is needed to address change at many levels-department, institution, academic community, and beyond-and enable gender equity in the development of successful biomedical careers. The authors suggest four distinct but interrelated aspects of culture conducive to gender equity: equal access to resources and opportunities, minimizing unconscious gender bias, enhancing work-life balance, and leadership engagement. They review the collection of eight articles in this issue, which each address one or more of the four dimensions of culture. The articles suggest that improving mentor-mentee fit, coaching grant reviewers on unconscious bias, and providing equal compensation and adequate resources for career development will contribute positively to gender equity in academic medicine.Academic medicine must adopt an integrated perspective on culture for women and acknowledge the multiple facets essential to gender equity. To effect change, culture must be addressed both within and beyond academic health centers (AHCs). Leaders within AHCs must examine their institutions' processes, resources, and assessment for fairness and transparency; mobilize personnel and financial resources to implement evidence-based initiatives; and assign accountability for providing transparent progress assessments. Beyond AHCs, organizations must examine their operations and implement change to ensure parity of funding, research, and leadership opportunities as well as transparency of assessment and accreditation.

  19. Pharmacodynamic-pharmacokinetic integration as a guide to medicinal chemistry.

    Science.gov (United States)

    Gabrielsson, Johan; Fjellström, Ola; Ulander, Johan; Rowley, Michael; Van Der Graaf, Piet H

    2011-01-01

    A primary objective of pharmacokinetic-pharmacodynamic (PKPD) reasoning is to identify key in vivo drug and system proper¬ties, enabling prediction of the magnitude and time course of drug responses under physiological and pathological conditions in animals and man. Since the pharmacological response generated by a drug is highly dependent on the actual system used to study its action, knowledge about its potency and efficacy at a given concentration or dose is insufficient to obtain a proper understanding of its pharmacodynamic profile. Hence, the output of PKPD activities extends beyond the provision of quantitative measures (models) of results, to the design of future protocols. Furthermore, because PKPD integrates DMPK (e.g. clearance) and pharmacology (e.g. potency),it provides an anchor point for compound selection, and, as such, should be viewed as an important weapon in medicinal chemistry. Here we outline key PK concepts relevant to PD, and then consider real-life experiments to illustrate the importance to the medicinal chemist of data obtained by PKPD. Useful assumptions and potential pitfalls are described, providing a holistic view of the plethora of determinants behind in vitro-in vivo correlations. By condensing complexity to simplicity, there are not only consequences for experimental design, and for the ranking and design of compounds, but it is also possible to make important predictions such as the impact of changes in drug potency and kinetics. In short, by using quantitative methods to tease apart pharmacodynamic complexities such as temporal differences and changes in plasma protein binding, it is possible to target the changes necessary for improving a compound's profile.

  20. Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges

    Science.gov (United States)

    Memon, M.A.; Shmalberg, J.; Adair, H.S.; Allweiler, S.; Bryan, J.N.; Cantwell, S.; Carr, E.; Chrisman, C.; Egger, C.M.; Greene, S.; Haussler, K.K.; Hershey, B.; Holyoak, G.R.; Johnson, M.; Jeune, S. Le; Looney, A.; McConnico, R.S.; Medina, C.; Morton, A.J.; Munsterman, A.; Nie, G.J.; Park, N.; Parsons-Doherty, M.; Perdrizet, J.A.; Peyton, J.L.; Raditic, D.; Ramirez, H.P.; Saik, J.; Robertson, S.; Sleeper, M.; Dyke, J. Van; Wakshlag, J.

    2016-01-01

    Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative. PMID:27200270

  1. Integrative Medicine Patients Have High Stress, Pain, and Psychological Symptoms.

    Science.gov (United States)

    Wolever, Ruth Q; Goel, Nikita S; Roberts, Rhonda S; Caldwell, Karen; Kligler, Benjamin; Dusek, Jeffery A; Perlman, Adam; Dolor, Rowena; Abrams, Donald I

    2015-01-01

    Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, and depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous medical conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN). IM patients reported higher levels of perceived stress, pain, and depressive symptoms, and lower levels of quality of life compared with national norms. Per provider reports, 60% of patients had at least one of the following: stress (9.3%), fatigue (10.2%), anxiety (7.7%), depression (7.2%), and/or sleep disorders (4.8%). Pain, having both physiological and psychological components, was also included and is the most common condition treated at IM clinics. Those with high stress, psychological conditions, and pain were most frequently treated with acupuncture, IM physician consultation, exercise, chiropractic services, diet/nutrition counseling, and massage. With baseline information on clinical presentation and service utilization, future PBRN studies can examine promising interventions delivered at the clinic to treat stress and psychological conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Sensitivity Analysis of the Surface Runoff Coefficient of HiPIMS in Simulating Flood Processes in a Large Basin

    Directory of Open Access Journals (Sweden)

    Yueling Wang

    2018-03-01

    Full Text Available To simulate flood processes at the basin level, the GPU-based High-Performance Integrated Hydrodynamic Modelling System (HiPIMS is gaining interest as computational capability increases. However, the difficulty of coping with rainfall input to HiPIMS reduces the possibility of acquiring a satisfactory simulation accuracy. The objective of this study is to test the sensitivity of the surface runoff coefficient in the HiPIMS source term in the Misai basin with an area of 797 km2 in south China. To achieve this, the basin was divided into 909,824 grid cells, to each of which a Manning coefficient was assigned based on its land use type interpreted from remote sensing data. A sensitivity analysis was conducted for three typical flood processes under four types of surface runoff coefficients, assumed a priori, upon three error functions. The results demonstrate the crucial role of the surface runoff coefficient in achieving better simulation accuracy and reveal that this coefficient varies with flood scale and is unevenly distributed over the basin.

  3. Introduction to the History and Current Status of Evidence-Based Korean Medicine: A Unique Integrated System of Allopathic and Holistic Medicine

    Directory of Open Access Journals (Sweden)

    Chang Shik Yin

    2014-01-01

    Full Text Available Objectives. Korean medicine, an integrated allopathic and traditional medicine, has developed unique characteristics and has been active in contributing to evidence-based medicine. Recent developments in Korean medicine have not been as well disseminated as traditional Chinese medicine. This introduction to recent developments in Korean medicine will draw attention to, and facilitate, the advancement of evidence-based complementary alternative medicine (CAM. Methods and Results. The history of and recent developments in Korean medicine as evidence-based medicine are explored through discussions on the development of a national standard classification of diseases and study reports, ranging from basic research to newly developed clinical therapies. A national standard classification of diseases has been developed and revised serially into an integrated classification of Western allopathic and traditional holistic medicine disease entities. Standard disease classifications offer a starting point for the reliable gathering of evidence and provide a representative example of the unique status of evidence-based Korean medicine as an integration of Western allopathic medicine and traditional holistic medicine. Conclusions. Recent developments in evidence-based Korean medicine show a unique development in evidence-based medicine, adopting both Western allopathic and holistic traditional medicine. It is expected that Korean medicine will continue to be an important contributor to evidence-based medicine, encompassing conventional and complementary approaches.

  4. Introduction to the history and current status of evidence-based korean medicine: a unique integrated system of allopathic and holistic medicine.

    Science.gov (United States)

    Yin, Chang Shik; Ko, Seong-Gyu

    2014-01-01

    Objectives. Korean medicine, an integrated allopathic and traditional medicine, has developed unique characteristics and has been active in contributing to evidence-based medicine. Recent developments in Korean medicine have not been as well disseminated as traditional Chinese medicine. This introduction to recent developments in Korean medicine will draw attention to, and facilitate, the advancement of evidence-based complementary alternative medicine (CAM). Methods and Results. The history of and recent developments in Korean medicine as evidence-based medicine are explored through discussions on the development of a national standard classification of diseases and study reports, ranging from basic research to newly developed clinical therapies. A national standard classification of diseases has been developed and revised serially into an integrated classification of Western allopathic and traditional holistic medicine disease entities. Standard disease classifications offer a starting point for the reliable gathering of evidence and provide a representative example of the unique status of evidence-based Korean medicine as an integration of Western allopathic medicine and traditional holistic medicine. Conclusions. Recent developments in evidence-based Korean medicine show a unique development in evidence-based medicine, adopting both Western allopathic and holistic traditional medicine. It is expected that Korean medicine will continue to be an important contributor to evidence-based medicine, encompassing conventional and complementary approaches.

  5. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    Science.gov (United States)

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  6. Pure- and mixed-gas CO2/CH4 separation properties of PIM-1 and an amidoxime-functionalized PIM-1

    KAUST Repository

    Swaidan, Raja

    2014-05-01

    The prototypical solution-processable polymer of intrinsic microporosity, PIM-1, and derivatives thereof offer combinations of permeability and selectivity that make them potential candidate materials for membrane-based gas separations. Paramount to the design and evaluation of PIMs for economical natural gas sweetening is a high and stable CO2/CH4 selectivity under realistic, mixed-gas conditions. Here, amidoxime-functionalized PIM-1 (AO-PIM-1) was prepared and examined for fundamental structure/property relationships. Qualitative NLDFT pore-size distribution analyses of physisorption isotherms (N2 at -196 oC; CO2 at 0 oC) reveal a tightened microstructure indicating size-sieving ultra-microporosity (<7Å). AO-PIM-1 demonstrated a three-fold increase in αD(CO2/CH4) over PIM-1, surpassing the 2008 upper bound with P(CO2)=1153Barrer and ideal α(CO2/CH4)=34. Under a 50:50 CO2:CH4 mixed-gas feed, AO-PIM-1 showed less selectivity loss than PIM-1, maintaining a mixed-gas α(CO2/CH4) ~21 across a 20bar pressure range. Conversely, PIM-1 endured up to 60% increases in mixed-gas CH4 permeability over pure-gas values concurrent with a selectivity of only ~8 at 20bar. A pervasive intermolecular hydrogen bonding network in AO-PIM-1 predominantly yields a rigidified microstructure that mitigates CO2-induced matrix dilations, reducing detrimental mixed-gas CH4 copermeation. © 2014 Elsevier B.V.

  7. The human protooncogene product p33pim is expressed during fetal hematopoiesis and in diverse leukemias

    International Nuclear Information System (INIS)

    Amson, R.; Przedborski, S.; Telerman, A.; Sigaux, F.; Flandrin, G.; Givol, D.

    1989-01-01

    The authors measured the human pim-1 protooncogene (PIM) expression during fetal development and in hematopoietic malignancies. The data indicate that during human fetal hematopoiesis the 33-kDa pim product, p33pim, is highly expressed in the liver and the spleen. In contrast, a the adult stage it is only slightly expressed in circulating granulocytes. Out of 70 hematopoietic malignancies analyzed, 51 patients and 19 cell lines, p33pim was overexpressed in ∼ 30% of the samples, particularly in myeloid and lymphoid acute leukemias. This overexpression was unrelated to any stage of cellular differentiation and was not due to gene rearrangement or amplification. These results imply a physiological role of the pim-1 protooncogene during hematopoietic development and a deregulation in various leukemias

  8. Cathode voltage and discharge current oscillations in HiPIMS

    Czech Academy of Sciences Publication Activity Database

    Klein, P.; Hnilica, J.; Hubička, Zdeněk; Čada, Martin; Šlapanská, M.; Zemánek, M.; Vašina, P.

    2017-01-01

    Roč. 26, č. 5 (2017), s. 1-12, č. článku 055015. ISSN 0963-0252 R&D Projects: GA ČR(CZ) GA15-00863S Institutional support: RVO:68378271 Keywords : HiPIMS * voltage and current oscillations * spokes Subject RIV: BL - Plasma and Gas Discharge Physics OBOR OECD: Fluids and plasma physics (including surface physics) Impact factor: 3.302, year: 2016

  9. Towards a model for integrative medicine in Swedish primary care

    Directory of Open Access Journals (Sweden)

    Falkenberg Torkel

    2007-07-01

    Full Text Available Abstract Background Collaboration between providers of conventional care and complementary therapies (CTs has gained in popularity but there is a lack of conceptualised models for delivering such care, i.e. integrative medicine (IM. The aim of this paper is to describe some key findings relevant to the development and implementation of a proposed model for IM adapted to Swedish primary care. Methods Investigative procedures involved research group and key informant meetings with multiple stakeholders including general practitioners, CT providers, medical specialists, primary care administrators and county council representatives. Data collection included meeting notes which were fed back within the research group and used as ongoing working documents. Data analysis was made by immersion/crystallisation and research group consensus. Results were categorised within a public health systems framework of structures, processes and outcomes. Results The outcome was an IM model that aimed for a patient-centered, interdisciplinary, non-hierarchical mix of conventional and complementary medical solutions to individual case management of patients with pain in the lower back and/or neck. The IM model case management adhered to standard clinical practice including active partnership between a gate-keeping general practitioner, collaborating with a team of CT providers in a consensus case conference model of care. CTs with an emerging evidence base included Swedish massage therapy, manual therapy/naprapathy, shiatsu, acupuncture and qigong. Conclusion Despite identified barriers such as no formal recognition of CT professions in Sweden, it was possible to develop a model for IM adapted to Swedish primary care. The IM model calls for testing and refinement in a pragmatic randomised controlled trial to explore its clinical effectiveness.

  10. Spokes and charged particle transport in HiPIMS magnetrons

    International Nuclear Information System (INIS)

    Brenning, N; Lundin, D; Minea, T; Vitelaru, C; Costin, C

    2013-01-01

    Two separate scientific communities are shown to have studied one common phenomenon, azimuthally rotating dense plasma structures, also called spokes, in pulsed-power E × B discharges, starting from quite different approaches. The first body of work is motivated by fundamental plasma science and concerns a phenomenon called the critical ionization velocity, CIV, while the other body of work is motivated by the applied plasma science of high power impulse magnetron sputtering (HiPIMS). Here we make use of this situation by applying experimental observations, and theoretical analysis, from the CIV literature to HiPIMS discharges. For a practical example, we take data from observed spokes in HiPIMS discharges and focus on their role in charged particle transport, and in electron energization. We also touch upon the closely related questions of how they channel the cross-B discharge current, how they maintain their internal potential structure and how they influence the energy spectrum of the ions? New particle-in-cell Monte Carlo collisional simulations that shed light on the azimuthal drift and expansion of the spokes are also presented. (paper)

  11. Recent development work on PIM: a Blumlein driven IVA machine

    International Nuclear Information System (INIS)

    Phillips, Martin J.; Sinclair, Mark A.; Williamson, Mark C.; Clough, Stephen G.; Thomas, Kenneth J.; Smith, Ian Douglas; Bailey, Vernon Leslie; Johnson, David Lee; Corcoran, Patrick Allen; Kishi, Hiroshi J.; Maenchen, John Eric

    2003-01-01

    An IVA (inductive voltage adder) research programme at AWE began with the construction of a small scale IVA test bed named LINX and progressed to building PIM (Prototype IVA Module). The work on PIM is geared towards furnishing AWE with a range of machines operating at 1 to 4 MV that may eventually supersede, with an upgrade in performance, existing machines operating in that voltage range. PIM has a water dielectric Blumlein of 10 ohms charged by a Marx generator. This has been used to drive either one or two 1.5 MV inductive cavities and fitting a third cavity may be attempted in the future. The latest two cavity configuration is shown which requires a split oil coax to connect the two cavities in parallel. It also has a laser triggering system for initiating the Blumlein and the prepulse reduction system fitted to the output of the Blumlein. A short MITL (magnetically insulated transmission line) connects the cavities, via a vacuum pumping section, to a chamber containing an e-beam diode test load.

  12. Research methods in complementary and alternative medicine: an integrative review.

    Science.gov (United States)

    de Almeida Andrade, Fabiana; Schlechta Portella, Caio Fabio

    2018-01-01

    The scientific literature presents a modest amount of evidence in the use of complementary and alternative medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important. Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide. Copyright © 2017 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

  13. Tuning PIM-PI-Based Membranes for Highly Selective Transport of Propylene/Propane

    KAUST Repository

    Swaidan, Ramy J.

    2016-12-06

    To date there exists a great deal of energetic and economic inefficiency in the separation of olefins from paraffins because the principal means of achieving industrial purity requirements is accomplished with very energy intensive cryogenic distillation. Mitigation of the severe energy intensity of the propylene/propane separation has been identified as one of seven chemical separations which can change the landscape of global energy use, and membranes have been targeted as an emerging technology because they offer scalability and lower capital and operating costs. The focus of this work was to evaluate a new direction of material development for the very industrially relevant propylene/propane separation using membranes. The objective was to develop a rational design approach for generating highly selective membranes using a relatively new platform of materials known as polyimides of intrinsic microporosity (PIM-PIs), the prospects of which have never been examined for the propylene/propane separation. Structurally, PIMs comprise relatively inflexible macromolecular architectures integrating contortion sites that help disrupt packing and trap microporous free volume elements (< 20 Å). To date most of the work reported in the literature on this separation is based on conventional low free volume 6FDA-based polyimides which in the best case show moderate C3H6/C3H8 selectivities (<20) with C3H6 permeabilities too low to garner industrial interest. Due to propylene and propane’s relatively large molecular size, we hypothesized that the use of more open structures can provide greater accessibility to the pores necessary to enhance membrane sieving and flux. It has been shown for numerous key gas separations that introduction of microporosity into a polymer structure can defy the notorious permeability/selectivity tradeoff curve and induce simultaneous boosts in both permeability and selectivity. The cornerstone approach to designing state of the art high

  14. Gynecologic oncologists' attitudes and practices relating to integrative medicine: results of a nationwide AGO survey.

    Science.gov (United States)

    Klein, Evelyn; Beckmann, Matthias W; Bader, Werner; Brucker, Cosima; Dobos, Gustav; Fischer, Dorothea; Hanf, Volker; Hasenburg, Annette; Jud, Sebastian M; Kalder, Matthias; Kiechle, Marion; Kümmel, Sherko; Müller, Andreas; Müller, Myrjam-Alice T; Paepke, Daniela; Rotmann, Andre-Robert; Schütz, Florian; Scharl, Anton; Voiss, Petra; Wallwiener, Markus; Witt, Claudia; Hack, Carolin C

    2017-08-01

    The growing popularity and acceptance of integrative medicine is evident both among patients and among the oncologists treating them. As little data are available regarding health-care professionals' knowledge, attitudes, and practices relating to the topic, a nationwide online survey was designed. Over a period of 11 weeks (from July 15 to September 30, 2014) a self-administered, 17-item online survey was sent to all 676 members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie) in the German Cancer Society. The questionnaire items addressed the use of integrative therapy methods, fields of indications for them, advice services provided, level of specific qualifications, and other topics. Of the 104 respondents (15.4%) using integrative medicine, 93% reported that integrative therapy was offered to breast cancer patients. The second most frequent type of tumor in connection with which integrative therapy methods were recommended was ovarian cancer, at 80% of the participants using integrative medicine. Exercise, nutritional therapy, dietary supplements, herbal medicines, and acupuncture were the methods the patients were most commonly advised to use. There is considerable interest in integrative medicine among gynecological oncologists, but integrative therapy approaches are at present poorly implemented in routine clinical work. Furthermore there is a lack of specific training. Whether future efforts should focus on extending counseling services on integrative medicine approaches in gynecologic oncology or not, have to be discussed. Evidence-based training on integrative medicine should be implemented in order to safely guide patients in their wish to do something by themselves.

  15. Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine.

    Science.gov (United States)

    Saha, Felix J; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

    2016-07-01

    Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.

  16. Scaling to Nanotechnology Limits with the PIMS Computer Architecture and a new Scaling Rule

    Energy Technology Data Exchange (ETDEWEB)

    Debenedictis, Erik P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-02-01

    We describe a new approach to computing that moves towards the limits of nanotechnology using a newly formulated sc aling rule. This is in contrast to the current computer industry scali ng away from von Neumann's original computer at the rate of Moore's Law. We extend Moore's Law to 3D, which l eads generally to architectures that integrate logic and memory. To keep pow er dissipation cons tant through a 2D surface of the 3D structure requires using adiabatic principles. We call our newly proposed architecture Processor In Memory and Storage (PIMS). We propose a new computational model that integrates processing and memory into "tiles" that comprise logic, memory/storage, and communications functions. Since the programming model will be relatively stable as a system scales, programs repr esented by tiles could be executed in a PIMS system built with today's technology or could become the "schematic diagram" for implementation in an ultimate 3D nanotechnology of the future. We build a systems software approach that offers advantages over and above the technological and arch itectural advantages. Firs t, the algorithms may be more efficient in the conventional sens e of having fewer steps. Second, the algorithms may run with higher power efficiency per operation by being a better match for the adiabatic scaling ru le. The performance analysis based on demonstrated ideas in physical science suggests 80,000 x improvement in cost per operation for the (arguably) gene ral purpose function of emulating neurons in Deep Learning.

  17. Overview of integrative medicine in child and adolescent psychiatry.

    Science.gov (United States)

    Simkin, Deborah R; Popper, Charles W

    2013-07-01

    Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. The Performance of a Thermally Cross-Linked Polymer of Intrinsic Microporosity (PIM-1) for Gas Separation

    KAUST Repository

    Alghunaimi, Fahd

    2013-01-01

    the performance of the TC-PIM-1 membranes with PIM-1 for natural gas separation. The TC-PIM-1 polymer was prepared by post-modification of PIM-1 at 300°C for a period of two days. Sorption isotherms of seven gases, including N2, O2, CH4, CO2, C2H6, C3H8 and n-C4H

  19. Integrating personal medicine into service delivery: empowering people in recovery.

    Science.gov (United States)

    MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

    2013-12-01

    Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  20. Exploring New Potentials of Blogs for Learning: Can Children Use Blogs for Personal Information Management (PIM)?

    Science.gov (United States)

    Yeo, Hwan-Ik; Lee, Yekyung Lisa

    2014-01-01

    This study explores the use of blogs for personal information management (PIM) as a learning tool that could bring increased efficiency and academic self-efficacy for carrying out learning tasks. In order to identify the uses and effects of using blogs for PIM by children, a control group that used personal spaces within the class website and an…

  1. PIM Pedagogy: Toward a Loosely Unified Model for Teaching and Studying Comics and Graphic Novels

    Science.gov (United States)

    Carter, James B.

    2015-01-01

    The article debuts and explains "PIM" pedagogy, a construct for teaching comics at the secondary- and post-secondary levels and for deep reading/studying comics. The PIM model for considering comics is actually based in major precepts of education studies, namely constructivist foundations of learning, and loosely unifies constructs…

  2. Advantages, Disadvantages, and Trend of Integrative Medicine in the Treatment of Heart Failure.

    Science.gov (United States)

    Zhang, PeiYing

    2015-06-01

    Integrative medicine therapy using traditional Chinese medicine (TCM) combined with western medicine has shown some advantages in treating heart failure (HF), such as holistic concept; multi-target treatment; dialectical logic; personalized therapy; formulae compatibility; and reduction of side effects of western medicine. However, problems still exist in TCM treatment of HF, including non-uniformed categorization of TCM, lack of standardized syndrome differentiation and lack of an evidence base. The future of treatment of HF seems to be focused on reversing ventricular remodeling, improving cardiac rehabilitation, and accelerating experimental research and drug discovery in TCM.

  3. Integrating Information Literacy and Evidence-Based Medicine Content within a New School of Medicine Curriculum: Process and Outcome.

    Science.gov (United States)

    Muellenbach, Joanne M; Houk, Kathryn M; E Thimons, Dana; Rodriguez, Bredny

    2018-01-01

    This column describes a process for integrating information literacy (IL) and evidence-based medicine (EBM) content within a new school of medicine curriculum. The project was a collaborative effort among health sciences librarians, curriculum deans, directors, and faculty. The health sciences librarians became members of the curriculum committees, developed a successful proposal for IL and EBM content within the curriculum, and were invited to become course instructors for Analytics in Medicine. As course instructors, the librarians worked with the other faculty instructors to design and deliver active learning class sessions based on a flipped classroom approach using a proprietary Information Mastery curriculum. Results of this collaboration may add to the knowledge base of attitudes and skills needed to practice as full faculty partners in curricular design and instruction.

  4. [Tianjin characteristics of integrated traditional Chinese and Western medicine in first aid medical system].

    Science.gov (United States)

    Li, Zhijun

    2018-05-01

    Tianjin, as the earliest city to open up, the exchange of Chinese and Western cultures also started earlier. Therefore, today's emergency medicine system with integrated features of Chinese and Western medicine is formed. Professor Wang Jinda, who works in Tianjin First Center Hospital, makes the theory of "treating bronchitis and treating diseases" and "three methods of three syndromes" for the treatment of severe diseases such as sepsis. The surgical aspect is the treatment of acute abdomen with the combination of Chinese and Western medicine which is proposed by Academician Wu Xianzhong who worked in Tianjin Nankai Hospital. In the aspect of acupuncture and moxibustion, Professor Guo Yi, who works in Tianjin University of Traditional Chinese Medicine, provides the twelve Jing points blood-letting therapy for cerebral diseases such as stroke. Professor Liu Xinqiao from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine also conducts in-depth studies on brain protection after cardiopulmonary resuscitation (CPR). He proposes the importance of traditional Chinese medicine in addition to mild hypothermia and neuroprotective agents. The author summarized these achievements, in light of which looked forward to the future and proposed the concept of establishing a multi-specialist collaboration and an emergency center with obvious characteristics of integrated Chinese and Western medicine, which would pave the way for the development of integrated Chinese and Western medicine first aid.

  5. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  6. Integrating herbal medicine into mainstream healthcare in Ghana: clients' acceptability, perceptions and disclosure of use.

    Science.gov (United States)

    Agyei-Baffour, Peter; Kudolo, Agnes; Quansah, Dan Yedu; Boateng, Daniel

    2017-12-01

    Although there are current efforts to integrate herbal medicine (HM) into mainstream healthcare in Ghana, there is paucity of empirical evidence on the acceptability and concurrent use of HM, in the formal health facilities in Ghana. This study sought to determine client perception, disclosure and acceptability of integrating herbal medicine in mainstream healthcare in Kumasi, Ghana. A cross-sectional study was conducted from May to August, 2015. Five hundred patients presenting at the outpatient departments of Kumasi South, Suntreso and Tafo Government Hospitals in Kumasi were randomly selected. Interviews were conducted with the use of structured questionnaires. A logistic regression analysis, using backward selection, was conducted to determine the influence of socio-demographic and facility related factors on the odds of using HM at the facility. All statistical tests were two-sided and considered significant at a p-value of herbal medicines. Respondents who rated themselves wealthy had increased odds of using herbal medicines at the health facility as compared to those who rated themselves poor (OR = 4.9; 95%CI = 1.6-15.3). This study shows that integration of herbal medicine is feasible and herbal medicines may be generally accepted as a formal source of healthcare in Ghana. The results of this study might serve as a basis for improvement and upscale of the herbal medicine integration programme in Ghana.

  7. Holding Pressure and Its Influence on Quality in PIM Technology

    Directory of Open Access Journals (Sweden)

    Pavel Petera

    2012-01-01

    Full Text Available The PIM (powder injection molding process consists of several steps in which faults can occur. The quality of the part that is produced usually cannot be seen until the end of the process. It is therefore necessary to find a way to discover the fault earlier in the process. The cause of defects is very often “phase separation” (inhomogeneity in powder distribution, which can also be influenced by the holding pressure. This paper evaluates the powder distribution with a new method based on density measurement. Measurements were made using various holding pressure values.

  8. The integral formation of the university technologists in nuclear medicine

    International Nuclear Information System (INIS)

    Tossi, Mirta H.; Chwojnik, Abraham; Otero, Dino

    2003-01-01

    Full text: Nuclear medicine has contributed to notable benefits to the human health from the very beginning. The Radioisotopes techniques, as well as the ionizing radiation used, have evolved providing functional and anatomical information of the patient, through non-invasive methods. With reference to Radiological Protection, the justification of each one of these practices and its perfect execution is intimately related to the benefit provided to the patients. The National Atomic Energy Commission apart from favouring the scientific and technological development, considers indispensable to work thoroughly on the professional training of the prospective technologists. Our over twenty-year experience in organizing and delivering courses of Technologists in Nuclear Medicine, although based on a much simpler program, have allowed the Institute of Nuclear Studies of the Ezeiza Atomic Center to acquire the capacity of developing a program to train highly qualified Technologists in that field. This project represents a step forward of great importance to the graduates qualification, since they will have the endorsement of CNEA and of the Faculty of Medicine of the Maimonides University. These are the three outstanding characteristics agreed on: 1.- General Education, carried out by subjects closely related to the optimisation of the relation Technologist - Patient - Environment and represented by: Radiological Protection and Hospital Security, Psychology, Ethics and Professional Medical Ethics, Nursing, English, Hygiene and Hospital Security and Management of the Quality in Services of Health. 2.- Diagnostic Procedures: planned according to organs, apparatuses or systems which are horizontally crossed by the anatomy, physiology and physiopathology Preparation of the patient, indications, main counter indications, radiopharmaceuticals, mechanisms of incorporation, pathologies, clinical protocols, instrumentation, post radiopharmaceuticals administration imaging

  9. Pim-1 Kinase Phosphorylates Cardiac Troponin I and Regulates Cardiac Myofilament Function

    Directory of Open Access Journals (Sweden)

    Ni Zhu

    2018-03-01

    Full Text Available Background/Aims: Pim-1 is a serine/threonine kinase that is highly expressed in the heart, and exerts potent cardiac protective effects through enhancing survival, proliferation, and regeneration of cardiomyocytes. Its myocardial specific substrates, however, remain unknown. In the present study, we aim to investigate whether Pim-1 modulates myofilament activity through phosphorylation of cardiac troponin I (cTnI, a key component in regulating myofilament function in the heart. Methods: Coimmunoprecipitation and immunofluorescent assays were employed to investigate the interaction of Pim-1 with cTnI in cardiomyocytes. Biochemical, site directed mutagenesis, and mass spectrometric analyses were utilized to identify the phosphorylation sites of Pim1 in cTnI. Myofilament functional assay using skinned cardiac fiber was used to assess the effect of Pim1-mediated phosphorylation on cardiac myofilament activity. Lastly, the functional significance of Pim1-mediated cTnI in heart disease was determined in diabetic mice. Results: We found that Pim-1 specifically interacts with cTnI in cardiomyocytes and this interaction leads to Pim1-mediated cTnI phosphorylation, predominantly at Ser23/24 and Ser150. Furthermore, our functional assay demonstrated that Pim-1 induces a robust phosphorylation of cTnI within the troponin complex, thus leading to a decreased Ca2+ sensitivity. Insulin-like growth factor 1 (IGF-1, a peptide growth factor that has been shown to stimulate myocardial contractility, markedly induces cTnI phosphorylation at Ser23/24 and Ser150 through increasing Pim-1 expression in cardiomyocytes. In a high-fat diabetic mice model, the expression of Pim1 in the heart is significantly decreased, which is accompanied by a decreased phosphorylation of cTnI at Ser23/24 and Ser150, further implicating the pathological significance of the Pim1/cTnI axis in the development of diabetic cardiomyopathy. Conclusion: Our results demonstrate that Pim-1 is a

  10. p-Medicine: From data sharing and integration via VPH models to personalized medicine

    Science.gov (United States)

    Rossi, S; Christ-Neumann, ML; Rüping, S; Buffa, FM; Wegener, D; McVie, G; Coveney, PV; Graf, N; Delorenzi, M

    2011-01-01

    The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6–8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html). Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF). The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium. In this communication, we summarize what we presented with particular attention to the interaction between the symposium’s topic and content and our project. PMID:22276060

  11. p-Medicine: From data sharing and integration via VPH models to personalized medicine.

    Science.gov (United States)

    Rossi, S; Christ-Neumann, Ml; Rüping, S; Buffa, Fm; Wegener, D; McVie, G; Coveney, Pv; Graf, N; Delorenzi, M

    2011-01-01

    The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6-8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html).Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF).The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium.In this communication, we summarize what we presented with particular attention to the interaction between the symposium's topic and content and our project.

  12. Cuestiones pendientes en la metodología PIMS: un breve recuento Pending question about the PIMS methodology: a brief account

    Directory of Open Access Journals (Sweden)

    Rubén M. Mosqueda Almanza

    2010-06-01

    Full Text Available Se asume que una estrategia adecuada impactara positivamente las ganancias de la empresa y le llevara a expandirse. Recientes descubrimientos sugieren que solo con la revisión y adecuación de los elementos mas relevantes del plan estratégico es posible llevar los resultados económicos de la empresa a un punto optimo. La metodología PIMS (que se traduce como Impacto de la Estrategia de Marketing sobre las Ganancias constituye un modelo para lograrlo, sin embargo, subsisten problemas fundamentales en el mismo modelo que lo limitan. Así, en el presente trabajo se hace un estudio exploratorio y se muestra la evolución de la metodología PIMS lo cual permite desvelar los retos y el posible rumbo del tema. La definición de la estrategia, el diseño de la encuesta tipo PIMS, los problemas de multicolinearidad y el efecto de la participación de mercado se plantean como los mas relevantes. Los resultados muestran la necesidad de definir con precisión la estrategia asumida por la empresa, el rediseño de la encuesta PIMS cuando se aplique a mercados incompletos y finalmente, se advierte un avance en el estudio econométrico sobre la metodología PIMS con énfasis en la variable Calidad Relativa del Producto para resolver el viejo dilema del efecto de la participación de mercado.We can assume that an appropriate strategy will have a positive impact on profits and it will contribute to having a company’s market share grow. Recent findings suggest that only the adaptation of a strategic plan can bring a company to perform at optimum levels. PIMS is an archetypical model to achieve that, but fundamental problems remain that limit it. This paper shows the evolution of the PIMS methodology and reveals its challenges and possible development. The adequate definition of this strategy, the redesign of the questionnaire PIMS, problems of Multicollinearity and the Market Share Effect would be the most relevant problems that this paper will address. The

  13. Integrating complementary and alternative medicine into cancer care: Canadian oncology nurses′ perspectives

    OpenAIRE

    Tracy L Truant; Lynda G Balneaves; Margaret I Fitch

    2015-01-01

    The integration of complementary and alternative medicine (CAM) and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs) to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP) education and attitudes about CA...

  14. Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

    Science.gov (United States)

    Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

    2015-01-01

    Background An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations − usually companies − are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. Purpose The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. Methods A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in “mergers,” which could be used to build an integrative medicine department or integrative medicine service. Results Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). Conclusion The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation. PMID:25632226

  15. Pim2 cooperates with PML-RARalpha to induce acute myeloid leukemia in a bone marrow transplantation model

    DEFF Research Database (Denmark)

    Agrawal-Singh, Shuchi; Koschmieder, Steffen; Gelsing, Sandra

    2010-01-01

    Although the potential role of Pim2 as a cooperative oncogene has been well described in lymphoma, its role in leukemia has remained largely unexplored. Here we show that high expression of Pim2 is observed in patients with acute promyelocytic leukemia (APL). To further characterize the cooperative...... role of Pim2 with promyelocytic leukemia/retinoic acid receptor alpha (PML/RARalpha), we used a well-established PML-RARalpha (PRalpha) mouse model. Pim2 coexpression in PRalpha-positive hematopoietic progenitor cells (HPCs) induces leukemia in recipient mice after a short latency. Pim2-PRalpha cells...... were able to repopulate mice in serial transplantations and to induce disease in all recipients. Neither Pim2 nor PRalpha alone was sufficient to induce leukemia upon transplantation in this model. The disease induced by Pim2 overexpression in PRalpha cells contained a slightly higher fraction...

  16. Synthesis and biological investigation of PIM mimics carrying biotin or a fluorescent label for cellular imaging.

    Science.gov (United States)

    Front, Sophie; Bourigault, Marie-Laure; Rose, Stéphanie; Noria, Ségueni; Quesniaux, Valérie F J; Martin, Olivier R

    2013-01-16

    Phosphatidyl inositol mannosides (PIMs) are constituents of the mycobacterial cell wall; these glycolipids are known to exhibit potent inhibitory activity toward the LPS-induced production of cytokines by macrophages, and therefore have potential as anti-inflammatory agents. Recently, heterocyclic analogues of PIMs in which the inositol is replaced by a piperidine (aza-PIM mimics) or a tetrahydropyran moiety (oxa-PIM mimics) have been prepared by short synthetic sequences and shown to retain the biological activity of the parent PIM structures. In this investigation, the aza-PIM analogue was used as a convenient scaffold to link biotin or a fluorescent label (tetramethyl-rhodamine) by way of an aminocaproyl spacer, with the goal of using these conjugates for intracellular localization and for the study of the mechanism of their antiinflammatory action. The synthesis of these compounds is reported, as well as the evaluation of their activities as inhibitors of LPS-induced cytokine production by macrophages (TNFα, IL12p40); preliminary investigations by FACS and confocal microscopy indicated that PIM-biotin conjugate binds to macrophage membranes with rapid kinetics.

  17. Systems medicine and integrated care to combat chronic noncommunicable diseases

    NARCIS (Netherlands)

    Bousquet, Jean; Anto, Josep M.; Sterk, Peter J.; Adcock, Ian M.; Chung, Kian Fan; Roca, Josep; Agusti, Alvar; Brightling, Chris; Cambon-Thomsen, Anne; Cesario, Alfredo; Abdelhak, Sonia; Antonarakis, Stylianos E.; Avignon, Antoine; Ballabio, Andrea; Baraldi, Eugenio; Baranov, Alexander; Bieber, Thomas; Bockaert, Joël; Brahmachari, Samir; Brambilla, Christian; Bringer, Jacques; Dauzat, Michel; Ernberg, Ingemar; Fabbri, Leonardo; Froguel, Philippe; Galas, David; Gojobori, Takashi; Hunter, Peter; Jorgensen, Christian; Kauffmann, Francine; Kourilsky, Philippe; Kowalski, Marek L.; Lancet, Doron; Pen, Claude Le; Mallet, Jacques; Mayosi, Bongani; Mercier, Jacques; Metspalu, Andres; Nadeau, Joseph H.; Ninot, Grégory; Noble, Denis; Oztürk, Mehmet; Palkonen, Susanna; Préfaut, Christian; Rabe, Klaus; Renard, Eric; Roberts, Richard G.; Samolinski, Boleslav; Schünemann, Holger J.; Simon, Hans-Uwe; Soares, Marcelo Bento; Superti-Furga, Giulio; Tegner, Jesper; Verjovski-Almeida, Sergio; Wellstead, Peter; Wolkenhauer, Olaf; Wouters, Emiel; Balling, Rudi; Brookes, Anthony J.; Charron, Dominique; Pison, Christophe; Chen, Zhu; Hood, Leroy; Auffray, Charles

    2011-01-01

    ABSTRACT: We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st

  18. Integrating Complementary and Alternative Medicine Into Conventional Health Care System in Developing Countries

    DEFF Research Database (Denmark)

    Mishra, Shiva Raj; Neupane, Dinesh; Kallestrup, Per

    2015-01-01

    Complementary and alternative medicine has been a part of human life and practices since the beginning of time. The role of complementary and alternative medicine for the health of humans is undisputed particularly in light of its role in health promotion and well-being. This article discusses wa...... through which complementary and alternative medicine can be promoted and sustained as an integrated element of health care in developing countries. We specifically present the exemplary of Amchi traditional doctors of Northern Himalayas......Complementary and alternative medicine has been a part of human life and practices since the beginning of time. The role of complementary and alternative medicine for the health of humans is undisputed particularly in light of its role in health promotion and well-being. This article discusses ways...

  19. Pim1 kinase is upregulated in glioblastoma multiforme and mediates tumor cell survival

    Science.gov (United States)

    Herzog, Susann; Fink, Matthias Alexander; Weitmann, Kerstin; Friedel, Claudius; Hadlich, Stefan; Langner, Sönke; Kindermann, Katharina; Holm, Tobias; Böhm, Andreas; Eskilsson, Eskil; Miletic, Hrvoje; Hildner, Markus; Fritsch, Michael; Vogelgesang, Silke; Havemann, Christoph; Ritter, Christoph Alexander; Meyer zu Schwabedissen, Henriette Elisabeth; Rauch, Bernhard; Hoffmann, Wolfgang; Kroemer, Heyo Klaus; Schroeder, Henry; Bien-Möller, Sandra

    2015-01-01

    Background The current therapy for glioblastoma multiforme (GBM), the most aggressive and common primary brain tumor of adults, involves surgery and a combined radiochemotherapy that controls tumor progression only for a limited time window. Therefore, the identification of new molecular targets is highly necessary. Inhibition of kinases has become a standard of clinical oncology, and thus the oncogenic kinase Pim1 might represent a promising target for improvement of GBM therapy. Methods Expression of Pim1 and associated signaling molecules was analyzed in human GBM samples, and the potential role of this kinase in patients' prognosis was evaluated. Furthermore, we analyzed the in vivo role of Pim1 in GBM cell growth in an orthotopic mouse model and examined the consequences of Pim1 inhibition in vitro to clarify underlying pathways. Results In comparison with normal brain, a strong upregulation of Pim1 was demonstrated in human GBM samples. Notably, patients with short overall survival showed a significantly higher Pim1 expression compared with GBM patients who lived longer than the median. In vitro experiments with GBM cells and analysis of patients' GBM samples suggest that Pim1 regulation is dependent on epidermal growth factor receptor. Furthermore, inhibition of Pim1 resulted in reduced cell viability accompanied by decreased cell numbers and increased apoptotic cells, as seen by elevated subG1 cell contents and caspase-3 and -9 activation, as well as modulation of several cell cycle or apoptosis regulatory proteins. Conclusions Altogether, Pim1 could be a novel therapeutic target, which should be further analyzed to improve the outcome of patients with aggressive GBM. PMID:25155357

  20. KSHV encoded LANA upregulates Pim-1 and is a substrate for its kinase activity

    International Nuclear Information System (INIS)

    Bajaj, Bharat G.; Verma, Subhash C.; Lan, Ke; Cotter, Murray A.; Woodman, Zenda L.; Robertson, Erle S.

    2006-01-01

    Pim kinases are proto-oncogenes that are upregulated in a number of B cell cancers, including Epstein-Barr Virus (EBV) associated Burkitt's lymphoma. They have also been shown to be upregulated in Kaposi sarcoma-associated herpes virus (KSHV) infected primary B cells. Most cells in KSHV-associated tumors are latently infected and express only a small subset of viral genes, with KSHV latency associated nuclear antigen (LANA) being constitutively expressed. LANA regulates the transcription of a large number of cellular and viral genes. Here, we show that LANA upregulates transcription from the Pim-1 promoter (pPim-1) and map this activation to a region in the promoter located within the sequence (-681 to +37). We show that LANA expressing cells can proliferate faster and are better protected from drug induced apoptosis. Since transition through cell cycle check points and anti-apoptosis are functions associated with Pim-1, it is likely that higher Pim-1 expression in cells expressing LANA is responsible, at least in part, for this effect. A Pim-1 phosphorylation site was also identified within the amino-terminal domain of LANA. Using in vitro kinase assays, we confirmed that LANA was indeed a Pim-1 substrate, and the failure of Pim-1 to phosphorylate LANA mutated at SS205/6RR identified this site as the specific serine residues phosphorylated by Pim-1. This report provides valuable insight into yet another cellular signaling pathway subverted by KSHV LANA and suggests a contribution to KSHV related oncogenesis

  1. Human CD180 Transmits Signals via the PIM-1L Kinase.

    Directory of Open Access Journals (Sweden)

    Nicole Egli

    Full Text Available Toll-like receptors (TLRs are important sensors of the innate immune system that recognize conserved structural motifs and activate cells via a downstream signaling cascade. The CD180/MD1 molecular complex is an unusual member of the TLR family, since it lacks the components that are normally required for signal transduction by other TLRs. Therefore the CD180/MD 1 complex has been considered of being incapable of independently initiating cellular signals. Using chemogenetic approaches we identified specifically the membrane bound long form of PIM-1 kinase, PIM-1L as the mediator of CD180-dependent signaling. A dominant negative isoform of PIM-1L, but not of other PIM kinases, inhibited signaling elicited by cross-linking of CD180, and this effect was phenocopied by PIM inhibitors. PIM-1L was directed to the cell membrane by its N-terminal extension, where it colocalized and physically associated with CD180. Triggering CD180 also induced increased phosphorylation of the anti-apoptotic protein BAD in a PIM kinase-dependent fashion. Also in primary human B cells, which are the main cells expressing CD180 in man, cross-linking of CD180 by monoclonal antibodies stimulated cell survival and proliferation that was abrogated by specific inhibitors. By associating with PIM-1L, CD180 can thus obtain autonomous signaling capabilities, and this complex is then channeling inflammatory signals into B cell survival programs. Pharmacological inhibition of PIM-1 should therefore provide novel therapeutic options in diseases that respond to innate immune stimulation with subsequently increased B cell activity, such as lupus erythematosus or myasthenia gravis.

  2. What does «integrative medicine» provide to daily scientific clinical care?

    Science.gov (United States)

    Bataller-Sifre, R; Bataller-Alberola, A

    2015-11-01

    Integrative medicine is an ambitious and noble-minded attempt to address the shortcomings of the current public health systems in our Western societies, which is restricted by the limited time available, especially in outpatient clinics. Integrative medicine also does not limit the possibilities of useful therapies that have been tested over the centuries (from China, India, etc.) or of certain resources that do not achieve the level of desired scientific credibility but that present certain therapeutic support in specific cases (homeopathy, acupuncture, etc.) but still require a scientific approach. Finally, the resource of botanical products (phytotherapy) constitutes a wide range of possibilities that universities can (and do) make progress on by providing drug brands for these products through the use of the scientific method and evidence-based medical criteria. This approach will help avoid the irrationality of the daily struggle between conventional scientific medicine (which we apply to the immense majority of patients) and the other diagnostic-therapeutic «guidelines» (natural medicine, alternative medicine, complementary medicine, patient-focused medicine and others). Copyright © 2015. Published by Elsevier España, S.L.U.

  3. Integrated Health Care Systems and Indigenous Medicine: Reflections from the Sub-Sahara African Region

    Directory of Open Access Journals (Sweden)

    Beth Maina Ahlberg

    2017-09-01

    Full Text Available Indigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to contribute to strengthening the health care systems in low income countries. This paper examines the state of traditional medicine using evidence from three case studies in Central Kenya. While the cases are too few to represent the broad diversity of cultures and related healing systems in the Sub-Sahara African Region, the way they seem to refute the main assumptions in the integration discourse is important, also because studies from other countries in the region report perspectives, similar to the case studies in Kenya. It is often argued that people continue to use traditional medicine because it is affordable, available, and culturally familiar. Its integration into the health care system would therefore promote cultural familiarity. The case studies however point to the loss of essential cultural elements central to traditional medicine in this particular area while users travel long distances to reach the healers. In addition, there are significant paradigm differences that may present obstacles to integration of the two systems. More problematic however is that integration is, as in many development interventions, a top-down policy that is rarely based on contextual realities and conditions. Instead, integration is often defined and dominated by biomedical professionals and health planners who may be unfamiliar or even hostile to some aspects of traditional medicine. Furthermore, integration efforts have tended to embrace selected components mostly herbal medicine. This has led to isolating herbal medicine from spiritualism, which may in turn affect the holistic perspective of traditional medicine. While familiarity and relevance may explain the continued use of traditional medicine, its services may not be as readily available, accessible, or even affordable as is often asserted. Globalization set in motion through colonization and

  4. The value of Avicenna's heritage in development of modern integrative medicine in Uzbekistan

    Directory of Open Access Journals (Sweden)

    Dilfuza Djamaldinovna Buranova

    2015-12-01

    Full Text Available The heritage of Abu Ali al-Husayn ibn Abd Allah ibn Sina (known in Europe as Avicenna, hereinafter referred to as Avicenna; around 980-1037 cehas been used in the practice of doctors of various specialties in the treatment of various diseases for many centuries. Extensive clinical experience accumulated over a long time is actively used in modern medicine. Avicenna has had an invaluable contribution to world medicine. He is the largest representative of advanced sociohumanitarian ideas among the peoples of Central Asia. He was a philosopher and physician, scientist and mathematician, poet, and specialist in literature. The rich heritage of the scientist takes a worthy place in the history of medicine in particular, and world civilization in general. Avicenna introduced the main contribution to the treasury of the universal culture by his work in medicine. Avicenna brought together the achievements of Hippocrates (c. 460-370 bce,Galen (c. 130-200 ce,and healers of Egypt, Persia, and India, and he supplemented them with own research results, brilliant discoveries, and hypotheses. Avicenna left many works, among them the especially popular Canon of Medicine. He paid great attention to the prevention of diseases rather than their treatment, which is important today. In his works he gives advice on the use of herbal medicines and biologically active points for various diseases. This article highlights some topical issues of multifaceted heritage of Avicenna for modern medicine and identified promising areas for the development of integrative medicine in Uzbekistan.

  5. Ethnopharmacology and integrative medicine - Let the history tell the future

    Directory of Open Access Journals (Sweden)

    Pulok K Mukherjee

    2010-01-01

    Full Text Available Traditional systems of medicines need more evidence-based studies on both crude drugs and purified phytomolecules. Utilization of natural products as pharmacological tools could lead to a number of new major therapeutically active metabolites. Lead molecules are further screened for their potential in terms of quality control, safety assessments, and studies about molecular pharmacology and their related properties. Identification, and quality and safety evaluation of natural products, is a fundamental requirement of industry and other organizations dealing with natural health products (NHPs. Marker analysis, based on chemo-profiling and development of characteristic fingerprints for individual plants, could help to develop uniform standardization tools. Beside such evaluations of clinical parameters, safety profiles as well as drug-herb and herb-herb interactions are the most important parameters for assessment and promotion. With the steady growth of the NHPs, advanced analytical- and mechanism-based screening should be considered for their promotion and value addition in every way for the betterment of healthcare. Thus, there is an urgent need for the development of international co-ordination to promote and develop NHPs, including their assessment, perspectives, pharmacovigilance, and potential harmonization of regulation, quality control and clinical uses.

  6. Elderly patient refractory to multiple pain medications successfully treated with integrative East–West medicine

    Directory of Open Access Journals (Sweden)

    Bill Tu

    2008-07-01

    Full Text Available Bill Tu, Michael Johnston, Ka-Kit HuiUCLA Center for East–West Medicine, Department of Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USABackground: Polypharmacy is a common and serious problem in the elderly today. Few solutions have been effective in reducing its incidence.Case summary: An 87-year-old female with a history of osteoarthritis and spinal stenosis presented with a five month history of severe right hip pain. She had been seen by multiple specialists and hospitalized many times. During these encounters, she was prescribed a long list of pain medications. However, these medications did not improve her pain and added to her risk of adverse drug events. After exhausting traditional Western medical therapies, she received a referral to the UCLA Center for East–West Medicine. There, clinicians treated her with a nonpharmacological integrative East-West medicine approach that included acupuncture, dry needling of trigger points, and education on self-acupressure. Her pain began improving and she was able to cut back on analgesic use under physician supervision. Ultimately, she improved to the point where she was able to discontinue all of her pain medications. Symptomatic relief was evidenced by improvement in health-related quality of life (HRQOL.Conclusions: This case study suggests that integrative East–West medicine may have the potential to reduce the incidence of polypharmacy in elderly patients presenting with pain conditions and improve their quality of life.Keywords: polypharmacy, pain, osteoarthritis, acupuncture, complementary and alternative medicine, integrative medicine, adverse drug reaction, elderly

  7. Efektivitas Layanan Weekend Banking (Studi BMI KCP PIM .

    Directory of Open Access Journals (Sweden)

    Rifa Farhah

    2014-01-01

    Full Text Available The Effectiveness of Weekend Banking Services (Study at BMI KCP PIM. The aim of this research is to analyze the effectiveness of weekend banking services at Bank Muamalat Indonesia. The method that used in this research is linier regression and. The result shown that the value of adjusted R-squared was 0.313409. It means that customer’s preference (dependent variable was influenced by location, brand image, and, product and services in the amount of 31.34% and the others 68.66% was influenced by the others factor. From the paired sample t-test shown that the weekend banking services still not effective to increase the third party funds  DOI:10.15408/aiq.v6i1.1370

  8. HiPIMS goes production, actual status and outlook

    International Nuclear Information System (INIS)

    Lemmer, Oliver; Kölker, Werner; Bolz, Stephan; Schiffers, Christoph

    2012-01-01

    Hardness, toughness, and adhesion are today among the most important characteristics of PVD (Physical Vapor Deposition) coatings for machining tools that are used for highly demanding hard, high-speed, and dry machining. The continued development and improvement of materials constantly creates new and more demanding challenges for machining tools. In particular, materials that are especially hard or difficult to machine, materials that are prone to stress hardening, and materials with low heat conductivity require coatings with high thermal and oxidation stability in addition to the properties already mentioned. With a view to these properties, the new HiPIMS technology is currently being used to develop a new generation of coatings with significantly improved properties compared to conventional coatings. They are able to process hard-to-machine materials such as nickel-based alloys and stainless austenitic steels at lower costs – with comparatively significantly improved machining parameters and considerably less tool wear.

  9. Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

    Science.gov (United States)

    Vogt, Henrik; Ulvestad, Elling; Eriksen, Thor Eirik; Getz, Linn

    2014-12-01

    The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense. © 2014 The Authors. Journal of Evaluation in Clinical

  10. [On the relationship of psychosomatic and mind-body medicine: integrative, complementary or alternative disciplines within an evolutionary approach?].

    Science.gov (United States)

    Brunnhuber, Stefan; Michalsen, Andreas

    2012-01-01

    The text outlines the relation between psychosomatic medicine as an established medical discipline and the emerging concept of mind-body medicine from a historical, clinical and epistemological perspective. Limitations and contributions of both disciplines are discussed and the opportunities within the concept of Integrative Medicine are outlined. Whereas psychosomatic medicine is perceived as a form of transformation through a primarily verbal discoursive relationship, mind-body medicine claims healing through increased traditional techniques of the relaxation response, increased awareness, mindfulness, increasing des-identification and health-promoting lifestyle modification. It becomes clear that mind-body medicine seems to be epistemologically the broader theoretical framework, whereas in a clinical context the combination of both disciplines appears to be complementary and synergistic. The connection between psychosomatic medicine and mind-body medicine can make an important and exemplary contribution to the concept of Integrative Medicine. Copyright © 2012 S. Karger AG, Basel.

  11. The evolution of integration: innovations in clinical skills and ethics in first year medicine.

    Science.gov (United States)

    Brunger, Fern; Duke, Pauline S

    2012-01-01

    Critical self-reflection, medical ethics and clinical skills are each important components of medical education but are seldom linked in curriculum development. We developed a curriculum that builds on the existing integration of ethics education into the clinical skills course to more explicitly link these three skills. The curriculum builds on the existing integration of clinical skills and ethics in first year medicine. It refines the integration through scheduling changes; adds case studies that emphasise the social, economic and political context of our province's patient population; and introduces reflection on the "culture of medicine" as a way to have students articulate and understand their own values and moral decision making frameworks. This structured Clinical Skills course is a model for successfully integrating critical self-reflection, reflection on the political, economic and cultural contexts shaping health and healthcare, and moral decision making into clinical skills training.

  12. Integration of PACS and HIS info the workflow of a nuclear medicine department. Experience in Regensburg

    International Nuclear Information System (INIS)

    Maenner, P.; Fuchs, E.; Marienhagen, J.; Schoenberger, J.; Eilles, C.; Tege, B.; Reicherzer, H.G.; Kurz, M.; Boerner, W.

    2006-01-01

    Aim: the development of new diagnostic techniques and the implementation of a modern quality control management system requires the continuous adaptation of existing data processing tools to the nuclear medicine diagnostic workflow. Furthermore, PACS connected to HIS facilitates and enhances the transfer of data and pictures, and satisfies the legal requirements for data retention as regulated by law. Therefore, the aim of this work is to present the architecture, structure and results of such a system newly installed in a department of nuclear medicine. Methods: initially, the nuclear medicine workflow was carefully analyzed and each step was correlated to the corresponding module. The standard SAP R/3 and IS-H / IS-H*med based software used for patient administration at the University of Regensburg Hospital was adapted to the needs of the Nuclear Medicine Department. The networking of the imaging systems was done by integration of a PACS. Finally, the PACS was connected to the HIS to allow the attachment of images to the medical report. Results, conclusion: by connecting the HIS to the nuclear medicine PACS, the workflow was significantly improved. The data management sequence starting at the reception desk, continuing through the nuclear medical examination, to the physician's final written and image report is clearly structured. Although high demands exist on technical support and administration the integration of PACS and HIS into the nuclear medicine workflow leads to enhanced efficiency and reduction in hospital costs. Patient and data management are considerably improved in this way. (orig.)

  13. Pim-2 activates API-5 to inhibit the apoptosis of hepatocellular carcinoma cells through NF-kappaB pathway.

    Science.gov (United States)

    Ren, Ke; Zhang, Wei; Shi, Yujun; Gong, Jianping

    2010-06-01

    Pim-2 is proved to be relevant to the tumorigenesis of hepatocellular carcinoma (HCC), but the mechanism is unclear. We studied the relationship among Pim-2, NF-kappaB and API-5. In our experiment, expression level of the three factors and phosphorylation level of API-5, as well as NF-kappaB activity, were detected in HCC tissues and the nontumorous controls. Then Pim-2 gene was transfected into nontumorous liver cells L02, and Pim-2 SiRNA was transfected into hepatoblastoma cell line HepG2. Parthenolide was added as NF-kappaB inhibitor. The same detections as above were repeated in the cells, along with the apoptosis analysis. We found the levels of Pim-2, NF-kappaB and API-5, as well as NF-kappaB activity, were significantly higher in HCC tissues. Pim-2 level was increased in L02 cells after the transfection of Pim-2 gene, but decreased in HepG2 cells after the transfection of Pim-2 SiRNA. The levels of NF-kappaB and API-5, as well as NF-kappaB activity and API-5 phosphorylation level, were in accordance with Pim-2 level, but could be reversed by Parthenolide. Cell apoptosis rates were negatively correlated with API-5 phosphorylation level. Therefore, we infer that Pim-2 could activate API-5 to inhibit the apoptosis of liver cells, and NF-kappaB is the key regulator.

  14. P06.01. Survey of Business and Care Models of Integrative Medicine

    OpenAIRE

    MacElhern, Lauray; Carter, Susan

    2013-01-01

    Focus Areas: Sustainable Business Models In 2012, the business sub-committee of the clinical working group for the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) launched a pilot survey to collect information about the structure and business models of the member integrative centers. Although the survey provided useful insight into the business operations and financial resources needed to start up a center, the survey needed a better design and response rate. The 2013 ...

  15. Pim kinases phosphorylate multiple sites on Bad and promote 14-3-3 binding and dissociation from Bcl-XL

    Directory of Open Access Journals (Sweden)

    Hastie C James

    2006-01-01

    Full Text Available Abstract Background Pim-1, 2 and 3 are a group of enzymes related to the calcium calmodulin family of protein kinases. Over-expression of Pim-1 and Pim-2 in mice promotes the development of lymphomas, and up-regulation of Pim expression has been observed in several human cancers. Results Here we show that the pim kinases are constitutively active when expressed in HEK-293 cells and are able to phosphorylate the Bcl-2 family member Bad on three residues, Ser112, Ser136 and Ser155 in vitro and in cells. In vitro mapping showed that Pim-2 predominantly phosphorylated Ser112, while Pim-1 phosphorylated Ser112, but also Ser136 and Ser155 at a reduced rate compared to Ser112. Pim-3 was found to be the least specific for Ser112, and the most effective at phosphorylating Ser136 and Ser155. Pim-3 was also able to phosphorylate other sites in Bad in vitro, including Ser170, another potential in vivo site. Mutation of Ser136 to alanine prevented the phosphorylation of Ser112 and Ser155 by Pim kinases in HEK-293 cells, suggesting that this site must be phosphorylated first in order to make the other sites accessible. Pim phosphorylation of Bad was also found to promote the 14-3-3 binding of Bad and block its association with Bcl-XL. Conclusion All three Pim kinase family members predominantly phosphorylate Bad on Ser112 and in addition are capable of phosphorylating Bad on multiple sites associated with the inhibition of the pro-apoptotic function of Bad in HEK-293 cells. This would be consistent with the proposed function of Pim kinases in promoting cell proliferation and preventing cell death.

  16. Application of plutonium inventory measurement system (PIMS) and temporary canister verification system (TCVS) at RRP

    International Nuclear Information System (INIS)

    Noguchi, Yoshihiko; Nakamura, Hironobu; Adachi, Hideto; Iwamoto, Tomonori

    2004-01-01

    In U-Pu co-denitration area at Rokkasho Reprocessing Plant (RRP), Plutonium Inventory Measurement System (PIMS) and Temporary Canister Verification System (TCVS) are installed to provide efficient and effective safeguards. PIMS measures Pu quantity inside pipes and vessels installed in glove boxes by total neutron counting method. PIMS consists of total 142 neutron detector attached on the wall and top of glove boxes and neutron count rates of each detectors are related to each other to calculate Pu quantity of each process areas. In this moment, inactive calibration using Cf-source was completed. On the other hand, TCVS measures Pu quantity of canisters inside temporary storage by coincidence counting method and it will be installed before the active test. These systems have monitoring function as additional measures. This paper describes specification, performance and measurement principles of PIMS and TCVS. (author)

  17. Bahamas Sea Water Temperature Data 1988-2003, PIMS Environmental Monitoring Program

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This metadata record references seawater temperature data collected at various sites and depths in the vicinity of PIMS research station on Lee Stocking Island,...

  18. In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

    Directory of Open Access Journals (Sweden)

    Andreas Michalsen

    2013-01-01

    Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

  19. Developing an integrated evidence-based medicine curriculum for family medicine residency at the University of Alberta.

    Science.gov (United States)

    Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna

    2008-06-01

    There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.

  20. Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

    Science.gov (United States)

    Oshman, Lauren D; Combs, Gene N

    2016-05-01

    Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

  1. The integration of chiropractors into healthcare teams: a case study from sport medicine.

    Science.gov (United States)

    Theberge, Nancy

    2008-01-01

    This article examines the integration of chiropractors into multi-disciplinary healthcare teams in the specialisation of sport medicine. Sport medicine is practised in a number of contexts in professional and amateur sport. The current analysis focuses on the highest levels of amateur sport, as exemplified by the Olympics. Data are taken from interviews with 35 health professionals, including physicians, physiotherapists, athletic therapists and chiropractors. A defining feature of sport medicine is an emphasis on performance, which is the basis for a client-centred model of practice. These two elements have provided the main grounds for the inclusion of chiropractic in sport medicine. While the common understanding that 'athletes wanted them' has helped to secure a position for chiropractic within the system of sport medicine professions, this position is marked by ongoing tensions with other professions over the scope and content of practice, and the nature of the patient-practitioner relationship. In the context of these tensions, chiropractors' success in achieving acceptance on sport medicine teams is contingent on two factors: (a) reduced scope of practice in which they work primarily as manual therapists; and (b) the exemplary performance of individual practitioners who 'fit' into multi-disciplinary sport medicine teams.

  2. [Clinical study of integrative medicine in treatment of nephropathy: strategy and innovation].

    Science.gov (United States)

    Chen, Yi-Ping

    2008-05-01

    The author analyzed the main issues in current clinical study of integrative medicine in treatment of renal diseases, and proposed the target-oriented strategy for clinical study of different renal diseases, emphasizing the importance of method improvement for academic innovation.

  3. Using Integrative Medicine in Pain Management: An Evaluation of Current Evidence.

    Science.gov (United States)

    Lin, Yuan-Chi; Wan, Limeng; Jamison, Robert N

    2017-12-01

    Complementary medicine therapies are frequently used to treat pain conditions such as headaches and neck, back, and joint pain. Chronic pain, described as pain lasting longer than 3-6 months, can be a debilitating condition that has a significant socioeconomic impact. Pharmacologic approaches are often used for alleviating chronic pain, but recently there has been a reluctance to prescribe opioids for chronic noncancer pain because of concerns about tolerance, dependence, and addiction. As a result, there has been increased interest in integrative medicine strategies to help manage pain and to reduce reliance on prescription opioids to manage pain. This article offers a brief critical review of integrative medical therapies used to treat chronic pain, including nutritional supplements, yoga, relaxation, tai chi, massage, spinal manipulation, and acupuncture. The goal of this article is to identify those treatments that show evidence of efficacy and to identify gaps in the literature where additional studies and controlled trials are needed. An electronic search of the databases of PubMed, The Cochrane Library, EMBASE, PsycINFO, and Science Citation Index Expanded was conducted. Overall, weak positive evidence was found for yoga, relaxation, tai chi, massage, and manipulation. Strong evidence for acupuncture as a complementary treatment for chronic pain that has been shown to decrease the usage of opioids was found. Few studies were found in which integrative medicine approaches were used to address opioid misuse and abuse among chronic pain patients. Additional controlled trials to address the use of integrative medicine approaches in pain management are needed.

  4. Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

    Science.gov (United States)

    Yang, Jing; Huang, Si-min; Li, Ze-jian; Feng, Lie; Lu, Chun-ting

    2018-01-01

    Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine. Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a…

  5. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  6. Integration of molecular pathology, epidemiology and social science for global precision medicine.

    Science.gov (United States)

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L; Nishihara, Reiko; Tan, Andy S; Kawachi, Ichiro; Ogino, Shuji

    2016-01-01

    The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science.

  7. Overcoming Resistance to Inhibitors of the Akt Protein Kinase by Modulation of the Pim Kinase Pathway

    Science.gov (United States)

    2017-01-01

    v e V ia b il it y Figure 8. PC3-LN4 cells in normoxia or hypoxia were treated with Pim inhibitors. Left panel shows a Western blot and the...3728-36, PMID 25241892 4. Warfel, NA, Kraft, AS. Pim kinase (and Akt) biology and signaling in tumors. Pharmacol Ther. 2015 Jul; 151: 41 - 9. doi: 10.1016...Associated Fibroblast Biology in Prostate Cancer These studies will accelerate and significantly advance the rational development of targeted agents

  8. Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study.

    Science.gov (United States)

    Nakau, Maiko; Imanishi, Jiro; Imanishi, Junichi; Watanabe, Satoko; Imanishi, Ayumi; Baba, Takeshi; Hirai, Kei; Ito, Toshinori; Chiba, Wataru; Morimoto, Yukihiro

    2013-01-01

    Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment. The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention. In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased. It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Azide-based cross-linking of polymers of intrinsic microporosity (PIMs) for condensable gas separation

    KAUST Repository

    Du, Naiying; Dal-Cin, Mauro M D; Pinnau, Ingo; Nicalek, Andrzej; Robertson, Gilles P.; Guiver, Michael D.

    2011-01-01

    Cross-linked polymers of intrinsic microporosity (PIM)s for gas separation membranes, were prepared by a nitrene reaction from a representative PIM in the presence of two different diazide cross-linkers. The reaction temperature was optimized using TGA. The homogenous membranes were cast from THF solutions of different ratios of PIM to azides. The resulting cross-linked structures of the PIMs membranes were formed at 175 °C after 7.5 h and confirmed by TGA, XPS, FT-IR spectroscopy and gel content analysis. These resulting cross-linked polymeric membranes showed excellent gas separation performance and can be used for O 2/N 2 and CO 2/N 2 gas pairs, as well as for condensable gases, such as CO 2/CH 4, propylene/propane separation. Most importantly, and differently from typical gas separation membranes derived from glassy polymers, the crosslinked PIMs showed no obvious CO 2 plasticization up to 20 atm pressure of pure CO 2 and CO 2/CH 4 mixtures. © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. The putative oncogene Pim-1 in the mouse: its linkage and variation among t haplotypes.

    Science.gov (United States)

    Nadeau, J H; Phillips, S J

    1987-11-01

    Pim-1, a putative oncogene involved in T-cell lymphomagenesis, was mapped between the pseudo-alpha globin gene Hba-4ps and the alpha-crystallin gene Crya-1 on mouse chromosome 17 and therefore within the t complex. Pim-1 restriction fragment variants were identified among t haplotypes. Analysis of restriction fragment sizes obtained with 12 endonucleases demonstrated that the Pim-1 genes in some t haplotypes were indistinguishable from the sizes for the Pim-1b allele in BALB/c inbred mice. There are now three genes, Pim-1, Crya-1 and H-2 I-E, that vary among independently derived t haplotypes and that have indistinguishable alleles in t haplotypes and inbred strains. These genes are closely linked within the distal inversion of the t complex. Because it is unlikely that these variants arose independently in t haplotypes and their wild-type homologues, we propose that an exchange of chromosomal segments, probably through double crossingover, was responsible for indistinguishable Pim-1 genes shared by certain t haplotypes and their wild-type homologues. There was, however, no apparent association between variant alleles of these three genes among t haplotypes as would be expected if a single exchange introduced these alleles into t haplotypes. If these variant alleles can be shown to be identical to the wild-type allele, then lack of association suggests that multiple exchanges have occurred during the evolution of the t complex.

  11. Azide-based cross-linking of polymers of intrinsic microporosity (PIMs) for condensable gas separation

    KAUST Repository

    Du, Naiying

    2011-03-11

    Cross-linked polymers of intrinsic microporosity (PIM)s for gas separation membranes, were prepared by a nitrene reaction from a representative PIM in the presence of two different diazide cross-linkers. The reaction temperature was optimized using TGA. The homogenous membranes were cast from THF solutions of different ratios of PIM to azides. The resulting cross-linked structures of the PIMs membranes were formed at 175 °C after 7.5 h and confirmed by TGA, XPS, FT-IR spectroscopy and gel content analysis. These resulting cross-linked polymeric membranes showed excellent gas separation performance and can be used for O 2/N 2 and CO 2/N 2 gas pairs, as well as for condensable gases, such as CO 2/CH 4, propylene/propane separation. Most importantly, and differently from typical gas separation membranes derived from glassy polymers, the crosslinked PIMs showed no obvious CO 2 plasticization up to 20 atm pressure of pure CO 2 and CO 2/CH 4 mixtures. © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Mixed Matrix Membranes of Boron Icosahedron and Polymers of Intrinsic Microporosity (PIM-1) for Gas Separation.

    Science.gov (United States)

    Khan, Muntazim Munir; Shishatskiy, Sergey; Filiz, Volkan

    2018-01-02

    This work reports on the preparation and gas transport performance of mixed matrix membranes (MMMs) based on the polymer of intrinsic microporosity (PIM-1) and potassium dodecahydrododecaborate (K₂B 12 H 12 ) as inorganic particles (IPs). The effect of IP loading on the gas separation performance of these MMMs was investigated by varying the IP content (2.5, 5, 10 and 20 wt %) in a PIM-1 polymer matrix. The derived MMMs were characterized by scanning electron microscopy (SEM), thermogravimetric analysis (TGA), single gas permeation tests and sorption measurement. The PIM1/K₂B 12 H 12 MMMs show good dispersion of the IPs (from 2.5 to 10 wt %) in the polymer matrix. The gas permeability of PIM1/K₂B 12 H 12 MMMs increases as the loading of IPs increases (up to 10 wt %) without sacrificing permselectivity. The sorption isotherm in PIM-1 and PIM1/K₂B 12 H 12 MMMs demonstrate typical dual-mode sorption behaviors for the gases CO₂ and CH₄.

  13. Synthesis and Transport Properties of Novel MOF/PIM-1/MOF Sandwich Membranes for Gas Separation.

    Science.gov (United States)

    Fuoco, Alessio; Khdhayyer, Muhanned R; Attfield, Martin P; Esposito, Elisa; Jansen, Johannes C; Budd, Peter M

    2017-02-11

    Metal-organic frameworks (MOFs) were supported on polymer membrane substrates for the fabrication of composite polymer membranes based on unmodified and modified polymer of intrinsic microporosity (PIM-1). Layers of two different MOFs, zeolitic imidazolate framework-8 (ZIF-8) and Copper benzene tricarboxylate ((HKUST-1), were grown onto neat PIM-1, amide surface-modified PIM-1 and hexamethylenediamine (HMDA) -modified PIM-1. The surface-grown crystalline MOFs were characterized by a combination of several techniques, including powder X-ray diffraction, infrared spectroscopy and scanning electron microscopy to investigate the film morphology on the neat and modified PIM-1 membranes. The pure gas permeabilities of He, H₂, O₂, N₂, CH₄, CO₂ were studied to understand the effect of the surface modification on the basic transport properties and evaluate the potential use of these membranes for industrially relevant gas separations. The pure gas transport was discussed in terms of permeability and selectivity, highlighting the effect of the MOF growth on the diffusion coefficients of the gas in the new composite polymer membranes. The results confirm that the growth of MOFs on polymer membranes can enhance the selectivity of the appropriately functionalized PIM-1, without a dramatic decrease of the permeability.

  14. Enhancement of myocardial regeneration through genetic engineering of cardiac progenitor cells expressing Pim-1 kinase.

    Science.gov (United States)

    Fischer, Kimberlee M; Cottage, Christopher T; Wu, Weitao; Din, Shabana; Gude, Natalie A; Avitabile, Daniele; Quijada, Pearl; Collins, Brett L; Fransioli, Jenna; Sussman, Mark A

    2009-11-24

    Despite numerous studies demonstrating the efficacy of cellular adoptive transfer for therapeutic myocardial regeneration, problems remain for donated cells with regard to survival, persistence, engraftment, and long-term benefits. This study redresses these concerns by enhancing the regenerative potential of adoptively transferred cardiac progenitor cells (CPCs) via genetic engineering to overexpress Pim-1, a cardioprotective kinase that enhances cell survival and proliferation. Intramyocardial injections of CPCs overexpressing Pim-1 were given to infarcted female mice. Animals were monitored over 4, 12, and 32 weeks to assess cardiac function and engraftment of Pim-1 CPCs with echocardiography, in vivo hemodynamics, and confocal imagery. CPCs overexpressing Pim-1 showed increased proliferation and expression of markers consistent with cardiogenic lineage commitment after dexamethasone exposure in vitro. Animals that received CPCs overexpressing Pim-1 also produced greater levels of cellular engraftment, persistence, and functional improvement relative to control CPCs up to 32 weeks after delivery. Salutary effects include reduction of infarct size, greater number of c-kit(+) cells, and increased vasculature in the damaged region. Myocardial repair is significantly enhanced by genetic engineering of CPCs with Pim-1 kinase. Ex vivo gene delivery to enhance cellular survival, proliferation, and regeneration may overcome current limitations of stem cell-based therapeutic approaches.

  15. Synthesis and Transport Properties of Novel MOF/PIM-1/MOF Sandwich Membranes for Gas Separation

    Directory of Open Access Journals (Sweden)

    Alessio Fuoco

    2017-02-01

    Full Text Available Metal-organic frameworks (MOFs were supported on polymer membrane substrates for the fabrication of composite polymer membranes based on unmodified and modified polymer of intrinsic microporosity (PIM-1. Layers of two different MOFs, zeolitic imidazolate framework-8 (ZIF-8 and Copper benzene tricarboxylate ((HKUST-1, were grown onto neat PIM-1, amide surface-modified PIM-1 and hexamethylenediamine (HMDA -modified PIM-1. The surface-grown crystalline MOFs were characterized by a combination of several techniques, including powder X-ray diffraction, infrared spectroscopy and scanning electron microscopy to investigate the film morphology on the neat and modified PIM-1 membranes. The pure gas permeabilities of He, H2, O2, N2, CH4, CO2 were studied to understand the effect of the surface modification on the basic transport properties and evaluate the potential use of these membranes for industrially relevant gas separations. The pure gas transport was discussed in terms of permeability and selectivity, highlighting the effect of the MOF growth on the diffusion coefficients of the gas in the new composite polymer membranes. The results confirm that the growth of MOFs on polymer membranes can enhance the selectivity of the appropriately functionalized PIM-1, without a dramatic decrease of the permeability.

  16. Synthesis and Transport Properties of Novel MOF/PIM-1/MOF Sandwich Membranes for Gas Separation

    Science.gov (United States)

    Fuoco, Alessio; Khdhayyer, Muhanned R.; Attfield, Martin P.; Esposito, Elisa; Jansen, Johannes C.; Budd, Peter M.

    2017-01-01

    Metal-organic frameworks (MOFs) were supported on polymer membrane substrates for the fabrication of composite polymer membranes based on unmodified and modified polymer of intrinsic microporosity (PIM-1). Layers of two different MOFs, zeolitic imidazolate framework-8 (ZIF-8) and Copper benzene tricarboxylate ((HKUST-1), were grown onto neat PIM-1, amide surface-modified PIM-1 and hexamethylenediamine (HMDA) -modified PIM-1. The surface-grown crystalline MOFs were characterized by a combination of several techniques, including powder X-ray diffraction, infrared spectroscopy and scanning electron microscopy to investigate the film morphology on the neat and modified PIM-1 membranes. The pure gas permeabilities of He, H2, O2, N2, CH4, CO2 were studied to understand the effect of the surface modification on the basic transport properties and evaluate the potential use of these membranes for industrially relevant gas separations. The pure gas transport was discussed in terms of permeability and selectivity, highlighting the effect of the MOF growth on the diffusion coefficients of the gas in the new composite polymer membranes. The results confirm that the growth of MOFs on polymer membranes can enhance the selectivity of the appropriately functionalized PIM-1, without a dramatic decrease of the permeability. PMID:28208658

  17. Assessing Patients' Preference for Integrating Herbal Medicine Within Primary Care Services in Saudi Arabia.

    Science.gov (United States)

    Allam, Safaa; Moharam, Maha; Alarfaj, Gada

    2014-07-01

    Family physician advice and follow-up may be important to reduce the negative aspects of locally marketed herbal remedies and improve the patient outcome. There is a lack of studies assessing the preference of Saudi patients for the integration of herbal medicine into primary care services. To examine the knowledge, attitudes, and practice of Saudi patients toward herbal medicine and its integration into primary care services. A cross-sectional study was conducted between February and March 2013 among adult patients attending the family medicine clinics at a primary care center in Riyadh, Saudi Arabia. A self-administered questionnaire (27 items) was developed and administered to all patients. A total of 240 patients were included in the current analysis. The average age was 33.5 ± 9.9 years, and 61% of the patients were women. Approximately 60% of the patients were aware of herbal medicine use and its possible side effects. More than 85% of the patients believed that herbal containers should be labeled with safety information. Approximately 71% of the patients had a favorable attitude toward integrated services. Approximately 65% of the patients used herbal remedies for themselves, and 42% used them for their children. Preference for integrated services was significantly associated with female sex, better knowledge, positive attitudes toward safety and regulations, and higher level of practice. A good knowledge and a very favorable attitude toward integrating herbal medicine into primary care services were found among a group of patients attending a primary care center in Saudi Arabia. © The Author(s) 2014.

  18. Integrating complementary/alternative medicine into primary care: evaluating the evidence and appropriate implementation

    Directory of Open Access Journals (Sweden)

    Wainapel SF

    2015-12-01

    Full Text Available Stanley F Wainapel,1 Stephanie Rand,1 Loren M Fishman,2 Jennifer Halstead-Kenny1 1The Arthur S Abramson Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 2Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA Abstract: The frequency with which patients utilize treatments encompassed by the term complementary/alternative medicine (CAM is well documented. A number of these therapies are beginning to be integrated into contemporary medical practice. This article examines three of them: osteopathic manipulation, yoga, and acupuncture, with a focus on their physiological effects, efficacy in treating medical conditions commonly encountered by practitioners, precautions or contraindications, and ways in which they can be incorporated into clinical practice. Physicians should routinely obtain information about use of CAM as part of their patient history and should consider their role based on physiological effects and clinical research results. Keywords: integrative medicine, osteopathic manipulation, yoga, acupuncture therapy

  19. [Holistic integrative medicine: application in prevention and treatment of oral mucosal diseases].

    Science.gov (United States)

    Jin, X; Xie, L; Zhao, X; Li, J; Zeng, X; Chen, Q M

    2017-08-09

    Holistic integrative medicine (HIM), as one of the important ideas in the field of medicine, arouses great concern recently. HIM regards the human body as a whole, turns data and evidence in medical research back to facts, integrates technologies and experience developed in clinical research into medical skills. The repeated practices at the levels of fact, experience, and medical skills will generate true knowledge to solve the wide spread problems brought by linearized thinking and fragmented knowledge. With the development of highly divided medical disciplines, how to utilize and practice HIM has become a common concern of the medical community. Specialization of stomatology, which is a first level discipline like medicine, has also become a trend for years. However, holistic concept cannot be overlooked, especially in the development of oral medicine. This article aims at the communication and exchange of knowledge about HIM among dental professionals. In order to serve the patients better, the authors look forward to practicing the HIM concept in the field of oral medicine through the efforts of us all.

  20. [Moderation-integrated-balance presupposition of Chinese medicine compound and pharmacological problems in traditional Chinese drug research].

    Science.gov (United States)

    Zhao, Jun-Ning

    2017-03-01

    The moderation-integrated-balance presupposition (MIBP) of Chinese medicine compound was first proposed in this paper based on the review of function characteristics and action principles of Chinese medicine compound. Furthermore, the pharmacological problems of traditional Chinese drug research were discussed in details. The results were of important value in accelerating the transformation of traditional Chinese medicine compound, and constructing the new drug innovation and review system for traditional Chinese medicine. Copyright© by the Chinese Pharmaceutical Association.

  1. [Strategy of constructing post-market integral evaluation system of traditional Chinese medicine injection].

    Science.gov (United States)

    Zhang, Xiao-Yu; Wang, Yan-Ping; Lin, Li-Kai; Shang, Hong-Cai; Wang, Yong-Yan

    2017-08-01

    As an important representative of modern Chinese medicine, traditional Chinese medicine (TCM) injzection has become an indispensable part of the Chinese medicine industry. However, its development is now restricted by the bottleneck of insufficient core competitiveness, low-level research and production, even injection quality and the safe use are not guaranteed. Thus, it is urgent to reevaluate post-marketing TCM injection generally and to make secondary development. Under current circumstances, taking major brands which have good clinical and market foundation, as well as research value, as the main subject of cultivation and evaluation is an important approach to innovative development of TCM injection industry. Unlike oral proprietary Chinese medicine, the cultivatation of major brands of TCM injection needs higher technical support, quality standards and more timely feedback. Therefore, a post-market integral evaluation system adaptive to TCM injection is required. This article discussed some key points on the construction of a post-market integral evaluation system of TCM injection in three levels: optimizing evaluation methods, building synergistic innovation platforms which combine the medical research institutions and pharmaceutical enterprises, and finally constructing the integral evaluation system. A "five to one" structure has been proposed to enhance TCM injection effectiveness, safety and adaptability on the whole, which are from the following aspects: mechanism research, clinical evidence validation, literature information mining, sustainable development of resources and industrialization operation. Copyright© by the Chinese Pharmaceutical Association.

  2. Natural Fostering in Fritillaria cirrhosa: Integrating herbal medicine production with biodiversity conservation

    Directory of Open Access Journals (Sweden)

    Xiwen Li

    2012-02-01

    Full Text Available Protected areas are generally regarded as a power tool to conserve biodiversity. Nonetheless, few protected areas could address three crucial problems simultaneously, namely funding, public participation and rural living. Here, we introduced a new protective approach, Natural Fostering, which integrated herbal medicine production with community conservation. The principles of Natural Fostering adopted species–species interaction at community level. Most effective chemical components of herbal medicine are derived from such interaction. Fritillaria cirrhosa was selected as an economic botany, one of herbal medicines, to carry out Natural Fostering. Community habitats, herbal medicine production, funding and income of local family were investigated to verify the feasibility of Natural Fostering for biodiversity. We found the density of plant populations and the annual average personal income of rural people increased. F. cirrhosa production could provide sufficient funds for sustainable conservation. Local people gradually changed their life style of wild collection and overgrazing, instead of herbal medicine production. The fostering area set up a good sustainable economic cycle. Natural Fostering can be presented as an effective and pragmatic way to conserve biological diversity and sustainable utilization of traditional medicinal resources.

  3. Interest in Integrative Medicine Among Postmenopausal Hormone Receptor–Positive Breast Cancer Patients in the EvAluate-TM Study

    Science.gov (United States)

    Hack, Carolin C.; Fasching, Peter A.; Fehm, Tanja; de Waal, Johann; Rezai, Mahdi; Baier, Bernd; Baake, Gerold; Kolberg, Hans-Christian; Guggenberger, Martin; Warm, Mathias; Harbeck, Nadia; Wuerstlein, Rachel; Deuker, Jörg-Uwe; Dall, Peter; Richter, Barbara; Wachsmann, Grischa; Brucker, Cosima; Siebers, Jan W.; Fersis, Nikos; Kuhn, Thomas; Wolf, Christopher; Vollert, Hans-Walter; Breitbach, Georg-Peter; Janni, Wolfgang; Landthaler, Robert; Kohls, Andreas; Rezek, Daniela; Noesslet, Thomas; Fischer, Gunnar; Henschen, Stefan; Praetz, Thomas; Heyl, Volker; Kühn, Thorsten; Krauss, Thomas; Thomssen, Christoph; Hohn, Andre; Tesch, Hans; Mundhenke, Christoph; Hein, Alexander; Rauh, Claudia; Bayer, Christian M.; Jacob, Adib; Schmidt, Katja; Belleville, Erik; Hadji, Peyman; Brucker, Sara Y.; Wallwiener, Diethelm; Kümmel, Sherko; Beckmann, Matthias W.; Paepke, Daniela

    2016-01-01

    Background. Breast cancer patients often use complementary and alternative medicine, but few prospectively collected data on the topic are available specifically for postmenopausal breast cancer patients. A large prospective study was therefore conducted within a noninterventional study in order to identify the characteristics of patients interested in integrative medicine. Methods. The EvAluate-TM study is a prospective, multicenter noninterventional study in which treatment with the aromatase inhibitor letrozole was evaluated in postmenopausal women with hormone receptor–positive primary breast cancer. Between 2008 and 2009, 5045 postmenopausal patients were enrolled at 339 certified breast centers in Germany. As part of the data collection process, patients were asked at the baseline about their interest in and information needs relating to integrative medicine. Results. Of the 5045 patients recruited, 3411 responded to the questionnaire on integrative medicine and took part in the analysis, 1583 patients expressed an interest in integrative medicine, and 1828 patients declared no interest. Relevant predictors of interest in integrative medicine were age, body mass index, tumor size, previous chemotherapy, and use of concomitant medications for other medical conditions. Interest in integrative medicine declined highly significantly (P 65 years, 38.0%). Patients in favor of integrative medicine were significantly less satisfied with the information received about individual treatments and antihormonal therapy. Patients with interest in integrative medicine were more often interested in rehabilitation and fitness, nutritional counseling, and additional support from self-help organizations. These women were mostly interested in receiving information about their disease and integrative medicine from a physician, rather than from other sources. Conclusions. This study shows that a considerable proportion of postmenopausal breast cancer patients are interested in

  4. Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

    Science.gov (United States)

    Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-04-27

    Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

  5. Utilization Pattern and Drug Use of Traditional Chinese Medicine, Western Medicine, and Integrated Chinese-Western Medicine Treatments for Allergic Rhinitis Under the National Health Insurance Program in Taiwan.

    Science.gov (United States)

    Huang, Sheng-Kang; Lai, Chih-Sung; Chang, Yuan-Shiun; Ho, Yu-Ling

    2016-10-01

    Patients in Taiwan with allergic rhinitis seek not only Western medicine treatment but also Traditional Chinese Medicine treatment or integrated Chinese-Western medicine treatment. Various studies have conducted pairwise comparison on Traditional Chinese Medicine, Western medicine, and integrated Chinese-Western medicine treatments. However, none conducted simultaneous analysis of the three treatments. This study analyzed patients with allergic rhinitis receiving the three treatments to identify differences in demographic characteristic and medical use and thereby to determine drug use patterns of different treatments. The National Health Insurance Research Database was the data source, and included patients were those diagnosed with allergic rhinitis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 470-478). Chi-square test and Tukey studentized range (honest significant difference) test were conducted to investigate the differences among the three treatments. Visit frequency for allergic rhinitis treatment was higher in female than male patients, regardless of treatment with Traditional Chinese Medicine, Western medicine, or integrated Chinese-Western medicine. Persons aged 0-19 years ranked the highest in proportion of visits for allergic rhinitis. Traditional Chinese Medicine treatment had more medical items per person-time and daily drug cost per person-time and had the lowest total expenditure per person-time. In contrast, Western medicine had the lowest daily drug cost per person-time and the highest total expenditure per person-time. The total expenditure per person-time, daily drug cost per person-time, and medical items per person-time of integrated Chinese-Western medicine treatment lay between those seen with Traditional Chinese Medicine and Western medicine treatments. Although only 6.82 % of patients with allergic rhinitis chose integrated Chinese-Western medicine treatment, the visit frequency per person-year of

  6. The Performance of a Thermally Cross-Linked Polymer of Intrinsic Microporosity (PIM-1) for Gas Separation

    KAUST Repository

    Alghunaimi, Fahd

    2013-05-01

    Gas transport properties of PIM-1 (the first ladder polymer with intrinsic microporosity) and TC-PIM-1 (thermally cross-linked PIM-1) at 35°C and different pressures were thoroughly studied. The purpose of this study was to evaluate and compare the performance of the TC-PIM-1 membranes with PIM-1 for natural gas separation. The TC-PIM-1 polymer was prepared by post-modification of PIM-1 at 300°C for a period of two days. Sorption isotherms of seven gases, including N2, O2, CH4, CO2, C2H6, C3H8 and n-C4H10, were determined for PIM-1 and TC-PIM-1 using the dual-volume barometric sorption technique at 35°C at different pressures. The sorption isotherms followed the dual-mode sorption model, which is typical for glassy polymers. Moreover, permeability (P) of eight gases, including He, H2, N2, O2, CH4, CO2, C3H8 and n-C4H10, were determined for PIM-1 and TC-PIM-1 at 35°C and 2.0 atm. Furthermore, average diffusion coefficients (D ̅) were calculated from the permeability and solubility data for all tested gases for both polymers. The sorption (S), permeability (P) and average diffusion coefficients (D ̅) for the TC-PIM-1 membrane exhibited lower values than the PIM-1 membrane. However, the TC-PIM-1 membrane showed exceptional gas separation performance. The TC-PIM-1 membrane had a helium (He) permeability of 1218 barrer with He/CH4 and He/N2 ideal selectivities of 27.1 and 23.9 respectively, and carbon dioxide (CO2) permeability of 1088 barrer with CO2/CH4 and CO2/N2 ideal selectivities of 24.2 and 21.3 respectively. Additionally, the TC-PIM-1 membrane showed a hydrogen (H2) permeability of 2452 barrer with an ideal H2/CH4 selectivity of 54.5.

  7. Demand for integrative medicine among women in pregnancy and childbed: a German survey on patients' needs.

    Science.gov (United States)

    Schürger, Nikolas; Klein, Evelyn; Hapfelmeier, Alexander; Kiechle, Marion; Paepke, Daniela

    2018-06-15

    Although integrative medicine is gaining increasing attention and is claiming more and more its place in modern health care, it still plays a marginal role in conventional maternity care. The present study aims to examine the patterns of Complementary and Alternative Medicine (CAM) use and the demand for integrative therapies, including CAM, relaxation therapies, nutritional counseling, and psychological assistance, among women in pregnancy and childbed. The survey was conducted from April 2017 to July 2017 by means of a pseudo-anonymous 38-item questionnaire at the Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich. Eligible participants were women hospitalized due to pregnancy related complications and women in childbed. Descriptive statistics were generated to determine patterns of CAM use and demand for integrative therapeutic approaches. Univariate analysis was used to detect associations between patients' characteristics and their interest in the different integrative therapies. Furthermore, binary logistic regression was used to estimate the odds ratio of demand for CAM. A total of 394 out of 503 patients participated in the survey (78%). 60% declared using CAM in general, 45% specifically in relation to their pregnancy or childbed. Most commonly used modalities were vitamins (31% of all patients), yoga (24%), and herbal supplements (23%). Most popular sources of recommendation of CAM use were midwives and gynecologists. Integrative therapy options patients would have wanted alongside conventional maternity care were CAM (64%), relaxation therapies (44%), dietary counseling (28%), and psychological counseling (15%). Furthermore, associations between patients' sociodemographic characteristics and their demand for integrative therapies were identified. The results of this study demonstrate that there is a considerable demand for integrative medicine and widespread use of CAM among women during pregnancy and

  8. Integration of naturopathic medicine into acute inpatient care: An approach for patient-centred medicine under diagnosis-related groups.

    Science.gov (United States)

    Romeyke, Tobias; Nöhammer, Elisabeth; Scheuer, Hans Christoph; Stummer, Harald

    2017-08-01

    The integration of naturopathic methods into acute inpatient care has been the subject of very few scientific studies. Patient expectations of the service received in hospital are increasing, and the integration of naturopathy into clinical practice can serve as Unique Selling Proposition. The present study was conducted over a period of two years. In total, over 1700 patients were included in the study. The setting is an acute hospital specialising in a multimodal, patient-centred approach to treatment. Patient satisfaction with the use of holistic care, patient perception of adherence to treatment and the amount of time care staff spend with patients were all investigated. The patients' principal diagnoses were also recorded using the DRG classification system, as were the number of concomitant diseases and the length of their stay in hospital. The majority of patients rate the integration of complementary care in the acute hospital very positively. The effects on patient perception of adherence to treatment and the amount of time care staff spend with patients are also assessed positively. At the same time, we can see that patients who receive patient-centred care in this study predominantly suffer from diseases and disorders of the musculoskeletal system and connective tissue, diseases of the nervous system and mental diseases and disorders. They also have numerous concomitant diseases. It could be shown that patients are very satisfied with the combination of naturopathy and academic medicine and with approaches that take patient preferences into account. Integrating naturopathy can be considered for multimorbid patients, in particular. Moreover, patient-centred care can improve staff satisfaction levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The Plasma Instrument for Magnetic Sounding (PIMS) on The Europa Clipper Mission

    Science.gov (United States)

    Westlake, J. H.; McNutt, R. L., Jr.; Kasper, J. C.; Battista, C.; Case, A. W.; Cochrane, C.; Grey, M.; Jia, X.; Kivelson, M.; Kim, C.; Korth, H.; Khurana, K. K.; Krupp, N.; Paty, C. S.; Roussos, E.; Rymer, A. M.; Stevens, M. L.; Slavin, J. A.; Smith, H. T.; Saur, J.; Coren, D.

    2017-12-01

    The Europa Clipper mission is equipped with a sophisticated suite of 9 instruments to study Europa's interior and ocean, geology, chemistry, and habitability from a Jupiter orbiting spacecraft. The Plasma Instrument for Magnetic Sounding (PIMS) on Europa Clipper is a Faraday Cup based plasma instrument whose heritage dates back to the Voyager spacecraft. PIMS will measure the plasma that populates Jupiter's magnetosphere and Europa's ionosphere. The science goals of PIMS are to: 1) estimate the ocean salinity and thickness by determining Europa's magnetic induction response, corrected for plasma contributions; 2) assess mechanisms responsible for weathering and releasing material from Europa's surface into the atmosphere and ionosphere; and 3) understand how Europa influences its local space environment and Jupiter's magnetosphere and vice versa. Europa is embedded in a complex Jovian magnetospheric plasma, which rotates with the tilted planetary field and interacts dynamically with Europa's ionosphere affecting the magnetic induction signal. Plasma from Io's temporally varying torus diffuses outward and mixes with the charged particles in Europa's own torus producing highly variable plasma conditions at Europa. PIMS works in conjunction with the Interior Characterization of Europa using Magnetometry (ICEMAG) investigation to probe Europa's subsurface ocean. This investigation exploits currents induced in Europa's interior by the moon's exposure to variable magnetic fields in the Jovian system to infer properties of Europa's subsurface ocean such as its depth, thickness, and conductivity. This technique was successfully applied to Galileo observations and demonstrated that Europa indeed has a subsurface ocean. While these Galileo observations contributed to the renewed interest in Europa, due to limitations in the observations the results raised major questions that remain unanswered. PIMS will greatly refine our understanding of Europa's global liquid ocean by

  10. Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

    Science.gov (United States)

    Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

    2002-07-01

    To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in

  11. Integrative pathway knowledge bases as a tool for systems molecular medicine.

    Science.gov (United States)

    Liang, Mingyu

    2007-08-20

    There exists a sense of urgency to begin to generate a cohesive assembly of biomedical knowledge as the pace of knowledge accumulation accelerates. The urgency is in part driven by the emergence of systems molecular medicine that emphasizes the combination of systems analysis and molecular dissection in the future of medical practice and research. A potentially powerful approach is to build integrative pathway knowledge bases that link organ systems function with molecules.

  12. Scientific publications from Arab world in leading journals of Integrative and Complementary Medicine: a bibliometric analysis

    OpenAIRE

    Zyoud, Sa’ed H.; Al-Jabi, Samah W.; Sweileh, Waleed M.

    2015-01-01

    Background Bibliometric analysis is increasingly employed as a useful tool to assess the quantity and quality of research performance. The specific goal of the current study was to evaluate the performance of research output originating from Arab world and published in international Integrative and Complementary Medicine (ICM) journals. Methods Original scientific publications and reviews from the 22 Arab countries that were published in 22 international peer-reviewed ICM journals during all ...

  13. [Establishment of diagnosis and treatment patterns of holistic integrated medicine for neuro-ophthalmology].

    Science.gov (United States)

    Wang, Yanling

    2014-12-01

    Neuro-ophthalmology, as an interdisciplinary, covers at least three disciplines- ophthalmology, neurology and neurosurgery. With limited knowledge in each discipline, doctors often make misdiagnoses for neuro-ophthalmology diseases. Therefore, it is imperative to abandon the distinction between disciplines and combine all the knowledge to diagnose and treat patients in patterns of holistic integrated medicine in order to effectively improve the diagnosis and treatment of neuro-ophthalmology.

  14. The openness of pluripotent epigenome - Defining the genomic integrity of stemness for regenerative medicine

    Directory of Open Access Journals (Sweden)

    Xuejun H Parsons

    2014-02-01

    Full Text Available This article is an editorial, and it doesn't include an abstract. Full text of this article is available in HTML and PDF.Cite this article as: Parsons XH. The openness of pluripotent epigenome - Defining the genomic Integrity of stemness for regenerative medicine. Int J Cancer Ther Oncol 2014; 2(1:020114.DOI: http://dx.doi.org/10.14319/ijcto.0201.14

  15. Integration of Molecular Pathology, Epidemiology, and Social Science for Global Precision Medicine

    Science.gov (United States)

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L.; Nishihara, Reiko; Tan, Andy S.; Kawachi, Ichiro; Ogino, Shuji

    2015-01-01

    Summary The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations, and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial, and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors, and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference, and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology, and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors, and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging, and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science. PMID:26636627

  16. Integration and disease control: notes from the Prince Leopold Institute of Tropical Medicine Colloquium 2002.

    Science.gov (United States)

    Mahendradhata, Yodi; Moerman, Filip

    2004-06-01

    The discussion on the desirability or not to integrate disease control activities with general health services is a longstanding one. The recent creations of global health initiatives for poverty-related disease control have refueled the debate. The Prince Leopold Institute of Tropical Medicine (ITM) convened a colloquium in Antwerp to clarify concepts involved in integrated disease control and contribute to the creation of a common scientific language and a better understanding of the issues at stake. We present an overview of highlights from the colloquium sessions. Some of the contributions reported here are presented in more detail elsewhere in this special issue.

  17. [Oral maxillofacial-head and neck tumor and holistic integrative medicine].

    Science.gov (United States)

    Zhang, C P

    2017-08-09

    The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

  18. Pim-3 contributes to radioresistance through regulation of the cell cycle and DNA damage repair in pancreatic cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiang-Yuan; Wang, Zhen [Cancer Research Institute, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Li, Bei [Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Zhang, Ying-Jian, E-mail: yjzhang111@aliyun.com [Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Li, Ying-Yi, E-mail: liyingyi@fudan.edu.cn [Cancer Research Institute, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China)

    2016-04-22

    Resistance of cancer cells to chemoradiotherapy is a major clinical problem in pancreatic cancer treatment. Therefore, understanding the molecular basis of cellular resistance and identifying novel targets are essential for improving treatment efficacy for pancreatic cancer patients. Previous studies have demonstrated a significant role for Pim-3 in pancreatic cancer survival against gemcitabine-induced genotoxic stress. Here, we observed that radiation treatment enhanced Pim-3 expression in human pancreatic cancer cells in vitro. Stable overexpression of Pim-3 in pancreatic cancer cells significantly protected cells against radiation treatment by attenuating G2/M phase cell cycle arrest and DNA damage response. Silencing of Pim-3 expression significantly elevated the phosphorylation of histone variant H2AX, a marker of DNA double strand breaks, and decreased the activation of ataxia-telangiectasia-mutated (ATM) kinase, along with its downstream targets, eventually enhancing the radiosensitivity of human pancreatic cancer cells in vitro and in vivo. Hence, we demonstrated a novel function for Pim-3 in human pancreatic cancer cell survival against radiation. Targeting Pim-3 may be a promising way to improve treatment efficacy in combination with radiotherapy in human pancreatic cancer. - Highlights: • This is first study to demonstrate that Pim-3 is endogenously induced by ionizing radiation in pancreatic cancer cells, and Pim-3 overexpression enhanced radioresistance of pancreatic cancer cells both in vitro and in vivo. • This is first study to provide evidence that radioresistance induced by Pim-3 is mainly attributed to Pim-3 induces activation of ATM, which subsequently activates checkpoint 1, leading to amplification of DNA repair through cell cycle arrest and DNA repair pathways. • This is first study to indicate that targeting Pim-3 may be a promising strategy to provide better treatment efficacy in combination with radiotherapy in human pancreatic

  19. Pim-3 contributes to radioresistance through regulation of the cell cycle and DNA damage repair in pancreatic cancer cells

    International Nuclear Information System (INIS)

    Chen, Xiang-Yuan; Wang, Zhen; Li, Bei; Zhang, Ying-Jian; Li, Ying-Yi

    2016-01-01

    Resistance of cancer cells to chemoradiotherapy is a major clinical problem in pancreatic cancer treatment. Therefore, understanding the molecular basis of cellular resistance and identifying novel targets are essential for improving treatment efficacy for pancreatic cancer patients. Previous studies have demonstrated a significant role for Pim-3 in pancreatic cancer survival against gemcitabine-induced genotoxic stress. Here, we observed that radiation treatment enhanced Pim-3 expression in human pancreatic cancer cells in vitro. Stable overexpression of Pim-3 in pancreatic cancer cells significantly protected cells against radiation treatment by attenuating G2/M phase cell cycle arrest and DNA damage response. Silencing of Pim-3 expression significantly elevated the phosphorylation of histone variant H2AX, a marker of DNA double strand breaks, and decreased the activation of ataxia-telangiectasia-mutated (ATM) kinase, along with its downstream targets, eventually enhancing the radiosensitivity of human pancreatic cancer cells in vitro and in vivo. Hence, we demonstrated a novel function for Pim-3 in human pancreatic cancer cell survival against radiation. Targeting Pim-3 may be a promising way to improve treatment efficacy in combination with radiotherapy in human pancreatic cancer. - Highlights: • This is first study to demonstrate that Pim-3 is endogenously induced by ionizing radiation in pancreatic cancer cells, and Pim-3 overexpression enhanced radioresistance of pancreatic cancer cells both in vitro and in vivo. • This is first study to provide evidence that radioresistance induced by Pim-3 is mainly attributed to Pim-3 induces activation of ATM, which subsequently activates checkpoint 1, leading to amplification of DNA repair through cell cycle arrest and DNA repair pathways. • This is first study to indicate that targeting Pim-3 may be a promising strategy to provide better treatment efficacy in combination with radiotherapy in human pancreatic

  20. Lymphoma induction by heterocyclic amines in Eu-pim-1 transgenic mice

    DEFF Research Database (Denmark)

    Sørensen, Ilona Kryspin; Kristiansen, E.; Mortensen, Alicja

    1997-01-01

    The usefulness of transgenic E mu-pim-1 mice bearing in their genome the pim-1 oncogene supplemented with an upstream immunoglobulin enhancer and a downstream murine leukaemia virus long terminal repeat, as sensitive test organisms was studied in two short-term carcinogenicity studies. The mice...... to bacteria and cultured mammalian cells. PhIP is a potent mouse lymphomagen, while IQ is a liver, lung and forestomach carcinogen in mice. We found that transgenic E mu-pim-1 mice are highly susceptible to PhIP induced lymphomagenesis but do not respond to IQ treatment. PhIP feeding of E mu-pim-1 mice...... not only increased the total number of T-cell lymphomas but also decreased the latency time compared to either transgenic or wild-type controls. The effect was most pronounced in the treated female E mu-pim-1 mice, which showed a higher incidence of PhIP induced T-cell lymphomas than transgenic males...

  1. Building more powerful less expensive supercomputers using Processing-In-Memory (PIM) LDRD final report.

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Richard C.

    2009-09-01

    This report details the accomplishments of the 'Building More Powerful Less Expensive Supercomputers Using Processing-In-Memory (PIM)' LDRD ('PIM LDRD', number 105809) for FY07-FY09. Latency dominates all levels of supercomputer design. Within a node, increasing memory latency, relative to processor cycle time, limits CPU performance. Between nodes, the same increase in relative latency impacts scalability. Processing-In-Memory (PIM) is an architecture that directly addresses this problem using enhanced chip fabrication technology and machine organization. PIMs combine high-speed logic and dense, low-latency, high-bandwidth DRAM, and lightweight threads that tolerate latency by performing useful work during memory transactions. This work examines the potential of PIM-based architectures to support mission critical Sandia applications and an emerging class of more data intensive informatics applications. This work has resulted in a stronger architecture/implementation collaboration between 1400 and 1700. Additionally, key technology components have impacted vendor roadmaps, and we are in the process of pursuing these new collaborations. This work has the potential to impact future supercomputer design and construction, reducing power and increasing performance. This final report is organized as follow: this summary chapter discusses the impact of the project (Section 1), provides an enumeration of publications and other public discussion of the work (Section 1), and concludes with a discussion of future work and impact from the project (Section 1). The appendix contains reprints of the refereed publications resulting from this work.

  2. Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

    Directory of Open Access Journals (Sweden)

    Witt CM

    2015-01-01

    Full Text Available Claudia M Witt,1–3 Marion Pérard,2 Brian Berman,3,4 Susan Berman,4 Timothy C Birdsall,5 Horst Defren,6 Sherko Kümmel,7 Gary Deng,8 Gustav Dobos,9 Atje Drexler,10 Christine Holmberg,2 Markus Horneber,11 Robert Jütte,9 Lori Knutson,12 Christopher Kummer,13 Susanne Volpers,14 David Schweiger15 1University Hospital Zurich, Institute for Complementary and Integrative Medicine, Zurich, Switzerland; 2Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; 3University of Maryland School of Medicine, Center for Integrative Medicine, Baltimore, Maryland, USA; 4The Institute for Integrative Health, Baltimore, USA; 5Cancer Treatment Centers of America, Goodyear, Arizona, USA, 6Kliniken Essen Mitte, Evang, Huyssen-Stiftung/Knappschaft GmbH Patientenmanagement, Essen, Germany; 7Department of Senology, Breast Center, Kliniken Essen-Mitte, Evang. Huyssens Stiftung, Knappschaft GmbH, Essen, Germany; 8Memorial Sloan-Kettering Cancer Center, New York, USA; 9Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, Germany; 10Robert Bosch Foundation GmbH, Stuttgart, Germany; 11Department of Internal Medicine, Division of Oncology and Hematology, Paracelsus Medical University, Klinikum Nürnberg, Germany; 12Integrative Healthcare Solutions, Minneapolis, Minnesota, USA; 13Institute of Mergers, Acquisitions and Alliances (IMAA, Zurich, Switzerland; 14Frauenselbsthilfe nach Krebs, Bonn, Germany; 15Schweiger, Schweiger & Associates, Hilton Head Island, South Carolina, USA Background: An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of

  3. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  4. The Mechanism of Action of Unique Small Molecules that Inhibit the Pim Protein Kinase Blocking Prostate Cancer Cell Growth

    Science.gov (United States)

    2010-05-01

    TKO∕EV) or Pim-3 (TKO∕Pim-3). Values ( cpm ∕mg protein) are the average of three independent measurements, and the standard deviation for the mean is...article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Received September 27, 2011

  5. Gas Sorption, Diffusion and Permeation in a Polymer of Intrinsic Microporosity (PIM-7)

    KAUST Repository

    Alaslai, Nasser Y.

    2013-05-08

    The entire world including Saudi Arabia is dependent on natural gas to provide new energy supplies for the future. Conventional ways for gas separation are expensive, and, hence, it is very important to reduce the cost and lower the energy consumption. Membrane technology is a relatively new separation process for natural gas purification with large growth potential, specifically for off-shore applications. The economics of any membrane separation process depend primarily on the intrinsic gas permeation properties of the membrane materials. All current commercial membranes for natural gas separation are made from polymers, which have several drawbacks, including low permeability, moderate selectivity, and poor stability in acid gas and hydrocarbon environments. The recent development of polymeric materials called “polymers of intrinsic microporosity” (PIMs) provide a new class of high-performance membrane materials that are anticipated to be used in natural gas separation processes including, but not limited to, acid gas removal and separation of hydrocarbons from methane. PIM-7 is an excellent example of a material from the PIMs series for gas separation. It was selected for this work since it has not been extensively tested for its gas permeation properties to date. Specifically, sorption and mixed-gas permeation data were not available for PIM-7 prior to this work. Sorption isotherms of N2, O2, CH4, CO2, C2H6, C3H8 and n-C4H10 were determined over a range of pressures at 35 oC for PIM-7 using a custom-designed dual-volume pressure decay system. Condensable hydrocarbon gases, such as C3H8 and n-C4H10, show significantly higher solubility than the other less condensable gas of the test series due to their high affinity to the polymer matrix. Dual-mode sorption model parameters were determined from the sorption isotherms. Henry’s law solubility, Langmuir capacity constant and the affinity constant increased with gas condensability. Permeability coefficients

  6. Up-regulation of Pim-3 in Chronic Obstructive Pulmonary Disease (COPD) patients and its potential therapeutic role in COPD rat modeling.

    Science.gov (United States)

    Yang, Cheng; Li, Li; Guo, Junhua; Zhang, Weiqiang; Zhu, Wenbiao; Rao, Xinhui; Huang, Wenjie

    2017-04-01

    Pim-3 belongs to the PIM kinase family and plays an important role in promoting inflammation, which is essential in the pathogenesis of Chronic Obstructive Pulmonary Disease (COPD). Immunohistochemistry (IHC), western blot, and RT-PCR analyses were performed to assess the expression of Pim-3 in both COPD and healthy lung tissue samples. SMA (Smooth Muscle Actin) and Cyclin D1 expression were detected by IHC. We also constructed animal models for the control, COPD, and Pim-3 inhibition groups, in order to analyze the effects of Pim-3 inhibition on COPD, and the role of Pim-3 in the p38 pathway. Compared with normal lung tissue, Pim-3 mRNA and protein were up-regulated in COPD tissue. Expression of Cyclin D1 and SMA were also up-regulated in the COPD group. In the animal model experiment, we found that suppression of Pim-3 decreased Pim-3, Cyclin D1, and SMA expression, as well as ameliorated lung damage in COPD patients. The inhibition of Pim-3 also resulted in the suppression of the p38 pathway. Our study suggests that up-regulation of Pim-3 successfully accelerated COPD development, and aggravated lung damage. The molecular mechanism of Pim-3 in COPD might be related to the p38 pathway, and is correlated with Cyclin D1 and SMA expression. Copyright © 2017 Elsevier GmbH. All rights reserved.

  7. PharmDB-K: Integrated Bio-Pharmacological Network Database for Traditional Korean Medicine.

    Directory of Open Access Journals (Sweden)

    Ji-Hyun Lee

    Full Text Available Despite the growing attention given to Traditional Medicine (TM worldwide, there is no well-known, publicly available, integrated bio-pharmacological Traditional Korean Medicine (TKM database for researchers in drug discovery. In this study, we have constructed PharmDB-K, which offers comprehensive information relating to TKM-associated drugs (compound, disease indication, and protein relationships. To explore the underlying molecular interaction of TKM, we integrated fourteen different databases, six Pharmacopoeias, and literature, and established a massive bio-pharmacological network for TKM and experimentally validated some cases predicted from the PharmDB-K analyses. Currently, PharmDB-K contains information about 262 TKMs, 7,815 drugs, 3,721 diseases, 32,373 proteins, and 1,887 side effects. One of the unique sets of information in PharmDB-K includes 400 indicator compounds used for standardization of herbal medicine. Furthermore, we are operating PharmDB-K via phExplorer (a network visualization software and BioMart (a data federation framework for convenient search and analysis of the TKM network. Database URL: http://pharmdb-k.org, http://biomart.i-pharm.org.

  8. Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration

    Directory of Open Access Journals (Sweden)

    Elio Rossi

    2017-01-01

    Full Text Available Background: According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods: The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results: After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions: The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems.

  9. Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration.

    Science.gov (United States)

    Rossi, Elio; Di Stefano, Mariella; Firenzuoli, Fabio; Monechi, Maria Valeria; Baccetti, Sonia

    2017-01-24

    Background : According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods : The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM) therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results : After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions : The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems.

  10. Human Microbiome and Learning Healthcare Systems: Integrating Research and Precision Medicine for Inflammatory Bowel Disease.

    Science.gov (United States)

    Chuong, Kim H; Mack, David R; Stintzi, Alain; O'Doherty, Kieran C

    2018-02-01

    Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care. To date, much discussion in this context has focused on the potential of human genomic data, and not yet on human microbiome data. Rapid advances in human microbiome research suggest that profiling of, and interventions on, the human microbiome can provide substantial opportunity for improved diagnosis, therapeutics, risk management, and risk stratification. In this study, we discuss a potential role for microbiome science in LHSs. We first review the key elements of LHSs, and discuss possibilities of Big Data and patient engagement. We then consider potentials and challenges of integrating human microbiome research into clinical practice as part of an LHS. With rapid growth in human microbiome research, patient-specific microbial data will begin to contribute in important ways to precision medicine. Hence, we discuss how patient-specific microbial data can help guide therapeutic decisions and identify novel effective approaches for precision care of inflammatory bowel disease. To the best of our knowledge, this expert analysis makes an original contribution with new insights poised at the emerging intersection of LHSs, microbiome science, and postgenomics medicine.

  11. The BraveNet prospective observational study on integrative medicine treatment approaches for pain.

    Science.gov (United States)

    Abrams, Donald I; Dolor, Rowena; Roberts, Rhonda; Pechura, Constance; Dusek, Jeffery; Amoils, Sandi; Amoils, Steven; Barrows, Kevin; Edman, Joel S; Frye, Joyce; Guarneri, Erminia; Kligler, Ben; Monti, Daniel; Spar, Myles; Wolever, Ruth Q

    2013-06-24

    Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (-23%) and interference (-28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. ClinicalTrials.gov, NCT01186341.

  12. [Occlusion: current situation and prospect in view of holistic integrative medicine].

    Science.gov (United States)

    Wang, M Q; Liu, X D

    2017-08-09

    The rise of holistic integrative medicine (HIM) is an inevitable consequence of modern medical development which emphasizes the change from specialization to integration of the most advanced medical knowledge. It does not mean a simple collection of the medical theories, but means the digestion of those theories for the clinical practical application. Because occlusal therapy is characterized as not only a high level of individualization, but also a relation to many stomatology and other disciplines, such as plastic surgery, orthopedics, neurosciences and psychology. It needs the HIM to guide the clinical practice. With undertaking occlusal therapy, to avoid the limitation due to the excessive specialized disciplines, and to provide effective treatment plans for abnormal occlusion induced diseases, it is necessary to develop the discipline of the holistic integrative stomatology.

  13. Desalination of Sea Water Using Polymer Inclusion Membran (PIM With Aliquat 336-TBP (Tributhyl Phosphate as Carrier Compound

    Directory of Open Access Journals (Sweden)

    Cholid Djunaidi Muhammad

    2018-01-01

    Full Text Available Desalination of Sea Water using Polymer Inclusion Membrane has been done. PIM is known has high stability membrane to overcome the instability of liquid membrane. PIM was placed among two phase : source phases was sea water and feed phases was aquadest. Efficiency of desalination is known by determining salinity concentration and ion Na+ in feed phases and stripping phases using refractometer and AAS. while membrane characterization is done using FTIR. SEM and UV-Vis spectroscopy. The PIM membrane that is produced has thin. transparent. clear and flexible properties. The result showed that PIM transport for 24 hours give the highest of salinity transport. there are 92.68% is transported from feed phases and 84.87% in stripping phases. Membrane characterization result by FTIR and UV spectroscopy showed that PIM membrane is stable enough.

  14. First Clear-Cut Experimental Evidence of a Glass Transition in a Polymer with Intrinsic Microporosity: PIM-1.

    Science.gov (United States)

    Yin, Huajie; Chua, Yeong Zen; Yang, Bin; Schick, Christoph; Harrison, Wayne J; Budd, Peter M; Böhning, Martin; Schönhals, Andreas

    2018-04-19

    Polymers with intrinsic microporosity (PIMs) represent a novel, innovative class of materials with great potential in various applications from high-performance gas-separation membranes to electronic devices. Here, for the first time, for PIM-1, as the archetypal PIM, fast scanning calorimetry provides definitive evidence of a glass transition ( T g = 715 K, heating rate 3 × 10 4 K/s) by decoupling the time scales responsible for glass transition and decomposition. Because the rigid molecular structure of PIM-1 prevents any conformational changes, small-scale bend and flex fluctuations must be considered the origin of its glass transition. This result has strong implications for the fundamental understanding of the glass transition and for the physical aging of PIMs and other complex polymers, both topical problems of materials science.

  15. Barriers and challenges in integration of anthroposophic medicine in supportive breast cancer care.

    Science.gov (United States)

    Ben-Arye, Eran; Schiff, Elad; Levy, Moti; Raz, Orit Gressel; Barak, Yael; Bar-Sela, Gil

    2013-01-01

    In the last decade, more and more oncology centers are challenged with complementary medicine (CM) integration within supportive breast cancer care. Quality of life (QOL) improvement and attenuation of oncology treatment side effects are the core objectives of integrative CM programs in cancer care. Yet, limited research is available on the use of specific CM modalities in an integrative setting and on cancer patients' compliance with CM consultation. Studies are especially warranted to view the clinical application of researched CM modalities, such as anthroposophic medicine (AM), a unique CM modality oriented to cancer supportive care. Our objective was to characterize consultation patterns provided by physicians trained in CM following oncology health-care practitioners' referral of patients receiving chemotherapy. We aimed to identify characteristics of patients who consulted with AM and to explore patients' compliance to AM treatment. Of the 341 patients consulted with integrative physicians, 138 were diagnosed with breast cancer. Following integrative physician consultation, 56 patients were advised about AM treatment and 285 about other CM modalities. Logistic multivariate regression model found that, compared with patients receiving non-anthroposophic CM, the AM group had significantly greater rates of previous CM use [EXP(B) = 3.25, 95% C.I. 1.64-6.29, p = 0.001] and higher rates of cancer recurrence at baseline (p = 0.038). Most AM users (71.4%) used a single AM modality, such as mistletoe (viscum album) injections, oral AM supplements, or music therapy. Compliance with AM modalities following physician recommendation ranged from 44% to 71% of patients. We conclude that AM treatment provided within the integrative oncology setting is feasible based on compliance assessment. Other studies are warranted to explore the effectiveness of AM in improving patients' QOL during chemotherapy.

  16. Integrating population health into a family medicine clerkship: 7 years of evolution.

    Science.gov (United States)

    Unverzagt, Mark; Wallerstein, Nina; Benson, Jeffrey A; Tomedi, Angelo; Palley, Toby B

    2003-01-01

    A population health curriculum using methodologies from community-oriented primary care (COPC) was developed in 1994 as part of a required third-year family medicine clerkship at the University of New Mexico. The curriculum integrates population health/community medicine projects and problem-based tutorials into a community-based, ambulatory clinical experience. By combining a required population health experience with relevant clinical training, student careers have the opportunity to be influenced during the critical third year. Results over a 7-year period describe a three-phase evolution of the curriculum, within the context of changes in medical education and in health care delivery systems in that same period of time. Early evaluation revealed that students viewed the curricular experience as time consuming and peripheral to their training. Later comments on the revised curriculum showed a higher regard for the experience that was described as important for student learning.

  17. Integrating complementary and alternative medicine into cancer care: Canadian oncology nurses′ perspectives

    Directory of Open Access Journals (Sweden)

    Tracy L Truant

    2015-01-01

    Full Text Available The integration of complementary and alternative medicine (CAM and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP education and attitudes about CAM; variable licensure, credentialing of CAM practitioners, and reimbursement issues across the country; an emerging CAM evidence base; and models of cancer care that privilege diseased-focused care at the expense of whole person care. Oncology nurses are optimally aligned to be leaders in the integration of CAM into cancer care in Canada. Beyond the respect afforded to oncology nurses by patients and family members that support them in broaching the topic of CAM, policies, and position statements exist that allow oncology nurses to include CAM as part of their scope. Oncology nurses have also taken on leadership roles in clinical innovation, research, education, and advocacy that are integral to the safe and informed integration of evidence-based CAM therapies into cancer care settings in Canada.

  18. Genetic modelling of PIM proteins in cancer: proviral tagging, cooperation with oncogenes, tumor suppressor genes and carcinogens.

    Directory of Open Access Journals (Sweden)

    Enara eAguirre

    2014-05-01

    Full Text Available The PIM proteins, which were initially discovered as proviral insertion sites in Moloney murine leukemia virus infection, are a family of highly homologous serine/threonine kinases that have been reported to be overexpressed in hematological malignancies and solid tumors. The PIM proteins have also been associated with metastasis and overall treatment responses and implicated in the regulation of apoptosis, metabolism, the cell cycle, and homing and migration, which makes these proteins interesting targets for anticancer drug discovery. The use of retroviral insertional mutagenesis and refined approaches such as complementation tagging has allowed the identification of myc, pim and a third group of genes (including bmi1 and gfi1 as complementing genes in lymphomagenesis. Moreover, mouse modeling of human cancer has provided an understanding of the molecular pathways that are involved in tumor initiation and progression at the physiological level. In particular, genetically modified mice have allowed researchers to further elucidate the role of each of the Pim isoforms in various tumor types. PIM kinases have been identified as weak oncogenes because experimental overexpression in lymphoid tissue, prostate and liver induces tumors at a relatively low incidence and with a long latency. However, very strong synergistic tumorigenicity between Pim1/2 and c-Myc and other oncogenes has been observed in lymphoid tissues. Mouse models have also been used to study whether the inhibition of specific PIM isoforms is required to prevent carcinogen-induced sarcomas, indicating that the absence of Pim2 and Pim3 greatly reduces sarcoma growth and bone invasion; the extent of this effect is similar to that observed in the absence of all 3 isoforms. This review will summarize some of the animal models that have been used to understand the isoform-specific contribution of PIM kinases to tumorigenesis.

  19. Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan.

    Science.gov (United States)

    Wells, Eden V; Benn, Rita K; Warber, Sara L

    2015-11-01

    The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Integrating precision cancer medicine into healthcare—policy, practice, and research challenges

    Directory of Open Access Journals (Sweden)

    Gabrielle Bertier

    2016-10-01

    Full Text Available Abstract Precision medicine (PM can be defined as a predictive, preventive, personalized, and participatory healthcare service delivery model. Recent developments in molecular biology and information technology make PM a reality today through the use of massive amounts of genetic, ‘omics’, clinical, environmental, and lifestyle data. With cancer being one of the most prominent public health threats in developed countries, both the research community and governments have been investing significant time, money, and efforts in precision cancer medicine (PCM. Although PCM research is extremely promising, a number of hurdles still remain on the road to an optimal integration of standardized and evidence-based use of PCM in healthcare systems. Indeed, PCM raises a number of technical, organizational, ethical, legal, social, and economic challenges that have to be taken into account in the development of an appropriate health policy framework. Here, we highlight some of the more salient issues regarding the standards needed for integration of PCM into healthcare systems, and we identify fields where more research is needed before policy can be implemented. Key challenges include, but are not limited to, the creation of new standards for the collection, analysis, and sharing of samples and data from cancer patients, and the creation of new clinical trial designs with renewed endpoints. We believe that these issues need to be addressed as a matter of priority by public health policymakers in the coming years for a better integration of PCM into healthcare.

  1. [Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

    Science.gov (United States)

    Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

    2017-01-23

    This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

  2. ZHAO Jian-xiong (赵健雄)——A Famous Expert in Integrative Medicine and Dunhuang Medicine

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ ZHAO Jian-xiong, was born in Yulin City on November 1, 1942, Shaanxi Province. He graduated from Lanzhou Medical College in 1965, and practiced Western medicine after his graduation while learning traditional Chinese medicine (TCM). In 1980, Dr. ZHAO was one of the first students who graduated from the TCM graduate program at the China Academy of Traditional Chinese Medicine with a master's degree.

  3. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    OpenAIRE

    Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland...

  4. XU Jian-zhong (许建中)——An Outstanding Doctor of Integrative Medicine on Respiratory Diseases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Professor XU Jian-zhong was born in a family of traditional Chinese doctor in Beijing, August, 1930. His native place is Putian, Fujian Province. Prof. XU has engaged for more than 40 years in clinical medicine since he was graduated from Shanxi Medical University in 1954. From 1958 to 1961, he was released from work to attend the TCM Learning Class for Doctors of Western Medicine for 3 years and granted the first grade prize by the Ministry of Health at graduation. Since then, the integration of traditional Chinese and western medicine (TCM-WM) has been the cause he devoted himself to. Now, he is Chief Doctor in Xiyuan Hospital, China Academy of Traditional Chinese Medicine, visiting professor of postgraduate education Department of China Academy of TCM, and Director of Specialty Committee of Respiratory Diseases, Chinese Association of Integration of Traditional and Western Medicine (CAIM).

  5. Teaching writing of scientific abstracts in English: CLIL methodology in an integrated English and Medicine course

    Directory of Open Access Journals (Sweden)

    Philippa Mungra

    2010-10-01

    Full Text Available In the I Faculty at the University of Rome “La Sapienza” Medical School, one of the several methodology courses aims at developing approaches by physicians to patient queries. One such course comprises several disciplines: Pathology, Immunology, Medical Statistics, Internal Medicine and English, with the specific aim of furnishing students, all Italian speakers, with skills for searching and evaluating the medical literature for answers to patient queries regarding risks and effectiveness of therapy. This paper describes the integration of English into a Methodology Course and delineates how the language component uses a Content and Language Integrated Learning (CLIL approach to train students to write the highly specific genre of journal abstracts for medical experimental research articles. A corpus of student writing is presented and discussed with the aim of furnishing one didactic model for language teaching within the Italian Medical Curriculum.

  6. MD-CTS: An integrated terminology reference of clinical and translational medicine

    Directory of Open Access Journals (Sweden)

    Will Ray

    2016-01-01

    Full Text Available New vocabularies are rapidly evolving in the literature relative to the practice of clinical medicine and translational research. To provide integrated access to new terms, we developed a mobile and desktop online reference—Marshfield Dictionary of Clinical and Translational Science (MD-CTS. It is the first public resource that comprehensively integrates Wiktionary (word definition, BioPortal (ontology, Wiki (image reference, and Medline abstract (word usage information. MD-CTS is accessible at http://spellchecker.mfldclin.edu/. The website provides a broadened capacity for the wider clinical and translational science community to keep pace with newly emerging scientific vocabulary. An initial evaluation using 63 randomly selected biomedical words suggests that online references generally provided better coverage (73%-95% than paper-based dictionaries (57–71%.

  7. Integrative approach to analyze biodiversity and anti-inflammatory bioactivity of Wedelia medicinal plants.

    Directory of Open Access Journals (Sweden)

    Wen-Ching Lin

    Full Text Available For the development of "medical foods" and/or botanical drugs as defined USA FDA, clear and systemic characterizations of the taxonomy, index phytochemical components, and the functional or medicinal bioactivities of the reputed or candidate medicinal plant are needed. In this study, we used an integrative approach, including macroscopic and microscopic examination, marker gene analysis, and chemical fingerprinting, to authenticate and validate various species/varieties of Wedelia, a reputed medicinal plant that grows naturally and commonly used in Asian countries. The anti-inflammatory bioactivities of Wedelia extracts were then evaluated in a DSS-induced murine colitis model. Different species/varieties of Wedelia exhibited distinguishable morphology and histological structures. Analysis of the ribosomal DNA internal transcribed spacer (ITS region revealed significant differences among these plants. Chemical profiling of test Wedelia species demonstrated candidate index compounds and distinguishable secondary metabolites, such as caffeic acid derivatives, which may serve as phytochemical markers or index for quality control and identification of specific Wedelia species. In assessing their effect on treating DSS induced-murine colitis, we observed that only the phytoextract from W. chinensis species exhibited significant anti-inflammatory bioactivity on DSS-induced murine colitis among the various Wedelia species commonly found in Taiwan. Our results provide a translational research approach that may serve as a useful reference platform for biotechnological applications of traditional phytomedicines. Our findings indicate that specific Wedelia species warrant further investigation for potential treatment of human inflammatory bowel disease.

  8. Integrative medicine: Breaking down silos of knowledge and practice an epigenetic approach.

    Science.gov (United States)

    McEwen, Bruce S

    2017-04-01

    The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw. Copyright © 2017. Published by Elsevier Inc.

  9. A case report for differential diagnosis: Integrative medicine vs child abuse.

    Science.gov (United States)

    Ribeiro, Cristina Silveira; Rodrigues, Fernanda; Ribeiro, Catarina; Magalhães, Teresa

    2010-11-01

    The authors present the case of a ten-year-old Chinese boy who was taken to a hospital due to the presence of suspicious bruises on his body. The child was examined in the National Institute of Legal Medicine by forensic doctors and a forensic psychologist. Clinical characteristics of the case are summarized stressing that a better understanding of some kinds of integrative medicine (IM) may help to differentiate injuries resulting from those practices. This is the only and unique case diagnosed by the medico-legal services in Portugal. In fact a great range of IM practice has the potential to create confusion in the diagnosis of physical child abuse. This study focuses on the differential diagnosis of one specific kind of frequent skin injury usually seen in situations of both child abuse and IM (in this case TuiNa) - bruises. As the number of people who practice Traditional Chinese Medicine and other forms of IM increases in the Western world, the child protection community would benefit from familiarizing itselves with these practices to prevent social and/or legal conflicts that may arise from mistaken diagnoses of abuse. The objective of this case report is to emphasize the relevance of comprehensive and interdisciplinary evaluation of child abuse cases taking into account the specifics of each case, to achieve a proper diagnosis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  10. Practice Innovation for Care Integration, Opioid Management, and Quality Measurement in Family Medicine.

    Science.gov (United States)

    Neale, Anne Victoria; Bowman, Marjorie A; Seehusen, Dean A

    Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices. Visit entropy is negative for hospital readmissions. Another article reaffirms the importance of family physicians in rural obstetrics, including Cesarean deliveries. Two articles address changing Latino health care access. New Mexico's innovative health extension agent implementation now includes research in ways that benefit all. And a glass half-full: the growth in the diversity of family medicine faculty is above average, but is not occurring as quickly as in the general population. © Copyright 2017 by the American Board of Family Medicine.

  11. Towards high quality ITO coatings: the impact of nitrogen admixture in HiPIMS discharges

    Czech Academy of Sciences Publication Activity Database

    Straňák, V.; Bogdanowicz, R.; Sezemsky, P.; Wulff, H.; Kruth, A.; Smietana, M.; Kratochvíl, J.; Čada, Martin; Hubička, Zdeněk

    2018-01-01

    Roč. 335, Feb (2018), s. 126-133 ISSN 0257-8972 Institutional support: RVO:68378271 Keywords : film properties * HiPIMS * ITO * plasma deposition Subject RIV: BL - Plasma and Gas Discharge Physics OBOR OECD: Fluids and plasma physics (including surface physics) Impact factor: 2.589, year: 2016

  12. Membranes of Polymers of Intrinsic Microporosity (PIM-1) Modified by Poly(ethylene glycol).

    Science.gov (United States)

    Bengtson, Gisela; Neumann, Silvio; Filiz, Volkan

    2017-06-05

    Until now, the leading polymer of intrinsic microporosity PIM-1 has become quite famous for its high membrane permeability for many gases in gas separation, linked, however, to a rather moderate selectivity. The combination with the hydrophilic and low permeable poly(ethylene glycol) (PEG) and poly(ethylene oxides) (PEO) should on the one hand reduce permeability, while on the other hand enhance selectivity, especially for the polar gas CO₂ by improving the hydrophilicity of the membranes. Four different paths to combine PIM-1 with PEG or poly(ethylene oxide) and poly(propylene oxide) (PPO) were studied: physically blending, quenching of polycondensation, synthesis of multiblock copolymers and synthesis of copolymers with PEO/PPO side chain. Blends and new, chemically linked polymers were successfully formed into free standing dense membranes and measured in single gas permeation of N₂, O₂, CO₂ and CH₄ by time lag method. As expected, permeability was lowered by any substantial addition of PEG/PEO/PPO regardless the manufacturing process and proportionally to the added amount. About 6 to 7 wt % of PEG/PEO/PPO added to PIM-1 halved permeability compared to PIM-1 membrane prepared under similar conditions. Consequently, selectivity from single gas measurements increased up to values of about 30 for CO₂/N₂ gas pair, a maximum of 18 for CO₂/CH₄ and 3.5 for O₂/N₂.

  13. Ionization of sputtered Ti, Al, and C coupled with plasma characterization in HiPIMS

    Czech Academy of Sciences Publication Activity Database

    Lundin, D.; Čada, Martin; Hubička, Zdeněk

    2015-01-01

    Roč. 24, č. 3 (2015), s. 035018 ISSN 0963-0252 R&D Projects: GA MŠk LH12043 EU Projects: European Commission(XE) 608800 - HIPPOCAMP Institutional support: RVO:68378271 Keywords : IPVD * HiPIMS * HPPMS * Langmuir probe * ion meter Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 2.808, year: 2015

  14. Analytical method of CIM to PIM transformation in Model Driven Architecture (MDA

    Directory of Open Access Journals (Sweden)

    Martin Kardos

    2010-06-01

    Full Text Available Information system’s models on higher level of abstraction have become a daily routine in many software companies. The concept of Model Driven Architecture (MDA published by standardization body OMG1 since 2001 has become a concept for creation of software applications and information systems. MDA specifies four levels of abstraction: top three levels are created as graphical models and the last one as implementation code model. Many research works of MDA are focusing on the lower levels and transformations between each other. The top level of abstraction, called Computation Independent Model (CIM and its transformation to the lower level called Platform Independent Model (PIM is not so extensive research topic. Considering to a great importance and usability of this level in practice of IS2Keywords: transformation, MDA, CIM, PIM, UML, DFD. development now our research activity is focused to this highest level of abstraction – CIM and its possible transformation to the lower PIM level. In this article we are presenting a possible solution of CIM modeling and its analytic method of transformation to PIM.

  15. How Do Organic Vapors Swell Ultra-Thin PIM-1 Films?

    KAUST Repository

    Ogieglo, Wojciech; Rahimi, Khosrow; Rauer, Sebastian Bernhard; Ghanem, Bader; Ma, Xiao-Hua; Pinnau, Ingo; Wessling, Matthias

    2017-01-01

    Dynamic sorption of ethanol and toluene vapor into ultra-thin supported PIM-1 films down to 6 nm are studied with a combination of in-situ spectroscopic ellipsometry and in-situ X-ray reflectivity. Both ethanol and toluene significantly swell

  16. Enhanced properties of tungsten thin films deposited with a novel HiPIMS approach

    Science.gov (United States)

    Velicu, Ioana-Laura; Tiron, Vasile; Porosnicu, Corneliu; Burducea, Ion; Lupu, Nicoleta; Stoian, George; Popa, Gheorghe; Munteanu, Daniel

    2017-12-01

    Despite the tremendous potential for industrial use of tungsten (W), very few studies have been reported so far on controlling and tailoring the properties of W thin films obtained by physical vapor deposition techniques and, even less, for those deposited by High Power Impulse Magnetron Sputtering (HiPIMS). This study presents results on the deposition process and properties characterization of nanocrystalline W thin films deposited on silicon and molybdenum substrates (100 W average sputtering power) by conventional dc magnetron sputtering (dcMS) and HiPIMS techniques. Topological, structural, mechanical and tribological properties of the deposited thin films were investigated. It was found that in HiPIMS, both deposition process and coatings properties may be optimized by using an appropriate magnetic field configuration and pulsing design. Compared to the other deposited samples, the W films grown in multi-pulse (5 × 3 μs) HiPIMS assisted by an additional magnetic field, created with a toroidal-shaped permanent magnet placed in front of the magnetron cathode, show significantly enhanced properties, such as: smoother surfaces, higher homogeneity and denser microstructure, higher hardness and Young's modulus values, better adhesion to the silicon substrate and lower coefficient of friction. Mechanical behaviour and structural changes are discussed based on plasma diagnostics results.

  17. Populism : polder and prairie: The rapid rise and fall of Pim Fortuyn

    NARCIS (Netherlands)

    Lucardie, Anthonie

    2004-01-01

    DUTCH POLITICS HAS A REPUTATION FOR DULLNESS AND STABILITY. But that was hardly the case in 2002, when Pim Fortuyn entered politics. His party came in second in that year's election, although it had not yet been formally founded and Fortuyn himself had been murdered a few days earlier. Yet it now

  18. The rise of right-wing populist Pim Fortuyn in The Netherlands: A discursive oppertunity approach

    NARCIS (Netherlands)

    Koopmans, R.; Muis, J.C.

    2009-01-01

    This article seeks to explain the dramatic rise of Pim Fortuyn's right-wing populist party during the campaign for the parliamentary elections in the Netherlands in 2002. Fortuyn succeeded in attracting by far the most media attention of all political actors and his new party won 17 per cent of the

  19. From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine Fellows.

    Science.gov (United States)

    Roze des Ordons, Amanda L; Doig, Christopher J; Couillard, Philippe; Lord, Jason

    2017-04-01

    Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication. A departmental needs assessment informed curriculum development. Five 4-hour classroom sessions were developed: basic communication principles, family meetings about goals and transitions of care, discussing patient safety incidents, addressing conflict, and offering organ donation. Teaching methods-including instructor-led presentations incorporating a consistent framework for approaching challenging conversations, simulation and clinical practice, and feedback from peers, trained facilitators, family members, and clinicians-supported integration of skills into the clinical setting and longitudinal development of skillful communication. Seven fellows participated during the first year of the curriculum. CCM fellows engaged enthusiastically in the program, commented that the framework provided was helpful, and highly valued the opportunity to practice challenging communication scenarios, learn from observing their peers, and receive immediate feedback. More detailed accounts of fellows', patients', and family members' experiences will be obtained to guide curricular development. The curriculum will be expanded to involve other members of the multidisciplinary intensive care unit team, and faculty education initiatives will be offered to enhance the quality of the feedback provided. The impact of the curriculum on initial skill development, retention, and progression will be assessed.

  20. Drug Discovery and Development of Type 2 Diabetes Mellitus: Modern-Integrative Medicinal Approach.

    Science.gov (United States)

    Ghosh, Debosree; Parida, Pratap

    2016-01-01

    Type 2 diabetes is a disorder of ages, which has become deadlier because of life style modification and adaptation in the modern world. Extensive sudy of the pathophysiology of diabetes has opened up various mysteries about the disease and has helped us to know and understand diabetes in a better manner. Presently, we know many minute details about the pathophysiology of diabetes mellitus and are thus well weaponed to fight against it. Treatment regime has been evolving daily. Besides the conventional anti-diabetic drugs, integrated medicinal approach for treating diabetes type 2 with a compact therapeutic approach consisting of various targeted treatments for individual symptoms associated with the disease are being tried currently. Diabetes associated complications like high blood pressure, hyperglycemia, microalbumuria, dyslipidemia, pro -coagulation, etc. are being targeted and dealt with individually in the integrative medicinal approach. The results are promising and thus ignite hope for a better and more successful handling of diabetes and diabetes related pathophysiological complications in near future.

  1. Development road of critical care medicine in China: reference, integration and improvement

    Directory of Open Access Journals (Sweden)

    Hai-tao ZHANG

    2013-07-01

    Full Text Available Fundamental critical care medicine (FCCM and specialty critical care medicine (SCCM have their own independent developmental itinerary and have made indelible contributions to intensive treatment in the long history of CCM. The experts in FCCM are usually dominant in the cross-sectional study for various severe illnesses, and lay emphases on balancing the relationship among the dysfunctional organs under the guidance of overall treatment concept. SCCM experts emphasize longitudinal in-depth study for a specialized subject or special disease in order to solve the principal problem of the severe illness under the guidance of its own principal. At present, the main challenge of CCM is to avoid the habitual linear thinking. It is necessary for the members of FCCM to learn the knowledge of different problems pertaining to various specialties from SCCM, thus FCCM doctors would be able to take care of patients suffering from derangements of specific organs. SCCM members also need to learn from FCCM for strengthening the concept of overall treatment, optimizing various treatment resources, and improving treatment effects. Members of FCCM and SCCM need to learn from each other, in order to integrate and improve treatment strategies together, so as to complement each other. This will broaden the knowledge of SCCM and deepen that of FCCM. The integration of knowledge and skill will enrich the connotation of the CCM.

  2. Incorporation of integrative medicine education into undergraduate medical education: a longitudinal study

    Institute of Scientific and Technical Information of China (English)

    Saswati Mahapatra; Anjali Bhagra; Bisrat Fekadu; Zhuo Li; Brent A.Bauer; Dietlind L.Wahner-Roedler

    2017-01-01

    OBJECTIVE:Integrative medicine (IM) combines complementary medical approaches into conventional medicine and considers the whole person.We implemented a longitudinal IM short-course curriculum into our medical school education.This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students.METHODS:A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies.Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school.Paired data analysis was done,and only students who completed surveys at both time points were included in final analyses.RESULTS:Of 52 students in each class,17 (33%) in the class of 2015 and 22 (42%) in the class of 2016 completed both surveys.After the IM curriculum,students' knowledge of and comfort with several IM therapies—biofeedback,mindfulness,and the use of St.John's wort—improved significantly.Students' personal health practices also improved,including better sleep,exercise,and stress management for the class of 2015.Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year.CONCLUSION:It is feasible to incorporate IM education into undergraduate medical education,and this is associated with improvement in students' knowledge of IM and personal health practices.

  3. 'Better medicines for children' within the Integrated Management of Childhood Illness framework: a qualitative inquiry in Uganda.

    Science.gov (United States)

    Nsabagasani, Xavier; Ogwal-Okeng, Japer; Hansen, Ebba Holme; Mbonye, Anthony; Muyinda, Herbert; Ssengooba, Freddie

    2016-01-01

    The Integrated Management of Childhood Illnesses is the main approach for treating children in more than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate 'better medicines for children' into their essential medicines lists and treatment guidelines. WHO regularly provides generic algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based on new evidence for member countries to adopt. However, the status of 'better medicines for children' within the Integrated Management of Childhood Illnesses approach in Uganda has not been studied. Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Child-appropriate dosage formulations were not included in the package for the Integrated Management of Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance from the World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do support supervision and update treatment guidelines to reflect 'better medicines for children'. Health workers reported difficulties in administering tablets and capsules to under-five children and that's why they preferred liquid oral dosage formulations, suppositories and injections. The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations - a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for the Integrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List of Uganda, the Uganda Clinical Guidelines and, the Treatment Charts for the

  4. Human Microbiome and Learning Healthcare Systems: Integrating Research and Precision Medicine for Inflammatory Bowel Disease

    Science.gov (United States)

    Chuong, Kim H.; Mack, David R.; Stintzi, Alain

    2018-01-01

    Abstract Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care. To date, much discussion in this context has focused on the potential of human genomic data, and not yet on human microbiome data. Rapid advances in human microbiome research suggest that profiling of, and interventions on, the human microbiome can provide substantial opportunity for improved diagnosis, therapeutics, risk management, and risk stratification. In this study, we discuss a potential role for microbiome science in LHSs. We first review the key elements of LHSs, and discuss possibilities of Big Data and patient engagement. We then consider potentials and challenges of integrating human microbiome research into clinical practice as part of an LHS. With rapid growth in human microbiome research, patient-specific microbial data will begin to contribute in important ways to precision medicine. Hence, we discuss how patient-specific microbial data can help guide therapeutic decisions and identify novel effective approaches for precision care of inflammatory bowel disease. To the best of our knowledge, this expert analysis makes an original contribution with new insights poised at the emerging intersection of LHSs, microbiome science, and postgenomics medicine. PMID:28282257

  5. The Plasma Instrument for Magnetic Sounding (PIMS) onboard the Europa Clipper Mission

    Science.gov (United States)

    Westlake, Joseph H.; McNutt, Ralph L.; Kasper, Justin C.; Rymer, Abigail; Case, Anthony; Battista, Corina; Cochrane, Corey; Coren, David; Crew, Alexander; Grey, Matthew; Jia, Xianzhe; Khurana, Krishan; Kim, Cindy; Kivelson, Margaret G.; Korth, Haje; Krupp, Norbert; Paty, Carol; Roussos, Elias; Stevens, Michael; Slavin, James A.; Smith, Howard T.; Saur, Joachim

    2017-10-01

    Europa is embedded in a complex Jovian magnetospheric plasma, which rotates with the tilted planetary field and interacts dynamically with Europa’s ionosphere affecting the magnetic induction signal. Plasma from Io’s temporally varying torus diffuses outward and mixes with the charged particles in Europa’s own torus producing highly variable plasma conditions. Onboard the Europa Clipper spacecraft the Plasma Instrument for Magnetic Sounding (PIMS) works in conjunction with the Interior Characterization of Europa using Magnetometry (ICEMAG) investigation to probe Europa’s subsurface ocean. This investigation exploits currents induced in Europa’s interior by the moon’s exposure to variable magnetic fields in the Jovian system to infer properties of Europa’s subsurface ocean such as its depth, thickness, and conductivity. This technique was successfully applied to Galileo observations and demonstrated that Europa indeed has a subsurface ocean. While these Galileo observations contributed to the renewed interest in Europa, due to limitations in the observations the results raised major questions that remain unanswered. PIMS will greatly refine our understanding of Europa’s global liquid ocean by accounting for contributions to the magnetic field from plasma currents.The Europa Clipper mission is equipped with a sophisticated suite of 9 instruments to study Europa's interior and ocean, geology, chemistry, and habitability from a Jupiter orbiting spacecraft. PIMS on Europa Clipper is a Faraday Cup based plasma instrument whose heritage dates back to the Voyager spacecraft. PIMS will measure the plasma that populates Jupiter’s magnetosphere and Europa’s ionosphere. The science goals of PIMS are to: 1) estimate the ocean salinity and thickness by determining Europa’s magnetic induction response, corrected for plasma contributions; 2) assess mechanisms responsible for weathering and releasing material from Europa’s surface into the atmosphere and

  6. COMPUTING THERAPY FOR PRECISION MEDICINE: COLLABORATIVE FILTERING INTEGRATES AND PREDICTS MULTI-ENTITY INTERACTIONS.

    Science.gov (United States)

    Regenbogen, Sam; Wilkins, Angela D; Lichtarge, Olivier

    2016-01-01

    Biomedicine produces copious information it cannot fully exploit. Specifically, there is considerable need to integrate knowledge from disparate studies to discover connections across domains. Here, we used a Collaborative Filtering approach, inspired by online recommendation algorithms, in which non-negative matrix factorization (NMF) predicts interactions among chemicals, genes, and diseases only from pairwise information about their interactions. Our approach, applied to matrices derived from the Comparative Toxicogenomics Database, successfully recovered Chemical-Disease, Chemical-Gene, and Disease-Gene networks in 10-fold cross-validation experiments. Additionally, we could predict each of these interaction matrices from the other two. Integrating all three CTD interaction matrices with NMF led to good predictions of STRING, an independent, external network of protein-protein interactions. Finally, this approach could integrate the CTD and STRING interaction data to improve Chemical-Gene cross-validation performance significantly, and, in a time-stamped study, it predicted information added to CTD after a given date, using only data prior to that date. We conclude that collaborative filtering can integrate information across multiple types of biological entities, and that as a first step towards precision medicine it can compute drug repurposing hypotheses.

  7. Integrative therapies for low back pain that include complementary and alternative medicine care: a systematic review.

    Science.gov (United States)

    Kizhakkeveettil, Anupama; Rose, Kevin; Kadar, Gena E

    2014-09-01

    Systematic review of the literature. To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians.

  8. UV-rearranged PIM-1 polymeric membranes for advanced hydrogen purification and production

    Energy Technology Data Exchange (ETDEWEB)

    Li, Fu Yun; Ong, Yee Kang; Chung, Tai-Shung [Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore (Singapore); Xiao, Youchang [Suzhou Faith and Hope Membrane Technology Co. Ltd., Jiangsu Province (China)

    2012-12-15

    Polymers of intrinsic microporosity (PIM-1) have been known for their super high permeability but average selectivity for medium-size gas pairs. They have unimpressive selectivity for H{sub 2} and CO{sub 2} separation (i.e., {alpha} (H{sub 2}/CO{sub 2}) = 0.6). For the first time, we have discovered that ultraviolet (UV)-rearranged polymers of PIM-1 membranes can be used for H{sub 2}/CO{sub 2} separation with far superior separation performance to others in literatures. The PIM-1 membrane after UV radiation for 4 hours shows H{sub 2} permeability of 452 barrer with H{sub 2}/CO{sub 2} selectivity of 7.3. Experimental data and molecular simulation reveal that the polymer chains of PIM-1 undergo 1,2-migration reaction and transform to close-to-planar like rearranged structure after UV radiation. As a result, the UV-irradiated PIM-1 membrane shows considerable drops in both fractional free volume (FFV) and size of micro-pores. Positron annihilation lifetime (PAL) results have confirmed the chemical and structural changes, suggesting the FFV and pore size drops are mainly ascribed to the destructed spiro-carbon centre during UV radiation. Sorption and x-ray diffractor (XRD) analyses indicate that the impressive H{sub 2}/CO{sub 2} selectivity arises from the significantly enhanced diffusivity selectivity induced by UV radiation, followed by molecular rearrangement, conformation change and chain packing. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  9. How Do Organic Vapors Swell Ultra-Thin PIM-1 Films?

    KAUST Repository

    Ogieglo, Wojciech

    2017-06-22

    Dynamic sorption of ethanol and toluene vapor into ultra-thin supported PIM-1 films down to 6 nm are studied with a combination of in-situ spectroscopic ellipsometry and in-situ X-ray reflectivity. Both ethanol and toluene significantly swell the PIM-1 matrix and, at the same time, induce persistent structural relaxations of the frozen-in glassy PIM-1 morphology. For ethanol below 20 nm three effects were identified. First, the swelling magnitude at high vapor pressures is reduced by about 30% as compared to thicker films. Second, at low penetrant activities (below 0.3 p/p0) films below 20 nm are able to absorb slightly more penetrant as compared with thicker films despite similar swelling magnitude. Third, for the ultra-thin films the onset of the dynamic penetrant-induced glass transition Pg has been found to shift to higher values indicating higher resistance to plasticization. All of these effects are consistent with a view where immobilization of the super-glassy PIM-1 at the substrate surface leads to an arrested, even more rigid and plasticization-resistant, yet still very open, microporous structure. PIM-1 in contact with the larger and more condensable toluene shows very complex, heterogeneous swelling dynamics and two distinct penetrant-induced relaxation phenomena, probably associated with the film outer surface and the bulk, are detected. Following the direction of the penetrant\\'s diffusion the surface seems to plasticize earlier than the bulk and the two relaxations remain well separated down to 6 nm film thickness, where they remarkably merge to form just a single relaxation.

  10. How Do Organic Vapors Swell Ultrathin Films of Polymer of Intrinsic Microporosity PIM-1?

    Science.gov (United States)

    Ogieglo, Wojciech; Rahimi, Khosorov; Rauer, Sebastian Bernhard; Ghanem, Bader; Ma, Xiaohua; Pinnau, Ingo; Wessling, Matthias

    2017-07-27

    Dynamic sorption of ethanol and toluene vapor into ultrathin supported films of polymer of intrinsic microporosity PIM-1 down to a thickness of 6 nm are studied with a combination of in situ spectroscopic ellipsometry and in situ X-ray reflectivity. Both ethanol and toluene significantly swell the PIM-1 matrix and, at the same time, induce persistent structural relaxations of the frozen-in glassy PIM-1 morphology. For ethanol below 20 nm, three effects were identified. First, the swelling magnitude at high vapor pressures is reduced by about 30% as compared to that of thicker films. Second, at low penetrant activities (below 0.3p/p 0 ), films below 20 nm are able to absorb slightly more penetrant as compared with thicker films despite a similar swelling magnitude. Third, for the ultrathin films, the onset of the dynamic penetrant-induced glass transition P g has been found to shift to higher values, indicating higher resistance to plasticization. All of these effects are consistent with a view where immobilization of the superglassy PIM-1 at the substrate surface leads to an arrested, even more rigid, and plasticization-resistant, yet still very open, microporous structure. PIM-1 in contact with the larger and more condensable toluene shows very complex, heterogeneous swelling dynamics, and two distinct penetrant-induced relaxation phenomena, probably associated with the film outer surface and the bulk, are detected. Following the direction of the penetrant's diffusion, the surface seems to plasticize earlier than the bulk, and the two relaxations remain well separated down to 6 nm film thickness, where they remarkably merge to form just a single relaxation.

  11. The effect of changing the magnetic field strength on HiPIMS deposition rates

    International Nuclear Information System (INIS)

    Bradley, J W; Mishra, A; Kelly, P J

    2015-01-01

    The marked difference in behaviour between HiPIMS and conventional dc or pulsed-dc magnetron sputtering discharges with changing magnetic field strengths is demonstrated through measurements of deposition rate. To provide a comparison between techniques the same circular magnetron was operated in the three excitation modes at a fixed average power of 680 W and a pressure of 0.54 Pa in the non-reactive sputtering of titanium. The total magnetic field strength B at the cathode surface in the middle of the racetrack was varied from 195 to 380 G. DC and pulsed-dc discharges show the expected behaviour that deposition rates fall with decreasing B (here by ∼25–40%), however the opposite trend is observed in HiPIMS with deposition rates rising by a factor of 2 over the same decrease in B.These observations are understood from the stand point of the different composition and transport processes of the depositing metal flux between the techniques. In HiPIMS, this flux is largely ionic and slow post-ionized sputtered particles are subject to strong back attraction to the target by a retarding plasma potential structure ahead of them. The height of this potential barrier is known to increase with increasing B.From a simple phenomenological model of the sputtered particles fluxes, and using the measured deposition rates from the different techniques as inputs, the combined probabilities of ionization, α, and back attraction, β, of the metal species in HiPIMS has been calculated. There is a clear fall in αβ (from ∼0.9 to ∼0.7) with decreasing B-field strengths, we argue primarily due to a weakening of electrostatic ion back attraction, so leading to higher deposition rates. The results indicate that careful design of magnetron field strengths should be considered to optimise HiPIMS deposition rates. (paper)

  12. Article Commentary: Integral Healthcare: The Benefits and Challenges of Integrating Complementary and Alternative Medicine with a Conventional Healthcare Practice

    Directory of Open Access Journals (Sweden)

    Christina L. Ross PhD

    2009-01-01

    Full Text Available Today's medicine is in the midst of an undeniable crisis. Calls to reform healthcare are in the forefront of economic and political discussions worldwide. Economic pressures reduce the amount of time physicians can spend with patients contributing to burnout among medical staff and endangering the patient iatrogenically. Politicians are getting involved as the public is calling for more affordable healthcare. A new paradigm must be embraced in order to address all aspects of this dilemma. It is clear that science and technology have resulted in vastly improved understanding, diagnosis, and treatment of disease, but the emphasis on science and technology to the exclusion of other elements of healing has also served to limit the development of a model that humanizes healthcare. The healing of a patient must include more than the biology and chemistry of their physical body; by necessity, it must include the mental, emotional and spiritual aspects. Because of these challenges, the development of an integral healthcare system that is rooted in appropriate regulation and supported by rigorous scientific evidence is the direction that many models of integrative healthcare are moving towards in the 21st century.

  13. G-DOC Plus - an integrative bioinformatics platform for precision medicine.

    Science.gov (United States)

    Bhuvaneshwar, Krithika; Belouali, Anas; Singh, Varun; Johnson, Robert M; Song, Lei; Alaoui, Adil; Harris, Michael A; Clarke, Robert; Weiner, Louis M; Gusev, Yuriy; Madhavan, Subha

    2016-04-30

    G-DOC Plus is a data integration and bioinformatics platform that uses cloud computing and other advanced computational tools to handle a variety of biomedical BIG DATA including gene expression arrays, NGS and medical images so that they can be analyzed in the full context of other omics and clinical information. G-DOC Plus currently holds data from over 10,000 patients selected from private and public resources including Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA) and the recently added datasets from REpository for Molecular BRAin Neoplasia DaTa (REMBRANDT), caArray studies of lung and colon cancer, ImmPort and the 1000 genomes data sets. The system allows researchers to explore clinical-omic data one sample at a time, as a cohort of samples; or at the level of population, providing the user with a comprehensive view of the data. G-DOC Plus tools have been leveraged in cancer and non-cancer studies for hypothesis generation and validation; biomarker discovery and multi-omics analysis, to explore somatic mutations and cancer MRI images; as well as for training and graduate education in bioinformatics, data and computational sciences. Several of these use cases are described in this paper to demonstrate its multifaceted usability. G-DOC Plus can be used to support a variety of user groups in multiple domains to enable hypothesis generation for precision medicine research. The long-term vision of G-DOC Plus is to extend this translational bioinformatics platform to stay current with emerging omics technologies and analysis methods to continue supporting novel hypothesis generation, analysis and validation for integrative biomedical research. By integrating several aspects of the disease and exposing various data elements, such as outpatient lab workup, pathology, radiology, current treatments, molecular signatures and expected outcomes over a web interface, G-DOC Plus will continue to strengthen precision medicine research. G-DOC Plus is available

  14. The Capabilities of Nurses for Complementary and Traditional Medicine Integration in Africa.

    Science.gov (United States)

    Gyasi, Razak Mohammed; Abass, Kabila; Adu-Gyamfi, Samuel; Accam, Burnett Tetteh; Nyamadi, Victoria Mensah

    2018-03-01

    Despite the political commitment of national governments and collaborative efforts by the World Health Organization (WHO) toward the actualization of intercultural healthcare system over the past decades, sub-Saharan African countries feature medical cohabitation rather than a truly integrated medical system. This hospital-based cross-sectional study analyzed the capabilities of nurses for complementary and traditional medicine (CTM) integration in Africa. Practicing nurses (n = 210) were recruited to respond to the CTM Health Belief Questionnaire (CHBQ) in December 2016. Normality of data was evaluated using Kolmogorov-Smirnov statistic with a Lilliefors significance correction. The authors assessed the relationship among nurses' knowledge, personal use, and clinical practice of CTM, using Spearman's Rank Order Correlation (rho). The differences and associations in continuous and categorical baseline variables were determined with Mann-Whitney U test/Kruskal-Wallis H test and Pearson's Chi-square test, respectively, at p nurses' knowledge of CTM therapies was 38 (interquartile range [IQR] 16). This low CTM-related knowledge reflected in the poor mean performance score of 30 (IQR 17) and 22 (IQR 6) for personal use and clinical practice of CTM, respectively, among nurses. Nurses, therefore, lacked the confidence to recommend CTM therapies to patients. Yet, nurses exhibited a high positive attitude to CTM (72.7 ± 12.5). In addition to significant associations among CTM-related knowledge, education (p = 0.023), and religion (p nurses' knowledge of CTM through evidence-based nursing education and training remains the surest way to achieve appropriate CTM integration in Africa as outlined in the WHO Traditional Medicine Strategy 2014-2023.

  15. Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

    Science.gov (United States)

    Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-05-01

    Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

  16. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

    Science.gov (United States)

    Singer, Judy; Adams, Jon

    2014-05-22

    Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person

  17. Diablo Canyon plant information management system and integrated communication system

    International Nuclear Information System (INIS)

    Stanley, J.W.; Groff, C.

    1990-01-01

    The implementation of a comprehensive maintenance system called the plant information management system (PIMS) at the Diablo Canyon plant, together with its associated integrated communication system (ICS), is widely regarded as the most comprehensive undertaking of its kind in the nuclear industry. This paper provides an overview of the program at Diablo Canyon, an evaluation of system benefits, and highlights the future course of PIMS

  18. Diablo Canyon plant information management system and integrated communication system

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, J.W.; Groff, C.

    1990-06-01

    The implementation of a comprehensive maintenance system called the plant information management system (PIMS) at the Diablo Canyon plant, together with its associated integrated communication system (ICS), is widely regarded as the most comprehensive undertaking of its kind in the nuclear industry. This paper provides an overview of the program at Diablo Canyon, an evaluation of system benefits, and highlights the future course of PIMS.

  19. Effective communication about the use of complementary and integrative medicine in cancer care.

    Science.gov (United States)

    Frenkel, Moshe; Cohen, Lorenzo

    2014-01-01

    Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the "how" and the "what". The "how" relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The "what" relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making.

  20. On art and science: an epistemic framework for integrating social science and clinical medicine.

    Science.gov (United States)

    Wasserman, Jason Adam

    2014-06-01

    Calls for incorporating social science into patient care typically have accounted for neither the logistic constraints of medical training nor the methodological fallacies of utilizing aggregate "social facts" in clinical practice. By elucidating the different epistemic approaches of artistic and scientific practices, this paper illustrates an integrative artistic pedagogy that allows clinical practitioners to generate social scientific insights from actual patient encounters. Although there is no shortage of calls to bring social science into medicine, the more fundamental processes of thinking by which art and science proceed have not been addressed to this end. As such, the art of medical practice is conceptualized as an innate gift, and thus little is done to cultivate it. Yet doing so is more important than ever because uncertainty in diagnosing and treating chronic illnesses, the most significant contemporary mortality risks, suggests a re-expanding role for clinical judgment. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  2. An integrated system for identifying the hidden assassins in traditional medicines containing aristolochic acids

    Science.gov (United States)

    Wu, Lan; Sun, Wei; Wang, Bo; Zhao, Haiyu; Li, Yaoli; Cai, Shaoqing; Xiang, Li; Zhu, Yingjie; Yao, Hui; Song, Jingyuan; Cheng, Yung-Chi; Chen, Shilin

    2015-08-01

    Traditional herbal medicines adulterated and contaminated with plant materials from the Aristolochiaceae family, which contain aristolochic acids (AAs), cause aristolochic acid nephropathy. Approximately 256 traditional Chinese patent medicines, containing Aristolochiaceous materials, are still being sold in Chinese markets today. In order to protect consumers from health risks due to AAs, the hidden assassins, efficient methods to differentiate Aristolochiaceous herbs from their putative substitutes need to be established. In this study, 158 Aristolochiaceous samples representing 46 species and four genera as well as 131 non-Aristolochiaceous samples representing 33 species, 20 genera and 12 families were analyzed using DNA barcodes based on the ITS2 and psbA-trnH sequences. Aristolochiaceous materials and their non-Aristolochiaceous substitutes were successfully identified using BLAST1, the nearest distance method and the neighbor-joining (NJ) tree. In addition, based on sequence information of ITS2, we developed a Real-Time PCR assay which successfully identified herbal material from the Aristolochiaceae family. Using Ultra High Performance Liquid Chromatography-Mass Spectrometer (UHPLC-HR-MS), we demonstrated that most representatives from the Aristolochiaceae family contain toxic AAs. Therefore, integrated DNA barcodes, Real-Time PCR assays using TaqMan probes and UHPLC-HR-MS system provides an efficient and reliable authentication system to protect consumers from health risks due to the hidden assassins (AAs).

  3. A monograph assignment as an integrative application of evidence-based medicine and pharmacoeconomic principles.

    Science.gov (United States)

    Law, Anandi V; Jackevicius, Cynthia A; Bounthavong, Mark

    2011-02-10

    To describe the development and assessment of monographs as an assignment to incorporate evidence-based medicine (EBM) and pharmacoeconomic principles into a third-year pharmacoeconomic course. Eight newly FDA-approved drugs were assigned to 16 teams of students, where each drug was assigned to 2 teams. Teams had to research their drug, write a professional monograph, deliver an oral presentation, and answer questions posed by faculty judges. One team was asked to present evidence for inclusion of the drug into a formulary, while another team presented evidence against inclusion. The teams' average score on the written report was 99.1%; on the oral presentation, 92.5%, and on the online quiz given at the end of the presentations, 77%. Monographs are a successful method of incorporating and integrating learning across different concepts, as well as increasing relevance of pharmacoeconomics in the PharmD curriculum.

  4. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  5. [Disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology: Confusions and countermeasures in studies].

    Science.gov (United States)

    Zhang, Min-Jian

    2017-07-01

    Researches on the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine are becoming a hot spot in andrology, but many recent studies of this kind have failed to explain the connotation of integrated traditional Chinese and Western medicine in andrology. Related existing problems include repeated researches into the same indexes of action mechanisms of different therapeutic principles of traditional Chinese medicine (TCM), Chinese herbal compound and special prescriptions, studies focusing on individual diseases but ignoring symptoms, immature syndrome models for studies of mechanisms, and too much attention to uncertain or immature target mechanisms. The stress should be placed on the action mechanisms of Chinese herbal compound and special prescriptions on male diseases and, what is more important, on the clarification of the essential principles of differentiation and treatment of TCM syndromes. In the recent years, proteomics, genomics, transcriptomics and metabolomics have shed some light upon researches into the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine in andrology. An insight into the TCM syndrome, a macroscopic inductive analysis, and a comprehension of such microcosmic aspects as the gene, protein, metabolism and metagenome may contribute to some breakthroughs and new ideas in the studies of disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology.

  6. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  7. Analysis on Outcome of 3537 Patients with Coronary Artery Disease: Integrative Medicine for Cardiovascular Events

    Directory of Open Access Journals (Sweden)

    Zhu-ye Gao

    2013-01-01

    Full Text Available Aims. To investigate the treatment of hospitalized patients with coronary artery disease (CAD and the prognostic factors in Beijing, China. Materials and Methods. A multicenter prospective study was conducted through an integrative platform of clinical and research at 12 hospitals in Beijing, China. The clinical information of 3537 hospitalized patients with CAD was collected from September 2009 to May 2011, and the efficacy of secondary prevention during one-year followup was evaluated. In addition, a logistic regression analysis was performed to identify some factors which will have independent impact on the prognosis. Results. The average age of all patients was 64.88 ± 11.97. Of them, 65.42% are males. The medicines for patients were as follows: antiplatelet drugs accounting for 91.97%, statins accounting for 83.66%, β-receptor blockers accounting for 72.55%, ACEI/ARB accounting for 58.92%, and revascularization (including PCI and CABG accounting for 40.29%. The overall incidence of cardiovascular events was 13.26% (469/3537. The logistic stepwise regression analysis showed that heart failure (OR, 3.707, 95% CI = 2.756–4.986, age ≥ 65 years old (OR, 2.007, 95% CI = 1.587–2.53, and myocardial infarction (OR, 1.649, 95% CI = 1.322–2.057 were the independent risk factors of others factors for cardiovascular events that occurred during followup of one-year period. Integrative medicine (IM therapy showed the beneficial tendency for decreasing incidence of cardiovascular events, although no statistical significance was found (OR, 0.797, 95% CI = 0.613~1.036. Conclusions. Heart failure, age ≥ 65 years old, and myocardial infarction were associated with an increase in incidence of cardiovascular events, and treatment with IM showed a tendency for decreasing incidence of cardiovascular events.

  8. A new fully automatic PIM tool to replicate two component tungsten DEMO divertor parts

    International Nuclear Information System (INIS)

    Antusch, Steffen; Commin, Lorelei; Heneka, Jochen; Piotter, Volker; Plewa, Klaus; Walter, Heinz

    2013-01-01

    Highlights: • Development of a fully automatic 2C-PIM tool. • Replicate fusion relevant components in one step without additional brazing. • No cracks or gaps in the seam of the joining zone visible. • For both material combinations a solid bond of the material interface was achieved. • PIM is a powerful process for mass production as well as for joining even complex shaped parts. -- Abstract: At Karlsruhe Institute of Technology (KIT), divertor design concepts for future nuclear fusion power plants beyond ITER are intensively investigated. One promising KIT divertor design concept for the future DEMO power reactor is based on modular He-cooled finger units. The manufacturing of such parts by mechanical machining such as milling and turning, however, is extremely cost and time intensive because tungsten is very hard and brittle. Powder Injection Molding (PIM) has been adapted to tungsten processing at KIT since a couple of years. This production method is deemed promising in view of large-scale production of tungsten parts with high near-net-shape precision, hence, offering an advantage of cost-saving process compared to conventional machining. The properties of the effectively and successfully manufactured divertor part tile consisting only of pure tungsten are a microstructure without cracks and a high density (>98% T.D.). Based on the achieved results a new fully automatic multicomponent PIM tool was developed and allows the replication and joining without brazing of fusion relevant components of different materials in one step and the creation of composite materials. This contribution describes the process route to design and engineer a new fully automatic 2C-PIM tool, including the filling simulation and the implementing of the tool. The complete technological fabrication process of tungsten 2C-PIM, including material and feedstock (powder and binder) development, injection molding, and heat-treatment of real DEMO divertor parts is outlined

  9. The MedSeq Project: a randomized trial of integrating whole genome sequencing into clinical medicine.

    Science.gov (United States)

    Vassy, Jason L; Lautenbach, Denise M; McLaughlin, Heather M; Kong, Sek Won; Christensen, Kurt D; Krier, Joel; Kohane, Isaac S; Feuerman, Lindsay Z; Blumenthal-Barby, Jennifer; Roberts, J Scott; Lehmann, Lisa Soleymani; Ho, Carolyn Y; Ubel, Peter A; MacRae, Calum A; Seidman, Christine E; Murray, Michael F; McGuire, Amy L; Rehm, Heidi L; Green, Robert C

    2014-03-20

    illuminate the impact of integrating genomic medicine into the clinical care of patients but also inform the design of future studies. ClinicalTrials.gov identifier NCT01736566.

  10. Determining the attitudes and use of complementary, alternative, and integrative medicine among undergraduates.

    Science.gov (United States)

    Liu, Michael A; Huynh, Ngoc-Tram; Broukhim, Michael; Cheung, Douglas H; Schuster, Tonya L; Najm, Wadie

    2014-09-01

    To (1) determine the attitudes, perceptions, and use of complementary, alternative, and integrative medicine among undergraduate students; (2) assess whether these students would benefit from more academic exposure to complementary and alternative medicine (CAM) and promotion of integrative medicine (IM); and (3) gauge the need and desire of undergraduates, particularly pre-health learners, to take courses about CAM/IM. This cross-sectional electronic survey study was conducted on the campus of the University of California (UC) Irvine. Selection criteria included being at least 18 years of age and a current undergraduate at UC Irvine. All survey responses were collected between November 20, 2010, and June 1, 2011. The data were analyzed by using Stata software, version 11-SE (Stata Corp., College Station, TX). Completed surveys were received from 2839 participants (mean age of respondents, 20.2 years). Thirty-five percent had used CAM within the past 12 months, and 92.8% believed CAM to be at least somewhat effective; however, only 31% had prior education on CAM. After adjustment for variables, familiarity and belief in effectiveness were both highly linked to the use of CAM, with ascending odds ratios (ORs; 95% confidence interval [CI]) of 3.9 (3.1-4.9), 8.1 (5.7-11.5), 13.4 (6.0-30.2), 2.1 (1.3-3.4), 4.9 (3.0-7.8), and 12.7 (6.9-23.4) among increasing categories (all p<0.01). Sex (OR, 1.26 [95% CI, 1.01-1.56]; p<0.05), Asian ethnicity (1.46 [1.14-1.88]; p<0.01), and prior education (1.26 [1.01-1.57]; p<0.05) were also significantly correlated to the use of CAM after adjustment. Most respondents indicated that they were likely to take a CAM college course if it fulfilled a graduation requirement (63.6%) or was offered within their major (56.4%). Overall, this large-scale study supports the ideas that education plays a pivotal factor in the decision to use CAM and that there is a large demand for additional CAM knowledge among college students.

  11. In utero exposure to benzene increases embryonic c-Myb and Pim-1 protein levels in CD-1 mice

    International Nuclear Information System (INIS)

    Wan, Joanne; Winn, Louise M.

    2008-01-01

    Benzene is a known human leukemogen, but its role as an in utero leukemogen remains controversial. Epidemiological studies have correlated parental exposure to benzene with an increased incidence of childhood leukemias. We hypothesize that in utero exposure to benzene may cause leukemogenesis by affecting the embryonic c-Myb/Pim-1 signaling pathway and that this is mediated by oxidative stress. To investigate this hypothesis, pregnant CD-1 mice were treated with either 800 mg/kg of benzene or corn oil (i.p.) on days 10 and 11 of gestation and in some cases pretreated with 25 kU/kg of PEG-catalase. Phosphorylated and total embryonic c-Myb and Pim-1 protein levels were assessed using Western blotting and maternal and embryonic oxidative stress were assessed by measuring reduced to oxidized glutathione ratios. Our results show increased oxidative stress at 4 and 24 h after exposure, increased phosphorylated Pim-1 protein levels 4 h after benzene exposure, and increased Pim-1 levels at 24 and 48 h after benzene exposure. Embryonic c-Myb levels were elevated at 24 h after exposure. PEG-catalase pretreatment prevented benzene-mediated increases in embryonic c-Myb and Pim-1 protein levels, and benzene-induced oxidative stress. These results support a role for ROS in c-Myb and Pim-1 alterations after in utero benzene exposure

  12. Relationship between Organizational Culture and the Use of Psychotropic Medicines in Nursing Homes: A Systematic Integrative Review.

    Science.gov (United States)

    Sawan, Mouna; Jeon, Yun-Hee; Chen, Timothy F

    2018-03-01

    Psychotropic medicines are commonly used in nursing homes, despite marginal clinical benefits and association with harm in the elderly. Organizational culture is proposed as a factor explaining the high-level use of psychotropic medicines. Schein describes three levels of culture: artifacts, espoused values, and basic assumptions. This integrative review aimed to investigate the facets and role of organizational culture in the use of psychotropic medicines in nursing homes. Five databases were searched for qualitative, quantitative, and mixed method empirical studies up to 13 February 2017. Articles were included if they examined an aspect of organizational culture according to Schein's theory and the use of psychotropic medicines in nursing homes for the management of behavioral and sleep disturbances in residents. Article screening and data extraction were performed independently by one reviewer and checked by the research team. The integrative review method, an approach similar to the method of constant comparison analysis was utilized for data analysis. Twenty-four studies met the inclusion criteria: 13 used quantitative methods, 9 used qualitative methods, 1 was quasi-qualitative, and 1 used mixed methods. Included studies were found to only address two aspects of organizational culture in relation to the use of psychotropic medicines: artifacts and espoused values. No studies addressed the basic assumptions, the unsaid taken-for-granted beliefs, which provide explanations for in/consistencies between the ideal use of psychotropic medicines and the actual use of psychotropic medicines. Previous studies suggest that organizational culture influences the use of psychotropic medicines in nursing homes; however, what is known is descriptive of culture only at the surface level, that is the artifacts and espoused values. Hence, future research that explains the impact of the basic assumptions of culture on the use of psychotropic medicines is important.

  13. Integrative mining of traditional Chinese medicine literature and MEDLINE for functional gene networks.

    Science.gov (United States)

    Zhou, Xuezhong; Liu, Baoyan; Wu, Zhaohui; Feng, Yi

    2007-10-01

    The amount of biomedical data in different disciplines is growing at an exponential rate. Integrating these significant knowledge sources to generate novel hypotheses for systems biology research is difficult. Traditional Chinese medicine (TCM) is a completely different discipline, and is a complementary knowledge system to modern biomedical science. This paper uses a significant TCM bibliographic literature database in China, together with MEDLINE, to help discover novel gene functional knowledge. We present an integrative mining approach to uncover the functional gene relationships from MEDLINE and TCM bibliographic literature. This paper introduces TCM literature (about 50,000 records) as one knowledge source for constructing literature-based gene networks. We use the TCM diagnosis, TCM syndrome, to automatically congregate the related genes. The syndrome-gene relationships are discovered based on the syndrome-disease relationships extracted from TCM literature and the disease-gene relationships in MEDLINE. Based on the bubble-bootstrapping and relation weight computing methods, we have developed a prototype system called MeDisco/3S, which has name entity and relation extraction, and online analytical processing (OLAP) capabilities, to perform the integrative mining process. We have got about 200,000 syndrome-gene relations, which could help generate syndrome-based gene networks, and help analyze the functional knowledge of genes from syndrome perspective. We take the gene network of Kidney-Yang Deficiency syndrome (KYD syndrome) and the functional analysis of some genes, such as CRH (corticotropin releasing hormone), PTH (parathyroid hormone), PRL (prolactin), BRCA1 (breast cancer 1, early onset) and BRCA2 (breast cancer 2, early onset), to demonstrate the preliminary results. The underlying hypothesis is that the related genes of the same syndrome will have some biological functional relationships, and will constitute a functional network. This paper presents

  14. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    Science.gov (United States)

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

  15. Integrative Laser Medicine and High-Tech Acupuncture at the Medical University of Graz, Austria, Europe

    Directory of Open Access Journals (Sweden)

    Gerhard Litscher

    2012-01-01

    Full Text Available At the moment, modernization of acupuncture has a high priority. On the traditional side, acupuncture has only recently been awarded the status of Intangible Cultural Heritage by the UNESCO. On the innovative side, high-tech acupuncture is a registered trademark in Austria. Acupuncture has been used for medical treatment for thousands of years. A large number of empirical data are available but the technical quantification of effects was not possible up to now. Using electroacupuncture, needle, or laser stimulation and modern biomedical techniques, it was possible for the first time to quantify changes in biological activities caused by acupuncture. This paper which serves as introduction for the special issue “High-Tech Acupuncture and Integrative Laser Medicine” of the present journal, focuses on the latest innovative aspects that underline the further enhancement and development of acupuncture. Special emphasis is given to new methodological and technical investigations, for example, results obtained from all kinds of acupuncture innovations (e.g., teleacupuncture and integrative laser medicine.

  16. Integrated Pathology Informatics Enables High-Quality Personalized and Precision Medicine: Digital Pathology and Beyond.

    Science.gov (United States)

    Volynskaya, Zoya; Chow, Hung; Evans, Andrew; Wolff, Alan; Lagmay-Traya, Cecilia; Asa, Sylvia L

    2018-03-01

    - The critical role of pathology in diagnosis, prognosis, and prediction demands high-quality subspecialty diagnostics that integrates information from multiple laboratories. - To identify key requirements and to establish a systematic approach to providing high-quality pathology in a health care system that is responsible for services across a large geographic area. - This report focuses on the development of a multisite pathology informatics platform to support high-quality surgical pathology and hematopathology using a sophisticated laboratory information system and whole slide imaging for histology and immunohistochemistry, integrated with ancillary tools, including electron microscopy, flow cytometry, cytogenetics, and molecular diagnostics. - These tools enable patients in numerous geographic locations access to a model of subspecialty pathology that allows reporting of every specimen by the right pathologist at the right time. The use of whole slide imaging for multidisciplinary case conferences enables better communication among members of patient care teams. The system encourages data collection using a discrete data synoptic reporting module, has implemented documentation of quality assurance activities, and allows workload measurement, providing examples of additional benefits that can be gained by this electronic approach to pathology. - This approach builds the foundation for accurate big data collection and high-quality personalized and precision medicine.

  17. Integrative Laser Medicine and High-Tech Acupuncture at the Medical University of Graz, Austria, Europe

    Science.gov (United States)

    Litscher, Gerhard

    2012-01-01

    At the moment, modernization of acupuncture has a high priority. On the traditional side, acupuncture has only recently been awarded the status of Intangible Cultural Heritage by the UNESCO. On the innovative side, high-tech acupuncture is a registered trademark in Austria. Acupuncture has been used for medical treatment for thousands of years. A large number of empirical data are available but the technical quantification of effects was not possible up to now. Using electroacupuncture, needle, or laser stimulation and modern biomedical techniques, it was possible for the first time to quantify changes in biological activities caused by acupuncture. This paper which serves as introduction for the special issue “High-Tech Acupuncture and Integrative Laser Medicine” of the present journal, focuses on the latest innovative aspects that underline the further enhancement and development of acupuncture. Special emphasis is given to new methodological and technical investigations, for example, results obtained from all kinds of acupuncture innovations (e.g., teleacupuncture) and integrative laser medicine. PMID:22570669

  18. Attitudes toward integration of complementary and alternative medicine with hospital-based care.

    Science.gov (United States)

    Lewis, D; Paterson, M; Beckerman, S; Sandilands, C

    2001-12-01

    To characterize those who have used, expect to use, or are opposed to the use of holistic therapies, especially in a conventional medical (hospital) setting. SAMPLE DESCRIPTION AND METHODS: Cross-sectional survey of a random sample of Hamilton-Wentworth residents between March and June 1998 (n = 416; response rate, 63%); analysis used logistic regression. Thirty-seven percent (37%) used at least one holistic therapy in the previous year: the three most common were chiropractic, massage, and herbal/phytology. The three most common reasons for use were general health, fatigue, and arthritis. Thirty-three percent (33%) would use holistic therapy in the future. Barriers to use were lack of information, perceived ineffectiveness, and cost; approximately 40% agreed they would only use holistic therapies with medical advice. Approximately 13% were opposed to holistic therapy and objected to its use in hospitals. Younger age, preference for holistic therapy over conventional medicine, and prior use of holism independently predicted high likelihood for future use. Lower income and high self-perceived health were associated with negative attitude toward use of holistic therapies in hospital. Most respondents would accept integration of holistic techniques into a hospital; therapies would be more acceptable if there were clear evidence of their efficacy. A few might find their opinion of a sponsoring hospital lowered by such integration.

  19. Barriers to Integration of Traditional and Complementary Medicine in Supportive Cancer Care of Arab Patients in Northern Israel

    Directory of Open Access Journals (Sweden)

    Eran Ben-Arye

    2012-01-01

    Full Text Available In 2008, an Integrative Oncology Program (IOP, aiming to improve patients’ quality of life during chemotherapy and advanced cancer, was launched within the Clalit Health Organization's oncology service at the Lin Medical Center, Haifa, Israel. The IOP clinical activity is documented using a research-based registry protocol. In this study, we present an analysis of the registry protocol of 15 Arab patients with cancer who were referred to the IOP. Analysis of patients’ reported outcomes using the Edmonton Symptom Assessment Scale suggests that integrative medicine care improves fatigue (=0.024, nausea (=0.043, depression (=0.012, anxiety (=0.044, appetite (=0.012, and general well-being (=0.031. Barriers to integration of traditional and complementary medicine in supportive care of Arab patients are discussed followed by six practical recommendations aimed at improving accessibility of patients to integrative supportive care, as well as compliance with treatments.

  20. [New theory of holistic integrative physiology and medicine. I: New insight of mechanism of control and regulation of breathing].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    The modern systemic physiology, based on limit-understand functional classification, has significant limitation and one-sidedness. Human being is organic; we should approach the mechanism of control and regulation of breathing integrating all the systems. We use new theory of holistic integrative physiology and medicine to explain the mechanism of control and regulation of breathing. Except the mean level information, the up-down "W" waveform information of arterial blood gas (ABG) is core signal to control and regulate breathing. In order to do so, we must integrate all systems together. New theory will help to explain some unanswered questions in physiology and medicine, for example: fetal does not breathing; how first breath generate; how respiratory rhythm and frequency generate, etc. Breathing is the sign of life. Mechanism of control and regulation of breathing has to integrate respiration, circulation, nerves, metabolism, exercise, sleep and digestion, absorption and elimination and etc altogether.

  1. R Package multiPIM: A Causal Inference Approach to Variable Importance Analysis

    Directory of Open Access Journals (Sweden)

    Stephan J Ritter

    2014-04-01

    Full Text Available We describe the R package multiPIM, including statistical background, functionality and user options. The package is for variable importance analysis, and is meant primarily for analyzing data from exploratory epidemiological studies, though it could certainly be applied in other areas as well. The approach taken to variable importance comes from the causal inference field, and is different from approaches taken in other R packages. By default, multiPIM uses a double robust targeted maximum likelihood estimator (TMLE of a parameter akin to the attributable risk. Several regression methods/machine learning algorithms are available for estimating the nuisance parameters of the models, including super learner, a meta-learner which combines several different algorithms into one. We describe a simulation in which the double robust TMLE is compared to the graphical computation estimator. We also provide example analyses using two data sets which are included with the package.

  2. Exploring surface photoreaction dynamics using pixel imaging mass spectrometry (PImMS)

    Science.gov (United States)

    Kershis, Matthew D.; Wilson, Daniel P.; White, Michael G.; John, Jaya John; Nomerotski, Andrei; Brouard, Mark; Lee, Jason W. L.; Vallance, Claire; Turchetta, Renato

    2013-08-01

    A new technique for studying surface photochemistry has been developed using an ion imaging time-of-flight mass spectrometer in conjunction with a fast camera capable of multimass imaging. This technique, called pixel imaging mass spectrometry (PImMS), has been applied to the study of butanone photooxidation on TiO2(110). In agreement with previous studies of this system, it was observed that the main photooxidation pathway for butanone involves ejection of an ethyl radical into vacuum which, as confirmed by our imaging experiment, undergoes fragmentation after ionization in the mass spectrometer. This proof-of-principle experiment illustrates the usefulness and applicability of PImMS technology to problems of interest within the surface science community.

  3. Assessing local market and organizational readiness for the integration of complementary and alternative medicine into ambulatory care centers.

    Science.gov (United States)

    Makowski, Suzana K E

    2004-01-01

    Complementary and alternative medicine (CAM) is one of the fastest growing segments of the health care industry today, with studies suggesting that between 30% and 50% of the adult population in the United States uses some form of CAM. Many ambulatory care centers are considering integrating CAM into their clinical services. This article will review some of the national trends and present a framework for assessing local market demand for CAM in order to help prioritize an organization's CAM integration strategy.

  4. Integrated internist - addiction medicine - hepatology model for hepatitis C management for individuals on methadone maintenance.

    Science.gov (United States)

    Martinez, A D; Dimova, R; Marks, K M; Beeder, A B; Zeremski, M; Kreek, M J; Talal, A H

    2012-01-01

    Despite a high prevalence of hepatitis C virus (HCV) among drug users, HCV evaluation and treatment acceptance are extremely low among these patients when referred from drug treatment facilities for HCV management. We sought to increase HCV treatment effectiveness among patients from a methadone maintenance treatment program (MMTP) by maintaining continuity of care. We developed, instituted and retrospectively assessed the effectiveness of an integrated, co-localized care model in which an internist-addiction medicine specialist from MMTP was embedded in the hepatitis clinic. Methadone maintenance treatment program patients were referred, evaluated by the internist and hepatologist in hepatitis clinic and provided HCV treatment with integration between both sites. Of 401 evaluated patients, anti-HCV antibody was detected in 257, 86% of whom were older than 40 years. Hepatitis C virus RNA levels were measured in 222 patients, 65 of whom were aviremic. Of 157 patients with detectable HCV RNA, 125 were eligible for referral to the hepatitis clinic, 76 (61%) of whom accepted and adhered with the referral. Men engaged in MMTP <36 months were significantly less likely to be seen in hepatitis clinic than men in MMTP more than 36 months (odds ratio = 7.7; 95% confidence interval 2.6-22.9) or women. We evaluated liver histology in 63 patients, and 83% had moderate to advanced liver disease. Twenty-four patients initiated treatment with 19 completing and 13 (54%) achieving sustained response. In conclusion, integrated care between the MMTP and the hepatitis clinic improves adherence with HCV evaluation and treatment compared to standard referral practices. © 2010 Blackwell Publishing Ltd.

  5. Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

    Science.gov (United States)

    Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

    2016-10-01

    Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

  6. First, keep it safe: Integration of a complementary medicine service within a hospital.

    Science.gov (United States)

    Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

    2018-05-01

    This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

  7. Symbol and Bit Error Rates Analysis of Hybrid PIM-CDMA

    Directory of Open Access Journals (Sweden)

    Ghassemlooy Z

    2005-01-01

    Full Text Available A hybrid pulse interval modulation code-division multiple-access (hPIM-CDMA scheme employing the strict optical orthogonal code (SOCC with unity and auto- and cross-correlation constraints for indoor optical wireless communications is proposed. In this paper, we analyse the symbol error rate (SER and bit error rate (BER of hPIM-CDMA. In the analysis, we consider multiple access interference (MAI, self-interference, and the hybrid nature of the hPIM-CDMA signal detection, which is based on the matched filter (MF. It is shown that the BER/SER performance can only be evaluated if the bit resolution conforms to the condition set by the number of consecutive false alarm pulses that might occur and be detected, so that one symbol being divided into two is unlikely to occur. Otherwise, the probability of SER and BER becomes extremely high and indeterminable. We show that for a large number of users, the BER improves when increasing the code weight . The results presented are compared with other modulation schemes.

  8. Development of performance indicators for municipal solid waste management (PIMS): A review.

    Science.gov (United States)

    Sanjeevi, V; Shahabudeen, P

    2015-12-01

    The aim of this paper is to review papers on municipal solid waste management (SWM) systems, especially on performance indicators (PIs), and suggest practical methods to manage the same by administrators. Worldwide, about 4 billion metric tons of solid waste (SW) is generated annually; the management of SW across cities is increasingly getting more complex and the funds available for providing service to citizens are shrinking. Analysis of the non-technical research papers shows that focus areas on SW can be grouped into 18 types, one being PIs. Historically, PIs for municipal SWM (PIMS) commenced with the publication of guidelines by various government agencies, starting in 1969. This was followed by a few benchmarking studies, commencing in 1998, by various international institutions. Many published comparative studies also disseminated good practices across the cities. From the 1990s onwards, research work started defining PIMS. These initiatives by various researchers took multiple dimensions and are reviewed in this paper. In almost all studies, the PIMS is measured in terms of investment decisions, public acceptance levels, social participation and environmental needs. The multiple indicators are complex, however, and managers of cities need simple tools to use. To make it simple, five-factor PIs are arrived at, considering simplicity and covering all the factors. A research agenda is outlined for future directions in the areas of cost reduction, citizens' services, citizen involvement and environmental impact. © The Author(s) 2015.

  9. The effectiveness of a clinically integrated e-learning course in evidence-based medicine: A cluster randomised controlled trial

    NARCIS (Netherlands)

    Kulier, Regina; Coppus, Sjors F. P. J.; Zamora, Javier; Hadley, Julie; Malick, Sadia; Das, Kausik; Weinbrenner, Susanne; Meyerrose, Berrit; Decsi, Tamas; Horvath, Andrea R.; Nagy, Eva; Emparanza, Jose I.; Arvanitis, Theodoros N.; Burls, Amanda; Cabello, Juan B.; Kaczor, Marcin; Zanrei, Gianni; Pierer, Karen; Stawiarz, Katarzyna; Kunz, Regina; Mol, Ben W. J.; Khan, Khalid S.

    2009-01-01

    ABSTRACT: BACKGROUND: To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content. METHODS: We conducted a cluster randomised controlled

  10. Integrative medicine for managing the symptoms of lupus nephritis: A protocol for systematic review and meta-analysis.

    Science.gov (United States)

    Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

    2018-03-01

    Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. PROSPERO 2018 CRD42018085205.

  11. Scientific publications from Arab world in leading journals of Integrative and Complementary Medicine: a bibliometric analysis.

    Science.gov (United States)

    Zyoud, Sa'ed H; Al-Jabi, Samah W; Sweileh, Waleed M

    2015-09-04

    Bibliometric analysis is increasingly employed as a useful tool to assess the quantity and quality of research performance. The specific goal of the current study was to evaluate the performance of research output originating from Arab world and published in international Integrative and Complementary Medicine (ICM) journals. Original scientific publications and reviews from the 22 Arab countries that were published in 22 international peer-reviewed ICM journals during all previous years up to December 31(st) 2013, were screened using the Web of Science databases. Five hundred and ninety-one documents were retrieved from 19 ICM journals. The h-index of the set of papers under study was 47. The highest h-index was 27 for Morocco, 21 for Jordan, followed by 19 for each Kingdom of Saudi Arabia (KSA), and Egypt, and the lowest h-index was 1 for each of Comoros, Qatar, and Syrian Arab Republic. No data related to ICM were published from Djibouti, and Mauritania. After adjusting for economy and population power, Somalia (89), Morocco (32.5), Egypt (31.1), Yemen (21.4), and Palestine (21.2) had the highest research productivity. The total number of citations was 9,466, with an average citation of 16 per document. The study identified 262 (44.3 %) documents with 39 countries in Arab-foreign country collaborations. Arab authors collaborated most with countries in Europe (24.2 %), followed by countries in the Asia-Pacific region (9.8 %). Scientific research output in the ICM field in the Arab world region is increasing. Most of publications from Arab world in ICM filed were driven by societal use of medicinal plants and herbs. Search for new therapies from available low cost medicinal plants in Arab world has motivated many researchers in academia and pharmaceutical industry. Further investigation is required to support these findings in a wider journal as well as to improve research output in the field of ICM from Arab world region by investing in more national and

  12. Integrated Development of Chinese Herbal Medicine Planting and Tourist Commodities: A Case Study of Green Handmade Soap Development in Shandong Province

    OpenAIRE

    LI, Xiu; CHEN, Mengxuan; SONG, Xiaoli

    2015-01-01

    Combining current situations of Chinese herbal medicine planting industry in Shandong, in line with existing problems of Chinese herbal medicine planting industry, this paper analyzed development prospect of tourist commodity industry in Shandong Province, and came up with actual selection and recommendations for integrated development of Chinese herbal medicine planting and tourist commodities.

  13. Characteristics of cancer patients presenting to an integrative medicine practice-based research network.

    Science.gov (United States)

    Edman, Joel S; Roberts, Rhonda S; Dusek, Jeffery A; Dolor, Rowena; Wolever, Ruth Q; Abrams, Donald I

    2014-09-01

    To assess psychosocial characteristics, symptoms and reasons for seeking integrative medicine (IM) care in cancer patients presenting to IM clinical practices. A survey of 3940 patients was conducted at 8 IM sites. Patient reported outcome measures were collected and clinicians provided health status data. This analysis compares 353 participants self-identified as cancer patients with the larger noncancer cohort. Mean age of the cancer cohort was 55.0 years. Participants were predominantly white (85.9%), female (76.4%), and well educated (80.5% completed college). For 15.2% of cancer patients, depression scores were consistent with depressive symptoms, and average scores for perceived stress were higher than normal, but neither were significantly different from noncancer patients. The most prevalent comorbid symptoms were chronic pain (39.8%), fatigue (33.5%), and insomnia (23.3%). In the cancer cohort, perceived stress was significantly associated with depression, fatigue, insomnia, pain, and QOL. Cancer patients who chose an IM clinical practice "seeking healthcare settings that address spirituality as an aspect of care" had significantly higher levels of perceived stress, depression, and pain than those not selecting this reason. Demographic characteristics, depression scores, perceived stress scores, and reasons for seeking integrative cancer care were not significantly different between cancer patients and noncancer patients. Perceived stress may be an important indicator of QOL. The association of perceived stress, depression and pain with seeking spirituality suggests that providing IM interventions, such as effective stress management techniques and pastoral or spiritual counseling, may be helpful to patients living with cancer. © The Author(s) 2014.

  14. Integrated model for providing tactical emergency medicine support (TEMS): analysis of 120 tactical situations.

    Science.gov (United States)

    Vainionpää, T; Peräjoki, K; Hiltunen, T; Porthan, K; Taskinen, A; Boyd, J; Kuisma, M

    2012-02-01

    Various models for organising tactical emergency medicine support (TEMS) in law enforcement operations exist. In Helsinki, TEMS is organised as an integral part of emergency medical service (EMS) and applied in hostage, siege, bomb threat and crowd control situations and in other tactical situations after police request. Our aim was to analyse TEMS operations, patient profile, and the level of on-site care provided. We conducted a retrospective cohort study of TEMS operations in Helsinki from 2004 to 2009. Data were retrieved from EMS, hospital and dispatching centre files and from TEMS reports. One hundred twenty TEMS operations were analysed. Median time from dispatching to arrival on scene was 10 min [Interquartile Range (IQR) 7-14]. Median duration of operations was 41 min (IQR 19-63). Standby was the only activity in 72 operations, four patients were dead on arrival, 16 requests were called off en route and patient examination or care was needed in 28 operations. Twenty-eight patients (records retrieved) were alive on arrival and were classified as trauma (n = 12) or medical (n = 16). Of traumas, two sustained a gunshot wound, one sustained a penetrating abdominal wound, three sustained medium severity injuries and nine sustained minor injuries. There was neither on-scene nor in-hospital mortality among patients who were alive on arrival. The level of on-site care performed was basic life support in all cases. The results showed that TEMS integrated to daily EMS services including safe zone working only was a feasible, rapid and efficient way to provide medical support to law enforcement operations. © 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  15. Personalizing Chinese medicine by integrating molecular features of diseases and herb ingredient information: application to acute myeloid leukemia.

    Science.gov (United States)

    Huang, Lin; Li, Haichang; Xie, Duoli; Shi, Tieliu; Wen, Chengping

    2017-06-27

    Traditional Chinese Medicine (TCM) has been widely used as a complementary medicine in Acute Myeloid Leukemia (AML) treatment. In this study, we proposed a new classification of Chinese Medicines (CMs) by integrating the latest discoveries in disease molecular mechanisms and traditional medicine theory. We screened out a set of chemical compounds on basis of AML differential expression genes and chemical-protein interactions and then mapped them to Traditional Chinese Medicine Integrated Database. 415 CMs contain those compounds and they were categorized into 8 groups according to the Traditional Chinese Pharmacology. Pathway analysis and synthetic lethality gene pairs were applied to analyze the dissimilarity, generality and intergroup relations of different groups. We defined hub CM pairs and alternative CM groups based on the analysis result and finally proposed a formula to form an effective anti-AML prescription which combined the hub CM pairs with alternative CMs according to patients' molecular features. Our method of formulating CMs based on patients' stratification provides novel insights into the new usage of conventional CMs and will promote TCM modernization.

  16. Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Claudia M. Witt

    2012-01-01

    Full Text Available The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER: (1 CER studies should be made a priority in this field; (2 stakeholders should be engaged at every stage of the research; (3 CER study designs should highlight effectiveness over efficacy; (4 research questions should be well defined to enable the selection of an appropriate CER study design; (5 the CIM community should cultivate widely shared understandings, discourse, tools, and technologies to support the use and validity of CER methods; (6 Effectiveness Guidance Documents on methodological standards should be developed to shape future CER studies. CER is an emerging field and its development and impact must be reflected in future research strategies within CIM. This stakeholder symposium was a first step in providing systematic guidance for future CER in this field.

  17. Communicating moral reasoning in medicine as an expression of respect for patients and integrity among professionals.

    Science.gov (United States)

    Kaldjian, Lauris Christopher

    2013-01-01

    The communication of moral reasoning in medicine can be understood as a means of showing respect for patients and colleagues through the giving of moral reasons for actions. This communication is especially important when disagreements arise. While moral reasoning should strive for impartiality, it also needs to acknowledge the individual moral beliefs and values that distinguish each person (moral particularity) and give rise to the challenge of contrasting moral frameworks (moral pluralism). Efforts to communicate moral reasoning should move beyond common approaches to principles-based reasoning in medical ethics by addressing the underlying beliefs and values that define our moral frameworks and guide our interpretations and applications of principles. Communicating about underlying beliefs and values requires a willingness to grapple with challenges of accessibility (the degree to which particular beliefs and values are intelligible between persons) and translatability (the degree to which particular beliefs and values can be transposed from one moral framework to another) as words and concepts are used to communicate beliefs and values. Moral dialogues between professionals and patients and among professionals themselves need to be handled carefully, and sometimes these dialogues invite reference to underlying beliefs and values. When professionals choose to articulate such beliefs and values, they can do so as an expression of respectful patient care and collaboration and as a means of promoting their own moral integrity by signaling the need for consistency between their own beliefs, words and actions.

  18. Integration of cardiac proteome biology and medicine by a specialized knowledgebase.

    Science.gov (United States)

    Zong, Nobel C; Li, Haomin; Li, Hua; Lam, Maggie P Y; Jimenez, Rafael C; Kim, Christina S; Deng, Ning; Kim, Allen K; Choi, Jeong Ho; Zelaya, Ivette; Liem, David; Meyer, David; Odeberg, Jacob; Fang, Caiyun; Lu, Hao-Jie; Xu, Tao; Weiss, James; Duan, Huilong; Uhlen, Mathias; Yates, John R; Apweiler, Rolf; Ge, Junbo; Hermjakob, Henning; Ping, Peipei

    2013-10-12

    Omics sciences enable a systems-level perspective in characterizing cardiovascular biology. Integration of diverse proteomics data via a computational strategy will catalyze the assembly of contextualized knowledge, foster discoveries through multidisciplinary investigations, and minimize unnecessary redundancy in research efforts. The goal of this project is to develop a consolidated cardiac proteome knowledgebase with novel bioinformatics pipeline and Web portals, thereby serving as a new resource to advance cardiovascular biology and medicine. We created Cardiac Organellar Protein Atlas Knowledgebase (COPaKB; www.HeartProteome.org), a centralized platform of high-quality cardiac proteomic data, bioinformatics tools, and relevant cardiovascular phenotypes. Currently, COPaKB features 8 organellar modules, comprising 4203 LC-MS/MS experiments from human, mouse, drosophila, and Caenorhabditis elegans, as well as expression images of 10,924 proteins in human myocardium. In addition, the Java-coded bioinformatics tools provided by COPaKB enable cardiovascular investigators in all disciplines to retrieve and analyze pertinent organellar protein properties of interest. COPaKB provides an innovative and interactive resource that connects research interests with the new biological discoveries in protein sciences. With an array of intuitive tools in this unified Web server, nonproteomics investigators can conveniently collaborate with proteomics specialists to dissect the molecular signatures of cardiovascular phenotypes.

  19. Complementary and alternative medicines in irritable bowel syndrome: An integrative view

    Science.gov (United States)

    Grundmann, Oliver; Yoon, Saunjoo L

    2014-01-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a high incidence in the general population. The diagnosis of IBS is mainly based on exclusion of other intestinal conditions through the absence of inflammatory markers and specific antigens. The current pharmacological treatment approaches available focus on reducing symptom severity while often limiting quality of life because of significant side effects. This has led to an effectiveness gap for IBS patients that seek further relief to increase their quality of life. Complementary and alternative medicines (CAM) have been associated with a higher degree of symptom management and quality of life in IBS patients. Over the past decade, a number of important clinical trials have shown that specific herbal therapies (peppermint oil and Iberogast®), hypnotherapy, cognitive behavior therapy, acupuncture, and yoga present with improved treatment outcomes in IBS patients. We propose an integrative approach to treating the diverse symptoms of IBS by combining the benefits of and need for pharmacotherapy with known CAM therapies to provide IBS patients with the best treatment outcome achievable. Initial steps in this direction are already being considered with an increasing number of practitioners recommending CAM therapies to their patients if pharmacotherapy alone does not alleviate symptoms sufficiently. PMID:24574705

  20. Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

    Science.gov (United States)

    Team, Victoria; Canaway, Rachel; Manderson, Lenore

    2011-01-01

    The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

  1. Making sense of "alternative", "complementary", "unconventional" and "integrative" medicine: exploring the terms and meanings through a textual analysis.

    Science.gov (United States)

    Ng, Jeremy Y; Boon, Heather S; Thompson, Alison K; Whitehead, Cynthia R

    2016-05-20

    Medical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as "conventional medicine" and thereby relegate all non-physician-related forms of healthcare to an "other" category. These "other" practitioners have been referred to as "unconventional", "alternative" and "complementary", among other terms throughout the past half century. This study investigates the discourses surrounding the changes in the terms, and their meanings, used to describe unconventional medicine in North America. Terms identified by the literature as synonymous to unconventional medicine were searched using the Scopus database. A textual analysis following the method described by Kripendorff 2013 was subsequently performed on the five most highly-cited unconventional medicine-related peer-reviewed literature published between 1970 and 2013. Five commonly-used, unconventional medicine-related terms were identified. Authors using "complementary and alternative", "complementary", "alternative", or "unconventional" tended to define them by what they are not (e.g., therapies not taught/used in conventional medicine, therapy demands not met by conventional medicine, and therapies that lack research on safety, efficacy and effectiveness). Authors defined "integrated/integrative" medicine by what it is (e.g., a new model of healthcare, the combining of both conventional and unconventional therapies, accounting for the whole person, and preventative maintenance of health). Authors who defined terms by "what is not" stressed that the purpose of conducting research in this area was solely to create knowledge. Comparatively, authors who defined terms by "what is" sought to advocate for the evidence-based combination of unconventional and conventional medicines. Both author groups used scientific rhetoric to define unconventional medical practices. This emergence of two groups of authors who used two different sets of terms to refer to the

  2. Epitaxial (100)-oriented Mo/V superlattice grown on MgO(100) by dcMS and HiPIMS

    International Nuclear Information System (INIS)

    Shayestehaminzadeh, S.; Magnusson, R.L.; Gislason, H.P.; Olafsson, S.

    2013-01-01

    Epitaxial (100)-oriented Mo/V superlattices have been grown by High Power Impulse Magnetron Sputtering (HiPIMS) and dc Magnetron Sputtering (dcMS) on single-crystalline MgO(100) substrates at growth temperatures ranging from 30 °C to 600 °C. Superlattice bilayer period of Mo/V around 12/12 monolayers and 15 repeat periods was studied. This study aims to investigate the effect of the HiPIMS process on reducing the growth temperature of Mo/V superlattices using the high energy ionized Mo, V species in the HiPIMS plasma. In one case, the Mo layer was only grown with the HiPIMS process and V layer grown using the dcMS process while in another both layers were grown with the HiPIMS process. The as-deposited films were characterized by X-ray reflection and diffraction techniques. The dcMS process was found to give superior superlattice growth at high growth temperatures while a mixed Mo HiPIMS and V dcMS process gives better result at lower growth temperatures (300 °C). Room temperature growth reveals that neither the mixed Mo HiPIMS and V dcMS process nor the pure HiPIMS for both materials can produce better result compared to the pure dcMS process, which gives a relatively better result. - Highlights: • Epitaxial (100)-oriented Mo/V superlattices have been grown by HiPIMS and dcMS on MgO(100) for various temperatures. • The study was aimed to investigate the effect of ionized HiPIMS process onlowering the growth temperature. • The dcMS process was found to give superior superlattice growth at high growth temperature. • The mixed Mo HiPIMS and V dcMS process gives best result at lower growth temperatures

  3. Challenges and perspectives in using PIMS methodology to explain the success of the marketing strategy in businesses

    Directory of Open Access Journals (Sweden)

    Rubén-Martín Mosqueda Almanza

    2011-01-01

    Full Text Available Se asume que una estrategia adecuada impactará positivamente sobre las ganancias de las empresas y las llevará a expandirse. Recientes descubrimientos sugieren que sólo con la revisión y adecuación de los elementos más relevantes del plan estratégico es posible llevar los resultados económicos de la empresa a un punto óptimo. El impacto de la estrategia de mercado en las ganancias (PIMS, en inglés constituye un modelo arquetipo para lograrlo, sin embargo, subsisten problemas fundamentales en el modelo que lo limitan. Así, en el presente trabajo se hace un estudio exploratorio de la evolución de la metodología PIMS que permite develar los retos y el posible rumbo del tema. La definición de la estrategia, el diseño de la encuesta tipo PIMS, los problemas de multicolinealidad y el efecto de la cuota de mercado se plantean como los más relevantes. Los resultados muestran la necesidad de definir con precisión la estrategia asumida por la empresa, el rediseño de la encuesta PIMS cuando se aplique a mercados incompletos y, finalmente, se advierte un avance en el estudio econométrico de PIMS poniendo énfasis en la variable calidad relativa del producto para resolver el viejo dilema del efecto de la cuota de mercado.

  4. Correlation between mass-spectrometer measurements and thin film characteristics using dcMS and HiPIMS discharges

    International Nuclear Information System (INIS)

    Ferrec, A.; Keraudy, J.; Jacq, S.; Jouan, P.Y.; Djouadi, M.A.; Schuster, F.

    2014-01-01

    In this work, chromium thin films were deposited using dcMS and HiPIMS technologies. To compare these technologies, we analyzed the ion flux and the Cr coating microstructure in the same plasma conditions. Ion flux was measured with a mass spectrometer in time-averaged for both discharge and time-resolved for HiPIMS discharge. Time-averaged measurements provided important information. First, the low energetic part of the ion energy distribution function (IEDF) was similar in dcMS and HiPIMS and second the high energetic component was more prominent in the HiPIMS discharge. Time-resolved measurements showed that the high energetic part of the ion flux reached the mass spectrometer faster than the lowest part. It is only after the pulse end that most of the thermalized ions arrived and then cooled the flux. The correlation of these results with microstructure analysis shows that energetic particles induced a higher film density and a smoother surface in HiPIMS compared to dcMS discharge. (authors)

  5. The Integration of Medical Toxicology and Addiction Medicine: a New Era in Patient Care.

    Science.gov (United States)

    Laes, JoAn R

    2016-03-01

    Medical toxicologists are frequently called upon to treat patients who are addicted to alcohol, tobacco, or other substances across many care settings. Medical toxicologists provide service to their patients through the identification, treatment, and prevention of addiction and its co-morbidities, and practice opportunities are quite varied. Training in addiction medicine can be obtained during or after medical toxicology fellowship through resources offered by the American Society of Addiction Medicine. Additionally, the American Board of Addiction Medicine offers certification in the specialty of addiction medicine to candidates across a wide range of medical specialties.

  6. Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

    Science.gov (United States)

    Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Bm, Berman

    2012-10-01

    In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

  7. [Which research is needed to support clinical decision-making on integrative medicine? Can comparative effectiveness research close the gap?].

    Science.gov (United States)

    Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Berman, Brian M

    2013-08-01

    In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of best care options. This evidence, more generalizable than evidence generated by traditional randomized clinical trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on CER is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

  8. Bias and other limitations affect measures of journals in integrative and complementary medicineKa-wai Fan, PhD.

    Science.gov (United States)

    Fan, Ka-wai

    2015-07-01

    Publishing articles in a prestigious journal is a golden rule for university professors and researchers nowadays. Impact factor, journal rank, and citation count, included in Science Citation Index managed by Thomson Reuters Web of Science, are the most important indicators for evaluating the quality of academic journals. By listing the journals encompassed in the "Integrative and Complementary Medicine" category of Science Citation Index from 2003 to 2013, this paper examines the publication trends of journals in the category. The examination includes number, country of origin, ranking, and languages of journals. Moreover, newly listed or removed journals in the category, journal publishers, and open access strategies are examined. It is concluded that the role of journal publisher should not be undermined in the "Integrative and Complementary Medicine" category.

  9. 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.

  10. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries.

    Science.gov (United States)

    Renom-Guiteras, Anna; Meyer, Gabriele; Thürmann, Petra A

    2015-07-01

    The aim of the study was to develop a European list of potentially inappropriate medications (PIM) for older people, which can be used for the analysis and comparison of prescribing patterns across European countries and for clinical practice. A preliminary PIM list was developed, based on the German PRISCUS list of potentially inappropriate medications and other PIM lists from the USA, Canada and France. Thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated; eight experts performed a structured expansion of the list, suggesting further medications; twenty-seven experts participated in a two-round Delphi survey assessing the appropriateness of drugs and suggesting dose adjustments and therapeutic alternatives. Finally, twelve experts completed a brief final survey to decide upon issues requiring further consensus. Experts reached a consensus that 282 chemical substances or drug classes from 34 therapeutic groups are PIM for older people; some PIM are restricted to a certain dose or duration of use. The PIM list contains suggestions for dose adjustments and therapeutic alternatives. The European Union (EU)(7)-PIM list is a screening tool, developed with participation of experts from seven European countries, that allows identification and comparison of PIM prescribing patterns for older people across European countries. It can also be used as a guide in clinical practice, although it does not substitute the decision-making process of individualised prescribing for older people. Further research is needed to investigate the feasibility and applicability and, finally, the clinical benefits of the newly developed list.

  11. Ethylene/ethane permeation, diffusion and gas sorption properties of carbon molecular sieve membranes derived from the prototype ladder polymer of intrinsic microporosity (PIM-1)

    KAUST Repository

    Salinas, Octavio; Ma, Xiaohua; Litwiller, Eric; Pinnau, Ingo

    2016-01-01

    Fine-tuning the microporosity of PIM-1 by heat treatment was applied to develop a suitable carbon molecular sieve membrane for ethylene/ethane separation. Pristine PIM-1 films were heated from 400 to 800 °C under inert N2 atmosphere (< 2 ppm O2

  12. Total neutron-counting plutonium inventory measurement systems (PIMS) and their potential application to near real time materials accountancy (NRTMA)

    International Nuclear Information System (INIS)

    Driscall, I.; Fox, G.H.; Orr, C.H.; Whitehouse, K.R.

    1988-01-01

    A radiometric method of determining the inventory of an operating plutonium plant is described. An array of total neutron counters distributed across the plant is used to estimate hold-up at each plant item. Corrections for the sensitivity of detectors to plutonium in adjacent plant items are achieved through a matrix approach. This paper describes our experience in design, calibration and operation of a Plutonium Inventory Measurement System (PIMS) on an oxalate precipitation plutonium finishing line. Data from a recent trial of Near-Real-Time Materials Accounting (NRTMA) using the PIMS are presented and used to illustrate its present performance and problem areas. The reader is asked to consider what role PIMS might have in future accountancy systems

  13. The Protein Information Management System (PiMS): a generic tool for any structural biology research laboratory.

    Science.gov (United States)

    Morris, Chris; Pajon, Anne; Griffiths, Susanne L; Daniel, Ed; Savitsky, Marc; Lin, Bill; Diprose, Jonathan M; da Silva, Alan Wilter; Pilicheva, Katya; Troshin, Peter; van Niekerk, Johannes; Isaacs, Neil; Naismith, James; Nave, Colin; Blake, Richard; Wilson, Keith S; Stuart, David I; Henrick, Kim; Esnouf, Robert M

    2011-04-01

    The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory workflow. The underlying philosophy and implementation of the Protein Information Management System (PiMS), a LIMS development specifically targeted at the flexible and unpredictable workflows of protein-production research laboratories of all scales, is described. PiMS is a web-based Java application that uses either Postgres or Oracle as the underlying relational database-management system. PiMS is available under a free licence to all academic laboratories either for local installation or for use as a managed service.

  14. Exploring integrative medicine for back and neck pain - a pragmatic randomised clinical pilot trial

    Directory of Open Access Journals (Sweden)

    Rydén Anna

    2009-09-01

    Full Text Available Abstract Background A model for integrative medicine (IM adapted to Swedish primary care was previously developed. The aim of this study was to explore the feasibility of a pragmatic randomised clinical trial to investigate the effectiveness of the IM model versus conventional primary care in the management of patients with non-specific back/neck pain. Specific objectives included the exploration of recruitment and retention rates, patient and care characteristics, clinical differences and effect sizes between groups, selected outcome measures and power calculations to inform the basis of a full-scale trial. Methods Eighty patients with back/neck pain of at least two weeks duration were randomised to the two types of care. Outcome measures were standardised health related quality of life (the eight domains of SF-36 complemented by a set of exploratory "IM tailored" outcomes targeting self-rated disability, stress and well-being (0-10 scales; days in pain (0-14; and the use of analgesics and health care over the last two weeks (yes/no. Data on clinical management were derived from medical records. Outcome changes from baseline to follow-up after 16 weeks were used to explore the differences between the groups. Results Seventy-five percent (80/107 of screened patients in general practice were eligible and feasible to enrol into the trial. Eighty-two percent (36/44 of the integrative and 75% (27/36 of the conventional care group completed follow-up after 16 weeks. Most patients had back/neck pain of at least three months duration. Conventional care typically comprised advice and prescription of analgesics, occasionally complemented with sick leave or a written referral to physiotherapy. IM care generally integrated seven treatment sessions from two different types of complementary therapies with conventional care over ten weeks. The study was underpowered to detect any statistically significant differences between the groups. One SF-36 domain

  15. Integration of basic science and clinical medicine: the innovative approach of the cadaver biopsy project at the Boston University School of Medicine.

    Science.gov (United States)

    Eisenstein, Anna; Vaisman, Lev; Johnston-Cox, Hillary; Gallan, Alexander; Shaffer, Kitt; Vaughan, Deborah; O'Hara, Carl; Joseph, Lija

    2014-01-01

    Curricular integration has emerged as a consistent theme in medical education reform. Vertical integration of topics such as pathology offers the potential to bring basic science content into the clinical arena, but faculty/student acceptance and curricular design pose challenges for such integration. The authors describe the Cadaver Biopsy Project (CBP) at Boston University School of Medicine as a sustainable model of vertical integration. Faculty and select senior medical students obtained biopsies of cadavers during the first-year gross anatomy course (fall 2009) and used these to develop clinical cases for courses in histology (spring 2010), pathology (fall 2010-spring 2011), and radiology (fall 2011 or spring 2012), thereby linking students' first experiences in basic sciences with other basic science courses and later clinical courses. Project goals included engaging medical stu dents in applying basic science princi ples in all aspects of patient care as they acquire skills. The educational intervention used a patient (cadaver)-centered approach and small-group, collaborative, case-based learning. Through this project, the authors involved clinical and basic science faculty-plus senior medical students-in a collaborative project to design and implement an integrated curriculum through which students revisited, at several different points, the microscopic structure and pathophysiology of common diseases. Developing appropriate, measurable out comes for medical education initiatives, including the CBP, is challenging. Accumu lation of qualitative feedback from surveys will guide continuous improvement of the CBP. Documenting longer-term impact of the curricular innovation on test scores and other competency-based outcomes is an ultimate goal.

  16. [Integrity].

    Science.gov (United States)

    Gómez Rodríguez, Rafael Ángel

    2014-01-01

    To say that someone possesses integrity is to claim that that person is almost predictable about responses to specific situations, that he or she can prudentially judge and to act correctly. There is a closed interrelationship between integrity and autonomy, and the autonomy rests on the deeper moral claim of all humans to integrity of the person. Integrity has two senses of significance for medical ethic: one sense refers to the integrity of the person in the bodily, psychosocial and intellectual elements; and in the second sense, the integrity is the virtue. Another facet of integrity of the person is la integrity of values we cherish and espouse. The physician must be a person of integrity if the integrity of the patient is to be safeguarded. The autonomy has reduced the violations in the past, but the character and virtues of the physician are the ultimate safeguard of autonomy of patient. A field very important in medicine is the scientific research. It is the character of the investigator that determines the moral quality of research. The problem arises when legitimate self-interests are replaced by selfish, particularly when human subjects are involved. The final safeguard of moral quality of research is the character and conscience of the investigator. Teaching must be relevant in the scientific field, but the most effective way to teach virtue ethics is through the example of the a respected scientist.

  17. Metabolomics and Integrative Omics for the Development of Thai Traditional Medicine

    Science.gov (United States)

    Khoomrung, Sakda; Wanichthanarak, Kwanjeera; Nookaew, Intawat; Thamsermsang, Onusa; Seubnooch, Patcharamon; Laohapand, Tawee; Akarasereenont, Pravit

    2017-01-01

    In recent years, interest in studies of traditional medicine in Asian and African countries has gradually increased due to its potential to complement modern medicine. In this review, we provide an overview of Thai traditional medicine (TTM) current development, and ongoing research activities of TTM related to metabolomics. This review will also focus on three important elements of systems biology analysis of TTM including analytical techniques, statistical approaches and bioinformatics tools for handling and analyzing untargeted metabolomics data. The main objective of this data analysis is to gain a comprehensive understanding of the system wide effects that TTM has on individuals. Furthermore, potential applications of metabolomics and systems medicine in TTM will also be discussed. PMID:28769804

  18. Integrating precision medicine in the study and clinical treatment of a severely mentally ill person

    Directory of Open Access Journals (Sweden)

    Jason A. O’Rawe

    2013-10-01

    carries the p.Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come.Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care.

  19. Mixed-Penetrant Sorption in Ultra-Thin Films of Polymer of Intrinsic Microporosity PIM-1

    KAUST Repository

    Ogieglo, Wojciech; Furchner, Andreas; Ghanem, Bader; Ma, Xiao-Hua; Pinnau, Ingo; Wessling, Matthias

    2017-01-01

    Mixed penetrant sorption into ultra-thin films of a super-glassy polymer of intrinsic microporosity (PIM-1) was studied for the first time by using interference-enhanced in-situ spectroscopic ellipsometry. PIM-1 swelling and the concurrent changes in its refractive index were determined in ultra-thin (12 - 14 nm) films exposed to pure and mixed penetrants. The penetrants included water, n-hexane and ethanol and were chosen based on their significantly different penetrant-penetrant and penetrant-polymer affinities. This allowed studying microporous polymer responses at diverse ternary compositions and revealed effects such as competition for the sorption sites (for water / n-hexane or ethanol / n-hexane) or enhancement in sorption of typically weakly sorbing water in the presence of more highly sorbing ethanol. The results reveal details of the mutual sorption effects which often complicate comprehension of glassy polymers' behavior in applications such as high-performance membranes, adsorbents or catalysts. Mixed-penetrant effects are typically very challenging to study directly and their understanding is necessary owing to a broadly recognized inadequacy of simple extrapolations from measurements in pure component environment.

  20. Mixed-Penetrant Sorption in Ultra-Thin Films of Polymer of Intrinsic Microporosity PIM-1

    KAUST Repository

    Ogieglo, Wojciech

    2017-10-12

    Mixed penetrant sorption into ultra-thin films of a super-glassy polymer of intrinsic microporosity (PIM-1) was studied for the first time by using interference-enhanced in-situ spectroscopic ellipsometry. PIM-1 swelling and the concurrent changes in its refractive index were determined in ultra-thin (12 - 14 nm) films exposed to pure and mixed penetrants. The penetrants included water, n-hexane and ethanol and were chosen based on their significantly different penetrant-penetrant and penetrant-polymer affinities. This allowed studying microporous polymer responses at diverse ternary compositions and revealed effects such as competition for the sorption sites (for water / n-hexane or ethanol / n-hexane) or enhancement in sorption of typically weakly sorbing water in the presence of more highly sorbing ethanol. The results reveal details of the mutual sorption effects which often complicate comprehension of glassy polymers\\' behavior in applications such as high-performance membranes, adsorbents or catalysts. Mixed-penetrant effects are typically very challenging to study directly and their understanding is necessary owing to a broadly recognized inadequacy of simple extrapolations from measurements in pure component environment.

  1. Mixed-Penetrant Sorption in Ultrathin Films of Polymer of Intrinsic Microporosity PIM-1.

    Science.gov (United States)

    Ogieglo, Wojciech; Furchner, Andreas; Ghanem, Bader; Ma, Xiaohua; Pinnau, Ingo; Wessling, Matthias

    2017-11-02

    Mixed-penetrant sorption into ultrathin films of a superglassy polymer of intrinsic microporosity (PIM-1) was studied for the first time by using interference-enhanced in situ spectroscopic ellipsometry. PIM-1 swelling and the concurrent changes in its refractive index were determined in ultrathin (12-14 nm) films exposed to pure and mixed penetrants. The penetrants included water, n-hexane, and ethanol and were chosen on the basis of their significantly different penetrant-penetrant and penetrant-polymer affinities. This allowed studying microporous polymer responses at diverse ternary compositions and revealed effects such as competition for the sorption sites (for water/n-hexane or ethanol/n-hexane) or enhancement in sorption of typically weakly sorbing water in the presence of more highly sorbing ethanol. The results reveal details of the mutual sorption effects which often complicate comprehension of glassy polymers' behavior in applications such as high-performance membranes, adsorbents, or catalysts. Mixed-penetrant effects are typically very challenging to study directly, and their understanding is necessary owing to a broadly recognized inadequacy of simple extrapolations from measurements in a pure component environment.

  2. A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

    Science.gov (United States)

    Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

    2016-10-26

    This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

  3. Comparative effectiveness of pediatric integrative medicine as an adjunct to usual care for pediatric inpatients of a North American tertiary care centre: A study protocol for a pragmatic cluster controlled trial

    Directory of Open Access Journals (Sweden)

    Sunita Vohra

    2017-03-01

    Discussion: This trial will be the first to evaluate the comparative effectiveness, both clinical and cost, of a PIM inpatient service. The evidence from this study will be useful to families, clinicians and decision makers, and will describe the clinical and economic value of PIM services for pediatric patients admitted to hospital.

  4. Integrating gender medicine into the workplace health and safety policy in the scientific research institutions: a mandatory task.

    Science.gov (United States)

    Giammarioli, Anna Maria; Siracusano, Alessandra; Sorrentino, Eugenio; Bettoni, Monica; Malorni, Walter

    2012-01-01

    Gender medicine is a multi-faceted field of investigation integrating various aspects of psycho-social and biological sciences but it mainly deals with the impact of the gender on human physiology, pathophysiology, and clinical features of diseases. In Italy, the Decree Law 81/2008 recently introduced the gender issue in the risk assessment at the workplaces. This review briefly describes our current knowledge on gender medicine and on the Italian legislation in risk management. Public or private scientific institutions should be the first to pay attention to the safety of their workers, who are simultaneously subjected to biological, chemical and physical agents. Main tasks of risk management in scientific research institutions are here analyzed and discussed in a gender perspective.

  5. Integrating gender medicine into the workplace health and safety policy in the scientific research institutions: a mandatory task

    Directory of Open Access Journals (Sweden)

    Anna Maria Giammarioli

    2012-01-01

    Full Text Available BACKGROUND: Gender medicine is a multi-faceted field of investigation integrating various aspects of psycho-social and biological sciences but it mainly deals with the impact of the gender on human physiology, pathophysiology, and clinical features of diseases. In Italy, the Decree Law 81/2008 recently introduced the gender issue in the risk assessment at the workplaces. AIMS: This review briefly describes our current knowledge on gender medicine and on the Italian legislation in risk management. CONCLUSIONS: Public or private scientific institutions should be the first to pay attention to the safety of their workers, who are simultaneously subjected to biological, chemical and physical agents. Main tasks of risk management in scientific research institutions are here analyzed and discussed in a gender perspective.

  6. YU Ren-cun(郁仁存)——A Famous Oncologist in Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ YU Ren-cun was born on August 1,1934.After graduating from Jiangxi Medical College in 1955,he took part in the very first Western Doctors' Class for Learning Traditional Chinese Medicine (TCM) held in Beijing from March 1959 to December 1961.Prof.YU systematically learned TCM while taking this class.Since 1962,he has been working in the Beijing Hospital of Traditional Chinese Medicine,eventually being promoted to a Chief Physician by the Beijing Municipal Government in May of 1981.In 1997,Prof.YU was selected as a well-known veteran for the National TCM Doctor Inheritance Work by the State Administration of Traditional Chinese Medicine (SATCM).The State Council of China has awarded him a special subsidy every month for his excellent work.

  7. [Therapeutic effects of the integrated acupuncture and Chinese herbal medicine on reflux esophagitis].

    Science.gov (United States)

    Zhang, Wan; Li, Bolin; Sun, Jianhui; Wang, Zhikun; Zhang, Nana; Shi, Fang; Pei, Lin

    2017-07-12

    To compare the differences in the clinical therapeutic effects on reflux esophagitis among the combined therapy of huazhuo jiedu jiangni decoction (the decoction for resolving the turbid, detoxification and reducing the pathologic upward qi in short) and acupuncture, omeprazole and Chinese herbal medicine. Ninety patients were randomized into 3 groups, 4 cases of them were dropped off. Finally, there were 29 cases in the combined therapy group with acupuncture and the decoction, 29 cases in the western medication group and 28 cases in the Chinese herbal medicine group in the statistical analysis. In the combined therapy group with acupuncture and the decoction, the decoction was prescribed recurrence rate. The therapeutic effects are better than the simple application of either Chinese herbal medicine or omeprazole. for oral administration. Additionally, acupuncture was applied to Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Ganshu (BL 18), Danshu (BL 19) and Taichong (LR 3). The decoction was applied one dose a day and acupuncture was once a day. In the western medication group, omeprazole capsules, 20 mg were prescribed for oral administration, twice a day. In the Chinese herbal medicine group, the decoction was simply applied. The treatment was 8 weeks in the 3 groups and the follow-up visit was 6 months. The score of reflux disorder questionnaire (RDQ) and the changes in esophageal mucosa under gastroscope were observed before and after treatment; the clinical therapeutic effects and recurrence rate were evaluated in the 3 groups. In 4 and 8 weeks of treatment, RDQ scores in the 3 groups were all reduced as compared with those before treatment (all P herbal medicine was lower than that in the western medication group ( P herbal medicine was lower than those in the western medication group and the Chinese herbal medicine group (both P herbal medicine group (all P <0.05). The combined therapy of huazhuo jiedu jiangni decoction and acupuncture achieve the

  8. Systems biology of resilience and optimal health: integrating Chinese and Western medicine perspectives

    Directory of Open Access Journals (Sweden)

    Herman van Wietmarschen

    2017-05-01

    Full Text Available Western science has been strong in measuring details of biological systems such as gene expression levels and metabolite concentrations, and has generally followed a bottom up approach with regard to explaining biological phenomena. Chinese medicine in contrast has evolved as a top down approach in which body and mind is seen as a whole, a phenomenological approach based on the organization and dynamics of symptom patterns. Western and Chinese perspectives are developing towards a ‘middle out’ approach. Chinese medicine diagnosis, we will argue, allows bridging the gap between biologists and psychologists and offers new opportunities for the development of health monitoring tools and health promotion strategies.

  9. Personalized Medicine: how to Switch from the Concept to the Integration into the Clinical Development Plan to Obtain Marketing Authorization.

    Science.gov (United States)

    Becquemont, Laurent; Bordet, Régis; Cellier, Dominic

    2012-01-01

    One of the challenges of the coming years is to personalize medicine in order to provide each patient with an individualized treatment plan. The three objectives of personalized medicine are to refine diagnosis, rationalize treatment and engage patients in a preventive approach. Personalization can be characterized by various descriptors whether related to the field, biology, imaging, type of lesion of the entity to be treated, comorbidity factors, coprescriptions or the environment As part of personalized medicine focused on biological markers including genetics or genomics, the integration of the clinical development plan to obtain marketing authorization may be segmented in 3 stages with a known descriptor identified before clinical development, a known descriptor discovered during clinical development or a known descriptor known after clinical development. For each stage, it is important to clearly define the technical optimization elements, to specify the expectations and objectives, to examine the methodological aspects of each clinical development phase and finally to consider the fast changing regulatory requirements in view of the few registered therapeutics complying with the definition of personalized medicine as well as the significant technological breakthroughs according to the screened and selected biomarkers. These considerations should be integrated in view of the time required for clinical development from early phase to MA, i.e. more than 10 years. Moreover, business models related to the economic environment should be taken into account when deciding whether or not to retain a biomarker allowing the selection of target populations in a general population. © 2012 Société Française de Pharmacologie et de Thérapeutique.

  10. Selective Removal of Butanol from Aqueous Solution by Pervaporation with a PIM-1 Membrane and Membrane Aging

    Czech Academy of Sciences Publication Activity Database

    Žák, Michal; Klepić, M.; Červenková Šťastná, Lucie; Sedláková, Zuzana; Vychodilová, Hana; Hovorka, Š.; Friess, K.; Randová, A.; Brožová, Libuše; Jansen, J. C.; Khdhayyer, M.R.; Budd, P.M.; Izák, Pavel

    2015-01-01

    Roč. 151, SEP 4 (2015), s. 108-114 ISSN 1383-5866 R&D Projects: GA ČR(CZ) GAP106/12/0569 Institutional support: RVO:67985858 ; RVO:61389013 Keywords : PIM membrane * aging of polymer membrane * pervaporation Subject RIV: CI - Industrial Chemistry, Chemical Engineering; CD - Macromolecular Chemistry (UMCH-V) Impact factor: 3.299, year: 2015

  11. Evaluation of the E mu-pim-1 transgenic mouse model for short-term carcinogenicity testing

    DEFF Research Database (Denmark)

    van Kreijl, C. F.; van Oordt, C. W. V.; Kroese, E. D.

    1998-01-01

    of T-cell lymphomas. Because of the low incidence of spontaneous tumors and the increased sensitivity to N-ethyl-N-nitrosourea-induced carcinogenesis, E mu-pim-1 mice were suggested to be one of the first potential and attractive candidates to be used in short-term carcinogenicity testing...

  12. The Protein Information Management System (PiMS): a generic tool for any structural biology research laboratory

    International Nuclear Information System (INIS)

    Morris, Chris; Pajon, Anne; Griffiths, Susanne L.; Daniel, Ed; Savitsky, Marc; Lin, Bill; Diprose, Jonathan M.; Wilter da Silva, Alan; Pilicheva, Katya; Troshin, Peter; Niekerk, Johannes van; Isaacs, Neil; Naismith, James; Nave, Colin; Blake, Richard; Wilson, Keith S.; Stuart, David I.; Henrick, Kim; Esnouf, Robert M.

    2011-01-01

    The Protein Information Management System (PiMS) is described together with a discussion of how its features make it well suited to laboratories of all sizes. The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory workflow. The underlying philosophy and implementation of the Protein Information Management System (PiMS), a LIMS development specifically targeted at the flexible and unpredictable workflows of protein-production research laboratories of all scales, is described. PiMS is a web-based Java application that uses either Postgres or Oracle as the underlying relational database-management system. PiMS is available under a free licence to all academic laboratories either for local installation or for use as a managed service

  13. The Protein Information Management System (PiMS): a generic tool for any structural biology research laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Morris, Chris [STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Pajon, Anne [Wellcome Trust Genome Campus, Hinxton CB10 1SD (United Kingdom); Griffiths, Susanne L. [University of York, Heslington, York YO10 5DD (United Kingdom); Daniel, Ed [STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Savitsky, Marc [University of Oxford, Roosevelt Drive, Oxford OX3 7BN (United Kingdom); Lin, Bill [STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Diprose, Jonathan M. [University of Oxford, Roosevelt Drive, Oxford OX3 7BN (United Kingdom); Wilter da Silva, Alan [Wellcome Trust Genome Campus, Hinxton CB10 1SD (United Kingdom); Pilicheva, Katya [University of Oxford, Roosevelt Drive, Oxford OX3 7BN (United Kingdom); Troshin, Peter [STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Niekerk, Johannes van [University of Dundee, Dundee DD1 5EH, Scotland (United Kingdom); Isaacs, Neil [University of Glasgow, Glasgow G12 8QQ, Scotland (United Kingdom); Naismith, James [University of St Andrews, St Andrews, Fife KY16 9ST, Scotland (United Kingdom); Nave, Colin; Blake, Richard [STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Wilson, Keith S. [University of York, Heslington, York YO10 5DD (United Kingdom); Stuart, David I. [University of Oxford, Roosevelt Drive, Oxford OX3 7BN (United Kingdom); Henrick, Kim [Wellcome Trust Genome Campus, Hinxton CB10 1SD (United Kingdom); Esnouf, Robert M., E-mail: robert@strubi.ox.ac.uk [University of Oxford, Roosevelt Drive, Oxford OX3 7BN (United Kingdom); STFC Daresbury Laboratory, Warrington WA4 4AD (United Kingdom)

    2011-04-01

    The Protein Information Management System (PiMS) is described together with a discussion of how its features make it well suited to laboratories of all sizes. The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory workflow. The underlying philosophy and implementation of the Protein Information Management System (PiMS), a LIMS development specifically targeted at the flexible and unpredictable workflows of protein-production research laboratories of all scales, is described. PiMS is a web-based Java application that uses either Postgres or Oracle as the underlying relational database-management system. PiMS is available under a free licence to all academic laboratories either for local installation or for use as a managed service.

  14. Incorporating and evaluating an integrated gender-specific medicine curriculum: a survey study in Dutch GP training

    Science.gov (United States)

    Dielissen, Patrick W; Bottema, Ben JAM; Verdonk, Petra; Lagro-Janssen, Toine LM

    2009-01-01

    Background We recently set standards for gender-specific medicine training as an integrated part of the GP training curriculum. This paper describes the programme and evaluation of this training. Methods The programme is designed for GP registrars throughout the 3-year GP training. The modules emphasize interaction, application, and clinically integrated learning and teaching methods in peer groups. In 2005 - 2008, after completion of each tutorial, GP registrars were asked to fill in a questionnaire on a 5-point Likert scale to assess the programme's methods and content. GP registrars were also asked to identify two learning points related to the programme. Results The teaching programme consists of five 3-hour modules that include gender themes related to and frequently seen by GPs such as in doctor-patient communication and cardiovascular disease. GP registrars evaluated the training course positively. The written learning points suggest that GP registrars have increased their awareness of why attention to gender-specific information is relevant. Conclusion In summary, gender-specific medicine training has been successfully integrated into an existing GP training curriculum. The modules and teaching methods are transferable to other training institutes for postgraduate training. The evaluation of the teaching programme shows a positive impact on GP registrars' gender awareness. PMID:19737396

  15. Incorporating and evaluating an integrated gender-specific medicine curriculum: a survey study in Dutch GP training

    Directory of Open Access Journals (Sweden)

    Lagro-Janssen Toine LM

    2009-09-01

    Full Text Available Abstract Background We recently set standards for gender-specific medicine training as an integrated part of the GP training curriculum. This paper describes the programme and evaluation of this training. Methods The programme is designed for GP registrars throughout the 3-year GP training. The modules emphasize interaction, application, and clinically integrated learning and teaching methods in peer groups. In 2005 - 2008, after completion of each tutorial, GP registrars were asked to fill in a questionnaire on a 5-point Likert scale to assess the programme's methods and content. GP registrars were also asked to identify two learning points related to the programme. Results The teaching programme consists of five 3-hour modules that include gender themes related to and frequently seen by GPs such as in doctor-patient communication and cardiovascular disease. GP registrars evaluated the training course positively. The written learning points suggest that GP registrars have increased their awareness of why attention to gender-specific information is relevant. Conclusion In summary, gender-specific medicine training has been successfully integrated into an existing GP training curriculum. The modules and teaching methods are transferable to other training institutes for postgraduate training. The evaluation of the teaching programme shows a positive impact on GP registrars' gender awareness.

  16. MiDas: automatic extraction of a common domain of discourse in sleep medicine for multi-center data integration.

    Science.gov (United States)

    Sahoo, Satya S; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S; Zhang, Guo-Qiang

    2011-01-01

    Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI's Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry.

  17. Health Promotion and Complementary Medicine: The Extent and Future of Professional Collaboration and Integration

    Science.gov (United States)

    Hill, Faith

    2006-01-01

    Purpose: To explore the professional interface between health promotion (HP) and complementary and alternative medicine. Design/methodology/approach: A discussion paper, based on qualitative research involving in-depth interviews with 52 participants from either side of the interface. Findings: The current interface is predominantly limited to…

  18. Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine.

    Science.gov (United States)

    Mola, Ernesto; De Bonis, Judith A; Giancane, Raffaele

    2008-01-01

    Efforts to improve the quality of healthcare for patients with chronic conditions have resulted in growing evidence supporting the inclusion of patient empowerment as a key ingredient of care. In 2002, WONCA Europe issued the European Definition of General Practice/Family Medicine, which is currently considered the point of reference for European health institutions and general medical practice. Patient empowerment does not appear among the 11 characteristics of the discipline. The aim of this study is to show that many characteristics of general practice are already oriented towards patient empowerment. Therefore, promoting patient empowerment and self-management should be included as a characteristic of the discipline. The following investigation was conducted: analysing the concept and approach to empowerment as applied to healthcare in the literature; examining whether aspects of empowerment are already part of general medical practice; and identifying reasons why the European definition of general practice/family medicine should contain empowerment as a characteristic of the discipline. General practice/family medicine is the most suitable setting for promoting patient empowerment, because many of its characteristics are already oriented towards encouraging it and because its widespread presence can ensure the generalization of empowerment promotion and self-management education to the totality of patients and communities. "Promoting patient empowerment and self-management" should be considered one of the essential characteristics of general practice/family medicine and should be included in its definition.

  19. Alternative medicine and general practitioners in The Netherlands: towards acceptance and integration.

    NARCIS (Netherlands)

    Visser, G.J.; Peters, L.

    1990-01-01

    A questionnaire on alternative medicine was sent to 600 general practitioners in the Netherlands. Most of the 360 (60%) GPs who replied expressed on interest in alternative practice; and 47% revealed that they used one or more alternative methods themselves, most often homoeopathy. However, the

  20. An Integrated Visualization and Basic Molecular Modeling Laboratory for First-Year Undergraduate Medicinal Chemistry

    Science.gov (United States)

    Hayes, Joseph M.

    2014-01-01

    A 3D model visualization and basic molecular modeling laboratory suitable for first-year undergraduates studying introductory medicinal chemistry is presented. The 2 h practical is embedded within a series of lectures on drug design, target-drug interactions, enzymes, receptors, nucleic acids, and basic pharmacokinetics. Serving as a teaching aid…

  1. Complementary and alternative medicine for cancer patients: results of the EPAAC survey on integrative oncology centres in Europe.

    Science.gov (United States)

    Rossi, Elio; Vita, Alessandra; Baccetti, Sonia; Di Stefano, Mariella; Voller, Fabio; Zanobini, Alberto

    2015-06-01

    The Region of Tuscany Health Department was included as an associated member in WP7 "Healthcare" of the European Partnership for Action Against Cancer (EPAAC), initiated by the EU Commission in 2009. The principal aim was to map centres across Europe prioritizing those that provide public health services and operating within the national health system in integrative oncology (IO). A cross-sectional descriptive survey design was used to collect data. A questionnaire was elaborated concerning integrative oncology therapies to be administered to all the national health system oncology centres or hospitals in each European country. These institutes were identified by convenience sampling, searching on oncology websites and forums. The official websites of these structures were analysed to obtain more information about their activities and contacts. Information was received from 123 (52.1 %) out of the 236 centres contacted until 31 December 2013. Forty-seven out of 99 responding centres meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centres providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centres (68.1 %) had research in progress or carried out until the deadline of the survey. The complementary and alternative medicines (CAMs) more frequently provided to cancer patients were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %). Treatments are mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The CAMs were also used to reduce pain and fatigue (10.9

  2. Computing thermal Wigner densities with the phase integration method

    International Nuclear Information System (INIS)

    Beutier, J.; Borgis, D.; Vuilleumier, R.; Bonella, S.

    2014-01-01

    We discuss how the Phase Integration Method (PIM), recently developed to compute symmetrized time correlation functions [M. Monteferrante, S. Bonella, and G. Ciccotti, Mol. Phys. 109, 3015 (2011)], can be adapted to sampling/generating the thermal Wigner density, a key ingredient, for example, in many approximate schemes for simulating quantum time dependent properties. PIM combines a path integral representation of the density with a cumulant expansion to represent the Wigner function in a form calculable via existing Monte Carlo algorithms for sampling noisy probability densities. The method is able to capture highly non-classical effects such as correlation among the momenta and coordinates parts of the density, or correlations among the momenta themselves. By using alternatives to cumulants, it can also indicate the presence of negative parts of the Wigner density. Both properties are demonstrated by comparing PIM results to those of reference quantum calculations on a set of model problems

  3. Computing thermal Wigner densities with the phase integration method.

    Science.gov (United States)

    Beutier, J; Borgis, D; Vuilleumier, R; Bonella, S

    2014-08-28

    We discuss how the Phase Integration Method (PIM), recently developed to compute symmetrized time correlation functions [M. Monteferrante, S. Bonella, and G. Ciccotti, Mol. Phys. 109, 3015 (2011)], can be adapted to sampling/generating the thermal Wigner density, a key ingredient, for example, in many approximate schemes for simulating quantum time dependent properties. PIM combines a path integral representation of the density with a cumulant expansion to represent the Wigner function in a form calculable via existing Monte Carlo algorithms for sampling noisy probability densities. The method is able to capture highly non-classical effects such as correlation among the momenta and coordinates parts of the density, or correlations among the momenta themselves. By using alternatives to cumulants, it can also indicate the presence of negative parts of the Wigner density. Both properties are demonstrated by comparing PIM results to those of reference quantum calculations on a set of model problems.

  4. Vertical Integration of Biochemistry and Clinical Medicine Using a Near-Peer Learning Model

    Science.gov (United States)

    Gallan, Alexander J.; Offner, Gwynneth D.; Symes, Karen

    2016-01-01

    Vertical integration has been extensively implemented across medical school curricula but has not been widely attempted in the field of biochemistry. We describe a novel curricular innovation in which a near-peer learning model was used to implement vertical integration in our medical school biochemistry course. Senior medical students developed…

  5. Building a bridge for integrating Chinese medicine into conventional healthcare: observations drawn from the development of the Chinese quality of life instrument.

    Science.gov (United States)

    Zhao, Li; Chan, Kelvin

    2005-01-01

    This paper describes the methods and theories of patient-reported outcomes, in particular to the health-related quality of life recently applied in Chinese medicine research. It begins with an investigation of the reasons for a patient-reported outcomes measure for Chinese medicine and the development of a new health-related quality of life instrument based on Chinese culture and Chinese medicine. Discussions on the importance and application of patient-reported outcomes as well as the relationship between quality of life and Chinese medicine are at the focus of this paper. Through a description of the Chinese Quality of Life Instrument and its development, the present work demonstrates an evidence-based approach using patient-reported outcomes or health-related quality of life measures to evaluate treatment efficacy of Chinese medicine, and thereby build a bridge for the integration of Chinese medicine into mainstream health care.

  6. A Precision Medicine Initiative for Alzheimer's disease: the road ahead to biomarker-guided integrative disease modeling.

    Science.gov (United States)

    Hampel, H; O'Bryant, S E; Durrleman, S; Younesi, E; Rojkova, K; Escott-Price, V; Corvol, J-C; Broich, K; Dubois, B; Lista, S

    2017-04-01

    After intense scientific exploration and more than a decade of failed trials, Alzheimer's disease (AD) remains a fatal global epidemic. A traditional research and drug development paradigm continues to target heterogeneous late-stage clinically phenotyped patients with single 'magic bullet' drugs. Here, we propose that it is time for a paradigm shift towards the implementation of precision medicine (PM) for enhanced risk screening, detection, treatment, and prevention of AD. The overarching structure of how PM for AD can be achieved will be provided through the convergence of breakthrough technological advances, including big data science, systems biology, genomic sequencing, blood-based biomarkers, integrated disease modeling and P4 medicine. It is hypothesized that deconstructing AD into multiple genetic and biological subsets existing within this heterogeneous target population will provide an effective PM strategy for treating individual patients with the specific agent(s) that are likely to work best based on the specific individual biological make-up. The Alzheimer's Precision Medicine Initiative (APMI) is an international collaboration of leading interdisciplinary clinicians and scientists devoted towards the implementation of PM in Neurology, Psychiatry and Neuroscience. It is hypothesized that successful realization of PM in AD and other neurodegenerative diseases will result in breakthrough therapies, such as in oncology, with optimized safety profiles, better responder rates and treatment responses, particularly through biomarker-guided early preclinical disease-stage clinical trials.

  7. The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation.

    Science.gov (United States)

    Johnson, Jill R; Crespin, Daniel J; Griffin, Kristen H; Finch, Michael D; Rivard, Rachael L; Baechler, Courtney J; Dusek, Jeffery A

    2014-12-13

    Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited. The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population. Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10). Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value value value medicine (p-value value value value based research to investigate the best approach for incorporating these therapies into an acute care setting such that IM therapies are most appropriately provided to patient populations.

  8. Utilizing Integrative Medicine in the U.S. Army Medical Department

    Science.gov (United States)

    2012-05-15

    Restoring healing to medicine is like restoring justice to the law.‖ --Dean Ornish, MD1 Introduction The 2009 National Defense Authorization...for all providers as an introduction to IM concepts, areas of practice, and an overview of each modality, with links to further references. This... Shakespeare , Hamlet, I.v.166-67. 67 ―When Congress authorized the USPSTF, it required the Department of Health and Human Services (HHS) to support

  9. Integrative Medicine Interventions for Military Personnel (Interventions medicales integrantes a destination du personnel militaire)

    Science.gov (United States)

    2017-03-01

    based Mind Fitness Training MPH Masters of Public Health MRI Magnetic Resonance Imaging MRMC Medical Research and Materiel Command mRNA...plant part) used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are sold as tablets ...as sugar pellets to be placed under the tongue; they may also be in other forms, such as ointments, gels, drops, creams, and tablets . Treatments are

  10. Early brain development toward shaping of human mind: an integrative psychoneurodevelopmental model in prenatal and perinatal medicine.

    Science.gov (United States)

    Hruby, Radovan; Maas, Lili M; Fedor-Freybergh, P G

    2013-01-01

    The article introduces an integrative psychoneurodevelopmental model of complex human brain and mind development based on the latest findings in prenatal and perinatal medicine in terms of integrative neuroscience. The human brain development is extraordinarily complex set of events and could be influenced by a lot of factors. It is supported by new insights into the early neuro-ontogenic processes with the help of structural 3D magnetic resonance imaging or diffusion tensor imaging of fetal human brain. Various factors and targets for neural development including birth weight variability, fetal and early-life programming, fetal neurobehavioral states and fetal behavioral responses to various stimuli and others are discussed. Molecular biology reveals increasing sets of genes families as well as transcription and neurotropic factors together with critical epigenetic mechanisms to be deeply employed in the crucial neurodevelopmental events. Another field of critical importance is psychoimmuno-neuroendocrinology. Various effects of glucocorticoids as well as other hormones, prenatal stress and fetal HPA axis modulation are thought to be of special importance for brain development. The early postnatal period is characterized by the next intense shaping of complex competences, induced mainly by the very unique mother - newborn´s interactions and bonding. All these mechanisms serve to shape individual human mind with complex abilities and neurobehavioral strategies. Continuous research elucidating these special competences of human fetus and newborn/child supports integrative neuroscientific approach to involve various scientific disciplines for the next progress in human brain and mind research, and opens new scientific challenges and philosophic attitudes. New findings and approaches in this field could establish new methods in science, in primary prevention and treatment strategies, and markedly contribute to the development of modern integrative and personalized

  11. Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study.

    Science.gov (United States)

    Ben-Arye, Eran; Schiff, Elad; Silbermann, Michael; Agbarya, Abed; Bar-Sela, Gil

    2015-05-01

    There is a dearth of studies on how cultural background influences patients' attitudes and choices regarding complementary and traditional medicine (CTM) integration. To explore Arab and Jewish patients' perspectives regarding CTM use and its possible integration within conventional cancer care. This was a cross-cultural study. We developed a 27-item questionnaire that evaluates patients' perceptions regarding CTM integration in supportive cancer care. The questionnaire was administered to a convenience sample of patients receiving cancer care in community and hospital oncology centers. Of the 770 respondents (response rate 88%), 324 defined their religion as Muslim, Christian, or Druze (henceforth, regarded as Arabs) and 446 were Jews. Respondents in the two groups differed significantly in terms of age, gender, marital status, number of children, education, religiosity, and prevalence of cancer types (excluding breast cancer). Although Arab respondents reported less use of CTM for cancer-related outcomes (39.6% vs. 52.1%; P = 0.001), they expressed greater support than Jewish respondents for optional CTM consultation if provided within conventional oncology care (P < 0.0001). Respondents in both groups stated that their primary expectation from the oncologist concerning CTM was to participate in formulating a CTM treatment plan to be provided within the oncology department. Compared with Arab respondents, Jews expected CTM consultations to focus on improving daily functioning and coping, reducing chemotherapy side effects, and providing spiritual support. Although quality of life-related expectations are more pronounced among Jewish respondents, both groups share the expectation from their health care providers to be actively involved in construction of a tailored integrative CTM treatment plan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  12. Integrating evidence based medicine into undergraduate medical education: combining online instruction with clinical clerkships.

    Science.gov (United States)

    Aronoff, Stephen C; Evans, Barry; Fleece, David; Lyons, Paul; Kaplan, Lawrence; Rojas, Roberto

    2010-07-01

    Incorporation of evidence based medicine into the undergraduate curriculum varies from school to school. The purpose of this study was to determine if an online course in evidence based medicine run concurrently with the clinical clerkships in the 3rd year of undergraduate medical education provided effective instruction in evidence based medicine (EBM). During the first 18 weeks of the 3rd year, students completed 6 online, didactic modules. Over the next 24 weeks, students developed questions independently from patients seen during clerkships and then retrieved and appraised relevant evidence. Online, faculty mentors reviewed student assignments submitted throughout the course to monitor progress. Mastery of the skills of EBM was assessed prior to and at the conclusion of the course using the Fresno test of competency. Paired data were available from 139 students. Postcourse test scores (M= 77.7; 95% CI = 59-96.4) were significantly higher than precourse scores (M= 66.6; 95% CI = 46.5-86.7), ponline, faculty mentored instruction. This method of instruction provided uniform instruction across geographic sites and medical specialties and permitted efficient use of faculty time.

  13. Earthworms Dilong: Ancient, Inexpensive, Noncontroversial Models May Help Clarify Approaches to Integrated Medicine Emphasizing Neuroimmune Systems

    Science.gov (United States)

    Cooper, Edwin L.; Balamurugan, Mariappan; Huang, Chih-Yang; Tsao, Clara R.; Heredia, Jesus; Tommaseo-Ponzetta, Mila; Paoletti, Maurizio G.

    2012-01-01

    Earthworms have provided ancient cultures with food and sources of medicinal cures. Ayurveda, traditional Chinese medicine (TCM), and practices in Japan, Vietnam, and Korea have focused first on earthworms as sources of food. Gradually fostering an approach to potential beneficial healing properties, there are renewed efforts through bioprospecting and evidence-based research to understand by means of rigorous investigations the mechanisms of action whether earthworms are used as food and/or as sources of potential medicinal products. Focusing on earthworms grew by serendipity from an extensive analysis of the earthworm's innate immune system. Their immune systems are replete with leukocytes and humoral products that exert credible health benefits. Their emerging functions with respect to evolution of innate immunity have long been superseded by their well-known ecological role in soil conservation. Earthworms as inexpensive, noncontroversial animal models (without ethical concerns) are not vectors of disease do not harbor parasites that threaten humans nor are they annoying pests. By recognizing their numerous ecological, environmental, and biomedical roles, substantiated by inexpensive and more comprehensive investigations, we will become more aware of their undiscovered beneficial properties. PMID:22888362

  14. Narrative Medicine perspectives on patient identity and integrative care in neuro-oncology.

    Science.gov (United States)

    Slocum, Robert B; Howard, Tracy A; Villano, John L

    2017-09-01

    Narrative Medicine sessions can encourage patients to rediscover personal identity and meaning by telling or writing their stories. We explored this process to improve care and quality of life for brain cancer patients in an academic neuro-oncology program. Brain cancer and its treatments may threaten a patient's quality of life and sense of self in many ways, including impaired cognitive skills, loss of memory, reduced coordination, and limited capacity for self-expression. The impact of symptoms and side effects on quality of life must be evaluated in terms of each patient's identity and may be understood in terms of each patient's story. Insights from Narrative Medicine visits may also be helpful for the treatment team as they seek to assess patient needs, attitudes, and abilities. We provide case-based histories demonstrating applications of Narrative Medicine in the care of patients with brain tumors whose sense of self and quality of life are challenged. The cases include managing frontal lobe syndrome of loss of initiative and pervasive emotional apathy with his wife and young children, regaining a meaningful activity in a patient, re-establishing self-identity in a young woman with ependymoma, and improving spells with coexistent epilepsy and psychogenic non-epileptic seizures (PNES).

  15. Biased HiPIMS technology for superconducting rf accelerating cavities coating

    CERN Document Server

    G. Rosaz, G.; Sonato, D.; Calatroni, S.; Ehiasarian, A.; Junginger, T.; Taborelli, M.

    2016-01-01

    In the last few years the interest of the thin film science and technology community on High Impulse Power Magnetron Sputtering (HIPIMS) coatings has steadily increased. HIPIMS literature shows that better thin film morphology, denser and smoother films can be achieved when compared with standard dc Magnetron Sputtering (dcMS) coating technology. Furthermore the capability of HIPIMS to produce a high quantity of ionized species can allow conformal coatings also for complex geometries. CERN already studied the possibility to use such a coating method for SRF accelerating cavities. Results are promising but not better from a RF point of view than dcMS coatings. Thanks to these results the next step is to go towards a biased HiPIMS approach. However the geometry of the cavities leads to complex changes in the coating setup in order to apply a bias voltage. Coating system tweaking and first superconducting properties of biased samples are presented.

  16. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents.

    Science.gov (United States)

    McClafferty, Hilary; Brooks, Audrey J; Chen, Mei-Kuang; Brenner, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Mark, John; Weydert, Joy; Yeh, Ann Ming; Maizes, Victoria

    2018-04-23

    It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents ( N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  17. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents

    Directory of Open Access Journals (Sweden)

    Hilary McClafferty

    2018-04-01

    Full Text Available It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents (N = 203, and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  18. [Modern research progress of traditional Chinese medicine based on integrative pharmacology].

    Science.gov (United States)

    Wang, Ping; Tang, Shi-Huan; Su, Jin; Zhang, Jia-Qi; Cui, Ru-Yi; Xu, Hai-Yu; Yang, Hong-Jun

    2018-04-01

    Integrative pharmacology (IP) is a discipline that studies the interaction, integration and principle of action of multiple components with the body, emphasizing the integrations of multi-level and multi-link, such as "whole and part", " in vivo and in vitro ", " in vivo process and activity evaluation". After four years of development and practice, the theory and method of IP has received extensive attention and application.In order to better promote the development of IP, this paper systematically reviews the concepts, research contents, research methods and application fields about IP. Copyright© by the Chinese Pharmaceutical Association.

  19. Treatment of Chemotherapy-Induced Peripheral Neuropathy in Integrative Oncology: A Survey of Acupuncture and Oriental Medicine Practitioners.

    Science.gov (United States)

    Lu, Zhaoxue; Moody, Jennifer; Marx, Benjamin L; Hammerstrom, Tracy

    2017-12-01

    Complementary and alternative medicine is increasingly integrated into cancer care. We sought detail on the treatment of chemotherapy-induced peripheral neuropathy (CIPN) with acupuncture and oriental medicine (AOM) by surveying practitioners at integrative oncology (IO) sites across the United States. Online survey of licensed acupuncturists. IO sites in the United States. Fifteen licensed acupuncturists who completed the survey between February 2014 and June 2014. Demographics, IO setting characteristics, AOM treatment characteristics, and practitioner-reported outcomes. Respondents reported an average of 31.3 ± 17.2 patients per week, and one-third (10.1 mean; 7.2 standard deviation [SD]) were treated for CIPN. Medical doctors (86.7%) were the most common providers with whom respondents worked. Traditional Chinese medicine style acupuncture was utilized by a majority of respondents (86.7%), and the most commonly used points were local, typically in the hands and feet, such as Ba Feng, Ba Xie, LV3, and LI4. In addition to acupuncture, nutritional advice was the most frequent auxiliary modality provided by respondents (85.7%). On average, respondents provided 12.75 ± 4.17 treatments for CIPN patients, and a majority (53%) reported treating patients once per week. Timing of the treatments relative to chemotherapy infusion was evenly distributed between "1-2 days after infusion" (60%), "at time of infusion" (53.3%), and "1-2 days before infusion" (46.7%). Sixty percent of respondents rated outcomes as "moderately successful with moderate improvement seen." This survey provides detail regarding IO sites using acupuncture for CIPN as well as real-world treatment patterns, including common point combinations, visit characteristics, and practitioner-reported outcomes. This information contributes to the emerging evidence on the use of acupuncture to address unmet needs of CIPN patients, and supports the development of best practice guidelines for the treatment

  20. Integral-equation based methods for parameter estimation in output pulses of radiation detectors: Application in nuclear medicine and spectroscopy

    Science.gov (United States)

    Mohammadian-Behbahani, Mohammad-Reza; Saramad, Shahyar

    2018-04-01

    Model based analysis methods are relatively new approaches for processing the output data of radiation detectors in nuclear medicine imaging and spectroscopy. A class of such methods requires fast algorithms for fitting pulse models to experimental data. In order to apply integral-equation based methods for processing the preamplifier output pulses, this article proposes a fast and simple method for estimating the parameters of the well-known bi-exponential pulse model by solving an integral equation. The proposed method needs samples from only three points of the recorded pulse as well as its first and second order integrals. After optimizing the sampling points, the estimation results were calculated and compared with two traditional integration-based methods. Different noise levels (signal-to-noise ratios from 10 to 3000) were simulated for testing the functionality of the proposed method, then it was applied to a set of experimental pulses. Finally, the effect of quantization noise was assessed by studying different sampling rates. Promising results by the proposed method endorse it for future real-time applications.

  1. Trends and challenges towards integration of traditional medicine in formal health care system: Historical perspectives and An Appraisal of education curricula in Sub-Sahara Africa

    Directory of Open Access Journals (Sweden)

    Ester Innocent

    2016-09-01

    Full Text Available The population residing Sub Sahara Africa (SSA continues to suffer from communicable health problems such as HIV/AIDS, Malaria, Tuberculosis, various Neglected Tropical as well as Non-Communicable Diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medicine and medical devices. Also, the population in most countries in this region still and has minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM systems. The ancient Pharaonic Egyptian traditional medicine system is one of the oldest documented form of traditional medicine practice in Africa and the pioneer of world’s medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health care system. Challenging issues that drags back integration is the development of education curricula for training Traditional medicine experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana has managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone and Tanzania have traditional medicine products being sold over the counters due to availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should taken in the integration process in order to safeguard the Sub-Sahara Africa population from disease burdens [J Complement Med Res 2016; 5(3.000: 312-316

  2. Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

    Science.gov (United States)

    Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

    2016-02-01

    Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

  3. Integrating data from the Investigational Medicinal Product Dossier/investigator's brochure. A new tool for translational integration of preclinical effects.

    Science.gov (United States)

    van Gerven, Joop; Cohen, Adam

    2018-01-30

    The first administration of a new compound in humans is an important milestone. A major source of information for the researcher is the investigator's brochure (IB). Such a document, has a size of several hundred pages. The IB should enable investigators or regulators to independently assess the risk-benefit of the proposed trial but the size and complexity makes this difficult. This article offers a practical tool for the integration and subsequent communication of the complex information from the IB or other relevant data sources. This paper is accompanied by an accessible software tool to construct a single page colour-coded overview of preclinical and clinical data. © 2018 The British Pharmacological Society.

  4. Communication and integration: a qualitative analysis of perspectives among Middle Eastern oncology healthcare professionals on the integration of complementary medicine in supportive cancer care.

    Science.gov (United States)

    Ben-Arye, Eran; Popper-Giveon, Ariela; Samuels, Noah; Mutafoglu, Kamer; Schiff, Elad; Omran, Suha; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

    2016-05-01

    The use of complementary and traditional medicine (CTM ) in Middle Eastern countries is widespread, including among patients with cancer. Perspectives of oncology healthcare professionals (HCPs) in this region regarding the integration of CTM within conventional supportive cancer care were explored. An 11-item questionnaire with an open-ended question asking respondents to comment about the integration of CTM within supportive cancer care was sent to Middle Eastern oncology HCPs, using snowball sampling methodology. The narratives provided were examined using thematic analysis. A total of 339 oncology HCPs completed and returned the study tool (80.3 % response rate ), of which 178 from 15 Middle Eastern countries responded to the open-ended question. The majority of respondents are in favor of the integration of CTM within supportive cancer care, though ideas on how this should be implemented varied. Thematic analysis identified multifactorial barriers to integration, which focused on HCPs' perspectives (e.g., a lack of knowledge and training; a skeptical approach to CTM), attitudes of patients and caregivers (e.g., unrealistic expectations regarding the outcomes of CTM treatments) and HCP-patient communication. In order to overcome these barriers, respondents suggested education and training programs for oncology HCPs which would focus on improving patients' quality-of-life-related outcomes. Middle Eastern oncology HCPs support the integration of CTM within supportive cancer care, while recognizing the need for education and training in this field. A better understanding of CTM would provide the knowledge and skills which would promote a non-judgmental, evidence-based approach, fostering better communication with patients.

  5. Ethylene/ethane permeation, diffusion and gas sorption properties of carbon molecular sieve membranes derived from the prototype ladder polymer of intrinsic microporosity (PIM-1)

    KAUST Repository

    Salinas, Octavio

    2016-01-05

    Fine-tuning the microporosity of PIM-1 by heat treatment was applied to develop a suitable carbon molecular sieve membrane for ethylene/ethane separation. Pristine PIM-1 films were heated from 400 to 800 °C under inert N2 atmosphere (< 2 ppm O2). At 400 °C, PIM-1 self-cross-linked and developed polar carbonyl and hydroxyl groups due to partial dioxane splitting in the polymer backbone. Significant degradation occurred at 600 °C due to carbonization of PIM-1 and resulted in 30% increase in cumulative surface area compared to its cross-linked predecessor. In addition, PIM-1-based CMS developed smaller ultramicropores with increasing pyrolysis temperature, which enhanced their molecular sieving capability by restricted diffusion of ethylene and ethane through the matrix due to microstructural carbon densification. Consequently, the pure-gas ethylene permeability (measured at 35 °C and 2 bar) decreased from 1600 Barrer for the pristine PIM-1 to 1.3 Barrer for the amorphous carbon generated at 800 °C, whereas the ethylene/ethane pure-gas selectivity increased significantly from 1.8 to 13.

  6. Open Access Integrated Therapeutic and Diagnostic Platforms for Personalized Cardiovascular Medicine

    Directory of Open Access Journals (Sweden)

    Todd T. Schlegel

    2013-08-01

    Full Text Available It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics.

  7. Resident response to integration of simulation-based education into emergency medicine conference.

    Science.gov (United States)

    Wang, Ernest E; Beaumont, Jennifer; Kharasch, Morris; Vozenilek, John A

    2008-11-01

    Utilization of simulation-based training has become increasingly prevalent in residency training. The authors compared emergency medicine (EM) resident feedback for simulation sessions to traditional lectures from an EM residency didactic program. The authors performed a retrospective review of all written EM conference evaluations over a 29-month period. Evaluation questions were scored on a 1-9 Likert scale. Lectures and simulation accounted for 77.6 and 22.4% of the conferences, respectively. Scored means (+/-standard deviations [SDs]) were as follows: overall, lecture 7.97 +/- 0.74 versus simulation 8.373 +/- 0.44 (p higher than traditional lectures. The scores over time suggest that this preference for simulation can be sustainable long term. Residents perceive simulation as more desirable teaching method compared to the traditional lecture format.

  8. [New theory of holistic integrative physiology and medicine. II: New insight of the control and regulation of circulation].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    The interpretation of control and regulation of circulatory parameters in traditional physiology has some limitations. Human being is an organic, circulatory control and regulation should involve all the systems. Based upon the theory of holistic integrative physiology and medicine, we approach to explain the circulatory control and regulation from its purpose. The main purpose of circulation is to maintain a stable metabolism of cells, i.e. transport oxygen (from lung) and nutrients (from gastrointestinal tract) to cells, and return carbon dioxide and metabolic products back for elimination. Based on this goal, all respiration and gastrointestinal digestion, absorption, urinary excretion, etc. are integrative together for regulation to maintain the supply-demand balance at any metabolic status of resting, exercise and sleep. So that, we can explain many existing problems and questions, for example: why and how the foramen ovale closed after birth; mechanism of Cheyne-Stokes respiration; blood flow redistribution during exercise; variabilities of systolic blood pressure, heart rate and autonomic tone. The circulatory control and regulation is the integration of all systems of the body.

  9. Genetic tests in major psychiatric disorders-integrating molecular medicine with clinical psychiatry-why is it so difficult?

    Science.gov (United States)

    Demkow, U; Wolańczyk, T

    2017-06-13

    With the advent of post-genomic era, new technologies create extraordinary possibilities for diagnostics and personalized therapy, transforming todays' medicine. Rooted in both medical genetics and clinical psychiatry, the paper is designed as an integrated source of information of the current and potential future application of emerging genomic technologies as diagnostic tools in psychiatry, moving beyond the classical concept of patient approach. Selected approaches are presented, starting from currently used technologies (next-generation sequencing (NGS) and microarrays), followed by newer options (reverse phenotyping). Next, we describe an old concept in a new light (endophenotypes), subsequently coming up with a sophisticated and complex approach (gene networks) ending by a nascent field (computational psychiatry). The challenges and barriers that exist to translate genomic research to real-world patient assessment are further discussed. We emphasize the view that only a paradigm shift can bring a fundamental change in psychiatric practice, allowing to disentangle the intricacies of mental diseases. All the diagnostic methods, as described, are directed at uncovering the integrity of the system including many types of relations within a complex structure. The integrative system approach offers new opportunity to connect genetic background with specific diseases entities, or concurrently, with symptoms regardless of a diagnosis. To advance the field, we propose concerted cross-disciplinary effort to provide a diagnostic platform operating at the general level of genetic pathogenesis of complex-trait psychiatric disorders rather than at the individual level of a specific disease.

  10. A Review and Integrative Analysis of Ancient Holistic Character Medicine Systems

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available The ancient holistic medical systems help the patient by balancing the “elements” of the human character. This work aims to understand the nature of these elements and the process of the physician balancing them. Using the concept of poly-ray cosmology we see that the medical systems from ancient India, China and Greek basically share the same inner structure and also the same logic of the treatment processes. We analyze the double concept of yin-yang, the Ayurvedic triadic concepts of Pitta, Kapha and Vata, the four elements of Hippocratic humoral medicine, and the five elements of Chinese medicine, and find that each of these conceptual frameworks make up a “theory” or model of the world that is a perfect wholeness, allowing the physician to interpret the world and his patient in order to identify the imbalances of his or her character that need to be treated. Independently of the system this can be a palliative treatment, if energies are only balanced in present time, or a causal cure if the physician is using the similarity principle to take his patient into regression back to the events in the personal history that originally created the imbalances (the traumas. To help the patient back to the traumas he is exposed to a small dose of the original harming stimulus; this can be an internal process like visualization supported by the therapist words, or an external process provoked by his actions. If the physician is balancing the elements without such a healing of the patient's existential core this can still momentarily help the patient by alleviating the symptoms, but it will not have a permanent effect.

  11. Gas transport behavior of mixed-matrix membranes composed of silica nanoparticles in a polymer of intrinsic microporosity (PIM-1)

    KAUST Repository

    Ahn, Juhyeon; Chung, Wookjin; Pinnau, Ingo; Song, Jingshe; Du, Naiying; Robertson, Gilles P.; Guiver, Michael D.

    2010-01-01

    Recently, high-free volume, glassy ladder-type polymers, referred to as polymers of intrinsic microporosity (PIM), have been developed and their reported gas transport performance exceeded the Robeson upper bound trade-off for O2/N2 and CO2/CH4. The present work reports the gas transport behavior of PIM-1/silica nanocomposite membranes. The changes in free volume, as well as the presence and volume of the void cavities, were investigated by analyzing the density, thermal stability, and nano-structural morphology. The enhancement in gas permeability (e.g., He, H2, O2, N2, and CO2) with increasing filler content shows that the trend is related to the true silica volume and void volume fraction. Crown Copyright © 2009.

  12. Bridging cross-cultural gaps: monitoring herbal use during chemotherapy in patients referred to integrative medicine consultation in Israel.

    Science.gov (United States)

    Almog, Limor; Lev, Efraim; Schiff, Elad; Linn, Shai; Ben-Arye, Eran

    2014-10-01

    The high prevalence of the use of traditional herbs among patients with cancer is a cause for concern with regard to potentially adverse interactions with conventional oncology treatments. In this study, we explore herbal use among patients with cancer in northern Israel who are referred by their health care providers to complementary and traditional medicine (CTM) consultations provided to them within the conventional oncology department. The study's objectives were to identify which herbs patients use and to examine the scope of current research on the efficacy and safety regarding the identified herbs. Herbal use by patients receiving oncology care was assessed prospectively from July 2009 to July 2012 by integrative physicians (IPs) trained in herbal medicine. Historical, ethnobotanical, basic research, and clinical data regarding the identified herbs were explored by using a keyword search in PubMed and Middle Eastern ethnohistorical literature. Disclosure of herbal use was reported by 154 of the 305 patients (50.5 %) interviewed by IPs. The use of 85 single herbs and 30 different herbal formulas was documented during the initial or follow-up IP assessments. Patients reported 14 quality of life-associated indications for herbal use. The ten most prevalent herbs displaying in vitro/in vivo anticancer activity and nine other herbs were preliminarily assessed concerning potential risks, safety, and interaction with chemotherapy. Herbal use by patients with cancer in northern Israel is widespread and calls for further study in order to address issues of safety and effectiveness. We recommend constructing a multinational and multidisciplinary team of researchers with ethnopharmacological and clinical expertise that will explore the use of herbs among patients with cancer in a cross-cultural perspective attuned with patients' affinity to traditional herbal medicine.

  13. [Ideas and methods on efficient screening of traditional medicines for anti-osteoporosis activity based on M-Act/Tox integrated evaluation using zebrafish].

    Science.gov (United States)

    Wang, Mo; Ling, Jie; Chen, Ying; Song, Jie; Sun, E; Shi, Zi-Qi; Feng, Liang; Jia, Xiao-Bin; Wei, Ying-Jie

    2017-11-01

    The increasingly apparent liver injury problems of bone strengthening Chinese medicines have brought challenges for clinical application, and it is necessary to consider both effectiveness and safety in screening anti-osteoporosis Chinese medicines. Metabolic transformation is closely related to drug efficacy and toxicity, so it is significant to comprehensively consider metabolism-action/toxicity(M-Act/Tox) for screening anti-osteoporosis Chinese medicines. The current evaluation models and the number of compounds(including metabolites) severely restrict efficient screening in vivo. By referring to previous relevant research and domestic and abroad literature, zebrafish M-Act/Tox integrative method was put forward for efficiently screening anti-osteoporosis herb medicines, which has organically integrated zebrafish metabolism model, osteoporosis model and toxicity evaluation method. This method can break through the bottleneck and blind spots that trace compositions can't achieve efficient and integrated in vivo evaluation, and realize both efficient and comprehensive screening on anti-osteoporosis traditional medicines based on in vivo process taking both safety and effectiveness into account, which is significant to accelerate discovery of effective and safe innovative traditional Chinese medicines for osteoporosis. Copyright© by the Chinese Pharmaceutical Association.

  14. [Construction and realization of real world integrated data warehouse from HIS on re-evaluation of post-maketing traditional Chinese medicine].

    Science.gov (United States)

    Zhuang, Yan; Xie, Bangtie; Weng, Shengxin; Xie, Yanming

    2011-10-01

    To construct real world integrated data warehouse on re-evaluation of post-marketing traditional Chinese medicine for the research on key techniques of clinic re-evaluation which mainly includes indication of traditional Chinese medicine, dosage usage, course of treatment, unit medication, combined disease and adverse reaction, which provides data for reviewed research on its safety,availability and economy,and provides foundation for perspective research. The integrated data warehouse extracts and integrate data from HIS by information collection system and data warehouse technique and forms standard structure and data. The further research is on process based on the data. A data warehouse and several sub data warehouses were built, which focused on patients' main records, doctor orders, diseases diagnoses, laboratory results and economic indications in hospital. These data warehouses can provide research data for re-evaluation of post-marketing traditional Chinese medicine, and it has clinical value. Besides, it points out the direction for further research.

  15. Students' perception of an integrated approach of teaching entire sequence of medicinal chemistry, pharmacology, and pharmacotherapeutics courses in PharmD curriculum.

    Science.gov (United States)

    Islam, Mohammed A; Schweiger, Teresa A

    2015-04-01

    To develop an integrated approach of teaching medicinal chemistry, pharmacology, and pharmacotherapeutics and to evaluate students' perceptions of integration as they progress through the PharmD curriculum. Instructors from each discipline jointly mapped the course contents and sequenced the course delivery based on organ systems/disease states. Medicinal chemistry and pharmacology contents were integrated and aligned with respective pharmacotherapeutics contents to deliver throughout second and third year of the curriculum. In addition to classroom lectures, active learning strategies such as recitation, case studies, online-discussion boards, open book quizzes, and writing patient progress notes were incorporated to enhance student learning. Student learning was assessed by examination scores, patient progress notes, and writing assignments. The impact of course integration was evaluated by a Web-based survey. One hundred and sixty-nine students completed the survey. Students exhibited positive attitude toward the integrated approach of teaching medicinal chemistry, pharmacology, and therapeutics. The P3 and P4 students better appreciated the benefits of integration compared to P2 students (P < .05). Students perceived the course integration as an effective way of learning. This study supports course improvement and the viability of expanding the concept of integration to other courses in the curriculum. © The Author(s) 2014.

  16. Research training in integrative medicine: how can we make teaching and learning in research methods more sustainable and engaging?

    Science.gov (United States)

    Witt, Claudia M; Withers, Shelly Rafferty

    2013-01-01

    The aim of this project was to identify strategies for increasing learner engagement and knowledge retention in clinical research training of complementary and integrative medicine (CIM) practitioners, and to offer a conceptual framework to address clinical research training for CIM practitioners. In a featured large-group discussion (15min presentation and 30min discussion), two questions (strategies that are recommended to overcome these barriers; relevant aspects for a framework for building sustainable knowledge) were put to the audience. The sample consisted of 43 participants at the International Congress of Educators in Complementary and Alternative Medicine, in Washington, DC, in October 2012. The featured discussion was moderated and detailed notes were taken. Notes were synthesized and discussed by both authors until consensus was reached. Based on the results from the featured discussion session and a focused literature search, a framework for building sustainable knowledge and skills in clinical research for CIM practitioners was developed. Participants' responses to the questions of engagement and sustainability included curricular structures, pedagogical strategies for instruction, the use of digital tools to extend the learning experience, the necessity to ground instruction firmly in the medical literature of the field, and the relevance of mentoring. Key considerations for building sustainable knowledge in clinical research for CIM practitioners are as follows: (1) prioritizing clinical research training, (2) issues of curriculum and pedagogy, (3) technology/digital tools, (4) administrative challenges, (5) supporting the formation of communities of practice, and (6) cultural perspectives of CIM practitioners. © 2013 Elsevier Inc. All rights reserved.

  17. Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia.

    Science.gov (United States)

    Fleming, Brandy M; Schwab, Emiko L; Nouer, Simonne S; Wan, Jim Y; LeDoux, Mark S

    2012-09-01

    Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety and effectiveness, and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of affected anatomical regions on botulinum toxin and CAM-I use and their perceived effectiveness. 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use - individuals with bachelor's degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for CAM-I (28%, p effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning.

    Science.gov (United States)

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2016-12-01

    BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

  19. Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

    International Nuclear Information System (INIS)

    De Jesus, M.; Trujillo-Zamudio, F. E.

    2010-01-01

    A building project of Radiotherapy and Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

  20. Therapeutic Value of PLK1 Knockdown in Combination with Prostate Cancer Drugs in PIM-1 Overexpressing Prostate Cancer Cells

    Science.gov (United States)

    2014-11-13

    targeting a total of 570 genes involved in key cancer relevant pathways (111 cell cycle, 318 apoptosis, 87 serine- threonine kinase and 54 tyrosine kinase...siRNAs that target genes encoding selected serine/threonine kinases, tyrosine kinases, cell cycle protein and apoptosis proteins to identify genes...PIM1 (Santa Cruz, sc-13513), PLK1 (Santa Cruz, sc-17783), phospho-PLK1 (Thr 210; Cell Signaling, #5472), phospho-histone H3 (Upstate, #06- 570 ), cleaved

  1. Developing a complex systems perspective for medical education to facilitate the integration of basic science and clinical medicine.

    Science.gov (United States)

    Aron, David C

    2017-04-01

    The purpose of medical education is to produce competent and capable professional practitioners who can combine the art and science of medicine. Moreover, this process must prepare individuals to practise in a field in which knowledge is increasing and the contexts in which that knowledge is applied are changing in unpredictable ways. The 'basic sciences' are important in the training of a physician. The goal of basic science training is to learn it in a way that the material can be applied in practice. Much effort has been expended to integrate basic science and clinical training, while adding many other topics to the medical curriculum. This effort has been challenging. The aims of the paper are (1) to propose a unifying conceptual framework that facilitates knowledge integration among all levels of living systems from cell to society and (2) illustrate the organizing principles with two examples of the framework in action - cybernetic systems (with feedback) and distributed robustness. Literature related to hierarchical and holarchical frameworks was reviewed. An organizing framework derived from living systems theory and spanning the range from molecular biology to health systems management was developed. The application of cybernetic systems to three levels (regulation of pancreatic beta cell production of insulin, physician adjustment of medication for glycaemic control and development and action of performance measures for diabetes care) was illustrated. Similarly distributed robustness was illustrated by the DNA damage response system and principles underlying patient safety. Each of the illustrated organizing principles offers a means to facilitate the weaving of basic science and clinical medicine throughout the course of study. The use of such an approach may promote systems thinking, which is a core competency for effective and capable medical practice. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  2. Internal medicine network: a new way of thinking hospital-territory integration and public-private partnership

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-10-01

    Full Text Available This working proposal aims to establish an Internal Medicine Network (IMN model for the appropriate management of the poly-pathological complex patient in the different phases of his illness natural hystory. The IMN is based on an organization recalling the Hub and Spoke system already used for existing specialized networks. The Internal Medicine Unit (IMU is the natural destination of acutely ill patients suffering from systemic or multi-organ diseases. Three are the IMU specific tasks: i to stabilize acute, severe, poly-pathologic and complex patients; ii to develop difficult etiological diagnosis in these patients and in those who should necessarily be admitted to the hospital, not being possible, for different reasons, alternative routes; iii to select the acute poly-pathological complex patient’s priorities. The expected results of a new model of integration system inside the IMN are: i reduction and rationalization of expenditure in the medical area, increasing effectiveness, quality and safety guaranteeing patient centrality; ii patients stratification based on characteristics of gravity, acute illness, estimated duration of hospitalization; iii reduction of inappropriate hospital admissions ensuring connections between hospital and primary care units; iv definition of different care pathways for patients hospitalized due to non-communicable diseases; v implementation of new common medical records. The public-private partnership inside the IMN could be able to increase appropriateness reducing health costs. Patient-centered problems assessment, together with integration, cooperation, coordination and effective communication are some simple rules useful to achieve tangible results in a complex system and the IMN model represents its practical application.

  3. Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study

    Science.gov (United States)

    2011-01-01

    Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with

  4. Research and development of a gaseous detector PIM (parallel ionization multiplier) dedicated to particle tracking under high hadron rates

    International Nuclear Information System (INIS)

    Beucher, J.

    2007-10-01

    PIM (Parallel Ionization Multiplier) is a multi-stage micro-pattern gaseous detector using micro-meshes technology. This new device, based on Micromegas (micro-mesh gaseous structure) detector principle of operation, offers good characteristics for minimum ionizing particles track detection. However, this kind of detectors placed in hadron environment suffers discharges which degrade sensibly the detection efficiency and account for hazard to the front-end electronics. In order to minimize these strong events, it is convenient to perform charges multiplication by several successive steps. Within the framework of a European hadron physics project we have investigated the multi-stage PIM detector for high hadrons flux application. For this part of research and development, a systematic study for many geometrical configurations of a two amplification stages separated with a transfer space operated with the gaseous mixture Ne + 10% CO 2 has been performed. Beam tests realised with high energy hadrons at CERN facility have given that discharges probability could be strongly reduced with a suitable PIM device. A discharges rate lower to 10 9 by incident hadron and a spatial resolution of 51 μm have been measured at the beginning efficiency plateau (>96 %) operating point. (author)

  5. Can foreign proteins imported into yeast mitochondria interfere with PIM1p protease and/or chaperone function?

    Science.gov (United States)

    Saveliev, A S; Kovaleva, I E; Novikova, L A; Isaeva, L V; Luzikov, V N

    1999-03-15

    When studying the fate of mammalian apocytochrome P450scc (apo-P450scc) imported in small amounts into isolated yeast mitochondria, we found that it undergoes degradation, this process being retarded if recipient mitochondria are preloaded in vivo (to about 0.2% of total organelle protein) with a fusion protein composed of mammalian adrenodoxin reductase and adrenodoxin (AdR-Ad); in parallel we observed aggregation of apo-P450scc. These effects suggest some overload of Pim1p protease and/or mtHsp70 system by AdR-Ad, as both of them are involved in the degradation of apo-P450scc (see Savel'ev et al. J. Biol. Chem. 273, 20596-20602, 1998). However, under the same conditions AdR-Ad was not able to impede the import of proteins into mitochondria and the development of the mitochondrial respiratory machinery in yeast, the processes requiring the mtHsp70 system and Pim1p, respectively. These data imply that chaperones and Pim1p protease prefer their natural targets in mitochondria to imported foreign proteins. Copyright 1999 Academic Press.

  6. The juxtamembrane domain in ETV6/FLT3 is critical for PIM-1 up-regulation and cell proliferation

    International Nuclear Information System (INIS)

    Vu, Hoang Anh; Xinh, Phan Thi; Kano, Yasuhiko; Tokunaga, Katsushi; Sato, Yuko

    2009-01-01

    We recently reported that the ETV6/FLT3 fusion protein conferred interleukin-3-independent growth on Ba/F3 cells. The present study has been conducted to assess role of the juxtamembrane domain of FLT3 for signal transduction and cell transformation. The wild-type ETV6/FLT3 fusion protein in transfected cells was a constitutively activated tyrosine kinase that led to up-regulation of PIM-1 and activations of STAT5, AKT, and MAPK. Deletion of the juxtamembrane domain abrogated interleukin-3-independent growth of the transfected cells and PIM-1 up-regulation, whereas it retained compatible levels of phosphorylations of STAT5, AKT, and MAPK. Further deletion of N-terminal region of the tyrosine kinase I domain of FLT3 completely abolished these phosphorylations. Our data indicate that the juxtamembrane domain of FLT3 in ETV6/FLT3 fusion protein is critical for cell proliferation and PIM-1 up-regulation that might be independent of a requirement for signaling through STAT5, MAPK, and AKT pathways.

  7. Effects of Integrated Traditional Chinese and Western Medicine for the Treatment of Lupus Nephritis: A Meta-Analysis of Randomized Trials

    Directory of Open Access Journals (Sweden)

    Mingli Heng

    2016-01-01

    Full Text Available After a thorough search through the database as CNKI database, VIP database, Wanfang database, PubMed, and Cochrane Library, the clinical experimental articles have been selected out on the effects of Integrated Traditional Chinese and Western Medicine on the treatment of lupus nephritis. A meta-analysis was carried out in terms of clinical efficacy criteria and safety criteria by RevMan 5.3 software. Based on the results, we cautiously conclude that Integrated Traditional Chinese and Western Medicine used for lupus nephritis could improve the clinical efficacy while at same time lower the 24-hour urine protein, serum creatinine, and adverse drug reactions.

  8. Effects and feasibility of an Integrative Medicine program for geriatric patients– a cluster-randomized pilot study

    Directory of Open Access Journals (Sweden)

    Teut M

    2013-07-01

    Full Text Available Michael Teut, Katharina Schnabel, Roland Baur, Annette Kerckhoff, Frauke Reese, Niels Pilgram, Franziska Berger, Rainer Luedtke, Claudia M Witt Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany Background: Older adults often use complementary medicine; however, very few interventional studies have focused on them. The aim of this study was to evaluate the feasibility and to obtain preliminary data on effectiveness of an Integrative Medicine (IM program compared to usual medical care. Methods: The study consisted of older adults living in shared apartment communities including caregiving. The shared apartments were cluster-randomized to the IM program or Usual Care (UC. IM consisted of additional lifestyle modification (exercise and diet, external naturopathic applications, homeopathic treatment, and modification of conventional drug therapy for 12 months. The UC group received conventional care alone. The following outcomes were used: Nurses Observation Scale for Geriatric Patients (NOSGER; Assessment of Motor and Process Skills; Barthel Index; Qualidem; Profile of Wellbeing; and Mini-mental State Examination. Exploratory effect sizes (Cohen’s d, means adjusted for differences of baseline values were calculated to analyze group differences. Results: A total of eight shared apartment communities were included; four were allocated to IM (29 patients, median seven patients; [mean ± standard deviation] 82.7 ± 8.6 years and four to UC (29 patients, median eight patients; 76.0 ± 12.8 years of age. After 12 months, effect sizes ≥0.3 were observed for activities of daily living on the NOSGER-Activities of Daily Living subscale (0.53, Barthel Index (0.30, Qualidem total sum score (0.39, Profile of Wellbeing (0.36, NOSGER-Impaired Social Behavior (0.47, and NOSGER-Depressed Mood subscales (0.40. Smaller or no effects were observed for all other outcomes. The intervention

  9. ‘Better medicines for children’ within the Integrated Management of Childhood Illness framework

    DEFF Research Database (Denmark)

    Nsabagasani, Xavier; Ogwal-Okeng, Jasper; Hansen, Ebba Holme

    2016-01-01

    . Conclusions: The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations – a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should...... approach in Uganda has not been studied. Methods: Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Results...

  10. Neuroscience in Psychiatry towards an integrative and personalized medicine in the DSM-V: a proposal

    Directory of Open Access Journals (Sweden)

    Erick Emmanuel Pérez Solís

    2009-05-01

    Full Text Available In the last Century the concept of health and, with it, medical science, has suffered a profound, conceptual and ontological change. However, this revolution has not reached, in the same way the field of mental health. In the next pages it will be shown, taking Major Depressive Disorder as a model, how it is possible and necessary, for the field ofpsychopathology (behavior and “mental” functions: rational, executive, cognitive, emotional, etc. the return to its medical origins, which will allow it to respond how the brain functions and its interactions with the rest of the organism and the environment, with the goal of obtaining patterns that will help us to define disease from an etiopathogenic point of view, so it would be possible to provide therapeutic options to theorgan in question. The time has come to ask if we have invented a science (psychiatry that has little to do with reality, and to answer that, the creation of multicentric data bases is proposed, in which biological (not just brain based, social, personal, clinical, etc. variables are integrated, to finally obtain correlations that allow us a reclassification of brain pathology that would be useful to offer integral and personalized treatments.

  11. BETTER UNDERSTANDING OF SOCIAL INTEGRATION AND SOLIDARITY AS PARAMETERS FOR POSTGRADUATE PROGRAM EVALUATION OF MEDICINE III.

    Science.gov (United States)

    Matias, Jorge Eduardo Fouto

    2015-01-01

    To provide information in the maturation process of the general conception of social inclusion and solidarity. The following official CAPES sources were consulted: resolutions of the Technical-Scientific Council; models of evaluation forms; current legislation and ordinances; relationship with the Great Area courses; Dinter and Minter evaluation projects; and the assessment application. Social inclusion and solidarity are recent and innovative parameters to be developed by postgraduate programs and evaluated by area committees organized by Capes. There is need for better understanding by the postgraduate faculty of Medicine III the characteristics of relevant actions on social inclusion. The basic theme of life support help in understanding how ​​Medicine III can expand its operations in basic education without compromising the innovative and transformer character of postgraduate. Postgraduate must innovate its insertion in teaching processes, managed care or any other field. What is sought is the power of social transformation, inherent to its spirit and exercise. Proporcionar informações que sejam de auxílio no amadurecimento da concepção geral sobre inserção social e solidariedade. Foram consultadas as seguintes fontes oficiais da CAPES: resoluções do Conselho Técnico-Científico; modelos das fichas de avaliação; legislação e portarias vigentes; relação dos cursos da Grande Área; avaliação de projetos Dinter e Minter; e o aplicativo de avaliação. Inserção social e solidariedade são parâmetros recentes e inovadores como ações a serem desenvolvidas por programas de pós-graduação e avaliadas pelos comitês de áreas organizados pela Capes. Há necessidade de melhor compreensão por parte dos professores de pós-graduação da Medicina III das características de ações relevantes de inserção social. O tema de suporte básico de vida ajuda na compreensão de como a área da Medicina III pode ampliar sua atuação em educação b

  12. Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

    Directory of Open Access Journals (Sweden)

    Stefanie Joos

    2011-01-01

    Full Text Available More than two-thirds of patients in Germany use complementary and alternative medicine (CAM provided either by physicians or non-medical practitioners (“Heilpraktiker”. There is little information about the number of family physicians (FPs providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34% returned the questionnaire and 444 (15% returned the postcard. Altogether, 886 of the 1471 responding FPs (60% reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%, a rather negative attitude by 127 FPs (14%. Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned.

  13. The oil-dispersion bath in anthroposophic medicine--an integrative review.

    Science.gov (United States)

    Büssing, Arndt; Cysarz, Dirk; Edelhäuser, Friedrich; Bornhöft, Gudrun; Matthiessen, Peter F; Ostermann, Thomas

    2008-12-04

    Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15-30 minutes. We review the current literature on oil-dispersion baths. The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals), 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects - although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future.

  14. The oil-dispersion bath in anthroposophic medicine – an integrative review

    Science.gov (United States)

    Büssing, Arndt; Cysarz, Dirk; Edelhäuser, Friedrich; Bornhöft, Gudrun; Matthiessen, Peter F; Ostermann, Thomas

    2008-01-01

    Background Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15–30 minutes. We review the current literature on oil-dispersion baths. Methods The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Results Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals), 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects – although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Conclusion Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future. PMID:19055811

  15. The oil-dispersion bath in anthroposophic medicine – an integrative review

    Directory of Open Access Journals (Sweden)

    Bornhöft Gudrun

    2008-12-01

    Full Text Available Abstract Background Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15–30 minutes. We review the current literature on oil-dispersion baths. Methods The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Results Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals, 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects – although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Conclusion Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future.

  16. Results of a 2-Week Inpatient Stay at the Department for Internal and Integrative Medicine: An Observational Study

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    2012-01-01

    Full Text Available Introduction. The Department for Internal and Integrative Medicine in Essen utilizes mind/body medical elements in order to empower patients with chronic diseases to better cope with their symptoms and to adopt a healthy lifestyle. This study explored the influence and predictors of a 2-week integrative treatment program on patients’ quality of life. Methods. This observational study was conducted with inpatients as part of the quality assurance program. Patients’ quality of life, psychological symptoms, and health locus of control were measured on admission and discharge and again 3, 6, and 12 months after discharge. Regression analyses were conducted to determine the factors predicting improved quality of life. Results. Data from 2486 inpatients treated in 2001–2004 were included (80% female, mean age 53.9 ± 14.3 years. Response rates decreased to 50% at 12 months. Small-to-moderate effects were found on patients’ quality of life, anxiety, and depression. Patients’ internal locus of control significantly increased. Improved quality of life was mainly predicted by lower baseline scores. Conclusion. Results of this study suggest that a 2-week inpatient treatment might sustainably reduce patients’ symptoms and increase their quality of life; however, conclusions are only preliminary. More research is needed to enable the effectiveness to be judged conclusively.

  17. Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-06-01

    Full Text Available Abstract Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1 a recruitment page, 2 a summary page, and 3 a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27% enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps

  18. Low-temperature plasma nitriding of sintered PIM 316L austenitic stainless steel

    Energy Technology Data Exchange (ETDEWEB)

    Mendes, Aecio Fernando; Scheuer, Cristiano Jose; Joanidis, Ioanis Labhardt; Cardoso, Rodrigo Perito; Mafra, Marcio; Klein, Aloisio Nelmo; Brunatto, Silvio Francisco, E-mail: brunatto@ufpr.br [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Dept. de Engenharia Mecanica. Grupo de Tecnologia de Fabricacao Assistida pro Plasma e Metalurgia do Po

    2014-08-15

    This work reports experimental results on sintered PIM 316L stainless steel low-temperature plasma nitriding. The effect of treatment temperature and time on process kinetics, microstructure and surface characteristics of the nitrided samples were investigated. Nitriding was carried out at temperatures of 350, 380, 410 and 440 °C , and times of 4, 8 and 16 h, using a gas mixture composed by 60% N2 + 20% H2 + 20% Ar, at a gas flow rate of 5.00 X 10{sup 6} Nm{sup 3-1}, and a pressure of 800 Pa. The treated samples were characterized by scanning electron microscopy, X-ray diffractometry and microhardness measurements. Results indicate that low-temperature plasma nitriding is a diffusion controlled process. The calculated activation energy for nitrided layer growth was 111.4 kJmol{sup -1}. Apparently precipitation-free layers were produced in this study. It was also observed that the higher the treatment temperature and time the higher is the obtained surface hardness. Hardness up to 1343 HV{sub 0.025} was verified for samples nitrided at 440 °C. Finally, the characterization of the treated surface indicates the formation of cracks, which were observed in regions adjacent to the original pores after the treatment. (author)

  19. Data reconciliation using PIMs historical data: a simple and low cost approach

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, Conrad A.A.; Oliveira, Elcio Cruz de [PETROBRAS Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil)

    2009-12-19

    The procedure known as data reconciliation is based on measurement adjustments so that the resulting values fit within the conservation laws and the restrictions imposed by the process. The classical general data reconciliation problem deals with a weighted least-squares minimization of the measurement adjustments subject to the model constraints. The reconciliation technique allows that two or more experimental redundant measurements can be reconciled to a single value, a better representation of the quantity to be analyzed, minimizing the measurement uncertainty. A critical step in this process is the acquisition and storage of long-term data. There are commercial applications available to solve this problem, although in many cases they don't apply to the plants particularities and, in cases they do, the presented solution is usually more complex and expensive. The purpose of this work was to develop a custom tool for volume data reconciliation on oil products storage and transportation plants using the process data stored on a PIMS server. The platform chosen for this development was an Excel environment. The main novelty presented in this tool is the intrinsic simplicity gained by using an Excel environment, due to its wide range usage facilitating the customization for different plants without extra costs for the company. (author)

  20. The effectiveness of a clinically integrated e-learning course in evidence-based medicine: A cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Arvanitis Theodoros N

    2009-05-01

    Full Text Available Abstract Background To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM among postgraduates compared to a traditional lecture-based course of equivalent content. Methods We conducted a cluster randomised controlled trial in the Netherlands and the UK involving postgraduate trainees in six obstetrics and gynaecology departments. Outcomes (knowledge gain and change in attitude towards EBM were compared between the clinically integrated e-learning course (intervention and the traditional lecture based course (control. We measured change from pre- to post-intervention scores using a validated questionnaire assessing knowledge (primary outcome and attitudes (secondary outcome. Results There were six clusters involving teaching of 61 postgraduate trainees (28 in the intervention and 33 in the control group. The intervention group achieved slightly higher scores for knowledge gain compared to the control, but these results were not statistically significant (difference in knowledge gain: 3.5 points, 95% CI -2.7 to 9.8, p = 0.27. The attitudinal changes were similar for both groups. Conclusion A clinically integrated e-learning course was at least as effective as a traditional lecture based course and was well accepted. Being less costly than traditional teaching and allowing for more independent learning through materials that can be easily updated, there is a place for incorporating e-learning into postgraduate EBM curricula that offer on-the-job training for just-in-time learning. Trial registration Trial registration number: ACTRN12609000022268.

  1. Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

    Science.gov (United States)

    Heinz, Jürgen; Fiori, Wolfgang; Heusser, Peter

    2013-01-01

    Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs). Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC) treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually. PMID:23431346

  2. Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

    Directory of Open Access Journals (Sweden)

    Jürgen Heinz

    2013-01-01

    Full Text Available Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs. Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually.

  3. An integrated clinical and genomic information system for cancer precision medicine.

    Science.gov (United States)

    Jang, Yeongjun; Choi, Taekjin; Kim, Jongho; Park, Jisub; Seo, Jihae; Kim, Sangok; Kwon, Yeajee; Lee, Seungjae; Lee, Sanghyuk

    2018-04-20

    Increasing affordability of next-generation sequencing (NGS) has created an opportunity for realizing genomically-informed personalized cancer therapy as a path to precision oncology. However, the complex nature of genomic information presents a huge challenge for clinicians in interpreting the patient's genomic alterations and selecting the optimum approved or investigational therapy. An elaborate and practical information system is urgently needed to support clinical decision as well as to test clinical hypotheses quickly. Here, we present an integrated clinical and genomic information system (CGIS) based on NGS data analyses. Major components include modules for handling clinical data, NGS data processing, variant annotation and prioritization, drug-target-pathway analysis, and population cohort explorer. We built a comprehensive knowledgebase of genes, variants, drugs by collecting annotated information from public and in-house resources. Structured reports for molecular pathology are generated using standardized terminology in order to help clinicians interpret genomic variants and utilize them for targeted cancer therapy. We also implemented many features useful for testing hypotheses to develop prognostic markers from mutation and gene expression data. Our CGIS software is an attempt to provide useful information for both clinicians and scientists who want to explore genomic information for precision oncology.

  4. Effectiveness of active self-care complementary and integrative medicine therapies: options for the management of chronic pain symptoms.

    Science.gov (United States)

    Crawford, Cindy; Lee, Courtney; Freilich, Daniel

    2014-04-01

    Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures that are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management. Active self-care CIM (ACT-CIM) therapies allow for a more diverse, patient-centered treatment of complex symptoms, promote self-management, and are relatively safe and cost-effective. To date, there are no systematic reviews examining the full range of ACT-CIM used for chronic pain symptom management. A systematic review was conducted, using Samueli Institute's Rapid Evidence Assessment of the Literature methodology, to rigorously assess both the quality of the research on ACT-CIM modalities and the evidence for their efficacy and effectiveness in treating chronic pain symptoms. A working group of subject matter experts was also convened to evaluate the overall literature pool and develop recommendations for the use and implementation of these modalities. Following key database searches, 146 randomized controlled trials were included in the review, 18 of which directly compared ACT-CIM approaches with one another. This article summarizes the current evidence, quality, effectiveness, and safety of these modalities. Recommendations and next steps to move this field of research forward are also discussed. The entire scope of the review is detailed throughout the current Pain Medicine supplement. Wiley Periodicals, Inc.

  5. Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa

    Science.gov (United States)

    Innocent, Ester

    2016-01-01

    The population residing Sub-Sahara Africa (SSA) continues to suffer from communicable health problems such as HIV/AIDS, malaria, tuberculosis, and various neglected tropical as well as non-communicable diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medical devices and minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is one of the oldest documented forms of TM practice in Africa and the pioneer of world’s medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. Challenging issues that drag back integration is the development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens. PMID:27366358

  6. Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa.

    Science.gov (United States)

    Innocent, Ester

    2016-01-01

    The population residing Sub-Sahara Africa (SSA) continues to suffer from communicable health problems such as HIV/AIDS, malaria, tuberculosis, and various neglected tropical as well as non-communicable diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medical devices and minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is one of the oldest documented forms of TM practice in Africa and the pioneer of world's medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. Challenging issues that drag back integration is the development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens.

  7. Autism, an extreme challenge to integrative medicine. Part 2: medical management.

    Science.gov (United States)

    Kidd, Parris M

    2002-12-01

    Autism and allied autistic spectrum disorders (ASD) present myriad behavioral, clinical, and biochemical abnormalities. Parental participation, advanced testing protocols, and eclectic treatment strategies have driven progress toward cure. Behavioral modification and structured education are beneficial but insufficient. Dietary restrictions, including removal of milk and other casein dairy products, wheat and other gluten sources, sugar, chocolate, preservatives, and food coloring are beneficial and prerequisite to benefit from other interventions. Individualized IgG or IgE testing can identify other troublesome foods but not non-immune mediated food sensitivities. Gastrointestinal improvement rests on controlling Candida and other parasites, and using probiotic bacteria and nutrients to correct dysbiosis and decrease gut permeability. Detoxification of mercury and other heavy metals by DMSA/DMPS chelation can have marked benefit. Documented sulfoxidation-sulfation inadequacies call for sulfur-sulfhydryl repletion and other liver p450 support. Many nutrient supplements are beneficial and well tolerated, including dimethylglycine (DMG) and a combination of pyridoxine (vitamin B6) and magnesium, both of which benefit roughly half of ASD cases. Vitamins A, B3, C, and folic acid; the minerals calcium and zinc; cod liver oil; and digestive enzymes, all offer benefit. Secretin, a triggering factor for digestion, is presently under investigation. Immune therapies (pentoxifyllin, intravenous immunoglobulin, transfer factor, and colostrum) benefit selected cases. Long-chain omega-3 fatty acids offer great promise. Current pharmaceuticals fail to benefit the primary symptoms and can have marked adverse effects. Individualized, in-depth clinical and laboratory assessments and integrative parent-physician-scientist cooperation are the keys to successful ASD management.

  8. Development and validation of a new global well-being outcomes rating scale for integrative medicine research

    Directory of Open Access Journals (Sweden)

    Bell Iris R

    2004-01-01

    Full Text Available Abstract Background Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM. Methods Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS, which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50 from healthy individuals (n = 50 in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI in undergraduate college students (N = 458. The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale in a different sample of undergraduate students (N = 62. Results Substudy (i Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50; controls r = 0.45. AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36; controls r = 0.50. Controls (r = 0.64 had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33, which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40. Substudy (iii AIOS scores were significantly

  9. Pim kinase inhibition sensitizes FLT3-ITD acute myeloid leukemia cells to topoisomerase 2 inhibitors through increased DNA damage and oxidative stress

    Science.gov (United States)

    Doshi, Kshama A.; Trotta, Rossana; Natarajan, Karthika; Rassool, Feyruz V.; Tron, Adriana E.; Huszar, Dennis; Perrotti, Danilo; Baer, Maria R.

    2016-01-01

    Internal tandem duplication of fms-like tyrosine kinase-3 (FLT3-ITD) is frequent (30 percent) in acute myeloid leukemia (AML), and is associated with short disease-free survival following chemotherapy. The serine threonine kinase Pim-1 is a pro-survival oncogene transcriptionally upregulated by FLT3-ITD that also promotes its signaling in a positive feedback loop. Thus inhibiting Pim-1 represents an attractive approach in targeting FLT3-ITD cells. Indeed, co-treatment with the pan-Pim kinase inhibitor AZD1208 or expression of a kinase-dead Pim-1 mutant sensitized FLT3-ITD cell lines to apoptosis triggered by chemotherapy drugs including the topoisomerase 2 inhibitors daunorubicin, etoposide and mitoxantrone, but not the nucleoside analog cytarabine. AZD1208 sensitized primary AML cells with FLT3-ITD to topoisomerase 2 inhibitors, but did not sensitize AML cells with wild-type FLT3 or remission bone marrow cells, supporting a favorable therapeutic index. Mechanistically, the enhanced apoptosis observed with AZD1208 and topoisomerase 2 inhibitor combination treatment was associated with increased DNA double-strand breaks and increased levels of reactive oxygen species (ROS), and co-treatment with the ROS scavenger N-acetyl cysteine rescued FLT3-ITD cells from AZD1208 sensitization to topoisomerase 2 inhibitors. Our data support testing of Pim kinase inhibitors with topoisomerase 2 inhibitors, but not with cytarabine, to improve treatment outcomes in AML with FLT3-ITD. PMID:27374090

  10. Three Myths About Dietary Supplements … and How Knowing the Right Answers Is Good for Your Integrative Medicine Practice

    Science.gov (United States)

    Israelsen, Loren; Lampe, Frank

    2016-01-01

    The use of safe and beneficial dietary supplements remains an important part of your patients’ healthy lifestyle—and supplements are likely an important part of your integrative medicine practice. Although issues surrounding potency, ingredient identification, adulteration, and the enforcement of existing laws are legitimate concerns for medical professionals and consumers, the responsible industry is actively working to raise quality standards for its products through a number of self-regulatory measures. These include education about and adoption of additional quality assurance initiatives, such as GMPs for botanical ingredients; better supply-chain management; adoption of improved identification and testing methodologies; an industry-wide product registry; the use of accredited third-party certifications and seals; and initiatives to promote widespread membership in the industry’s trade associations, which is a reliable indicator of a company’s support of and adherence to strict quality guidelines. Also, industry support of appropriate enforcement actions against problem players and products from the US Food and Drug Administration (FDA), the Federal Trade Commission (FTC), and states’ attorneys general continues in an effort to rid the market of unsafe and mislabeled products. PMID:27547162

  11. Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.

    Science.gov (United States)

    Attias, Samuel; Keinan Boker, Lital; Arnon, Zahi; Ben-Arye, Eran; Bar'am, Ayala; Sroka, Gideon; Matter, Ibrahim; Somri, Mostafa; Schiff, Elad

    2016-03-01

    Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, peffective than individualized CAM (Peffective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

    Science.gov (United States)

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2011-02-01

    This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Three Myths About Dietary Supplements … and How Knowing the Right Answers Is Good for Your Integrative Medicine Practice.

    Science.gov (United States)

    Israelsen, Loren; Lampe, Frank

    2016-06-01

    The use of safe and beneficial dietary supplements remains an important part of your patients' healthy lifestyle-and supplements are likely an important part of your integrative medicine practice. Although issues surrounding potency, ingredient identification, adulteration, and the enforcement of existing laws are legitimate concerns for medical professionals and consumers, the responsible industry is actively working to raise quality standards for its products through a number of self-regulatory measures. These include education about and adoption of additional quality assurance initiatives, such as GMPs for botanical ingredients; better supply-chain management; adoption of improved identification and testing methodologies; an industry-wide product registry; the use of accredited third-party certifications and seals; and initiatives to promote widespread membership in the industry's trade associations, which is a reliable indicator of a company's support of and adherence to strict quality guidelines. Also, industry support of appropriate enforcement actions against problem players and products from the US Food and Drug Administration (FDA), the Federal Trade Commission (FTC), and states' attorneys general continues in an effort to rid the market of unsafe and mislabeled products.

  14. Tribological properties of TiC/a-C:H nanocomposite coatings prepared via HiPIMS

    Science.gov (United States)

    Sánchez-López, J. C.; Dominguez-Meister, S.; Rojas, T. C.; Colasuonno, M.; Bazzan, M.; Patelli, A.

    2018-05-01

    High power impulse magnetron sputtering (HiPIMS) technology has been employed to prepare TiC/a-C:H nanocomposite coatings from a titanium target in acetylene (C2H2) reactive atmospheres. Gas fluxes were varied from 1.3 to 4.4 sccm to obtain C/Ti ratios from 2 to 15 as measured by electron probe microanalysis (EPMA). X-ray diffraction and transmission electron microscopy demonstrate the presence of TiC nanocrystals embedded in an amorphous carbon-based matrix. The hardness properties decrease from 17 to 10 GPa as the carbon content increases. The tribological properties were measured using a pin-on-disk tribometer in ambient air (RH = 30-40%) at 10 cm/s with 5 N of applied load against 6-mm 100Cr6 balls. The friction coefficient and the film wear rates are gradually improved from 0.3 and 7 × 10-6 mm3/N m to 0.15 and 2 × 10-7 mm3/N m, respectively, by increasing the C2H2 flux. To understand the tribological processes appearing at the interface and to elucidate the wear mechanism, microstructural and chemical investigations of the coatings were performed before and after the friction test. EPMA, X-ray photoelectron and electron energy-loss spectroscopies were employed to obtain an estimation of the fraction of the a-C:H phase, which can be correlated with the tribological behavior. Examination of the friction counterfaces (ball and track) by Raman microanalysis reveals an increased ordering of the amorphous carbon phase concomitant with friction reduction. The tribological results were compared with similar TiC/a-C(:H) composites prepared by the conventional direct current process.

  15. We and they in the house of healing: debate among Arab complementary medicine practitioners on an integrative versus alternative approach to supportive cancer care.

    Science.gov (United States)

    Popper-Giveon, Ariela; Schiff, Elad; Ben-Arye, Eran

    2013-11-01

    Complementary and traditional medicine (CTM) plays an important role in culture-centered care for cancer patients in the Middle East. In this article, we have studied the attitudes of Arab CTM therapists concerning integration of complementary medicine within the conventional supportive cancer care of Arab patients in northern Israel. Semistructured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran, and various CTM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. We first summarized the different characteristics of the various CTM therapists, including training, typical practice, and so on. Thematic analysis revealed that folk healers and complementary medicine therapists describe their role as supportive and secondary to that of physicians. Their goal was not to cure patients with cancer but rather to enhance their quality of life by reducing the severity of both the disease symptoms and the side effects of cancer treatment. Religious healers, by contrast, purport to cure the disease. While folk healers opt for parallel alternative care and complementary therapists support integrative care, religious healers claimed that they offer an alternative to conventional medicine in terms of both etiology and practice. The majority of Arab CTM therapists support integration of their treatments with the conventional system, but in practice, they are not sure how to bring about this change or create a parallel model in which 2 different systems are active, but not integrated. Our findings emphasized the need to promote doctor-CTM practitioner communication based on structured referral and bidirectional consultation. Moreover, we recommend intensifying research on the efficacy and safety of CTM in the Middle East and the potential role in promoting culture-based supportive care.

  16. Time-resolved plasma parameters in the HiPIMS discharge with Ti target in Ar/O2 atmosphere

    Czech Academy of Sciences Publication Activity Database

    Čada, Martin; Hubička, Zdeněk; Adámek, Petr; Klusoň, Jan; Jastrabík, Lubomír

    2011-01-01

    Roč. 205, č. 2 (2011), S317-S321 ISSN 0257-8972 R&D Projects: GA ČR GP202/09/P159; GA AV ČR KJB100100805; GA MŠk(CZ) 1M06002; GA AV ČR KAN400720701; GA ČR GA202/09/0800 Institutional research plan: CEZ:AV0Z10100522 Keywords : HiPIMS * Langmuir probe * ion flux * reactive sputtering Subject RIV: BH - Optics, Masers, Lasers Impact factor: 1.867, year: 2011

  17. Characterization and device applications of ZnO films deposited by high power impulse magnetron sputtering (HiPIMS)

    Science.gov (United States)

    Partridge, J. G.; Mayes, E. L. H.; McDougall, N. L.; Bilek, M. M. M.; McCulloch, D. G.

    2013-04-01

    ZnO films have been reactively deposited on sapphire substrates at 300 °C using a high impulse power magnetron sputtering deposition system and characterized structurally, optically and electronically. The unintentionally doped n-type ZnO films exhibit high transparency, moderate carrier concentration (˜5 × 1018 cm-3) and a Hall mobility of 8.0 cm2 V-1 s-1, making them suitable for electronic device applications. Pt/ZnO Schottky diodes formed on the HiPIMS deposited ZnO exhibited rectification ratios up to 104 at ±2 V and sensitivity to UV light.

  18. Comparison of measurements from optical CMM and focus-variation microscope of a μPIM mechanical part

    DEFF Research Database (Denmark)

    Quagliotti, Danilo; Salaga, Jacek; Tosello, Guido

    2016-01-01

    Two sets of 5 green and 5 sintered mechanical parts, manufactured by micro powder injection moulding (μPIM), were measured using an optical coordinate measuring machine (OCMM) and a focus-variation microscope (FVM). The examined features of size, including diameter, radii and distances, span...... geometrical features, such as surface texture and flatness, may depict FVM measurements as more attractive. However, measurements should be suitable for in-line quality control, in a production environment, where fast cycle time is required and measuring times are more compatible to those of the OCMM....

  19. Necesidades de aprendizaje del especialista de Medicina General Integral, acerca de la conducta suicida Learning needs of the specialist in Integral General Medicine on the suicidal behavior

    Directory of Open Access Journals (Sweden)

    Víctor Tadeo Pérez Martínez

    2011-12-01

    identify the learning needs of physicians working in the primary health care staffs on the suicidal behavior at three polyclinics of Playa municipality. Methods: Authors identified the learning needs using a write questionnaire applied if a collective and anonymous way in 20 specialists of Integral General Medicine selected at random working in three polyclinics of the far East of Playa municipality. Results: The deficiencies and insufficiencies of professional knowledges and abilities on the suicidal behavior, mainly in the clinical perspective of this complex and multidimensional phenomenon. Conclusions: In spite the fact that suicidal behavior is in the first care level, one of the priority programs concerning the mental health, most of specialists have difficulties in the integral care of these patients, which is a low screened risk. Occasionally, its evaluation is lacking of investigation and analysis elements, affecting the appropriate follow-up of these patients.

  20. Alternative and Integrative Medicine

    Science.gov (United States)

    ... are part of complete “systems” of healthcare that began many years before, and/or separate from, the ... can be found everywhere—in books, on the Internet, from organizations promoting its use, and from friends ...

  1. Advancing the Integration of Population Medicine into Medical Curricula at The Warren Alpert Medical School of Brown University: A New Master's Degree Program.

    Science.gov (United States)

    Mello, Michael J; Feller, Edward; George, Paul; Borkan, Jeffrey

    2015-09-01

    Additional knowledge, attitudes and skills are required for the next generation of medical students as they expand the traditional focus on individual patients to include population-based health and scholarly investigation. The Warren Alpert Medical School of Brown University (AMS) is initiating a master's degree program as a key component of the new Primary Care-Population Medicine program at AMS leading to both a Doctorate in Medicine (MD) and Master of Science in Population Medicine (ScM) degrees in four years. The ScM is composed of a series of nine courses, integrated into the four-year MD curriculum, as well as a thesis. Additional attention will be given to leadership and quality improvement training. The goal is to produce graduates competent in the care of individual patients, panels, communities, and populations.

  2. How to treat a patient with chronic low back pain - methodology and results of the first international case conference of integrative medicine.

    Science.gov (United States)

    Brinkhaus, Benno; Lewith, George; Rehberg, Benno; Heusser, Peter; Cummings, Mike; Michalsen, Andreas; Teut, Michael; Willich, Stefan N; Irnich, Dominik

    2011-02-01

    Complementary and alternative medicine (CAM) is frequently used in patients in industrialised countries. Despite this popularity, there remains a considerable deficit of discourse and cooperation between physicians practicing CAM and conventional medicine. The aim is to present the methodology and results of the first international case conference on integrative medicine (IM) dealing with a patient with low back pain. In this paper the methodological tool "case conference on IM" is also described. The interactive case conference took place on November 20th, 2009 as part of the "2nd European Congress of IM" in Berlin, Germany. An experienced expert panel from both conventional medicine and CAM developed integrative medical diagnoses and therapeutic strategies using as their starting point an individual patient case on chronic low back pain (LBP). The case was selected because LBP is a common diagnosis with considerable economic impact and a problem which is often treated with CAM. In this case conference, the expert panel agreed on a diagnosis of "chronic non-specific LBP with somatic and psychological factors" and proposed multi-modal short- and long-term treatment including of CAM. The importance of the patient-physician-relationship and the consultation process with appropriate consultation time for treatment success was highlighted. There was consensus that the diagnostic process and resulting treatment plan should be individualised and focussed on the patient as a complete person, identifying the significance the disease has for the patient and not just on the disease for itself. Considerable differences were found amongst the experts regarding the first steps of treatment and each expert saw possibilities of "effective and adequate treatment" being met by their own individual treatment method. The case conference on integrative medicine stimulated an intensive exchange between the approaches used by conventional medicine and CAM clarifying different treatment

  3. Long-Term Course of Failed Back Surgery Syndrome (FBSS Patients Receiving Integrative Korean Medicine Treatment: A 1 Year Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Jinho Lee

    Full Text Available With increase of spine surgeries, failed back surgery syndrome (FBSS prevalence is also rising. While complementary and alternative medicine (CAM is commonly used for low back pain (LBP, there are no studies reporting use of integrative Korean medicine in FBSS patients.Patients with pain continuing after back surgery or recurring within 1 year and visual analogue scale (VAS of LBP or leg pain of ≥6 (total n = 120 were recruited at 2 hospital sites from November 2011 to September 2014. Weekly sessions of integrative Korean medicine treatment were conducted for 16 weeks (herbal medicine, acupuncture/electroacupuncture, pharmacopuncture/bee venom pharmacopuncture, and Chuna manual therapy with additional follow-ups at 24 weeks and 1 year. Outcome measures included VAS of LBP and leg pain (primary outcome, Oswestry Disability Index (ODI, Short-Form 36 (SF-36, medical use, and patient global impression of change (PGIC.VAS of LBP and leg pain improved at 6 months (LBP from 6.1±2.0 at baseline to 2.9±2.3; and leg pain from 5.4±2.6 to 2.4±2.5, respectively. Eighty patients (66.7% showed improvement of 50% or more in main pain of LBP or leg pain from baseline. Disability and quality of life also improved at 6 months (ODI from 41.3±12.3 at baseline to 23.6±13.6; and SF-36 from 42.8±14.5 to 62.7±16.8. At 1 year follow-up, conventional medical management use decreased, improvement in pain and disability was maintained, and 79.2% reported improvement of PGIC.Despite limitations as an observational study, integrative Korean medicine treatment showed positive results in pain, function, and quality of life of FBSS patients.

  4. A Case Study of the Neti Pot's Rise, Americanization, and Rupture as Integrative Medicine in U.S. Media Discourse.

    Science.gov (United States)

    Ho, Evelyn Y; Cady, Kathryn A; Robles, Jessica S

    2016-10-01

    In a period of only one decade in the United States, the neti pot shifted from obscure Ayurvedic health device to mainstream complementary and integrative medicine (CIM), touted by celebrities and sold widely in drug stores. We examine the neti pot as a case study for understanding how a foreign health practice became mainstreamed, and what that process reveals about more general discourses of health in the United States. Using discourse analysis of U.S. popular press and new media news (1999-2012) about the neti pot, we trace the development of discourses from neti's first introduction in mainstream news, through the hype following Dr. Oz's presentation on Oprah, to 2011 when two adults tragically died after using Naegleria fowleri amoeba-infested tap water in their neti pots. Neti pot discourses are an important site for communicative analysis because of the pot's complexity as an intercultural artifact: Neti pots and their use are enfolded into the biomedical practice of nasal irrigation and simultaneously Orientalized as exotic/magical and suspect/dangerous. This dual positioning as normal and exotic creates inequitable access for using the neti pot as a resource for increasing cultural health capital (CHC). This article contributes to work that critically theorizes the transnationalism of CIM, as the neti pot became successfully Americanized. These results have implications for understanding global health practices' incorporation or co-optation in new contexts, and the important role that popularly mediated health communication can play in framing what health care products and practices mean for consumers.

  5. Integrating medicinal chemistry, organic/combinatorial chemistry, and computational chemistry for the discovery of selective estrogen receptor modulators with Forecaster, a novel platform for drug discovery.

    Science.gov (United States)

    Therrien, Eric; Englebienne, Pablo; Arrowsmith, Andrew G; Mendoza-Sanchez, Rodrigo; Corbeil, Christopher R; Weill, Nathanael; Campagna-Slater, Valérie; Moitessier, Nicolas

    2012-01-23

    As part of a large medicinal chemistry program, we wish to develop novel selective estrogen receptor modulators (SERMs) as potential breast cancer treatments using a combination of experimental and computational approaches. However, one of the remaining difficulties nowadays is to fully integrate computational (i.e., virtual, theoretical) and medicinal (i.e., experimental, intuitive) chemistry to take advantage of the full potential of both. For this purpose, we have developed a Web-based platform, Forecaster, and a number of programs (e.g., Prepare, React, Select) with the aim of combining computational chemistry and medicinal chemistry expertise to facilitate drug discovery and development and more specifically to integrate synthesis into computer-aided drug design. In our quest for potent SERMs, this platform was used to build virtual combinatorial libraries, filter and extract a highly diverse library from the NCI database, and dock them to the estrogen receptor (ER), with all of these steps being fully automated by computational chemists for use by medicinal chemists. As a result, virtual screening of a diverse library seeded with active compounds followed by a search for analogs yielded an enrichment factor of 129, with 98% of the seeded active compounds recovered, while the screening of a designed virtual combinatorial library including known actives yielded an area under the receiver operating characteristic (AU-ROC) of 0.78. The lead optimization proved less successful, further demonstrating the challenge to simulate structure activity relationship studies.

  6. [Designs and thoughts of real world integrated data warehouse from HIS on re-evaluation of post-maketing traditional Chinese medicine].

    Science.gov (United States)

    Zhuang, Yan; Xie, Bangtie; Weng, Shengxin; Xie, Yanming

    2011-10-01

    To discuss the feasibility and necessity of using HIS data integration to build large data warehouse system which is extensively used on re-evaluation of post-marketing traditional Chinese medicine, and to provide the thought and method of the overall design for it. With domestic and overseas' analysis and comparison on clinical experiments' design based on real world using electronic information system, and with characteristics of HIS in China, a general framework was designed and discussed which refers to design thought, design characteristics, existing problems and solutions and so on. A design scheme of HIS data warehouse on re-evaluation of post-marketing traditional Chinese medicine was presented. The design scheme was proved to be high coherence and low coupling, safe, Universal, efficient and easy to maintain, which can effectively solve the problems many hospitals have faced during the process of HIS data integration.

  7. Current concepts on integrative safety assessment of active substances of botanical, mineral or chemical origin in homeopathic medicinal products within the European regulatory framework.

    Science.gov (United States)

    Buchholzer, Marie-Luise; Werner, Christine; Knoess, Werner

    2014-03-01

    For active substances of botanical, mineral or chemical origin processed in homeopathic medicinal products for human use, the adequate safety principles as with other human medicinal products are applied in line with the European regulatory framework. In homeopathy, nonclinical safety assessment is facing a particular challenge because of a multitude and diversity of source materials used and due to rarely available toxicological data. Thus, current concepts applied by the national regulatory authority in Germany (BfArM) on integrative safety assessment of raw materials used in homeopathic medicinal products involve several evaluation approaches like the use of the Lowest Human Recommended Dose (LHRD), toxicological limit values, Threshold of Toxicological Concern (TTC), data from food regulation or the consideration of unavoidable environmental or dietary background exposure. This publication is intended to further develop and clarify the practical use of these assessment routes by exemplary application on selected homeopathic preparations. In conclusion, the different approaches are considered a very useful scientific and simultaneously pragmatic procedure in differentiated risk assessment of homeopathic medicinal products. Overall, this paper aims to increase the visibility of the safety issues in homeopathy and to stimulate scientific discussion of worldwide existing regulatory concepts on homeopathic medicinal products. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Low-energy ion irradiation in HiPIMS to enable anatase TiO2 selective growth

    Science.gov (United States)

    Cemin, Felipe; Tsukamoto, Makoto; Keraudy, Julien; Antunes, Vinícius Gabriel; Helmersson, Ulf; Alvarez, Fernando; Minea, Tiberiu; Lundin, Daniel

    2018-06-01

    High power impulse magnetron sputtering (HiPIMS) has already demonstrated great potential for synthesizing the high-energy crystalline phase of titanium dioxide (rutile TiO2) due to large quantities of highly energetic ions present in the discharge. In this work, it is shown that the metastable anatase phase can also be obtained by HiPIMS. The required deposition conditions have been identified by systematically studying the phase formation, microstructure and chemical composition as a function of mode of target operation as well as of substrate temperature, working pressure, and peak current density. It is found that films deposited in the metal and transition modes are predominantly amorphous and contain substoichiometric TiO x compounds, while in compound mode they are well-crystallized and present only O2‑ ions bound to Ti4+, i.e. pure TiO2. Anatase TiO2 films are obtained for working pressures between 1 and 2 Pa, a peak current density of ~1 A cm‑2 and deposition temperatures lower than 300 °C. Rutile is favored at lower pressures (2 A cm‑2), while amorphous films are obtained at higher pressures (5 Pa). Microstructural characterization of selected films is also presented.

  9. Triple probe interrogation of spokes in a HiPIMS discharge

    International Nuclear Information System (INIS)

    Lockwood Estrin, F; Bradley, J W; Karkari, S K

    2017-01-01

    Using a triple probe situated above the racetrack and inside the magnetic trap of a magnetron, rotating spoke-like structures have been clearly identified in a single HiPIMS pulse as periodic modulations of the electron temperature T e , electron density n e , ion saturation current I isat , floating potential V f and plasma potential V p . The spokes rotate in the E   ×   B direction with a velocity of ∼8.8 km s −1 . Defining the spoke shape from the footprint of the ion current, they deliver to flush-mounted probes embedded in the target, each spoke can be characterised by a dense but cool leading edge ( n e ∼ 2.0  ×  10 19 m −3 , T e ∼ 2.1 eV) and a relatively hotter but more rarefied trailing edge ( n e ∼ 1  ×  10 19 m −3 , T e ∼ 3.9 eV). Measurements of V p show a potential hump towards the rear of the spoke, separated from regions of the highest density, with plasma potentials up to 8 V more positive than the inter-spoke regions. Azimuthal electric fields of ∼1 kV m −1 associated with these structures are calculated. Transforming the triple probe time-traces to functions of the azimuthal angle θ and assuming a Gaussian radial profile for the plasma parameters, 2D spatial maps of n e , T e and V p have been constructed as well as the target ion current density J p from the embedded probes. The phase relationship between T e , V p and n e can be clearly seen using this representation with n e leading T e and V p with a phase shift between them of ∼50°. Regions of maximum ion current to the target, delivered by individual spokes, coincide with the overlap of regions of high n e and T e measured above the target at a height of 15 mm. Ions created at elevated positions above the target in the observed dense region will take several micro-seconds to reach that surface, so contributing to the target ion current in the following spokes. (paper)

  10. Integration of Homeopathy and Complementary Medicine in the Tuscan Public Health System and the Experience of the Homeopathic Clinic of the Lucca Hospital.

    Science.gov (United States)

    Rossi, E; Di Stefano, M; Picchi, M; Panozzo, M A; Noberasco, C; Nurra, L; Baccetti, S

    2018-03-17

     The healthcare programs of the Region of Tuscany (Italy) have started the process of integration of some types of complementary medicine (CM), including homeopathy, which began in 1996. The Homeopathic Clinic of Lucca was opened in 1998, followed by the Homeopathic Clinic for Women in 2003, and the Clinic for CM and Diet in Oncology in 2013.  Observational longitudinal studies conducted on 5,877 patients (3,937 in the general clinic, 1,606 in the women's clinic and 334 in oncology) were consecutively examined from 2003 to 2016. The Outcome in Relation to Impact on Daily Living (ORIDL) was generally used to assess outcomes.  Comparing the clinical conditions before and after homeopathic treatment, improvement was observed in 88.8% of general medicine patients with follow-up (45.1%); in particular, 68.1% of the patients had a major improvement in or resolution (ORIDL +2, +3, +4) of their condition. In women, an improvement was obtained in 74.1% cases and a major improvement in 61.2%. In cancer patients with homeopathic and integrative treatment, a significant improvement was observed for all the symptoms during anti-cancer therapy, particularly for hot flashes, nausea, depression, asthenia, and anxiety.  These results suggest that homeopathy can effectively be integrated with allopathic medicine and that the Tuscan experience could provide a useful reference for developing national and European regulations on the use of CM and homeopathy in public healthcare. The Faculty of Homeopathy.

  11. [Experience of integrated traditional Chinese and Western medicine in first case of imported Zika virus disease in China].

    Science.gov (United States)

    Deng, Yichu; Zeng, Liping; Bao, Wen; Xu, Pinghua; Zhong, Gongrong

    2016-02-01

    Zika virus disease is an acute infectious disease caused by Zika virus transmitted through Aedes mosquitoes. To explore the therapeutic effect of integrated traditional Chinese and Western Medicine for Zika virus disease, the treatment process of the first imported case in China was reviewed. The first imported Zika virus disease in China was admitted to Ganxian People's Hospital in Jiangxi Province on February 6th, 2016, and the patient received isolation treatment for 9 days and cured later. The effect of antiviral treatments including Xiyanping injection was evaluated based on clinical diagnosis and treatment process of the patient. A 34-year old male patient was admitted with chief complaint of fever for 9 days, orbital pain and itching rash for 4 days on February 6th, 2016. (1) Epidemiological characteristics: the patient was bitted by mosquitoes during his business trip in Venezuela since January 1st, where Zika virus disease was spreading. On January 20th he had dizziness without fever, and the symptom disappeared after taking medicines without details. Paroxysmal dizziness, chills and mild fever without myalgia was experienced on January 28th. On February 3rd small red rash appeared in the neck, spreading to anterior part of chest, limbs and trunk, and the fever, fatigue, nausea was continued, and a new symptom of paroxysmal pain in back of ears and orbits appeared, during which he had not go to hospital. The symptoms relieved on February 4th. He returned to Ganxian County on February 5th, he had yellow stool 3 times with normal temperature, without abdominal pain, and red rash still appeared in the neck. He went to Ganxian People's Hospital on February 6th, 2016. (2) Clinical manifestation: the vital signs showed a temperature of 36.8?centigrade, a pulse rate of 80 bpm, a respiratory rate of 20 bpm, and a blood pressure of 110/70 mmHg (1 mmHg = 0.133 kPa). It was showed by physical examination that red rash appeared in the neck, and no superficial enlarged

  12. [Clinical investigation on treatment of integrated traditional and Western medicine in hyperthyroidism with leukocytopenia induced by sulfourea drugs].

    Science.gov (United States)

    Lu, W

    1998-01-01

    To seek for a safe and effective drug to treat hyperthyroidism. Sixty cases of hyperthyroidism with leukocytopenia induced by sulfourea drugs were divided into treatment and control groups by 31 cases who were treated by traditional medicine Syndrome Differentiation and 29 cases who were treated by conventional western medicine alone respectively at random. They were estimated by total effective rate, major symptoms, WBC and immunological tests after four weeks. The total effective rate in the treatment group (96.8%) was more effective than that in the control group (86.2%, P symptom recovery rate in the treatment group was better than that in the control group. The WBC in both were all increased, but in the treatment group, it was better than that in the control group (P symptoms and immune function, but also increase WBC by using western medicine in combination with traditional medicine in treating hyperthyroidism.

  13. The development of pipeline integrity management in the world and practice in China

    Energy Technology Data Exchange (ETDEWEB)

    Shaohua, Dong; Qing, Wang; Feifan [China National Petroleum Corporation (CNPC), Beijing (China)

    2009-07-01

    The paper analyzed the pipeline integrity management latest development, and the relationship among HSE management, pipeline integrity management (PIM) and asset integrity management (AIM). CNPC is a pioneer of China industry on implementation of pipeline integrity management by using latest developed technologies such as in-line inspection, GIS, Risk assessment and advanced repair technologies, and it is typical model of PIM in China pipeline who supply the gas to whole Beijing city. With smart pigging inspection and implementation of GIS and EAM(enterprise assets management) system on two thousand kilometers of Shaanxi-Beijing gas pipeline BHGC is able to manage pipeline integrity in five areas which include pipe materials safety, nature and geotechnical hazards management, coating and corrosion protection, stationing and associated facilities maintenance, and underground gas storage integrity. This paper presents latest achievement of BHGC in their pipeline integrity programs. (author)

  14. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals.

    Science.gov (United States)

    Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale

    2014-06-16

    Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach's alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann-Whitney U-test for independent variables to calculate group differences. The level of significance was set at p 0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. The lower quality of PGMT in German hospitals can be attributed to

  15. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    Science.gov (United States)

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. Methods An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach’s alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann–Whitney U-test for independent variables to calculate group differences. The level of significance was set at p 0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. Conclusion The lower quality of PGMT in

  16. Concurrent Inhibition of Pim and FLT3 Kinases Enhances Apoptosis of FLT3-ITD Acute Myeloid Leukemia Cells through Increased Mcl-1 Proteasomal Degradation.

    Science.gov (United States)

    Kapoor, Shivani; Natarajan, Karthika; Baldwin, Patrick R; Doshi, Kshama A; Lapidus, Rena G; Mathias, Trevor J; Scarpa, Mario; Trotta, Rossana; Davila, Eduardo; Kraus, Manfred; Huszar, Dennis; Tron, Adriana E; Perrotti, Danilo; Baer, Maria R

    2018-01-01

    Purpose: fms -like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) is present in 30% of acute myeloid leukemia (AML), and these patients have short disease-free survival. FLT3 inhibitors have limited and transient clinical activity, and concurrent treatment with inhibitors of parallel or downstream signaling may improve responses. The oncogenic serine/threonine kinase Pim-1 is upregulated downstream of FLT3-ITD and also promotes its signaling in a positive feedback loop, suggesting benefit of combined Pim and FLT3 inhibition. Experimental Design: Combinations of clinically active Pim and FLT3 inhibitors were studied in vitro and in vivo Results: Concurrent treatment with the pan-Pim inhibitor AZD1208 and FLT3 inhibitors at clinically applicable concentrations abrogated in vitro growth of FLT3-ITD, but not wild-type FLT3 (FLT3-WT), cell lines. AZD1208 cotreatment increased FLT3 inhibitor-induced apoptosis of FLT3-ITD, but not FLT3-WT, cells measured by sub-G 1 fraction, annexin V labeling, mitochondrial membrane potential, and PARP and caspase-3 cleavage. Concurrent treatment with AZD1208 and the FLT3 inhibitor quizartinib decreased growth of MV4-11 cells, with FLT3-ITD, in mouse xenografts, and prolonged survival, enhanced apoptosis of FLT3-ITD primary AML blasts, but not FLT3-WT blasts or remission marrow cells, and decreased FLT3-ITD AML blast colony formation. Mechanistically, AZD1208 and quizartinib cotreatment decreased expression of the antiapoptotic protein Mcl-1. Decrease in Mcl-1 protein expression was abrogated by treatment with the proteasome inhibitor MG132, and was preceded by downregulation of the Mcl-1 deubiquitinase USP9X, a novel mechanism of Mcl-1 regulation in AML. Conclusions: The data support clinical testing of Pim and FLT3 inhibitor combination therapy for FLT3-ITD AML. Clin Cancer Res; 24(1); 234-47. ©2017 AACR . ©2017 American Association for Cancer Research.

  17. Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: a cross-cultural study.

    Science.gov (United States)

    Ben-Arye, Eran; Karkabi, Khaled; Karkabi, Sonia; Keshet, Yael; Haddad, Maria; Frenkel, Moshe

    2009-01-01

    The purpose of this cross-cultural study was to evaluate patient perspectives on complementary and alternative medicine (CAM) integration within primary care clinics. It is one of the first multiethnic studies to explore patients' perspectives on the best model for integrating CAM into the conventional care setting. We developed a 13-item questionnaire that addresses issues of CAM use, expectations from the primary care physicians concerning CAM, and attitudes toward CAM integration within a patient's primary care clinic. We constructed the questionnaire with cross-cultural sensitivity concerning the core concepts of CAM and traditional medicine in both the Arab and Jewish communities in northern Israel. Data for statistical analysis were obtained from 3840 patients attending seven primary care clinics. Of the 3713 respondents who were willing to identify their religion, 2184 defined themselves as Muslims, Christians, or Druze and 1529 as Jews. Respondents in the two groups were equally distributed by sex but differed significantly by age, education, self-rated religiosity, and self-reported chronic diseases in their medical background. Respondents in the two groups reported comparable overall CAM use during the previous year, but the Arab respondents reported more use of herbs and traditional medicine. Respondents in both groups stated that their primary expectation from a family physician concerning CAM was to refer them appropriately and safely to a CAM practitioner. Respondents in both groups greatly supported a theoretical scenario of CAM integration into primary medical care. However, Arab respondents were more supportive of the option that non-physician CAM practitioners would provide CAM rather than physicians.

  18. [New theory of holistic integrative physiology and medicine. III: New insight of neurohumoral mechanism and pattern of control and regulation for core axe of respiration, circulation and metabolism].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    Systemic mechanism of neurohumoral control and regulation for human is limited. We used the new theory of holistic integrative physiology and medicine to approach the mechanism and pattern of neurohumoral control and regulation for life. As the core of human life, there are two core axes of functions. The first one is the common goal of respiration and circulation to transport oxygen and carbon dioxide for cells, and the second one is the goal of gastrointestinal tract and circulation to transport energy material and metabolic product for cells. These two core axes maintain the metabolism. The neurohumoral regulation is holistically integrated and unified for all functions in human body. We simplified explain the mechanism of neurohumoral control and regulation life (respiration and circulation) as the example pattern of sound system. Based upon integrated regulation of life, we described the neurohumoral pattern to control respiration and circulation.

  19. Short- and long-term plasma phenomena in a HiPIMS discharge

    International Nuclear Information System (INIS)

    Poolcharuansin, P; Bradley, J W

    2010-01-01

    Using a time-resolved Langmuir probe the temporal evolution of the bulk plasma parameters in a high-power impulse magnetron sputtering (HiPIMS) discharge was investigated for a number of different discharge conditions. The magnetron was operated in argon between 0.5 and 1.6 Pa with a titanium target and with peak target power densities up to 1000 W cm -2 . The pulse width and repetition rate were held constant at 100 μs and 100 Hz, respectively. Using an OML analysis as well as a Druyvesteyn formulation, the electron densities, effective temperatures and energy distribution functions were obtained throughout the pulse period (0-9 ms), including a detailed study of the first 10 μs, which was achieved with a temporal resolution better than 0.5 μs. In the initial phase of the voltage pulse (t ∼ 1-4 μs), three distinct groups of electrons (indistinguishable from Maxwellian electrons) were observed, namely 'super-thermal', 'hot' and 'cold' populations with effective temperatures of 70-100 eV, 5-7 eV and 0.8-1 eV, respectively. After 4 μs these groups become energetically indistinguishable from each other to form a single distribution with an electron temperature that decays from about 5 to 3 eV during the rest of the pulse on-time. The presence of the 'super-thermal' electron group pushes the probe floating potential to a very negative value (significantly deeper than -95 V) during the initial period of the pulse. In the off-time, the electron density decays with two-fold characteristic times, revealing initially short-term (30-40 μs) and ultimately long-term (3-4 ms) decay rates. These long decay times lead to a relative high density remnant plasma (2 x 10 9 cm -3 ) at the end of the off-time, which serves to seed the next voltage pulse. The electron temperature and plasma potential also exhibit two-fold decay in the off-time, but with typically somewhat faster decays, particularly for the long-term decay (100-500 μs) up to the end of the off-time. The time

  20. Investigation on the corrosion resistance of PIM 316L stainless steel in PEM fuel cell simulated environment

    International Nuclear Information System (INIS)

    Oliveira, Mara Cristina Lopes de; Costa, Isolda; Antunes, Renato Altobelli

    2009-01-01

    Bipolar plates play main functions in PEM fuel cells, accounting for the most part of the weight and cost of these devices. Powder metallurgy may be an interesting manufacturing process of these components owing to the production of large scale, complex near-net shape parts. However, corrosion processes are a major concern due to the increase of the passive film thickness on the metal surface, lowering the power output of the fuel cell. In this work, the corrosion resistance of PIM AISI 316L stainless steel specimens was evaluated in 1M H 2 SO 4 + 2 ppm HF solution at room temperature during 30 days of immersion. The electrochemical measurements comprised potentiodynamic polarization and electrochemical impedance spectroscopy. The surface morphology of the specimens was observed before and after the corrosion tests through SEM images. The material presented low corrosion current density suggesting that it is suitable to operate in the PEM fuel cell environment. (author)

  1. First measurements of the temporal evolution of the plasma density in HiPIMS discharges using THz time domain spectroscopy

    Science.gov (United States)

    Meier, Steffen M.; Hecimovic, Ante; Tsankov, Tsanko V.; Luggenhölscher, Dirk; Czarnetzki, Uwe

    2018-03-01

    In this paper, the novel technique of THz time domain spectroscopy has been applied to obtain time-resolved measurements of the plasma density in the active zone of a HiPIMS discharge with a titanium target. The obtained peak values are in the range of 1012-1013 cm-3 for discharge current densities of 1-4 A cm-2 at 0.5 and 2 Pa argon pressure. The measured densities show good correlation with the discharge current and voltage and the intensity of various atomic and ionic lines. The well known phases of the discharge have been identified and related to the variation of the electron density. The measurement results show that the plasma density remains nearly constant during the runaway/self-sputtering phase. Based on that, it is conjectured that singly charged titanium ions are the dominant ion species during this phase.

  2. Personalized laboratory medicine

    DEFF Research Database (Denmark)

    Pazzagli, M.; Malentacchi, F.; Mancini, I.

    2015-01-01

    diagnostic tools and expertise and commands proper state-of-the-art knowledge about Personalized Medicine and Laboratory Medicine in Europe, the joint Working Group "Personalized Laboratory Medicine" of the EFLM and ESPT societies compiled and conducted the Questionnaire "Is Laboratory Medicine ready...... in "omics"; 2. Additional training for the current personnel focused on the new methodologies; 3. Incorporation in the Laboratory of new competencies in data interpretation and counselling; 4. Improving cooperation and collaboration between professionals of different disciplines to integrate information...

  3. 06. Facilitating Collection of Research and Quality Data in Integrative Medicine Clinical Settings: Views From Academic, Health System and Private Clinics

    Science.gov (United States)

    Dolor, Rowena; Victorson, David; Amoils, Steve

    2013-01-01

    Focus Areas: Integrative Approaches to Care The purpose of this panel discussion is to share successful efforts from a practice-based research network (PBRN) including ten integrative medicine clinics. The BraveNet PBRN includes integrative medicine clinics with academic health centers, large health systems, and a stand-alone private practice clinic. While clinical care is prioritized across all of these centers, introducing research into clinical sites oriented to providing care poses challenges that vary by clinic environment. We will highlight some of the unique issues encountered when trying to standardize data collection in sites practicing a patient-centered, whole-systems approach to healing as well as the solutions used to overcome these issues. We will present some operational solutions and data collected from the PBRN's ongoing data registry, entitled PRIMIER. The panel will engage attendees in a dialogue centering on potential for future analyses of existing results, ideas for possible upcoming studies, and creative ways to expand the PBRN data registry to include additional sites that may have expertise and interest in participating.

  4. Effect of Health Education Based on Integrative Therapy of Chinese and Western Medicine for Adult Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study.

    Science.gov (United States)

    Shi, Mai; Liu, Zhao-Lan; Zhu, Yan-Bo; Xu, Mei-Yan; Duan, Xue-Ying; Shi, Hui-Mei; Jiang, Bo; Zhang, Xiao-Mei; Yu, Xiao-Han

    2018-02-01

    To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus (T2DM) from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control. Patients were individually randomized into intervention group (receiving integrative education, n=120) and control group (receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c (HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models (HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQoL scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group (all Peducation based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.

  5. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Justin Shmalberg

    2015-01-01

    Full Text Available Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions. The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.. Older neutered or spayed dogs (mean age = 9.0 years and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients. Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P<0.05. The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.

  6. Cultural consonance, constructions of science and co-existence: a review of the integration of traditional, complementary and alternative medicine in low- and middle-income countries

    Science.gov (United States)

    Lakshmi, Josyula K; Nambiar, Devaki; Narayan, Venkatesh; Sathyanarayana, Tamysetty N; Porter, John; Sheikh, Kabir

    2015-01-01

    This review examined the determinants, patterns and imports of official recognition, and incorporation of different traditional, complementary and alternative systems of medicine (TCAM) in the public health establishment of low- and middle-income countries, with a particular focus on India. Public health systems in most countries have tended to establish health facilities centred on allopathy, and then to recognize or derecognize different TCAM based on evidence or judgement, to arrive at health-care configurations that include several systems of medicine with disparate levels of authority, jurisdiction and government support. The rationale for the inclusion of TCAM providers in the public health workforce ranges from the need for personnel to address the disease burden borne by the public health system, to the desirability of providing patients with a choice of therapeutic modalities, and the nurturing of local culture. Integration, mostly described as a juxtaposition of different systems of medical practice, is often implemented as a system of establishing personnel with certification in different medical systems, in predominantly allopathic health-care facilities, to practise allopathic medicine. A hierarchy of systems of medicine, often unacknowledged, is exercised in most societies, with allopathy at the top, certain TCAM systems next and local healing traditions last. The tools employed by TCAM practitioners in diagnosis, research, pharmacy, marketing and education and training, which are seen to increasingly emulate those of allopathy, are sometimes inappropriate for use in therapeutic systems with widely divergent epistemologies, which call for distinct research paradigms. The coexistence of numerous systems of medicine, while offering the population greater choice, and presumably enhancing geographical access to health care as well, is often fraught with tensions related to the coexistence of philosophically disparate, even opposed, disciplines, with

  7. The Short-Term Effect of Integrated Complementary and Alternative Medicine Treatment in Inpatients Diagnosed with Lumbar Intervertebral Disc Herniation: A Prospective Observational Study.

    Science.gov (United States)

    Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Jung, Jaehoon; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk

    2016-07-01

    This study aimed to investigate the short-term effect of hospital-based intensive nonsurgical treatment in lumbar intervertebral disc herniation (IDH) inpatients admitted to an integrated hospital that offers both complementary and alternative medicine (CAM) and conventional medicine treatment. A prospective observational study. A private Korean medicine hospital inpatient setting in Korea. A total of 524 inpatients diagnosed with lumbar IDH admitted from June 1, 2012, to May 31, 2013. The participants received treatment according to a CAM treatment protocol (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation) and conventional medicine treatment as needed. Numeric rating scale (NRS) of low back pain (LBP) and leg pain, Oswestry Disability Index (ODI), and patient global impression of change. The study also assessed whether improvement was obtained over minimal clinically important difference (MCID) in LBP or leg pain. The average hospital stay was 24.4 ± 13.2 days. The majority of patients received CAM treatment and a few selected conventional medicine, such as pain killers (22.7%; 4.2 ± 3.0 administrations) or nerve blocks (14.1%; 1.4 ± 0.7 sessions). At discharge, the average reduction in NRS was 3.18 ± 2.29 (95% confidence interval [CI], 2.99-3.38) for LBP and 2.61 ± 2.60 (95% CI, 2.38-2.83) for leg pain the average reduction in ODI was 19.45 ± 19.53 (95% CI, 17.77-21.12). Two-hundred and seventy patients (51.5%) showed improvement over MCID in both NRS and ODI, 150 (28.6%) in either NRS or ODI, and 104 (19.8%) in neither. Integrated CAM treatment during hospitalization was effective for patients with lumbar IDH who had severe LBP and disability. However, these results must be investigated further to assess whether the effects surpass those seen with placebo and are cost-effective.

  8. Mesopotamian medicine.

    Science.gov (United States)

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots.

  9. Back to the basic sciences: an innovative approach to teaching senior medical students how best to integrate basic science and clinical medicine.

    Science.gov (United States)

    Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L

    2008-07-01

    Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.

  10. Nuclear Medicine

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  11. Research enrichment: evaluation of structured research in the curriculum for dental medicine students as part of the vertical and horizontal integration of biomedical training and discovery

    Directory of Open Access Journals (Sweden)

    Stewart Tanis

    2008-02-01

    Full Text Available Abstract Background Research programs within medical and dental schools are important vehicles for biomedical and clinical discovery, serving as effective teaching and learning tools by providing situations in which predoctoral students develop problem-solving and critical-thinking skills. Although research programs at many medical and dental schools are well-established, they may not be well integrated into the predoctoral curriculum to effectively support the learning objectives for their students. Methods A series of structured seminars, incorporating faculty research, was designed for first-year dental students at the University of Nevada, Las Vegas, School of Dental Medicine to reinforce and support the concepts and skills taught in concurrent courses. A structured research enrichment period was also created to facilitate student engagement in active research using faculty and student curricular release time. Course evaluations and surveys were administered to gauge student perceptions of the curricular integration of research, the impact of these seminars on recruitment to the research program, and overall levels of student satisfaction with research enrichment. Results The analysis of course surveys revealed that students perceived the research-containing seminars effectively illustrated concepts, were logically sequenced, and were well-integrated into their curriculum. In addition, analysis of surveys revealed that the Integration Seminar courses motivated students to engage in research enrichment. Finally, this analysis provided evidence that students were very satisfied with their overall learning experience during research enrichment. Conclusion Curricular integration is one method of improving the teaching and learning of complicated and inter-related concepts, providing an opportunity to incorporate research training and objectives into traditionally separate didactic courses. Despite the benefits of curricular integration, finding

  12. Research enrichment: evaluation of structured research in the curriculum for dental medicine students as part of the vertical and horizontal integration of biomedical training and discovery.

    Science.gov (United States)

    Kingsley, Karl; O'Malley, Susan; Stewart, Tanis; Howard, Katherine M

    2008-02-19

    Research programs within medical and dental schools are important vehicles for biomedical and clinical discovery, serving as effective teaching and learning tools by providing situations in which predoctoral students develop problem-solving and critical-thinking skills. Although research programs at many medical and dental schools are well-established, they may not be well integrated into the predoctoral curriculum to effectively support the learning objectives for their students. A series of structured seminars, incorporating faculty research, was designed for first-year dental students at the University of Nevada, Las Vegas, School of Dental Medicine to reinforce and support the concepts and skills taught in concurrent courses. A structured research enrichment period was also created to facilitate student engagement in active research using faculty and student curricular release time. Course evaluations and surveys were administered to gauge student perceptions of the curricular integration of research, the impact of these seminars on recruitment to the research program, and overall levels of student satisfaction with research enrichment. The analysis of course surveys revealed that students perceived the research-containing seminars effectively illustrated concepts, were logically sequenced, and were well-integrated into their curriculum. In addition, analysis of surveys revealed that the Integration Seminar courses motivated students to engage in research enrichment. Finally, this analysis provided evidence that students were very satisfied with their overall learning experience during research enrichment. Curricular integration is one method of improving the teaching and learning of complicated and inter-related concepts, providing an opportunity to incorporate research training and objectives into traditionally separate didactic courses. Despite the benefits of curricular integration, finding the most appropriate points of integration, obtaining release time

  13. Integration of behavioral medicine competencies into physiotherapy curriculum in an exemplary Swedish program: rationale, process, and review.

    Science.gov (United States)

    Sandborgh, Maria; Dean, Elizabeth; Denison, Eva; Elvén, Maria; Fritz, Johanna; Wågert, Petra von Heideken; Moberg, Johan; Overmeer, Thomas; Snöljung, Åsa; Johansson, Ann-Christin; Söderlund, Anne

    2018-06-21

    In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicine content and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.

  14. Integrating Traditional Chinese Medicine Services in Community Health Centers: Insights into Utilization Patterns in the Pearl River Region of China

    Directory of Open Access Journals (Sweden)

    Vincent C. H. Chung

    2013-01-01

    Full Text Available In China's healthcare reform, community health centers (CHCs are designed to take a pivotal role in providing primary care. Whilst about 20% of all outpatient care in China is delivered by the traditional Chinese medicine (TCM sector, hospitals, instead of CHCs, are major providers. Using current patterns of patient utilization this study aims to inform CHCs on how they may strengthen access to TCM services. Three thousand three hundred and sixty CHC patients from six cities within the urban Pearl Delta Region were enumerated using multistage cluster sampling. Fifty-two percent had visited herbalists within three months with a mean visit frequency of 1.50 times. Herbal treatments, which are cheaper than western medicines, were more popular amongst those who needed to pay out of pocket including the uninsured. Herbal medicines appeared to be an alternative for those who are underinsured. Acupuncturists and massage therapists were visited by smaller proportions, 6.58% and 5.98%, respectively, with a mean three-month visit of 0.27 and 0.26 times. Access was restricted by lack of social insurance coverage. Whilst increasing provision of TCM in CHCs might respond to patient demand, increasing insurance coverage for TCM needs to be evaluated using current evidence on safety and effectiveness.

  15. Integration

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2004-01-01

    Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration......Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration...

  16. Randomized trial of the effect of an integrative medicine approach to the management of asthma in adults on disease-related quality of life and pulmonary function.

    Science.gov (United States)

    Kligler, Benjamin; Homel, Peter; Blank, Arthur E; Kenney, Jeanne; Levenson, Hanniel; Merrell, Woodson

    2011-01-01

    The purpose of this study was to test the effectiveness of an integrative medicine approach to the management of asthma compared to standard clinical care on quality of life (QOL) and clinical outcomes. This was a prospective parallel group repeated measurement randomized design. Participants were adults aged 18 to 80 years with asthma. The intervention consisted of six group sessions on the use of nutritional manipulation, yoga techniques, and journaling. Participants also received nutritional supplements: fish oil, vitamin C, and a standardized hops extract. The control group received usual care. Primary outcome measures were the Asthma Quality of Life Questionnaire (AQLQ), The Medical Outcomes Study Short Form-12 (SF-12), and standard pulmonary function tests (PFTs). In total, 154 patients were randomized and included in the intention-to-treat analysis (77 control, 77 treatment). Treatment participants showed greater improvement than controls at 6 months for the AQLQ total score (PMental health (P= .003 and .02, respectively). There was no change in PFTs in either group. A low-cost group-oriented integrative medicine intervention can lead to significant improvement in QOL in adults with asthma.

  17. Integrating qualitative and quantitative characterization of traditional Chinese medicine injection by high-performance liquid chromatography with diode array detection and tandem mass spectrometry.

    Science.gov (United States)

    Xie, Yuan-yuan; Xiao, Xue; Luo, Juan-min; Fu, Chan; Wang, Qiao-wei; Wang, Yi-ming; Liang, Qiong-lin; Luo, Guo-an

    2014-06-01

    The present study aims to describe and exemplify an integrated strategy of the combination of qualitative and quantitative characterization of a multicomponent mixture for the quality control of traditional Chinese medicine injections with the example of Danhong injection (DHI). The standardized chemical profile of DHI has been established based on liquid chromatography with diode array detection. High-performance liquid chromatography coupled with time-of-flight mass spectrometry and high-performance liquid chromatography with electrospray multistage tandem ion-trap mass spectrometry have been developed to identify the major constituents in DHI. The structures of 26 compounds including nucleotides, phenolic acids, and flavonoid glycosides were identified or tentatively characterized. Meanwhile, the simultaneous determination of seven marker constituents, including uridine, adenosine, danshensu, protocatechuic aldehyde, p-coumaric acid, rosmarinic acid, and salvianolic acid B, in DHI was performed by multiwavelength detection based on high-performance liquid chromatography with diode array detection. The integrated qualitative and quantitative characterization strategy provided an effective and reliable pattern for the comprehensive and systematic characterization of the complex traditional Chinese medicine system. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Challenges in integrating component level technology and system level information from Ayurveda: Insights from NMR phytometabolomics and anti-HIV potential of select Ayurvedic medicinal plants.

    Science.gov (United States)

    Jayasundar, Rama; Ghatak, Somenath; Makhdoomi, Muzamil Ashraf; Luthra, Kalpana; Singh, Aruna; Velpandian, Thirumurthy

    2018-01-03

    Information from Ayurveda meeting the analytical challenges of modern technology is an area of immense relevance. Apart from the cerebral task of bringing together two different viewpoints, the question at the pragmatic level remains 'who benefits whom'. The aim is to highlight the challenges in integration of information (Ayurvedic) and technology using test examples of Nuclear Magnetic Resonance (NMR) metabolomics and anti-HIV-1 potential of select Ayurvedic medicinal plants. The other value added objective is implications and relevance of such work for Ayurveda. Six medicinal plants (Azadirachta indica, Tinospora cordifolia, Swertia chirata, Terminalia bellerica, Zingiber officinale and Symplocos racemosa) were studied using high resolution proton NMR spectroscopy based metabolomics and also evaluated for anti-HIV-1 activity on three pseudoviruses (ZM53 M.PB12, ZM109F.PB4, RHPA 4259.7). Of the six plants, T.bellerica and Z.officinale showed minimum cell cytotoxicity and maximum anti-HIV-1 potential. T.bellerica was effective against all the three HIV-1 pseudoviruses. Untargeted NMR profiling and multivariate analyses demonstrated that the six plants, all of which had different Ayurvedic pharmacological properties, showed maximum differences in the aromatic region of the spectra. The work adds onto the list of potential plants for anti-HIV-1 drug molecules. At the same time, it has drawn attention to the different perspectives of Ayurveda and Western medicine underscoring the inherent limitations of conceptual bilinguism between the two systems, especially in the context of medicinal plants. The study has also highlighted the potential of NMR metabolomics in study of plant extracts as used in Ayurveda. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  19. 100-Gb/s 80-km transmission of PIM-SSB-OFDM at C-band using a single-end photodetector

    Science.gov (United States)

    Huo, Jiahao; Zhou, Xian; Zhong, Kangping; Gui, Tao; Tan, Fengze; Tu, Jiajing; Yuan, Jinhui; Zhang, Hongyu; Long, Keping; Yu, Changyuan; Lau, Alan Pak Tao; Lu, Chao

    2017-10-01

    Polarization-interleave-multiplexed (PIM) with single-sideband orthogonal frequency-division multiplexing (SSB-OFDM) based on direct detection is proposed for short-reach applications transmitted up to 80 km in which the guard band can be shared for the two SSB signals with interleave electrical center frequencies. Based on two dual-drive Mach-Zehnder modulators with one single-end photodetector (PD), 100-Gb/s PIM-SSB-OFDM transmission over a 80-km standard single-mode fiber is successfully demonstrated. After 80-km transmission, the optical signal-to-noise ratio requirement is 29.1 dB with respect to the bit error rate threshold of 7% hard decision-forward error correction overhead.

  20. Traditional Chinese Medicine: An Introduction

    Science.gov (United States)

    ... Resources CME/CEU and Online Lectures Online Continuing Education Series Distinguished Lecture Series Integrated Medicine Research Lecture ... TCM, it is important to separate questions about traditional theories and ... of modern science-based medicine and health promotion practices. The ...

  1. Integration of Structural Dynamics and Molecular Evolution via Protein Interaction Networks: A New Era in Genomic Medicine

    Science.gov (United States)

    Kumar, Avishek; Butler, Brandon M.; Kumar, Sudhir; Ozkan, S. Banu

    2016-01-01

    Summary Sequencing technologies are revealing many new non-synonymous single nucleotide variants (nsSNVs) in each personal exome. To assess their functional impacts, comparative genomics is frequently employed to predict if they are benign or not. However, evolutionary analysis alone is insufficient, because it misdiagnoses many disease-associated nsSNVs, such as those at positions involved in protein interfaces, and because evolutionary predictions do not provide mechanistic insights into functional change or loss. Structural analyses can aid in overcoming both of these problems by incorporating conformational dynamics and allostery in nSNV diagnosis. Finally, protein-protein interaction networks using systems-level methodologies shed light onto disease etiology and pathogenesis. Bridging these network approaches with structurally resolved protein interactions and dynamics will advance genomic medicine. PMID:26684487

  2. [Integrative management using Ayurvedic medicine in a patient with advanced malignant mixed Muellerian tumor - a case report].

    Science.gov (United States)

    Kronpaß, Ludwig; Krampol, Stefan; Brattinger, Petra; Stapelfeldt, Elmar; Kessler, Christian

    2014-01-01

    Carcinosarcoma of the uterus is a rare malignant tumor with an extremely poor prognosis. Because there are just a few cases described, there is little evidence on possible treatment options. An improvement in the overall unsatisfactory therapeutic situation is required. The management of an advanced stage uterine carcinosarcoma, at the time of primary diagnosis in FIGO stage 4, in a 67-year-old woman is described, including multiple surgical interventions, radiotherapy, chemotherapy, and the complementary use of elements of Ayurvedic medicine. To this date, the 3-year follow-up revealed no evidence of distant metastasis. A high quality of life could be ensured continuously. Even with poor prognosis, tumor entities can be controlled by using all the available medical resources, enabling a satisfactory quality of life over a longer period of time. For this reason, the complementary use of the traditional medical system Ayurveda could be helpful.

  3. Engineering, Life Sciences, and Health/Medicine Synergy in Aerospace Human Systems Integration: The Rosetta Stone Project

    Science.gov (United States)

    Williams, Richard S. (Editor); Doarn, Charles R. (Editor); Shepanek, Marc A.

    2017-01-01

    In the realm of aerospace engineering and the physical sciences, we have developed laws of physics based on empirical and research evidence that reliably guide design, research, and development efforts. For instance, an engineer designs a system based on data and experience that can be consistently and repeatedly verified. This reproducibility depends on the consistency and dependability of the materials on which the engineer works and is subject to physics, geometry and convention. In life sciences and medicine, these apply as well, but individuality introduces a host of variables into the mix, resulting in characteristics and outcomes that can be quite broad within a population of individuals. This individuality ranges from differences at the genetic and cellular level to differences in an individuals personality and abilities due to sex and gender, environment, education, etc.

  4. Integration of structural dynamics and molecular evolution via protein interaction networks: a new era in genomic medicine.

    Science.gov (United States)

    Kumar, Avishek; Butler, Brandon M; Kumar, Sudhir; Ozkan, S Banu

    2015-12-01

    Sequencing technologies are revealing many new non-synonymous single nucleotide variants (nsSNVs) in each personal exome. To assess their functional impacts, comparative genomics is frequently employed to predict if they are benign or not. However, evolutionary analysis alone is insufficient, because it misdiagnoses many disease-associated nsSNVs, such as those at positions involved in protein interfaces, and because evolutionary predictions do not provide mechanistic insights into functional change or loss. Structural analyses can aid in overcoming both of these problems by incorporating conformational dynamics and allostery in nSNV diagnosis. Finally, protein-protein interaction networks using systems-level methodologies shed light onto disease etiology and pathogenesis. Bridging these network approaches with structurally resolved protein interactions and dynamics will advance genomic medicine. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. An Integrated Career Coaching and Time-Banking System Promoting Flexibility, Wellness, and Success: A Pilot Program at Stanford University School of Medicine.

    Science.gov (United States)

    Fassiotto, Magali; Simard, Caroline; Sandborg, Christy; Valantine, Hannah; Raymond, Jennifer

    2018-06-01

    Faculty in academic medicine experience multiple demands on their time at work and home, which can become a source of stress and dissatisfaction, compromising success. A taskforce convened to diagnose the state of work-life flexibility at Stanford University School of Medicine uncovered two major sources of conflict: work-life conflict, caused by juggling demands of career and home; and work-work conflict, caused by competing priorities of the research, teaching, and clinical missions combined with service and administrative tasks. Using human-centered design research principles, the 2013-2014 Academic Biomedical Career Customization (ABCC) pilot program incorporated two elements to mitigate work-life and work-work conflict: integrated career-life planning, coaching to create a customized plan to meet both career and life goals; and a time-banking system, recognizing behaviors that promote team success with benefits that mitigate work-life and work-work conflicts. A matched-sample pre-post evaluation survey found the two-part program increased perceptions of a culture of flexibility (P = .020), wellness (P = .013), understanding of professional development opportunities (P = .036), and institutional satisfaction (P = .020) among participants. In addition, analysis of research productivity indicated that over the two-year program, ABCC participants received 1.3 more awards, on average, compared with a matched set of nonparticipants, a funding difference of approximately $1.1 million per person. These results suggest it is possible to mitigate the effects of extreme time pressure on academic medicine faculty, even within existing institutional structures.

  6. Maimonides? Appreciation for Medicine

    OpenAIRE

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for wi...

  7. Treatment of severe fluoroacetamide poisoning in patient with combined multiple organ dysfunction syndrome by evidence-based integrated Chinese and Western medicines: A case report.

    Science.gov (United States)

    Wen, Wanxin; Gao, Hongxia; Kang, Nini; Lu, Aili; Qian, Caiwen; Zhao, Yuanqi

    2017-07-01

    Fluoroacetamide poisoning is the acute and severe disease of human, which leads to nervous, digestive, and cardiovascular system damage or even death in a short period of time. We report a case of a 65-year-old woman with loss of consciousness, nausea, and vomiting who was sent to the hospital by passers-by. She was diagnosed with severe fluoroacetamide poisoning with combined multiple organ dysfunction syndrome. When the diagnosis was unclear, we gave gastric lavage, support and symptomatic treatment, and closely with the vital sign. When the diagnosis was clear, based on the evidence of retrieved, muscle injection of acetamide, calcium gluconate, and vitamin C. Traditional Chinese medicine aspect, oral administration of mung bean soup of glycyrrhizae and Da-Cheng-Qi decoction enema. By setting reasonable treatment for patients, she had no special discomfort and complications after treatment. Besides, through 1-month follow-up, it was confirmed that the treatments were effective. Evidence-based integrated Chinese and Western medicines can effectively improve the therapeutic effects in severe fluoroacetamide-poisoned patients with combined MODS.

  8. Discussion group networks in occupational medicine: A tool for continuing education to promote the integration of workers with disabilities.

    Science.gov (United States)

    Rinsky-Halivni, Lilah; Lerman, Yehuda

    2018-04-01

    Despite their legal rights, individuals with disabilities face numerous obstacles to integration in the workplace which can result in their discharge from the labor force. Currently occupational physicians have few resources to help decide whether to integrate disabled workers in pre-placement, or in cases of return-to-work. A network of 13 discussion groups comprised of the occupational physicians of each regional clinic of a large Health Maintenance Organization (HMO) in Israel was created to deal with disability management dilemmas. A moderator compiles and shares the physicians' opinions and experiences with all network members thus assisting the consulting physician in decision-making. Successful management of three representative cases is described to illustrate real-life implementations of this network. The network enables both the consulting and other physicians to tap a large knowledge base and decision-making experience concerning cases of occupational disability management, contributing to professional development and improved service delivery. © 2018 Wiley Periodicals, Inc.

  9. Integration of Andrographis paniculata as Potential Medicinal Plant in Chir Pine (Pinus roxburghii Sarg. Plantation of North-Western Himalaya

    Directory of Open Access Journals (Sweden)

    Chandra Shekher Sanwal

    2016-01-01

    Full Text Available The integration of Andrographis paniculata under Pinus roxburghii (Chir pine plantation has been studied to evaluate the growth and yield for its economic viability and conservation. It was grown on three topographical aspects, namely, northern, north-western, and western, at a spacing of 30 cm × 30 cm, followed by three tillage depths, namely, minimum (0 cm, medium (up to 10 cm, and deep (up to 15 cm tillage. The growth parameters, namely, plant height and number of branches per plant, were recorded as significantly higher on western aspect and lowest on northern aspect except for leaf area index which was found nonsignificant. However under all tillage practices all the growth parameters in both understorey and open conditions were found to be nonsignificant except for plant height which was found to be significantly highest under deep tillage and lowest under minimum tillage. The study of net returns for Andrographis paniculata revealed that it had positive average annual returns even in understorey conditions which indicate its possible economic viability under integration of Chir pine plantations. Hence net returns can be enhanced by integrating Andrographis paniculata and this silvimedicinal system can be suggested which will help utilizing an unutilized part of land and increase total productivity from such lands besides conservation of the A. paniculata in situ.

  10. Integration of Andrographis paniculata as Potential Medicinal Plant in Chir Pine (Pinus roxburghii Sarg.) Plantation of North-Western Himalaya

    Science.gov (United States)

    Sanwal, Chandra Shekher; Bhardwaj, S. D.

    2016-01-01

    The integration of Andrographis paniculata under Pinus roxburghii (Chir pine) plantation has been studied to evaluate the growth and yield for its economic viability and conservation. It was grown on three topographical aspects, namely, northern, north-western, and western, at a spacing of 30 cm × 30 cm, followed by three tillage depths, namely, minimum (0 cm), medium (up to 10 cm), and deep (up to 15 cm) tillage. The growth parameters, namely, plant height and number of branches per plant, were recorded as significantly higher on western aspect and lowest on northern aspect except for leaf area index which was found nonsignificant. However under all tillage practices all the growth parameters in both understorey and open conditions were found to be nonsignificant except for plant height which was found to be significantly highest under deep tillage and lowest under minimum tillage. The study of net returns for Andrographis paniculata revealed that it had positive average annual returns even in understorey conditions which indicate its possible economic viability under integration of Chir pine plantations. Hence net returns can be enhanced by integrating Andrographis paniculata and this silvimedicinal system can be suggested which will help utilizing an unutilized part of land and increase total productivity from such lands besides conservation of the A. paniculata in situ. PMID:27563482

  11. The medicine from behind

    NARCIS (Netherlands)

    Andel, Van Tinde; Onselen, Van Sabine; Myren, Britt; Towns, Alexandra; Quiroz, Diana

    2015-01-01

    Ethnopharmacological relevance Purgative enemas form an integral part of African traditional medicine. Besides possible benefits, serious health risks of rectal herbal therapy have been described in literature. To design appropriate health education programs, it is essential to understand

  12. Produkt- und Innovationsmanagement (PIM ZB MED. Prozess zur laufenden Überprüfung des Angebots

    Directory of Open Access Journals (Sweden)

    Gail, Fabian

    2015-12-01

    Full Text Available With the integrated process of “product and innovation management” ZB MED has created the basis for the continuous updating of the product portfolio. The existing products are maintained by those in charge with the help of product sheets, tested ideas for changes to existing or new products are checked transparently.

  13. Integration of electro-optical mechanical systems and medicine: where are we and where can we go?

    Science.gov (United States)

    Gourley, Mark F.; Gourley, Paul L.

    1997-03-01

    The marriage of microfabricated materials with microbiological systems will allow advances in medicine to proceed at an unprecedented pace. Biomedical research is placing new demands on speed and limits of detection to assay body tissues and fluids. Emerging microfabricated chip technologies from the engineering community offer researchers novel types of analysis of human samples. In guiding these developments, the ability to swiftly and accurately gain useful information for identification and establish a diagnosis, is of utmost importance. Current examples of such technology include DNA amplification and analysis, and fluorescent cell analysis by flow cytometry. Potential applications include the development of rapid techniques for examining large number of cells in tissue or in blood. These could serve as screening tools for the detection and quantification of abnormal cell types; for example malignant or HIV infected cells. Micro/nanofabrication methods will make these devices compact, providing access of this technology to point of care providers; in a clinic, ambulance, or on a battlefield. Currently, these tools are in the construction phase. Upon delivery to researchers, validation of these instruments leads to clinical demand that requires approval from the Food and Drug Administration. This paper outlines criteria that successful devices must satisfy.

  14. Pipeline four-dimension management is the trend of pipeline integrity management in the future

    Energy Technology Data Exchange (ETDEWEB)

    Shaohua, Dong; Feifan; Zhongchen, Han [China National Petroleum Corporation (CNPC), Beijing (China)

    2009-07-01

    Pipeline integrity management is essential for today's operators to operate their pipelines safety and cost effectively. The latest developments of pipeline integrity management around the world are involved with change of regulation, industry standard and innovation of technology. And who know the trend of PIM in the future, which can be answered in the paper. As a result, the concept of P4DM was set up firstly in the world. The paper analyzed the pipeline HSE management, pipeline integrity management (PIM) and asset integrity management (AIM), the problem of management was produced, and also the Pipeline 4-dimension Management (P4DM) theory was brought forward. According to P4DM, from the hierarchy of P4DM, the management elements, fields, space and time was analyzed. The main content is P4DM integrate the space geography location and time, control and manage the pipeline system in whole process, anywhere and anytime. It includes the pipeline integrity, pipeline operation and emergency, which is integrated by IT system. It come true that the idea, solution, technology, organization, manager alternately intelligently control the process of management. What the paper talks about included the definition of pipeline 4D management, the research develop of P4DM, the theory of P4DM, the relationship between P4DM and PIM, the technology basis of P4DM, how to perform the P4DM and conclusion. The P4DM was produced, which provide the development direction of PIM in the future, and also provide the new ideas for PetroChina in the field of technology and management. (author)