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Sample records for large treatment differences

  1. Racial differences in treatment and survival in older patients with diffuse large B-cell lymphoma (DLBCL)

    International Nuclear Information System (INIS)

    Griffiths, Robert; Gleeson, Michelle; Knopf, Kevin; Danese, Mark

    2010-01-01

    .35; P = 0.01), but not mortality due to NHL (HR 1.16; P = 0.19). In elderly patients diagnosed with DLBCL, there are large differences in treatment access and survival between blacks and whites

  2. Efficacy of different doses of cimetidine in the treatment of reflux esophagitis. A review of three large, double-blind, controlled trials

    NARCIS (Netherlands)

    Tytgat, G. N.; Nicolai, J. J.; Reman, F. C.

    1990-01-01

    Four different cimetidine dosage regimens--800 mg u.i.d. HS or nocte, 800 mg u.i.d. dinnertime, 400 mg q.i.d., and 800 mg b.i.d.--were investigated for the treatment of reflux esophagitis in three independent large-scale, double-blind, controlled multicenter trials in which more than 1100 patients

  3. Endoscopic treatment of large vesical calculi

    International Nuclear Information System (INIS)

    Rauf, A.; Ahmed, I.; Rauf, M.H.; Rauf, M.

    2015-01-01

    Objective: To determine the efficiency and safety of endoscopic treatment of large vesical calculi with the available modern endoscopic instruments. Methology: In case series, patients were collected randomly from 2007 to 2014. Patients were diagnosed with ultrasound and Nephroscope with Swiss pneumatic lithoclast, lithotrite and stone punch were used for treatment. Results: Majority of the patient could be managed with the method adopted. Stone size, hardness or softness, gender were the factors affecting treatment. Associated prostate pathology was seen in four patients. Postoperative complications included hemorrhage, perforation, residual stone and transurethral resection of prostate syndrome. Conclusion: Overall, it is a safe procedure except in patients with large enlarged prostate and large vesical calculi. Very hard vesical calculus may need vesicolithotomy. (author)

  4. Multimodality treatment of large AVMs in eloquent areas

    International Nuclear Information System (INIS)

    Inoue, Hiroshi K.; Naitou, Isao

    2004-01-01

    Our treatment of arteriovenous malformations (AVMs) with Gamma Knife Radiosurgery (optimal dose treatment) showed 88.4% total obliteration in small AVMs less than 10 ml after the first treatment and very low morbidity (1.7%) in long-term follow-up (5 to 12 years). These results indicate that combined treatment is a good strategy for large AVMs in eloquent areas. Therefore, we evaluated larger AVMs treated with direct surgery including feeder clipping and/or intravascular embolization prior to radiosurgery for further development of radiosurgery of large AVMs. Fifty of 171 patients had combined treatment (embolization: 27, direct surgery: 19, both: 4) and were followed more than 4 years and 6 months. Mean volume at the time of radiosurgery was smallest in the surgery group. Total obliteration was obtained in 94.4% of small AVMs less than 10 ml (surgery: 100%, embolization: 88.9%), although larger AVMs still have a lower obliteration rate. No lethal hemorrhages appeared after combination treatment up to date. We concluded that radiosurgery combined with surgery and/or embolization is a safe and effective treatment for large AVMs in eloquent areas. (author)

  5. Non-invasive endodontic treatment of large periapical lesions

    Directory of Open Access Journals (Sweden)

    Harry Huiz Peeters

    2008-09-01

    Full Text Available Background: In most cases of large periapical radiolucent lesions of pulpal origin, we often encounter a dilemmatic situation, such as whether to either treat these cases endodontically or surgically. Development of techniques, instruments and root medicaments as well as the tendency toward minimally invasive treatment, all support dentists to treat those cases using the minimal invasive principle (i.e. endodontically instead of surgically. Purpose: The purpose of this paper is to report and discuss the managing of periapical lesions by endodontic no invasive treatment. Case management: The patient with large periapical lesions were treated with noninvasive endodontic treatment. After 6 months, patients in this report were asymptomatic and radiolucencies had disappeared. When the root canal treatment is done according to accepted clinical principles and under aseptic condition, including cleaning, shaping, abturating as well as proper diagnosis, the healing process of the infected area will occur. Conclusion: Some lesions, however, may not be treated conservatively and may require surgical treatment for total elimination of the lesions.

  6. Large scale treatment of total petroleum-hydrocarbon contaminated groundwater using bioaugmentation.

    Science.gov (United States)

    Poi, Gregory; Shahsavari, Esmaeil; Aburto-Medina, Arturo; Mok, Puah Chum; Ball, Andrew S

    2018-05-15

    Bioaugmentation or the addition of microbes to contaminated sites has been widely used to treat contaminated soil or water; however this approach is often limited to laboratory based studies. In the present study, large scale bioaugmentation has been applied to total petroleum hydrocarbons (TPH)-contaminated groundwater at a petroleum facility. Initial TPH concentrations of 1564 mg L -1 in the field were reduced to 89 mg L -1 over 32 days. This reduction was accompanied by improved ecotoxicity, as shown by Brassica rapa germination numbers that increased from 52 at day 0 to 82% by the end of the treatment. Metagenomic analysis indicated that there was a shift in the microbial community when compared to the beginning of the treatment. The microbial community was dominated by Proteobacteria and Bacteroidetes from day 0 to day 32, although differences at the genus level were observed. The predominant genera at the beginning of the treatment (day 0 just after inoculation) were Cloacibacterium, Sediminibacterium and Brevundimonas while at the end of the treatment members of Flavobacterium dominated, reaching almost half the population (41%), followed by Pseudomonas (6%) and Limnobacter (5.8%). To the author's knowledge, this is among the first studies to report the successful large scale biodegradation of TPH-contaminated groundwater (18,000 L per treatment session) at an offshore petrochemical facility. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Whole-procedure clinical accuracy of Gamma Knife treatments of large lesions

    International Nuclear Information System (INIS)

    Ma Lijun; Chuang, Cynthia; Descovich, Martina; Petti, Paula; Smith, Vernon; Verhey, Lynn

    2008-01-01

    The mechanical accuracy of Gamma Knife radiosurgery based on single-isocenter measurement has been established to within 0.3 mm. However, the full delivery accuracy for Gamma Knife treatments of large lesions has only been estimated via the quadrature-sum analysis. In this study, the authors directly measured the whole-procedure accuracy for Gamma Knife treatments of large lesions to examine the validity of such estimation. The measurements were conducted on a head-phantom simulating the whole treatment procedure that included frame placement, computed tomography imaging, treatment planning, and treatment delivery. The results of the measurements were compared with the dose calculations from the treatment planning system. Average agreements of 0.1-1.6 mm for the isodose lines ranging from 25% to 90% of the maximum dose were found despite potentially large contributing uncertainties such as 3-mm imaging resolution, 2-mm dose grid size, 1-mm frame registration, multi-isocenter deliveries, etc. The results of our measurements were found to be significantly smaller (>50%) than the calculated value based on the quadrature-sum analysis. In conclusion, Gamma Knife treatments of large lesions can be delivered much more accurately than predicted from the quadrature-sum analysis of major sources of uncertainties from each step of the delivery chain.

  8. [Diverticular disease of the large bowel - surgical treatment].

    Science.gov (United States)

    Levý, M; Herdegen, P; Sutoris, K; Simša, J

    2013-07-01

    Surgical treatment, despite the rapid development of the numerous modern miniinvasive intervention techniques, remains essential in the treatment of complicated diverticular disease. The aim of this work is to summarize indications for surgical treatment in both acute and elective patients suffering from diverticular disease of the large bowel. Review of the literature and recent findings concerning indications for surgical intervention in patients with diverticulosis of the colon. The article describes indications, types of procedures, techniques and postoperative care in patients undergoing surgical intervention for diverticular disease.

  9. Analysis of a large number of clinical studies for breast cancer radiotherapy: estimation of radiobiological parameters for treatment planning

    International Nuclear Information System (INIS)

    Guerrero, M; Li, X Allen

    2003-01-01

    Numerous studies of early-stage breast cancer treated with breast conserving surgery (BCS) and radiotherapy (RT) have been published in recent years. Both external beam radiotherapy (EBRT) and/or brachytherapy (BT) with different fractionation schemes are currently used. The present RT practice is largely based on empirical experience and it lacks a reliable modelling tool to compare different RT modalities or to design new treatment strategies. The purpose of this work is to derive a plausible set of radiobiological parameters that can be used for RT treatment planning. The derivation is based on existing clinical data and is consistent with the analysis of a large number of published clinical studies on early-stage breast cancer. A large number of published clinical studies on the treatment of early breast cancer with BCS plus RT (including whole breast EBRT with or without a boost to the tumour bed, whole breast EBRT alone, brachytherapy alone) and RT alone are compiled and analysed. The linear quadratic (LQ) model is used in the analysis. Three of these clinical studies are selected to derive a plausible set of LQ parameters. The potential doubling time is set a priori in the derivation according to in vitro measurements from the literature. The impact of considering lower or higher T pot is investigated. The effects of inhomogeneous dose distributions are considered using clinically representative dose volume histograms. The derived LQ parameters are used to compare a large number of clinical studies using different regimes (e.g., RT modality and/or different fractionation schemes with different prescribed dose) in order to validate their applicability. The values of the equivalent uniform dose (EUD) and biologically effective dose (BED) are used as a common metric to compare the biological effectiveness of each treatment regime. We have obtained a plausible set of radiobiological parameters for breast cancer. This set of parameters is consistent with in vitro

  10. Surgical Treatment of a Large Complex Odontoma

    Directory of Open Access Journals (Sweden)

    Burak Cezairli

    2017-08-01

    Full Text Available The treatment modalities for odontomas are generally depend on the tumors size. Small and medium lesions can usually be removed easily allowing preservation of surrounding anatomical structures. In our study, we reported a conservative surgical treatment of a large complex odontoma. A 19-year-old woman was referred to our clinic after an incidentally observed lesion on her right mandibular angle. The patient was symptom-free at the time of visit. Computed tomography (CT images showed a mass with a size of 3.5 cm x 3 cm x 2 cm. CT sections and tridimensional images showed partially eroded buccal and lingual cortex. Surgical treatment was indicated with an initial diagnosis of compound odontoma. The lesion removed after sectioning with bur and maxillo-mandibular fixation (MMF were not thought to be necessary while the buccal and lingual cortexes were mostly reliable for preventing a fracture. In our case, the size of the odontoma was suitable for a conservative treatment method and with this modality we managed to prevent a possible fracture and eliminate the disadvantages of MMF.

  11. Large individual differences in free recall

    OpenAIRE

    Tarnow, Eugen

    2016-01-01

    Using single factor ANOVA I show that there are large individual differences in free recall ({\\eta} ranges from 0.09-0.26) including the total recall, the balance between recency and primacy, and the initial recall (subsequent recalls show smaller individual differences). All three memory properties are relatively uncorrelated. The variance in the initial position may be a measure of executive control and is correlated with total recall (the smaller the variation, the larger the recall).

  12. The "3"2P applicator combined with propranolol in the treatment of large area skin capillary hemangiomain children

    International Nuclear Information System (INIS)

    Duan Yongqiang; Wu Zhenfu; Wu Min; Qiu Xuan; Fei Shinuan

    2016-01-01

    Objective: To investigate the clinical efficacy of "3"2P applicator plus propranolol in children with a large area of skin capillary hemangioma. Methods: Forty five cases of large hemangioma were divided into two groups. Control group of 20 patients recieved the conventional "3"2P application therapy. Of 20 cases in control group, there were 10 cases ≤3 years old children with hemangiomas, and 10 cases > 3 years old children with Port Wine Stain(PWS). Observation group of 25 cases recieved "3"2P applicator plus propranolol. Of 25 cases in observation group 10 cases werer ≤3 years old children with hemangiomas, 15 cases of children with PWS. Comparison was made between two different types of vascular tumors, treatment in ≤3 years old children and > 3 years old children, and adverse reactions. Data statistical analysis used χ"2 test and zero reaction test. P 0.05). The treatment efficacy in ≤3 years old children with infant hemangioma was 90.0% in control group and 100% in observation group (P > 0.05 ). The treatment efficacy for PWS in > 3 years old children was 40.0% in control group and 80% in observation group. Here the difference is statistically significant(P 3 years old children in control group,the treatment efficacy was 90.0% and 40.0%, respectively P 3 years old children in observation group, the treatment efficacy was 100.0% and 80.0% with no significant difference(P > 0.05). Complication of moist dermatitis was 25.0% in control group and 40.0% in observation group. Occurrence of depigmentation was 75.0% and 84.0% in control and observation group with no significant difference(P > 0.05). Changing in heart rate occurs in ≤3 years old children and > 3 years old children, 50.0% and 40.0%, respectively, with no significant difference(P > 0.05). Conclusion: "3"2P applicator plus propranolol treatment of refractory large hemangioma is simple, safe, and effective. But close attention needs to be paid to both "3"2P and propranolol on adverse reactions

  13. Actin and microtubule networks contribute differently to cell response for small and large strains

    Science.gov (United States)

    Kubitschke, H.; Schnauss, J.; Nnetu, K. D.; Warmt, E.; Stange, R.; Kaes, J.

    2017-09-01

    Cytoskeletal filaments provide cells with mechanical stability and organization. The main key players are actin filaments and microtubules governing a cell’s response to mechanical stimuli. We investigated the specific influences of these crucial components by deforming MCF-7 epithelial cells at small (≤5% deformation) and large strains (>5% deformation). To understand specific contributions of actin filaments and microtubules, we systematically studied cellular responses after treatment with cytoskeleton influencing drugs. Quantification with the microfluidic optical stretcher allowed capturing the relative deformation and relaxation of cells under different conditions. We separated distinctive deformational and relaxational contributions to cell mechanics for actin and microtubule networks for two orders of magnitude of drug dosages. Disrupting actin filaments via latrunculin A, for instance, revealed a strain-independent softening. Stabilizing these filaments by treatment with jasplakinolide yielded cell softening for small strains but showed no significant change at large strains. In contrast, cells treated with nocodazole to disrupt microtubules displayed a softening at large strains but remained unchanged at small strains. Stabilizing microtubules within the cells via paclitaxel revealed no significant changes for deformations at small strains, but concentration-dependent impact at large strains. This suggests that for suspended cells, the actin cortex is probed at small strains, while at larger strains; the whole cell is probed with a significant contribution from the microtubules.

  14. Outcome of emergency endovascular treatment of large internal iliac artery aneurysms with guidewires

    International Nuclear Information System (INIS)

    Cambj-Sapunar, Liana; Maskovic, Josip; Brkljacic, Boris; Radonic, Vedran; Dragicevic, Dragan; Ajduk, Marko

    2010-01-01

    Purpose: Guidewires have been reported as a useful occlusion material for large aneurysms of different locations with good short-term results. In this study we retrospectively evaluate long-term results of emergency embolization technique with guidewires in symptomatic internal iliac artery aneurysm (IIAA) impending rupture. Patients and methods: In four patients presented with acute abdominal pain, multidetector computed tomography revealed unstable, 7-14 cm large, IIAAs. Two patients were treated with coil embolization of distal branches followed by occlusion of aneurysmal sac with guidewires. In two patients embolization of aneurysmal sac alone was performed. Results: In three patients complete or near complete occlusion of the aneurysmal sac was achieved and abdominal pain ceased within hours. Two patients treated with embolization of distal iliac artery branches and aneurysmal sac developed claudication that lasted up to 1 year. Their aneurysms remained thrombosed and they were without symptoms until they died 31 and 56 months later of causes unrelated to IIAA. Two patients treated with embolization of the aneurysm alone were free of ischemic symptoms. Because of incomplete embolization of the sac in one patient open surgery treatment in a non-emergency setting was performed. Complete filling of aneurysmal sac was achieved in other patient but 2 years later his aneurysm re-opened and required open surgery treatment. Conclusion: Embolization of aneurysmal sac of large IIAA with guidewires may be effective for immediate treatment of impending rupture. Long-term results were better when embolization of the aneurysmal sac was combined with embolization of distal IIA branches.

  15. Efficacy and safety of minor endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in treatment of elderly patients with multiple large common bile duct stones

    Directory of Open Access Journals (Sweden)

    HE Yongfeng

    2018-02-01

    Full Text Available Objective To investigate the clinical effect and safety of minor endoscopic sphincterotomy (mEST combined with endoscopic papillary large balloon dilation (EPLBD in the treatment of elderly patients with multiple large common bile duct stones. MethodsA retrospective analysis was performed for 229 patients with multiple large common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP in Endoscopy Center, Ankang Municipal Central Hospital, from January 2012 to December 2016, and the surgical procedure was selected based on the size of stones and the morphology of the common bile duct. According to the endoscopic surgical procedure, the patients were divided into mEST+EPLBD group (treatment group with 136 patients and endoscopic phincterotomy (EST group (control group with 93 patients. The two groups were compared in terms of the success rate of first stone removal, use rate of mechanical lithotripsy (ML, time spent on stone removal, and the incidence rate of complications. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in the success rate of first stone removal between the treatment group and the control group (91.17% vs 87.10%, χ2=0.980, P>0.05, while there were significant differences in the time spent on stone removal (18.2±4.3 min vs 37.4±6.7 min, χ2=37.1526, P<0.01 and use rate of ML (6.71% vs 40.00%, t=24.411, P<0.01. There were no significant differences in the incidence rates of pancreatitis (2.94% vs 6.45%, χ2=1.630, P>0.05 and bleeding (2.21% vs 2.15%, χ2=0.001, P>0.05 between the two groups, and no patient experienced perforation or infection. ConclusionmEST+EPLBD has a good clinical effect in the treatment of elderly patients with multiple large common bile duct stones and can effectively shorten the time spent on stone removal, reduce the

  16. COPD, stage and treatment in a large outpatient clinic

    DEFF Research Database (Denmark)

    Holm, Claire Præst; Holm, Jakob; Nørgaard, Annette

    2017-01-01

    of exacerbations. Our aim was to describe COPD patient characteristics and compare roflumilast treatment eligible to non-eligible patients. An observational cross-section study was conducted. Patients were included from a large COPD outpatient clinic. Information regarding COPD patient characteristics...... was registered on a standardized form and lung function was measured. Patients were categorized according to the GOLD classification. Eligibility for roflumilast treatment was assessed and patient characteristics compared between groups. 547 patients were included. Most patients (54%) were in GOLD group D. 62...

  17. Differences of Organizational Culture between Small and Large Enterprises

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    Ovidiu-Iliuta Dobre

    2016-01-01

    Full Text Available This research paper analyses the organizational culture of small enterprises and largeenterprises, and highlights the common elements and the main differences. The results of the studyshow significant differences in terms of organizational culture between the two types oforganizations. Employees working in small size enterprises are oriented towards innovation,whereas the ones working in large enterprises are more aware of social responsibility. In addition,small organizations are perceived to have a more supportive organizational culture than largeenterprises. Furthermore, the study reveals differences in management and leadership styles whenanalyzing the small and large enterprises. Considering the flatter organizational structure of smallenterprises, the managers have a personal relationship with the employees and they motivate thembetter and align their goals with the ones of the enterprise. In large organizations, the managersneed to have a tighter control, as more procedures have to be followed.

  18. Attribution-based motivation treatment efficacy in an online learning environment for students who differ in cognitive elaboration

    OpenAIRE

    Hamm, Jeremy M.; Perry, Raymond P.; Chipperfield, Judith G.; Murayama, Kou; Weiner, Bernard

    2017-01-01

    Attribution-based motivation treatments can boost performance in competitive achievement settings (Perry and Hamm 2017), yet their efficacy relative to mediating processes and affect-based treatments remains largely unexamined. In a two-semester, pre-post, randomized treatment study (n = 806), attributional retraining (AR) and stress-reduction (SR) treatments were administered in an online learning environment to first-year college students who differed in cognitive elaboration (low, high). L...

  19. High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis

    DEFF Research Database (Denmark)

    Laursen, Jens Ole

    2017-01-01

    PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant...... pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients...

  20. Gender Differences in Epidemiology, Pathophysiology, and Treatment of Hypertension.

    Science.gov (United States)

    Di Giosia, Paolo; Giorgini, Paolo; Stamerra, Cosimo Andrea; Petrarca, Marco; Ferri, Claudio; Sahebkar, Amirhossein

    2018-02-14

    This review aims to examine gender differences in both the epidemiology and pathophysiology of hypertension and to explore gender peculiarities on the effects of antihypertensive agents in decreasing BP and CV events. Men and women differ in prevalence, awareness, and control rate of hypertension in an age-dependent manner. Studies suggest that sex hormones changes play a pivotal role in the pathophysiology of hypertension in postmenopausal women. Estrogens influence the vascular system inducing vasodilatation, inhibiting vascular remodeling processes, and modulating the renin-angiotensin aldosterone system and the sympathetic system. This leads to a protective effect on arterial stiffness during reproductive age that is dramatically reversed after menopause. Data on the efficacy of antihypertensive therapy between genders are conflicting, and the underrepresentation of aged women in large clinical trials could influence the results. Therefore, further clinical research is needed to uncover potential gender differences in hypertension to promote the development of a gender-oriented approach to antihypertensive treatment.

  1. Visualization and direct comparison of large displacements using difference holographic interferometry

    International Nuclear Information System (INIS)

    Necati Ecevit, F.; Aydin, R.

    1994-01-01

    The difference holographic interferometry provides the possibility of direct comparison of large displacements and deformations of two similar but different objects by application of a special kind of illumination. In this work, the principles of the difference holographic interferometry and the experimental results obtained by applying the single beam technique to large displacements is presented. (author). 10 refs, 4 figs

  2. A single point acupuncture treatment at large intestine meridian: a randomized controlled trial in acute tonsillitis and pharyngitis.

    Science.gov (United States)

    Fleckenstein, Johannes; Lill, Christian; Lüdtke, Rainer; Gleditsch, Jochen; Rasp, Gerd; Irnich, Dominik

    2009-09-01

    One out of 4 patients visiting a general practitioner reports of a sore throat associated with pain on swallowing. This study was established to examine the immediate pain alleviating effect of a single point acupuncture treatment applied to the large intestine meridian of patients with sore throat. Sixty patients with acute tonsillitis and pharyngitis were enrolled in this randomized placebo-controlled trial. They either received acupuncture, or sham laser acupuncture, directed to the large intestine meridian section between acupuncture points LI 8 and LI 10. The main outcome measure was the change of pain intensity on swallowing a sip of water evaluated by a visual analog scale 15 minutes after treatment. A credibility assessment regarding the respective treatment was performed. The pain intensity for the acupuncture group before and immediately after therapy was 5.6+/-2.8 and 3.0+/-3.0, and for the sham group 5.6+/-2.5 and 3.8+/-2.5, respectively. Despite the articulation of a more pronounced improvement among the acupuncture group, there was no significant difference between groups (Delta=0.9, confidence interval: -0.2-2.0; P=0.12; analysis of covariance). Patients' satisfaction was high in both treatment groups. The study was prematurely terminated due to a subsequent lack of suitable patients. A single acupuncture treatment applied to a selected area of the large intestine meridian was no more effective in the alleviation of pain associated with clinical sore throat than sham laser acupuncture applied to the same area. Hence, clinically relevant improvement could be achieved. Pain alleviation might partly be due to the intense palpation of the large intestine meridian. The benefit of a comprehensive acupuncture treatment protocol in this condition should be subject to further trials.

  3. SU-F-T-538: CyberKnife with MLC for Treatment of Large Volume Tumors: A Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Bichay, T; Mayville, A [Mercy Health, Saint Mary’s, Grand Rapids, MI (United States)

    2016-06-15

    Purpose: CyberKnife is a well-documented modality for SRS and SBRT treatments. Typical tumors are small and 1–5 fractions are usually used. We determined the feasibility of using CyberKnife, with an InCise multileaf collimator option, for larger tumors undergoing standard dose and fractionation. The intent was to understand the limitation of using this modality for other external beam radiation treatments. Methods: Five tumors from different anatomical sites with volumes from 127.8 cc to 1,320.5 cc were contoured and planned on a Multiplan V5.1 workstation. The target average diameter ranged from 7 cm to 13 cm. The dose fractionation was 1.8–2.0 Gy/fraction and 25–45 fractions for total doses of 45–81 Gy. The sites planned were: pancreas, head and neck, prostate, anal, and esophagus. The plans were optimized to meet conventional dose constraints based on various RTOG protocols for conventional fractionation. Results: The Multiplan treatment planning system successfully generated clinically acceptable plans for all sites studied. The resulting dose distributions achieved reasonable target coverage, all greater than 95%, and satisfactory normal tissue sparing. Treatment times ranged from 9 minutes to 38 minutes, the longest being a head and neck plan with dual targets receiving different doses and with multiple adjacent critical structures. Conclusion: CyberKnife, with the InCise multileaf collimation option, can achieve acceptable dose distributions in large volume tumors treated with conventional dose and fractionation. Although treatment times are greater than conventional accelerator time; target coverage and dose to critical structures can be kept within a clinically acceptable range. While time limitations exist, when necessary CyberKnife can provide an alternative to traditional treatment modalities for large volume tumors.

  4. Large herbivores maintain termite-caused differences in herbaceous species diversity patterns.

    Science.gov (United States)

    Okullo, Paul; Moe, Stein R

    2012-09-01

    Termites and large herbivores affect African savanna plant communities. Both functional groups are also important for nutrient redistribution across the landscape. We conducted an experiment to study how termites and large herbivores, alone and in combination, affect herbaceous species diversity patterns in an African savanna. Herbaceous vegetation on large vegetated Macrotermes mounds (with and without large herbivores) and on adjacent savanna areas (with and without large herbivores) was monitored over three years in Lake Mburo National Park, Uganda. We found substantial differences in species richness, alpha diversity, evenness, and stability between termite mound herbaceous vegetation and adjacent savanna vegetation. Within months of fencing, levels of species richness, evenness, and stability were no longer significantly different between savanna and mounds. However, fencing reduced the cumulative number of species, particularly for forbs, of which 48% of the species were lost. Fencing increased the beta diversity (dissimilarity among plots) on the resource-poor (in terms of both nutrients and soil moisture) savanna areas, while it did not significantly affect beta diversity on the resource-rich termite mounds. While termites cause substantial heterogeneity in savanna vegetation, large herbivores further amplify these differences by reducing beta diversity on the savanna areas. Large herbivores are, however, responsible for the maintenance of a large number of forbs at the landscape level. These findings suggest that the mechanisms underlying the effects of termites and large herbivores on savanna plant communities scale up to shape community structure and dynamics at a landscape level.

  5. Treatment of severe pulmonary hypertension in the setting of the large patent ductus arteriosus.

    Science.gov (United States)

    Niu, Mary C; Mallory, George B; Justino, Henri; Ruiz, Fadel E; Petit, Christopher J

    2013-05-01

    Treatment of the large patent ductus arteriosus (PDA) in the setting of pulmonary hypertension (PH) is challenging. Left patent, the large PDA can result in irreversible pulmonary vascular disease. Occlusion, however, may lead to right ventricular failure for certain patients with severe PH. Our center has adopted a staged management strategy using medical management, noninvasive imaging, and invasive cardiac catheterization to treat PH in the presence of a large PDA. This approach determines the safety of ductal closure but also leverages medical therapy to create an opportunity for safe PDA occlusion. We reviewed our experience with this approach. Patients with both severe PH and PDAs were studied. PH treatment history and hemodynamic data obtained during catheterizations were reviewed. Repeat catheterizations, echocardiograms, and clinical status at latest follow-up were also reviewed. Seven patients had both PH and large, unrestrictive PDAs. At baseline, all patients had near-systemic right ventricular pressures. Nine catheterizations were performed. Two patients underwent 2 catheterizations each due to poor initial response to balloon test occlusion. Six of 7 patients exhibited subsystemic pulmonary pressures during test occlusion and underwent successful PDA occlusion. One patient did not undergo PDA occlusion. In follow-up, 2 additional catheterizations were performed after successful PDA occlusion for subsequent hemodynamic assessment. At the latest follow-up, the 6 patients who underwent PDA occlusion are well, with continued improvement in PH. Five patients remain on PH treatment. A staged approach to PDA closure for patients with severe PH is an effective treatment paradigm. Aggressive treatment of PH creates a window of opportunity for PDA occlusion, echocardiography assists in identifying the timing for closure, and balloon test occlusion during cardiac catheterization is critical in determining safety of closure. By safely eliminating the large PDA

  6. Evaluation of the biological differences of canine and human factor VIII in gene delivery: Implications in human hemophilia treatment

    Science.gov (United States)

    The canine is the most important large animal model for testing novel hemophilia A(HA) treatment. It is often necessary to use canine factor VIII (cFIII) gene or protein for the evaluation of HA treatment in the canine model. However, the different biological properties between cFVIII and human FVII...

  7. Literature Review: Herbal Medicine Treatment after Large-Scale Disasters.

    Science.gov (United States)

    Takayama, Shin; Kaneko, Soichiro; Numata, Takehiro; Kamiya, Tetsuharu; Arita, Ryutaro; Saito, Natsumi; Kikuchi, Akiko; Ohsawa, Minoru; Kohayagawa, Yoshitaka; Ishii, Tadashi

    2017-01-01

    Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation's experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords "disaster" and "herbal medicine" were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.

  8. Dosimetric comparison of different treatment modalities for stereotactic radiotherapy.

    Science.gov (United States)

    Hsu, Shih-Ming; Lai, Yuan-Chun; Jeng, Chien-Chung; Tseng, Chia-Ying

    2017-09-16

    The modalities for performing stereotactic radiotherapy (SRT) on the brain include the cone-based linear accelerator (linac), the flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) linac, and tomotherapy. In this study, the cone-based linac, FFF-VMAT linac, and tomotherapy modalities were evaluated by measuring the differences in doses delivered during brain SRT and experimentally assessing the accuracy of the output radiation doses through clinical measurements. We employed a homemade acrylic dosimetry phantom representing the head, within which a thermoluminescent dosimeter (TLD) and radiochromic EBT3 film were installed. Using the conformity/gradient index (CGI) and Paddick methods, the quality of the doses delivered by the various SRT modalities was evaluated. The quality indicators included the uniformity, conformity, and gradient indices. TLDs and EBT3 films were used to experimentally assess the accuracy of the SRT dose output. The dose homogeneity indices of all the treatment modalities were lower than 1.25. The cone-based linac had the best conformity for all tumors, regardless of the tumor location and size, followed by the FFF-VMAT linac; tomography was the worst-performing treatment modality in this regard. The cone-based linac had the best gradient, regardless of the tumor location and size, whereas the FFF-VMAT linac had a better gradient than tomotherapy for a large tumor diameter (28 mm). The TLD and EBT3 measurements of the dose at the center of tumors indicated that the average difference between the measurements and the calculated dose was generally less than 4%. When the 3% 3-mm gamma passing rate metric was used, the average passing rates of all three treatment modalities exceeded 98%. Regarding the dose, the cone-based linac had the best conformity and steepest dose gradient for tumors of different sizes and distances from the brainstem. The results of this study suggest that SRT should be performed using the cone

  9. PENGARUH LARGE POSITIVE ABNORMAL BOOK-TAX DIFFERENCES TERHADAP PERSISTENSI LABA

    Directory of Open Access Journals (Sweden)

    Nurul Aisyah Rachmawati

    2014-12-01

    Full Text Available The purpose of this study is to analyze the effect of Large Positive Abnormal Book-Tax Differences (LPABTD on earnings persistence and accruals persistence. This study used unbalanced panel data of listed companies in Indonesia Stock Exchange from 2006-2011. It is hypothesized that firms with LPABTD exhibit lower earnings and accruals persistence than other firms with Large Positive Normal Book-Tax Differences (LPNBTD. The results provide evidence which is consistent with the hypotheses. It is shown that firms with LPABTD exhibit lower earnings quality than other firms with LPNBTD.

  10. Standard and biological treatment in large vessel vasculitis: guidelines and current approaches.

    Science.gov (United States)

    Muratore, Francesco; Pipitone, Nicolò; Salvarani, Carlo

    2017-04-01

    Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.

  11. Post-treatment surveillance in a large cohort of patients with colon cancer.

    Science.gov (United States)

    Hu, Chung-Yuan; Delclos, George L; Chan, Wenyaw; Du, Xianglin L

    2011-05-01

    To determine how patients complied with different components of guideline-recommended post-treatment surveillance in a large nationwide population-based cohort of patients with colon cancer. Retrospective cohort study. We used the linked Surveillance, Epidemiology, and End Results-Medicare database to identify patients 66 years or older diagnosed as having stage I to stage III colon adenocarcinoma between January 2000 and June 2002 with a follow-up duration of at least 3.5 years. After tumor resection, patients who completed at least 2 office visits per year for 3 years, at least 2 carcinoembryonic antigen tests per year (in the first and second years of follow-up), and at least 1 colonoscopy within 3 years were defined as meeting the recommended post-treatment care. We identified 7348 patients, with a median follow-up duration of 59 months. Adherence to post-treatment surveillance was 83.9% for office visits, 29.4% for carcinoembryonic antigen tests, and 74.3% for colonoscopy. Younger age at diagnosis, white race/ethnicity, married status, advanced tumor stage, fewer comorbidities, and chemotherapy use were significantly associated with guideline adherence. Adherence to colon cancer posttreatment surveillance was low, although proportions of patients complying with office visits and colonoscopy were reasonably high. Underlying reasons for noncompliance, which varied by type of service, may need further investigation.

  12. First treatment contact for ADHD: predictors of and gender differences in treatment seeking.

    Science.gov (United States)

    Dakwar, Elias; Levin, Frances R; Olfson, Mark; Wang, Shuai; Kerridge, Bradley; Blanco, Carlos

    2014-12-01

    For attention-deficit hyperactivity disorder (ADHD), treatment seeking is a critical first step in treatment initiation and remains insufficiently understood. The aims of this study were to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. Data were drawn from 2001 to 2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions, a two-wave face-to-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism (N=34,653). The lifetime cumulative probability of ADHD treatment seeking was estimated at 55%. Males identifying as African American, with less than 12 years of education, or paranoid personality disorder or in an older cohort (>30 years old) at the time of interview were more likely to experience delays, whereas males with comorbid alcohol dependence, dysthymic disorder, borderline personality disorder, or histrionic personality disorder were less likely. Among females, older age (>44 years) was the only predictor of a delay to first treatment seeking, whereas bipolar disorder was associated with more rapid treatment seeking. Age of onset had opposite effects on treatment-seeking delays by gender; males but not females with early-onset ADHD were more likely to experience treatment-seeking delays. A large proportion of persons with ADHD do not seek treatment. Furthermore, treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry. Future research should explore how to facilitate early access to treatment for individuals with ADHD.

  13. Overview of a large-scale bioremediation soil treatment project

    International Nuclear Information System (INIS)

    Stechmann, R.

    1991-01-01

    How long does it take to remediate 290,000 yd 3 of impacted soil containing an average total petroleum hydrocarbon concentration of 3,000 ppm? Approximately 15 months from start to end of treatment using bioremediation. Mittelhauser was retained by the seller of the property (a major oil company) as technical manager to supervise remediation of a 45-ac parcel in the Los Angeles basin. Mittelhauser completed site characterization, negotiated clean-up levels with the regulatory agencies, and prepared the remedial action plan (RAP) with which the treatment approach was approved and permitted. The RAP outlined the excavation, treatment, and recompaction procedures for the impacted soil resulting from leakage of bunker fuel oil from a large surface impoundment. The impacted soil was treated on site in unline Land Treatment Units (LTUs) in 18-in.-thick lifts. Due to space restraints, multiple lifts site. The native microbial population was cultivated using soil stabilization mixing equipment with the application of water and agricultural grade fertilizers. Costs on this multimillion dollar project are broken down as follows: general contractor cost (47%), bioremediation subcontractor cost (35%), site characterization (10%), technical management (7%), analytical services (3%), RAP preparation and permitting (1%), and civil engineering subcontractor cost (1%). Start-up of field work could have been severely impacted by the existence of Red Fox habitation. The foxes were successfully relocated prior to start of field work

  14. Carbon Footprint Analyses of Mainstream Wastewater Treatment Technologies under Different Sludge Treatment Scenarios in China

    Directory of Open Access Journals (Sweden)

    Chunyan Chai

    2015-03-01

    Full Text Available With rapid urbanization and infrastructure investment, wastewater treatment plants (WWTPs in Chinese cities are putting increased pressure on energy consumption and exacerbating greenhouse gas (GHG emissions. A carbon footprint is provided as a tool to quantify the life cycle GHG emissions and identify opportunities to reduce climate change impacts. This study examined three mainstream wastewater treatment technologies: Anaerobic–Anoxic–Oxic (A–A–O, Sequencing Batch Reactor (SBR and Oxygen Ditch, considering four different sludge treatment alternatives for small-to-medium-sized WWTPs. Following the life cycle approach, process design data and emission factors were used by the model to calculate the carbon footprint. Results found that direct emissions of CO2 and N2O, and indirect emissions of electricity use, are significant contributors to the carbon footprint. Although sludge anaerobic digestion and biogas recovery could significantly contribute to emission reduction, it was less beneficial for Oxygen Ditch than the other two treatment technologies due to its low sludge production. The influence of choosing “high risk” or “low risk” N2O emission factors on the carbon footprint was also investigated in this study. Oxygen Ditch was assessed as “low risk” of N2O emissions while SBR was “high risk”. The carbon footprint of A–A–O with sludge anaerobic digestion and energy recovery was more resilient to changes of N2O emission factors and control of N2O emissions, though process design parameters (i.e., effluent total nitrogen (TN concentration, mixed-liquor recycle (MLR rates and solids retention time (SRT and operation conditions (i.e., nitrite concentration are critical for reducing carbon footprint of SBR. Analyses of carbon footprints suggested that aerobic treatment of sludge not only favors the generation of large amounts of CO2, but also the emissions of N2O, so the rationale of reducing aerobic treatment and

  15. Risk comparison of different treatment and disposal strategies of high level liquid radioactive waste

    International Nuclear Information System (INIS)

    Fang Dong

    1997-01-01

    The risk of different treatment and disposal strategies of high level liquid radioactive waste from spent fuel reprocessing is estimated and compared. The conclusions obtained are that risk difference from these strategies is very small and high level liquid waste can be reduced to middle and low level waste, if the decontamination factor for 99 Tc is large enough, which is the largest risk contributor in the high level radioactive waste from spent fuel reprocessing. It is also shown that the risk of high level radioactive waste could be reduced by the technical strategy of combining partitioning and transmutation

  16. Do drug treatment facilities increase clients' exposure to potential neighborhood-level triggers for relapse? A small-area assessment of a large, public treatment system.

    Science.gov (United States)

    Jacobson, Jerry O

    2006-03-01

    Research on drug treatment facility locations has focused narrowly on the issue of geographic proximity to clients. We argue that neighborhood conditions should also enter into the facility location decision and illustrate a formal assessment of neighborhood conditions at facilities in a large, metropolitan area, taking into account conditions clients already face at home. We discuss choice and construction of small-area measures relevant to the drug treatment context, including drug activity, disadvantage, and violence as well as statistical comparisons of clients' home and treatment locations with respect to these measures. Analysis of 22,707 clients discharged from 494 community-based outpatient and residential treatment facilities that received public funds during 1998-2000 in Los Angeles County revealed no significant mean differences between home and treatment neighborhoods. However, up to 20% of clients are exposed to markedly higher levels of disadvantage, violence, or drug activity where they attend treatment than where they live, suggesting that it is not uncommon for treatment locations to increase clients' exposure to potential environmental triggers for relapse. Whereas on average both home and treatment locations exhibit higher levels of these measures than the household locations of the general population, substantial variability in public treatment clients' home neighborhoods calls into question the notion that they hail exclusively from poor, high drug activity areas. Shortcomings of measures available for neighborhood assessment of treatment locations and implications of the findings for other areas of treatment research are also discussed.

  17. Large granular lymphocyte leukemia: natural history and response to treatment.

    LENUS (Irish Health Repository)

    Fortune, Anne F

    2012-02-01

    Large granular lymphocyte leukemia (T-LGL) is an indolent T lymphoproliferative disorder that was difficult to diagnose with certainty until clonality testing of the T cell receptor gene became routinely available. We studied the natural history and response to treatment in 25 consecutive patients with T-LGL diagnosed between 2004 and 2008 in which the diagnosis was confirmed by molecular analysis, to define an effective treatment algorithm. The median age at diagnosis was 61 years (range 27-78), with a male to female ratio of 1:1.8 and presenting features of fatigue (n = 13), recurrent infections (n = 9), and\\/or abnormal blood counts (n = 5). Thirteen patients with symptomatic disease were treated as follows: pentostatin (nine patients), cyclosporine (six patients), methotrexate (three patients), and alemtuzumab in two patients in whom pentostatin was ineffective. Pentostatin was the single most effective therapy, with a response rate of 75% and minimal toxicity. The overall survival (OS) and progression-free survival (PFS) 37 months from diagnosis were 80% and 52%, respectively. Treatment of T-LGL should be reserved for patients with symptomatic disease, but in this series, pentostatin treatment was less toxic and more effective than cyclosporine or methotrexate.

  18. Comparative Analysis of Different Protocols to Manage Large Scale Networks

    OpenAIRE

    Anil Rao Pimplapure; Dr Jayant Dubey; Prashant Sen

    2013-01-01

    In recent year the numbers, complexity and size is increased in Large Scale Network. The best example of Large Scale Network is Internet, and recently once are Data-centers in Cloud Environment. In this process, involvement of several management tasks such as traffic monitoring, security and performance optimization is big task for Network Administrator. This research reports study the different protocols i.e. conventional protocols like Simple Network Management Protocol and newly Gossip bas...

  19. Thermal treatments of solid wastes. Different strategies for related pollutant management

    Energy Technology Data Exchange (ETDEWEB)

    Nicolella, C.; Convertti, A.; Rovatti, M. [Genoa Univ. (Italy); Boschi, R.; Cozzani, V.; Tognotti, L. [Pisa Univ. (Italy). Dept. of Chemistry Engineering

    1995-12-31

    Thermal treatment of solid wastes present different advantages/disadvantages as far as recovery and emissions concerns. They provide a captive energy source; reduce the quantity of waste to be landfilled; there are limited by-product and pollutant generating problems. Combined treatment of solid wastes (incineration, pyrolysis, gasification) have been considered to evaluate the energy recovery as well as the quality and the amount of pollutants potentially generated by the combined processes. Direct incineration of MSW, RDF or specific industrial wastes represents a viable, definitive, low environmental impact solution for most refuses. Treatment of emissions can be efficiently achieved by dry or wet processes. Nowadays abatement technologies are able to provide emissions within the guidelines of EEC countries. Problems arise when wastes contain large amount of chlorinated compounds (for example PVC) and/or heavy rentals: incineration may be not best way to be pursued. The general aim of the research program carried out by ISTIC (Genova), and Department of Chemical Engineering (Pisa) is to gain fundamental information on pyrolysis of refuse materials and to study the possible industrial application of these processes. Possible solutions have been studied in terms of material and energy balances, in order to verify the feasibility of combined treatments. Here, preliminary results are given on a two-stage process (low temperature pyrolysis (LTP) followed by incineration or gasification/pyrolysis) for treating specific wastes. (author)

  20. Thermal treatments of solid wastes. Different strategies for related pollutant management

    Energy Technology Data Exchange (ETDEWEB)

    Nicolella, C; Convertti, A; Rovatti, M [Genoa Univ. (Italy); Boschi, R; Cozzani, V; Tognotti, L [Pisa Univ. (Italy). Dept. of Chemistry Engineering

    1996-12-31

    Thermal treatment of solid wastes present different advantages/disadvantages as far as recovery and emissions concerns. They provide a captive energy source; reduce the quantity of waste to be landfilled; there are limited by-product and pollutant generating problems. Combined treatment of solid wastes (incineration, pyrolysis, gasification) have been considered to evaluate the energy recovery as well as the quality and the amount of pollutants potentially generated by the combined processes. Direct incineration of MSW, RDF or specific industrial wastes represents a viable, definitive, low environmental impact solution for most refuses. Treatment of emissions can be efficiently achieved by dry or wet processes. Nowadays abatement technologies are able to provide emissions within the guidelines of EEC countries. Problems arise when wastes contain large amount of chlorinated compounds (for example PVC) and/or heavy rentals: incineration may be not best way to be pursued. The general aim of the research program carried out by ISTIC (Genova), and Department of Chemical Engineering (Pisa) is to gain fundamental information on pyrolysis of refuse materials and to study the possible industrial application of these processes. Possible solutions have been studied in terms of material and energy balances, in order to verify the feasibility of combined treatments. Here, preliminary results are given on a two-stage process (low temperature pyrolysis (LTP) followed by incineration or gasification/pyrolysis) for treating specific wastes. (author)

  1. Study of heat treatment parameters for large-scale hydraulic steel gate track

    Directory of Open Access Journals (Sweden)

    Ping-zhou Cao

    2013-10-01

    Full Text Available In order to enhance external hardness and strength, a large-scale hydraulic gate track should go through heat treatment. The current design method of hydraulic gate wheels and tracks is based on Hertz contact linear elastic theory, and does not take into account the changes in mechanical properties of materials caused by heat treatment. In this study, the heat treatment parameters were designed and analyzed according to the bearing mechanisms of the wheel and track. The quenching process of the track was simulated by the ANSYS program, and the temperature variation, residual stress, and deformation were obtained and analyzed. The metallurgical structure field after heat treatment was predicted by the method based on time-temperature-transformation (TTT curves. The results show that the analysis method and designed track heat treatment process are feasible, and can provide a reference for practical projects.

  2. Performance of informative priors skeptical of large treatment effects in clinical trials: A simulation study.

    Science.gov (United States)

    Pedroza, Claudia; Han, Weilu; Thanh Truong, Van Thi; Green, Charles; Tyson, Jon E

    2018-01-01

    One of the main advantages of Bayesian analyses of clinical trials is their ability to formally incorporate skepticism about large treatment effects through the use of informative priors. We conducted a simulation study to assess the performance of informative normal, Student- t, and beta distributions in estimating relative risk (RR) or odds ratio (OR) for binary outcomes. Simulation scenarios varied the prior standard deviation (SD; level of skepticism of large treatment effects), outcome rate in the control group, true treatment effect, and sample size. We compared the priors with regards to bias, mean squared error (MSE), and coverage of 95% credible intervals. Simulation results show that the prior SD influenced the posterior to a greater degree than the particular distributional form of the prior. For RR, priors with a 95% interval of 0.50-2.0 performed well in terms of bias, MSE, and coverage under most scenarios. For OR, priors with a wider 95% interval of 0.23-4.35 had good performance. We recommend the use of informative priors that exclude implausibly large treatment effects in analyses of clinical trials, particularly for major outcomes such as mortality.

  3. Large central lesions compressing the hypothalamus and brainstem. Operative approaches and combination treatment with radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Hiroshi K.; Negishi, Masatoshi; Kohga, Hideaki; Hirato, Masafumi; Ohye, Chihiro [Gunma Univ., Maebashi (Japan). School of Medicine; Shibazaki, Tohru

    1998-09-01

    A major aim of minimally invasive neurosurgery is to preserve function in the brain and cranial nerves. Based on previous results of radiosurgery for central lesions (19 craniopharyngiomas, 46 pituitary adenomas, 9 meningeal tumors), combined micro- and/or radiosurgery was applied for large lesions compressing the hypothalamus and/or brainstem. A basal interhemispheric approach via superomedial orbitotomy or a transcallosal-transforaminal approach was used for these large tumors. Tumors left behind in the hypothalamus or cavernous sinus were treated with radiosurgery using a gamma unit. Preoperative hypothalamo-pituitary functions were preserved in most of these patients. Radiosurgical results were evaluated in patients followed for more than 2 years after treatment. All 9 craniopharyngiomas decreased in size after radiosurgery, although a second treatment was required in 4 patients. All 20 pituitary adenomas were stable or decreased in size and 5 of 7 functioning adenomas showed normalized values of hormones in the serum. All 3 meningeal tumors were stable or decreased in size after treatment. No cavernous sinus symptoms developed after radiosurgery. We conclude that combined micro- and radio-neurosurgery is an effective and less invasive treatment for large central lesions compressing the hypothalamus and brainstem. (author)

  4. Large central lesions compressing the hypothalamus and brainstem. Operative approaches and combination treatment with radiosurgery

    International Nuclear Information System (INIS)

    Inoue, Hiroshi K.; Negishi, Masatoshi; Kohga, Hideaki; Hirato, Masafumi; Ohye, Chihiro; Shibazaki, Tohru

    1998-01-01

    A major aim of minimally invasive neurosurgery is to preserve function in the brain and cranial nerves. Based on previous results of radiosurgery for central lesions (19 craniopharyngiomas, 46 pituitary adenomas, 9 meningeal tumors), combined micro- and/or radiosurgery was applied for large lesions compressing the hypothalamus and/or brainstem. A basal interhemispheric approach via superomedial orbitotomy or a transcallosal-transforaminal approach was used for these large tumors. Tumors left behind in the hypothalamus or cavernous sinus were treated with radiosurgery using a gamma unit. Preoperative hypothalamo-pituitary functions were preserved in most of these patients. Radiosurgical results were evaluated in patients followed for more than 2 years after treatment. All 9 craniopharyngiomas decreased in size after radiosurgery, although a second treatment was required in 4 patients. All 20 pituitary adenomas were stable or decreased in size and 5 of 7 functioning adenomas showed normalized values of hormones in the serum. All 3 meningeal tumors were stable or decreased in size after treatment. No cavernous sinus symptoms developed after radiosurgery. We conclude that combined micro- and radio-neurosurgery is an effective and less invasive treatment for large central lesions compressing the hypothalamus and brainstem. (author)

  5. Differences of protein profile before and after orthodontic treatment

    Science.gov (United States)

    Nasri, Farah Amirah Mohd; Wahab, Rohaya Megat Abdul; Karsani, Saiful Anuar; Ariffin, Shahrul Hisham Zainal

    2016-11-01

    Mechanical forces in orthodontic treatment used to treat malocclusion can cause inflamed gingival tissue and the process of tooth movement may resorb dental root. Root resorption is an iatrogenic effect of orthodontic treatment but it can be monitored using protein biomarker. This study aims to investigate the differences of protein profile before and after orthodontic treatment using different staining methods. Human gingival crevicular fluid and saliva were collected from orthodontic patients before and after treatment. Protein profile were observed using SDS-PAGE. Our study shows down regulation of proteins after 3 months of treatment. Hence, there are potential values from this study to aid in investigation for specific biomarkers for root resorption.

  6. Efficacy of different treatment methods for ADHD and associated ...

    African Journals Online (AJOL)

    This study investigated the efficacy of different treatment methods for Attention Deficit Hyperactivity Disorder (ADHD) in improving attention, and neuromotor difficulties. Children (N=95, 60 boys; 35 girls) with a mean age of 6.99+0.64 years were divided into five groups that represented different treatment modes: ...

  7. Opiate addicts in and outside of treatment; Different populations?

    NARCIS (Netherlands)

    M.A. Goossensen (Anne)

    1997-01-01

    textabstractThe core of this study is related to the insight that the population of opiate addicls is quite an invisible group. Some paris of this group can be identified at treatment institutions and in prisons. However, a large pari of the opiate addicls is hard to detect. This is because

  8. RESOURCE SAVING TECHNOLOGICAL PROCESS OF LARGE-SIZE DIE THERMAL TREATMENT

    Directory of Open Access Journals (Sweden)

    L. A. Glazkov

    2009-01-01

    Full Text Available The given paper presents a development of a technological process pertaining to hardening large-size parts made of die steel. The proposed process applies a water-air mixture instead of a conventional hardening medium that is industrial oil.While developing this new technological process it has been necessary to solve the following problems: reduction of thermal treatment duration, reduction of power resource expense (natural gas and mineral oil, elimination of fire danger and increase of process ecological efficiency. 

  9. Gender differences in pathological gamblers seeking medication treatment.

    Science.gov (United States)

    Grant, Jon E; Kim, Suck Won

    2002-01-01

    Gender differences in pathological gambling disorder (PGD) have received little investigation. This study was constructed to detail the demographic and phenomenological differences in men and women with PGD. We assessed gender differences in 131 subjects with PGD who were evaluated in terms of demographic characteristics, clinical features of PGD, and treatment history. Seventy-eight (60%) subjects were women, and 53 (40%) were men. Men had an earlier age of onset of gambling behavior, while women progressed to pathological gambling sooner after beginning to gamble. In terms of gambling behavior, men were more likely to engage in blackjack, cards, sporting events, and the track, whereas women played slot machines and bingo. Women reported that loneliness was the major trigger to gambling, while men were more likely to gamble secondary to sensory stimuli. Although men were as likely as women to have filed bankruptcy because of gambling, women were more likely to have written bad checks and men were more likely to have lost significant savings. Both groups were equally likely to seek treatment, but Gamblers Anonymous (GA) and outpatient therapy were reported equally ineffective in reducing gambling symptoms. There appear to be some gender differences in the clinical features of PGD, and these differences may have treatment implications. Copyright 2002 by W.B. Saunders Company

  10. Process evaluation of treatment times in a large radiotherapy department

    International Nuclear Information System (INIS)

    Beech, R.; Burgess, K.; Stratford, J.

    2016-01-01

    Purpose/objective: The Department of Health (DH) recognises access to appropriate and timely radiotherapy (RT) services as crucial in improving cancer patient outcomes, especially when facing a predicted increase in cancer diagnosis. There is a lack of ‘real-time’ data regarding daily demand of a linear accelerator, the impact of increasingly complex techniques on treatment times, and whether current scheduling reflects time needed for RT delivery, which would be valuable in highlighting current RT provision. Material/methods: A systematic quantitative process evaluation was undertaken in a large regional cancer centre, including a satellite centre, between January and April 2014. Data collected included treatment room-occupancy time, RT site, RT and verification technique and patient mobility status. Data was analysed descriptively; average room-occupancy times were calculated for RT techniques and compared to historical standardised treatment times within the department. Results: Room-occupancy was recorded for over 1300 fractions, over 50% of which overran their allotted treatment time. In a focused sample of 16 common techniques, 10 overran their allocated timeslots. Verification increased room-occupancy by six minutes (50%) over non-imaging. Treatments for patients requiring mobility assistance took four minutes (29%) longer. Conclusion: The majority of treatments overran their standardised timeslots. Although technique advancement has reduced RT delivery time, room-occupancy has not necessarily decreased. Verification increases room-occupancy and needs to be considered when moving towards adaptive techniques. Mobility affects room-occupancy and will become increasingly significant in an ageing population. This evaluation assesses validity of current treatment times in this department, and can be modified and repeated as necessary. - Highlights: • A process evaluation examined room-occupancy for various radiotherapy techniques. • Appointment lengths

  11. New analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program: do different treatments reflect different processes?

    Science.gov (United States)

    Herbert, Gregory L; Callahan, Jennifer; Ruggero, Camilo J; Murrell, Amy R

    2013-01-01

    To determine whether or not different therapies have distinct patterns of change, it is useful to investigate not only the end result of psychotherapy (outcome) but also the processes by which outcomes are attained. The present study subjected data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program to survival analyses to examine whether the process of psychotherapy, as conceptualized by the phase model, differed between psychotherapy treatment approaches. Few differences in terms of progression through phases of psychotherapy were identified between cognitive behavior therapy and interpersonal therapy. Additionally, results indicate that phases of psychotherapy may not represent discrete, sequentially invariant processes.

  12. A control study of TACE using high-dosed and routine-dosed iodized oil as a treatment of large hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Zhou Junmin; Zhan Jincheng; Zhang Zhenming

    2005-01-01

    Objective: To investigate the side effects and curative effect in high-dosed lipiodol-transcatheter arterial chemoembolization as a treatment of large hepatocellular carcinoma. Methods: 79 patients with unresectable hepatocellular carcinoma were treated by TACE, and divided into 2 groups. In group A, 39 patients with the tumor sized 7-18cm in diameter, routine-dosed, 10-20ml lipiodol was given in TACE. 40 patients were enrolled in the high-dosed group B, who were given more than 20ml iodized oil in TACE. Results: The First to third year survival rate of group A was 66.7%, 33.3%, 0% respectively,while in group B it was 75%, 45%, 7.5% respectively. The effective rate was 71.7% in Group A and 87.5% in Group B. There was a significant difference between both groups. There was no significant difference of critical side effects and liver function damage between group A and B. Conclusion: High-dosed lipiodol chemoembolization as a treatment of unresectable hepatocellular carcinoma is superior to the routine TACE, especially when the tumor is large and the liver function reserve is good. (authors)

  13. Treatment of Large Bulla Formation after Tattoo Removal with a Q-Switched Laser

    Science.gov (United States)

    Kartono, Francisca; Desai, Alpesh; Kaur, Ravneet R.; Desai, Tejas

    2010-01-01

    Widely considered the gold standard treatment option for tattoo removal, the use of Q-switched lasers may very rarely result in the formation of large bulla. While very disconcerting to patients, these lesions are easily managed and, with proper care, heal quickly with no long-term consequences. The authors present three cases of patients who had bullous reactions shortly after receiving Q-switched laser treatment of tattoo ink. Bullous formation in all three patients was treated successfully. PMID:20725537

  14. Three-dimensional patient setup errors at different treatment sites measured by the Tomotherapy megavoltage CT

    Energy Technology Data Exchange (ETDEWEB)

    Hui, S.K.; Lusczek, E.; Dusenbery, K. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Therapeutic Radiology - Radiation Oncology; DeFor, T. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Biostatistics and Informatics Core; Levitt, S. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Therapeutic Radiology - Radiation Oncology; Karolinska Institutet, Stockholm (Sweden). Dept. of Onkol-Patol

    2012-04-15

    Reduction of interfraction setup uncertainty is vital for assuring the accuracy of conformal radiotherapy. We report a systematic study of setup error to assess patients' three-dimensional (3D) localization at various treatment sites. Tomotherapy megavoltage CT (MVCT) images were scanned daily in 259 patients from 2005-2008. We analyzed 6,465 MVCT images to measure setup error for head and neck (H and N), chest/thorax, abdomen, prostate, legs, and total marrow irradiation (TMI). Statistical comparisons of the absolute displacements across sites and time were performed in rotation (R), lateral (x), craniocaudal (y), and vertical (z) directions. The global systematic errors were measured to be less than 3 mm in each direction with increasing order of errors for different sites: H and N, prostate, chest, pelvis, spine, legs, and TMI. The differences in displacements in the x, y, and z directions, and 3D average displacement between treatment sites were significant (p < 0.01). Overall improvement in patient localization with time (after 3-4 treatment fractions) was observed. Large displacement (> 5 mm) was observed in the 75{sup th} percentile of the patient groups for chest, pelvis, legs, and spine in the x and y direction in the second week of the treatment. MVCT imaging is essential for determining 3D setup error and to reduce uncertainty in localization at all anatomical locations. Setup error evaluation should be performed daily for all treatment regions, preferably for all treatment fractions. (orig.)

  15. Thermal oxidation of nuclear graphite: A large scale waste treatment option

    Science.gov (United States)

    Jones, Abbie N.; Marsden, Barry J.

    2017-01-01

    This study has investigated the laboratory scale thermal oxidation of nuclear graphite, as a proof-of-concept for the treatment and decommissioning of reactor cores on a larger industrial scale. If showed to be effective, this technology could have promising international significance with a considerable impact on the nuclear waste management problem currently facing many countries worldwide. The use of thermal treatment of such graphite waste is seen as advantageous since it will decouple the need for an operational Geological Disposal Facility (GDF). Particulate samples of Magnox Reactor Pile Grade-A (PGA) graphite, were oxidised in both air and 60% O2, over the temperature range 400–1200°C. Oxidation rates were found to increase with temperature, with a particular rise between 700–800°C, suggesting a change in oxidation mechanism. A second increase in oxidation rate was observed between 1000–1200°C and was found to correspond to a large increase in the CO/CO2 ratio, as confirmed through gas analysis. Increasing the oxidant flow rate gave a linear increase in oxidation rate, up to a certain point, and maximum rates of 23.3 and 69.6 mg / min for air and 60% O2 respectively were achieved at a flow of 250 ml / min and temperature of 1000°C. These promising results show that large-scale thermal treatment could be a potential option for the decommissioning of graphite cores, although the design of the plant would need careful consideration in order to achieve optimum efficiency and throughput. PMID:28793326

  16. Thermal oxidation of nuclear graphite: A large scale waste treatment option.

    Directory of Open Access Journals (Sweden)

    Alex Theodosiou

    Full Text Available This study has investigated the laboratory scale thermal oxidation of nuclear graphite, as a proof-of-concept for the treatment and decommissioning of reactor cores on a larger industrial scale. If showed to be effective, this technology could have promising international significance with a considerable impact on the nuclear waste management problem currently facing many countries worldwide. The use of thermal treatment of such graphite waste is seen as advantageous since it will decouple the need for an operational Geological Disposal Facility (GDF. Particulate samples of Magnox Reactor Pile Grade-A (PGA graphite, were oxidised in both air and 60% O2, over the temperature range 400-1200°C. Oxidation rates were found to increase with temperature, with a particular rise between 700-800°C, suggesting a change in oxidation mechanism. A second increase in oxidation rate was observed between 1000-1200°C and was found to correspond to a large increase in the CO/CO2 ratio, as confirmed through gas analysis. Increasing the oxidant flow rate gave a linear increase in oxidation rate, up to a certain point, and maximum rates of 23.3 and 69.6 mg / min for air and 60% O2 respectively were achieved at a flow of 250 ml / min and temperature of 1000°C. These promising results show that large-scale thermal treatment could be a potential option for the decommissioning of graphite cores, although the design of the plant would need careful consideration in order to achieve optimum efficiency and throughput.

  17. Hypopigmentation Induced by Frequent Low-Fluence, Large-Spot-Size QS Nd:YAG Laser Treatments.

    Science.gov (United States)

    Wong, Yisheng; Lee, Siong See Joyce; Goh, Chee Leok

    2015-12-01

    The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.

  18. Dosimetric Comparison Between 3DCRT and IMRT Using Different Multileaf Collimators in the Treatment of Brain Tumors

    International Nuclear Information System (INIS)

    Ding Meisong; Newman, Francis M.S.; Chen Changhu; Stuhr, Kelly; Gaspar, Laurie E.

    2009-01-01

    We investigated the differences between 3-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT), and the impact of collimator leaf-width on IMRT plans for the treatment of nonspherical brain tumors. Eight patients treated by 3DCRT with Novalis were selected. We developed 3 IMRT plans with different multileaf collimators (Novalis m3, Varian MLC-120, and Varian MLC-80) with the same treatment margins, number of beams, and gantry positions as in the 3DCRT treatment plans. Treatment planning utilized the BrainLAB treatment planning system. For each patient, the dose constraints and optimization parameters remained identical for all plans. The heterogeneity index, the percentage target coverage, critical structures, and normal tissue volumes receiving 50% of the prescription dose were calculated to compare the dosimetric difference. Equivalent uniform dose (EUD) and tumor control probability (TCP) were also introduced to evaluate the radiobiological effect for different plans. We found that IMRT significantly improved the target dose homogeneity compared to the 3DCRT. However, IMRT showed the same radiobiological effect as 3DCRT. For the brain tumors adjacent to (or partially overlapping with) critical structures, IMRT dramatically spared the volume of the critical structures to be irradiated. In IMRT plans, the smaller collimator leaf width could reduce the volume of critical structures irradiated to the 50% level for those partially overlapping with the brain tumors. For relatively large and spherical brain tumors, the smaller collimator leaf widths give no significant benefit

  19. Carbon footprint of four different wastewater treatment scenarios

    Science.gov (United States)

    Diafarou, Moumouni; Mariska, Ronteltap, ,, Dr.; Damir, Brdjanovic, ,, Prof.

    2014-05-01

    Since the era of industrialization, concentrations of greenhouse gases (GHGs) have tremendously increased in the atmosphere, as a result of the extensive use of fossil fuels, deforestation, improper waste management, transport, and other economic activities (Boer, 2008).This has led to a great accumulation of greenhouse gases, forming a blanket around the Earth which contributes in the so-called "Global Warming". Over the last decades, wastewater treatment has developed strongly and has become a very important asset in mitigating the impact of domestic and industrial effluents on the environment. There are many different forms of wastewater treatment, and one of the most effective treatment technology in terms COD, N and P removal, activated sludge is often criticized for its high energy use. Some other treatment concepts have a more "green" image, but it is not clear whether this image is justified based on their greenhouse gas emission. This study focuses on the estimation of GHG emissions of four different wastewater treatment configurations, both conventional and innovative systems namely: (1) Harnaschpolder, (2) Sneek, (3) EIER-Ouaga and (4) Siddhipur. This analysis is based on COD mass balance, the Intergovernmental Panel on Climate Change (IPCC) 2006 guidelines for estimating CO2 and CH4, and literature review. Furthermore, the energy requirements for each of the systems were estimated based on energy survey. The study showed that an estimated daily average of 87 g of CO2 equivalent, ranging between 38 to 192 g, was derived to be the per capita CO2 emission for the four different wastewater treatment scenarios. Despite the fact that no electrical energy is used in the treatment process, the GHG emission from EIER Ouaga anaerobic pond systems is found to be the highest compared to the three other scenarios analysed. It was estimated 80% higher than the most favourable scenario (Sneek). Moreover, the results indicate that the GHGs emitted from these WWTPs are

  20. Why do different criteria for 'cure' yield different conclusions in comparing two treatments for bacterial vaginosis?

    Science.gov (United States)

    Thomas, Katherine K; Sanchez, Sixto; Garcia, Patricia J; Holmes, King K

    2005-09-01

    The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules. We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment. Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure. Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.

  1. Dosimetric Effects Of Different Treatment Tables During Radiotherapy

    International Nuclear Information System (INIS)

    Murkovic, M.; Grego, T.; Bibic, J.

    2015-01-01

    The aim of our study was to measure the effect of mega-voltage photon beam attenuation when treating patients through carbon fibre treatment table with and without the carbon laminate base plate on it. We also examined the ability of XiO treatment planning system in modelling this effect. Direct attenuation measurements were made for two treatment tables, Siemens TxT 550 treatment table with TT-A table top and Elekta Precise table with iBEAM evo table top. On both treatment tables we used Orfit Base Plate (32301). Measurements were taken for two photon energies (6 MV and 18 MV), at two different field sizes (5 x 5 cm 2 and 10 x 10 cm 2 ) and different gantry angles in 50 intervals using stationary water phantom and Farmer type ionization chamber. These values were compared to values calculated in XiO. In order to account for the effect of table and base plate during treatment planning in XiO, customized table and base plate templates were develop in Focal planning system. To construct these customized templates, table and base plate contours as well as respective relative electron density's to water were obtained on CT scanner. The largest attenuation effect was seen for oblique treatment angles using low energy and small field sizes, 6.6 percent for the Elekta table top and 8.4 percent for Siemens table top. In this paper we show that customized table and base plate templates introduced in the patient treatment plan can accurately model the attenuation due to their presence to within 0.3 percent. Since dose modifications due to such carbon fiber accessories can be significant, it can be concluded that introduction of customized table and base plate templates into TPS brings an important improvement to patient treatment planning, and should be included in dose calculations whenever possible. (author).

  2. Large-scale experience with biological treatment of contaminated soil

    International Nuclear Information System (INIS)

    Schulz-Berendt, V.; Poetzsch, E.

    1995-01-01

    The efficiency of biological methods for the cleanup of soil contaminated with total petroleum hydrocarbons (TPH) and polycyclic aromatic hydrocarbons (PAH) was demonstrated by a large-scale example in which 38,000 tons of TPH- and PAH-polluted soil was treated onsite with the TERRAFERM reg-sign degradation system to reach the target values of 300 mg/kg TPH and 5 mg/kg PAH. Detection of the ecotoxicological potential (Microtox reg-sign assay) showed a significant decrease during the remediation. Low concentrations of PAH in the ground were treated by an in situ technology. The in situ treatment was combined with mechanical measures (slurry wall) to prevent the contamination from dispersing from the site

  3. Spatiotemporal Fractionation Schemes for Irradiating Large Cerebral Arteriovenous Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Unkelbach, Jan, E-mail: junkelbach@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Bussière, Marc R. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Chapman, Paul H. [Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Loeffler, Jay S.; Shih, Helen A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-07-01

    Purpose: To optimally exploit fractionation effects in the context of radiosurgery treatments of large cerebral arteriovenous malformations (AVMs). In current practice, fractionated treatments divide the dose evenly into several fractions, which generally leads to low obliteration rates. In this work, we investigate the potential benefit of delivering distinct dose distributions in different fractions. Methods and Materials: Five patients with large cerebral AVMs were reviewed and replanned for intensity modulated arc therapy delivered with conventional photon beams. Treatment plans allowing for different dose distributions in all fractions were obtained by performing treatment plan optimization based on the cumulative biologically effective dose delivered at the end of treatment. Results: We show that distinct treatment plans can be designed for different fractions, such that high single-fraction doses are delivered to complementary parts of the AVM. All plans create a similar dose bath in the surrounding normal brain and thereby exploit the fractionation effect. This partial hypofractionation in the AVM along with fractionation in normal brain achieves a net improvement of the therapeutic ratio. We show that a biological dose reduction of approximately 10% in the healthy brain can be achieved compared with reference treatment schedules that deliver the same dose distribution in all fractions. Conclusions: Boosting complementary parts of the target volume in different fractions may provide a therapeutic advantage in fractionated radiosurgery treatments of large cerebral AVMs. The strategy allows for a mean dose reduction in normal brain that may be valuable for a patient population with an otherwise normal life expectancy.

  4. Large cavernous hemangioma of the adrenal gland: Laparoscopic treatment. Report of a case

    Directory of Open Access Journals (Sweden)

    A. Agrusa

    2015-01-01

    Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of diagnosis of benign lesions. In this case report we discussed a large adrenal cavernous hemangioma treated with laparoscopic approach. Fundamental is the study of preoperative endocrine disorders and radiologic findings to exclude signs of malignancy.

  5. [Effects of application of pulse contour cardiac output monitoring technology in early treatment of patients with large area burns].

    Science.gov (United States)

    Wang, D Y; Xie, W G; Xi, M M; Li, Z; Wang, B

    2018-01-20

    Objective: To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Methods: Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample t test and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis. Results: (1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 ( F =7.428, P 0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 ( F =7.863, P 0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 ( F =0.704, P >0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value ( t =-3.112, -3.554, -2.969, -2.450, -2.476, P 0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 ( F =1.859, P 0.05). (5) The fluid infusion

  6. Comparison of treatments of steep and shoot generated by different inverse planning systems

    International Nuclear Information System (INIS)

    Perez Moreno, J. M.; Zucca Aparicio, D.; Fernandez Leton, P.; Garcia Ruiz-Zorrilla, J.; Minambres Moro, A.

    2011-01-01

    The problem of IMRT treatments with the technique Steep and Shoot or static is the number of segments and monitor units used in the treatment. These parameters depend largely on the inverse planning system which determines treatment. Are evaluated three commercial planning systems, with each one performing clinical dosimetry for the same series of patients. Dosimetric results are compared, UM calculated and number of segments.

  7. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores.

    Science.gov (United States)

    Cho, Soo Ick; Chung, Bo Young; Choi, Min Gyu; Baek, Ji Hwoon; Cho, Hee Jin; Park, Chun Wook; Lee, Cheol Heon; Kim, Hye One

    2012-07-01

    Fractional technology overcomes the problems of ablative lasers, such as inaccurate depth control and damage to the epidermis. Minimally invasive fractional radiofrequency microneedle devices allow for more-selective heating of the dermis. To evaluate the clinical efficacy of fractional radiofrequency microneedle (ERM) treatment in acne scars and large facial pores. Thirty patients with acne scars and large facial pores were enrolled. Bipolar radiofrequency energy was delivered to the skin through the electrodes of the FRM device. Skin lesions were evaluated according to grade of acne scars, Investigator Global Assessment of large pores, skin surface roughness, transepidermal water loss (TEWL), dermal density, microscopic and composite image, sebum measurement, and questionnaires regarding patient satisfaction. The grade of acne scars and Investigator Global Assessment of large pores improved in more than 70% of all patients. Skin surface roughness, dermal density, and microscopic and composite images also improved, whereas TEWL and sebum measurement did not change. Clinical improvement from FRM treatment appeared to be related to dermal matrix regeneration. FRM treatment may be effective in improving acne scars and facial pores. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  8. Vapor and healing treatment for CH3NH3PbI3-xClx films toward large-area perovskite solar cells

    Science.gov (United States)

    Gouda, Laxman; Gottesman, Ronen; Tirosh, Shay; Haltzi, Eynav; Hu, Jiangang; Ginsburg, Adam; Keller, David A.; Bouhadana, Yaniv; Zaban, Arie

    2016-03-01

    Hybrid methyl-ammonium lead trihalide perovskites are promising low-cost materials for use in solar cells and other optoelectronic applications. With a certified photovoltaic conversion efficiency record of 20.1%, scale-up for commercial purposes is already underway. However, preparation of large-area perovskite films remains a challenge, and films of perovskites on large electrodes suffer from non-uniform performance. Thus, production and characterization of the lateral uniformity of large-area films is a crucial step towards scale-up of devices. In this paper, we present a reproducible method for improving the lateral uniformity and performance of large-area perovskite solar cells (32 cm2). The method is based on methyl-ammonium iodide (MAI) vapor treatment as a new step in the sequential deposition of perovskite films. Following the MAI vapor treatment, we used high throughput techniques to map the photovoltaic performance throughout the large-area device. The lateral uniformity and performance of all photovoltaic parameters (Voc, Jsc, Fill Factor, Photo-conversion efficiency) increased, with an overall improved photo-conversion efficiency of ~100% following a vapor treatment at 140 °C. Based on XRD and photoluminescence measurements, We propose that the MAI treatment promotes a ``healing effect'' to the perovskite film which increases the lateral uniformity across the large-area solar cell. Thus, the straightforward MAI vapor treatment is highly beneficial for large scale commercialization of perovskite solar cells, regardless of the specific deposition method.Hybrid methyl-ammonium lead trihalide perovskites are promising low-cost materials for use in solar cells and other optoelectronic applications. With a certified photovoltaic conversion efficiency record of 20.1%, scale-up for commercial purposes is already underway. However, preparation of large-area perovskite films remains a challenge, and films of perovskites on large electrodes suffer from non

  9. Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma

    International Nuclear Information System (INIS)

    Inaba, Koji; Morota, Madoka; Mayahara, Hiroshi; Ito, Yoshinori; Sumi, Minako; Uno, Takashi; Itami, Jun; Kushima, Ryoji; Murakami, Naoya; Kuroda, Yuuki; Harada, Ken; Kitaguchi, Mayuka; Yoshio, Kotaro; Sekii, Shuhei; Takahashi, Kana

    2013-01-01

    There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma. The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population. There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma. There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma

  10. Interpreting small treatment differences from quality of life data in cancer trials: an alternative measure of treatment benefit and effect size for the EORTC-QLQ-C30.

    Science.gov (United States)

    Khan, Iftekhar; Bashir, Zahid; Forster, Martin

    2015-11-14

    The EORTC-QLQ-C30 is a widely used health related quality of life (HRQoL) questionnaire in lung cancer patients. Small HRQoL treatment effects are often reported as mean differences (MDs) between treatments, which are rarely justified or understood by patients and clinicians. An alternative approach using odds ratios (OR) for reporting effects is proposed. This may offer advantages including facilitating alignment between patient and clinician understanding of HRQoL effects. Data from six CRUK sponsored randomized controlled lung cancer trials (2 small cell and 4 in non-small cell, in 2909 patients) were used to HRQoL effects. Results from Beta-Binomial (BB) standard mixed effects were compared. Preferences for ORs vs MDs were determined and Time to Deterioration (TD) was also compared. HRQoL effects using ORs offered coherent interpretations: MDs >0 resulted in ORs >1 and vice versa; effect sizes were classified as 'Trivial' if the OR was between 1 ± 0.05 (i.e. 0.95 to 1.05); 'Small': for 1 ± 0.1; 'Medium': 1 ± 0.2 and 'Large': OR 1.20. Small HRQoL effects on the MD scale may translate to important treatment differences on the OR scale: for example, a worsening in symptoms (MD) by 2.6 points (p = 0.1314) would be a 17 % deterioration (p small ORs are unlikely to yield large MDs because methods based on OR model skewed data well. Initial evidence also suggests oncologists prefer ORs over MDs since interpretation is similar to hazard ratios. Reporting HRQoL benefits as MDs can be misleading. Estimates of HRQoL treatment effects in terms of ORs are preferred over MDs. Future analysis of QLQ-C30 and other HRQoL measures should consider reporting HRQoL treatment effects as ORs.

  11. Clinical characteristics and treatment results of large cell lung cancer-62 case report

    International Nuclear Information System (INIS)

    Chen Dongfu; Ou Guangfei; Cheng Guiyu; Zhou Zongmei; Zhao Lujun; Wang Lvhua

    2004-01-01

    Objective: Objective To evaluate the clinical characteristics and treatment results of 60 patients with large cell lung cancer (LCLC). Methods: All sixty-two patients were diagnosed histopathologically with 5 in stage I, 13 in stage II, 30 in stage III and 14 in stage IV. Forty-five patients received primary surgical resection with 38 radical resection and 7 palliative resection. Non-surgical treatment was given to 17 patients. Mediastinum and ipsilateral hilum were treated to the total dose of 40-60 Gy in 4-6 weeks in 16 patients as postoperative adjuvant radiotherapy. For patients treated by radiation alone, the primary tumor bed, bilateral mediastinum and ipsilateral hilum were treated to the total dose of 36-70 Gy in 4-7 weeks. Results: The overall 1-, 3- and 5- year survival rates were 25.7%, 15.4% and 11.6%, respectively with the median survival time of 11.6 months. In the radically resected patients, the 1-, 3- and 5-year survival rates and the median survival time were 51.3%, 24.7%, 24.7% and 13 months, compared to those of 0%, 0%, 0% and 2 months in the palliatively resected group. In non-surgical treatment group, the 1-, 3- and 5-year survival rates and the median survival time were 41.2%, 21.2%, 7.0% and 11 months, respectively. Conclusions: The prognosis of large cell lung cancer is poor due to high distant metastasis rate. The long-term survival rate after radical resection is worse than the other lung cancers, but similar to the non-surgical treatment. (authors)

  12. Biomass Morphology Subjected to Different Chemical Treatment

    Science.gov (United States)

    Sutan, Norsuzailina Mohamed; Masjida Mazlan, Siti; Taib, Siti Noor Linda; Lee, Delsye Teo Ching; Hassan, Alsidqi; Kudnie Sahari, Siti; Mohamad Said, Khairul Anwar; Rahman Sobuz, Habibur

    2018-03-01

    A growing interest of sugarcane bagasse fibre composite has been observed in recent years due to its attractiveness properties such as low specific weight, renewable source and producible with low investment at low cost. However, these materials have a low interfacial adhesion between fibre and matrix which lead to reduction in certain mechanical properties of the composite. To overcome this problem, studies show that certain chemical treatments on the surface of the fibres are some alternatives that significantly increase the adhesion reinforcement/matrix, in some cases improving its mechanical properties. The objective of this study was to evaluate the effect of different type of chemical treatment which are alkali and acid treatment on sugarcane bagasse fibre surface morphology. Seeking to improve the adhesion fibre matrix, the fibre has been treated with 5% of NaOH and 5% of HCL solution with added of bagasse fibre used in the range of 0% to 3% of cement weight respectively. Through SEM investigation, it is confirmed that chemical treatment helps to remove hemicelluloses from raw bagasse fiber as well as improved fibre matrix adhesion.

  13. [Influence of different surface treatments on porcelain surface topography].

    Science.gov (United States)

    Tai, Yinxia; Zhu, Xianchun; Sen, Yan; Liu, Chang; Zhang, Xian; Shi, Xueming

    2013-02-01

    To evaluate the influence of different surface treatments on porcelain surface topography. Metal ceramic prostheses in 6 groups were treated according to the different surface treatment methods, and the surface topography was observed through scanning electron microscope (SEM). Group A was the control one (untreated), group B was etched by 9.6% hydrofluoric acid(HF), group C was deglazed by grinding and then etched by 9.6% HF, group D was treated with Nd: YAG laser irradiation(0.75 W) and HF etching, group E was treated with Nd: YAG laser irradiation (1.05 W) and HF etching, and group F was treated with laser irradiation (1.45 W) and HF etching. Surface topography was different in different groups. A lot of inerratic cracks with the shapes of rhombuses and grid, and crater with a shape of circle were observed on the ceramic surface after treatment with energy parameters of 1.05 W Nd: YAG laser irradiation and 9.6% HF etching (group E). Surface topography showed a lot of concaves on the inner wall of the cracks, and the concaves with diameter of 1-5 microm could be observed on the inner wall of the holes, which had a diameter of 20 microm under SEM. The use of Nd: YAG laser irradiation with the energy parameters of 1.05 W and the HF with a concentration of 9.6% can evenly coarsen the porcelain surface, that is an effective surface treatment method.

  14. Endovascular treatment for acute ischaemic stroke with large vessel occlusion: the experience of a regional stroke service

    International Nuclear Information System (INIS)

    McCusker, M.W.; Robinson, S.; Looby, S.; Power, S.; Ti, J.P.; Grech, R.; Galvin, L.; O'Hare, A.; Brennan, P.; O'Kelly, P.; O'Brien, P.; Collins, R.; Dolan, E.; Williams, D.J.; Thornton, J.

    2015-01-01

    Aim: To report the experience of a regional stroke referral service with endovascular treatment for patients with acute ischaemic stroke (AIS) and large vessel occlusion. Materials and methods: A prospective review was undertaken of 93 consecutive cases receiving endovascular treatment for AIS over a 42-month period (January 2010 to June 2013). The National Institutes of Health Stroke Scale (NIHSS), location of large vessel occlusion, details of endovascular procedure, and degree of reperfusion achieved (Thrombolysis In Cerebral Infarction [TICI] score) were recorded. Mortality and functional outcome (modified Rankin Scale [mRS]) were measured at 90 days. Results: The mean patient age was 62 years (range 26–87 years). The mean NIHSS at presentation was 16 (range 6–29). All patients had confirmed proximal large-artery occlusion on computed tomography (CT) angiography: 87 in the anterior circulation, six in the posterior circulation. Of the 93 patients treated, 64 (69%) received intravenous thrombolysis. Successful reperfusion (TICI grade 2a to 3) was achieved in 80 (86%) cases. There were 13 (14%) cases of failed vessel recanalisation (TICI grade 0). Good functional outcome (mRS ≤2) was achieved in 51 (55%) cases. The 90-day mortality was 20 (22%) cases. Fifty-seven (61%) cases were transferred from outside centres. There was no significant increase in morbidity or mortality for transferred patients. Conclusion: Successful endovascular recanalisation can result in good functional outcomes for patients with AIS and large vessel occlusion. Our interventional neuroradiology service provides endovascular treatment as part of a regional stroke service without increase in morbidity or mortality for patients transferred from outside institutions. - Highlights: • Acute stoke patients may benefit from transfer to a specialist centre for endovascular treatment. • The authors offer endovascular treatment for suitable patients as part of a regional stroke service.

  15. Traditional Chinese Medicine in the Treatment of Reproductive Disorders of Large Animals in Asia

    Directory of Open Access Journals (Sweden)

    ZH Zuo, TY Zhang, J Chu, Q Zhang, YX Guo, ZQ Shen and C He

    2016-11-01

    Full Text Available Reproductive diseases have been a great threat in large animal herds. Before induction of western medicines, traditional Chinese medicine (TCM that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years. The foundational text of Chinese medicine dated back to 5th century to 3rd century BCE, humans in China began developing the TCM therapy by maintaining normal homeostasis and body functions. Traditional Chinese medicine prophylaxis is a very different strategy from that of the western medicine, targeting the balance of the diseased animals as compared to the single lesion. Traditional Chinese medicine was also applied to cure ruminant’s reproductive disorders such as infertility, abortion and retained placenta. With the increasing concerns of the antibiotic resistance and drug abuse happened, TCM has acquired re-recognition as compared to western medicines due to eco-friendly consumer-driven developments and less residue in food chains. More importantly, a growing number of active substances or extracts with the reliable efficacy are being identified, meanwhile, the quality control measures are satisfied in the large-scale production already. However, few TCM is recognized to be used internationally as the popular human medication. Even less TCM is prescribed legally to animal industry due to poor understanding TCM philosophy and lack of the right guidelines of the registration. This summary aims to elucidate the TCM application in the treatment of the reproductive disorder in large animals and offer alternative strategies for prophylaxis.

  16. Racial/ethnic differences in perception of need for mental health treatment in a US national sample.

    Science.gov (United States)

    Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C; Burnam, M Audrey; Hunter, Gerald P; Florez, Karen R; Collins, Rebecca L

    2017-08-01

    To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, -5.8% (95% CI -6.5, -5.2%), and largest among Hispanics interviewed in Spanish, -11.2% (95% CI -12.4, -10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, -23.3% (95% CI -34.9, -11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI -48.0, -17.2%). This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities.

  17. Effectiveness of different pre-treatments in recovering pre-burial isotopic ratios of charred plants.

    Science.gov (United States)

    Brinkkemper, O; Braadbaart, F; van Os, B; van Hoesel, A; van Brussel, A A N; Fernandes, R

    2018-02-15

    Isotopic analysis of archaeological charred plant remains offers useful archaeological information. However, adequate sample pre-treatment protocols may be necessary to provide a contamination-free isotopic signal while limiting sample loss and achieving a high throughput. Under these constraints, research was undertaken to compare the performance of different pre-treatment protocols. Charred archaeological plant material was selected for isotopic analysis (δ 13 C and δ 15 N values) by isotope ratio mass spectrometry from a variety of plant species, time periods and soil conditions. Preservation conditions and the effectiveness of cleaning protocols were assessed through Fourier transform infrared spectroscopy and X-ray fluorescence (XRF) spectrometry. An acid-base-acid protocol, successfully employed in radiocarbon dating, was used to define a contamination-free isotopic reference. Acid-base-acid isotopic measurements were compared with those obtained from untreated material and an acid-only protocol. The isotopic signals of untreated material and the acid-only protocol typically did not differ more than 1‰ from those of the acid-base-acid reference. There were no significant isotopic offsets between acid-base-acid and acid-only or untreated samples. Sample losses in the acid-base-acid protocol were on average 50 ± 17% (maximum = 98.4%). Elemental XRF measurements showed promising results in the detection of more contaminated samples albeit with a high rate of false positives. For the large range of preservation conditions described in the study, untreated charred plant samples, water cleaned of sediments, provide reliable stable isotope ratios of carbon and nitrogen. The use of pre-treatments may be necessary under different preservation conditions or more conservative measurement uncertainties should be reported. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Hematological differences between patients with different subtypes of sickle cell disease on hydroxyurea treatment

    Directory of Open Access Journals (Sweden)

    Fabia Neves

    2012-01-01

    Full Text Available OBJECTIVE: Sickle cell anemia and the interaction S/Beta thalassemia differ in hematological values due to microcytosis and hypochromia caused by the thalassemic mutation. The clinical benefit of long-term hydroxyurea treatment is undeniable in sickle cell disease with monitoring of the biological action of the drug being by the complete blood count. The objective of this work is to compare changes in some of the erythrocytic indexes between S/Beta thalassemia and sickle cell anemia patients on long-term hydroxyurea treatment. METHODS: The values of erythrocyte indexes (mean corpuscular volume and mean corpuscular hemoglobin were compared in a retrospective study of two groups of patients (Sickle cell anemia and S/Beta thalassemia on hydroxyurea treatment over a mean of six years. RESULTS: The quantitative values of the two parameters differed between the groups. Increases in mean corpuscular volume and reductions in mean corpuscular hemoglobin delay longer in S/Beta thalassemia patients (p-value = 0.018. CONCLUSION: Hematological changes are some of the beneficial effects of hydroxyurea in sickle cell disease as cellular hydration increases and the hemoglobin S concentration is reduced. The complete blood count is the best test to monitor changes, but the interpretation of the results in S/Beta thalassemia should be different.

  19. Treatment time reduction for large thermal lesions by using a multiple 1D ultrasound phased array system

    International Nuclear Information System (INIS)

    Liu, H.-L.; Chen, Y.-Y.; Yen, J.-Y.; Lin, W.-L.

    2003-01-01

    To generate large thermal lesions in ultrasound thermal therapy, cooling intermissions are usually introduced during the treatment to prevent near-field heating, which leads to a long treatment time. A possible strategy to shorten the total treatment time is to eliminate the cooling intermissions. In this study, the two methods, power optimization and acoustic window enlargement, for reducing power accumulation in the near field are combined to investigate the feasibility of continuously heating a large target region (maximally 3.2 x 3.2 x 3.2 cm 3 ). A multiple 1D ultrasound phased array system generates the foci to scan the target region. Simulations show that the target region can be successfully heated without cooling and no near-field heating occurs. Moreover, due to the fact that there is no cooling time during the heating sessions, the total treatment time is significantly reduced to only several minutes, compared to the existing several hours

  20. Cold, Flu, or Allergy? Know the Difference for Best Treatment

    Science.gov (United States)

    ... October 2014 Print this issue Cold, Flu, or Allergy? Know the Difference for Best Treatment En español ... Peanut Allergy Therapy Wise Choices Cold, Flu, or Allergy? Treatment depends on which you have. A health ...

  1. Effect of different treatments on breaking dormancy of Teucrium polium

    Directory of Open Access Journals (Sweden)

    alireza koochaki

    2009-06-01

    Full Text Available In order to evaluate effects of different treatments on breaking dormancy of Teucrium polium, an experiment was conducted with 3 replications in a completely randomized design. Seeds were subjected to different treatments including various levels of GA3, H2SO4, soaking with water and chilling. Germination of Teucrium polium increased with different concentrations of GA3. Percentage germination Maximum and rate was obtained at concentrations of 250, 1500 ppm (72h GA3 and combination of GA3 (1500ppm and chilling (5 ºC for a period of 14 days. GA3 (500ppm increased germination percentage but not germination rate. Soaking with water broke dormancy and induced 32% seed germination of Teucrium polium, but H2SO4, freezing (-10 ºC and combination of both treatments had no effect on dormancy.

  2. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.

    Science.gov (United States)

    Krappinger, Dietmar; Irenberger, Alexander; Zegg, Michael; Huber, Burkhart

    2013-06-01

    The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. A consecutive series of 15 patients with posttraumatic tibial bone defects of >30 mm after sustaining open tibial fractures and failure of internal fixation was included. The objective outcome was assessed at final follow-up using Paley's criteria. For the assessment of the subjective outcome, all patients were asked to evaluate their satisfaction with the function of the lower leg, the cosmetic appearance and overall outcome as well. The physical and mental stress of the treatment for the patients and the nearest relative of patients were assessed at the time of frame removal using a custom-made questionnaire. The SF-36 was used to evaluate the general health status at final follow-up. Solid bone union with stable soft tissue coverage and eradication of infection was achieved in all patients despite a high complication rate. The functional outcome at final follow-up was excellent or good in all patients. The patients' satisfaction with the overall outcome and the function of the lower extremity was high as well. The fear of amputation and complications was the major subjective burden for both the patients and their relatives. The long external fixation time is another relevant issue. The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high

  3. Treatment strategies for different types of teacher burnout.

    Science.gov (United States)

    Farber, B A

    2000-05-01

    Using teachers as a prototype, this article suggests that there are three types of burnout: "wearout," wherein an individual gives up, feeling depleted in confronting stress; "classic" burnout, wherein an individual works increasingly hard in the face of stress; and an "underchallenged" type, wherein an individual is faced not with excessive degrees of stress per se (e.g., overload), but rather with monotonous and unstimulating work conditions. The major arguments put forward are that: a) clinicians should avoid treating teacher burnout as if it were a single phenomenon, and instead tailor their treatment to the specific type of burnout manifested by their client; and b) these treatments, while embodying different elements, should be essentially integrative in nature. Psychoanalytic insight, cognitive restructuring, empathic concern, and stress-reduction techniques may all be necessary, albeit in different combinations, to treat successfully burnout of each type.

  4. Treatment of different cases o esophageal cancer metastases

    International Nuclear Information System (INIS)

    Pirogov, A.I.; Ryndin, V.D.

    1983-01-01

    Treatment of esophagus cancer taking into account frequency of metastatic spread in lymph nodes of different esophagus sections is presented. In the case of metastases in retroperitoneal lymph nodes esophagus resection is useless and radiation therapy is of palliation character. After removal of metastases in paracardial lymph nodes and nodes of the lesser omentum the patients should be considered as a group for provesory radical surgery, radiation and combined treatment for subsequent evaluation of the treatment expediency as more data are accumulated. In cases of middle mediastinum cancer of the lower third of esophagus all lymph nodes along esophagus below bifurcation of the trachea should be subjected to surgical (radiation) treatment. In the case of median third of esophagus cancer - the nodes along the entire thoracic part of the esophagus. For radiation therapy of the upper third of the esophagus irradiation fields should comprise lymph nodes along the esophagus above bifurcation of the trachea and cervicosubclavicular lymph nodes

  5. [Cotard's syndrome. Different treatment strategies according to subclassification].

    Science.gov (United States)

    Madani, Y; Sabbe, B G C

    2007-01-01

    After performing an exploratory factor analysis, Berrios & Luque (1995) identified three subcategories in the Cotard's syndrome: Cotard type I, Cotard type II and Cotard type psychotic depression. The article, which is based on two case studies and an examination of the relevant literature since 1995, explores whether there are different treatment strategies for Cotard type I and the Cotard type psychotic depression. For the Cotard type psychotic depression, electroconvulsive therapy proves to be an effective method of treatment. For Cotard type I, antipsychotic therapy seems to be sufficient.

  6. 20 years of experience on treatment of large contaminated components and on clearance of material for recycling

    International Nuclear Information System (INIS)

    Lorenzen, Joachim; Lindberg, Maria; Amcoff, Bjoern; Wirendal, Bo

    2005-01-01

    This paper will describe the treatment of contaminated, large, retired components from NPP:s, at low and intermediate activity waste levels for recycling in Sweden. Decontamination and melting of various large components, as well as other metal scrap, has been conducted at Studsvik since the mid 1980:ies. Experience on clearance for recycling, i.e. for unconditional re-use of the metals in the public domain will be described. The contaminated material may be Co-60 dominated as well as Uranium Bearing Waste. During these years different techniques for decontamination and segmentation as well as pre- and post treatment have been developed and successively applied at Studsvik melting facility in Nykoeping, Sweden. This collective experience is presently used for the planning and treatment of both domestic and foreign larger components, like heat exchangers, reactors vessel heads, turbine parts, steam generators, fuel bottles and Giant boilers. During 2005 one 300 ton full size, 400 m 3 Westinghouse Steam Generator is under treatment using advanced decontamination, segmentation and melting techniques to be applied in a specifically designed and confined environment. The conduction of demonstration projects as well as commercial projects will be explained and described. The Studsvik melting facility is today treating components and scrap metal comprising stainless and carbon steel as well as aluminium, copper, brass and lead. Studsvik RadWaste has licenses for treating not only components from Swedish nuclear facilities but also for processing components from nuclear industries outside Sweden, including temporary import and export within a limited time window for each international project. Direct clearance or clearance after limited decay storage at Studsvik site is possible. The high Recycling Rate is due to optimized production to leave an extremely low percentage of secondary waste, including post-treatment of the secondary waste volume. Further, the waste volume

  7. Effect of Heat Treatment Process on Mechanical Properties and Microstructure of a 9% Ni Steel for Large LNG Storage Tanks

    Science.gov (United States)

    Zhang, J. M.; Li, H.; Yang, F.; Chi, Q.; Ji, L. K.; Feng, Y. R.

    2013-12-01

    In this paper, two different heat treatment processes of a 9% Ni steel for large liquefied natural gas storage tanks were performed in an industrial heating furnace. The former was a special heat treatment process consisting of quenching and intercritical quenching and tempering (Q-IQ-T). The latter was a heat treatment process only consisting of quenching and tempering. Mechanical properties were measured by tensile testing and charpy impact testing, and the microstructure was analyzed by optical microscopy, transmission electron microscopy, and x-ray diffraction. The results showed that outstanding mechanical properties were obtained from the Q-IQ-T process in comparison with the Q-T process, and a cryogenic toughness with charpy impact energy value of 201 J was achieved at 77 K. Microstructure analysis revealed that samples of the Q-IQ-T process had about 9.8% of austenite in needle-like martensite, while samples of the Q-T process only had about 0.9% of austenite retained in tempered martensite.

  8. Sex differences in the psychopharmacological treatment of depression.

    Science.gov (United States)

    Sramek, John J; Murphy, Michael F; Cutler, Neal R

    2016-12-01

    Although a number of studies have observed that females respond better to serotonergic antidepressants than males and that postmenopausal females have a diminished response to antidepressants compared with younger females, there are also studies that conflict with both of these findings, making any generalizations regarding sex differences difficult to make. Sex variance in antidepressant efficacy and pharmacokinetics profiles have been attributed to sex-based physiological differences, behavioral differences, related disorders, and sex-specific conditions, including pregnancy and menopause. This paper will review the history and current research on sex effects of antidepressant treatment.

  9. Effects of different rhizosphere ventilation treatment on water and ...

    African Journals Online (AJOL)

    The objective of this study was to explore the effects of different rhizosphere ventilation treatment on water and nutrients absorption of maize. The pot experiment was conducted using three methods: no ventilation, two day ventilation and four day ventilation, under conditions of the different levels of irrigation methods.

  10. Racial/ethnic differences in perception of need for mental health treatment in a US national sample

    Science.gov (United States)

    Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C.; Burnam, M. Audrey; Hunter, Gerald P.; Florez, Karen R.; Collins, Rebecca L.

    2017-01-01

    Purpose To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Methods Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Results Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, −5.8% (95% CI −6.5, −5.2%), and largest among Hispanics interviewed in Spanish, - 11.2% (95% CI −12.4, −10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, −23.3% (95% CI −34.9, −11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI −48.0, −17.2%). Conclusions This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities. PMID:28550518

  11. Organized Chronic Subdural Hematomas Treated by Large Craniotomy with Extended Membranectomy as the Initial Treatment

    Science.gov (United States)

    Balevi, Mustafa

    2017-01-01

    Objective: The aim of this retrospective study is to evaluate the efficacy and incidence of complications of craniotomy and membranectomy in elderly patients for the treatment of organized chronic subdural hematoma (OCSH). Materials and Methods: We retrospectively reviewed a series of 28 consecutive patients suffering from OCSH, diagnosed by magnetic resonance imaging (MRI) or computer tomography (CT) to establish the degree of organization and determine the intrahematomal architecture including inner membrane ossification. The indication to perform a primary enlarged craniotomy as initial treatment for nonliquefied OCSH with multilayer loculations was based on the hematoma MRI appearance – mostly hyperintense in both T1- and T2-weighted images with a hypointense web- or net-like structure within the hematoma cavity or inner membrane calcification CT appearance - hyperdense. These cases have been treated by a large craniotomy with extended membranectomy as the initial treatment. However, the technique of a burr hole with closed system drainage for 24–72 h was chosen for cases of nonseptated and mostly liquefied Chronic Subdural Hematoma (CSDH). Results: Between 1998 and 2015, 148 consecutive patients were surgically treated for CSDH at our institution. Of these, 28 patients which have OSDH underwent a large craniotomy with extended membranectomy as the initial treatment. The average age of the patients was 69 (69.4 ± 12.1). Tension pneumocephalus (TP) has occurred in 22.8% of these patients (n = 28). Recurring subdural hemorrhage (RSH) in the operation area has occurred in 11.9% of these patients in the first 24 h. TP with RSH was seen in 4 of 8 TP patients (50%). Large epidural air was seen in one case. Postoperative seizures requiring medical therapy occurred in 25% of our patients. The average stay in the department of neurosurgery was 11 days, ranging from 7 to 28 days. Four patients died within 28 days after surgery; mortality rate was 14.28%. Conclusion

  12. The coupled dynamical problem of thermoelasticity in case of large temperature differences

    International Nuclear Information System (INIS)

    Szekeres, A.

    1981-01-01

    In the tasks of thermoelasticity in general, also in dynamical problems it is common to suppose small temperature differences. The equations used in scientific literature refer to these. It arises the thought of what is the influence on the dynamical problems of taking into account the large temperature changes. To investigate this first we present the general equation of heat conduction in case of small temperature differences according to Nowacki and Biot. On this basis we introduce the general equation of heat conduction with large temperature changes. Some remarks show the connection between the two cases. Using the latter in the equations of thermoelasticity we write down the expressions of the problem for the thermal shock of a long bar. Finally we show the results of the numerical example and the experimental opoortunity to measure some of the constants. (orig.)

  13. Prospective and Retrospective Studies of Substance Abuse Treatment Outcomes: Methods and Results of Four Large-Scale Follow-Up Studies.

    Science.gov (United States)

    Gerstein, Dean R.; Johnson, Robert A.

    This report compares the research methods, provider and patient characteristics, and outcome results from four large-scale followup studies of drug treatment during the 1990s: (1) the California Drug and Alcohol Treatment Assessment (CALDATA); (2) Services Research Outcomes Study (SROS); (3) National Treatment Improvement Evaluation Study (NTIES);…

  14. RADIOMETRIC NORMALIZATION OF LARGE AIRBORNE IMAGE DATA SETS ACQUIRED BY DIFFERENT SENSOR TYPES

    Directory of Open Access Journals (Sweden)

    S. Gehrke

    2016-06-01

    Full Text Available Generating seamless mosaics of aerial images is a particularly challenging task when the mosaic comprises a large number of im-ages, collected over longer periods of time and with different sensors under varying imaging conditions. Such large mosaics typically consist of very heterogeneous image data, both spatially (different terrain types and atmosphere and temporally (unstable atmo-spheric properties and even changes in land coverage. We present a new radiometric normalization or, respectively, radiometric aerial triangulation approach that takes advantage of our knowledge about each sensor’s properties. The current implementation supports medium and large format airborne imaging sensors of the Leica Geosystems family, namely the ADS line-scanner as well as DMC and RCD frame sensors. A hierarchical modelling – with parameters for the overall mosaic, the sensor type, different flight sessions, strips and individual images – allows for adaptation to each sensor’s geometric and radiometric properties. Additional parameters at different hierarchy levels can compensate radiome-tric differences of various origins to compensate for shortcomings of the preceding radiometric sensor calibration as well as BRDF and atmospheric corrections. The final, relative normalization is based on radiometric tie points in overlapping images, absolute radiometric control points and image statistics. It is computed in a global least squares adjustment for the entire mosaic by altering each image’s histogram using a location-dependent mathematical model. This model involves contrast and brightness corrections at radiometric fix points with bilinear interpolation for corrections in-between. The distribution of the radiometry fixes is adaptive to each image and generally increases with image size, hence enabling optimal local adaptation even for very long image strips as typi-cally captured by a line-scanner sensor. The normalization approach is implemented in

  15. RETROPERITONEAL LAPAROSCOPIC TREATMENT OF LARGE ...

    African Journals Online (AJOL)

    Conclusion Retroperitoneal laparoscopic ureterolithotomy is a good minimally invasive alternative line of treatment for ureteral stones in cases not amenable for ESWL or endoscopy. However, it takes a long learning curve. Moreover, a careful case selection and good working instruments are necessary for success.

  16. Optimal number of coarse-grained sites in different components of large biomolecular complexes.

    Science.gov (United States)

    Sinitskiy, Anton V; Saunders, Marissa G; Voth, Gregory A

    2012-07-26

    The computational study of large biomolecular complexes (molecular machines, cytoskeletal filaments, etc.) is a formidable challenge facing computational biophysics and biology. To achieve biologically relevant length and time scales, coarse-grained (CG) models of such complexes usually must be built and employed. One of the important early stages in this approach is to determine an optimal number of CG sites in different constituents of a complex. This work presents a systematic approach to this problem. First, a universal scaling law is derived and numerically corroborated for the intensity of the intrasite (intradomain) thermal fluctuations as a function of the number of CG sites. Second, this result is used for derivation of the criterion for the optimal number of CG sites in different parts of a large multibiomolecule complex. In the zeroth-order approximation, this approach validates the empirical rule of taking one CG site per fixed number of atoms or residues in each biomolecule, previously widely used for smaller systems (e.g., individual biomolecules). The first-order corrections to this rule are derived and numerically checked by the case studies of the Escherichia coli ribosome and Arp2/3 actin filament junction. In different ribosomal proteins, the optimal number of amino acids per CG site is shown to differ by a factor of 3.5, and an even wider spread may exist in other large biomolecular complexes. Therefore, the method proposed in this paper is valuable for the optimal construction of CG models of such complexes.

  17. Differences in Treatment of Chlamydia trachomatis by Ambulatory Care Setting.

    Science.gov (United States)

    Pearson, William S; Gift, Thomas L; Leichliter, Jami S; Jenkins, Wiley D

    2015-12-01

    Chlamydia trachomatis (CT) is the most commonly reported sexually transmitted infection (STI) in the US and timely, correct treatment can reduce CT transmission and sequelae. Emergency departments (ED) are an important location for diagnosing STIs. This study compared recommended treatment of CT in EDs to treatment in physician offices. Five years of data (2006-2010) were analyzed from the National Ambulatory Medical Care Survey, and the National Hospital Ambulatory Medical Care Surveys (NHAMCS), including the Outpatient survey (NHAMCS-OPD) and Emergency Department survey (NHAMCS-ED). All visits with a CT diagnosis and those with a diagnosis of unspecified venereal disease were selected for analysis. Differences in receipt of recommended treatments were compared between visits to physician offices and emergency departments using Chi square tests and logistic regression models. During the 5 year period, approximately 3.2 million ambulatory care visits had diagnosed CT or an unspecified venereal disease. A greater proportion of visits to EDs received the recommended treatment for CT compared to visits to physician offices (66.1 vs. 44.9 %, p < .01). When controlling for patients' age, sex and race/ethnicity, those presenting to the ED with CT were more likely to receive the recommended antibiotic treatment than patients presenting to a physician's office (OR 2.16; 95 % CI 1.04-4.48). This effect was attenuated when further controlling for patients' expected source of payment. These analyses demonstrate differences in the treatment of CT by ambulatory care setting as well as opportunities for increasing use of recommended treatments for diagnosed cases of this important STI.

  18. Gender Differences in Bladder Cancer Treatment Decision Making.

    Science.gov (United States)

    Pozzar, Rachel A; Berry, Donna L

    2017-03-01

    To explore gender differences in bladder cancer treatment decision making.
. Secondary qualitative analysis of interview transcripts.
. One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews. Participants were primarily Caucasian, and most had at least some college education.
. Word frequency reports were used to identify thematic differences between the men's and women's statements. Line-by-line coding of constructs prevalent among women was then performed on all participants in NVivo 9. Coding results were compared between genders using matrix coding queries.
. The role of family in the decision-making process was found to be a dominant theme for women but not for men. Women primarily described family members as facilitators of bladder cancer treatment-related decisions, but men were more likely to describe family in a nonsupportive role.
. The results suggest that influences on the decision-making process are different for men and women with bladder cancer. Family may play a particularly important role for women faced with bladder cancer treatment-related decisions.
. Clinical nurses who care for individuals with bladder cancer should routinely assess patients' support systems and desired level of family participation in decision making. For some people with bladder cancer, family may serve as a stressor. Nurses should support the decision-making processes of all patients and be familiar with resources that can provide support to patients who do not receive it from family.

  19. Gender-related differences in individuals seeking treatment for kleptomania.

    Science.gov (United States)

    Grant, Jon E; Potenza, Marc N

    2008-03-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for prevention and treatment strategies. Few empirical investigations have been performed in kleptomania, particularly with respect to gender-related influences. From 2001--2007, 95 adult subjects (n=27 [28.4%] males) with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined kleptomania were assessed on sociodemographics and clinical characteristics, including symptom severity, comorbidity, and functional impairment, to identify gender-related differences. Men and women showed substantial symptom severity and functional impairment. Compared with affected men, women with kleptomania were more likely to be married (47.1% vs 25.9%; P=.039), have a later age at shoplifting onset (20.9 vs 14 years of age; P=.001), steal household items (PKleptomania is similarly associated with significant impairment in women and men. Gender-related differences in clinical features and co-occurring disorders suggest that prevention and treatment strategies incorporate gender considerations.

  20. Factors Affecting Quality of Life at Different Intervals After Treatment of Localized Prostate Cancer: Unique Influence of Treatment Decision Making Satisfaction, Personality and Sexual Functioning.

    Science.gov (United States)

    Victorson, David E; Schuette, Stephanie; Schalet, Benjamin D; Kundu, Shilajit D; Helfand, Brian T; Novakovic, Kristian; Sufrin, Nathaniel; McGuire, Michael; Brendler, Charles

    2016-11-01

    Using patient reported outcomes measures we identified the most informative set of factors associated with quality of life in a large sample of men treated for localized prostate cancer. We examined relationships with quality of life using FACIT (Functional Assessment of Chronic Illness Therapy). We also hypothesized variables in a sample of men diagnosed with localized prostate cancer who represented different time points since treatment, including less than 12 months in 70, 1 to 3 years in 344, greater than 3 to 5 years in 291 and greater than 5 years in 97. Correlative measures included subscales of MAX-PC (Memorial Anxiety Scale for Prostate Cancer), short forms of PROMIS® and SOMS (Surgical Outcomes Measurement System), TDM-SATS (Treatment Decision-Making Satisfaction Scale) and subscales of the BFI (Big Five Inventory) of personality. Quality of life was significantly associated with hypothesized variables across different time cohorts. In regression models several factors accounted for most of the variability in quality of life scores depending on time since treatment, including 47%, 22%, 29% and 27% at less than 12 months, 1 to 3 years, greater than 3 to 5 years and greater than 5 years, respectively. Upon examining the unique contribution of these variables, treatment decision making satisfaction was the only variable to have a significant and unique contribution to quality of life across all 4 time cohorts (standardized coefficients 0.33, 0.27, 0.31 and 0.49, respectively, p personality style also had unique associations with quality of life (standardized coefficients 0.25 and -0.20, respectively). When considering the short-term and the longer term quality of life of a man after treatment for localized prostate cancer, our findings highlight the importance of treatment decision making satisfaction, erectile function and personality. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  1. Racial Differences in the Diagnosis and Treatment of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Giuliano Di Pietro

    2016-11-01

    Full Text Available Disparities between African American and Caucasian men in prostate cancer (PCa diagnosis and treatment in the United States have been well established, with significant racial disparities documented at all stages of PCa management, from differences in the type of treatment offered to progression-free survival or death. These disparities appear to be complex in nature, involving biological determinants as well as socioeconomic and cultural aspects. We present a review of the literature on racial disparities in the diagnosis of PCa, treatment, survival, and genetic susceptibility. Significant differences were found among African Americans and whites in the incidence and mortality rates; namely, African Americans are diagnosed with PCa at younger ages than whites and usually with more advanced stages of the disease, and also undergo prostate-specific antigen testing less frequently. However, the determinants of the high rate of incidence and aggressiveness of PCa in African Americans remain unresolved. This pattern can be attributed to socioeconomic status, detection occurring at advanced stages of the disease, biological aggressiveness, family history, and differences in genetic susceptibility. Another risk factor for PCa is obesity. We found many discrepancies regarding treatment, including a tendency for more African American patients to be in watchful waiting than whites. Many factors are responsible for the higher incidence and mortality rates in African Americans. Better screening, improved access to health insurance and clinics, and more homogeneous forms of treatment will contribute to the reduction of disparities between African Americans and white men in PCa incidence and mortality.

  2. Student Engagement at a Large Suburban Community College: Gender and Race Differences

    Science.gov (United States)

    Sontam, Varalakshmi; Gabriel, George

    2012-01-01

    Previous research shows that there are individual differences in academic achievement associated with gender and race. Research also suggests that student engagement is an important determinant of student outcomes/achievement. The present study explored student engagement at an extra-large community college. It specifically investigated possible…

  3. 40 CFR 141.81 - Applicability of corrosion control treatment steps to small, medium-size and large water systems.

    Science.gov (United States)

    2010-07-01

    ... treatment steps to small, medium-size and large water systems. 141.81 Section 141.81 Protection of... WATER REGULATIONS Control of Lead and Copper § 141.81 Applicability of corrosion control treatment steps...). (ii) A report explaining the test methods used by the water system to evaluate the corrosion control...

  4. Dental treatment for handicapped patients; sedation vs general anesthesia and update of dental treatment in patients with different diseases

    Science.gov (United States)

    Corcuera-Flores, José R.; Delgado-Muñoz, José M.; Ruiz-Villandiego, José C.; Maura-Solivellas, Isabel

    2014-01-01

    Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. According to this situation we can opt for an outpatient treatment without any kind of previous medication, a treatment under conscious or deep sedation or a under general anesthesia treatment. With this systematic review is intended to help clarify in which cases patients should be treated under general anesthesia, sedation (conscious or deep) or outpatient clinic without any medication, as well as clarify what kind of treatments can be carried in private dental clinics and which should be carried out in a hospital. It will also discuss the most common diseases among this group of patients and the special care to be taken for their dental treatment. Key words:Hospital dentistry, handicapped patient. PMID:24121922

  5. Colorectal cancer in Slovenia – differences in surgical treatment and patient survival

    Directory of Open Access Journals (Sweden)

    Gregor Norčič

    2005-12-01

    Full Text Available Background: Colorectal cancer (CRC is one of the most frequent malignant diseases in Slovenia. Its incidence rises constantly in the last years while the outcome of treatment is poorer than in other developed countries.Methods: In a retrospective study we analysed 940 colorectal cancer patients diagnosed in Slovenia in 1997.Results: Differences in outcome between the Slovenian institutions are due to different stage-distributions and differences in surgical radicality. Differences in pathohistological staging and medical oncological treatment are probably less important. The same can be said regarding some of the examples from abroad.Conclusions: With constant and objective auditing, the improvement of all aspects of treatment can be achieved, resulting in better survival of all Slovenian colorectal cancer patients.

  6. Biology, diagnosis and treatment of canine appendicular osteosarcoma: similarities and differences with human osteosarcoma.

    Science.gov (United States)

    Morello, Emanuela; Martano, Marina; Buracco, Paolo

    2011-09-01

    Osteosarcoma (OSA) is the most common primary bone tumour in dogs. The appendicular locations are most frequently involved and large to giant breed dogs are commonly affected, with a median age of 7-8 years. OSA is a locally invasive neoplasm with a high rate of metastasis, mostly to the lungs. Due to similarities in biology and treatment of OSA in dogs and humans, canine OSA represents a valid and important tumour model. Differences between canine and human OSAs include the age of occurrence (OSA is most commonly an adolescent disease in humans), localisation (the stifle is the most common site of localisation in humans) and limited use of neoadjuvant chemotherapy in canine OSA. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. SU-E-T-235: Data Mining for Evaluating Treatment Performances Over a Large Quantity of Data to Monitor and Improve SBRT Workflow

    Energy Technology Data Exchange (ETDEWEB)

    Feng, W [Columbia University Medical Center, New York, NY (United States); Bayhealth Medical Center, Dover, DE (United States); Chu, A [New York Presbyterian Hospital, New York, AA (United States); Wuu, C [Columbia University, New York, NY (United States); Nguyen, K [Bayhealth Medical Center, Dover, DE (United States)

    2015-06-15

    Purpose: To quality assure a large quantity of retrospective treatment cases for treatment performances by randomly sampling is inefficient. Here we provide a method to efficiently monitor and investigate the QA of SBRT workflow over Mosaiq. Methods: The code developed with Microsoft SQL Server Management Studio 2008R2 and VBA was used for retrieving and sorting data from Mosaiq (version 2.3–2.6 during 2012–2015). SBRT patients were filtered by fractional dose over 350cGy and total fraction number less than 6, which SBRT prescriptions were defined. The quality assurance on the SBRT workflow was focused on the treatment deliveries such as patient positioning setup, CBCT indicated offsets and couch shifted corrections. The treatment delivery were done by Varian Truebeam systems and the record/verify by Mosaiq. Results: Total 82 SBRT patients corresponding to 103 courses and 854 CBCT images were found by the retrieval query. Most centers record daily pre-treatment (Pre-Tx: before treatment shift) image-guided shifts along treatment course for inter-fraction motion record, and it is useful to also verify it with post-treatment imaging (Post-Tx: after treatment CBCT verification) to verify intra-fraction motion. Analyzing the details of daily recorded shifts can reveals the information of patient-setup and staff’s record/verify behaviors. 3 examples were provided as solid evidences and on-going rectification for preventing future mistakes. Conclusions: The report gave feasible examples for inspector to verify a large amount of data during site investigation. This program can also be extended to a scheduled data mining with software to periodical analyze the timely records in Mosaiq, for example, a various control charts for different QA purposes. As the current trend of automation in radiation therapy field, the data mining would be a necessary tool in the future, just as the automatic plan quality evaluation has been under development in Eclipse.

  8. SU-E-T-235: Data Mining for Evaluating Treatment Performances Over a Large Quantity of Data to Monitor and Improve SBRT Workflow

    International Nuclear Information System (INIS)

    Feng, W; Chu, A; Wuu, C; Nguyen, K

    2015-01-01

    Purpose: To quality assure a large quantity of retrospective treatment cases for treatment performances by randomly sampling is inefficient. Here we provide a method to efficiently monitor and investigate the QA of SBRT workflow over Mosaiq. Methods: The code developed with Microsoft SQL Server Management Studio 2008R2 and VBA was used for retrieving and sorting data from Mosaiq (version 2.3–2.6 during 2012–2015). SBRT patients were filtered by fractional dose over 350cGy and total fraction number less than 6, which SBRT prescriptions were defined. The quality assurance on the SBRT workflow was focused on the treatment deliveries such as patient positioning setup, CBCT indicated offsets and couch shifted corrections. The treatment delivery were done by Varian Truebeam systems and the record/verify by Mosaiq. Results: Total 82 SBRT patients corresponding to 103 courses and 854 CBCT images were found by the retrieval query. Most centers record daily pre-treatment (Pre-Tx: before treatment shift) image-guided shifts along treatment course for inter-fraction motion record, and it is useful to also verify it with post-treatment imaging (Post-Tx: after treatment CBCT verification) to verify intra-fraction motion. Analyzing the details of daily recorded shifts can reveals the information of patient-setup and staff’s record/verify behaviors. 3 examples were provided as solid evidences and on-going rectification for preventing future mistakes. Conclusions: The report gave feasible examples for inspector to verify a large amount of data during site investigation. This program can also be extended to a scheduled data mining with software to periodical analyze the timely records in Mosaiq, for example, a various control charts for different QA purposes. As the current trend of automation in radiation therapy field, the data mining would be a necessary tool in the future, just as the automatic plan quality evaluation has been under development in Eclipse

  9. Metabolomic Analyses of Leishmania Reveal Multiple Species Differences and Large Differences in Amino Acid Metabolism.

    Directory of Open Access Journals (Sweden)

    Gareth D Westrop

    Full Text Available Comparative genomic analyses of Leishmania species have revealed relatively minor heterogeneity amongst recognised housekeeping genes and yet the species cause distinct infections and pathogenesis in their mammalian hosts. To gain greater information on the biochemical variation between species, and insights into possible metabolic mechanisms underpinning visceral and cutaneous leishmaniasis, we have undertaken in this study a comparative analysis of the metabolomes of promastigotes of L. donovani, L. major and L. mexicana. The analysis revealed 64 metabolites with confirmed identity differing 3-fold or more between the cell extracts of species, with 161 putatively identified metabolites differing similarly. Analysis of the media from cultures revealed an at least 3-fold difference in use or excretion of 43 metabolites of confirmed identity and 87 putatively identified metabolites that differed to a similar extent. Strikingly large differences were detected in their extent of amino acid use and metabolism, especially for tryptophan, aspartate, arginine and proline. Major pathways of tryptophan and arginine catabolism were shown to be to indole-3-lactate and arginic acid, respectively, which were excreted. The data presented provide clear evidence on the value of global metabolomic analyses in detecting species-specific metabolic features, thus application of this technology should be a major contributor to gaining greater understanding of how pathogens are adapted to infecting their hosts.

  10. Back-transformation of treatment differences - an approximate method

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Dalskov, Stine-Mathilde; Damsgaard, Camilla Trab

    2014-01-01

    Background/Objectives:Transformation of outcomes is frequently used in the analysis of studies in clinical nutrition. However, back-transformation of estimated treatment means and differences is complicated by the nonlinear nature of the transformations. It is not straightforward to obtain an est...... publication, 11 December 2013; doi:10.1038/ejcn.2013.259....

  11. Heterotrophic monitoring at a drinking water treatment plant by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry after different drinking water treatments.

    Science.gov (United States)

    Sala-Comorera, Laura; Blanch, Anicet R; Vilaró, Carles; Galofré, Belén; García-Aljaro, Cristina

    2017-10-01

    The aim of this work was to assess the suitability of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) for routine heterotrophic monitoring in a drinking water treatment plant. Water samples were collected from raw surface water and after different treatments during two campaigns over a 1-year period. Heterotrophic bacteria were studied and isolates were identified by MALDI-TOF MS. Moreover, the diversity index and the coefficient of population similarity were also calculated using biochemical fingerprinting of the populations studied. MALDI-TOF MS enabled us to characterize and detect changes in the bacterial community composition throughout the water treatment plant. Raw water showed a large and diverse population which was slightly modified after initial treatment steps (sand filtration and ultrafiltration). Reverse osmosis had a significant impact on the microbial diversity, while the final chlorination step produced a shift in the composition of the bacterial community. Although MALDI-TOF MS could not identify all the isolates since the available MALDI-TOF MS database does not cover all the bacterial diversity in water, this technique could be used to monitor bacterial changes in drinking water treatment plants by creating a specific protein profile database for tracking purposes.

  12. Nonlinear continuum mechanics and large inelastic deformations

    CERN Document Server

    Dimitrienko, Yuriy I

    2010-01-01

    This book provides a rigorous axiomatic approach to continuum mechanics under large deformation. In addition to the classical nonlinear continuum mechanics - kinematics, fundamental laws, the theory of functions having jump discontinuities across singular surfaces, etc. - the book presents the theory of co-rotational derivatives, dynamic deformation compatibility equations, and the principles of material indifference and symmetry, all in systematized form. The focus of the book is a new approach to the formulation of the constitutive equations for elastic and inelastic continua under large deformation. This new approach is based on using energetic and quasi-energetic couples of stress and deformation tensors. This approach leads to a unified treatment of large, anisotropic elastic, viscoelastic, and plastic deformations. The author analyses classical problems, including some involving nonlinear wave propagation, using different models for continua under large deformation, and shows how different models lead t...

  13. [Effects of different surface treatments on the zirconia-resin cement bond strength].

    Science.gov (United States)

    Liao, Y; Liu, X Q; Chen, L; Zhou, J F; Tan, J G

    2018-02-18

    To evaluate the effects of different surface treatments on the shear bond strength between zirconia and resin cement. Forty zirconia discs were randomly divided into four groups (10 discs in each group) for different surface treatments: control, no surface treatment; sandblast, applied air abrasion with aluminum oxide particles; ultraviolet (UV), the zirconia sample was placed in the UV sterilizer at the bottom of the UV lamp at 10 mm, and irradiated for 48 h; cold plasma, the discs were put in the cold plasma cabinet with the cold plasma generated from the gas of He for 30 s. Specimens of all the groups were surface treated prior to cementation with Panavia F 2.0 cement. The surface morphology and contact angle of water were measured. The shear bond strengths were tested and the failure modes were examined with a stereomicroscope. Surface morphology showed no difference between the UV/cold plasma group and the control group. Sandblasted zirconia displayed an overall heterogeneous distribution of micropores. The contact angle of the control group was 64.1°±2.0°. After sandblasting, UV irradiation and cold plasma exposure, the values significantly decreased to 48.8°±2.6°, 27.1°±3.6° and 32.0°±3.3°. The values of shear bond strength of the specimens with sandblasted (14.82±2.01) MPa were higher than those with no treatment (9.41±1.07) MPa with statistically significant difference (Pbond strength of the specimens with UV irradiation (10.02±0.64) MPa were higher than those with no treatment (9.41±1.07) MPa, but without statistically significant difference (P>0.05). The values of cold plasma group (18.34±3.05) MPa were significantly higher than those of control group (9.41±1.07) MPa, even more than those with sandblast(14.82±2.01) MPa (PUV and cold plasma treatment. The surface C/O ratio also decreased after UV and cold plasma treatment. Zirconia specimens treated with UV and cold plasma could significantly improve the hydrophilicity. The surface

  14. Intra- and interspecific differences in diet quality and composition in a large herbivore community.

    Directory of Open Access Journals (Sweden)

    Claire Redjadj

    Full Text Available Species diversity in large herbivore communities is often explained by niche segregation allowed by differences in body mass and digestive morphophysiological features. Based on large number of gut samples in fall and winter, we analysed the temporal dynamics of diet composition, quality and interspecific overlap of 4 coexisting mountain herbivores. We tested whether the relative consumption of grass and browse differed among species of different rumen types (moose-type and intermediate-type, whether diet was of lower quality for the largest species, whether we could identify plant species which determined diet quality, and whether these plants, which could be "key-food-resources" were similar for all herbivores. Our analyses revealed that (1 body mass and rumen types were overall poor predictors of diet composition and quality, although the roe deer, a species with a moose-type rumen was confirmed as an "obligatory non grazer", while red deer, the largest species, had the most lignified diet; (2 diet overlap among herbivores was well predicted by rumen type (high among species of intermediate types only, when measured over broad plant groups, (3 the relationship between diet composition and quality differed among herbivore species, and the actual plant species used during winter which determined the diet quality, was herbivore species-specific. Even if diets overlapped to a great extent, the species-specific relationships between diet composition and quality suggest that herbivores may select different plant species within similar plant group types, or different plant parts and that this, along with other behavioural mechanisms of ecological niche segregation, may contribute to the coexistence of large herbivores of relatively similar body mass, as observed in mountain ecosystems.

  15. Different approaches to acute organophosphorus poison treatment.

    Science.gov (United States)

    Nurulain, Syed Muhammad

    2012-07-01

    Organophosphorus compounds (OPCs) have a wide variety of applications and are a serious threat for self-poisoning, unintentional misuse, terrorist attack, occupational hazard and warfare attack. The present standard treatment has been reported to be unsatisfactory. Many novel approaches are being used and tested for acute organophosphorus (OP) poison treatment. The bioscavenger concept captured high attention among the scientific community during the last few decades. Other approaches like alkalinisation of blood plasma/serum and use of weak inhibitors against strong inhibitors, though it showed promising results, did not get such wide attention. The introduction of a novel broad-spectrum oxime has also been in focus. In this mini-review, an update of the overview of four different approaches has been discussed. The standard therapy that is atropine+oxime+benzodiazepine along with supportive measures will continue to be the best option with only the replacement of a single oxime to improve its broad-spectrum efficacy.

  16. Bioethical differences between drug addiction treatment professionals inside and outside the Russian Federation

    Directory of Open Access Journals (Sweden)

    Mendelevich Vladimir D

    2011-06-01

    Full Text Available Abstract This article provides an overview of a sociological study of the views of 338 drug addiction treatment professionals. A comparison is drawn between the bioethical approaches of Russian and foreign experts from 18 countries. It is concluded that the bioethical priorities of Russian and foreign experts differ significantly. Differences involve attitudes toward confidentiality, informed consent, compulsory treatment, opioid agonist therapy, mandatory testing of students for psychoactive substances, the prevention of mental patients from having children, harm reduction programs (needle and syringe exchange, euthanasia, and abortion. It is proposed that the cardinal dissimilarity between models for providing drug treatment in the Russian Federation versus the majority of the countries of the world stems from differing bioethical attitudes among drug addiction treatment experts.

  17. Stability comparison of two different dentoalveolar expansion treatment protocols

    Directory of Open Access Journals (Sweden)

    Ezgi Atik

    Full Text Available ABSTRACT Objective: The aim of this study was to compare the longitudinal stability of the conventional straight-wire system after the use of a quad-helix appliance with Damon self-ligating system in patients with Class I malocclusion. Methods: 27 adolescent patients were evaluated at three different periods: pre-treatment (T1, post-treatment (T2 and three years post-treatment (T3. Group 1 included 12 patients (with a mean age of 14.65 year treated with Damon 3MX bracket system; and Group 2 included 15 patients (with a mean age of 14.8 year who underwent orthodontic treatment with Roth prescribed brackets after expansion with Quad-Helix appliance. Relapse was evaluated with dental cast examination and cephalometric radiograph tracings. Statistical analysis was performed with IBM-SPSS for Windows software, version 21 (SPSS Inc., Chicago, IL. A p-value smaller than 0.05 was considered statistically significant. Results: There were significant increases in all transverse dental and postero-anterior measurements (except for UL6-ML mm in Group 1 with active treatment. There was some significant relapse in the long-term in inter-canine width in both groups and in the inter-first premolar width in Group 2 (p< 0.05. Significant decrease in all frontal measurements from T2 to T3 was seen for both groups. Upper and lower incisors significantly proclined in T1-T2 (p<0.05, however no relapse was found for both groups. When two systems were compared, there was no significant difference for the long-term follow-up period. Conclusion: Conventional (quad-helix appliance with conventional brackets and Damon systems were found similar with regard to the long-term incisor positions and transverse dimension changes of maxillary arch.

  18. Large-scale multi-stage constructed wetlands for secondary effluents treatment in northern China: Carbon dynamics.

    Science.gov (United States)

    Wu, Haiming; Fan, Jinlin; Zhang, Jian; Ngo, Huu Hao; Guo, Wenshan

    2018-02-01

    Multi-stage constructed wetlands (CWs) have been proved to be a cost-effective alternative in the treatment of various wastewaters for improving the treatment performance as compared with the conventional single-stage CWs. However, few long-term full-scale multi-stage CWs have been performed and evaluated for polishing effluents from domestic wastewater treatment plants (WWTP). This study investigated the seasonal and spatial dynamics of carbon and the effects of the key factors (input loading and temperature) in the large-scale seven-stage Wu River CW polishing domestic WWTP effluents in northern China. The results indicated a significant improvement in water quality. Significant seasonal and spatial variations of organics removal were observed in the Wu River CW with a higher COD removal efficiency of 64-66% in summer and fall. Obvious seasonal and spatial variations of CH 4 and CO 2 emissions were also found with the average CH 4 and CO 2 emission rates of 3.78-35.54 mg m -2 d -1 and 610.78-8992.71 mg m -2 d -1 , respectively, while the higher CH 4 and CO 2 emission flux was obtained in spring and summer. Seasonal air temperatures and inflow COD loading rates significantly affected organics removal and CH 4 emission, but they appeared to have a weak influence on CO 2 emission. Overall, this study suggested that large-scale Wu River CW might be a potential source of GHG, but considering the sustainability of the multi-stage CW, the inflow COD loading rate of 1.8-2.0 g m -2 d -1 and temperature of 15-20 °C may be the suitable condition for achieving the higher organics removal efficiency and lower greenhouse gases (GHG) emission in polishing the domestic WWTP effluent. The obtained knowledge of the carbon dynamics in large-scale Wu River CW will be helpful for understanding the carbon cycles, but also can provide useful field experience for the design, operation and management of multi-stage CW treatments. Copyright © 2017 Elsevier Ltd. All rights

  19. Nucleoli in large (giant bi- and multinucleate cells after apoptosis-inducing photodynamic treatment

    Directory of Open Access Journals (Sweden)

    K Smetana

    2009-06-01

    Full Text Available The present experimental study was undertaken to provide information on nucleolar changes accompanying the apoptotic process in large or giant binucleate and multinucleate cells (LBMNCs. Such cells were present in a small but constant percentage in cultures of HL-60 cells. The apoptotic process was induced by photodynamic treatment (PDT by means of 5-aminolaevulinic acid (ALA as the precursor of the photosensitizer protoporphyrin IX and irradiation with broad spectrum blue light (BL. Nucleolar changes in LBMNCs were characterized by marked reduction or disappearance of silver stained particles representing AgNORs in nucleoli including the large ones. In addition, PDT also significantly reduced the number of nucleoli regardless of their size. These changes apparently reflected the decrease or cessation of nucleolar biosynthetic activities and resembled those which were previously observed in naturally maturing bone marrow megakaryocytes (Janoutová et al., 2001.

  20. Zonal PANS: evaluation of different treatments of the RANS-LES interface

    Science.gov (United States)

    Davidson, L.

    2016-03-01

    The partially Reynolds-averaged Navier-Stokes (PANS) model can be used to simulate turbulent flows either as RANS, large eddy simulation (LES) or DNS. Its main parameter is fk whose physical meaning is the ratio of the modelled to the total turbulent kinetic energy. In RANS fk = 1, in DNS fk = 0 and in LES fk takes values between 0 and 1. Three different ways of prescribing fk are evaluated for decaying grid turbulence and fully developed channel flow: fk = 0.4, fk = k3/2tot/ɛ and, from its definition, fk = k/ktot where ktot is the sum of the modelled, k, and resolved, kres, turbulent kinetic energy. It is found that the fk = 0.4 gives the best results. In Girimaji and Wallin, a method was proposed to include the effect of the gradient of fk. This approach is used at RANS- LES interface in the present study. Four different interface models are evaluated in fully developed channel flow and embedded LES of channel flow: in both cases, PANS is used as a zonal model with fk = 1 in the unsteady RANS (URANS) region and fk = 0.4 in the LES region. In fully developed channel flow, the RANS- LES interface is parallel to the wall (horizontal) and in embedded LES, it is parallel to the inlet (vertical). The importance of the location of the horizontal interface in fully developed channel flow is also investigated. It is found that the location - and the choice of the treatment at the interface - may be critical at low Reynolds number or if the interface is placed too close to the wall. The reason is that the modelled turbulent shear stress at the interface is large and hence the relative strength of the resolved turbulence is small. In RANS, the turbulent viscosity - and consequently also the modelled Reynolds shear stress - is only weakly dependent on Reynolds number. It is found in the present work that it also applies in the URANS region.

  1. Large differences in the diabatic heat budget of the tropical UTLS in reanalyses

    OpenAIRE

    J. S. Wright; S. Fueglistaler

    2013-01-01

    We present the time mean heat budgets of the tropical upper troposphere (UT) and lower stratosphere (LS) as simulated by five reanalysis models: MERRA, ERA-Interim, CFSR, JRA-25/JCDAS, and NCEP/NCAR. The simulated diabatic heat budget in the tropical UTLS differs significantly from model to model, with substantial implications for representations of transport and mixing. Large differences are apparent both in the net heat budget and in all comparable individual components, including la...

  2. Laser treatment in patients with bilateral large drusen: the complications of age-related macular degeneration prevention trial.

    Science.gov (United States)

    2006-11-01

    To evaluate the efficacy and safety of low-intensity laser treatment in the prevention of visual acuity (VA) loss among participants with bilateral large drusen. Multicenter randomized clinical trial. One eye of each participant was assigned to treatment, and the contralateral eye was assigned to observation. A total of 1052 participants who had > or =10 large (>125 microm) drusen and VA> or =20/40 in each eye enrolled through 22 clinical centers. The initial laser treatment protocol specified 60 barely visible burns applied in a grid pattern within an annulus between 1500 and 2500 mum from the foveal center. At 12 months, eyes assigned to treatment that had sufficient drusen remaining were retreated with 30 burns by targeting drusen within an annulus between 1000 and 2000 mum from the foveal center. Proportion of eyes at 5 years with loss of > or =3 lines of VA from baseline. Secondary outcome measures included the development of choroidal neovascularization or geographic atrophy (GA), change in contrast threshold, change in critical print size, and incidence of ocular adverse events. At 5 years, 188 (20.5%) treated eyes and 188 (20.5%) observed eyes had VA scores > or = 3 lines worse than at the initial visit (P = 1.00). Cumulative 5-year incidence rates for treated and observed eyes were 13.3% and 13.3% (P = 0.95) for choroidal neovascularization and 7.4% and 7.8% (P = 0.64) for GA, respectively. The contrast threshold doubled in 23.9% of treated eyes and in 20.5% of observed eyes (P = 0.40). The critical print size doubled in 29.6% of treated eyes and in 28.4% of observed eyes (P = 0.70). Seven treated eyes and 14 observed eyes had an adverse event of a > or =6-line loss in VA in the absence of late age-related macular degeneration or cataract. As applied in the Complications of Age-Related Macular Degeneration Prevention Trial, low-intensity laser treatment did not demonstrate a clinically significant benefit for vision in eyes of people with bilateral large

  3. Depression in Chinese men undergoing different assisted reproductive technique treatments: prevalence and risk factors.

    Science.gov (United States)

    Li, Li; Zhang, Yuanzhen; Zeng, Dan; Li, Fei; Cui, Dan

    2013-09-01

    To explore the prevalence and risk factors for depression in men undergoing different assisted reproductive technique (ART) treatments in Chinese population. This was a prospective study of 844 men undergoing ART treatments. All men were distributed to four groups, according to they received treatments. The treatments included IUI (intrauterine insemination), IVF(in vitro fertilization), ICSI(intra cytoplasmatic sperm injection) and TESA/PESA (percutaneous epididymal sperm aspiration/testicular sperm aspiration). Their symptoms of depression were measured with use of the Center for Epidemiologic Studies of Depression scale(CES-D). Data were collected about age, BMI, education, duration of marriage, duration of infertility, smoking, type of infertility, infertility causes, history of ejaculation failure, and financial burden of the treatment. We estimated the prevalence of depressive symptom in men undergoing different ART and used logistic regression models to identify risk factors for depression in different groups. The overall prevalence of depression was 13.3 % for men undergoing ART treatments: 14.5 % of IUI group, 12.4 % of IVF group, 19.2 % of ICSI group and 6.2 % of TESA/PESA group. Prevalence of depression among IUI group, IVF group and ICSI group were not significantly different. For IUI group, the factors were found to increase depression risk were treatment financial burden and duration of marriage, to decrease depression risk was age. For IVF group, the risk factors independently associated with depression were both male and female infertility, unexplained infertility, and history of ejaculation failure. In a sample of Chinese men undergoing ART treatments, the prevalence of depression was higher than other country. The risk factors for depression varied in different ART treatments groups. when routine screening to identify the sub-group of vulnerable men which need counselling before ART treatments, we should also consider which pattern of ART

  4. Hierarchical 2.5D scene alignment for change detection with large viewpoint differences

    NARCIS (Netherlands)

    van de Wouw, D.; Dubbelman, G.; de With, P.H.N.

    2016-01-01

    Change detection from mobile platforms is a relevant topic in the field of intelligent vehicles and has many applications, such as countering improvised explosive devices (C-IED). Existing real-time C-IED systems are not robust against large viewpoint differences, which are unavoidable under

  5. The effect of different treatments on improving seed germination ...

    African Journals Online (AJOL)

    Creating optimal conditions for germination of medicinal plants seed is essential for their cultivation. Therefore, to evaluate the effect of different treatments on seed germination of two medicinal species, Descurainia sophia and Plantago ovata collected in 2009 from Tehran Province, an experiment with a factorial ...

  6. Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

    Science.gov (United States)

    Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

    2018-04-01

    To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

  7. Treatment planning using MRI data: an analysis of the dose calculation accuracy for different treatment regions

    Directory of Open Access Journals (Sweden)

    Karlsson Mikael

    2010-06-01

    Full Text Available Abstract Background Because of superior soft tissue contrast, the use of magnetic resonance imaging (MRI as a complement to computed tomography (CT in the target definition procedure for radiotherapy is increasing. To keep the workflow simple and cost effective and to reduce patient dose, it is natural to strive for a treatment planning procedure based entirely on MRI. In the present study, we investigate the dose calculation accuracy for different treatment regions when using bulk density assignments on MRI data and compare it to treatment planning that uses CT data. Methods MR and CT data were collected retrospectively for 40 patients with prostate, lung, head and neck, or brain cancers. Comparisons were made between calculations on CT data with and without inhomogeneity corrections and on MRI or CT data with bulk density assignments. The bulk densities were assigned using manual segmentation of tissue, bone, lung, and air cavities. Results The deviations between calculations on CT data with inhomogeneity correction and on bulk density assigned MR data were small. The maximum difference in the number of monitor units required to reach the prescribed dose was 1.6%. This result also includes effects of possible geometrical distortions. Conclusions The dose calculation accuracy at the investigated treatment sites is not significantly compromised when using MRI data when adequate bulk density assignments are made. With respect to treatment planning, MRI can replace CT in all steps of the treatment workflow, reducing the radiation exposure to the patient, removing any systematic registration errors that may occur when combining MR and CT, and decreasing time and cost for the extra CT investigation.

  8. EFFECTS OF LONG-TERM ALENDRONATE TREATMENT ON A LARGE SAMPLE OF PEDIATRIC PATIENTS WITH OSTEOGENESIS IMPERFECTA.

    Science.gov (United States)

    Lv, Fang; Liu, Yi; Xu, Xiaojie; Wang, Jianyi; Ma, Doudou; Jiang, Yan; Wang, Ou; Xia, Weibo; Xing, Xiaoping; Yu, Wei; Li, Mei

    2016-12-01

    Osteogenesis imperfecta (OI) is a group of inherited diseases characterized by reduced bone mass, recurrent bone fractures, and progressive bone deformities. Here, we evaluate the efficacy and safety of long-term treatment with alendronate in a large sample of Chinese children and adolescents with OI. In this prospective study, a total of 91 children and adolescents with OI were included. The patients received 3 years' treatment with 70 mg alendronate weekly and 500 mg calcium daily. During the treatment, fracture incidence, bone mineral density (BMD), and serum levels of the bone turnover biomarkers (alkaline phosphatase [ALP] and cross-linked C-telopeptide of type I collagen [β-CTX]) were evaluated. Linear growth speed and parameters of safety were also measured. After 3 years of treatment, the mean annual fracture incidence decreased from 1.2 ± 0.8 to 0.2 ± 0.3 (Posteogenesis imperfecta PTH = parathyroid hormone.

  9. Differences in seed rain composition in small and large fragments in the northeast Brazilian Atlantic Forest.

    Science.gov (United States)

    Knörr, U C; Gottsberger, G

    2012-09-01

    Tropical forests are seriously threatened by fragmentation and habitat loss. The impact of fragment size and forest configuration on the composition of seed rain is insufficiently studied. For the present study, seed rain composition of small and large forest fragments (8-388 ha) was assessed in order to identify variations in seed abundance, species richness, seed size and dispersal mode. Seed rain was documented during a 1-year period in three large and four small Atlantic Forest fragments that are isolated by a sugarcane matrix. Total seed rain included 20,518 seeds of 149 species of trees, shrubs, palms, lianas and herbs. Most species and seeds were animal-dispersed. A significant difference in the proportion of seeds and species within different categories of seed size was found between small and large fragments. Small fragments received significantly more very small-sized seeds (1.5 cm) that were generally very rare, with only one species in small and eight in large fragments. We found a negative correlation between the inflow of small-sized seeds and the percentage of forest cover. Species richness was lower in small than in large fragments, but the difference was not very pronounced. Given our results, we propose changing plant species pools through logging, tree mortality and a high inflow of pioneer species and lianas, especially in small forest fragments and areas with low forest cover. Connecting forest fragments through corridors and reforestation with local large-seeded tree species may facilitate the maintenance of species diversity. © 2012 German Botanical Society and The Royal Botanical Society of the Netherlands.

  10. Nutrient digestibility of veal calves fed large amounts of different solid feeds during the first 80 days of fattening

    Directory of Open Access Journals (Sweden)

    Marta Brscic

    2014-10-01

    Full Text Available The study aimed at evaluating nutrients apparent digestibility in veal calves fed 3 feeding plans based on milk-replacer plus large amounts of solid feeds differing in their composition during the first 80 days of fattening. Twelve Polish Friesian male calves (70.6±1.9 kg were randomly assigned to one of the following feeding treatments: i milk-replacer plus corn grain (CG; ii milk-replacer plus 80:20 mixture (as fed basis of corn grain and wheat straw (CGS; and iii milk-replacer plus 72:20:8 mixture of corn grain, wheat straw and extruded soybean (CGSES. Calves received the same milk-replacer but the daily amount was restricted (96% for CGSES calves to balance dietary protein. Total dry matter intake from milk-replacer and solid feeds was similar among treatments, but CGSES calves showed better growth performance than CG ones. Calves were introduced into a metabolism stall (1/pen during week 9 of fattening for a 3- day adaptation period and a 4-day digestibility trial. Calves fed CG showed the greatest DM, NFC, and ash digestibility while CGSES calves showed the lowest CP digestibility. Haemoglobin concentrations measured at day 5, 31 and 80 were similar among feeding treatments and significantly decreased over time. In CGSES treatment, the combination of milkreplacer with solid feed closer to a complete diet for ruminants led to better calves’ growth performance. However, the reduced protein digestibility with CGSES indicates that protein quality becomes a key factor when formulating diets for veal calves using alternatives to dairy sources.

  11. Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial

    Science.gov (United States)

    Forestier, R; Desfour, H; Tessier, J-M; Françon, A; Foote, A M; Genty, C; Rolland, C; Roques, C-F; Bosson, J-L

    2010-01-01

    Objective To determine whether spa therapy, plus home exercises and usual medical treatment provides any benefit over exercises and usual treatment, in the management of knee osteoarthritis. Methods Large multicentre randomised prospective clinical trial of patients with knee osteoarthritis according to the American College of Rheumatology criteria, attending French spa resorts as outpatients between June 2006 and April 2007. Zelen randomisation was used so patients were ignorant of the other group and spa personnel were not told which patients were participating. The main endpoint criteria were patient self-assessed. All patients continued usual treatments and performed daily standardised home exercises. The spa therapy group also received 18 days of spa therapy (massages, showers, mud and pool sessions). Main Endpoint The number of patients achieving minimal clinically important improvement (MCII) at 6 months, defined as ≥19.9 mm on the visual analogue pain scale and/or ≥9.1 points in a normalised Western Ontario and McMaster Universities osteoarthritis index function score and no knee surgery. Results The intention to treat analysis included 187 controls and 195 spa therapy patients. At 6 months, 99/195 (50.8%) spa group patients had MCII and 68/187 (36.4%) controls (χ2=8.05; df=1; p=0.005). However, no improvement in quality of life (Short Form 36) or patient acceptable symptom state was observed at 6 months. Conclusion For patients with knee osteoarthritis a 3-week course of spa therapy together with home exercises and usual pharmacological treatments offers benefit after 6 months compared with exercises and usual treatment alone, and is well tolerated. Trial registration number NCT00348777. PMID:19734131

  12. Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma : A clinical report

    NARCIS (Netherlands)

    Hoekstra, Jitske; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita

    Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted

  13. Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation.

    Science.gov (United States)

    Beitel, Mark; Oberleitner, Lindsay; Muthulingam, Dharushana; Oberleitner, David; Madden, Lynn M; Marcus, Ruthanne; Eller, Anthony; Bono, Madeline H; Barry, Declan T

    2018-03-09

    Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.

  14. Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling

    DEFF Research Database (Denmark)

    Grant, Jon E; Chamberlain, Samuel R; Schreiber, Liana R N

    2012-01-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cogn...... and cognitive differences in treatment-seeking people with pathological gambling as a function of gender....

  15. Laser ablation and 131-iodine: a 24-month pilot study of combined treatment for large toxic nodular goiter.

    Science.gov (United States)

    Chianelli, M; Bizzarri, G; Todino, V; Misischi, I; Bianchini, A; Graziano, F; Guglielmi, R; Pacella, C M; Gharib, H; Papini, E

    2014-07-01

    It is normally recognized that the preferred treatment in large toxic thyroid nodules should be thyroidectomy. The aim of the study was to assess the efficacy of combined laser ablation treatment (LAT) and radioiodine 131 (131I) treatment of large thyroid toxic nodules with respect to rapidity of control of local symptoms, of hyperthyroidism, and of reduction of administered 131I activity in patients at refusal or with contraindications to surgery. We conducted a pilot study at a single center specializing in thyroid care. Fifteen patients were treated with LAT, followed by 131I (group A), and a series of matched consecutive patients were treated by 131I only (group B). Laser energy was delivered with an output power of 3 W (1800 J per fiber per treatment) through two 75-mm, 21-gauge spinal needles. Radioiodine activity was calculated to deliver 200 Gy to the hyperfunctioning nodule. Thyroid function, thyroid peroxidase antibody, thyroglobulin antibody, ultrasound, and local symptoms were measured at baseline and up to 24 months. Nodule volume reduction at 24 months was: 71.3 ± 13.4 vs 47.4 ± 5.5%, group A (LAT+131I) vs group B (131I), respectively; P symptom score demonstrated a more rapid reduction in group A (LAT+131I). In three cases, no 131I treatment was needed after LAT. In this pilot study, combined LAT/131I treatment induced faster and greater improvement of local and systemic symptoms compared to 131I only. This approach seems a possible alternative to thyroidectomy in patients at refusal of surgery.

  16. Benchmarking Insulin Treatment Persistence Among Patients with Type 2 Diabetes Across Different U.S. Payer Segments.

    Science.gov (United States)

    Wei, Wenhui; Jiang, Jenny; Lou, Youbei; Ganguli, Sohini; Matusik, Mark S

    2017-03-01

    Treatment persistence with basal insulins is crucial to achieving sustained glycemic control, which is associated with a reduced risk of microvascular disease and other complications of type 2 diabetes (T2D). However, studies suggest that persistence with basal insulin treatment is often poor. To measure and benchmark real-world basal insulin treatment persistence among patients with T2D across different payer segments in the United States. This was a retrospective observational study of data from a national pharmacy database (Walgreen Co., Deerfield, IL). The analysis included patients with T2D aged ≥ 18 years who filled ≥ 1 prescription for basal insulins between January 2013 and June 2013 (the index prescription) and who had also filled prescriptions for ≥ 1 oral antidiabetes drug in the database. Patients with claims for premixed insulin were excluded. Treatment persistence was defined as remaining on the study medication(s) during the 1-year follow-up period. Patients were stratified according to treatment history (existing basal insulin users vs. new insulin users), payer segments (commercially insured, Medicare, Medicaid, or cash-pay), type of basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin [NPH]), and device for insulin administration (pen or vial/syringe). A total of 274,102 patients were included in this analysis, 82% of whom were existing insulin users. In terms of payer segments, 45.3% of patients were commercially insured, 47.8% had Medicare, 5.9% had Medicaid, and 1.1% were cash-pay. At the 1-year follow-up, basal insulin treatment persistence rate was 66.8% overall, 61.7% for new users, and 67.9% for existing users. In general, for both existing and new basal insulin users, higher persistence rate and duration were associated with Medicare versus cash-pay patients, use of insulin pens versus vial/syringe, and use of insulin glargine versus NPH. This large-scale study provides a benchmark of basal insulin

  17. Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

    Directory of Open Access Journals (Sweden)

    Marie Dorow

    2018-05-01

    Full Text Available Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1 investigate treatment preferences for depression including internet-based interventions and (2 examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.Results: Patients had a mean age of 43.9 years (SD = 13.8 and more than two thirds (68.6% were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.

  18. Uncertainty assessment of a model for biological nitrogen and phosphorus removal: Application to a large wastewater treatment plant

    Science.gov (United States)

    Mannina, Giorgio; Cosenza, Alida; Viviani, Gaspare

    In the last few years, the use of mathematical models in WasteWater Treatment Plant (WWTP) processes has become a common way to predict WWTP behaviour. However, mathematical models generally demand advanced input for their implementation that must be evaluated by an extensive data-gathering campaign, which cannot always be carried out. This fact, together with the intrinsic complexity of the model structure, leads to model results that may be very uncertain. Quantification of the uncertainty is imperative. However, despite the importance of uncertainty quantification, only few studies have been carried out in the wastewater treatment field, and those studies only included a few of the sources of model uncertainty. Seeking the development of the area, the paper presents the uncertainty assessment of a mathematical model simulating biological nitrogen and phosphorus removal. The uncertainty assessment was conducted according to the Generalised Likelihood Uncertainty Estimation (GLUE) methodology that has been scarcely applied in wastewater field. The model was based on activated-sludge models 1 (ASM) and 2 (ASM2). Different approaches can be used for uncertainty analysis. The GLUE methodology requires a large number of Monte Carlo simulations in which a random sampling of individual parameters drawn from probability distributions is used to determine a set of parameter values. Using this approach, model reliability was evaluated based on its capacity to globally limit the uncertainty. The method was applied to a large full-scale WWTP for which quantity and quality data was gathered. The analysis enabled to gain useful insights for WWTP modelling identifying the crucial aspects where higher uncertainty rely and where therefore, more efforts should be provided in terms of both data gathering and modelling practises.

  19. Do Males and Females Conceptualise Work and Social Impairment Differently Following Treatment for Different Mental Health Problems?

    Science.gov (United States)

    Smith, David; Fairweather-Schmidt, A Kate; Riley, Ben; Javidi, Zhila; Zabeen, Sara; Lawn, Sharon; Battersby, Malcolm

    2018-04-01

    The Work and Social Adjustment Scale (WSAS) is used by psychiatric nurses for screening and evaluating patients' treatment outcomes for a variety of mental health problems. This study investigated longitudinal and gender measurement invariance of WSAS using structural equation modeling within a help-seeking problem gambling sample (n=445), and an intervention program for depression and anxiety sample (n=444). The concept of functional impairment was defined by all WSAS items in males and females at pre- and post-treatment assessments. These findings confirm that the WSAS is a robust and efficacious instrument for evaluating treatment outcomes in two differing populations. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. SU-F-J-21: Clinical Evaluation of Surface Scanning Systems in Different Treatment Locations

    Energy Technology Data Exchange (ETDEWEB)

    Moser, T; Karger, C [German Cancer Research Center (DKFZ), Heidelberg (Germany); Stefanowicz, S; Rhein, B; Oetzel, D; Adeberg, S; Koenig, L; Wolf, R; Rieken, S [Heidelberg University, Heidelberg (Germany)

    2016-06-15

    Purpose: To reduce imaging dose in fractionated IGRT, the ability of optical surface imaging systems (OSIS) to detect setup errors was tested. Therefore, clinical studies to evaluate for different treatment locations setup corrections derived by OSIS in comparison with x-ray image guidance in fractionated radiation therapy was performed. Methods: The setup correction accuracy of an OSIS system (AlignRT, VisionRT, London, UK) will be analysed for the 4 tumour locations Pelvis, Upper Abdomen, Thorax and Breast, 20 patients for each location in comparison to a different system (Sentinel, C-RAD, SE). For each patient, the setup corrections of the cone-beam computed tomography (CBCT) of an Elekta Versa HD linear accelerator (Elekta, Crawley, UK) is considered as gold-standard and then compared with those of the OSIS for the first ten fractions retrospectively. There were no clinical decisions made based on the surrogate system. For the OSIS, the reference surface is highly important as it represents the actual ground truth. It can be obtained either with the system itself or the surface structure delineated in the planning CT can be imported via DICOM interface. In this paper, the first results for the treatment region thorax are presented. The reference image modalities were compared. Results: Table 1 displays the difference between the setup corrections obtained with OSIS and CBCT in lateral (LAT), longitudinal (LNG) and vertical (VRT) direction for the DICOM reference image. While the median deviations are within a few millimeters, some outliers showed large deviations. Generally, the mean deviation as well as the spread was smallest in lateral and largest in vertical direction. Conclusion: Although the system allows fast, simple and non-invasive determination of setup corrections, it should be evaluated treatment region dependant. Therefore, the study is ongoing. The application of OSIS may help to reduce the imaging dose for the patient. We gratefully acknowledge

  1. Effects of Different Imagery Strategies in the Psychological Treatment of Chronic Headache

    Directory of Open Access Journals (Sweden)

    Gisela Peters

    1998-01-01

    Full Text Available This study investigates the effects of four different imagery techniques: pleasant imagery versus imaginative transformations, and response versus stimulus imagery. One may expect imaginative transformations to be more effective than pleasant imagery. Response imaginative transformations should be more effective than stimulus imaginative transformations, while the pleasant imagery conditions are not expected to have different effects. In a 2x2 design, treatment conditions were compared. Forty patients (33 females, seven males with different types of chronic headache were referred by their physicians and took part in the study. Pain diaries and questionnaires of pain experience and pain behaviour were used as outcome measures. Imaginative transformations - irrespective of response or stimulus orientation - were found to be more effective than pleasant imagery in reducing headache frequency. Reductions remained stable over an eight-month follow-up. There are no significant differences between response and stimulus imagery. Treatment effects were manifested in a reduction of headache frequency, while headache duration and headache intensity did not change. Suffering and avoidance behaviours were reduced in all treatment groups, while the use of distraction strategies was increased. The reductions in suffering were significantly greater in the groups treated with imaginative transformations. In the eight-month follow-up, group differences in reductions in suffering were no longer significant, which is probably due to the reduced sample size. The results support the hypothesis that a cognitive redefinition is responsible for the beneficial treatment effects because only instructions to imagine a change in pain sensations and/or pain responses led to significant improvements.

  2. Population-based differences in treatment outcome following anticancer drug therapies.

    Science.gov (United States)

    Ma, Brigette By; Hui, Edwin P; Mok, Tony Sk

    2010-01-01

    Population-based differences in toxicity and clinical outcome following treatment with anticancer drugs have an important effect on oncology practice and drug development. These differences arise from complex interactions between biological and environmental factors, which include genetic diversity affecting drug metabolism and the expression of drug targets, variations in tumour biology and host physiology, socioeconomic disparities, and regional preferences in treatment standards. Some well-known examples include the high prevalence of activating epidermal growth factor receptor (EGFR) mutations in pulmonary adenocarcinoma among northeast (China, Japan, Korea) and parts of southeast Asia (excluding India) non-smokers, which predict sensitivity to EGFR kinase inhibitors, and the sharp contrast between Japan and the west in the management and survival outcome of gastric cancer. This review is a critical overview of population-based differences in the four most prevalent cancers in the world: lung, breast, colorectal, and stomach cancer. Particular attention is given to the clinical relevance of such knowledge in terms of the individualisation of drug therapy and in the design of clinical trials. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  3. Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

    Science.gov (United States)

    Zhang, Xingming; Shen, Pengfei; He, Qiying; Yin, Xiaoxue; Chen, Zhibin; Gui, Haojun; Shu, Kunpeng; Tang, Qidun; Yang, Yaojing; Pan, Xiuyi; Wang, Jia; Chen, Ni; Zeng, Hao

    2016-01-01

    All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. PMID:27009501

  4. Large-scale production of graphitic carbon nitride with outstanding nitrogen photofixation ability via a convenient microwave treatment

    International Nuclear Information System (INIS)

    Ma, Huiqiang; Shi, Zhenyu; Li, Shuang; Liu, Na

    2016-01-01

    Highlights: • Microwave method for synthesizing g-C_3N_4 with N_2 photofixation ability is reported. • Nitrogen vacancies play the important role on the nitrogen photofixation ability. • The present process is a convenient method for large-scale production of g-C_3N_4. - Abstract: A convenient microwave treatment for synthesizing graphitic carbon nitride (g-C_3N_4) with outstanding nitrogen photofixation ability under visible light is reported. X-ray diffraction (XRD), N_2 adsorption, UV–vis spectroscopy, SEM, N_2-TPD, EPR, photoluminescence (PL) and photocurrent measurements were used to characterize the prepared catalysts. The results indicate that microwave treatment can form many irregular pores in as-prepared g-C_3N_4, which causes the increased surface area and separation rate of electrons and holes. More importantly, microwave treatment causes the formation of many nitrogen vacancies in as-prepared g-C_3N_4. These nitrogen vacancies not only serve as active sites to adsorb and activate N_2 molecules but also promote interfacial charge transfer from catalysts to N_2 molecules, thus significantly improving the nitrogen photofixation ability. Moreover, the present process is a convenient method for large-scale production of g-C_3N_4 which is significantly important for the practical application.

  5. Sex Differences in Behavioral Dyscontrol: Role in Drug Addiction and Novel Treatments.

    Science.gov (United States)

    Carroll, Marilyn E; Smethells, John R

    2015-01-01

    The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, is discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug-abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as (1) using natural consequences such as non-drug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, (2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and (3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.

  6. Sex differences in behavioral dyscontrol: Role in drug addiction and novel treatments

    Directory of Open Access Journals (Sweden)

    Marilyn E. Carroll

    2016-02-01

    Full Text Available The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, are discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as: 1 using natural consequences such as nondrug rewards (e.g., exercise to maintain abstinence, or using punishment as a consequence for drug use, 2 targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and 3 combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.

  7. Sex Differences in Behavioral Dyscontrol: Role in Drug Addiction and Novel Treatments

    Science.gov (United States)

    Carroll, Marilyn E.; Smethells, John R.

    2016-01-01

    The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, is discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug-abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as (1) using natural consequences such as non-drug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, (2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and (3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments. PMID:26903885

  8. Gender differences in the treatment of patients with bipolar disorder: a study of 7354 patients.

    Science.gov (United States)

    Karanti, Alina; Bobeck, Christian; Osterman, Maja; Kardell, Mathias; Tidemalm, Dag; Runeson, Bo; Lichtenstein, Paul; Landén, Mikael

    2015-03-15

    Gender differences in treatment that are not supported by empirical evidence have been reported in several areas of medicine. Here, the aim was to evaluate potential gender differences in the treatment for bipolar disorder. Data was collected from the Swedish National Quality Assurance Register for bipolar disorder (BipoläR). Baseline registrations from the period 2004-2011 of 7354 patients were analyzed. Multiple logistic regression analysis was used to study the impact of gender on interventions. Women were more often treated with antidepressants, lamotrigine, electroconvulsive therapy, benzodiazepines, and psychotherapy. Men were more often treated with lithium. There were no gender differences in treatment with mood stabilizers as a group, neuroleptics, or valproate. Subgroup analyses revealed that ECT was more common in women only in the bipolar I subgroup. Contrariwise, lamotrigine was more common in women only in the bipolar II subgroup. As BipoläR contains data on outpatient treatment of persons with bipolar disorder in Sweden, it is unclear if these findings translate to inpatient care and to outpatient treatment in other countries. Men and women with bipolar disorder receive different treatments in routine clinical settings in Sweden. Gender differences in level of functioning, bipolar subtype, or severity of bipolar disorder could not explain the higher prevalence of pharmacological treatment, electroconvulsive therapy, and psychotherapy in women. Our results suggest that clinicians׳ treatment decisions are to some extent unduly influenced by patients׳ gender. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Acne treatment patterns, expectations, and satisfaction among adult females of different races/ethnicities

    Directory of Open Access Journals (Sweden)

    Rendon MI

    2015-05-01

    Full Text Available Marta I Rendon,1 David A Rodriguez,2 Ariane K Kawata,3 Arnold N Degboe,4 Teresa K Wilcox,3 Caroline T Burk,5 Selena R Daniels,4 Wendy E Roberts6 1Rendon Center for Dermatology and Aesthetic Medicine, Boca Raton, FL, USA; 2Dermatology Associates and Research, Coral Gables, FL, USA; 3Evidera, Bethesda, MD, USA; 4Allergan Inc., Irvine, CA, USA; 5Health Outcomes Consultant, Laguna Beach, CA, USA; 6Generational and Cosmetic Dermatology, Rancho Mirage, CA, USA Background: Limited data are available on acne treatment patterns, expectations, and satisfaction in the adult female subpopulation, particularly among different racial and ethnic groups. Objective: Describe acne treatment patterns and expectations in adult females of different racial/ethnic groups and analyze and explore their potential effects on medication compliance and treatment satisfaction. Methods: A cross-sectional, Web-based survey was administered to US females (25–45 years with facial acne (≥25 visible lesions. Data collected included sociodemographics, self-reported clinical characteristics, acne treatment use, and treatment expectations and satisfaction. Results: Three hundred twelve subjects completed the survey (mean age, 35.3±5.9 years, comprising black (30.8%, Hispanic (17.6%, Asian/other (17.3%, and white (34.3%. More than half of the subjects in each racial group recently used an acne treatment or procedure (black, 63.5%; Hispanic, 54.5%; Asian/other, 66.7%; white, 66.4%. Treatment use was predominantly over-the-counter (OTC (47.4% versus prescription medications (16.6%. OTC use was highest in white subjects (black, 42.7%; Hispanic, 34.5%; Asian/other, 44.4%; white, 59.8%; P<0.05. The most frequently used OTC treatments in all racial/ethnic groups were salicylic acid (SA (34.3% and benzoyl peroxide (BP (32.1%. Overall, compliance with acne medications was highest in white versus black (57.0±32.4 vs 42.7±33.5 days, P>0.05, Hispanic (57.0±32.4 vs 43.2±32.9 days, P>0

  10. Gender Differences in Antithrombotic Treatment for Newly Diagnosed Atrial Fibrillation

    DEFF Research Database (Denmark)

    Mazurek, Michał; Huisman, Menno V; Rothman, Kenneth J

    2018-01-01

    was -0.5% (95% CI, -1.8%, 0.8%). VKAs were prescribed to 32.8% and 31.9% (NOACs 46.8% and 48.3%) of women and men, respectively. No confounder for the association between gender and anticoagulant prescription was identified. Between-gender differences in anticoagulant use (lower use in women compared......AIMS: Data on gender differences in oral anticoagulation for stroke prevention in patients with atrial fibrillation are conflicting, largely limited to regional reports and Vitamin K antagonist (VKA) use. We aimed to analyze gender-specific anticoagulant prescription patterns early following...... atrial fibrillation (difference in prevalence of anticoagulant use...

  11. Cognitive behaviour therapy for chronic fatigue syndrome: Differences in treatment outcome between a tertiary treatment centre in the United Kingdom and the Netherlands.

    Science.gov (United States)

    Worm-Smeitink, M; Nikolaus, S; Goldsmith, K; Wiborg, J; Ali, S; Knoop, H; Chalder, T

    2016-08-01

    Cognitive behaviour therapy (CBT) reduces fatigue and disability in chronic fatigue syndrome (CFS). However, outcomes vary between studies, possibly because of differences in patient characteristics, treatment protocols, diagnostic criteria and outcome measures. The objective was to compare outcomes after CBT in tertiary treatment centres in the Netherlands (NL) and the United Kingdom (UK), using different treatment protocols but identical outcome measures, while controlling for differences in patient characteristics and diagnostic criteria. Consecutively referred CFS patients who received CBT were included (NL: n=293, UK: n=163). Uncontrolled effect sizes for improvement in fatigue (Chalder Fatigue Questionnaire), physical functioning (SF-36 physical functioning subscale) and social functioning (Work and Social Adjustment Scale) were compared. Multiple regression analysis was used to examine whether patient differences explained outcome differences between centres. Effect sizes differed between centres for fatigue (Cohen's D NL=1.74, 95% CI=1.52-1.95; UK=0.99, CI=0.73-1.25), physical functioning (NL=0.99, CI=0.81-1.18; UK=0.33, CI=0.08-0.58) and social functioning (NL=1.47, CI=1.26-1.69; UK=0.61, CI=0.35-0.86). Patients in the UK had worse physical functioning at baseline and there were minor demographic differences. These could not explain differences in centre outcome. Effectiveness of CBT differed between treatment centres. Differences in treatment protocols may explain this and should be investigated to help further improve outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Monitoring the effects of different conservation treatments on paper-infecting fungi.

    Science.gov (United States)

    Michaelsen, Astrid; Pinzari, Flavia; Barbabietola, Nicoletta; Piñar, Guadalupe

    2013-10-01

    Fungi are among the most degradative organisms inducing biodeterioration of paper-based items of cultural heritage. Appropriate conservation measures and restoration treatments to deal with fungal infections include mechanical, chemical, and biological methods, which entail effects on the paper itself and health hazards for humans. Three different conservation treatments, namely freeze-drying, gamma rays, and ethylene oxide fumigation, were compared and monitored to assess their short- (one month, T1) and long-term (one year, T2) effectiveness to inhibit fungal growth. After the inoculation with fungi possessing cellulose hydrolysis ability - Chaetomium globosum , Trichoderma viride, and Cladosporium cladosporioides - as single strains or as a mixture, different quality paper samples were treated and screened for fungal viability by culture-dependent and -independent techniques. Results derived from both strategies were contradictory. Both gamma irradiation and EtO fumigation showed full efficacy as disinfecting agents when evaluated with cultivation techniques. However, when using molecular analyses, the application of gamma rays showed a short-term reduction in DNA recovery and DNA fragmentation; the latter phenomenon was also observed in a minor degree in samples treated with freeze-drying. When RNA was used as an indicator of long-term fungal viability, differences in the RNA recovery from samples treated with freeze-drying or gamma rays could be observed in samples inoculated with the mixed culture. Only the treatment with ethylene oxide proved negative for both DNA and RNA recovery. Therefore, DNA fragmentation after an ethylene oxide treatment can hamper future paleogenetic and archaeological molecular studies on the objects.

  13. Padé approximant for normal stress differences in large-amplitude oscillatory shear flow

    Science.gov (United States)

    Poungthong, P.; Saengow, C.; Giacomin, A. J.; Kolitawong, C.; Merger, D.; Wilhelm, M.

    2018-04-01

    Analytical solutions for the normal stress differences in large-amplitude oscillatory shear flow (LAOS), for continuum or molecular models, normally take the inexact form of the first few terms of a series expansion in the shear rate amplitude. Here, we improve the accuracy of these truncated expansions by replacing them with rational functions called Padé approximants. The recent advent of exact solutions in LAOS presents an opportunity to identify accurate and useful Padé approximants. For this identification, we replace the truncated expansion for the corotational Jeffreys fluid with its Padé approximants for the normal stress differences. We uncover the most accurate and useful approximant, the [3,4] approximant, and then test its accuracy against the exact solution [C. Saengow and A. J. Giacomin, "Normal stress differences from Oldroyd 8-constant framework: Exact analytical solution for large-amplitude oscillatory shear flow," Phys. Fluids 29, 121601 (2017)]. We use Ewoldt grids to show the stunning accuracy of our [3,4] approximant in LAOS. We quantify this accuracy with an objective function and then map it onto the Pipkin space. Our two applications illustrate how to use our new approximant reliably. For this, we use the Spriggs relations to generalize our best approximant to multimode, and then, we compare with measurements on molten high-density polyethylene and on dissolved polyisobutylene in isobutylene oligomer.

  14. Surgical treatment of a large congenital cavernous hemangioma on the thorax of a foal

    DEFF Research Database (Denmark)

    Jacobsen, Stine; Christophersen, Mogens Teken; Tnibar, Aziz

    2018-01-01

    A 3-day-old male foal was presented with a fluctuant 25 × 15 cm mass on the thorax. The mass had increased in size since birth. The mass did not respond to conservative treatment consisting of aspiration of serohaemorrhagic contents and compression bandages, and it was therefore surgically removed...... when the foal was approximately 2½ weeks. A histopathological diagnosis of cavernous haemangioma was made. Healing progressed without complications despite a large surgical wound left to heal by second intention. Recurrence was not observed during the 1.5-year follow-up period....

  15. Single-tooth replacement: factors affecting different prosthetic treatment modalities

    Directory of Open Access Journals (Sweden)

    Al-Quran Firas A

    2011-12-01

    Full Text Available Abstract Background The choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options. Method 200 volunteers involved (121 females and 79 males divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire. Results The highest percentage of males within groups (58% was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency. Conclusions The final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.

  16. Assisted outpatient treatment in New York: regional differences in New York's assisted outpatient treatment program.

    Science.gov (United States)

    Robbins, Pamela Clark; Keator, Karli J; Steadman, Henry J; Swanson, Jeffrey W; Wilder, Christine M; Swartz, Marvin S

    2010-10-01

    This study sought to describe the implementation of "Kendra's Law" in New York State and examine regional differences in the application of the program. Between February 2007 and April 2008, interviews were conducted with 50 key informants across New York State. Key informants included assisted outpatient treatment (AOT) county coordinators, county directors of community services, judges, attorneys from the Mental Hygiene Legal Service (MHLS), psychiatrists, treatment providers, peer advocates, family members, and other referred individuals. Additional analyses were conducted using AOT program administrative and evaluation databases and client history data. From program inception in 1999 through 2007, a total of 8,752 initial AOT orders and 5,684 renewals were granted. Notable regional differences were found in the use of two distinct models of AOT: AOT First and Enhanced Voluntary Services First. Regional differences were also found in how the AOT program was implemented and administered. Other variations stemmed from the court proceedings themselves, the continuity and interest of the presiding judge, and the attitudes of the MHLS attorneys. Many regional adaptations of the AOT program were found. Many were the result of lack of guidance in implementing Kendra's Law. Policy makers may want to consider whether the law should change to allow for these differences or whether additional support from a central source is warranted to ensure more uniformity in the implementation of AOT and thus the fairness of its application across the state.

  17. Comparative study of 6 MV and 15 MV treatment plans for large chest wall irradiation

    International Nuclear Information System (INIS)

    Prasana Sarathy, N.; Kothanda Raman, S.; Sen, Dibyendu; Pal, Bipasha

    2007-01-01

    Conventionally, opposed tangential fields are used for the treatment of chest wall irradiation. If the chest wall is treated in the linac, 4 or 6 MV photons will be the energy of choice. It is a welI-established rule that for chest wall separations up to 22 cm, one can use mid-energies, with acceptable volume of hot spots. For larger patient sizes (22 cm and above), mid-energy beams produce hot spots over large volumes. The purpose of this work is to compare plans made with 6 and 15 MV photons, for patients with large chest wall separations. The obvious disadvantage in using high-energy photons for chest wall irradiation is inadequate dose to the skin. But this can be compensated by using a bolus of suitable thickness

  18. Investigating sex differences in psychological predictors of snack intake among a large representative sample

    NARCIS (Netherlands)

    Adriaanse, M.A.; Evers, C.; Verhoeven, A.A.C.; de Ridder, D.T.D.

    It is often assumed that there are substantial sex differences in eating behaviour (e.g. women are more likely to be dieters or emotional eaters than men). The present study investigates this assumption in a large representative community sample while incorporating a comprehensive set of

  19. Letter-Sound Knowledge: Exploring Gender Differences in Children When They Start School Regarding Knowledge of Large Letters, Small Letters, Sound Large Letters, and Sound Small Letters

    Directory of Open Access Journals (Sweden)

    Hermundur Sigmundsson

    2017-09-01

    Full Text Available This study explored whether there is a gender difference in letter-sound knowledge when children start at school. 485 children aged 5–6 years completed assessment of letter-sound knowledge, i.e., large letters; sound of large letters; small letters; sound of small letters. The findings indicate a significant difference between girls and boys in all four factors tested in this study in favor of the girls. There are still no clear explanations to the basis of a presumed gender difference in letter-sound knowledge. That the findings have origin in neuro-biological factors cannot be excluded, however, the fact that girls probably have been exposed to more language experience/stimulation compared to boys, lends support to explanations derived from environmental aspects.

  20. Second-line therapy in diffuse large B-cell lymphoma (DLBCL): treatment patterns and outcomes in older patients receiving outpatient chemotherapy.

    Science.gov (United States)

    Danese, Mark D; Griffiths, Robert I; Gleeson, Michelle L; Dalvi, Tapashi; Li, Jingyi; Mikhael, Joseph R; Deeter, Robert; Dreyling, Martin

    2017-05-01

    Using SEER-Medicare linked data we identified elderly patients diagnosed with diffuse large B-cell lymphoma (DLBCL) between January 2000 and December 2007 who received second-line outpatient chemotherapy for relapsed or refractory disease. Second-line regimens were classified into three mutually exclusive groups: aggressive, conventional, and palliative. Of the 632 (426 relapsed, 206 refractory) patients in the cohort, 27.8% received aggressive second-line therapy, 39.1% received conventional therapy, and 33.1% received palliative therapy. There were no differences in survival by type of therapy received, either for relapsed or refractory patients, although the patient risk profile differed significantly. However, duration of remission, male gender, and anemia at diagnosis were important predictors in relapsed patients, and male gender, B-symptoms, comorbidity burden, and poverty status were important predictors in refractory patients. Survival in elderly patients receiving second-line therapy remains poor, and the 24-month cost of all care exceeds $97,000. Patients would benefit from improved treatment options.

  1. A large-scale analysis of sex differences in facial expressions.

    Directory of Open Access Journals (Sweden)

    Daniel McDuff

    Full Text Available There exists a stereotype that women are more expressive than men; however, research has almost exclusively focused on a single facial behavior, smiling. A large-scale study examines whether women are consistently more expressive than men or whether the effects are dependent on the emotion expressed. Studies of gender differences in expressivity have been somewhat restricted to data collected in lab settings or which required labor-intensive manual coding. In the present study, we analyze gender differences in facial behaviors as over 2,000 viewers watch a set of video advertisements in their home environments. The facial responses were recorded using participants' own webcams. Using a new automated facial coding technology we coded facial activity. We find that women are not universally more expressive across all facial actions. Nor are they more expressive in all positive valence actions and less expressive in all negative valence actions. It appears that generally women express actions more frequently than men, and in particular express more positive valence actions. However, expressiveness is not greater in women for all negative valence actions and is dependent on the discrete emotional state.

  2. Effects of Different Treatments on Seed Germination Improvement of Calotropis persica

    Directory of Open Access Journals (Sweden)

    Asghar Farajollahi

    2014-01-01

    Full Text Available The purpose of this study was to investigate the effects of different treatments on seed germination in the desert plant species Calotropis persica (Gand.. This species is known to have long time for seed germination considering arid region condition and short time of access moist. An experiment was performed with 13 treatments and 4 replications in a completely randomized design. Treatments included KNO3 with concentrations of 0.1, 0.2, and 0.3 percent, immersion in hot water for five min, acetylsalicylic acid 100, 200, and 300 mg L−1, ethereal sulfuric acid (60% for 5 and 10 min, thiourea with concentrations of 0.1% and 0.3%, and prechilling for 10 days. Tap water was used as the control. Our findings indicate that KNO3 0.1% and 100 mg L−1 acetylsalicylic acid were the most effective treatments for improvement of seed germination properties in this species. In a comparison of the two mentioned treatment, KNO3 0.1% treatments is the best.

  3. Ethnic Differences in Parental Beliefs of Attention-Deficit/Hyperactivity Disorder and Treatment

    Science.gov (United States)

    Pham, Andy V.; Carlson, John S.; Kosciulek, John F.

    2010-01-01

    Objective: A survey study was conducted to explore ethnic differences in parental beliefs about the causes and treatments of ADHD and whether these beliefs predicted treatment preference. Method: Ethnically diverse parents of 5- to 12-year-old children with ADHD (n = 58) and without ADHD (n = 61) completed a questionnaire developed by the authors…

  4. Effect of high temperature heat treatments on the quality factor of a large-grain superconducting radio-frequency niobium cavity

    Science.gov (United States)

    Dhakal, P.; Ciovati, G.; Myneni, G. R.; Gray, K. E.; Groll, N.; Maheshwari, P.; McRae, D. M.; Pike, R.; Proslier, T.; Stevie, F.; Walsh, R. P.; Yang, Q.; Zasadzinzki, J.

    2013-04-01

    Large-grain Nb has become a viable alternative to fine-grain Nb for the fabrication of superconducting radio-frequency cavities. In this contribution we report the results from a heat treatment study of a large-grain 1.5 GHz single-cell cavity made of “medium purity” Nb. The baseline surface preparation prior to heat treatment consisted of standard buffered chemical polishing. The heat treatment in the range 800-1400°C was done in a newly designed vacuum induction furnace. Q0 values of the order of 2×1010 at 2.0 K and peak surface magnetic field (Bp) of 90 mT were achieved reproducibly. A Q0 value of (5±1)×1010 at 2.0 K and Bp=90mT was obtained after heat treatment at 1400°C. This is the highest value ever reported at this temperature, frequency, and field. Samples heat treated with the cavity at 1400°C were analyzed by secondary ion mass spectrometry, x-ray photoelectron spectroscopy, energy dispersive x ray, point-contact tunneling, and x-ray diffraction, and revealed a complex surface composition which includes titanium oxide, increased carbon, and nitrogen content but reduced hydrogen concentration compared to a non-heat-treated sample.

  5. Differences between hospitals in attainment of parathyroid hormone treatment targets in chronic kidney disease do not reflect differences in quality of care.

    Science.gov (United States)

    Peeters, Mieke J; van Zuilen, Arjan D; van den Brand, Jan A J G; Blankestijn, Peter J; ten Dam, Marc A G J; Wetzels, Jack F M

    2012-08-06

    Transparency in quality of care (QoC) is stimulated and hospitals are compared and judged on the basis of indicators of performance on specific treatment targets. In patients with chronic kidney disease, QoC differed significantly between hospitals. In this analysis we explored additional parameters to explain differences between centers in attainment of parathyroid hormone (PTH) treatment targets. Using MASTERPLAN baseline data, we selected one of the worst (center A) and one of the best (center B) performing hospitals. Differences between the two centers were analyzed from the year prior to start of the MASTERPLAN study until the baseline evaluation. Determinants of PTH were assessed. 101 patients from center A (median PTH 9.9 pmol/l, in 67 patients exceeding recommended levels) and 100 patients from center B (median PTH 6.5 pmol/l, in 34 patients exceeding recommended levels), were included. Analysis of clinical practice did not reveal differences in PTH management between the centers. Notably, hyperparathyroidism resulted in a change in therapy in less than 25% of patients. In multivariate analysis kidney transplant status, MDRD-4, and treatment center were independent predictors of PTH. However, when MDRD-6 (which accounts for serum urea and albumin) was used instead of MDRD-4, the center effect was reduced. Moreover, after calibration of the serum creatinine assays treatment center no longer influenced PTH. We show that differences in PTH control between centers are not explained by differences in treatment, but depend on incomparable patient populations and laboratory techniques. Therefore, results of hospital performance comparisons should be interpreted with great caution.

  6. The comparison of greenhouse gas emissions in sewage treatment plants with different treatment processes.

    Science.gov (United States)

    Masuda, Shuhei; Sano, Itsumi; Hojo, Toshimasa; Li, Yu-You; Nishimura, Osamu

    2018-02-01

    Greenhouse gas emissions from different sewage treatment plants: oxidation ditch process, double-circulated anoxic-oxic process and anoxic-oxic process were evaluated based on the survey. The methane and nitrous oxide characteristics were discussed based on the gaseous and dissolved gas profiles. As a result, it was found that methane was produced in the sewer pipes and the primary sedimentation tank. Additionally, a ventilation system would promote the gasification of dissolved methane in the first treatment units. Nitrous oxide was produced and emitted in oxic tanks with nitrite accumulation inside the sewage treatment plant. A certain amount of nitrous oxide was also discharged as dissolved gas through the effluent water. If the amount of dissolved nitrous oxide discharge is not included, 7-14% of total nitrous oxide emission would be overlooked. Based on the greenhouse gas calculation, electrical consumption and the N 2 O emission from incineration process were major sources in all the plants. For greenhouse gas reduction, oxidation ditch process has an advantage over the other advanced systems due to lower energy consumption, sludge production, and nitrogen removal without gas stripping. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Effects of different temperature treatments on biological ice nuclei in snow samples

    Science.gov (United States)

    Hara, Kazutaka; Maki, Teruya; Kakikawa, Makiko; Kobayashi, Fumihisa; Matsuki, Atsushi

    2016-09-01

    The heat tolerance of biological ice nucleation activity (INA) depends on their types. Different temperature treatments may cause varying degrees of inactivation on biological ice nuclei (IN) in precipitation samples. In this study, we measured IN concentration and bacterial INA in snow samples using a drop freezing assay, and compared the results for unheated snow and snow treated at 40 °C and 90 °C. At a measured temperature of -7 °C, the concentration of IN in untreated snow was 100-570 L-1, whereas the concentration in snow treated at 40 °C and 90 °C was 31-270 L-1 and 2.5-14 L-1, respectively. In the present study, heat sensitive IN inactivated by heating at 40 °C were predominant, and ranged 23-78% of IN at -7 °C compared with untreated samples. Ice nucleation active Pseudomonas strains were also isolated from the snow samples, and heating at 40 °C and 90 °C inactivated these microorganisms. Consequently, different temperature treatments induced varying degrees of inactivation on IN in snow samples. Differences in the concentration of IN across a range of treatment temperatures might reflect the abundance of different heat sensitive biological IN components.

  8. Sex differences in drug abuse: Etiology, prevention, and treatment.

    Science.gov (United States)

    Evans, Suzette M; Reynolds, Brady

    2015-08-01

    This special issue exemplifies one of the major goals of the current editor of Experimental and Clinical Psychopharmacology (Dr. Suzette Evans): to increase the number of manuscripts that emphasize females and address sex differences. Taken together, these articles represent a broad range of drug classes and approaches spanning preclinical research to treatment to better understand the role of sex differences in drug abuse. While not all studies found sex differences, we want to emphasize that finding no sex difference is just as important as confirming one, and should be reported in peer-reviewed journals. It is our intention and hope that this special issue will further advance scientific awareness about the importance of accounting for sex differences in the study of substance abuse. Participant sex is an essential variable to consider in developing a more comprehensive understanding of substance abuse. Rather than viewing investigating sex differences as burdensome, investigators should seize this opportune area ripe for innovative research that is long overdue. (c) 2015 APA, all rights reserved).

  9. Large-scale production of graphitic carbon nitride with outstanding nitrogen photofixation ability via a convenient microwave treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Huiqiang [College of Chemistry, Chemical Engineering, and Environmental Engineering, Liaoning Shihua University, Fushun 113001 (China); College of Environment and Resources, Key Lab of Groundwater Resources and Environment, Ministry of Education, Jilin University, Changchun 130021 (China); Shi, Zhenyu; Li, Shuang [College of Chemistry, Chemical Engineering, and Environmental Engineering, Liaoning Shihua University, Fushun 113001 (China); Liu, Na, E-mail: Naliujlu@163.com [College of Environment and Resources, Key Lab of Groundwater Resources and Environment, Ministry of Education, Jilin University, Changchun 130021 (China)

    2016-08-30

    Highlights: • Microwave method for synthesizing g-C{sub 3}N{sub 4} with N{sub 2} photofixation ability is reported. • Nitrogen vacancies play the important role on the nitrogen photofixation ability. • The present process is a convenient method for large-scale production of g-C{sub 3}N{sub 4}. - Abstract: A convenient microwave treatment for synthesizing graphitic carbon nitride (g-C{sub 3}N{sub 4}) with outstanding nitrogen photofixation ability under visible light is reported. X-ray diffraction (XRD), N{sub 2} adsorption, UV–vis spectroscopy, SEM, N{sub 2}-TPD, EPR, photoluminescence (PL) and photocurrent measurements were used to characterize the prepared catalysts. The results indicate that microwave treatment can form many irregular pores in as-prepared g-C{sub 3}N{sub 4}, which causes the increased surface area and separation rate of electrons and holes. More importantly, microwave treatment causes the formation of many nitrogen vacancies in as-prepared g-C{sub 3}N{sub 4}. These nitrogen vacancies not only serve as active sites to adsorb and activate N{sub 2} molecules but also promote interfacial charge transfer from catalysts to N{sub 2} molecules, thus significantly improving the nitrogen photofixation ability. Moreover, the present process is a convenient method for large-scale production of g-C{sub 3}N{sub 4} which is significantly important for the practical application.

  10. Enhancing Growth and Yield of Grey Oyster Mushroom (Plearotussajorcaju Using Different Acoustic Sound Treatments

    Directory of Open Access Journals (Sweden)

    Ibrahim Roshita

    2017-01-01

    Full Text Available Mushroom, as believed by many people, grows on specific time and condition as in the wild it grows after a heavy rain falls. The effects of lightning and thunderstorm may suppress the mychorrizal structure to grow and eventually forming fruiting body. This study was conducted to determine the effect of different acoustic sound treatments on the growth and yield of grey oyster mushroom (Pleurotussajor-caju. Five different acoustic sound treatments had been applied during spawning period which were thunder storm, hardcore music, soothing instrumental, Quranic recital and without any sound treatment applied which served as control. The parameters studied were mycelium growth rate, days of mycelium filled up the bags, days of pinhead emergence, days of fruiting body formation, total weight, percentage biological efficiency, pileus color and texture. There were significant differences (P0.05 observed in other parameters, such as pinhead emergence, fruiting bodies formation, pileus color and texture. In summary, treatments using different acoustic sound at 75 dB could be considered as better treatment to enhance the mycelium growth thus accelerate the mushroom cultivation process as well as increasing the mushroom productivity. This research could help farmers to grow and harvest their mushroom at specific time frame and fulfill customer’s demand.

  11. 40 CFR 63.1581 - Does the subpart distinguish between different types of POTW treatment plants?

    Science.gov (United States)

    2010-07-01

    ... different types of POTW treatment plants? 63.1581 Section 63.1581 Protection of Environment ENVIRONMENTAL... treatment plants? Yes, POTW treatment plants are divided into two subcategories. A POTW treatment plant which does not meet the characteristics of an industrial POTW treatment plant belongs in the non...

  12. Different techniques recently used for the treatment of textile dyeing effluents: a review

    International Nuclear Information System (INIS)

    Altaf, A.; Noor, S.; Sharif, Q.M.; Najeebullah, M.

    2010-01-01

    Industrial textile processing comprises the operation of pretreatment dyeing printing and finishing. These production processes produce a substantial amount of chemical pollution. Textile finishing's wastewater, especially dye house effluent, contain different classes of organic dyes, chemicals and auxiliaries. They are colored and have extreme pH, COD and BOD values, and contain different salts, surfactants heavy metals and mineral oils. Therefore, dye bath effluents have to be treated before being discharge into the environment or municipal wastewater reservoir. This paper presents the review of different techniques currently used for the treatment of textile effluent, which are based on carbon adsorption, filtration, chemical precipitation, photo degradation, biodegradation and electrolytic chemical treatment. Membrane Technology has also been applied with the objective of recovering dyes and water. Biological processes could be adopted as a pretreatment decolorization step, combined with conventional treatment system (eg. coagulation flocculation, adsorption on activated carbon) to reduce the COD and BOD, an effective alternative for use by the textile dyeing industries. Electrochemical oxidation is an efficient process for the removal of colour and total organic carbon in reactive dyes textile wastewater. The ozonation is effective for decolorization of several dyes of different classes. Practical application of this process is feasible by treating industrial textile effluent after biological treatment. Processes using membranes technique, very interesting possibilities of separating hydrolyzed dyestuffs, dyeing auxiliaries and reuse treated wastewater in different finishing operation of textile industries. (author)

  13. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    Directory of Open Access Journals (Sweden)

    Tomaras V

    2008-11-01

    Full Text Available Abstract Background The study examines differences regarding quality of life (QoL, mental health and illness beliefs between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD/PD patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a 77 in-centre haemodialysis (HD and 58 continuous ambulatory peritoneal dialysis (CAPD/PD patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years. Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a 41 in-centre haemodialysis (HD and b 48 continuous ambulatory peritoneal dialysis (CAPD/PD patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas

  14. Quantum mechanical treatment of large spin baths

    Science.gov (United States)

    Röhrig, Robin; Schering, Philipp; Gravert, Lars B.; Fauseweh, Benedikt; Uhrig, Götz S.

    2018-04-01

    The electronic spin in quantum dots can be described by central spin models (CSMs) with a very large number Neff≈104 to 106 of bath spins posing a tremendous challenge to theoretical simulations. Here, a fully quantum mechanical theory is developed for the limit Neff→∞ by means of iterated equations of motion (iEoM). We find that the CSM can be mapped to a four-dimensional impurity coupled to a noninteracting bosonic bath in this limit. Remarkably, even for infinite bath the CSM does not become completely classical. The data obtained by the proposed iEoM approach are tested successfully against data from other, established approaches. Thus the iEoM mapping extends the set of theoretical tools that can be used to understand the spin dynamics in large CSMs.

  15. Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes

    Directory of Open Access Journals (Sweden)

    Mehrfam Khoshkhounejad

    2015-11-01

    Full Text Available Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA and BiodentineTM as coronal barriers and different irrigants, which led to different clinical outcomes.

  16. Visualization and measurement of gas-liquid metal two-phase flow with large density difference using thermal neutrons as microscopic probes

    International Nuclear Information System (INIS)

    Saito, Y.; Hibiki, T.; Mishima, K.; Nishihara, H.; Yamamoto, A.; Kanda, K.; Tobita, Y.; Konishi, K.; Matsubayashi, M.

    1998-01-01

    In a core melt accident of a fast breeder reactor there is a possibility of boiling of fuel-steel mixture in the containment pool. In relation to safety evaluation on severe accident, it is indispensable to evaluate the recriticality of melted core. Gas-liquid two-phase flow with a large density difference is formed due to the boiling of fuel-steel mixture. Although the large density difference may affect the basic characteristics of two-phase flow, little work has been performed so far on two-phase flow with large density difference has not been performed well. In this study, visualization and void fraction measurement of gas-liquid metal two-phase flow were performed by using neutron radiography. The effect of the large density difference between gas and liquid phases on the basic flow characteristics of two-phase flow was clarified. (author)

  17. Development of large bore superconducting magnet for wastewater treatment application

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hui Ming; Xu, Dong; Shen, Fuzhi; Zhang, Hengcheng; Li, Lafeng [State Key Laboratory of Technologies in Space Cryogenic Propellants, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing (China)

    2017-03-15

    Water issue, especially water pollution, is a serious issue of 21st century. Being an significant technique for securing water resources, superconducting magnetic separation wastewater system was indispensable. A large bore conduction-cooled magnet was custom-tailored for wastewater treatment. The superconducting magnet has been designed, fabricated and tested. The superconducting magnet was composed of NbTi solenoid coils with an effective horizontal warm bore of 400 mm and a maximum central field of 2.56T. The superconducting magnet system was cooled by a two-stage 1.5W 4K GM cryocooler. The NbTi solenoid coils were wound around an aluminum former that is thermally connected to the second stage cold head of the cryocooler through a conductive copper link. The temperature distribution along the conductive link was measured during the cool-down process as well as at steady state. The magnet was cooled down to 4.8K in approximately 65 hours. The test of the magnetic field and quench analysis has been performed to verify the safe operation for the magnet system. Experimental results show that the superconducting magnet reached the designed magnetic performance.

  18. Large differences in publicly visible health behaviours across two neighbourhoods of the same city.

    Directory of Open Access Journals (Sweden)

    Daniel Nettle

    Full Text Available BACKGROUND: There are socioeconomic disparities in the likelihood of adopting unhealthy behaviours, and success at giving them up. This may be in part because people living in deprived areas are exposed to greater rates of unhealthy behaviour amongst those living around them. Conventional self-report surveys do not capture these differences in exposure, and more ethological methods are required in order to do so. METHODOLOGY/PRINCIPAL FINDINGS: We performed 12 hours of direct behavioural observation in the streets of two neighbourhoods of the same city which were similar in most regards, except that one was much more socioeconomically deprived than the other. There were large differences in the publicly visible health behaviours observed. In the deprived neighbourhood, we observed 266 more adults smoking (rate ratio 3.44, 53 more adults drinking alcohol (rate ratio not calculable, and 38 fewer adults running (rate ratio 0.23, than in the affluent neighbourhood. We used data from the Health Survey for England to calculate the differences we ought to expect to have seen given the individual-level socioeconomic characteristics of the residents. The observed disparities between the two neighbourhoods were considerably greater than this null model predicted. There were also different patterns of smoking in proximity to children in the two neighbourhoods. CONCLUSIONS/SIGNIFICANCE: The differences in observed smoking, drinking alcohol, and physical activity between these two neighbourhoods of the same city are strikingly large, and for smoking and running, their magnitude suggests substantial area effects above and beyond the compositional differences between the neighbourhoods. Because of these differences, individuals residing in deprived areas are exposed to substantially more smoking and public drinking, and less physical activity, as they go about their daily lives, than their affluent peers. This may have important implications for the initiation

  19. Large spot transpupillary thermotherapy: a quicker laser for treatment of high risk prethreshold retinopathy of prematurity - a randomized study.

    Science.gov (United States)

    Shah, Parag K; Narendran, V; Kalpana, N

    2011-01-01

    To compare structural and functional outcome and time efficiency between standard spot sized conventional pulsed mode diode laser and continuous mode large spot transpupillary thermotherapy (LS TTT) for treatment of high risk prethreshold retinopathy of prematurity (ROP). Ten eyes of five preterm babies having bilateral symmetrical high risk prethreshold ROP were included in this study. One eye of each baby was randomized to get either standard spot sized conventional pulsed mode diode laser or continuous mode LS TTT. There was no significant difference between structural or functional outcome in either group. The mean time taken for conventional diode laser was 20.07 minutes, while that for LS TTT was 12.3 minutes. LS TTT was 40% more time efficient than the conventional laser. It may be better suited for the very small fragile premature infants as it is quicker than the conventional laser.

  20. Do different methods of modeling statin treatment effectiveness influence the optimal decision?

    NARCIS (Netherlands)

    B.J.H. van Kempen (Bob); B.S. Ferket (Bart); A. Hofman (Albert); S. Spronk (Sandra); E.W. Steyerberg (Ewout); M.G.M. Hunink (Myriam)

    2012-01-01

    textabstractPurpose. Modeling studies that evaluate statin treatment for the prevention of cardiovascular disease (CVD) use different methods to model the effect of statins. The aim of this study was to evaluate the impact of using different modeling methods on the optimal decision found in such

  1. Subsurface flow constructed wetlands for the treatment of wastewater from different sources. Design and operation

    OpenAIRE

    Torrens Armengol, Antonina

    2016-01-01

    The aim of the thesis is to examine the viability of the subsurface constructed wetlands for the treatment of wastewater derived from three different sources (treatment ponds, pig farms and car wash facilities), and to evaluate the influence of design (size, type and depth of media, presence of Phragmites australis) and operational parameters (hydraulic load, dosing and feeding modes) on treatment efficiency and hydraulic behavior. Several studies were done in the framework of different ...

  2. Effect of high temperature heat treatments on the quality factor of a large-grain superconducting radio-frequency niobium cavity

    Directory of Open Access Journals (Sweden)

    P. Dhakal

    2013-04-01

    Full Text Available Large-grain Nb has become a viable alternative to fine-grain Nb for the fabrication of superconducting radio-frequency cavities. In this contribution we report the results from a heat treatment study of a large-grain 1.5 GHz single-cell cavity made of “medium purity” Nb. The baseline surface preparation prior to heat treatment consisted of standard buffered chemical polishing. The heat treatment in the range 800–1400°C was done in a newly designed vacuum induction furnace. Q_{0} values of the order of 2×10^{10} at 2.0 K and peak surface magnetic field (B_{p} of 90 mT were achieved reproducibly. A Q_{0} value of (5±1×10^{10} at 2.0 K and B_{p}=90  mT was obtained after heat treatment at 1400°C. This is the highest value ever reported at this temperature, frequency, and field. Samples heat treated with the cavity at 1400°C were analyzed by secondary ion mass spectrometry, x-ray photoelectron spectroscopy, energy dispersive x ray, point-contact tunneling, and x-ray diffraction, and revealed a complex surface composition which includes titanium oxide, increased carbon, and nitrogen content but reduced hydrogen concentration compared to a non-heat-treated sample.

  3. Effect of high temperature heat treatments on the quality factor of a large-grain superconducting radio-frequency niobium cavity

    Energy Technology Data Exchange (ETDEWEB)

    Dhakal, P.; Ciovati, G.; Myneni, G. R.; Gray, K. E.; Groll, N.; Maheshwari, P.; McRae, D. M.; Pike, R.; Proslier, T.; Stevie, F.; Walsh, R. P.; Yang, Q.; Zasadzinzki, J.

    2013-04-01

    Large-grain Nb has become a viable alternative to fine-grain Nb for the fabrication of superconducting radio-frequency cavities. In this contribution we report the results from a heat treatment study of a large-grain 1.5 GHz single-cell cavity made of “medium purity” Nb. The baseline surface preparation prior to heat treatment consisted of standard buffered chemical polishing. The heat treatment in the range 800–1400°C was done in a newly designed vacuum induction furnace. Q{sub 0} values of the order of 2×10{sup 10} at 2.0 K and peak surface magnetic field (B{sub p}) of 90 mT were achieved reproducibly. A Q{sub 0} value of (5±1)×10{sup 10} at 2.0 K and B{sub p}=90mT was obtained after heat treatment at 1400°C. This is the highest value ever reported at this temperature, frequency, and field. Samples heat treated with the cavity at 1400°C were analyzed by secondary ion mass spectrometry, x-ray photoelectron spectroscopy, energy dispersive x ray, point-contact tunneling, and x-ray diffraction, and revealed a complex surface composition which includes titanium oxide, increased carbon, and nitrogen content but reduced hydrogen concentration compared to a non-heat-treated sample.

  4. Large-scale transcriptome analysis reveals arabidopsis metabolic pathways are frequently influenced by different pathogens.

    Science.gov (United States)

    Jiang, Zhenhong; He, Fei; Zhang, Ziding

    2017-07-01

    Through large-scale transcriptional data analyses, we highlighted the importance of plant metabolism in plant immunity and identified 26 metabolic pathways that were frequently influenced by the infection of 14 different pathogens. Reprogramming of plant metabolism is a common phenomenon in plant defense responses. Currently, a large number of transcriptional profiles of infected tissues in Arabidopsis (Arabidopsis thaliana) have been deposited in public databases, which provides a great opportunity to understand the expression patterns of metabolic pathways during plant defense responses at the systems level. Here, we performed a large-scale transcriptome analysis based on 135 previously published expression samples, including 14 different pathogens, to explore the expression pattern of Arabidopsis metabolic pathways. Overall, metabolic genes are significantly changed in expression during plant defense responses. Upregulated metabolic genes are enriched on defense responses, and downregulated genes are enriched on photosynthesis, fatty acid and lipid metabolic processes. Gene set enrichment analysis (GSEA) identifies 26 frequently differentially expressed metabolic pathways (FreDE_Paths) that are differentially expressed in more than 60% of infected samples. These pathways are involved in the generation of energy, fatty acid and lipid metabolism as well as secondary metabolite biosynthesis. Clustering analysis based on the expression levels of these 26 metabolic pathways clearly distinguishes infected and control samples, further suggesting the importance of these metabolic pathways in plant defense responses. By comparing with FreDE_Paths from abiotic stresses, we find that the expression patterns of 26 FreDE_Paths from biotic stresses are more consistent across different infected samples. By investigating the expression correlation between transcriptional factors (TFs) and FreDE_Paths, we identify several notable relationships. Collectively, the current study

  5. Evidence from stellar abundances for a large age difference between two globular clusters

    International Nuclear Information System (INIS)

    Dickens, R.J.; Croke, B.F.W.; Cannon, R.D.; Bell, R.A.

    1991-01-01

    The globular clusters NGC288 and NGC362 are central to recent claims of large age differences (∼3 Gyr) between globular clusters associated with our Galaxy. According to standard models for the formation of the Galaxy, the system of globular clusters formed during the dynamical collapse of the protogalactic cloud, a process which should have lasted no more than 1 Gyr. But the claimed age differences are derived from stellar evolution models using assumed CNO abundances, and uncertainty in the actual CNO abundances of about a factor of three could account for an apparent 2-Gyr age difference. We have accurately measured abundances in red giants in NGC288 and NGC362, and find that the Fe abundance and the sum of the C, N and O abundances are essentially the same in every star studied. By eliminating compositional differences and thus confirming the reality of the age difference, these results imply a cluster formation period that is hard to reconcile with the standard collapse model. (author)

  6. Racial/Ethnic Differences in the Relationship between Obesity and Depression Treatment.

    Science.gov (United States)

    Abdus, Salam; Zuvekas, Samuel H

    2015-10-01

    Using data from the 2004 to 2008 Medical Expenditure Panel Survey (MEPS), this study examined the relationship between obesity and the treatment of depression across racial/ethnic subgroups, controlling for depressive symptoms, self-rated mental health, health status, and socioeconomic characteristics. The association between obesity and depression-related medication was significant for white women but not for black or Hispanic women. Similarly, the association between obesity and depression-related ambulatory visits was significant for white women but not for black or Hispanic women. The results for men were, in general, mixed and inconsistent. The significant racial/ethnic differences found in the relationship between obesity and depression treatment among women suggest that social and cultural factors might play important roles in depression treatment among women.

  7. The influence of different irradiation sources on the treatment of nitrobenzene

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, Miguel [Universidad de Los Andes, Escuela Basica de Ingenieria, La Hechicera, Merida (Venezuela); Timokhin, Vitaliy [Department of Physical Chemistry, Institute of Physical Chemistry, National Academy of Sciences of Ukraine, 3a Naukova Street, 79053 Lviv (Ukraine); Michl, Florian; Contreras, Sandra; Gimenez, Jaime; Esplugas, Santiago [Department d' Enginyeria Quimica i Metallurgia, Universitat de Barcelona, Marti i Franques 1, 08028 Barcelona (Spain)

    2002-11-15

    This work describes the influence of light on the treatment of nitrobenzene (NB) in aqueous solutions. Three different experimental devices were used to perform a detailed study: a photoreactor with four low-pressure mercury lamps ({lambda}=253.7nm), a tubular photoreactor with a polychromatic Xe lamp (290<{lambda}<1200nm), and finally a solar reactor (sunlight). TOC analyses were performed in order to monitor and compare the extent of these processes, each of them being performed with one of the three different sources of light. The influence of Fe(II), Fe(III), H{sub 2}O{sub 2}, and light on the mineralization of NB in aqueous solutions was also studied. The successful use of sunlight as a source of energy and its effectiveness regarding Fenton processes as well as direct photolysis in the treatment of NB are presented.

  8. Effectiveness of Psychotherapy in Personality Disorders Not Otherwise Specified: A Comparison of Different Treatment Modalities.

    Science.gov (United States)

    Horn, Eva K; Bartak, Anna; Meerman, Anke M M A; Rossum, Bert V; Ziegler, Uli M; Thunnissen, Moniek; Soons, Mirjam; Andrea, Helene; Hamers, Elisabeth F M; Emmelkamp, Paul M G; Stijnen, Theo; Busschbach, Jan J V; Verheul, Roel

    2015-01-01

    Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive

  9. Multidose Stereotactic Radiosurgery (9 Gy × 3) of the Postoperative Resection Cavity for Treatment of Large Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Minniti, Giuseppe, E-mail: gminniti@ospedalesantandrea.it [Radiation Oncology Unit, Sant' Andrea Hospital, University “Sapienza,” Rome (Italy); Department of Neurological Sciences, Scientific Institute IRCCS Neuromed, Pozzilli (Italy); Esposito, Vincenzo [Department of Neurological Sciences, Scientific Institute IRCCS Neuromed, Pozzilli (Italy); Clarke, Enrico; Scaringi, Claudia [Radiation Oncology Unit, Sant' Andrea Hospital, University “Sapienza,” Rome (Italy); Lanzetta, Gaetano [Department of Neurological Sciences, Scientific Institute IRCCS Neuromed, Pozzilli (Italy); Salvati, Maurizio [Department of Neurological Sciences, Scientific Institute IRCCS Neuromed, Pozzilli (Italy); Neurosurgery Unit, Umberto I Hospital, University “Sapienza,” Rome (Italy); Raco, Antonino [Neurosurgery Unit, Sant' Andrea Hospital, University “Sapienza,” Rome (Italy); Bozzao, Alessandro [Neuroradiology Unit, Sant' Andrea Hospital, University “Sapienza,” Rome (Italy); Maurizi Enrici, Riccardo [Radiation Oncology Unit, Sant' Andrea Hospital, University “Sapienza,” Rome (Italy)

    2013-07-15

    Purpose: To evaluate the clinical outcomes with linear accelerator-based multidose stereotactic radiosurgery (SRS) to large postoperative resection cavities in patients with large brain metastases. Methods and Materials: Between March 2005 to May 2012, 101 patients with a single brain metastasis were treated with surgery and multidose SRS (9 Gy × 3) for large resection cavities (>3 cm). The target volume was the resection cavity with the inclusion of a 2-mm margin. The median cavity volume was 17.5 cm{sup 3} (range, 12.6-35.7 cm{sup 3}). The primary endpoint was local control. Secondary endpoints were survival and distant failure rates, cause of death, performance measurements, and toxicity of treatment. Results: With a median follow-up of 16 months (range, 6-44 months), the 1-year and 2-year actuarial survival rates were 69% and 34%, respectively. The 1-year and 2-year local control rates were 93% and 84%, with respective incidences of new distant brain metastases of 50% and 66%. Local control was similar for radiosensitive (non-small cell lung cancer and breast cancer) and radioresistant (melanoma and renal cell cancer) brain metastases. On multivariate Cox analysis stable extracranial disease, breast cancer histology, and Karnofsky performance status >70 were associated with significant survival benefit. Brain radionecrosis occurred in 9 patients (9%), being symptomatic in 5 patients (5%). Conclusions: Adjuvant multidose SRS to resection cavity represents an effective treatment option that achieves excellent local control and defers the use of whole-brain radiation therapy in selected patients with large brain metastases.

  10. Endometritis treatment with a PGF2alpha analog does not improve reproductive performance in a large dairy herd in Argentina.

    Science.gov (United States)

    Mejía, Miguel Eduardo; Lacau-Mengido, Isabel María

    2005-03-15

    In Argentina, most dairy cows with endometritis are treated with prostaglandin (PGF(2alpha) or its analogs) and insemination is withheld until there are no signs of endometritis. The objective of the present study was to evaluate if this method of managing endometritis enhances reproductive performance. Three experiments were conducted over 4 years in a large farm in the west of Buenos Aires province. In Experiment 1, half of the cows diagnosed with endometritis (>1.5-fold difference in diameter of uterine horns, as determined by rectal palpation) received standard endometritis management (treatment with tiaprost, a PGF(2alpha) analog, rectal palpation every 20 days, and withholding of AI until endometritis apparently resolved) and the other half was untreated, with AI at the first estrus after the voluntary waiting period. Untreated cows were inseminated and conceived 20 days earlier than treated cows, and the pregnancy rate by Day 90 postpartum was higher in the untreated group. In Experiment 2, cows with endometritis were divided into four groups according to the severity of symptoms; within each group, cows were allocated to treatment or control, as in Experiment 1. Although first service conception rate decreased as endometritis severity increased, reproductive performance in treated versus control cows was similar to that of Experiment 1 (with no interaction due to degree of endometritis). Re-evaluation of the treated cow (to confirm uterine "normality") may have been responsible for the delay in conception in both experiments. The objective of Experiment 3 was to determine the effects of tiaprost treatment on clinically normal postpartum cows (no evidence of endometritis). Tiaprost treatment reduced the interval from calving to conception in multiparous cows, but it delayed conception and reduced the conception rate in primiparous cows. In conclusion, treatment with tiaprost impaired reproductive performance in primiparous cows (in the absence of

  11. Characterization of Different Types of Excitability in Large Somatosensory Neurons and Its Plastic Changes in Pathological Pain States

    Science.gov (United States)

    Xie, Rou-Gang; Chu, Wen-Guang; Hu, San-Jue; Luo, Ceng

    2018-01-01

    Sensory neuron types have been distinguished by distinct morphological and transcriptional characteristics. Excitability is the most fundamental functional feature of neurons. Mathematical models described by Hodgkin have revealed three types of neuronal excitability based on the relationship between firing frequency and applied current intensity. However, whether natural sensory neurons display different functional characteristics in terms of excitability and whether this excitability type undergoes plastic changes under pathological pain states have remained elusive. Here, by utilizing whole-cell patch clamp recordings, behavioral and pharmacological assays, we demonstrated that large dorsal root ganglion (DRG) neurons can be classified into three classes and four subclasses based on their excitability patterns, which is similar to mathematical models raised by Hodgkin. Analysis of hyperpolarization-activated cation current (Ih) revealed different magnitude of Ih in different excitability types of large DRG neurons, with higher Ih in Class 2-1 than that in Class 1, 2-2 and 3. This indicates a crucial role of Ih in the determination of excitability type of large DRG neurons. More importantly, this pattern of excitability displays plastic changes and transition under pathological pain states caused by peripheral nerve injury. This study sheds new light on the functional characteristics of large DRG neurons and extends functional classification of large DRG neurons by integration of transcriptomic and morphological characteristics. PMID:29303989

  12. Characterization of Different Types of Excitability in Large Somatosensory Neurons and Its Plastic Changes in Pathological Pain States

    Directory of Open Access Journals (Sweden)

    Rou-Gang Xie

    2018-01-01

    Full Text Available Sensory neuron types have been distinguished by distinct morphological and transcriptional characteristics. Excitability is the most fundamental functional feature of neurons. Mathematical models described by Hodgkin have revealed three types of neuronal excitability based on the relationship between firing frequency and applied current intensity. However, whether natural sensory neurons display different functional characteristics in terms of excitability and whether this excitability type undergoes plastic changes under pathological pain states have remained elusive. Here, by utilizing whole-cell patch clamp recordings, behavioral and pharmacological assays, we demonstrated that large dorsal root ganglion (DRG neurons can be classified into three classes and four subclasses based on their excitability patterns, which is similar to mathematical models raised by Hodgkin. Analysis of hyperpolarization-activated cation current (Ih revealed different magnitude of Ih in different excitability types of large DRG neurons, with higher Ih in Class 2-1 than that in Class 1, 2-2 and 3. This indicates a crucial role of Ih in the determination of excitability type of large DRG neurons. More importantly, this pattern of excitability displays plastic changes and transition under pathological pain states caused by peripheral nerve injury. This study sheds new light on the functional characteristics of large DRG neurons and extends functional classification of large DRG neurons by integration of transcriptomic and morphological characteristics.

  13. Differences and effects of medium and large adult cuffs on blood pressure readings in individuals with muscular arms.

    Science.gov (United States)

    Fonseca-Reyes, Salvador; Fajardo-Flores, Ismael; Montes-Casillas, Mayra; Forsyth-Macquarrie, Avril

    2009-08-01

    This study analyzed systolic and diastolic blood pressure (SBP and DBP) reading differences in individuals with muscular arms, using medium and large adult cuffs. Resting blood pressures (BPs) were measured in bodybuilders competing at the Mexican National Bodybuilding and Fitness Championship. The means of two bilateral simultaneous arm BP measurements were obtained using two different cuff sizes, 12 cm (medium adult) and 16 cm (large adult). A total of 193 bodybuilders completed the measurements. With an arm circumference greater than 33 cm, the SBP and DBP average taken with the medium adult cuff was higher than that obtained with the large adult cuff, 8.2+/-10.6 and 1.6+/-7.4 mmHg, respectively; however, a significant difference was observed only with the SBP. With the medium adult cuff, 48 of 144 individuals showed SBP at least 140 mmHg, whereas with the large adult cuff there were only 17 of 144 individuals. In those participants with an arm circumference less than 33 cm, the BP was nonsignificantly lower with the large cuff, -4.24+/-9.2 and -2.24+/-5.4 mmHg for the SBP and DBP, respectively. Incorrect cuffing of a muscular arm leads to significant errors in the measurement of SBP and DBP, similar to that observed in miscuffing of nonmuscular arms.

  14. Motivation and readiness for drug treatment: differences by modality and special populations.

    Science.gov (United States)

    Melnick, Gerald; Hawke, Josephine; De Leon, George

    2014-01-01

    The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of more than 6,000 admissions to 38 programs. Results from multilevel analyses show (a) an ordered increase in motivation by settings from referral to outpatient, to methadone maintenance, and to the highest levels in residential programs and (b) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment.

  15. A Novel Treatment of Fear of Flying Using a Large Virtual Reality System.

    Science.gov (United States)

    Czerniak, Efrat; Caspi, Asaf; Litvin, Michal; Amiaz, Revital; Bahat, Yotam; Baransi, Hani; Sharon, Hanania; Noy, Shlomo; Plotnik, Meir

    2016-04-01

    Fear of flying (FoF), a common phobia in the developed world, is usually treated with cognitive behavioral therapy, most efficiently when combined with exposure methods, e.g., virtual reality exposure therapy (VRET). We evaluated FoF treatment using VRET in a large motion-based VR system. The treated subjects were seated on a moving platform. The virtual scenery included the interior of an aircraft and a window view to the outside world accompanied by platform movements simulating, e.g., takeoff, landing, and air turbulence. Relevant auditory stimuli were also incorporated. Three male patients with FoF underwent a clinical interview followed by three VRETs in the presence and with the guidance of a therapist. Scores on the Flight Anxiety Situation (FAS) and Flight Anxiety Modality (FAM) questionnaires were obtained on the first and fourth visits. Anxiety levels were assessed using the subjective units of distress (SUDs) scale during the exposure. All three subjects expressed satisfaction regarding the procedure and did not skip or avoid any of its stages. Consistent improvement was seen in the SUDs throughout the VRET session and across sessions, while patients' scores on the FAS and FAM showed inconsistent trends. Two patients participated in actual flights in the months following the treatment, bringing 12 and 16 yr of avoidance to an end. This VR-based treatment includes critical elements for exposure of flying experience beyond visual and auditory stimuli. The current case reports suggest VRET sessions may have a meaningful impact on anxiety levels, yet additional research seems warranted.

  16. Costs and cost-effectiveness of different DOT strategies for the treatment of tuberculosis in Pakistan. Directly Observed Treatment.

    Science.gov (United States)

    Khan, M A; Walley, J D; Witter, S N; Imran, A; Safdar, N

    2002-06-01

    An economic study was conducted alongside a clinical trial at three sites in Pakistan to establish the costs and effectiveness of different strategies for implementing directly observed treatment (DOT) for tuberculosis. Patients were randomly allocated to one of three arms: DOTS with direct observation by health workers (at health centres or by community health workers); DOTS with direct observation by family members; and DOTS without direct observation. The clinical trial found no statistically significant difference in cure rate for the different arms. The economic study collected data on the full range of health service costs and patient costs of the different treatment arms. Data were also disaggregated by gender, rural and urban patients, by treatment site and by economic categories, to investigate the costs of the different strategies, their cost-effectiveness and the impact that they might have on patient compliance with treatment. The study found that direct observation by health centre-based health workers was the least cost-effective of the strategies tested (US dollars 310 per case cured). This is an interesting result, as this is the model recommended by the World Health Organization and International Union against Tuberculosis and Lung Disease. Attending health centres daily during the first 2 months generated high patient costs (direct and in terms of time lost), yet cure rates for this group fell below those of the non-observed group (58%, compared with 62%). One factor suggested by this study is that the high costs of attending may be deterring patients, and in particular, economically active patients who have most to lose from the time taken by direct observation. Without stronger evidence of benefits, it is hard to justify the costs to health services and patients that this type of direct observation imposes. The self-administered group came out as most cost-effective (164 dollars per case cured). The community health worker sub-group achieved the

  17. Histotripsy Liquefaction of Large Hematomas.

    Science.gov (United States)

    Khokhlova, Tatiana D; Monsky, Wayne L; Haider, Yasser A; Maxwell, Adam D; Wang, Yak-Nam; Matula, Thomas J

    2016-07-01

    Intra- and extra-muscular hematomas result from repetitive injury as well as sharp and blunt limb trauma. The clinical consequences can be serious, including debilitating pain and functional deficit. There are currently no short-term treatment options for large hematomas, only lengthy conservative treatment. The goal of this work was to evaluate the feasibility of a high intensity focused ultrasound (HIFU)-based technique, termed histotripsy, for rapid (within a clinically relevant timeframe of 15-20 min) liquefaction of large volume (up to 20 mL) extra-vascular hematomas for subsequent fine-needle aspiration. Experiments were performed using in vitro extravascular hematoma phantoms-fresh bovine blood poured into 50 mL molds and allowed to clot. The resulting phantoms were treated by boiling histotripsy (BH), cavitation histotripsy (CH) or a combination in a degassed water tank under ultrasound guidance. Two different transducers operating at 1 MHz and 1.5 MHz with f-number = 1 were used. The liquefied lysate was aspirated and analyzed by histology and sized in a Coulter Counter. The peak instantaneous power to achieve BH was lower than (at 1.5 MHz) or equal to (at 1 MHz) that which was required to initiate CH. Under the same exposure duration, BH-induced cavities were one and a half to two times larger than the CH-induced cavities, but the CH-induced cavities were more regularly shaped, facilitating easier aspiration. The lysates contained a small amount of debris larger than 70 μm, and 99% of particulates were smaller than 10 μm. A combination treatment of BH (for initial debulking) and CH (for liquefaction of small residual fragments) yielded 20 mL of lysate within 17.5 minutes of treatment and was found to be most optimal for liquefaction of large extravascular hematomas. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

    Science.gov (United States)

    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

  19. Contemporary conceptions of etiology, pathogenesis, management and treatment of primary diffuse large b-cell central nervous system lymphoma

    Directory of Open Access Journals (Sweden)

    S. V. Voloshin

    2013-01-01

    Full Text Available In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms,previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm. 

  20. Contemporary conceptions of etiology, pathogenesis, management and treatment of primary diffuse large b-cell central nervous system lymphoma

    Directory of Open Access Journals (Sweden)

    S. V. Voloshin

    2014-07-01

    Full Text Available In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms,previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm. 

  1. Large spot transpupillary thermotherapy: A quicker laser for treatment of high risk prethreshold retinopathy of prematurity - A randomized study

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2011-01-01

    Full Text Available To compare structural and functional outcome and time efficiency between standard spot sized conventional pulsed mode diode laser and continuous mode large spot transpupillary thermotherapy (LS TTT for treatment of high risk prethreshold retinopathy of prematurity (ROP. Ten eyes of five preterm babies having bilateral symmetrical high risk prethreshold ROP were included in this study. One eye of each baby was randomized to get either standard spot sized conventional pulsed mode diode laser or continuous mode LS TTT. There was no significant difference between structural or functional outcome in either group. The mean time taken for conventional diode laser was 20.07 minutes, while that for LS TTT was 12.3 minutes. LS TTT was 40% more time efficient than the conventional laser. It may be better suited for the very small fragile premature infants as it is quicker than the conventional laser.

  2. The acceptability of stem cell-based fertility treatments for different indications

    NARCIS (Netherlands)

    Hendriks, S.; Dancet, E. A. F.; Vliegenthart, R.; Repping, S.

    2017-01-01

    STUDY QUESTION: What is the acceptability of using stem cell-based fertility treatments (SCFT) for different indications according to gynaecologists and the general public? SUMMARY ANSWER: The majority of gynaecologists and the general public accept SCFT for the indications female or male

  3. Dental Fear and Avoidance in Treatment Seekers at a Large, Urban Dental Clinic.

    Science.gov (United States)

    Heyman, Richard E; Slep, Amy M Smith; White-Ajmani, Mandi; Bulling, Lisanne; Zickgraf, Hana F; Franklin, Martin E; Wolff, Mark S

    2016-01-01

    The prevalence and correlates of dental fear have been studied in representative population studies, but not in patients presenting for dental treatment. We hypothesized that dental fear among patients presenting at a large, urban college of dentistry would be similar to that of the population (e.g. 11% high dental fear, 17% to 35% moderate or higher fear) and that fear would be associated with avoidance of routine dental care, increased use of urgent dental care and poor oral health. Participants were 1070 consecutive patients at a large, urban dental care center. All patients completed a clinical interview, including demographics, medical history, dental history and presenting concerns, and behavioral health history. Patients were also asked to rate their dental anxiety/fear on a 1 (none) to 10 (high) scale. Over 20% of patients reported elevated anxiety/fear, of which 12.30% reported moderate and 8.75% high fear. Severity of dental anxiety/fear was strongly related to the likelihood of avoiding dental services in the past and related to myriad presenting problems. As hypothesized, the prevalence of moderate or higher fear in dental patients was considerable and closely matched that found in general population surveys. Thus, the 'dental home' is an ideal location to treat clinically significant dental anxiety/fear.

  4. Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve outcome?

    Science.gov (United States)

    Jansen, Esther J S; Dijkman, Koen P; van Lingen, Richard A; de Vries, Willem B; Vijlbrief, Daniel C; de Boode, Willem P; Andriessen, Peter

    2017-10-01

    The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes. Materials and methods We carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure. In total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33-63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1-4), and the need for surgical ligation after failure of pharmacological treatment (8-52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre. Using benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure.

  5. Microbial production of volatile sulphur compounds in the large intestine of pigs fed two different diets.

    Science.gov (United States)

    Poulsen, H V; Jensen, B B; Finster, K; Spence, C; Whitehead, T R; Cotta, M A; Canibe, N

    2012-07-01

      To investigate the production of volatile sulphur compounds (VSC) in the segments of the large intestine of pigs and to assess the impact of diet on this production.   Pigs were fed two diets based on either wheat and barley (STD) or wheat and dried distillers grains with solubles (DDGS). Net production of VSC and potential sulphate reduction rate (SRR) (sulphate saturated) along the large intestine were determined by means of in vitro incubations. The net production rate of hydrogen sulphide and potential SRR increased from caecum towards distal colon and were significantly higher in the STD group. Conversely, the net methanethiol production rate was significantly higher in the DDGS group, while no difference was observed for dimethyl sulphide. The number of sulphate-reducing bacteria and total bacteria were determined by quantitative PCR and showed a significant increase along the large intestine, whereas no diet-related differences were observed.   VSC net production varies widely throughout the large intestine of pigs and the microbial processes involved in this production can be affected by diet.   This first report on intestinal production of all VSC shows both spatial and dietary effects, which are relevant to both bowel disease- and odour mitigation research. © 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

  6. Variable-Frequency Ultrasonic Treatment on Microstructure and Mechanical Properties of ZK60 Alloy during Large Diameter Semi-Continuous Casting

    Directory of Open Access Journals (Sweden)

    Xingrui Chen

    2017-05-01

    Full Text Available Traditional fixed-frequency ultrasonic technology and a variable-frequency ultrasonic technology were applied to refine the as-cast microstructure and improve the mechanical properties of a ZK60 (Mg–Zn–Zr alloy during large diameter semi-continuous casting. The acoustic field propagation was obtained by numerical simulation. The microstructure of the as-cast samples was characterized by optical and scanning electron microscopy. The variable-frequency ultrasonic technology shows its outstanding ability in grain refinement compared with traditional fixed-ultrasonic technology. The variable-frequency acoustic field promoted the formation of small α-Mg globular grains and changed the distribution and morphology of β-phases throughout the castings. Ultimate tensile strength and elongation are increased to 280 MPa and 8.9%, respectively, which are 19.1% and 45.9% higher than the values obtained from billets without ultrasonic treatment and are 11.6% and 18.7% higher than fixed-frequency ultrasound treated billets. Different refinement efficiencies appear in different districts of billets attributed to the sound attenuation in melt. The variable-frequency acoustic field improves the refinement effect by enhancing cavitation-enhanced heterogeneous nucleation and dendrite fragmentation effects.

  7. Wastewater treatment in horizontal subsurface flow constructed wetlands using different media (setup stage

    Directory of Open Access Journals (Sweden)

    Abdel Razik A. Zidan

    2015-04-01

    Full Text Available Wastewater treatment through horizontal subsurface flow (HSSF constructed wetlands (CWs using three different treatment media (gravel, pieces of plastic pipes, and shredded tire rubber chips were investigated in Samaha village, Dakahliya, Egypt. The study focused on the wetland setup stage during the first months of its operation (setup stage. In this stage media porosity, bacterial biofilm, and plant roots growth were in progress and it was prior to the operational steady state stage. Objectives of this paper are to study the change in media porosity of HSSF wetland cells in order to estimate duration of wetland setup stage, and to evaluate the use of different bed media on biological oxygen demand (BOD, chemical oxygen demand (COD and total suspended solids (TSS treatment. The results showed that after 180 days of operation, the wetland cells had reached steady porosity and had started stable treatment. Also performance of plastic media bed in pollutants reduction was better than gravel and rubber beds and gravel media was in advanced than rubber media.

  8. Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation

    Science.gov (United States)

    We measured the concentrations of 56 active pharmaceutical ingredients (APIs) and seven metabolites, including 50 prioritized APIs, in 24-hour composite effluent samples collected from 50 very large municipal wastewater treatment plants across the US. Hydrochlorothiazide was foun...

  9. Treatment of melasma with low fluence, large spot size, 1064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of melasma in Fitzpatrick skin types II-IV.

    Science.gov (United States)

    Brown, Alia S; Hussain, Mussarat; Goldberg, David J

    2011-12-01

    Melasma is a common condition affecting over six million American women. Treatment of dermal or combined melasma is difficult and does not respond well to conventional topical therapies. Various light sources have been used recently in the treatment of melasma including fractionated ablative and non-ablative lasers as well as intense pulse light. We report the use of low fluence, large spot size Q-switched, Nd:Yag laser for the treatment of melasma in skin types II-IV.

  10. Application of different types of mandible resection in combined treatment of oral cancer patient (pt.): results and complications

    International Nuclear Information System (INIS)

    Matyakin, E.G.; Uvarov, A.A.; Kropotov, M.A.; Azizjan, R.I.

    1998-01-01

    Surgery is the main part of combined treatment of advanced oral cancer. Three types of mandible resection were applied in our center. Rim mandibulectomy leads to satisfactory cosmetic and functional results, in case of segmental mandibulectomy different methods of mandible restoration are applied. Middle mandibulotomy creates the optimum access to the operation field in patients with a large primary tumor of mobile tongue and a tumor thai is posteriorly located. Aims of the study: analyse of material to estimate the results and complications in cases of application of different types of mandible resection. Conclusions: Segmental mandibulectomy should be performed if erosion of alveolar ridge is detected. Rim manidibulectomy and segmental mandibylectomy with reconstructive surgery lead to good cosmetic and functional results. Usage of mini plates in reconstruction of mandibular arch decrease the number of postoperative complications even in patients after radiation therapy. Previous radiotherapy significantly increase the risk of the postoperative osteomyelitis of mandible

  11. Differences between child and adult large-scale functional brain networks for reading tasks.

    Science.gov (United States)

    Liu, Xin; Gao, Yue; Di, Qiqi; Hu, Jiali; Lu, Chunming; Nan, Yun; Booth, James R; Liu, Li

    2018-02-01

    Reading is an important high-level cognitive function of the human brain, requiring interaction among multiple brain regions. Revealing differences between children's large-scale functional brain networks for reading tasks and those of adults helps us to understand how the functional network changes over reading development. Here we used functional magnetic resonance imaging data of 17 adults (19-28 years old) and 16 children (11-13 years old), and graph theoretical analyses to investigate age-related changes in large-scale functional networks during rhyming and meaning judgment tasks on pairs of visually presented Chinese characters. We found that: (1) adults had stronger inter-regional connectivity and nodal degree in occipital regions, while children had stronger inter-regional connectivity in temporal regions, suggesting that adults rely more on visual orthographic processing whereas children rely more on auditory phonological processing during reading. (2) Only adults showed between-task differences in inter-regional connectivity and nodal degree, whereas children showed no task differences, suggesting the topological organization of adults' reading network is more specialized. (3) Children showed greater inter-regional connectivity and nodal degree than adults in multiple subcortical regions; the hubs in children were more distributed in subcortical regions while the hubs in adults were more distributed in cortical regions. These findings suggest that reading development is manifested by a shift from reliance on subcortical to cortical regions. Taken together, our study suggests that Chinese reading development is supported by developmental changes in brain connectivity properties, and some of these changes may be domain-general while others may be specific to the reading domain. © 2017 Wiley Periodicals, Inc.

  12. 12 CFR 360.9 - Large-bank deposit insurance determination modernization.

    Science.gov (United States)

    2010-01-01

    ... market discipline, ensure equitable treatment of depositors at different institutions and reduce the FDIC... section for a covered institution that: Has a composite rating of 3, 4, or 5 under the Uniform Financial... operations of a large insured depository institution (defined as a “Covered Institution”) to continue...

  13. Repair Bond Strength of Aged Resin Composite after Different Surface and Bonding Treatments

    Directory of Open Access Journals (Sweden)

    Michael Wendler

    2016-07-01

    Full Text Available The aim of this study was to compare the effect of different mechanical surface treatments and chemical bonding protocols on the tensile bond strength (TBS of aged composite. Bar specimens were produced using a nanohybrid resin composite and aged in distilled water for 30 days. Different surface treatments (diamond bur, phosphoric acid, silane, and sandblasting with Al2O3 or CoJet Sand, as well as bonding protocols (Primer/Adhesive were used prior to application of the repair composite. TBS of the specimens was measured and the results were analyzed using analysis of variance (ANOVA and the Student–Newman–Keuls test (α = 0.05. Mechanically treated surfaces were characterized under SEM and by profilometry. The effect of water aging on the degree of conversion was measured by means of FTIR-ATR spectroscopy. An important increase in the degree of conversion was observed after aging. No significant differences in TBS were observed among the mechanical surface treatments, despite variations in surface roughness profiles. Phosphoric acid etching significantly improved repair bond strength values. The cohesive TBS of the material was only reached using resin bonding agents. Application of an intermediate bonding system plays a key role in achieving reliable repair bond strengths, whereas the kind of mechanical surface treatment appears to play a secondary role.

  14. Phospholipid fatty acid patterns of microbial communities in paddy soil under different fertilizer treatments

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi-chun; WANG Guang-huo; YAO Huai-ying

    2007-01-01

    The microbial communities under irrigated rice cropping with different fertilizer treatments, including control (CK), PK, NK, NP, NPK fertilization, were investigated using phospholipid fatty acid (PLFA) profile method. The results of this study revealed that the fertilizer practice had an impact on the community structure of specific microbial groups. The principal components analysis (PCA) showed that proportion of the actinomycete PLFAs (10Me 18:0 and 10Me 16:0) were the lowest in the PK treatment and the highest in the NPK treatment, which means that soil nitrogen status affected the diversity of actinomycetes, whereas nitrogen cycling was related to the actinomycets. Under CK treatment, the ratio of Gram-positive to Gram-negative bacteria was lower compared with that in fertilizer addition treatments, indicating that fertilizer application stimulated Gram-positive bacterial population in paddy soil. The fatty acid 18:2ω6, 9, which is considered to be predominantly of fungal origin, was at low level in all the treatments. The ratio of cy19:0 to 18:1ω7, which has been proposed as an indicator of stress conditions, decreased in PK treatment. Changes of soil microbial community under different fertilizer treatments of paddy soil were detected in this study; however, the causes that lead to changes in the microbial community still needs further study.

  15. Effects of different remediation treatments on crude oil contaminated saline soil.

    Science.gov (United States)

    Gao, Yong-Chao; Guo, Shu-Hai; Wang, Jia-Ning; Li, Dan; Wang, Hui; Zeng, De-Hui

    2014-12-01

    Remediation of the petroleum contaminated soil is essential to maintain the sustainable development of soil ecosystem. Bioremediation using microorganisms and plants is a promising method for the degradation of crude oil contaminants. The effects of different remediation treatments, including nitrogen addition, Suaeda salsa planting, and arbuscular mycorrhiza (AM) fungi inoculation individually or combined, on crude oil contaminated saline soil were assessed using a microcosm experiment. The results showed that different remediation treatments significantly affected the physicochemical properties, oil contaminant degradation and bacterial community structure of the oil contaminated saline soil. Nitrogen addition stimulated the degradation of total petroleum hydrocarbon significantly at the initial 30d of remediation. Coupling of different remediation techniques was more effective in degrading crude oil contaminants. Applications of nitrogen, AM fungi and their combination enhanced the phytoremediation efficiency of S. salsa significantly. The main bacterial community composition in the crude oil contaminated saline soil shifted with the remediation processes. γ-Proteobacteria, β-Proteobacteria, and Actinobacteria were the pioneer oil-degraders at the initial stage, and Firmicutes were considered to be able to degrade the recalcitrant components at the later stage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Racial/ethnic differences in perceived reasons for mental health treatment in US adolescents with major depression.

    Science.gov (United States)

    Cummings, Janet R; Case, Brady G; Ji, Xu; Chae, David H; Druss, Benjamin G

    2014-09-01

    Racial/ethnic differences in the course of treatment for a major depressive episode (MDE) among adolescents may arise, in part, from variation in the perceived rationale for treatment. We examined racial/ethnic differences in the perceived reasons for receiving mental health (MH) treatment among adolescents with an MDE. A total of 2,789 adolescent participants who experienced an MDE and received MH treatment in the past year were drawn from the 2005 to 2008 National Survey on Drug Use and Health. Adolescents reported the settings in which they received care and reasons for their most recent visit to each setting. Distributions of specific depressive symptoms were compared across racial/ethnic groups. Racial/ethnic differences in endorsing each of 11 possible reasons for receiving treatment were examined using weighted probit regressions adjusted for sociodemographic characteristics, health and mental health status, treatment setting, and survey year. Despite similar depressive symptom profiles, Hispanic adolescents were more likely than whites to endorse "breaking rules" or getting into physical fights as reasons for MH treatment. Black adolescents were more likely than white adolescents to endorse "problems at school" but less likely to endorse "felt very afraid or tense" or "eating problems" as reasons for treatment. Asian adolescents were more likely to endorse "problems with people other than friends or family" but less likely than whites to endorse "suicidal thoughts/attempt" and "felt depressed" as reasons for treatment. Racial/ethnic minority participants were more likely than white participants to endorse externalizing or interpersonal problems and less likely to endorse internalizing problems as reasons for MH treatment. Understanding racial/ethnic differences in the patient's perceived treatment rationale can offer opportunities to enhance outcomes for depression among diverse populations. Copyright © 2014 American Academy of Child and Adolescent

  17. [IMPROVEMENT AND CHOICE OF COLOSTOMY METHOD IN THE TREATMENT OF PATIENTS, SUFFERING AN ACUTE OBTURATIVE IMPASSABILITY OF LARGE BOWEL].

    Science.gov (United States)

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.

  18. Effect of different surface treatments on the shear bond strength of nanofilled composite repairs

    Directory of Open Access Journals (Sweden)

    Ghazaleh Ahmadizenouz

    2016-03-01

    Full Text Available Background. Repairing aged composite resin is a challenging process. Many surface treatment options have been proposed to this end. This study evaluated the effect of different surface treatments on the shear bond strength (SBS of nano-filled composite resin repairs. Methods. Seventy-five cylindrical specimens of a Filtek Z350XT composite resin were fabricated and stored in 37°C distilled water for 24 hours. After thermocycling, the specimens were divided into 5 groups according to the following surface treatments: no treatment (group 1; air abrasion with 50-μm aluminum oxide particles (group 2; irradiation with Er:YAG laser beams (group 3; roughening with coarse-grit diamond bur + 35% phosphoric acid (group 4; and etching with 9% hydrofluoric acid for 120 s (group 5. Another group of Filtek Z350XT composite resin samples (4×6 mm was fabricated for the measurement of cohesive strength (group 6. A silane coupling agent and an adhesive system were applied after each surface treatment. The specimens were restored with the same composite resin and thermocycled again. A shearing force was applied to the interface in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests (P < 0.05. Results. One-way ANOVA indicated significant differences between the groups (P < 0.05. SBS of controls was significantly lower than the other groups; differences between groups 2, 3, 4, 5 and 6 were not significant. Surface treatment with diamond bur + 35% phosphoric acid resulted in the highest bond strength. Conclusion. All the surface treatments used in this study improved the shear bond strength of nanofilled composite resin used.

  19. Evaluation of carbon diffusion in heat treatment of H13 tool steel under different atmospheric conditions

    Directory of Open Access Journals (Sweden)

    Maziar Ramezani

    2015-04-01

    Full Text Available Although the cost of the heat treatment process is only a minor portion of the total production cost, it is arguably the most important and crucial stage on the determination of material quality. In the study of the carbon diffusion in H13 steel during austenitization, a series of heat treatment experiments had been conducted under different atmospheric conditions and length of treatment. Four austenitization atmospheric conditions were studied, i.e., heat treatment without atmospheric control, heat treatment with stainless steel foil wrapping, pack carburization heat treatment and vacuum heat treatment. The results showed that stainless steel foil wrapping could restrict decarburization process, resulting in a constant hardness profile as vacuum heat treatment does. However, the tempering characteristic between these two heat treatment methods is different. Results from the gas nitrided samples showed that the thickness and the hardness of the nitrided layer is independent of the carbon content in H13 steel.

  20. Gender Differences Among Patients With Hepatitis C Virus Undergoing Rehabilitation Through Methadone Maintenance Treatment

    Directory of Open Access Journals (Sweden)

    Omid Massah

    2018-03-01

    Discussion: The study results demonstrated some gender differences in baseline characteristics and psychological problems. Such differences may have important impacts on methadone treatment outcomes. Further studies are suggested.

  1. Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary- an experience in Taiwan

    International Nuclear Information System (INIS)

    Chang, Morgan Fu-Ti; Chang, Joseph Tung-Chieh; Wang, Hung-Ming; Kang, Chung-Jan; Huang, Shiang-Fu; Lin, Chien-Yu; Fang, Kang-Hsing; Chen, Eric Yen-Chao; Chen, I-How; Liao, Chun-Ta

    2010-01-01

    The aim of this study was to evaluate treatment results in our hypopharyngeal cancer patients. A total of three hundred and ninety five hypopharyngeal cancer patients received radical treatment at our hospital; 96% were male. The majority were habitual smokers (88%), alcohol drinkers (73%) and/or betel quid chewers (51%). All patients received a CT scan or MRI for tumor staging before treatment. The stage distribution was stage I: 2 (0.5%); stage II: 22 (5.6%); stage III: 57 (14.4%) and stage IV: 314 (79.5%). Radical surgery was used first in 81 patients (20.5%), and the remaining patients (79.5%) received organ preservation-intended treatment (OPIT). In the OPIT group, 46 patients received radiotherapy alone, 156 patients received chemotherapy followed by radiotherapy (CT/RT) and 112 patients received concomitant chemo-radiotherapy (CCRT). The five-year overall survival rates for stages I/II, III and IV were 49.5%, 47.4% and 18.6%, respectively. There was no significant difference in overall and disease-specific survival rates between patients who received radical surgery first and those who received OPIT. In the OPIT group, CCRT tended to preserve the larynx better (p = 0.088), with three-year larynx preservation rates of 44.8% for CCRT and 27.2% for CT/RT. Thirty-seven patients developed a second malignancy, with an annual incidence of 4.6%. There was no survival difference between OPIT and radical surgery in hypopharyngeal cancer patients at our hospital. CCRT may offer better laryngeal preservation than RT alone or CT/RT. However, prospective studies are still needed to confirm this finding. Additionally, second primary cancers are another important issue for hypopharyngeal cancer management

  2. Health-related quality of life in different stages of chronic kidney disease and at initiation of dialysis treatment.

    Science.gov (United States)

    Pagels, Agneta A; Söderkvist, Birgitta Klang; Medin, Charlotte; Hylander, Britta; Heiwe, Susanne

    2012-06-18

    To evaluate health-related quality of life (HRQoL) in patients in different stages of chronic kidney disease (CKD) up to initiation of dialysis treatment and to explore possible correlating and influencing factors. Cross-sectional design with 535 patients in CKD stages 2-5 and 55 controls assessed for HRQoL through SF-36 together with biomarkers. All HRQoL dimensions deteriorated significantly with CKD stages with the lowest scores in CKD 5. The largest differences between the patient groups were seen in 'physical functioning', 'role physical', 'general health' and in physical summary scores (PCS). The smallest disparities were seen in mental health and pain. Patients in CKD stages 2-3 showed significantly decreased HRQoL compared to matched controls, with differences of large magnitude - effect size (ES) ≥ .80 - in 'general health' and PCS. Patients in CDK 4 demonstrated deteriorated scores with a large magnitude in 'physical function', 'general health' and PCS compared to the patients in CKD 2-3. Patients in CKD 5 demonstrated deteriorated scores with a medium sized magnitude (ES 0.5 - 0.79) in 'role emotional' and mental summary scores compared to the patients in CKD 4. Glomerular filtration rate stages of the disease. At the time for dialysis initiation HRQoL is substantially deteriorated. Co-existing conditions, such as inflammation and cardiovascular disease seem to be powerful predictors of impaired HRQoL in patients with CKD. Within routine renal care, strategies to improve function and well-being considering the management of co-existing conditions like inflammation and CVD need to be developed.

  3. Seasonal and spatial variations of PPCP occurrence, removal and mass loading in three wastewater treatment plants located in different urbanization areas in Xiamen, China

    International Nuclear Information System (INIS)

    Sun, Qian; Li, Mingyue; Ma, Cong; Chen, Xiangqiang; Xie, Xiaoqing; Yu, Chang-Ping

    2016-01-01

    The occurrence and fate of 48 pharmaceuticals and personal care products (PPCPs) in three wastewater treatment plants (WWTPs) located in different urbanization areas in Xiamen, China was investigated over one year. Results showed that PPCPs were widely detected, but the major PPCPs in the influent, effluent, and sludge were different. Spatial and seasonal variations of PPCP levels in the influent and sludge were observed. The removal efficiencies for most PPCPs were similar among the three WWTPs, although they employed different biological treatment processes. Furthermore, the mass loadings per inhabitant of most pharmaceuticals had a positive correlation with the urbanization levels, indicating that most pharmaceutical usage was higher in the urban core compared to the suburban zones. The total mass loadings of all the 48 PPCPs in the effluent and waste sludge showed close proportions, which suggested the importance of proper waste sludge disposal to prevent a large quantity of PPCPs from entering the environment. - Highlights: • The major components in the influent, effluent, and sludge were different. • Removal rates were similar for most PPCPs under different treatment processes. • Pharmaceutical usage was higher in the urban core compared to suburban zones. • Effluent and sludge shared close proportions for PPCP releasing to the environment. - The total mass loadings of PPCPs per inhabitant in the influent, effluent and waste sludge of WWTPs were higher in the urban core compared to the suburban zones.

  4. Surgical treatment of metachronous metastases in different organs following radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Carlos M. N. de Jesus

    2003-06-01

    Full Text Available Renal clear cell carcinoma (RCCC is a neoplasia resistant to radio and chemotherapy, with surgical treatment being the procedure that is recognized for its curative treatment. This case report demonstrates the success of an aggressive surgical treatment for consecutive and late metachronous metastases following radical nephrectomy. CASE REPORT: Asymptomatic 50-year old man. During a routine examination, an incidental mass was found by renal ultrasonography. He underwent right radical nephrectomy due to RCCC in June 1992. During the follow-up metastases were evidenced in cerebellum on the seventh year, and in left lung and pancreas on the eighth year following the radical nephrectomy, with all of them successfully treated by surgical excision. COMMENTS: The surgical excision of consecutive and late metachronous metastases in different organs arising from RCCC is feasible, being a good therapeutic alternative in selected cases.

  5. Similarities and differences in ablative and non-ablative iron oxide nanoparticle hyperthermia cancer treatment

    Science.gov (United States)

    Petryk, Alicia A.; Misra, Adwiteeya; Kastner, Elliot J.; Mazur, Courtney M.; Petryk, James D.; Hoopes, P. Jack

    2015-03-01

    The use of hyperthermia to treat cancer is well studied and has utilized numerous delivery techniques, including microwaves, radio frequency, focused ultrasound, induction heating, infrared radiation, warmed perfusion liquids (combined with chemotherapy), and recently, metallic nanoparticles (NP) activated by near infrared radiation (NIR) and alternating magnetic field (AMF) based platforms. It has been demonstrated by many research groups that ablative temperatures and cytotoxicity can be produced with locally NP-based hyperthermia. Such ablative NP techniques have demonstrated the potential for success. Much attention has also been given to the fact that NP may be administered systemically, resulting in a broader cancer therapy approach, a lower level of tumor NP content and a different type of NP cancer therapy (most likely in the adjuvant setting). To use NP based hyperthermia successfully as a cancer treatment, the technique and its goal must be understood and utilized in the appropriate clinical context. The parameters include, but are not limited to, NP access to the tumor (large vs. small quantity), cancer cell-specific targeting, drug carrying capacity, potential as an ionizing radiation sensitizer, and the material properties (magnetic characteristics, size and charge). In addition to their potential for cytotoxicity, the material properties of the NP must also be optimized for imaging, detection and direction. In this paper we will discuss the differences between, and potential applications for, ablative and non-ablative magnetic nanoparticle hyperthermia.

  6. Large differences in the diabatic heat budget of the tropical UTLS in reanalyses

    Science.gov (United States)

    Wright, J. S.; Fueglistaler, S.

    2013-04-01

    We present the time mean heat budgets of the tropical upper troposphere (UT) and lower stratosphere (LS) as simulated by five reanalysis models: MERRA, ERA-Interim, CFSR, JRA-25/JCDAS, and NCEP/NCAR. The simulated diabatic heat budget in the tropical UTLS differs significantly from model to model, with substantial implications for representations of transport and mixing. Large differences are apparent both in the net heat budget and in all comparable individual components, including latent heating, heating due to radiative transfer, and heating due to parameterised vertical mixing. We describe and discuss the most pronounced differences. Although they may be expected given difficulties in representing moist convection in models, the discrepancies in latent heating are still disturbing. We pay particular attention to discrepancies in radiative heating (which may be surprising given the strength of observational constraints on temperature and tropospheric water vapour) and discrepancies in heating due to turbulent mixing (which have received comparatively little attention).

  7. No major differences found between the effects of microwave-based and conventional heat treatment methods on two different liquid foods.

    Science.gov (United States)

    Géczi, Gábor; Horváth, Márk; Kaszab, Tímea; Alemany, Gonzalo Garnacho

    2013-01-01

    Extension of shelf life and preservation of products are both very important for the food industry. However, just as with other processes, speed and higher manufacturing performance are also beneficial. Although microwave heating is utilized in a number of industrial processes, there are many unanswered questions about its effects on foods. Here we analyze whether the effects of microwave heating with continuous flow are equivalent to those of traditional heat transfer methods. In our study, the effects of heating of liquid foods by conventional and continuous flow microwave heating were studied. Among other properties, we compared the stability of the liquid foods between the two heat treatments. Our goal was to determine whether the continuous flow microwave heating and the conventional heating methods have the same effects on the liquid foods, and, therefore, whether microwave heat treatment can effectively replace conventional heat treatments. We have compared the colour, separation phenomena of the samples treated by different methods. For milk, we also monitored the total viable cell count, for orange juice, vitamin C contents in addition to the taste of the product by sensory analysis. The majority of the results indicate that the circulating coil microwave method used here is equivalent to the conventional heating method based on thermal conduction and convection. However, some results in the analysis of the milk samples show clear differences between heat transfer methods. According to our results, the colour parameters (lightness, red-green and blue-yellow values) of the microwave treated samples differed not only from the untreated control, but also from the traditional heat treated samples. The differences are visually undetectable, however, they become evident through analytical measurement with spectrophotometer. This finding suggests that besides thermal effects, microwave-based food treatment can alter product properties in other ways as well.

  8. No major differences found between the effects of microwave-based and conventional heat treatment methods on two different liquid foods.

    Directory of Open Access Journals (Sweden)

    Gábor Géczi

    Full Text Available Extension of shelf life and preservation of products are both very important for the food industry. However, just as with other processes, speed and higher manufacturing performance are also beneficial. Although microwave heating is utilized in a number of industrial processes, there are many unanswered questions about its effects on foods. Here we analyze whether the effects of microwave heating with continuous flow are equivalent to those of traditional heat transfer methods. In our study, the effects of heating of liquid foods by conventional and continuous flow microwave heating were studied. Among other properties, we compared the stability of the liquid foods between the two heat treatments. Our goal was to determine whether the continuous flow microwave heating and the conventional heating methods have the same effects on the liquid foods, and, therefore, whether microwave heat treatment can effectively replace conventional heat treatments. We have compared the colour, separation phenomena of the samples treated by different methods. For milk, we also monitored the total viable cell count, for orange juice, vitamin C contents in addition to the taste of the product by sensory analysis. The majority of the results indicate that the circulating coil microwave method used here is equivalent to the conventional heating method based on thermal conduction and convection. However, some results in the analysis of the milk samples show clear differences between heat transfer methods. According to our results, the colour parameters (lightness, red-green and blue-yellow values of the microwave treated samples differed not only from the untreated control, but also from the traditional heat treated samples. The differences are visually undetectable, however, they become evident through analytical measurement with spectrophotometer. This finding suggests that besides thermal effects, microwave-based food treatment can alter product properties in other

  9. Integration of HIV and TB services results in improved TB treatment outcomes and earlier prioritized ART initiation in a large urban HIV clinic in Uganda.

    Science.gov (United States)

    Hermans, Sabine M; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M A; Hoepelman, Andy I M; Coutinho, Alex; Manabe, Yukari C

    2012-06-01

    The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to evaluate associated TB and HIV treatment outcomes. Routinely collected clinical, pharmacy, and laboratory data were merged with TB clinic data for patients initiating TB treatment in 2009 and with TB register data for patients in 2007. TB treatment outcomes and (timing of) antiretroviral therapy (ART) initiation in ART-naive patients [overall and stratified by CD4+ T cell (CD4) count] in 2007 and 2009 were compared. Nosocomial transmission rates could not be assessed. Three hundred forty-six patients were initiated on TB treatment in 2007 and 366 in 2009. Median CD4 counts at TB diagnosis did not differ. TB treatment cure or completion increased from 62% to 68%, death or default decreased from 33% to 25% (P ART-naive TB patients were initiated on ART in 2009 versus 2007 (57% and 66%, P = 0.031), but this decrease was only in patients with CD4 counts >250 cells per cubic millimeter (19% vs. 48%, P = 0.003). More patients were started on ART during TB treatment (94% vs. 78%, P ART initiation. This supports rollout of a fully integrated TB/HIV service delivery model throughout high-prevalence TB and HIV settings.

  10. Analysis of Large-Strain Extrusion Machining with Different Chip Compression Ratios

    Directory of Open Access Journals (Sweden)

    Wen Jun Deng

    2012-01-01

    Full Text Available Large-Strain Extrusion Machining (LSEM is a novel-introduced process for deforming materials to very high plastic strains to produce ultra-fine nanostructured materials. Before the technique can be exploited, it is important to understand the deformation behavior of the workpiece and its relationship to the machining parameters and friction conditions. This paper reports finite-element method (FEM analysis of the LSEM process to understand the evolution of temperature field, effective strain, and strain rate under different chip compression ratios. The cutting and thrust forces are also analyzed with respect to time. The results show that LSEM can produce very high strains by changing in the value of chip compression ratio, thereby enabling the production of nanostructured materials. The shape of the chip produced by LSEM can also be geometrically well constrained.

  11. Hydrogen Treatment for Superparamagnetic VO2 Nanowires with Large Room-Temperature Magnetoresistance.

    Science.gov (United States)

    Li, Zejun; Guo, Yuqiao; Hu, Zhenpeng; Su, Jihu; Zhao, Jiyin; Wu, Junchi; Wu, Jiajing; Zhao, Yingcheng; Wu, Changzheng; Xie, Yi

    2016-07-04

    One-dimensional (1D) transition metal oxide (TMO) nanostructures are actively pursued in spintronic devices owing to their nontrivial d electron magnetism and confined electron transport pathways. However, for TMOs, the realization of 1D structures with long-range magnetic order to achieve a sensitive magnetoelectric response near room temperature has been a longstanding challenge. Herein, we exploit a chemical hydric effect to regulate the spin structure of 1D V-V atomic chains in monoclinic VO2 nanowires. Hydrogen treatment introduced V(3+) (3d(2) ) ions into the 1D zigzag V-V chains, triggering the formation of ferromagnetically coupled V(3+) -V(4+) dimers to produce 1D superparamagnetic chains and achieve large room-temperature negative magnetoresistance (-23.9 %, 300 K, 0.5 T). This approach offers new opportunities to regulate the spin structure of 1D nanostructures to control the intrinsic magnetoelectric properties of spintronic materials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Underground structure pattern and multi AO reaction with step feed concept for upgrading an large wastewater treatment plant

    Science.gov (United States)

    Peng, Yi; Zhang, Jie; Li, Dong

    2018-03-01

    A large wastewater treatment plant (WWTP) could not meet the new demand of urban environment and the need of reclaimed water in China, using a US treatment technology. Thus a multi AO reaction process (Anaerobic/oxic/anoxic/oxic/anoxic/oxic) WWTP with underground structure was proposed to carry out the upgrade project. Four main new technologies were applied: (1) multi AO reaction with step feed technology; (2) deodorization; (3) new energy-saving technology such as water resource heat pump and optical fiber lighting system; (4) dependable old WWTP’s water quality support measurement during new WWTP’s construction. After construction, upgrading WWTP had saved two thirds land occupation, increased 80% treatment capacity and improved effluent standard by more than two times. Moreover, it had become a benchmark of an ecological negative capital changing to a positive capital.

  13. Different Perspectives of Clinicians and Patients with Severe Mental Illness on Motivation for Treatment.

    Science.gov (United States)

    Jochems, Eline C; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Feltz-Cornelis, Christina M; Mulder, Niels L

    2016-09-01

    The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions. Copyright © 2015 John Wiley & Sons, Ltd. Clinicians show poor to moderate capability in estimating how patients perceive their motivation for engaging in treatment, especially so when the patient's motives revolve around feelings of shame and guilt. Clinicians generally give higher motivation ratings for patients where they experience a

  14. Shelf life of donkey milk subjected to different treatment and storage conditions.

    Science.gov (United States)

    Giacometti, Federica; Bardasi, Lia; Merialdi, Giuseppe; Morbarigazzi, Michele; Federici, Simone; Piva, Silvia; Serraino, Andrea

    2016-06-01

    The aim of this study was to investigate the effects of different treatment conditions on microbiological indicators of donkey milk hygiene and their evolution during shelf life at 4 and 12°C from 3 to 30d, simulating a farm-scale pasteurization and packing system. Four treatment conditions were tested: no treatment (raw milk), pasteurization (65°C × 30 min), high-pressure processing (HPP), and pasteurization plus HPP. The microbiological quality of the raw donkey milk investigated was not optimal; our results highlight the importance of raw milk management with the need for animal hygiene management and good dairy farming practices on donkey farms to improve handling procedures. The raw milk treated with HPP alone showed visible alterations with flocks, making the milk unfit for sale. The microbiological risk posed by consumption of raw donkey milk was significantly reduced by heat treatment but farm-scale packing systems cannot guarantee an extended shelf life. In contrast, the pasteurization plus HPP treatment was the most effective method to maintain microbiological milk quality. Microflora growth had little effect on pH in donkey milk: pH values were significantly different only between raw milk and pasteurized and pasteurized plus HPP milk stored at 12°C for 3d. Alkaline phosphatase activity and furosine could be used as indicators of proper pasteurization and thermal processing in donkey milk. Moreover, the presence and growth of Bacillus cereus in the case of thermal abuse hamper the wide-scale marketing of donkey milk due to the potential consequences for sensitive consumers and therefore further tests with time/temperature/high-pressure protocols associated with B. cereus are needed. Finally, our study shows that an HPP treatment of pasteurized milk after packing extends the shelf life of donkey milk and assures its microbial criteria up to 30d if properly stored at 4°C until opening; therefore, combined heat treatment and storage strategies are

  15. Functional dyspepsia. Different mechanisms, comprehensive treatment

    Directory of Open Access Journals (Sweden)

    A.E. Dorofeyev

    2017-09-01

    Full Text Available Functional dyspepsia (FD is a disease with different prevailing pathogenetic mechanisms. The prevalence of FD varies widely from 10 to 30 % of the population, depending on the country and the surveyed cohort. There are two forms of FD: postprandial distress syndrome manifested by a fullness/early satiety after eating, and epigastric pain syndrome — pain/burning in the epigastrium, which may worsen after eating. In a significant part of patients with FD, there are manifestations of both syndromes, the so-called overlap, or a mixed type. In the Ukrainian population, all patients with dyspepsia should be diagnosed and, if found, — undergo mandatory eradication of H.pylori. In patients with persistent symptoms or in those initially not infected with H.pylori, in our opinion, it is advisable to use the combination of proton pomp inhibitor and prokinetic as starting treatment. In our country, a fixed combination of omeprazole and domperidone is available in two dosages. This is Omez D containing 10 mg of both components and a more highly dosed Omez DSR containing 20 mg of omeprazole and 30 mg of domperidone in the form of sustained-release pellets.

  16. Large and Small Dendritic Spines Serve Different Interacting Functions in Hippocampal Synaptic Plasticity and Homeostasis

    Directory of Open Access Journals (Sweden)

    Joshua J. W. Paulin

    2016-01-01

    Full Text Available The laying down of memory requires strong stimulation resulting in specific changes in synaptic strength and corresponding changes in size of dendritic spines. Strong stimuli can also be pathological, causing a homeostatic response, depressing and shrinking the synapse to prevent damage from too much Ca2+ influx. But do all types of dendritic spines serve both of these apparently opposite functions? Using confocal microscopy in organotypic slices from mice expressing green fluorescent protein in hippocampal neurones, the size of individual spines along sections of dendrite has been tracked in response to application of tetraethylammonium. This strong stimulus would be expected to cause both a protective homeostatic response and long-term potentiation. We report separation of these functions, with spines of different sizes reacting differently to the same strong stimulus. The immediate shrinkage of large spines suggests a homeostatic protective response during the period of potential danger. In CA1, long-lasting growth of small spines subsequently occurs consolidating long-term potentiation but only after the large spines return to their original size. In contrast, small spines do not change in dentate gyrus where potentiation does not occur. The separation in time of these changes allows clear functional differentiation of spines of different sizes.

  17. Effect of different seed treatments on maize seed germination parameters under optimal and suboptimal temperature conditions

    Directory of Open Access Journals (Sweden)

    Vujošević Bojana

    2017-01-01

    Full Text Available The aim of this study was to determine the effect of different seed treatments on germination parameters of three maize genotypes under optimal and suboptimal temperature conditions. Seed was treated with recommended doses of three commercial pesticide formulations: metalaxyl-m 10 g/L + fludioxonil 25 g/L, metalaxyl 20 g/kg + prothioconazole 100 g/kg and thiacloprid 400 g/L. Testing was conducted at 25°C and 15°C. Results of the study indicate that there are differences in response of maize genotypes to applied seed treatments, as well as to a specific treatment at optimal and suboptimal temperatures. Some treatments, depending on the mixing partner and temperature conditions, can affect final germination. In other cases, germination rate can be accelerated or prolonged, but with no effect on final germination. In order to provide fast and uniform emergence under different temperature conditions, further examination of the response of maize genotypes to specific seed treatments would be beneficial.

  18. Fate of sulfonamides, macrolides, and trimethoprim in different wastewater treatment technologies

    International Nuclear Information System (INIS)

    Goebel, Anke; McArdell, Christa S.; Joss, Adriano; Siegrist, Hansruedi; Giger, Walter

    2007-01-01

    The elimination of sulfonamides, macrolides and trimethoprim from raw wastewater was investigated in several municipal wastewater treatment plants. Primary treatment provided no significant elimination for the investigated substances. Similar eliminations were observed in the secondary treatment of two conventional activated sludge (CAS) systems and a fixed-bed reactor (FBR). Sulfamethoxazole, including the fraction present as N 4 -acetyl-sulfamethoxazole, was eliminated by approximately 60% in comparison to about 80% in a membrane bioreactor (MBR) independently of the solid retention time (SRT), indicating a positive correlation of the observed elimination to the organic substrate concentration. The elimination for macrolides and trimethoprim varied significantly between the different sampling campaigns in the two CAS systems and in the FBR. In the MBR, these analytes were eliminated up to 50% at SRT of 16 ± 2 and 33 ± 3 d. Trimethoprim, clarithromycin and dehydro-erythromycin showed a higher elimination of up to 90% at a SRT of 60-80 d indicating a correlation with reduced substrate loading (SL). Together with the high SRT, the SL may lead to an increased biodiversity of the active biomass, resulting in a broader range of degradation pathways available. Two investigated sand filters showed different elimination behavior. One led to a significant elimination of most macrolides (17-23%) and trimethoprim (74 ± 14%), while no elimination was observed in the other sand filter investigated

  19. Changes of occlusal plane inclination after orthodontic treatment in different dentoskeletal frames.

    Science.gov (United States)

    Li, Jin-le; Kau, Chung; Wang, Min

    2014-06-25

    The inclination of the occlusal plane (OP) is related to facial types and experiences physiological growth-related changes. The aims of this research were to determine if there were any differences in the inclination of OP in subjects with three types of skeletal malocclusion and to investigate the characteristics and differences of functional occlusal plane (FOP) compared to bisected occlusal plane (BOP). A sample of 90 Caucasians patients was skeletal-classified into three (n = 30), and pre- and post-treatment cephalograms were digitized. Six linear and 8 angular cephalometric measurements were selected. The changes of OP inclination within each group and the differences among the three groups pre- and post-treatment were compared with paired t test and ANOVA test, respectively. The comparison and correlation between BOP and FOP were analyzed with paired t test and coefficient of correlation, respectively. The BOP angle increased in all of the three groups but only had statistically significant differences in skeletal class II patients in a mean of 1.51° (p stability (p > 0.05) in all three groups. The inclination of FOP was closely related to that of BOP (p stability in orthodontically treated patients with all three skeletal patterns.

  20. Real efficiency of ambulatory laser treatment at the patients with different rheumatic diseases

    Science.gov (United States)

    Sidenco, Elena-Luminita; Ristache, Sanda; Belu, Luminita

    2001-06-01

    We consulted 189 patients, with different locomotory diseases: degenerative, posttraumatic and chronic inflammatory rheumatic diseases. We followed the main clinical parameters: pain, limitation of mobility, affected function, inflammation and disorders of sensitivity. We applied an infrared LASER source of 100 mW (BTL), daily, for 5 days. The tolerance of the patients at the LASER treatment was excellent (100%). The evolution of the clinical parameters was variated, but inflammation, limitation of mobility and the affected function significantly improved (30-50%). We found a significant diminution of pain (27- 39%). We believe the LASER treatment in ambulatory conditions is essential for the function of the patients with different locomotory diseases.

  1. Dental treatment for handicapped patients: sedation vs general anesthesia and update of dental treatment in patients with different diseases

    OpenAIRE

    Corcuera Flores, José Ramón; Delgado Muñoz, José María; Ruiz Villandiego, José Cruz; Maura Solivellas, Isabel; Machuca Portillo, Guillermo

    2014-01-01

    Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. According to this situation we can opt f...

  2. [Treatment results for different categories of vaginal intraepithelial neoplasia with electrocoagulation, 5-fluorouracil and combined treatment].

    Science.gov (United States)

    Veloz-Martínez, María Guadalupe; Quintana-Romero, Verónica; Contreras-Morales, María del Rosario Sandra; Jiménez-Vieyra, Carlos Ramón

    2015-10-01

    Vaginal intraepithelial neoplasia (VAIN) represents a variety of changes that initiate as an intraepithelial squamous lesion with the possibility of resulting in cancer. To compare the results of the treatment for the different categories of VAIN with electrocoagulation, 5-fluorouracil and combined treatment. Observational an analytical study. We stablished groups according to the category of VAIN evaluating and comparing remission, persistence, recurrence, or progression of the disease ac- cording to the received treatment, with a 1-year follow up. The results were compared by chi2 and Kruskal Wallis. The statistics analysis was done with the SPSS program version 20. One hundred thirty seven patients between 20 and 81 years of age (mean age: 52.49 years) were included. Seventy-four percent of the patients had a history of premalignant or malignant cervical lesions. Seventy-four patients had VAIN I, 34 patients had VAIN II, 22 patients had VAIN III and there were seven cases of vaginal carcinoma in situ. Fifty-eight patients were treated with electrocoagulation, 55 patients were treated with 5-FU, 16 patients had combined treatment, and eight patients received expectant management. Sixty three percent of patients had total remission of the lesion, 34% had persistence and 3% showed progression, and there were no cases of recurrence. Results were better in patients with VAIN I treated with 5-FU (bigger percentage of remission P .026), for the remaining categories of VAIN, no treatment showed superior results. The superior response occurs in patients with VAIN I treated with 5-FU. None of the treatments achieves a 100% remission. The VAIN frequency is high, patients with a history of malignant or premalignant cervical pathology should undergo a closer surveillance through cytocolposcopic control with respect to the remaining population.

  3. Factors influencing subjective orthodontic treatment need and culture-related differences among Chinese natives and foreign inhabitants.

    Science.gov (United States)

    Xiao-Ting, Li; Tang, Yin; Huang, Xue-Lian; Wan, Hua; Chen, Yang-Xi

    2010-09-01

    The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2) subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need. A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data. 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by "to be pretty" (35.2%). The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P different (P differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

  4. Addiction and Women Gender Differences Concerning Drug Abuse and its Treatment

    Directory of Open Access Journals (Sweden)

    Fatemeh Safari

    2003-05-01

    Full Text Available This article focuses on the quantitative grounds for the emergence and spread of addiction among women, its medical, social and psychological problems, impediments for the treatment of addiction among women as well as gender differences concerning drug abuse and its treatment. This article is a translation of a statistical research on addiction among women and a number of other researches. Based on conclusions drawn from the said researches, women become inclined to addiction mostly by their husbands due to their cordial relationships. Moreover, the negative attitudes of peer groups can overshadow girls and women more than boys and men. From the viewpoint of psychological disorders, the relationship between disorders resulting from psychological pressure after an incident and addiction is stronger among girls and women compared to boys and men. Addiction among women in addition to certain ailments such as malnutrition, hypertension and cancer, can expose them to dangerous diseases such as Hepatitis and AIDS. There is more possibility for addicted women to be infected with AIDS and other sexually transmitted diseases compared to men and they are more exposed to female ailments compared to other women. As far as treatment impediments are concerned, women face a greater social stigma due to their addiction compared to men. Social approach considering addicted women as an indecent person is a major impediment for their treatment. Taking care of the child is also another obstacle for their treatment. There is less possibility for women to receive support from their families for quitting their addiction compared to men. Treatment programs also unwantedly may create obstacles for the treatment of women such as financial constraints, administrative bureaucracy, concentration of treatment programs for men and lack of sensitivity towards women’s addiction. The psychological impediments to treatment include internalizing the notion that addiction is a

  5. [Cancer treatment in Skane and in Sjaelland. Do differences concerning examination and treatment explain reduced survival among Danish cancer patients?

    DEFF Research Database (Denmark)

    Specht, Lena; Landberg, T.

    2001-01-01

    if differences in the diagnostic workup and treatment can explain some of this variation. MATERIAL AND METHODS: Aspects of the diagnostic workup and treatment of the above mentioned four cancer types are examined using data from cancer registry analyses and official reports. These data are seen in the context...... of counts of trained personnel and equipment in cancer diagnostics and treatment in the two countries. RESULTS: With regard to lung and breast cancer, the data seem to indicate that Danish patients are diagnosed later, and that Denmark lags behind in treatment capacity. With regard to rectal cancer......, the data seem to indicate that concentrating operations in fewer hospitals, and improvements in operation technique have been introduced earlier in Sweden than in Denmark. With regard to prostate cancer, however, the data seem to indicate that many more indolent cases that do not need treatment...

  6. Type 1 Retinopathy of Prematurity and Its Laser Treatment of Large Preterm Infants in East China.

    Science.gov (United States)

    Shan, Haidong; Ni, Yinqing; Xue, Kang; Yu, Jia; Huang, Xin

    2015-01-01

    To describe Type 1 retinopathy of prematurity (ROP) and its laser treatment outcomes in premature infants with birth weight > 1250 g in Eastern China. A retrospective review of 3175 ROP records was conducted at Shanghai Eye & ENT Hospital of Fudan University. The records were collected at the ROP clinic from 2006 to 2014, including their demographic and medical information such as gestational age, birth weight, supplemental oxygen therapy, systemic complications, ROP stage, location, presence of plus disease. All infants were examined by RetCam fundus camera. Those with Type 1 ROP were also examined by indirect ophthalmoscope before undergoing transpupillary laser treatment. A total of 12 infants (24 eyes) with Type 1 ROP and birth weight > 1250 g were enrolled. All infants enrolled had plus disease and ROP in zone II retina. Specifically, 16 eyes (67%) had stage 2 ROP. 8 eyes (33%) had stage 3 ROP. ROP regressed in 23 eyes (96%) following laser treatment. Partial retinal detachment developed in one eye (4%). No severe involution sequelaes or laser-related complications were recorded. Mean follow-up was 30±6 weeks. Type 1 ROP may occur in large premature infants who have undergone supplemental oxygen therapy. This Type 1 ROP is mainly located in zone II retina. Laser treatment is a safe and effective intervention for these infants.

  7. Responses of growth of lady's fingers (Abelmoschus esculentus L.) to different treatments methods of dairy wastewater.

    Science.gov (United States)

    Al-Dulaimi, Rana Ibrahim; Ismail, Norli; Ibrahim, Mahamad H

    2014-01-01

    Water is one of the most important precious resources found on the earth, and are most often affected by anthropogenic activities and by industry. Pollution caused by human beings and industries is a serious concern throughout the world. Population growth, massive urbanization, rapid rate of industrialization and modern techniques in agriculture have accelerated water pollution and led to the gradual deterioration of its quality. A large quantity of waste water disposed of at sea or on land has caused environmental problems which have led to environmental pollution, economic losses and chemical risks caused by the wastewater, and its impact on agriculture. However, waste water which contain nutrients and organic matter has possible advantages for agricultural purposes. Therefore, the presented study was undertaken to assess the impact of Dairy Effluent (treated and untreated waste water) on seed germination, seedling growth, dry matter production and the biochemical parameters of lady's fingers (Abelmoschus esculentus L.). A field experiment in a green house was conducted to use raw and treated dairy wastewater for watering lady's fingers (Abelmoschus esculentus L.). The plants were watered using (WW) raw dairy wastewater, (T1) chemicals treatment, (T2) physical treatment, (T3) dilution method treatment and tap water (TW) in pot experiments. Ten plants of each treatment /3 replicate were randomly selected and labelled for the collection of data. The data was collected sequentially, starting with chlorophyll content pre-harvest, vegetative qualities (shoot, root and seedling length) and dry matter quality (shoot and root dry matter) pos-tharvest. The effect was seen on the germination seed and growth of the plant. The results showed inhibitory effect from dairy effluent (WW) on seed germination and plant growth. Treatment with chemicals showed statistically significant differences with other treatments. Chemical treatment (TC2) at 20 mg/L Al2(SO4)3 and pH 6

  8. Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary- an experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Lin Chien-Yu

    2010-10-01

    Full Text Available Abstract Purpose The aim of this study was to evaluate treatment results in our hypopharyngeal cancer patients. Patients and Methods A total of three hundred and ninety five hypopharyngeal cancer patients received radical treatment at our hospital; 96% were male. The majority were habitual smokers (88%, alcohol drinkers (73% and/or betel quid chewers (51%. All patients received a CT scan or MRI for tumor staging before treatment. The stage distribution was stage I: 2 (0.5%; stage II: 22 (5.6%; stage III: 57 (14.4% and stage IV: 314 (79.5%. Radical surgery was used first in 81 patients (20.5%, and the remaining patients (79.5% received organ preservation-intended treatment (OPIT. In the OPIT group, 46 patients received radiotherapy alone, 156 patients received chemotherapy followed by radiotherapy (CT/RT and 112 patients received concomitant chemo-radiotherapy (CCRT. Results The five-year overall survival rates for stages I/II, III and IV were 49.5%, 47.4% and 18.6%, respectively. There was no significant difference in overall and disease-specific survival rates between patients who received radical surgery first and those who received OPIT. In the OPIT group, CCRT tended to preserve the larynx better (p = 0.088, with three-year larynx preservation rates of 44.8% for CCRT and 27.2% for CT/RT. Thirty-seven patients developed a second malignancy, with an annual incidence of 4.6%. Conclusions There was no survival difference between OPIT and radical surgery in hypopharyngeal cancer patients at our hospital. CCRT may offer better laryngeal preservation than RT alone or CT/RT. However, prospective studies are still needed to confirm this finding. Additionally, second primary cancers are another important issue for hypopharyngeal cancer management.

  9. Simulation model for planning metallurgical treatment of large-size billets

    International Nuclear Information System (INIS)

    Timofeev, M.A.; Echeistova, L.A.; Kuznetsov, V.G.; Semakin, S.V.; Krivonogov, A.B.

    1989-01-01

    The computerized simulation system ''Ritm'' for planning metallurgical treatment of billets is developed. Three principles, specifying the organization structure of the treatment cycle are formulated as follows: a cycling principle, a priority principle and a principle of group treatment. The ''Ritm'' software consists of three independent operating systems: preparation of source data, simulation, data output

  10. Treatment Professionals' Basic Beliefs About Alcohol Use Disorders: The Impact of Different Cultural Contexts.

    Science.gov (United States)

    Koski-Jännes, Anja; Pennonen, Marjo; Simmat-Durand, Laurence

    2016-01-01

    The treatment of alcohol abusers in different cultural contexts does not depend only on the methods used but also on the ways in which treatment providers perceive the problem and relate to their clients. This study compares treatment professionals' basic beliefs about alcohol use disorders in two culturally different European countries to find out to what extent these ideas are shaped by the respondents' socio-cultural context, profession, and other background variables. Similar postal surveys were conducted among professionals working in specialized addiction treatment units in Finland (n = 520) and France (n = 472). The data were analyzed by descriptive statistical methods and logistic regression analysis. Consistent cultural differences were found in almost all the questions asked and they remained significant even after controlling for the other background factors. The French professionals emphasized the addictiveness of alcohol more than their Finnish colleagues. They also believed less in the chances of recovery and attributed more responsibility for the problem to external factors, while the Finns emphasized individual responsibility. Profession, gender and some other background variables also modified beliefs about specific questions. Cultural factors shape the ways in which alcohol use disorders are perceived more pervasively than the other background variables. The French professionals' low trust in treatment and the Finnish professionals' lack of concern for the addiction potential of alcohol and stronger tendency to regard the person as responsible for the problem could be seen as potential impediments to effective ways of helping alcohol abusers in these countries.

  11. Comparison of different source calculations in two-nucleon channel at large quark mass

    Science.gov (United States)

    Yamazaki, Takeshi; Ishikawa, Ken-ichi; Kuramashi, Yoshinobu

    2018-03-01

    We investigate a systematic error coming from higher excited state contributions in the energy shift of light nucleus in the two-nucleon channel by comparing two different source calculations with the exponential and wall sources. Since it is hard to obtain a clear signal of the wall source correlation function in a plateau region, we employ a large quark mass as the pion mass is 0.8 GeV in quenched QCD. We discuss the systematic error in the spin-triplet channel of the two-nucleon system, and the volume dependence of the energy shift.

  12. Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments.

    Science.gov (United States)

    Callan, Laurence Brian

    A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

  13. Racial differences in treatment effect among men in a substance abuse and domestic violence program.

    Science.gov (United States)

    Scott, Melanie C; Easton, Caroline J

    2010-11-01

    It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.

  14. Treatment of giant and large fusiform middle cerebral artery aneurysms with excision and interposition radial artery graft in a 4-year-old child: case report.

    Science.gov (United States)

    Mrak, Goran; Paladino, Josip; Stambolija, Vasilije; Nemir, Jakob; Sekhar, Laligam N

    2014-03-01

    We report an unusual case of complex giant and large fusiform aneurysms not amenable for clipping or coiling in a 4-year-old child managed with aneurysm resection and radial artery interposition graft. A 4-year-old child presented with repeated severe headache and vomiting. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography and digital subtraction angiography showed a giant fusiform aneurysm on the right middle cerebral artery (MCA). Because of the complex shape, endovascular treatment or clip reconstruction was not possible, and a bypass procedure was planned. Right frontotemporal craniotomy and orbitotomy was performed. Two aneurysms involving the M1 segment of the MCA were found in line, 1 giant, and the other large in size. The aneurysms were resected and treated with short radial artery interposition graft, which was narrower than the proximal or distal MCA. The child recovered normally, and the bypass was patent after 1 year. Large fusiform MCA aneurysms may be difficult to treat, but there are treatment options that include a bypass procedure. Resection and short interposition radial artery graft is an excellent but rare treatment option in a very young child. This was a very successful treatment in this child.

  15. Multidrug-resistant Acinetobacter meningitis in neurosurgical patients with intraventricular catheters: assessment of different treatments.

    Science.gov (United States)

    Rodríguez Guardado, A; Blanco, A; Asensi, V; Pérez, F; Rial, J C; Pintado, V; Bustillo, E; Lantero, M; Tenza, E; Alvarez, M; Maradona, J A; Cartón, J A

    2008-04-01

    The treatment of multidrug-resistant Acinetobacter baumannii meningitis is a serious therapeutic problem due to the limited penetration of antibiotics into the CSF. We describe the clinical features and the outcome of a group of patients with nosocomial neurosurgical meningitis treated with different therapeutic options. All patients with nosocomial post-surgical meningitis due to A. baumannii diagnosed between 1990 and 2004 were retrospectively reviewed. During the period of study, 51 cases of this nosocomial infection were identified. Twenty-seven patients were treated with intravenous (iv) monotherapy: carbapenems (21 cases), ampicillin/sulbactam (4 cases) and other antibiotics (2 cases). Four patients were treated with iv combination therapy. Nineteen patients were treated with iv and intrathecal regimens: colistin by both routes (8 cases), carbapenems plus iv and intrathecal (4 cases) or only intrathecal (5 cases) aminoglycosides, and others (2 cases). Seventeen patients died due to the infection. One patient died without treatment. The mean (SD) duration of therapy was 17.4 (8.3) days (range 3-44). Although no patients treated with colistin died, we did not observe statistically significant differences in the mortality among the groups with different treatments. Nosocomial Acinetobacter meningitis has a high mortality. Combined therapy with iv and intrathecal colistin is a useful and safe option in the treatment of nosocomial Acinetobacter meningitis.

  16. A three-temperature model of selective photothermolysis for laser treatment of port wine stain containing large malformed blood vessels

    International Nuclear Information System (INIS)

    Li, D.; Wang, G.X.; He, Y.L.; Wu, W.J.; Chen, B.

    2014-01-01

    As congenital vascular malformations, port wine stain (PWS) is composed of ectatic venular capillary blood vessels buried within healthy dermis. In clinic, pulsed dye laser (PDL) in visible band (e.g. 585 nm) together with cryogen spray cooling (CSC) have become the golden standard for treatment of PWS. However, due to the limited energy deposition of the PDL in blood, large blood vessels are likely to survive from the laser irradiation. As a result, complete clearance of the lesions is rarely achieved. Assuming the local thermal non-equilibrium in skin tissue during the laser surgery, a three-temperature model is proposed to treat the PWS tissue as a porous media composed of a non-absorbing dermal matrix buried with the blood as well as the large malformed blood vessels. Three energy equations are constructed and solved coupling for the temperature of the blood in average-sized PWS vessels, non-absorbing dermal tissues and large malformed blood vessels, respectively. Subsequently, the thermal responses of human skin to visible (585 nm) and near-infrared (1064 nm) laser irradiations with various pulse durations in conjunction with cryogen spray cooling are investigated by the new model, and Arrhenius integral is used to analyze the thermal damage. The simulations show that the short pulse duration of 1.5 ms results in a higher selective heating of blood over epidermis, which will lead to a desired clinic outcome than the longer pulse duration. Due to a much deeper light penetration depth, laser irradiation with 1064 nm in wavelength is superior to that with 585 nm in treating patients with cutaneous hyper-vascular malformation. Complete coagulations are predicted in large-sized and deeply extending blood vessels by 1064 nm laser. - Highlights: •A three-temperature model is proposed for the laser treatment of port wine stain (PWS). •Average sized and large malformed blood vessels in porous medium (tissue) are considered. •Thermal responses of PWS to

  17. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.

    Science.gov (United States)

    Sood, Nikhil; Maheshwari, Neha; Gothi, Rajat; Sood, Niti

    2015-01-01

    Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137.

  18. Different yet similar: Examining race and ethnicity in treatment-seeking adults with binge eating disorder.

    Science.gov (United States)

    Lydecker, Janet A; Grilo, Carlos M

    2016-01-01

    This study examined racial/ethnic differences in demographic variables and the clinical presentation of treatment-seeking adults with binge eating disorder (BED) who participated in treatment research at a medical school-based program. Participants were 775 (n = 195 men, n = 560 women) treatment-seeking adults with DSM-IV-defined BED who self-identified as Black (n = 121), Hispanic (n = 54), or White (n = 580). Doctoral-level research clinicians assessed participants for BED and for eating disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview, and measured height and weight. Participants also completed established self-report measures. Black participants had a greater proportion of women than White participants and White participants had higher education than Black and Hispanic participants. Black participants had higher body mass index (BMI) and reported more frequent binge eating episodes than White participants but eating-disorder psychopathology (EDE scales and Global Severity) did not significantly differ across racial/ethnic groups. Black participants had lower levels of depression than Hispanic and White participants. These differences in clinical presentation remained unchanged after adjusting for age, education, sex, and BMI. White participants had younger ages of onset for dieting, binge eating, and obesity, but not BED, than Black and Hispanic participants. There are some racial/ethnic differences in the developmental trajectories and clinical presentation of treatment-seeking adults with BED that remain unchanged after adjusting for demographic differences. Black participants presented for treatment with higher BMI and binge eating frequency than White participants and with lower depression than White and Hispanic groups, but associated eating disorder psychopathology levels were similar across racial/ethnic groups. (c) 2015 APA, all rights reserved).

  19. Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma: A clinical report.

    Science.gov (United States)

    Hoekstra, Jitske; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita

    2017-05-01

    Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted of resecting the tumor and external part of the skull bone. To protect the brain and to cover the defect of the hairy skull, an acrylic resin skull prosthesis with hair was designed to mask the defect. The skull prosthesis was retained on 8 extraoral implants placed at the margins of the defect in the skull bone. The patient was satisfied with the treatment outcome. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  20. A comparison of different antibiotic regimens for the treatment of infective endocarditis.

    Science.gov (United States)

    Martí-Carvajal, Arturo J; Dayer, Mark; Conterno, Lucieni O; Gonzalez Garay, Alejandro G; Martí-Amarista, Cristina Elena; Simancas-Racines, Daniel

    2016-04-19

    Infective endocarditis is a microbial infection of the endocardial surface of the heart. Antibiotics are the cornerstone of treatment, but their use is not standardised, due to the differences in presentation, populations affected and the wide variety of micro-organisms that can be responsible. To assess the existing evidence about the clinical benefits and harms of different antibiotics regimens used to treat people with infective endocarditis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE Classic and EMBASE, LILACS, CINAHL and the Conference Proceedings Citation Index on 30 April 2015. We also searched three trials registers and handsearched the reference lists of included papers. We applied no language restrictions. We included randomised controlled trials assessing the effects of antibiotic regimens for treating possible infective endocarditis diagnosed according to modified Duke's criteria. We considered all-cause mortality, cure rates and adverse events as the primary outcomes. We excluded people with possible infective endocarditis and pregnant women. Three review authors independently performed study selection, 'Risk of bias' assessment and data extraction in duplicate. We constructed 'Summary of findings' tables and used GRADE methodology to assess the quality of studies. We described the included studies narratively. Four small randomised controlled trials involving 728 allocated/224 analysed participants met our inclusion criteria. These trials had a high risk of bias. Drug companies sponsored two of the trials. We were unable to pool the data due to the heterogeneity in outcome definitions and the different antibiotics used.The included trials compared the following antibiotic schedules. The first trial compared quinolone (levofloxacin) plus standard treatment (anti-staphylococcal penicillin (cloxacillin or dicloxacillin), aminoglycoside (tobramycin or netilmicin) and rifampicin) versus standard treatment

  1. Promoter methylation patterns in Richter syndrome affect stem-cell maintenance and cell cycle regulation and differ from de novo diffuse large B-cell lymphoma.

    Science.gov (United States)

    Rinaldi, Andrea; Mensah, Afua Adjeiwaa; Kwee, Ivo; Forconi, Francesco; Orlandi, Ester M; Lucioni, Marco; Gattei, Valter; Marasca, Roberto; Berger, Françoise; Cogliatti, Sergio; Cavalli, Franco; Zucca, Emanuele; Gaidano, Gianluca; Rossi, Davide; Bertoni, Francesco

    2013-10-01

    In a fraction of patients, chronic lymphocytic leukaemia (CLL) can transform to Richter syndrome (RS), usually a diffuse large B-cell lymphoma (DLBCL). We studied genome-wide promoter DNA methylation in RS and clonally related CLL-phases of transformed patients, alongside de novo DLBCL (of non-germinal centre B type), untransformed-CLL and normal B-cells. The greatest differences in global DNA methylation levels were observed between RS and DLBCL, indicating that these two diseases, although histologically similar, are epigenetically distinct. RS was more highly methylated for genes involved in cell cycle regulation. When RS was compared to the preceding CLL-phase and with untransformed-CLL, RS presented a higher degree of methylation for genes possessing the H3K27me3 mark and PRC2 targets, as well as for gene targets of TP53 and RB1. Comparison of the methylation levels of individual genes revealed that OSM, a stem cell regulatory gene, exhibited significantly higher methylation levels in RS compared to CLL-phases. Its transcriptional repression by DNA methylation was confirmed by 5-aza-2'deoxycytidine treatment of DLBCL cells, determining an increased OSM expression. Our results showed that methylation patterns in RS are largely different from de novo DLBCL. Stem cell-related genes and cell cycle regulation genes are targets of DNA methylation in RS. © 2013 John Wiley & Sons Ltd.

  2. Outcomes of different Class II treatments : Comparisons using the American Board of Orthodontics Model Grading System.

    Science.gov (United States)

    Akinci Cansunar, Hatice; Uysal, Tancan

    2016-07-01

    The aim of this study was to evaluate the clinical outcomes of three different Class II treatment modalities followed by fixed orthodontic therapy, using the American Board of Orthodontics Model Grading System (ABO-MGS). As a retrospective study, files of patients treated at postgraduate orthodontic  clinics in different cities in Turkey was randomly selected. From 1684 posttreatment records, 669 patients were divided into three groups: 269 patients treated with extraction of two upper premolars, 198 patients treated with cervical headgear, and 202 patients treated with functional appliances. All the cases were evaluated by one researcher using ABO-MGS. The χ (2), Z test, and multivariate analysis of variance were used for statistical evaluation (p < 0.05). No significant differences were found among the groups in buccolingual inclination, overjet, occlusal relationship, and root angulation. However, there were significant differences in alignment, marginal ridge height, occlusal contact, interproximal contact measurements, and overall MGS average scores. The mean treatment time between the extraction and functional appliance groups was significantly different (p = 0.017). According to total ABO-MGS scores, headgear treatment had better results than functional appliances. The headgear group had better tooth alignment than the extraction group. Headgear treatment resulted in better occlusal contacts than the functional appliances and had lower average scores for interproximal contact measurements. Functional appliances had the worst average scores for marginal ridge height. Finally, the functional appliance group had the longest treatment times.

  3. A study of the health and economic effects of influenza-like illness on the working population under different working environments of a large corporation in Hong Kong.

    Science.gov (United States)

    Lee, Kenneth K C; Li, Shu Chuen; Kwong, Kai Sun; Chan, Thomas Y K; Lee, Vivian W Y; Lau, Joseph T F

    2008-01-01

    The incidence, health and economic impacts of influenza-like illness (ILI) among the working population in Hong Kong had never been studied. Due to the nature of the disease, ILIs can have a significant impact on the operation of a corporation in terms of loss of productivity and reduced work performance. The present study was undertaken to determine the health and economic impacts of ILIs under different environmental conditions on the working population of a large corporation. Over 2,000 employees of a large corporation in the travelling and tourism industry were studied with three different types of working environment (confined, typical office and well ventilated) by two structured questionnaires. The most affected group in terms of productivity and health was the group working in a confined area, whilst those working in a well-ventilated area were least affected. However, symptoms of the confined area group seemed to disappear faster. The infection rate appeared to vary according to work environment for the studied population. Policies on preventive measures and early treatment are important for a corporation to reduce loss in productivity due to ILIs.

  4. Recent quality of ultra large rotor shafts

    International Nuclear Information System (INIS)

    Suzuki, Akira; Kinoshita, Shushi; Morita, Kikuo; Kikuchi, Hideo; Takada, Masayoshi

    1983-01-01

    Large size and high quality are required for rotor shafts accompanying recent trend of thermal and nuclear power generation toward large capacity. As for the low pressure rotor shafts for large capacity turbines, the disks and a shaft tend to be made into one body instead of conventional shrink fit construction, because of the experience of rotor accidents and the improvement of reliability. Therefore the ingots required become more and more large, and excellent production techniques are required for steel making, forging and heat treatment. Kobe Steel Ltd. have made about 20 large generator shafts from 420 t and 500 t ingots, and confirmed their stable high quality. Also a one-body low pressure rotor of 2600 mm diameter was made for trial, and its quality was examined. It was confirmed that the effect of forging and heat treatment was given sufficiently, and the production techniques for super-large one-body rotors were established. In steel making, vacuum degassing was applied twice to decrease hydrogen content, and VV restriction forging and pre-stage treatment were carried out. The properties of large rotors are reported. (Kako, I.)

  5. Comparing centralised and decentralised anaerobic digestion of stillage from a large-scale bioethanol plant to animal feed production.

    Science.gov (United States)

    Drosg, B; Wirthensohn, T; Konrad, G; Hornbachner, D; Resch, C; Wäger, F; Loderer, C; Waltenberger, R; Kirchmayr, R; Braun, R

    2008-01-01

    A comparison of stillage treatment options for large-scale bioethanol plants was based on the data of an existing plant producing approximately 200,000 t/yr of bioethanol and 1,400,000 t/yr of stillage. Animal feed production--the state-of-the-art technology at the plant--was compared to anaerobic digestion. The latter was simulated in two different scenarios: digestion in small-scale biogas plants in the surrounding area versus digestion in a large-scale biogas plant at the bioethanol production site. Emphasis was placed on a holistic simulation balancing chemical parameters and calculating logistic algorithms to compare the efficiency of the stillage treatment solutions. For central anaerobic digestion different digestate handling solutions were considered because of the large amount of digestate. For land application a minimum of 36,000 ha of available agricultural area would be needed and 600,000 m(3) of storage volume. Secondly membrane purification of the digestate was investigated consisting of decanter, microfiltration, and reverse osmosis. As a third option aerobic wastewater treatment of the digestate was discussed. The final outcome was an economic evaluation of the three mentioned stillage treatment options, as a guide to stillage management for operators of large-scale bioethanol plants. Copyright IWA Publishing 2008.

  6. Epidemiology and Self-Treatment of Travelers’ Diarrhea in a Large, Prospective Cohort of Department of Defense Beneficiaries

    Science.gov (United States)

    Lalani, Tahaniyat; Maguire, Jason D.; Grant, Edward M.; Fraser, Jamie; Ganesan, Anuradha; Johnson, Mark D.; Deiss, Robert G.; Riddle, Mark S.; Burgess, Timothy; Tribble, David R.

    2014-01-01

    Background Infectious diarrhea is a common problem among travelers. Expert guidelines recommend the prompt use of antibiotics for self-treatment of moderate or severe traveler’s diarrhea (TD). There is limited data on whether travelers follow these self-treatment guidelines. We evaluated the risk factors associated with TD, use of TD self-treatment, and risk of irritable bowel syndrome (IBS) during travel. Methods Department of Defense beneficiaries traveling outside the US for ≤ 6.5 months were enrolled in a prospective cohort study. Participants received pre- and post-travel surveys, and could opt into a travel illness diary and follow-up surveys for symptoms of IBS. Standard definitions were used to assess for TD and IBS. Sub-optimal self-treatment was defined as use of antibiotics (with or without antidiarrheal agents) for mild TD, or use of antidiarrheals alone or no self-treatment in cases of moderate or severe TD. Results Twenty-four percent of participants (270/1120) met criteria for TD. The highest incidence was recorded in Africa (8.6 cases/100 person-weeks, 95% CI: 6.7–10.5). Two hundred and twelve TD cases provided information regarding severity and self-treatment: 89 (42%) had mild TD and 123 (58%) had moderate or severe TD. Moderate or severe TD was independently associated with suboptimal self-treatment (OR 10.4 [95% CI: 4.92–22.0]). Time to last unformed stool did not differ between optimal and suboptimal self-treatment. IBS occurred in 4.5% (7/154) of TD cases and 3.1% (16/516) of patients without TD (p=0.39). Among TD cases, a lower incidence of IBS was noted in participants who took antibiotics (4.8% (5/105) vs. 2.2% (1/46)), but the difference did not reach statistical significance (p=0.60). Conclusions Our results suggest the underutilization of antibiotics in travelers with moderate or severe TD. Further studies are needed to systematically evaluate pre-travel instruction and traveler adherence to self-treatment guidelines, and the

  7. How should treatment approaches differ depending on the severity of asthma?

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2017-12-01

    Asthma is nowadays regarded as a syndrome of various overlapping phenotypes with defined clinical characteristics, different underlying inflammatory mechanisms, identifiable genetic background, environmental risk factors and possible biomarkers. There are no doubts that due to the diversity of asthma, a 'one size fits all' management of the disease is no longer valid. Areas covered: Nowadays asthma management is based on the control of the disease, and the goals of asthma treatment are defined as good symptom control, decreased future risk of exacerbations, fixed airflow limitation, and side-effects of treatment. Alternative strategies for adjusting asthma treatment such as sputum or exhaled nitric oxide guided protocols have been evaluated and despite some effectiveness, are regarded as impractical in every-day clinical conditions. Further studies in the field of asthma phenotypes/endotypes and biomarkers are warranted with the main goal to define which of those possible subgroups will be useful in clinical practice in regards to the potential allocation of successful treatment. Expert commentary: Despite the availability of guidelines on the diagnosis and management of asthma, it seems that the disease is still not optimally controlled. Addressing unmet needs in every day care, improving education, adherence/compliance and inhalation technique may significantly improve asthma control across all severities of the disease.

  8. Examination of Sex Differences in a Large Sample of Young Children with Autism Spectrum Disorder and Typical Development

    Science.gov (United States)

    Reinhardt, Vanessa P.; Wetherby, Amy M.; Schatschneider, Christopher; Lord, Catherine

    2015-01-01

    Despite consistent and substantive research documenting a large male to female ratio in Autism Spectrum Disorder (ASD), only a modest body of research exists examining sex differences in characteristics. This study examined sex differences in developmental functioning and early social communication in children with ASD as compared to children with…

  9. Pregabalin for the treatment of postoperative pain: results from three controlled trials using different surgical models

    Directory of Open Access Journals (Sweden)

    Singla NK

    2014-12-01

    Full Text Available Neil K Singla,1 Jacques E Chelly,2 David R Lionberger,3 Joseph Gimbel,4 Luis Sanin,5 Jonathan Sporn,5 Ruoyong Yang,5 Raymond Cheung,5 Lloyd Knapp,6 Bruce Parsons5 1Lotus Clinical Research, Pasadena, CA, USA; 2Division of Acute Interventional Perioperative Pain, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA; 4Arizona Research Center, Phoenix, AZ, USA; 5Pfizer Inc., New York, NY, USA; 6Pfizer Inc., New London, CT, USA Purpose: To evaluate the efficacy and safety of pregabalin (150 or 300 mg/d as an adjunctive therapy for the treatment of postoperative pain. Patients and methods: This study reports findings from three separate, multicenter, randomized, double-blind, placebo-controlled trials of adjunctive pregabalin for the treatment of postoperative pain. Patients underwent one of three categories of surgical procedures (one procedure per study: elective inguinal hernia repair (post-IHR; elective total knee arthroplasty (post-TKA; or total abdominal hysterectomy (posthysterectomy. The primary endpoint in each trial, mean worst pain over the past 24 hours, was assessed 24 hours post-IHR and posthysterectomy, and 48 hours post-TKA. Patients rated their pain on a scale from 0 to 10, with higher scores indicating greater pain severity. Results: In total, 425 (post-IHR, 307 (post-TKA, and 501 (posthysterectomy patients were randomized to treatment. There were no statistically significant differences between the pregabalin and placebo groups with respect to the primary endpoint in any of the three trials. The least squares mean difference in worst pain, between 300 mg/d pregabalin and placebo, was -0.7 (95% confidence interval [CI] =-1.4, -0.1; Hochberg adjusted P=0.067 post-IHR; -0.34 (95% CI =-1.07, 0.39; P=0.362 post-TKA; and -0.2 (95% CI =-0.66, 0.31; P=0.471 posthysterectomy. Conclusion: There were no significant differences

  10. Treatment of Previously Treated Facial Capillary Malformations: Results of Single-Center Retrospective Objective 3-Dimensional Analysis of the Efficacy of Large Spot 532 nm Lasers.

    Science.gov (United States)

    Kwiek, Bartłomiej; Ambroziak, Marcin; Osipowicz, Katarzyna; Kowalewski, Cezary; Rożalski, Michał

    2018-06-01

    Current treatment of facial capillary malformations (CM) has limited efficacy. To assess the efficacy of large spot 532 nm lasers for the treatment of previously treated facial CM with the use of 3-dimensional (3D) image analysis. Forty-three white patients aged 6 to 59 were included in this study. Patients had 3D photography performed before and after treatment with a 532 nm Nd:YAG laser with large spot and contact cooling. Objective analysis of percentage improvement based on 3D digital assessment of combined color and area improvement (global clearance effect [GCE]) were performed. The median maximal improvement achieved during the treatment (GCE) was 59.1%. The mean number of laser procedures required to achieve this improvement was 6.2 (range 1-16). Improvement of minimum 25% (GCE25) was achieved by 88.4% of patients, a minimum of 50% (GCE50) by 61.1%, a minimum of 75% (GCE75) by 25.6%, and a minimum of 90% (GCE90) by 4.6%. Patients previously treated with pulsed dye lasers had a significantly less response than those treated with other modalities (GCE 37.3% vs 61.8%, respectively). A large spot 532 nm laser is effective in previously treated patients with facial CM.

  11. Comparative efficacy of tulathromycin versus a combination of florfenicol-oxytetracycline in the treatment of undifferentiated respiratory disease in large numbers of sheep

    Directory of Open Access Journals (Sweden)

    Mohsen Champour

    2015-09-01

    Full Text Available The objective of this study was to compare the efficacy of tulathromycin (TUL with a combination of florfenicol (FFC and long-acting oxytetracycline (LAOTC in the treatment of naturally occurring undifferentiated respiratory diseases in large numbers of sheep. In this study, seven natural outbreaks of sheep pneumonia in Garmsar, Iran were considered. From these outbreaks, 400 sheep exhibiting the signs of respiratory diseases were selected, and the sheep were randomly divided into two equal groups. The first group was treated with a single injection of TUL (dosed at 2.5 mg/kg body weight, and the second group was treated with concurrent injections of FFC (dosed at 40 mg/kg bwt and LAOTC (dosed at 20 mg/kg bwt. In the first group, 186 (93% sheep were found to be cured 5 days after the injection, and 14 (7% sheep needed further treatment, of which 6 (3% were cured, and 8 (4% died. In the second group, 172 (86% sheep were cured after the injections, but 28 (14% sheep needed further treatment, of which 10 (5% were cured, and 18 (9% died. This study revealed that TUL was more efficacious as compared to the combined treatment using FFC and LAOTC. As the first report, this field trial describes the successful treatment of undifferentiated respiratory diseases in large numbers of sheep. Thus, TUL can be used for the treatment of undifferentiated respiratory diseases in sheep. [J Adv Vet Anim Res 2015; 2(3.000: 279-284

  12. The dynamics of histamine level in patients with chronic urticaria under the influence of different methods of treatment.

    Directory of Open Access Journals (Sweden)

    Dytyatkovska Ye.M.

    2014-11-01

    Full Text Available There was studied the efficiency of different methods of chronic urticaria treatment. All patients were divided into 2 groups depending on treatment scteme. The paper shows the dynamics of histamine level in blood plasma, intestine disbiosis in patients with chronic urticaria under the influence of different treatment complexes. It was proved that there exists the correlation between the serum histamine level and method of treatment. Intro¬ducing bionorm into the treatment allows to decrease histamine level and correspondingly to significantly improve clinical effect and patients’ life quality.

  13. Carcass characteristics and meat evaluation of Nelore cattle subjected to different antioxidant treatments

    Directory of Open Access Journals (Sweden)

    Thiago de Jesus do Carmo

    Full Text Available ABSTRACT Forty Nelore cattle were used to evaluate the effects of supplementation with different antioxidants on carcass characteristics and meat quality of feedlot cattle. Animals were fed Brachiaria brizantha hay and subjected to five treatments (control and four antioxidants: zinc, selenium, vitamin E, and selenium + vitamin E. After a 105-day feeding period, cattle were slaughtered. Tissue composition, as well as carcass proximate composition, color, tenderness, pH, and fatty acid profile were evaluated. Analysis of variance was carried out and means compared by Tukey test at 0.05 probability. The group fed selenium showed the lowest muscle amount (66.61 g/100 g compared with the other antioxidants evaluated. There was no difference among treatments for bone, fat, and comestible portion percentages as well as muscle:bone, muscle:fat, and comestible portion:bone ratios, with mean values of 16.85 g/100 g, 14.70 g/100 g, 82.99 g/100 g, 4.06, 4.85, and 4.95, respectively. Neither brightness, red, or yellow contents of the meat nor carcass pH were affected by treatments. For tenderness and losses during thawing and cooking, there were no differences among treatments, with averages of 6.43 kgf cm2, 3.22 g/100 g, and 21.15 g/100 g, respectively. Supplementation of Nelore cattle fed Brachiaria brizantha hay with antioxidants do not influence carcass characteristics or meat quality. However, vitamin E supplementation reduces the levels of omega 3 fatty acid, whereas supplementation with selenium + vitamin E promotes an increase in linoleic and palmitoleic acids and a decrease in myristoleic acid, making the supplementation feasible due to the beneficial effects provided by these acids.

  14. Large-watershed flood simulation and forecasting based on different-resolution distributed hydrological model

    Science.gov (United States)

    Li, J.

    2017-12-01

    Large-watershed flood simulation and forecasting is very important for a distributed hydrological model in the application. There are some challenges including the model's spatial resolution effect, model performance and accuracy and so on. To cope with the challenge of the model's spatial resolution effect, different model resolution including 1000m*1000m, 600m*600m, 500m*500m, 400m*400m, 200m*200m were used to build the distributed hydrological model—Liuxihe model respectively. The purpose is to find which one is the best resolution for Liuxihe model in Large-watershed flood simulation and forecasting. This study sets up a physically based distributed hydrological model for flood forecasting of the Liujiang River basin in south China. Terrain data digital elevation model (DEM), soil type and land use type are downloaded from the website freely. The model parameters are optimized by using an improved Particle Swarm Optimization(PSO) algorithm; And parameter optimization could reduce the parameter uncertainty that exists for physically deriving model parameters. The different model resolution (200m*200m—1000m*1000m ) are proposed for modeling the Liujiang River basin flood with the Liuxihe model in this study. The best model's spatial resolution effect for flood simulation and forecasting is 200m*200m.And with the model's spatial resolution reduction, the model performance and accuracy also become worse and worse. When the model resolution is 1000m*1000m, the flood simulation and forecasting result is the worst, also the river channel divided based on this resolution is differs from the actual one. To keep the model with an acceptable performance, minimum model spatial resolution is needed. The suggested threshold model spatial resolution for modeling the Liujiang River basin flood is a 500m*500m grid cell, but the model spatial resolution with a 200m*200m grid cell is recommended in this study to keep the model at a best performance.

  15. Changes in different organic matter fractions during conventional treatment and advanced treatment

    Institute of Scientific and Technical Information of China (English)

    Chao Chen; Xiaojian Zhang; Lingxia Zhu; Wenjie He; Hongda Han

    2011-01-01

    XAD-8 resin isolation of organic matter in water was used to divide organic matter into the hydrophobic and hydrophilic fractions.A pilot plant was used to investigate the change in both fractions during conventional and advanced treatment processes.The treatment of hydrophobic organics (HPO), rather than hydrophilic organicas (HPI), should carry greater emphasis due to HPO's higher trihalomethane formation potential (THMFP) and haloacetic acid formation potential (HAAFP).The removal of hydrophobic matter and its transmission into hydrophilic matter reduced ultimate DBP yield during the disinfection process.The results showed that sand filtration, ozonation, and biological activated carbon (BAC) filtration had distinct influences on the removal of both organic fractions.Additionally, the combination of processes changed the organic fraction proportions present during treatment.The use of ozonation and BAC maximized organic matter removal efficiency, especially for the hydrophobic fraction.In sum, the combination of pre-ozonation,conventional treatment, and O3-BAC removed 48% of dissolved organic carbon (DOC), 60% of HPO, 30% of HPI, 63% of THMFP,and 85% of HAAFP.The use of conventional treatment and O3-BAC without pre-ozonation had a comparable performance, removing 51% of DOC, 56% of HPO, 45% of HPI, 61% of THMFP, and 72% of HAAFP.The effectiveness of this analysis method indicated that resin isolation and fractionation should be standardized as an applicable test to help assess water treatment process efficiency.

  16. Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis

    Directory of Open Access Journals (Sweden)

    T. A. G. van Vugt

    2016-01-01

    Full Text Available Osteomyelitis is a common occurrence in orthopaedic surgery, which is caused by different bacteria. Treatment of osteomyelitis patients aims to eradicate infection by debridement surgery and local and systemic antibiotic therapy. Local treatment increases success rates and can be performed with different antimicrobial bone graft substitutes. This review is performed to assess the level of evidence of synthetic bone graft substitutes in osteomyelitis treatment. According to the PRISMA statement for reporting systematic reviews, different types of clinical studies concerning treatment of osteomyelitis with bone graft substitutes are included. These studies are assessed on their methodological quality as level of evidence and bias and their clinical outcomes as eradication of infection. In the fifteen included studies, the levels of evidence were weak and in ten out of the fifteen studies there was a moderate to high risk of bias. However, first results of the eradication of infection in these studies showed promising results with their relatively high success rates and low complication rates. Due to the low levels of evidence and high risks of bias of the included studies, these results are inconclusive and no conclusions regarding the performed clinical studies of osteomyelitis treatment with antimicrobial bone graft substitutes can be drawn.

  17. Esophageal Large-Cell Neuroendocrine Carcinoma with Inconsistent Response to Treatment in the Primary and Metastatic Lesions

    Directory of Open Access Journals (Sweden)

    Takashi Tomiyama

    2018-05-01

    Full Text Available Esophageal large-cell neuroendocrine carcinoma (NEC is a rare malignant tumor that is characterized by high-grade malignancy and a poor prognosis. However, the rarity of esophageal NEC has prevented the development of an established treatment, and no reports have described a discrepancy in the effectiveness of cisplatin plus irinotecan between primary and metastatic lesions. A 43-year-old Japanese man was referred to our hospital with refractory epigastralgia. A previous gastrointestinal endoscopy had revealed a 50-mm type 2 tumor in the abdominal esophagus. The pathological findings indicated poorly differentiated squamous cell carcinoma. Contrast-enhanced computed tomography revealed a metastatic liver tumor. One cycle of fluorouracil and cisplatin was not effective, and endoscopy was repeatedly performed. The pathological findings indicated a large-cell malignant tumor with tumor cells that were positive for CD56, synaptophysin, and Ki-67 (> 80%. Based on a diagnosis of esophageal large-cell NEC with a metastatic liver tumor, the patient received cisplatin plus irinotecan biweekly. After 4 months, computed tomography revealed marked shrinkage of the metastatic tumor, but the patient complained of dysphagia. Endoscopy revealed enlargement of the primary tumor, which was then treated using radiotherapy plus fluorouracil and cisplatin. The primary tumor subsequently shrank, and the patient’s symptoms were relieved, but the metastatic tumor grew. Thus, chemoradiotherapy could be an option for managing a primary esophageal large-cell NEC that does not respond to chemotherapy alone. However, the possibility of an inconsistent response to therapy in primary and metastatic lesions should be considered.

  18. Effects of Different Cultivation Practices and Postharvest Treatments ...

    African Journals Online (AJOL)

    These preharvest treatments were combined with three disinfection and two storage treatments. The tomatoes were periodically analyzed for weight loss, total soluble solids, pH, titratable acidity, ascorbic acid and marketability. Preharvest ComCat® and ComCat® + manure treatments improved the quality of tomato during ...

  19. Citric waste saccharification under different chemical treatments

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo de Farias Silva

    2015-10-01

    Full Text Available Second generation ethanol from lignocellulose materials has been used in applications for food processing wastes. Since Brazil has a leading position in orange juice exports, the influence of acid and alkali pretreatments on liquor saccharification, solubilization of solid fraction and mass yield was evaluated. Time and Cacid or Calkaline at different concentrations of solids (low to moderate, 1 to 9% and high catalyst concentrations were analyzed. A hydrothermal pretreatment was conducted under the same conditions of acid and alkaline treatments to investigate the relative selectivity increase in using the catalysts. The chemical analyses of wastes indicated a 70% total carbohydrate level denoting a promising raw material for bioethanol production. Pretreatment caused acid saccharifications between 25 and 65% in total reducing sugars (TRS and mass yields (MY between 30 and 40%. In alkaline pretreatment, these rates ranged between 2 and 22.5% and between 30 and 80, respectively. In hydrothermal pretreatment, solubilized TRS varied between 3 and 37%, whereas MY remained between 45 and 60%, respectively. Cbiomass strongly influenced the three variables; in the same way, time affected MY.

  20. Quality and Reliability of Large-Eddy Simulations

    CERN Document Server

    Meyers, Johan; Sagaut, Pierre

    2008-01-01

    Computational resources have developed to the level that, for the first time, it is becoming possible to apply large-eddy simulation (LES) to turbulent flow problems of realistic complexity. Many examples can be found in technology and in a variety of natural flows. This puts issues related to assessing, assuring, and predicting the quality of LES into the spotlight. Several LES studies have been published in the past, demonstrating a high level of accuracy with which turbulent flow predictions can be attained, without having to resort to the excessive requirements on computational resources imposed by direct numerical simulations. However, the setup and use of turbulent flow simulations requires a profound knowledge of fluid mechanics, numerical techniques, and the application under consideration. The susceptibility of large-eddy simulations to errors in modelling, in numerics, and in the treatment of boundary conditions, can be quite large due to nonlinear accumulation of different contributions over time, ...

  1. Long-term treatment of phenylketonuria with a new medical food containing large neutral amino acids.

    Science.gov (United States)

    Concolino, D; Mascaro, I; Moricca, M T; Bonapace, G; Matalon, K; Trapasso, J; Radhakrishnan, G; Ferrara, C; Matalon, R; Strisciuglio, P

    2017-01-01

    Phenylketonuria (PKU) is an autosomal recessive disease caused by deficient activity of phenylalanine hydroxylase. A low phenylalanine (Phe) diet is used to treat PKU. The diet is very restrictive, and dietary adherence tends to decrease as patients get older. Methods to improve dietary adherence and blood Phe control are continuously under investigation. A new formula Phe-neutral amino acid (PheLNAA) has been tested in this study with the purpose of improving the compliance and lowering blood phenylalanine. The formula has been tested for nitrogen balance, and it is nutritionally complete. It is fortified with more nutritional additives that can be deficient in the PKU diet, such as B12, Biotin, DHA, Lutein and increased levels of large neutral amino acids to help lower blood Phe. The new formula has been tested on 12 patients with a loading test of 4 weeks. Fifty-eight percent of patients had a significant decline in blood Phe concentration from baseline throughout the study. The PheLNAA was well tolerated with excellent compliance and without illnesses during the study. In conclusion, the new formula is suitable for life-long treatment of PKU, and it offers the PKU clinic a new choice for treatment.

  2. Surface-Treated versus Untreated Large-Bore Catheters as Vascular Access in Hemodialysis and Apheresis Treatments

    Directory of Open Access Journals (Sweden)

    Rolf Bambauer

    2012-01-01

    Full Text Available Background. Catheter-related infections, thrombosis, and stenosis are among the most frequent complications associated with catheters, which are inserted in vessels. Surface treatment processes of the outer surface, such as ion-beam-assisted deposition, can be used to mitigate such complications. Methods. This retrospective study (1992–2007 evaluated silver-coated (54 patients and noncoated (105 patients implanted large-bore catheters used for extracorporeal detoxification. The catheters were inserted into the internal jugular or subclavian veins. After removal, the catheters were cultured for bacterial colonization using standard microbiologic assays. They also were examined using scanning electron microscope. Results. The silver coated catheters showed a tendency towards longer in situ time. The microbiologic examinations of the catheter tips were in both catheter types high positive, but not significant. Conclusion. The silver-coated catheters showed no significantly reduction in infection rate by evaluation of all collected data in this retrospective study. There was no association between both catheters in significantly reducing savings in treatment costs and in reducing patient discomfort. Other new developed catheter materials such as the microdomain-structured inner and outer surface are considered more biocompatible because they mimic the structure of natural biological surface.

  3. In vitro resistance to fracture of two nickel-titanium rotary instruments made with different thermal treatments.

    Science.gov (United States)

    Miccoli, Gabriele; Gaimari, Gianfranco; Seracchiani, Marco; Morese, Antonio; Khrenova, Tatyana; Di Nardo, Dario

    2017-01-01

    Aim of the study was to evaluate effectiveness of different heat treatments in improving Ni-Ti endodontic rotary instruments' resistance to fracture. 24 new NiTi instruments similar in length and shape: 12 M3 instruments, tip size 25 and .06 taper (United Dental, Shanghai, China), and 12 M3 Pro Gold instruments tip size 25 and .06 taper (United Dental, Shanghai, China), were tested in a 60° curved artificial root canal. Each group received a different heat treatment. Cycles to fracture were calculated for each instrument. Differences among groups were evaluated with an analysis of variance test (significance level was set at Pinstruments were significantly more resistant to fatigue (mean values = 1012, SD +/- 77) than M3 instruments (mean values = 748, SD +/- 62). No statistically significant differences were found between fragments' lengths (p>0,05). An increased flexibility and the reduction of internal defects produced by heat treatments during or after manufacturing processes, may be responsible for improving resistance to cyclic fatigue and flexural stresses.

  4. Analysis of influence of different pressure and different depth of pvd on soft foundation treatment

    Science.gov (United States)

    Li, Bin; Wang, XueKui

    2018-02-01

    According to the depth of plastic vertical drainage (pvd), the arrangement mode and the loading mode to analyze the influence of Vacuum preloading near the existing road. An arrangement mode of vacuum preloading to reduce the impact was put forward. The combination of different depth of pvd and loading modes are used to analyze the effect of vacuum preloading treatment and its influence range. The calculations show that the deformation and the influence distance are smaller by using the 40kPa vacuum loading and 41kPa surcharge load preloading. Reducing the depth of the pvd and vacuum combined surcharge preloading can weaken the influence to the existing highway.

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

    Directory of Open Access Journals (Sweden)

    Miguel Angel Suarez

    2012-10-01

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

  6. Endovascular strategy for the elective treatment of concomitant aortoiliac aneurysm and symptomatic large bowel diverticular disease.

    Science.gov (United States)

    Illuminati, Giulio; Ricco, Jean-Baptiste; Schneider, Fabrice; Caliò, Francesco G; Ceccanei, Gianluca; Pacilè, Maria A; Pizzardi, Giulia; Palumbo, Piergaspare; Vietri, Francesco

    2014-07-01

    The purpose of this study was to evaluate the strategy for treatment of patients presenting with asymptomatic diverticular disease of the large bowel associated with an asymptomatic aortoiliac aneurysmal (AAA) disease. Sixty-nine patients were included in this retrospective study. The patients were divided into 5 groups according to the type and sequence of the surgical treatment: 32 patients (47%) underwent colectomy followed by a staged open AAA repair (group A); 10 patients (14%) were treated with open AAA repair followed by a staged colectomy (group B); 13 patients (18%) received endovascular aneurysm repair (EVAR) followed by a staged bowel resection (group C); 8 patients (12%) had a bowel resection followed by staged EVAR (group D); and 6 patients (9%) underwent simultaneous open AAA repair and bowel resection (group E). Primary end points were mortality and complications after any of the procedures. Secondary end point was the time interval between the staged procedures. The cumulative death rate for delayed treatment of AAA was 6.5% and 0% for delayed treatment of diverticular disease [P=0.22]. The mean time interval between the staged procedures was 11 days for EVAR/colon resection (group C and group D) and 73 days for open AAA repair/colon resection (group A and group B; P<0.01). EVAR allows a significant reduction in the time required between AAA repair and colon resection, but no definite rule can be established regarding the sequence of staged procedures. Combined procedures should be reserved for selected cases. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Evaluation of different techniques for erosion control on different roadcuts in its first year of implantation

    Science.gov (United States)

    Gomez, Jose Alfonso; Rodríguez, Abraham; Viedma, Antonio; Contreras, Valentin; Vanwalleghem, Tom; Taguas, Encarnación V.; Giráldez, Juan Vicente

    2014-05-01

    Linear infrastructures, such as highways and railways, present a large environmental impact. Among this impact is the effect on landscape and the modification of the hydrological conditions of the area and an increase in erosive processes (Martin et al., 2011). The increase of erosive processes is specially significant in roadbanks, resulting in high maintenance costs as well as security risks for the use of the infrastructure if it is not properly controlled. Among roadbanks, roadcuts are specially challenging areas for erosion control and ecological restoration, due to their usually steep slope gradient and poor conditions for establishment of vegetation. There are several studies in Mediterranean conditions indicating how the combination of semiarid conditions with, sporadic, intense rainfall events makes a successful vegetation development and erosion control in motorway roadbanks extremely difficult (e.g. Andrés and Jorbat, 2000; Bochet and García-Fayos, 2004). This communication presents the results of the first year evaluation (hydrological year 2012-2013) of five different erosion control strategies on six different locations under different materials on roadcuts of motorways or railways in Andalusia during 2012-2013 using natural rainfall and simulated rainfall. The six sites were located on roadcuts between 10 and 20 m long on slope steepness ranging from 40 to 90%, in motorways and railways spread over different materials in Andalusia. Site 1, Huelva was located on consolidated sand material, sites 2, Osuna I, site 3, Osuna II and site 4, Mancha Real, on marls. Sites 5, Guadix, and 6, Fiñana, were located on phyllites, in comparison a harder material. At each site 12 plots (10 m long and 2 m wide) were installed using metal sheets buried 10 cm within the soil with their longest side in the direction of the roadcut maximum slope. Six different treatments were evaluated at each site, two replications each. These treatments were: 1- A control with bare

  8. Effect of different oral oxytetracycline treatment regimes on selection of antimicrobial resistant coliforms in nursery pigs.

    Science.gov (United States)

    Herrero-Fresno, Ana; Zachariasen, Camilla; Nørholm, Nanna; Holm, Anders; Christiansen, Lasse Engbo; Olsen, John Elmerdahl

    2017-09-01

    A major concern derived from using antimicrobials in pig production is the development of resistance. This study aimed to assess the impact of selected combinations of oral dose and duration of treatment with oxytetracycline (OTC) on selection of tetracycline resistant (TET-R) coliforms recovered from swine feces. The work encompassed two studies: 1) OTC 5mg/kg and 20mg/kg were administered to nursery pigs for 3 and 10days, respectively, under controlled experimental conditions, and 2) 10mg/kg, 20mg/kg and 30mg/kg OTC were given to a higher number of pigs for 6, 3 and 2days, respectively, under field conditions. Statistical modeling was applied to analyze trends in the proportion of TET-R coliforms. In the experimental study, no statistical difference in proportion of TET-R coliforms was observed between treatments at the end of the trial (day 18) and compared to day 0. In the field study, treatment had a significant effect on the proportion of TET-R bacteria two days after the end of treatment (2dAT) with the regimes "low dose-six days" and "medium dose-three days" yielding the highest and lowest proportions of TET-R strains, respectively. No indication of co-selection for ampicillin- and sulphonamide -R bacteria was observed for any treatment at 2dAT. By the end of the nursery period, the proportion of TET-R bacteria was not significantly different between treatments and compared to day 0. Our results suggest that similar resistance levels might be obtained by using different treatment regimes regardless of the combinations of oral dose-duration of treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Childhood Non-Hodgkin Lymphoma Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Childhood non-Hodgkin lymphoma has different types including Burkitt, diffuse large B-cell, primary mediastinal B-cell, lymphoblastic, and anaplastic large cell lymphoma. Get information about the risk factors, symptoms, tests to diagnose, staging, and treatment of all types of newly diagnosed and recurrent NHL and lymphoproliferative disease in this expert-reviewed summary.

  10. Dosimetric characterization of hypofractionated Gamma Knife radiosurgery of large or complex brain tumors versus linear accelerator-based treatments.

    Science.gov (United States)

    Dong, Peng; Pérez-Andújar, Angélica; Pinnaduwage, Dilini; Braunstein, Steve; Theodosopoulos, Philip; McDermott, Michael; Sneed, Penny; Ma, Lijun

    2016-12-01

    OBJECTIVE Noninvasive Gamma Knife (GK) platforms, such as the relocatable frame and on-board imaging, have enabled hypofractionated GK radiosurgery of large or complex brain lesions. This study aimed to characterize the dosimetric quality of such treatments against linear accelerator-based delivery systems that include the CyberKnife (CK) and volumetric modulated arc therapy (VMAT). METHODS Ten patients treated with VMAT at the authors' institution for large brain tumors (> 3 cm in maximum diameter) were selected for the study. The median prescription dose was 25 Gy (range 20-30 Gy) in 5 fractions. The median planning target volume (PTV) was 9.57 cm 3 (range 1.94-24.81 cm 3 ). Treatment planning was performed using Eclipse External Beam Planning V11 for VMAT on the Varian TrueBeam system, Multiplan V4.5 for the CyberKnife VSI System, and Leksell GammaPlan V10.2 for the Gamma Knife Perfexion system. The percentage of the PTV receiving at least the prescription dose was normalized to be identical across all platforms for individual cases. The prescription isodose value for the PTV, conformity index, Paddick gradient index, mean and maximum doses for organs at risk, and normal brain dose at variable isodose volumes ranging from the 5-Gy isodose volume (V5) to the 15-Gy isodose volume (V15) were compared for all of the cases. RESULTS The mean Paddick gradient index was 2.6 ± 0.2, 3.2 ± 0.5, and 4.3 ± 1.0 for GK, CK, and VMAT, respectively (p 0.06). The average prescription isodose values were 52% (range 47%-69%), 60% (range 46%-68%), and 88% (range 70%-94%) for GK, CK, and VMAT, respectively, thus producing significant variations in dose hot spots among the 3 platforms. Furthermore, the mean V5 values for GK and CK were similar (p > 0.79) at 71.9 ± 36.2 cm 3 and 73.3 ± 31.8 cm 3 , respectively, both of which were statistically lower (p linear accelerator-based treatments. Such a result supports the use of a large number of isocenters or confocal beams for the

  11. Ash behavior during hydrothermal treatment for solid fuel applications. Part 1: Overview of different feedstock

    International Nuclear Information System (INIS)

    Mäkelä, Mikko; Fullana, Andrés; Yoshikawa, Kunio

    2016-01-01

    Highlights: • Ash behavior of 29 different feedstock interpreted using multivariate data analysis. • Two different groups identified based on char ash content and ash yield. • Solubility of individual elements evaluated based on a smaller data set. • Ash from industrial sludge contained anthropogenic metals with low solubility. - Abstract: Differences in ash behavior during hydrothermal treatment were identified based on multivariate data analysis of literature information on 29 different feedstock. In addition, the solubility of individual elements was evaluated based on a smaller data set. As a result two different groups were distinguished based on char ash content and ash yield. Virgin terrestrial and aquatic biomass, such as different types of wood and algae, in addition to herbaceous and agricultural biomass, bark, brewer’s spent grain, compost and faecal waste showed lower char ash content than municipal solid wastes, anaerobic digestion residues and municipal and industrial sludge. Lower char ash content also correlated with lower ash yield indicating differences in chemical composition and ash solubility. Further evaluation of available data showed that ash in industrial sludge mainly contained anthropogenic Al, Fe and P or Ca and Si with low solubility during hydrothermal treatment. Char from corn stover, miscanthus, switch grass, rice hulls, olive, artichoke and orange wastes and empty fruit bunch had generally higher contents of K, Mg, S and Si than industrial sludge although differences existed within the group. In the future information on ash behavior should be used for enhancing the fuel properties of char based on feedstock type and hydrothermal treatment conditions.

  12. How Hyperarousal and Sleep Reactivity Are Represented in Different Adult Age Groups: Results from a Large Cohort Study on Insomnia.

    Science.gov (United States)

    Altena, Ellemarije; Chen, Ivy Y; Daviaux, Yannick; Ivers, Hans; Philip, Pierre; Morin, Charles M

    2017-04-14

    Hyperarousal is a 24-h state of elevated cognitive and physiological activation, and is a core feature of insomnia. The extent to which sleep quality is affected by stressful events-so-called sleep reactivity-is a vulnerability factor for developing insomnia. Given the increasing prevalence of insomnia with age, we aimed to investigate how hyperarousal and sleep reactivity were related to insomnia severity in different adult age groups. Data were derived from a large cohort study investigating the natural history of insomnia in a population-based sample ( n = 1693). Baseline data of the Arousal Predisposition Scale (APS) and Ford Insomnia Response to Stress Test (FIRST) were examined across age and sleep/insomnia subgroups: 25-35 ( n = 448), 35-45 ( n = 528), and 45-55 year olds ( n = 717); good sleepers ( n = 931), individuals with insomnia symptoms ( n = 450), and individuals with an insomnia syndrome ( n = 312). Results from factorial analyses of variance (ANOVA) showed that APS scores decreased with increasing age, but increased with more severe sleep problems. FIRST scores were not significantly different across age groups, but showed the same strong increase as a function of sleep problem severity. The findings indicate that though arousal predisposition and sleep reactivity increase with more severe sleep problems, only arousal decreases with age. How arousing events affect an individual during daytime thus decreases with age, but how this arousal disrupts sleep is equivalent across different adult age groups. The main implication of these findings is that treatment of insomnia could be adapted for different age groups and take into consideration vulnerability factors such as hyperarousal and stress reactivity.

  13. Performance assessment of different STPs based on UASB followed by aerobic post treatment systems.

    Science.gov (United States)

    Khan, Abid Ali; Gaur, Rubia Zahid; Mehrotra, Indu; Diamantis, Vasileios; Lew, Beni; Kazmi, Absar Ahmad

    2014-01-27

    This paper present the experiences gained from the study of ten up flow anaerobic sludge blanket (UASB) based sewage treatment plants (STPs) of different cities of India. Presently 37 UASB based STPs were under operation and about 06 UASB based STPs are under construction and commissioning phase at different towns. The nature of sewage significantly varied at each STP. Two STP were receiving sewage with high sulfate and heavy metals due to the mixing of industrial waste. The treatment performance of all UASB reactors in terms of BOD, COD and TSS were observed between 55 to 70% respectively. The post treatment units down flow hanging sponge (DHS) and Aeration followed by activated sludge process (ASP) at two STPs were performing well and enable to achieve the required disposal standards. Results indicate the effluent quality in terms of BOD and SS were less than 30 and 50 mg/L and well below the discharging standards.

  14. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

    Directory of Open Access Journals (Sweden)

    Eoin McElroy

    2016-04-01

    Full Text Available Background: Childhood sexual abuse (CSA is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective: This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method: The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434. Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III. Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts and 10 adult clinical syndromes. Results: There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions: The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

  15. Pathological gambling and age: differences in personality, psychopathology, and response to treatment variables.

    Science.gov (United States)

    González-Ibáñez, A; Mora, M; Gutiérrez-Maldonado, J; Ariza, A; Lourido-Ferreira, M R

    2005-02-01

    The aim of this study was to ascertain the possible differences in personality, psychopathology, and response to treatment in pathological gambling according to age. The sample, comprising 67 participants, was divided into three groups: 32.6% with ages ranging between 17 and 26 years, 31.3% between 27 and 43 years, and 35.8% over 44 years of age. The participants were administered the following tests, Minnesota Multiphasic Personality Inventory [MMPI; Hathaway, S.R. & McKinley, J.C. (1943, 1961). Cuestionario de personalidad MMPI. Madrid Seccion de Estudios de TEA ed. 1970, 1975], sensation-seeking questionnaire [SSS; Zuckerman, M. (1979). Sensation seeking; beyond the optimal level of arousal. Hillsdale, NJ: Lawrence Erlbaum Associates], and the Symptom Check List Revised [SCL-90-R; Derogatis, L.R. (1977). Symptom check list-90 revised. Administration scoring and procedures manual. Baltimore]. All underwent a group treatment programme that was carried out in the Pathological Gambling Unit at Ciutat Sanitaria i Universitaria de Bellvitge (CSUB), Teaching hospital, Barcelona, Spain. The findings show differences depending on age in the participants' personality and in psychopathology and in their response to treatment.

  16. Large-scale functional networks connect differently for processing words and symbol strings.

    Science.gov (United States)

    Liljeström, Mia; Vartiainen, Johanna; Kujala, Jan; Salmelin, Riitta

    2018-01-01

    Reconfigurations of synchronized large-scale networks are thought to be central neural mechanisms that support cognition and behavior in the human brain. Magnetoencephalography (MEG) recordings together with recent advances in network analysis now allow for sub-second snapshots of such networks. In the present study, we compared frequency-resolved functional connectivity patterns underlying reading of single words and visual recognition of symbol strings. Word reading emphasized coherence in a left-lateralized network with nodes in classical perisylvian language regions, whereas symbol processing recruited a bilateral network, including connections between frontal and parietal regions previously associated with spatial attention and visual working memory. Our results illustrate the flexible nature of functional networks, whereby processing of different form categories, written words vs. symbol strings, leads to the formation of large-scale functional networks that operate at distinct oscillatory frequencies and incorporate task-relevant regions. These results suggest that category-specific processing should be viewed not so much as a local process but as a distributed neural process implemented in signature networks. For words, increased coherence was detected particularly in the alpha (8-13 Hz) and high gamma (60-90 Hz) frequency bands, whereas increased coherence for symbol strings was observed in the high beta (21-29 Hz) and low gamma (30-45 Hz) frequency range. These findings attest to the role of coherence in specific frequency bands as a general mechanism for integrating stimulus-dependent information across brain regions.

  17. Assessment of alternatives to correct inventory difference statistical treatment deficiencies

    International Nuclear Information System (INIS)

    Byers, K.R.; Johnston, J.W.; Bennett, C.A.; Brouns, R.J.; Mullen, M.F.; Roberts, F.P.

    1983-11-01

    This document presents an analysis of alternatives to correct deficiencies in the statistical treatment of inventory differences in the NRC guidance documents and licensee practice. Pacific Northwest Laboratory's objective for this study was to assess alternatives developed by the NRC and a panel of safeguards statistical experts. Criteria were developed for the evaluation and the assessment was made considering the criteria. The results of this assessment are PNL recommendations, which are intended to provide NRC decision makers with a logical and statistically sound basis for correcting the deficiencies

  18. Synovial Tissue Response to Treatment with TNF Blockers in Peripheral Spondyloarthritis

    NARCIS (Netherlands)

    Paramarta, Jacqueline E.; Baeten, Dominique; de Rycke, Leen

    2011-01-01

    This review describes the synovial response to treatment in peripheral spondyloarthritis (SpA). A series of recent studies demonstrates that the synovial histopathology is largely homogenous between different SpA subtypes and can be strongly modulated by effective treatment such as tumor necrosis

  19. Gender differences in substance use, consequences, motivation to change, and treatment seeking in people with serious mental illness.

    Science.gov (United States)

    Drapalski, Amy; Bennett, Melanie; Bellack, Alan

    2011-01-01

    Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender.

  20. Evaluation of carbon diffusion in heat treatment of H13 tool steel under different atmospheric conditions

    OpenAIRE

    Ramezani, Maziar; Pasang, Timotius; Chen, Zhan; Neitzert, Thomas; Au, Dominique

    2015-01-01

    Although the cost of the heat treatment process is only a minor portion of the total production cost, it is arguably the most important and crucial stage on the determination of material quality. In the study of the carbon diffusion in H13 steel during austenitization, a series of heat treatment experiments had been conducted under different atmospheric conditions and length of treatment. Four austenitization atmospheric conditions were studied, i.e., heat treatment without atmospheric contro...

  1. [Differences between adolescents with pathological Internet use in inpatient and outpatient treatment].

    Science.gov (United States)

    Wartberg, Lutz; Moll, Bettina; Baldus, Christiane; Thomsen, Monika; Thomasius, Rainer

    2017-07-01

    In epidemiological studies high prevalence estimates for pathological Internet use in adolescence were reported. There are only few studies published, reporting data of adolescents seeking treatment concerning their pathological Internet use. Currently, a comparison of patients in inpatient versus outpatient treatment is not available. We investigated 74 adolescents reporting pathological Internet use with standardized questionnaires concerning problematic Internet use, psychopathological symptoms and life satisfaction. Overall, 35 adolescents were treated in an outpatient and another 39 adolescents in an inpatient setting. A substantial portion in both groups showed comorbid mental health problems. There were no differences in the degree of problematic Internet use between the two groups. However, compared to adolescents in an outpatient setting, adolescents in inpatient treatment reported longer average Internet usage times, a lower life satisfaction as well as more anxiety/depressiveness and self-esteem problems. In a multivariate logistic regression analysis Internet usage time and life satisfaction were identified as statistically significant factors for the affiliation to one of the two treatment groups. The results of the present study could be useful as a further description of this group of patients and more general to develop interventions for adolescents reporting pathological Internet use.

  2. Impact of different treatment methods on survival in advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Brasiuniene, B.; Juozaityte, E.; Barauskas, G.

    2005-01-01

    The aim of the study was to evaluate the impact of different treatment methods on survival of patients treated for advanced pancreatic cancer at Kaunas University of Medicine Hospital from 1987 to 2003. Data on 262 patients with advanced pancreatic cancer treated from 1987 to 2003 were analyzed retrospectively. Four groups of patients were analyzed. One hundred eighty patients underwent palliative bypass or endoscopic bile duct stenting or observation alone. Forty three patients in addition to surgery were treated by radiotherapy. Twenty five patients received gemcitabine in standard doses and schedules. Fourteen patients received concomitant chemoradiotherapy (with gemcitabine or 5-fluorouracil). All patients were grouped by treatment method and median survival was analyzed. Median survival of patients treated by palliative surgery only or observation alone was 1.9 month, and for patients treated by palliative surgery and radiotherapy was 6.1 months (p=0.00007). Median survival of patients treated with gemcitabine was 9.5 months (p<0.001), and median survival of patients treated with concomitant chemoradiotherapy was 8.5 months (p=0.00003). Patients diagnosed with advanced pancreatic cancer in addition to surgical treatment should be treated by chemotherapy, concomitant chemoradiotherapy or radiotherapy. (author)

  3. A comparison study of different physical treatments on cartilage matrix derived porous scaffolds for tissue engineering applications

    International Nuclear Information System (INIS)

    Moradi, Ali; Pramanik, Sumit; Ataollahi, Forough; Pingguan-Murphy, Belinda; Abdul Khalil, Alizan; Kamarul, Tunku

    2014-01-01

    Native cartilage matrix derived (CMD) scaffolds from various animal and human sources have drawn attention in cartilage tissue engineering due to the demonstrable presence of bioactive components. Different chemical and physical treatments have been employed to enhance the micro-architecture of CMD scaffolds. In this study we have assessed the typical effects of physical cross-linking methods, namely ultraviolet (UV) light, dehydrothermal (DHT) treatment, and combinations of them on bovine articular CMD porous scaffolds with three different matrix concentrations (5%, 15% and 30%) to assess the relative strengths of each treatment. Our findings suggest that UV and UV–DHT treatments on 15% CMD scaffolds can yield architecturally optimal scaffolds for cartilage tissue engineering. (paper)

  4. Primary cutaneous anaplastic large-cell lymphoma.

    Science.gov (United States)

    Perry, Edward; Karajgikar, Jay; Tabbara, Imad A

    2013-10-01

    Since the recognition of the anaplastic large-cell lymphomas in the 1980s, much has been learned about the diagnosis, clinical presentation, and treatment of these malignant conditions. The systemic and primary cutaneous types of anaplastic large cell lymphomas have been differentiated on clinical and immunophenotypical findings, but further research is required to elucidate their exact etiologies and pathogeneses. Primary cutaneous anaplastic large-cell lymphoma has a 95% disease-specific 5-year survival, owing partly to the relatively benign course of the disease and partly to the variety of effective treatments that are available. As with many other oncological diseases, new drugs are continually being tested and developed, with immunotherapy and biological response modifiers showing promise.

  5. Hepatocellular carcinoma: treatment with transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Acunas, Buelent; Rozanes, Izzet

    1999-01-01

    This article presents a review of the literature regarding the use of transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). There have been two different approaches to the treatment: (a) percutaneous tumor ablation methods which can be divided into injectable and thermal methods; percutaneous ethanol injection (PEI) is the most widely used method, and (b) TACE. PEI is the treatment of choice for single HCCs smaller or equal to 3 cm in size. For patients with large HCCs combined TACE and PEI is probably the most effective nonsurgical treatment. In the presence of multiple HCC nodules, TACE remains the treatment of choice

  6. Psychiatric comorbidity and gender difference among treatment-seeking heroin abusers in Taiwan.

    Science.gov (United States)

    Chiang, Shu-Chuan; Chan, Hung-Yu; Chang, Yuan-Ying; Sun, Hsiao-Ju; Chen, Wei J; Chen, Chih-Ken

    2007-02-01

    The objectives of the present study were to estimate the psychiatric comorbidity of Taiwanese heroin users seeking treatment and to identify the gender differences in psychiatric comorbidity and drug use behavior. Subjects were interviewed using a structured questionnaire on drug use behavior and the Mini International Neuropsychiatric Interview for psychiatric disorders. Of the subjects, 58.5% of the male and 62.5% of the female subjects had at least one non-substance-use axis I psychiatric disorder or antisocial personality disorder. Compared to male subjects, female subjects were younger, were less educated, had higher rates of unemployment and had earlier onset of illicit drug use. Female subjects were 11-fold more likely than male subjects to exhibit suicidal behavior. Among heroin abusers in the present study, female subjects were more widely exposed to unfavorable social factors and had substantially higher incidence of suicidal behavior than male subjects. Drug treatment centers should be aware of these gender differences and pay particular attention to comorbid depressive disorders and suicidal behavior of female heroin abusers.

  7. EXPERIENCE OF ADMINISTRATION OF GROWTH HORMONE IN TREATMENT OF DIFFERENT TYPES OF MICROSOMIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    V.A. Peterkova

    2009-01-01

    Full Text Available The opportunities of receiving of genetically engineered medications, e.g. somatotropic hormone (STG are almost unrestricted, and treatment and monitoring of patients with different types of microsomia can be held on modern, new level with the help of it. STG provides normal stature and valuable quality of life in these patients. Treatment with growth hormone influences on hormonal, metabolic and psychical status of patient. Metabolic effects are: increasing of muscle strength, improving of renal blood flow, increasing of cardiac output, absorbability of calcium in intestines and mineralization of bones. The level of blood cholesterol, lipoproteins is descended; blood alkaline phosphatase, phosphorus, urine and fatty acid are increased. Patients' vitality and quality of life are normalized. Besides somatotropic insufficiency, growth hormone is widely used in growth_stimulating treatment of different types of dwarism in children: microsomia due to pre_natal growth delay, genetic syndromes: Silwer–Russell, Shereshevsky–Turner, Nunan, Prader–Willi, and microsomia in patients with chronic renal disease.Key words: children, microsomia, somatotropic hormone, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:86-93

  8. Imiquimod 5% cream for the treatment of large nodular basal cell carcinoma at the medial canthal area

    Directory of Open Access Journals (Sweden)

    Gamze Ozturk Karabulut

    2017-01-01

    Full Text Available Context (Background: Imiquimod (IMQ 5% cream is an immunomodulatory and antitumorigenic agent, which was used as a topical treatment regimen, who had periocular basal cell carcinoma (BCC. Aim: This study aims to present three cases with large BCC at the medial canthal area treated with IMQ 5% cream. Materials and Methods: IMQ 5% cream was used in three patients with ages 45, 49, and 73 who preferred medical treatment over surgery. Following incisional biopsy IMQ cream was used once a day, 5 times a week and the patients were followed up weekly during 12 week treatment period and monthly after the clearance of the lesion. Results: Erythema and erosion on the surface of the lesion, injection of conjunctiva, burning and itching sensation, epiphora and punctate keratitis were seen in all patients during the treatment period. The ophthalmic side effects could be managed by topical lubricating eye drops and the inflammatory reactions resolved within 1 month after cessation of therapy. The patients were followed up for at least 3 years without tumor recurrence and the biopsies taken from the suspected area were found to be tumor free. Conclusion: Surgical excision of carcinoma of the eyelid at medial canthal area can be difficult without causing damage to the lacrimal system and reconstruction of the defect may need grafts or flaps. IMQ may provide an alternative therapy to surgery in certain cases.

  9. Different treatment modalities for refractory vaginismus in western Saudi Arabia.

    Science.gov (United States)

    Fageeh, Wafa M K

    2011-06-01

    Although vaginismus is a common sexual dysfunction in Saudi Arabia, there are limited data concerning the treatment modalities associated with patients with symptoms of vaginismus. This study is aimed to evaluate the presentation and different modalities of management in patients with severe refractory vaginismus in western Saudi Arabia. Successful penetrative sexual intercourse suggesting that common elements of the therapies used were successful. A retrospective study of patients presenting with severe refractory vaginismus treated in Jeddah, Saudi Arabia. The subjects were 15 women with third to fourth degree vaginismus who presented to King Abdulazziz University Hospital between January 1, 2008 and January 1, 2009. The mean age of the participants was 23 years. The mean duration of marriage before seeking medical advice was 12 months. Six patients had undergone conventional therapy successfully. The other six cases, four of which had a previous history of treatment failure, and two who were unresponsive to 4 months of conventional therapy were offered botulinum toxin type A. Five patients who received the Botox therapy had satisfactory intercourse on the same day of the treatment. One patient required a repeat injection after 2 months for recurrent vaginismus. Three of the 15 patients refused the treatment as they were already divorced and had only come in to exclude organic causes for their condition. Vaginismus is an overlooked topic in conservative societies such as Saudi Arabia. For most patients, not knowing who to confide in or where to turn to plays a major role in the under diagnosis of vaginismus. Conventional therapy proved effective in mild and moderate cases, while botulinum toxin has a more rapid effect and was thus more effective in severe cases. © 2011 International Society for Sexual Medicine.

  10. A comparison of different three-dimensional treatment planning techniques for localized radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Koswig, S.; Dinges, S.; Buchali, A.; Boehmer, D.; Salk, J.; Rosenthal, P.; Harder, C.; Schlenger, L.; Budach, V.

    1999-01-01

    Purpose: Four different three-dimensional planning techniques for localized radiotherapy of prostate cancer were compared with regard to dose homogeneity within the target volume and dose to organs at risk, dependent upon tumor stage. Patients and Methods: Six patients with stage T1, 7 patients with stage T2 and 4 patients with stage T3 were included in this study. Four different 3D treatment plans (rotation, 4-field, 5-field and 6-field technique) were calculated for each patient. Dose was calculated with the reference point at the isocenter (100%). The planning target volume was encompassed within the 95% isodose surface. All the techniques used different shaped portal for each beam. Dose volume histograms were created and compared for the planning target volume and the organs at risk (33%, 50%, 66% volume level) in all techniques. Results: The 4 different three-dimensional planning techniques revealed no differences concerning dose homogeneity within the planning target volume. The dose volume distribution at organs at risk show differences between the calculated techniques. In our study the best protection for bladder and rectum in stage T1 and T2 was achieved by the 6-field technique. A significant difference was achieved between 6-field and 4-field technique only in the 50% volume of the bladder (p=0.034), between the 6-field and rotation technique (all volume levels) and between 5-field and rotation technique (all volume levels). In stage T1, T2 6-field and 4-field technique in 50% (p-0.033) and 66% (p=0.011) of the rectum volume. In stage T3 a significant difference was not observed between the 4 techniques. The best protection of head of the femur was achieved by the rotation technique. Conclusion: In the localized radiotherapy of prostate cancer in stage T1 or T2 the best protection for bladder and rectum was achieved by a 3D-planned conformal 6-field technique. If the seminal vesicles have been included in the target volume and in the case of large

  11. Large sexual-orientation-related differences in performance on mental rotation and judgment of line orientation tasks.

    Science.gov (United States)

    Rahman, Qazi; Wilson, Glenn D

    2003-01-01

    This study examined the performance of heterosexual and homosexual men and women on 2 tests of spatial processing, mental rotation (MR) and Benton Judgment of Line Orientation (JLO). The sample comprised 60 heterosexual men, 60 heterosexual women, 60 homosexual men, and 60 homosexual women. There were significant main effects of gender (men achieving higher scores overall) and Gender x Sexual Orientation interactions. Decomposing these interactions revealed large differences between the male groups in favor of heterosexual men on JLO and MR performance. There was a modest difference between the female groups on MR total correct scores in favor of homosexual women but no differences in MR percentage correct. The evidence suggests possible variations in the parietal cortex between homosexual and heterosexual persons.

  12. WATER MICROPOLLUTANTS: CLASSIFICATION AND TREATMENT TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    Yolanda Patiño

    2014-06-01

    Full Text Available This article reviews the different kinds of emerging contaminants, their origin and use, and their presence in the Spanish waters, both in surface and groundwater. Micropollutants are compounds of different origin and chemical nature which had been unnoticed (due to their low concentration and don’t have specific regulation. They are divided into six major groups, and many of them behave as endocrine disruptors causing large negative effects on human health and environment. They are in waters because the waste water treatment plants are not designed for their removal, so they are being discharged. Different alternatives for their removal are discussed - physico- chemical, biological and hybrid treatment technologies -. Among the physicochemical process, the advance oxidation processes (AOPs are very promising.

  13. Segregation distortion causes large-scale differences between male and female genomes in hybrid ants.

    Science.gov (United States)

    Kulmuni, Jonna; Seifert, Bernhard; Pamilo, Pekka

    2010-04-20

    Hybridization in isolated populations can lead either to hybrid breakdown and extinction or in some cases to speciation. The basis of hybrid breakdown lies in genetic incompatibilities between diverged genomes. In social Hymenoptera, the consequences of hybridization can differ from those in other animals because of haplodiploidy and sociality. Selection pressures differ between sexes because males are haploid and females are diploid. Furthermore, sociality and group living may allow survival of hybrid genotypes. We show that hybridization in Formica ants has resulted in a stable situation in which the males form two highly divergent gene pools whereas all the females are hybrids. This causes an exceptional situation with large-scale differences between male and female genomes. The genotype differences indicate strong transmission ratio distortion depending on offspring sex, whereby the mother transmits some alleles exclusively to her daughters and other alleles exclusively to her sons. The genetic differences between the sexes and the apparent lack of multilocus hybrid genotypes in males can be explained by recessive incompatibilities which cause the elimination of hybrid males because of their haploid genome. Alternatively, differentiation between sexes could be created by prezygotic segregation into male-forming and female-forming gametes in diploid females. Differentiation between sexes is stable and maintained throughout generations. The present study shows a unique outcome of hybridization and demonstrates that hybridization has the potential of generating evolutionary novelties in animals.

  14. Secondary neutron doses received by patients of different ages during intracranial proton therapy treatments

    International Nuclear Information System (INIS)

    Sayah, R.

    2012-01-01

    Proton therapy is an advanced radiation therapy technique that allows delivering high doses to the tumor while saving the healthy surrounding tissues due to the protons' ballistic properties. However, secondary particles, especially neutrons, are created during protons' nuclear reactions in the beam-line and the treatment room components, as well as inside the patient. Those secondary neutrons lead to unwanted dose deposition to the healthy tissues located at distance from the target, which may increase the secondary cancer risks to the patients, especially the pediatric ones. The aim of this work was to calculate the neutron secondary doses received by patients of different ages treated at the Institut Curie-centre de Protontherapie d'Orsay (ICPO) for intracranial tumors, using a 178 MeV proton beam. The treatments are undertaken at the new ICPO room equipped with an IBA gantry. The treatment room and the beam-line components, as well as the proton source were modeled using the Monte Carlo code MCNPX. The obtained model was then validated by a series of comparisons between model calculations and experimental measurements. The comparisons concerned: a) depth and lateral proton dose distributions in a water phantom, b) neutron spectrometry at one position in the treatment room, c) ambient dose equivalents at different positions in the treatment room and d) secondary absorbed doses inside a physical anthropomorphic phantom. A general good agreement was found between calculations and measurements, thus our model was considered as validated. The University of Florida hybrid voxelized phantoms of different ages were introduced into the MCNPX validated model, and secondary neutron doses were calculated to many of these phantoms' organs. The calculated doses were found to decrease as the organ's distance to the treatment field increases and as the patient's age increases. The secondary doses received by a one year-old patient may be two times higher than the doses

  15. What Is the Optimal Treatment of Large Brain Metastases? An Argument for a Multidisciplinary Approach

    International Nuclear Information System (INIS)

    Choi, Clara Y.H.; Chang, Steven D.; Gibbs, Iris C.; Adler, John R.; Harsh, Griffith R.; Atalar, Banu; Lieberson, Robert E.; Soltys, Scott G.

    2012-01-01

    Purpose: Single-modality treatment of large brain metastases (>2 cm) with whole-brain irradiation, stereotactic radiosurgery (SRS) alone, or surgery alone is not effective, with local failure (LF) rates of 50% to 90%. Our goal was to improve local control (LC) by using multimodality therapy of surgery and adjuvant SRS targeting the resection cavity. Patients and Methods: We retrospectively evaluated 97 patients with brain metastases >2 cm in diameter treated with surgery and cavity SRS. Local and distant brain failure (DF) rates were analyzed with competing risk analysis, with death as a competing risk. The overall survival rate was calculated by the Kaplain-Meier product-limit method. Results: The median imaging follow-up duration for all patients was 10 months (range, 1–80 months). The 12-month cumulative incidence rates of LF, with death as a competing risk, were 9.3% (95% confidence interval [CI], 4.5%–16.1%), and the median time to LF was 6 months (range, 3–17 months). The 12-month cumulative incidence rate of DF, with death as a competing risk, was 53% (95% CI, 43%–63%). The median survival time for all patients was 15.6 months. The median survival times for recursive partitioning analysis classes 1, 2, and 3 were 33.8, 13.7, and 9.0 months, respectively (p = 0.022). On multivariate analysis, Karnofsky Performance Status (≥80 vs. <80; hazard ratio 0.54; 95% CI 0.31–0.94; p = 0.029) and maximum preoperative tumor diameter (hazard ratio 1.41; 95% CI 1.08–1.85; p = 0.013) were associated with survival. Five patients (5%) required intervention for Common Terminology Criteria for Adverse Events v4.02 grade 2 and 3 toxicity. Conclusion: Surgery and adjuvant resection cavity SRS yields excellent LC of large brain metastases. Compared with other multimodality treatment options, this approach allows patients to avoid or delay whole-brain irradiation without compromising LC.

  16. Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

    Directory of Open Access Journals (Sweden)

    Östlund Ollie

    2011-04-01

    Full Text Available Abstract Background Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM maintenance and reliever therapy (Symbicort SMART® Turbuhaler® in patients previously prescribed treatments from Global Initiative for Asthma (GINA Steps 2, 3 or 4. Methods This is a post hoc analysis of the results of five large clinical trials (>12000 patients comparing BUD/FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined. Results At each GINA treatment step, the proportion of patients achieving target levels of current clinical control were similar or higher with BUD/FORM maintenance and reliever therapy compared with the same or a higher fixed maintenance dose of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA (plus short-acting β2-agonist [SABA] as reliever, and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P Conclusions BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps.

  17. Monitoring Utilization of a Large Scale Addiction Treatment System: The Drug and Alcohol Treatment Information System (DATIs

    Directory of Open Access Journals (Sweden)

    Nooshin Khobzi Rotondi

    2012-01-01

    Full Text Available Client-based information systems can yield data to address issues of system accountability and planning, and contribute information related to changing patterns of substance use in treatment and, indirectly, general populations. The Drug and Alcohol Treatment Information System (DATIS monitors the number/types of clients treated in approximately 170 publicly-funded addiction treatment agencies in Ontario. The purpose of this study was to estimate the caseload of addiction treatment agencies, and describe important characteristics of clients, their patterns of service utilization and trends over-time from 2005 to 2010. In 2009–2010, 47,065 individuals were admitted to treatment. Since 2005–2006, there has been an increase in adolescents/youth in treatment, and a decrease in the male-female gender ratio. Alcohol problems predominated, but an increasing proportion of clients used cannabis and prescription opioids. DATIS is an evolving system and an integral component of Ontario's performance measurement system. Linkages with healthcare information systems will allow for longitudinal tracking of client health-related outcomes.

  18. Toxicity assessment of water at different stages of treatment using Microtox assay

    Directory of Open Access Journals (Sweden)

    Pogorzelec Marta

    2017-01-01

    Full Text Available Number of potentially toxic hydrophobic organic contaminants e.g. polycyclic aromatic hydrocarbons, pesticides, polychlorinated biphenyls and dioxins having entered aquatic environment, including potential sources of drinking water. Unfortunately, not all micropollutants can be removed during water treatment processes. What is more, disinfectants can react with some organic compounds already present in the water, and form disinfection by-products which also can be toxic. The aim of this study was to assess toxicity of water at different stages of water treatment and to verify usefulness semipermeable membrane devices in monitoring of drinking water. For this purpose, semipermeable membrane devices (SPMDs were deployed in a surface water treatment plant. To determine the effect of water treatment on the presence of toxic micropollutants, study was conducted for a period of 5 months. Three sampling places were chosen: raw water input, stream of water just before disinfection and treated water output. After sampling dialysis in organic solvent was carried out and extracts were then analyzed with the Microtox acute toxicity test. The study has indicated the utility as well as some limitations of combining SPMDs with bioluminescence assay in the monitoring of biological effects of bioavailable hydrophobic pollutants in drinking water.

  19. Advances in the treatment of malignant large-bowel obstruction

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... Most cases of large-bowel obstruction are due to colonic adeno- carcinoma. 324 ... to perforation and faeculent peritonitis. .... advance in emergency colorectal surgery has been the .... where there is clinical suspicion of bowel.

  20. Formation of titanate nanostructures under different NaOH concentration and their application in wastewater treatment

    International Nuclear Information System (INIS)

    Huang Jiquan; Cao Yongge; Deng Zhonghua; Tong Hao

    2011-01-01

    The effects of the concentration of NaOH on the formation and transformation of various titanate nanostructures were studied. With increasing NaOH concentration, three different formation mechanisms were proposed. Nanotubes can only be obtained under moderate NaOH conditions, and should transform into nanowires with prolonged hydrothermal treatment, and their formation rate is accelerated by increasing NaOH concentration. Low concentration of NaOH results in the direct formation of nanowires, while extra high concentration of NaOH leads to the formation of amorphous nanoparticles. Adsorption and photocatalysis studies show that titanate nanowires and nanotubes might be potential adsorbents for the removal of both heavy metal ions and dyes and photocatalysts for the removal of dyes from wastewater. -- Graphical abstract: The morphologies of the titanates depend deeply on the concentration of NaOH. With increasing NaOH concentration, three different formation mechanisms were proposed. The application of these titanate nanostructures in the wastewater treatment was studied. Display Omitted Research highlights: → Effect of NaOH concentration on the structures of various titanates was reported. → Three different formation mechanisms were presented with increasing NaOH concentration. → Various titanates were used as adsorbents/photocatalysts in wastewater treatment.

  1. Sex differences in reinstatement of cocaine-seeking with combination treatments of progesterone and atomoxetine.

    Science.gov (United States)

    Swalve, Natashia; Smethells, John R; Zlebnik, Natalie E; Carroll, Marilyn E

    2016-06-01

    Two repurposed medications have been proposed to treat cocaine abuse. Progesterone, a gonadal hormone, and atomoxetine, a medication commonly used to treat attention deficit/hyperactivity disorder, have both been separately shown to reduce cocaine self-administration and reinstatement (i.e., relapse). The goal of the present study was to examine sex differences in the individual effects of PRO and ATO as well as the combination PRO+ATO treatment on cocaine (COC), caffeine (CAF), and/or cue-primed reinstatement of cocaine-seeking. Adult male and female Wistar rats lever-pressed under a FR 1 schedule for cocaine infusions (0.4mg/kg/inf). After 14 sessions of stable responding in daily 2-h sessions, rats underwent a 21-day extinction period when no drug or drug-related stimuli were present. Rats were then separated into four groups that received PRO (0.5mg/kg) alone (PRO+SAL), ATO (1.5mg/kg) alone (VEH+ATO), control (VEH+SAL) or combination (PRO+ATO) treatments prior to the reinstatement condition. Reinstatement of cocaine-seeking to cues and/or drug injections of cocaine or caffeine was tested after extinction. During maintenance, females self-administered more cocaine than males, but no sex differences were seen during extinction. Females showed greater cocaine-seeking than males after a CAF priming injection. Individual treatment with ATO did not decrease reinstatement under any priming condition; however, the combination treatment decreased cocaine-seeking under the COC+CUES priming condition in males, and both PRO alone and the combination treatment decreased cocaine-seeking in the CAF+CUES condition in females. Overall, PRO alone was only effective in reducing reinstatement in females, while the combination treatment was consistently effective in reducing reinstatement in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Gender differences in temporal relationships between gambling urge and cognitions in treatment-seeking adults.

    Science.gov (United States)

    Dunsmuir, Phoebe; Smith, David; Fairweather-Schmidt, A Kate; Riley, Ben; Battersby, Malcolm

    2018-04-01

    Many gambling-specific CBT programs seek to target either gambling-related urge or cognitions or both. However, little is known of the influence of one symptom type on another across time and whether these differ for men and women help-seeking problem gamblers. The aim of this study was threefold: to determine presence of measurement invariance for urge and cognition measures over time; to investigate the effect of baseline urge on end-of-treatment gambling-related cognitions - and the reciprocal relationship; and, identify whether these pathways differ across gender. Self-reported gambling urge (GUS), and gambling-related cognitions (GRCS) data from treatment-seeking problem gamblers prior to and post treatment (N = 223; 62% men) were analyzed with cross-lagged panel models, moderated by gender. Conceptualization of urge and cognitions were found to be temporally stable. There was no significant association between baseline GUS scores and post-treatment GRCS scores, nor the reverse relationship. Putatively, this infers that coexisting urge and gambling-related cognition components of problem gambling operate independently over time. Analyses revealed gambling urge had a significantly stronger tracking correlation across time for men than women when adjusting for cognition paths. This investigation provides early evidence for tailoring CBT in response to sub-population gambling-related characteristics, demonstrated across men and women. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. A Study on the Microstructural Evolution of a Low Alloy Steel by Different Shot Peening Treatments

    Directory of Open Access Journals (Sweden)

    Juan González

    2018-03-01

    Full Text Available Recent studies have shown that severe shot peening can be categorized as a severe plastic deformation surface treatment that is able to strongly modify the microstructure of the surface layer of materials, by both increasing the dislocation density and introducing a large number of defects that define new grain boundaries and form ultrafine structure. In this work, conventional shot peening and severe shot peening treatments were applied to 39NiCrMo3 steel samples. The samples were characterized in terms of microstructure, surface roughness, microhardness, residual stresses, and surface work-hardening as a function of surface coverage. Particular attention was focused on the analysis of the microstructure to assess the evolution of grain size from the surface to the inner material to capture the gradient microstructure. Severe shot peening proved to cause a more remarkable improvement of the general mechanical characteristics compared to conventional shot peening; more significant improvement was associated with the microstructural alteration induced by the treatment. Our datas provide a detailed verification of the relationship between shot peening treatment parameters and the microstructure evolution from the treated surface to the core material.

  4. Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference?

    Science.gov (United States)

    Samus, Quincy M; Vavilikolanu, Amrita; Mayer, Lawrence; McNabney, Matthew; Brandt, Jason; Lyketsos, Constantine G; Rosenblatt, Adam

    2013-12-01

    There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems. Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001-2003] and Cohort 2 [evaluated 2004-2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel. Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models. We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

  5. Evaluation of the Efficacy of Different Concentrations of Dextrose Prolotherapy in Temporomandibular Joint Hypermobility Treatment.

    Science.gov (United States)

    Mustafa, Rawand; Güngörmüş, Metin; Mollaoğlu, Nur

    2018-03-12

    The aim of this study was to compare and evaluate the efficacy of different concentrations of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. A prospective, randomized clinical trial including patients with subluxation or dislocation was performed. The study comprised 40 patients. Patients were randomly divided into 4 groups: control group, 10% dextrose, 20% dextrose, and 30% dextrose group. Patients in all groups received injections into 4 different areas of each TMJ in 4 sessions at monthly intervals. Visual analog scale of TMJ pain intensity, maximum mouth opening (MMO), joint sounds, and frequency of luxations were recorded preoperatively and postoperatively after 1 month of last injection. The collected data were then statistically analyzed. Each group showed postoperatively significant improvement in TMJ pain, significant decrease in both MMO and joint sound. Besides that, TMJ locking was not observed in any patient during the follow-up period. There were no statistically significant differences throughout the study intervals between the groups. It was concluded that there was no significant difference between control group and dextrose groups and there is no superiority of any concentration of dextrose over the others in TMJ prolotherapy, and all treatment procedures were efficient in improvement of clinical symptoms related to TMJ hypermobility. If dextrose is used as a proliferant, it can be said that 10% dextrose can be sufficient in TMJ hypermobility treatment.

  6. The limited contribution of large trees to annual biomass production in an old-growth tropical forest.

    Science.gov (United States)

    Ligot, Gauthier; Gourlet-Fleury, Sylvie; Ouédraogo, Dakis-Yaoba; Morin, Xavier; Bauwens, Sébastien; Baya, Fidele; Brostaux, Yves; Doucet, Jean-Louis; Fayolle, Adeline

    2018-04-16

    Although the importance of large trees regarding biodiversity and carbon stock in old-growth forests is undeniable, their annual contribution to biomass production and carbon uptake remains poorly studied at the stand level. To clarify the role of large trees in biomass production, we used data of tree growth, mortality, and recruitment monitored during 20 yr in 10 4-ha plots in a species-rich tropical forest (Central African Republic). Using a random block design, three different silvicultural treatments, control, logged, and logged + thinned, were applied in the 10 plots. Annual biomass gains and losses were analyzed in relation to the relative biomass abundance of large trees and by tree size classes using a spatial bootstrap procedure. Although large trees had high individual growth rates and constituted a substantial amount of biomass, stand-level biomass production decreased with the abundance of large trees in all treatments and plots. The contribution of large trees to annual stand-level biomass production appeared limited in comparison to that of small trees. This pattern did not only originate from differences in abundance of small vs. large trees or differences in initial biomass stocks among tree size classes, but also from a reduced relative growth rate of large trees and a relatively constant mortality rate among tree size classes. In a context in which large trees are increasingly gaining attention as being a valuable and a key structural characteristic of natural forests, the present study brought key insights to better gauge the relatively limited role of large trees in annual stand-level biomass production. In terms of carbon uptake, these results suggest, as already demonstrated, a low net carbon uptake of old-growth forests in comparison to that of logged forests. Tropical forests that reach a successional stage with relatively high density of large trees progressively cease to be carbon sinks as large trees contribute sparsely or even

  7. Different goods, different effects: Exploring the effects of generalized social trust in large-N collective action

    DEFF Research Database (Denmark)

    Sønderskov, Kim Mannemar

    2009-01-01

    Does generalized social trust help solve large-N collective action problems? This paper argues so, offering a novel explanation for the relationship: People tend to cooperate if they expect others to be cooperating, which implies that people holding generalized social trust more readily cooperate...... in large-N dilemmas because they expect that most people will cooperate. The paper tests the explanation in a rigorous design. The analyses show a positive, robust effect of generalized social trust on public good provision, but no effect is found in a joint product situation. This supports the hypothesis......, indicating that trust specifically enhances cooperation in collective action dilemmas....

  8. Normative and subjective need for orthodontic treatment within different age groups in a population in Turkey.

    Science.gov (United States)

    Nur Yilmaz, R B; Oktay, I; Ilhan, D; Fişekçioğlu, E; Özdemir, Fulya

    2017-12-01

    To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey. One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean, and Central Anatolia Region) (mean age ± SD: 12.80 ± 3.57 years) were randomly selected and divided into six age groups (7-8,9-10,11-12,13-14,15-16, and 17-18 year-olds) and categorized according to the dental health component (DHC) of the index for orthodontic treatment need (IOTN). Additionally, the patients were asked to indicate the photograph that was most similar to their own dentition from the 10-point scale of the aesthetic component of IOTN. The DHC of IOTN was not significantly different between the six age groups (P > 0.05). However, no/slight need (aesthetic component 1-4) for orthodontic treatment according to AC of IOTN was significantly higher in 13-14,15-16, and 17-18 age groups than 7-8, 9-10, and 11-12 age groups (P age groups (P > 0.05). The normative need distribution was homogeneous within all the age groups according to DHC. However, the subjective need for orthodontic treatment was higher in the younger age groups.

  9. [Corrosion resistance of casted titanium by compound treatments in the artificial saliva with different fluoride concentrations].

    Science.gov (United States)

    Wang, Xian-li; Guo, Tian-wen

    2012-09-01

    To study the corrosion resistance of casted titanium by plasma nitriding and TiN-coated compound treatments in the artificial saliva with different fluoride concentrations and to investigate whether compound treatments can increase the corrosion resistance of casted titanium. Potentiodynamic polarization technique was used to depict polarization curve and to measured the current density of corrosion (Icorr) and the electric potential of corrosion (Ecorr) of casted titanium (Group A) and casted titanium by compound treatments (Group B) in the artificial saliva with different fluoride concentrations. After electrochemical experiment, the microstructure was observed by scanning electron microscope (SEM). The Icorrs of Group A and B in the artificial saliva of different fluoride concentrations were (1530.23 ± 340.12), (2290.36 ± 320.10), (4130.52 ± 230.17) nA and (2.62 ± 0.64), (7.37 ± 3.59), (10.76 ± 6.05) nA, respectively. The Ecorrs were (-0.93 ± 0.10), (-0.89 ± 0.21), (-0.57 ± 0.09) V and (-0.21 ± 0.04), (-0.17 ± 0.03), (-0.22 ± 0.03) V, respectively.The Icorrs of Group B were significantly lower (P compound treatments can significantly increase the corrosion resistance of casted titanium.

  10. Pompe Disease: Early Diagnosis and Early Treatment Make a Difference

    Directory of Open Access Journals (Sweden)

    Yin-Hsiu Chien

    2013-08-01

    Full Text Available Pompe disease (glycogen storage disease type II or acid maltase deficiency is a lysosomal disorder in which acid α-glucosidase (GAA deficiencies lead to intralysosomal accumulation of glycogen in all tissues; most notably in skeletal muscles. Both the patient's age at the onset of Pompe disease symptoms and the rate of deterioration caused by the disease can vary considerably. In classical infant-onset Pompe disease (IOPD, symptoms start very early in life, and death occurs soon afterward if the disease remains untreated. In later-onset Pompe disease, symptoms are slower to appear, and patients often progress to wheelchair confinement and eventual respiratory failure. A diagnosis can be made by screening for GAA in dried blood samples, followed either by GAA assessment in lymphocytes or in fibroblasts or by the genetic analysis of mutations. Treatment by enzyme replacement therapy (ERT with alglucosidase alfa was approved for human use in 2006. In classical IOPD, treatment significantly lengthens survival and improves motor development and cardiac function. The sooner ERT begins, the better are the results. Newborn screening aims to take advantage of different technologies for diagnosing and treating newborns early on and it yields better outcomes. However, newborns diagnosed early and other long-term survivors may encounter fresh problems, making up a new phenotype of IOPD patients. Further modifications of the treatment, such as a decrease in immune responses to ERT, a higher dosage, a better uptake formulation, and gene therapy delivered locally or systemically are being explored.

  11. ECONOMIC EFFICIENCY OF DIFFERENT PROTECTION TREATMENTS IN APPLE PRODUCTION

    Directory of Open Access Journals (Sweden)

    Vesna Tomaš

    2015-06-01

    Full Text Available Apple is the most represented fruit species in Croatia. Codling moth, Cydia pomonella L, is one of the most important apple pests whose population is growing from year to year. The aim of this study was to determine the economic effectiveness of four treatments against codling moth (1 - based on baculovirus; 2 - based on the group of synthetic pyrethroid; 3 - based on kaolin, 4 - control treatment, on the three apple varieties. The experiment was performed at the Agricultural Institute Osijek, Croatia, during three years (2012-2014. In order to analyze the results of apple production it was necessary to calculate production efficiency, labor productivity, and profitability of production. The results of the research of economic efficiency according to market prices treatment 1 and treatment 2 had economic coefficient above 1 with tendency of significant growth, while treatment 3 and 4 were uneconomical. The treatment 1showed advantage over the treatment 2 because of its positive effects on human health and biodiversity, as well as satisfactory economic efficiency.

  12. Technically enhanced naturally occurring radioactive materials; identification, characterization and treatment

    International Nuclear Information System (INIS)

    Aly, H.F.

    2001-01-01

    Radioactive materials (TENORM) is produced in a relatively large amount with relatively small radioactivity, however in many instances the radioactivity levels exceeds that permissible. In this presentation, the different industries where enhanced levels of natural radioactivity is identified and characterized will be given. The different approaches for treatment of this enhanced radioactivity will be addressed. Finally, our research and development activities in characterization and treatment of TENORM produced from the oil fields in Egypt will be presented. (authors)

  13. [Risk assessment of different grades of hypertension during the treatment of patients with acute pulpitis].

    Science.gov (United States)

    Chen, Hong-tao; Wang, Wen-ying; Wang, Jin; Liang, Ya-ping; Wang, Xiao-ting; Hou, Guang-min; Ji, Ai-ping

    2016-02-18

    To evaluate the vital signs changes, influence factors in different grades of hypertension patients during the treatment of acute pulpitis, in order to obtain the risk prevention measures. In this study, 90 different grades of hypertension patients with acute pulpitis were recruited from February 2014 to February 2015 in the Department of Oral Emergency, Peking University School and Hospital of Stomatology. The information about the patients'general health, oral treatment, life signs of change information was collected. Patients were divided into high risk group, middle risk group, and low risk group (30 patients for each group). (1) Compared with the preoperative, systolic blood pressure (90%), diastolic blood pressure (80%), heart rate increase (100%) were increased in the high risk group. The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (Ppulpitis treatment. Dentist should take some measures to avoid the risks.

  14. Effects of Different Animal Waste Treatment Technologies on Detection and Viability of Porcine Enteric Viruses▿

    Science.gov (United States)

    Costantini, Verónica P.; Azevedo, Ana C.; Li, Xin; Williams, Mike C.; Michel, Frederick C.; Saif, Linda J.

    2007-01-01

    Enteric pathogens in animal waste that is not properly processed can contaminate the environment and food. The persistence of pathogens in animal waste depends upon the waste treatment technology, but little is known about persistence of porcine viruses. Our objectives were to characterize the porcine enteric viruses (porcine noroviruses [PoNoVs], porcine sapoviruses [PoSaVs], rotavirus A [RV-A], RV-B, and RV-C) in fresh feces or manure and to evaluate the effects of different candidate environmentally superior technologies (ESTs) for animal waste treatment on the detection of these viruses. Untreated manure and samples collected at different stages during and after treatment were obtained from swine farms that used conventional waste management (CWM) and five different candidate ESTs. The RNA from porcine enteric viruses was detected by reverse transcription-PCR and/or seminested PCR; PoSaV and RV-A were also detected by enzyme-linked immunosorbent assay. Cell culture immunofluorescence (CCIF) and experimental inoculation of gnotobiotic (Gn) pigs were used to determine RV-A/C infectivity in posttreatment samples. The PoSaV and RV-A were detected in pretreatment samples from each farm, whereas PoNoV and RV-C were detected in pretreatment feces from three of five and four of five farms using the candidate ESTs, respectively. After treatment, PoSaV RNA was detected only in the samples from the farm using CWM and not from the farms using the candidate ESTs. RV-A and RV-C RNAs were detected in four of five and three of four candidate ESTs, respectively, after treatment, but infectious particles were not detected by CCIF, nor were clinical signs or seroconversion detected in inoculated Gn pigs. These results indicate that only RV-A/C RNA, but no viral infectivity, was detected after treatment. Our findings address a public health concern regarding environmental quality surrounding swine production units. PMID:17601821

  15. Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling.

    Science.gov (United States)

    Grant, Jon E; Chamberlain, Samuel R; Schreiber, Liana R N; Odlaug, Brian L

    2012-09-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cognitive differences in treatment-seeking people with pathological gambling as a function of gender. 501 adult subjects (n = 274 [54.7%] females) with DSM-IV pathological gambling presenting for various clinical research trials over a 9-year period were assessed in terms of sociodemographics and clinical characteristics. A subset (n = 77) had also undertaken neuropsychological assessment with the Stop-signal and set-shift tasks. PG in females was associated with significantly worse disease severity, elevated mood and anxiety scores, and history of affective disorders, later age of study presentation, later age of disease onset, and elevated risk of having a first-degree relative with gambling or alcohol problems. These findings were of small effect size (0.20-0.35). Additionally, PG in females was associated with proportionately more non-strategic gambling with medium effect size (0.61). In contrast, PG in males was associated with a significantly greater lifetime history of an alcohol use disorder and any substance use disorder (small effect sizes 0.22-0.38); and slower motoric reaction times (medium effect size, 0.50). Response inhibition and cognitive flexibility were similar between the groups. These data suggest that important differences exist in the features of pathological gambling in women and men. Findings are of considerable relevance to clinicians and in terms of targeted treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Extinction of radiant energy by large atmospheric crystals with different shapes

    International Nuclear Information System (INIS)

    Shefer, Olga

    2016-01-01

    The calculated results of extinction characteristics of visible and infrared radiation for large semi-transparent crystals are obtained by hybrid technique, which is a combination of the geometric optics method and the physical optics method. Energy and polarization characteristics of the radiation extinction in terms of the elements of the extinction matrix for individual large crystals and ensemble of crystals are discussed. Influences of particle shapes, aspect ratios, parameters of size distribution, complex refractive index, orientation of crystals, wavelength, and the polarization state of an incident radiation on the extinction are illustrated. It is shown that the most expressive and stable features of energy and polarization characteristics of the extinction are observed in the midinfrared region, despite the fact that the ice particles significantly absorb the radiant energy of this spectrum. It is demonstrated that the polarized extinction characteristics can reach several tens of percent at IR wavelengths. For the large crystals, the conditions of occurrence of the spectral behavior of the extinction coefficient in the visible, near-IR, and mid-IR wavelength ranges are determined. - Highlights: • Method of physical optics is used at coherent sum of diffracted and refracted fields. • The extinction characteristics in terms of elements of extinction matrix are obtained. • Influence of shapes and sizes of large particles on the extinction is evaluated. • Conditions of occurrence of extinction features are determined.

  17. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods

    International Nuclear Information System (INIS)

    Guerra Liberal, Francisco D. C.; Tavares, Adriana Alexandre S.; Tavares, João Manuel R. S.

    2014-01-01

    Purpose: Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope. Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods. Methods: Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 ( 32 P), strontium-89 ( 89 Sr), yttrium-90 ( 90 Y ), tin-117 ( 117m Sn), samarium-153 ( 153 Sm), holmium-166 ( 166 Ho), thulium-170 ( 170 Tm), lutetium-177 ( 177 Lu), rhenium-186 ( 186 Re), rhenium-188 ( 188 Re), and radium-223 ( 223 Ra). Results: 223 Ra alpha particles, 177 Lu beta minus particles, and 170 Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by 89 Sr and 153 Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than 177 Lu beta minus particles and 223 Ra alpha particles. Conclusions: 223 Ra and 177 Lu hold the highest potential for palliative treatment of bone metastases of all radioisotopes compared in this study. Data reported here may prompt future in vitro and in vivo

  18. Synthetic wastewaters treatment by electrocoagulation to remove silver nanoparticles produced by different routes.

    Science.gov (United States)

    Matias, M S; Melegari, S P; Vicentini, D S; Matias, W G; Ricordel, C; Hauchard, D

    2015-08-15

    Nanoscience is a field that has stood out in recent years. The accurate long-term health and environmental risks associated with these emerging materials are unknown. Therefore, this work investigated how to eliminate silver nanoparticles (AgNPs) from synthetic effluents by electrocoagulation (EC) due to the widespread use of this type of nanoparticle (NP) in industry and its potential inhibition power over microorganisms responsible for biological treatment in effluent treatment plants. Synthesized AgNPs were studied via four different routes by chemical reduction in aqueous solutions to simulate the chemical variations of a hypothetical industrial effluent, and efficiency conditions of the EC treatment were determined. All routes used silver nitrate as the source of silver ions, and two synthesis routes were studied with sodium citrate as a stabilizer. In route I, sodium citrate functioned simultaneously as the reducing agent and stabilizing agent, whereas route II used sodium borohydride as a reducing agent. Route III used D-glucose as the reducing agent and sodium pyrophosphate as the stabilizer; route IV used sodium pyrophosphate as the stabilizing agent and sodium borohydride as the reducing agent. The efficiency of the EC process of the different synthesized solutions was studied. For route I, after 85 min of treatment, a significant decrease in the plasmon resonance peak of the sample was observed, which reflects the efficiency in the mass reduction of AgNPs in the solution by 98.6%. In route II, after 12 min of EC, the absorbance results reached the detection limit of the measurement instrument, which indicates a minimum reduction of 99.9% of AgNPs in the solution. During the 4 min of treatment in route III, the absorbance intensities again reached the detection limit, which indicates a minimum reduction of 99.8%. In route IV, after 10 min of treatment, a minimum AgNP reduction of 99.9% was observed. Based on these results, it was possible to verify that

  19. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States.

    Science.gov (United States)

    Roberts, A L; Gilman, S E; Breslau, J; Breslau, N; Koenen, K C

    2011-01-01

    To identify sources of race/ethnic differences related to post-traumatic stress disorder (PTSD), we compared trauma exposure, risk for PTSD among those exposed to trauma, and treatment-seeking among Whites, Blacks, Hispanics and Asians in the US general population. Data from structured diagnostic interviews with 34 653 adult respondents to the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analysed. The lifetime prevalence of PTSD was highest among Blacks (8.7%), intermediate among Hispanics and Whites (7.0% and 7.4%) and lowest among Asians (4.0%). Differences in risk for trauma varied by type of event. Whites were more likely than the other groups to have any trauma, to learn of a trauma to someone close, and to learn of an unexpected death, but Blacks and Hispanics had higher risk of child maltreatment, chiefly witnessing domestic violence, and Asians, Black men, and Hispanic women had higher risk of war-related events than Whites. Among those exposed to trauma, PTSD risk was slightly higher among Blacks [adjusted odds ratio (aOR) 1.22] and lower among Asians (aOR 0.67) compared with Whites, after adjustment for characteristics of trauma exposure. All minority groups were less likely to seek treatment for PTSD than Whites (aOR range: 0.39-0.61), and fewer than half of minorities with PTSD sought treatment (range: 32.7-42.0%). When PTSD affects US race/ethnic minorities, it is usually untreated. Large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.

  20. Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT).

    Science.gov (United States)

    Aldridge, Arnie; Linford, Robyn; Bray, Jeremy

    2017-02-01

    To estimate changes in the substance use behaviors of patients who received services as part of the US Substance Abuse and Mental Health Services Administration's (SAMHSA) Screening, Brief Intervention and Referral to Treatment (SBIRT) grant program. We use a pre-post design and performance monitoring data collected by SBIRT organizations. For a sample of 17 575 patients, we compare pre-SBIRT substance use with substance use 6 months after receipt of SBIRT services. SBIRT's correlation with changes in substance use was estimated using generalized linear mixed models to account for the clustering of patients within health-care facility and US state. From pre- to post-SBIRT we found large and statistically significant decreases for almost every measure of substance use. Model-adjusted means indicate that the prevalence of alcohol use was lower 6 months later by 35.6%, heavy drinking by 43.4% and illicit drug use by 75.8%. Greater intervention intensity was associated with larger decreases in substance use. The study design does not support causal conclusions and estimated decreases in reported substance use are due, at least in part, to a well-known set of confounders and natural substance use patterns that may be unrelated to any particular SBIRT intervention. Compared with previously published findings on the Screening, Brief Intervention and Referral to Treatment grant program, our estimates of substance use reduction were smaller, but still consistently large in absolute magnitude and within ranges of estimates from past trials of Screening, Brief Intervention and Referral to Treatment. © 2017 Society for the Study of Addiction.

  1. Effect of Different Surface Treatments on Repair Micro-shear Bond Strength of Silica- and Zirconia-filled Composite Resins

    Directory of Open Access Journals (Sweden)

    Mohammad Joulaei

    2012-11-01

    Full Text Available Background and aims. Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS of silica- (Spectrum TPH and zirconia-filled (Filtek Z250 composite resins. Materials and methods. Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05. Results. Analysis of data showed that the effect of composite resin type was not significant (p > 0.05, but the effects of the type of surface treatment (p = 0.01 and the type of adhesive system (p = 0.01 were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05. However, the cumulative effects of the adhesive system-surface treatment (p = 0.03 and the composite type-the adhesive system-surface treatments (p = 0.002 were significant. Conclusion. Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently.

  2. Effect of Different Surface Treatments on Repair Micro-shear Bond Strength of Silica- and Zirconia-filled Composite Resins

    Science.gov (United States)

    Joulaei, Mohammad; Bahari, Mahmoud; Ahmadi, Anahid; Savadi Oskoee, Siavash

    2012-01-01

    Background and aims Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS) of silica- (Spectrum TPH) and zirconia-filled (Filtek Z250) composite resins. Materials and methods Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05). Results Analysis of data showed that the effect of composite resin type was not significant (p > 0.05), but the effects of the type of surface treatment (p = 0.01) and the type of adhesive system (p = 0.01) were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05). However, the cumulative effects of the adhesive system-surface treatment (p = 0.03) and the composite type-the adhesive system-surface treatments (p = 0.002) were significant. Conclusion Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently. PMID:23277859

  3. Effect of pulsed electric field treatment on hot-boned muscles of different potential tenderness.

    Science.gov (United States)

    Suwandy, Via; Carne, Alan; van de Ven, Remy; Bekhit, Alaa El-Din A; Hopkins, David L

    2015-07-01

    In this study, the effect of pulsed electric field (PEF) treatment and ageing on the quality of beef M. longissimus lumborum (LL) and M. semimembranosus (SM) muscles was evaluated, including the tenderness, water loss and post-mortem proteolysis. Muscles were obtained from 12 steers (6 steers for each muscle), removed from the carcasses 4 hour postmortem and were treated with pulsed electric field within 2h. Six different pulsed electric field intensities (voltages of 5 and 10 kV × frequencies of 20, 50 and 90 Hz) plus a control were applied to each muscle to determine the optimum treatment conditions. Beef LL was found to get tougher with increasing treatment frequency whereas beef SM muscle was found to have up to 21.6% reduction in the shear force with pulsed electric field treatment. Post-mortem proteolysis showed an increase in both troponin and desmin degradation in beef LL treated with low intensity PEF treatment (20 Hz) compared to non-treated control samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Can long-term antibiotic treatment prevent progression of peripheral arterial occlusive disease? A large, randomized, double-blinded, placebo-controlled trial

    DEFF Research Database (Denmark)

    Joensen, J B; Juul, Svend; Henneberg, E

    2007-01-01

    PURPOSE: The purpose was to investigate in a large, randomized, double-blinded, placebo-controlled trial, whether antibiotic treatment can prevent progression of peripheral arterial disease (PAD). MATERIAL AND METHODS: Five hundred and seven patients were included; all patients had an established...... analyzed mainly by Cox regression and linear regression. RESULTS: Included patients with PAD were randomized. Two patients withdrew. Of the remaining, 248 received roxithromycin and 257 placebo. In the treatment group 55% were seropositive and 53% in the placebo group. Mean follow-up was 2.1 years (range 0.......06-5.1 years). In the placebo group, 26 died and 80 primary events occurred in total. In the treatment group, 28 died and 74 primary events were observed. The hazard ratio of death was 1.13 (95% CI: 0.68; 1.90), and of primary events 0.92 (95% CI: 0.67; 1.26). Also on secondary events and ABPI changes...

  5. Comparison of adrenal tumor treatment results by different volume of surgical interventions.

    Directory of Open Access Journals (Sweden)

    Dmitriy J. Semenov

    2016-10-01

    Full Text Available In recent years detection of various adrenal tumors has increased greatly. Total adrenalectomy remains the standart of surgical managment for adrenal tumors, although, the vast majority of these tumors turn out to be benign on the routine histological examination. Performing organ-sparing surgery would allow to avoid hormone insufficiency after total adrenalectomy. Aim: to compare results of adrenal tumors treatment by different volume of surgical interventions. Materials and methods. We evaluated the short-term results of 237 patients treatment with various adrenal tumors. Total adrenalectomy were performed on 206 cases, 31 patients undergone adrenal resection. There were analyzed intraoperative and postoperative complications, assessed the hormonal status of the patients, depending on the extent of surgical treatment. Besides, the long-term results were evaluated in 141 patients underwent total adrenalectomy and 30 patients after organ-sparing surgery. Moreover, we analyzed the percentage of recurrenses, assessed the hormonal status of the patients and the effectiveness of treatment. Results. Performing the organ-sparing operations doesn't increase the risk of intraoperative complications. In all patients with hormone-active tumors we found decline of pathologically increased hormone levels and trend to regress of clinical manifestations of the disease in early postoperative period. We found no difference in local recurrences in both groups, and its occurrence did not exceed 3.33%. Refractory postoperative adrenal insufficiency was observed only in corticosteroma patients in spite of surgery volume. In case of both side adrenal tumors there was no need in replacement therapy after total adrenalectomy from there one side and resection from the other. Conclusions. In cases of adrenal tumor performing organ-sparing operations is advisable, if there are no preoperative sings of malignancy.

  6. Spontaneous Retroperitoneal Hemorrhage (Wunderlich Syndrome due to Large Upper Pole Renal Angiomyolipoma: Does Robotic-Assisted Laparoscopic Partial Nephrectomy Have a Role in Primary Treatment?

    Directory of Open Access Journals (Sweden)

    Achilles Ploumidis

    2013-01-01

    Full Text Available Spontaneous rapture with consequent retroperitoneal hemorrhage (Wunderlich’s syndrome is the complication mostly feared from large renal angiomyolipomas (RAMLs. In hemodynamic stable patients, minimal invasive therapies have superseded open surgery as the mainstay of treatment, with contemporary cases mostly treated by selective arterial embolization. Robotic-assisted laparoscopic partial nephrectomy (RALPN is an established minimal access treatment that has been used in the past for benign and malignant lesions of the kidney in the elective setting, but rarely in urgent situations as primary treatment. We present a case of a ruptured RAML in a young female treated effectively by RALPN.

  7. Clinical picture and treatment of complications of lower part of large intestine resulting from radiotherapy for intra-pelvic cancer

    International Nuclear Information System (INIS)

    Ikeda, Yoshihito; Sunagawa, Keishin; Matsumura, Shigejiro; Watanabe, Kenji; Masaoka, Yoshio

    1976-01-01

    The authors described clinical pictures and those treatments of 40 patients with complications of the lower part of the large intestine resulting from radiotherapy for cancer of the uterus, ovarium or the penis. As the radiotherapy, 60 Co-telecobalt (6,000-16,000R) and 60 Co-needle (1,000-8,568 mch) intracavitary irradiation were used alone or in combination. Findings in the complications of the lower part of the large intestine were classified into Grade I (13 cases), II (14), III (14), and IV (4) according to Sherman. The prodromal symptoms of the complications appeared in 2-6 months following the irradiation in more than a half of the patients, and it appeared within a year in most of the patients. Most of the patients complained about melena, anemia, proctagra, tenesmus and diarrhea. In the cases of Grade III, the symptoms of ileus such as constipation, abdominal distention, and abdominal pain appeared. Internal treatment was given principally, and preternal anus was made when frequent blood transfusion was required. Fourteen cases of those in Grade I and II recovered within 1-3 years. The cases which received proctostomy, including those who had bleeding, stricture and fistulation, had favorable prognosis. This result suggested that the radiotherapy for intra-pelvic cancer should be controlled to prevent further development of the complications in the rectum beyond Grade I. (Serizawa, K.)

  8. Review on adjuvant chemotherapy for rectal cancer - why do treatment guidelines differ so much?

    DEFF Research Database (Denmark)

    Poulsen, Laurids Ø; Qvortrup, Camilla; Pfeiffer, Per

    2015-01-01

    /oxaliplatin. METHODS: A review of the literature was made identifying 24 randomized controlled trials on adjuvant treatment of rectal cancer based on about 10 000 patients. The trials were subdivided into a number of clinically relevant subgroups. RESULTS: As regards patients treated with preoperative (chemo...... chemotherapy for patients already treated with preoperative (chemo) radiotherapy. For patients not treated preoperatively, several studies support the use of single agent 5-FU chemotherapy. Treatment guidelines seem to differ according to if preoperative chemoradiation is considered of importance for use...

  9. Lessons learned in the conduct of a global, large simple trial of treatments indicated for schizophrenia.

    Science.gov (United States)

    Kolitsopoulos, Francesca M; Strom, Brian L; Faich, Gerald; Eng, Sybil M; Kane, John M; Reynolds, Robert F

    2013-03-01

    Large, "practical" or streamlined trials (LSTs) are used to study the effectiveness and/or safety of medicines in real world settings with minimal study imposed interventions. While LSTs have benefits over traditional randomized clinical trials and observational studies, there are inherent challenges to their conduct. Enrollment and follow-up of a large study sample of patients with mental illness pose a particular difficulty. To assist in overcoming operational barriers in future LSTs in psychiatry, this paper describes the recruitment and observational follow-up strategies used for the ZODIAC study, an international, open-label LST, which followed 18,239 persons randomly assigned to one of two treatments indicated for schizophrenia for 1 year. ZODIAC enrolled patients in 18 countries in North America, South America, Europe, and Asia using broad study entry criteria and required minimal clinical care intervention. Recruitment of adequate numbers and continued engagement of both study centers and subjects were significant challenges. Strategies implemented to mitigate these in ZODIAC include global study expansion, study branding, field coordinator and site relations programs, monthly site newsletters, collection of alternate contact information, conduct of national death index (NDI) searches, and frequent sponsor, contract research organization (CRO) and site interaction to share best practices and address recruitment challenges quickly. We conclude that conduct of large LSTs in psychiatric patient populations is feasible, but importantly, realistic site recruitment goals and maintaining site engagement are key factors that need to be considered in early study planning and conduct. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Retrospective single center study of the efficacy of large spot 532 nm laser for the treatment of facial capillary malformations in 44 patients with the use of three-dimensional image analysis.

    Science.gov (United States)

    Kwiek, Bartłomiej; Rożalski, Michał; Kowalewski, Cezary; Ambroziak, Marcin

    2017-10-01

    We wanted to asses the efficacy of large spot 532 nm laser for the treatment of facial capillary malformations with the use of three-dimensional (3D) image analysis. Retrospective single center study on previously non-treated patients with facial capillary malformations (CM) was performed. A total of 44 consecutive Caucasian patients aged 5-66 were included. Patients had 3D photography performed before and after and had at least one single session of treatment with 532 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with contact cooling, fluencies ranging from 8 to 11.5 J/cm 2 , pulse duration ranging from 5 to 9 milliseconds and spot size ranging from 5 to 10 mm. Objective analysis of percentage improvement based on 3D digital assessment of combined color and area improvement (global clearance effect [GCE]) were performed. Median maximal improvement achieved during the treatment (GCE max ) was 70.4%. Mean number of laser procedures required to achieve this improvement was 7.1 (ranging from 2 to 14)). Improvement of minimum 25% (GCE 25) was achieved by all patients, of minimum 50% (GCE 50) by 77.3%, of minimum 75% (GCE 75) by 38.6%, and of minimum 90% (GCE 90) by 13.64. Large spot 532 nm laser is highly effective in the treatment of facial CM. 3D color and area image analysis provides an objective method to compare different methods of facial CM treatment in future studies. Lasers Surg. Med. 49:743-749, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Sclerotherapy for large hydrocoeles in Nigeria.

    Science.gov (United States)

    Onu, P E

    2000-07-01

    Sclerotherapy with tetracycline hydrochloride was used to treat 99 patients with large hydrocoeles (range 300-1500 ml). The mean age of these patients was 52 years. In 55.5% of the patients one treatment was adequate. Two treatments were required in 22%; three in 10%; four in 3%; and five in 7% of the patients. In two patients sclerotherapy failed. Complications were minimal. Only 15% of the patients complained of severe pain. The overall success rate was 98%. Tetracycline sclerotherapy for large hydrocoeles is effective, safe and economical and is preferred for older patients who are at risk from anaesthetic complications.

  12. Methane emissions during storage of different treatments from cattle manure in Tianjin

    Institute of Scientific and Technical Information of China (English)

    Jiajun Wang; Chiqing Duan; Yaqin Ji; Yichao Sun

    2010-01-01

    Many studies on methane emissions from animal manure have revealed that animal manure is a major source of methane emissions to the atmosphere that can have negative consequences for people,animals and environment.In general,the release of methane can be influenced by the type of feed taken by animals,temperature,manure characteristics and so on.This study aimed at quantifying and comparing methane release from dairy manure with different piling treatments.Four treatments were designed including manure piling height 30,45,60 cm and adding 6 cm manure every day until the piling height was 60 cm.Static chamber method and gas chromatography were adopted to measure the methane emissions from April to June in 2009.Methane emission rates of all four manure treatments were low in the first week and then increased sharply until reaching the peak values.Subsequently,all the methane emission rates decreased and fluctuated within the steady range till the end of the experiment.Wilcoxon nonparametric tests analysis indicated that methane emission rate was greatly influenced by manure piling height and manner.There were no significant relationships between methane emission rates and the temperatures of ambience and heap.However,regression analysis showed that the quadratic equations were found between emission rates of all treatments and the gas temperature in the barrels.

  13. Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe

    DEFF Research Database (Denmark)

    McQuiston Haslund, Josephine; Rosborg Dinesen, Marianne; Nielsen, Anni Brit Sternhagen

    2013-01-01

    OBJECTIVE: Uncomplicated urinary tract infection (uUTI) is a common reason for antibiotic treatment in primary health care. Due to the increasing prevalence of antibiotic-resistant uropathogens it is crucial to use the most appropriate antibiotics for first-choice empiric treatment of uUTI....... Particularly, it is important to avoid antibiotics associated with a high rate of antimicrobial resistance. This study compares national recommendations from six European countries, investigating recommendations for first-choice antibiotic therapy of uUTI. SETTING: General practice in six European countries...... at least one antibiotic associated with a low (UTI could not be explained by differences in local bacterial aetiology or by different patterns of antimicrobial resistance. Despite resistance rates exceeding 10...

  14. Improve germination of caper (Capparis Spinosa l. seeds by different induction treatments of seed dormancy breaking

    Directory of Open Access Journals (Sweden)

    M. R. Labbafi

    2018-03-01

    Full Text Available Seed dormancy is a common phase of the plant life cycle; different treatments can be used for breaking dormancy. The aim of this study was to find the best treatment for breaking dormancy and improve germination of caper (Capparis spinosa L.. This study based on the completely randomized design (CRD with 3 replications was done at research Laboratory of Medicinal Plants Institute, ACECR, Karaj, Iran. After different induction treatments containing different levels of potassium nitrate (KNO3, GA3, soaking and soaking with runner water, sulfuric acid, thidiazuron, and benzyl amino-purine, seeds were placed in Petri-dishes and incubated in two temperature regimes, first at fixed 20 ͦC, and second, alternate between 20 and 30 ͦC. The result showed that the germination percentage and germination rate of caper increased up to 75% and 1.35 respectively when the seeds treated with sulfuric acid for 15 min, and 2000 ppm GA3 under alternate 20-30 ͦC temperatures. Caper seed dormancy is mainly due to the inhibitors and hard seed coat that it prevents seed germination.

  15. Personality does not predict treatment preference, treatment experience does: a study of four complementary pain treatments.

    Science.gov (United States)

    Blasche, Gerhard; Melchart, Herbert; Leitner, Daniela; Marktl, Wolfgang

    2007-10-01

    The aim of the present study was to determine the extent to which personality and treatment experience affect patients' appraisals of 4 complementary treatments for chronic pain. A total of 232 chronic pain patients (164 females, 68 males, average age 56.6 years) visiting a spa clinic in Austria returned a questionnaire on patient characteristics and personality (autonomy, depressiveness, assertiveness, self-control) as well as attitudes towards (i.e. appealing, effective, pleasant) and experience of the treatments. Results were analysed by use of linear regression analysis and confidence intervals. Although all treatments were appraised positively, the passive treatments (thermal water tub baths, classical massage) were favoured more than the active treatments (relaxation training or exercise therapy). Treatment appraisal was not predicted by any of the personality traits but to a large extent by treatment experience. Relaxing, not unpleasant treatments were the most highly esteemed treatments. How strenuous or tiring a treatment was only had a minor effect on its appraisal. Neither do dependent, passive patients prefer passive treatments, nor do conscientious patients prefer active treatments. Instead, the appraisal of treatments that induce specific somatosensory sensations is largely determined by treatment experiences, i.e. what the treatment feels like. Despite the popularity of CAM which encompasses many experientially intensive treatments, treatment experience has to date been a neglected topic of treatment research.

  16. Teaching a Large Multi-Level Class Using Different Strategies and Activities to Motivate English Language Learning

    OpenAIRE

    Julia Sevy

    2016-01-01

    Many challenges face English language teachers today, but two common problems in Ecuador specifically in universities are large class sizes and multi-level students. These problems can create boredom, anxiety, and over all lack of interest in English language learning. It is shown in this article how to combat these particular problems through various strategies utilized to teach to the students’ needs, help them work together and intrinsically motivate them to learn different English languag...

  17. Optimizing molluscicide treatment strategies in different control stages of schistosomiasis in the People's Republic of China.

    Science.gov (United States)

    Yang, Guo-Jing; Sun, Le-Ping; Hong, Qing-Biao; Zhu, Hong-Ru; Yang, Kun; Gao, Qi; Zhou, Xiao-Nong

    2012-11-14

    The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme. The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established. The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time. We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption

  18. Sex differences in the pharmacological treatment of hypertension : a review of population-based studies

    NARCIS (Netherlands)

    Klungel, O.H.; de Boer, A; Paes, A.H.P.; Seidell, J C; Bakker, A

    OBJECTIVE: To summarize all available literature on sex differences in the pharmacological treatment of hypertension with respect to the percentage of hypertensive patients treated pharmacologically and the selection of antihypertensive drugs. The influences of the calendar period, age, definition

  19. Examining Rural/Urban Differences in Prescription Opioid Misuse Among US Adolescents.

    Science.gov (United States)

    Monnat, Shannon M; Rigg, Khary K

    2016-01-01

    This study examines differences in prescription opioid misuse (POM) among adolescents in rural, small urban, and large urban areas of the United States and identifies several individual, social, and community risk factors contributing to those differences. We used nationally representative data from the 2011 and 2012 National Survey on Drug Use and Health and estimated binary logistic regression and formal mediation models to assess past-year POM among 32,036 adolescents aged 12-17. Among adolescents, 6.8% of rural, 6.0% of small urban, and 5.3% of large urban engaged in past-year POM. Net of multiple risk and protective factors, rural adolescents have 35% greater odds and small urban adolescents have 21% greater odds of past-year POM compared to large urban adolescents. The difference between rural and small urban adolescents was not significant. Criminal activity, lower perceived substance use risk, and greater use of emergency medical treatment partially contribute to higher odds among rural adolescents, but they are also partially buffered by less peer substance use, less illicit drug access, and stronger religious beliefs. Researchers, policy makers, and treatment providers must consider the complex array of individual, social, and community risk and protective factors to understand rural/urban differences in adolescent POM. Potential points of intervention to prevent POM in general and reduce rural disparities include early education about addiction risks, use of family drug courts to link criminal offenders to treatment, and access to nonemergency medical services to reduce rural residents' reliance on emergency departments where opioid prescribing is more likely. © 2015 National Rural Health Association.

  20. Decision making in treatment strategy of AVMs. Treatment board system at Tohoku University

    International Nuclear Information System (INIS)

    Jokura, Hidefumi; Yoshimoto, Takashi

    1999-01-01

    Treatment of some large, deep-seated arteriovenous malformations is still a challenge to neurosurgeons. The recent development of non-invasive imaging modalities has increased the chance of finding asymptomatic AVM's, for which evaluation for treatment is more complicated than in symptomatic cases. Currently there are 3 major treatment options for AVM: microsurgical removal, radiosurgery, and intravascular embolization. It is not easy to choose the best single modality or combination of modalities for individual patients, who have different types of onset, neurological deficits, size and location, and social background. After the installation of the Gamma Knife in November 1991, we established an 'AVM Treatment Board.' It comprises vascular neurosurgeons, endovascular neurosurgeons, and radio-neurosurgeons, and meetings are held twice a month. Every AVM case referred to us is presented to the board, and treatment strategy is selected after a discussion among experts who know the advantages and drawbacks of each treatment modality. We describe this board system in detail and emphasize the importance of gathering expertise in decision making. (author)

  1. Clinical risk factors for weight gain during psychopharmacologic treatment of depression: results from 2 large German observational studies.

    Science.gov (United States)

    Kloiber, Stefan; Domschke, Katharina; Ising, Marcus; Arolt, Volker; Baune, Bernhard T; Holsboer, Florian; Lucae, Susanne

    2015-06-01

    Weight gain during psychopharmacologic treatment has considerable impact on the clinical management of depression, treatment continuation, and risk for metabolic disorders. As no profound clinical risk factors have been identified so far, the aim of our analyses was to determine clinical risk factors associated with short-term weight development in 2 large observational psychopharmacologic treatment studies for major depression. Clinical variables at baseline (age, gender, depression psychopathology, anthropometry, disease history, and disease entity) were analyzed for association with percent change in body mass index (BMI; normal range, 18.5 to 25 kg/m(2)) during 5 weeks of naturalistic psychopharmacologic treatment in patients who had a depressive episode as single depressive episode, in the course of recurrent unipolar depression or bipolar disorder according to DSM-IV criteria. 703 patients participated in the Munich Antidepressant Response Signature (MARS) project, an ongoing study since 2002, and 214 patients participated in a study conducted at the University of Muenster from 2004 to 2006 in Germany. Lower BMI, weight-increasing side effects of medication, severity of depression, and psychotic symptoms could be identified as clinical risk factors associated with elevated weight gain during the initial treatment phase of 5 weeks in both studies. Based on these results, a composite risk score for weight gain consisting of BMI ≤ 25 kg/m(2), Hamilton Depression Rating Scale (17-item) score > 20, presence of psychotic symptoms, and administration of psychopharmacologic medication with potential weight-gaining side effects was highly discriminative for mean weight gain (F4,909 = 26.77, P = 5.14E-21) during short-term psychopharmacologic treatment. On the basis of our results, depressed patients with low to normal BMI, severe depression, or psychotic symptoms should be considered at higher risk for weight gain during acute antidepressant treatment. We introduce

  2. Decentralization matters – Differently organized mental health services relationship to staff competence and treatment practice: the VELO study

    Directory of Open Access Journals (Sweden)

    Molvik Stian

    2009-05-01

    Full Text Available Abstract Background The VELO study is a comparative study of two Community Mental Health Centres (CMHC in Northern Norway. The CMHCs are organized differently: one has no local inpatient unit, the other has three. Both CMHCs use the Central Mental Hospital situated rather far away for compulsory and other admissions, but one uses mainly local beds while the other uses only central hospital beds. In this part of the study the ward staffs level of competence and treatment philosophy in the CMHCs bed units are compared to Central Mental Hospital units. Differences may influence health service given, resulting in different treatment for similar patients from the two CMHCs. Methods 167 ward staff at Vesterålen CMHCs bed units and the Nordland Central Mental Hospital bed units answered two questionnaires on clinical practice: one with questions about education, work experience and clinical orientation; the other with questions about the philosophy and practice at the unit. An extended version of Community Program Philosophy Scale (CPPS was used. Data were analyzed with descriptive statistics, non-parametric test and logistic regression. Results We found significant differences in several aspects of competence and treatment philosophy between local bed units and central bed units. CMHC staff are younger, have shorter work experience and a more generalised postgraduate education. CMHC emphasises family therapy and cooperation with GP, while Hospital staff emphasise diagnostic assessment, medication, long term treatment and handling aggression. Conclusion The implications of the differences found, and the possibility that these differences influence the treatment mode for patients with similar psychiatric problems from the two catchment areas, are discussed.

  3. Effect of various bleaching treatments on shear bond strength of different universal adhesives and application modes

    Science.gov (United States)

    2018-01-01

    Objectives The aim of this in vitro study was to evaluate the bond strength of 2 universal adhesives used in different application modes to bleached enamel. Materials and Methods Extracted 160 sound human incisors were used for the study. Teeth were divided into 4 treatment groups: No treatment, 35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide. After bleaching treatments, groups were divided into subgroups according to the adhesive systems used and application modes (n = 10): 1) Single Bond Universal, etch and rinse mode; 2) Single Bond Universal, self-etch mode; 3) Gluma Universal, etch and rinse mode; 4) Gluma Universal, self-etch mode. After adhesive procedures nanohybrid composite resin cylinders were bonded to the enamel surfaces. All specimens were subjected to shear bond strength (SBS) test after thermocycling. Data were analyzed using a 3-way analysis of variance (ANOVA) and Tukey post hoc test. Results No significant difference were found among bleaching groups (35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide, and no treatment groups) in the mean SBS values. There was also no difference in SBS values between Single Bond Universal and Gluma Universal at same application modes, whereas self-etch mode showed significantly lower SBS values than etch and rinse mode (p adhesives was enhanced with the etch and rinse mode application to bleached enamel and non-bleached enamel. PMID:29765900

  4. Magneto-laser-ultrasonic therapy. Particular methodic of different diseases treatment. Scientific materials used in practice. V.4(2)

    International Nuclear Information System (INIS)

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

    2001-01-01

    Contemporary data about the use of magnetotherapy, ultrasound and magnetolaser therapy in resonance energy ranges are presented in this book. Practical methodics of simultaneous and combined use of these physical factors in different branches of clinical medicine (neurology, cardiology, gastroenterology and others) are described. Modern principles of the sensitive zone choice, bases of biorhythmic and resonance phenomena are presented. Practical uses of them became more and more important in physiotherapy and acupuncture. Diseases of different organs are considered, and magnetic, laser and ultrasound mehtods of their treatment are discussed. Special attention is paid to the use of magneto-laser and low-frequency ultrasonic therapy methods for diabetus melitus and respiratory organ treatment. Diseases of urinary tract, of ischemia, insult, ophthalmological ones and series of surgery profile diseases are considered in connection with different modern treatment methods of them. Review of cardiovascular, skin, digestive system diseases, those of ophtalmology, stomatology, otolaryngology nervous-psychic violations is presented and optimum methods of their treatment are recommended. The most part of magneto-laser-ultrasound therapy uses refers to the new generation of series 'MIT' and 'MIT-11' apparata which combine all three treatment factors

  5. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    NARCIS (Netherlands)

    Snijder, Marieke B.; Agyemang, Charles; Peters, Ron J.; Stronks, Karien; Ujcic-Voortman, Joanna K.; van Valkengoed, Irene G. M.

    2017-01-01

    Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We

  6. Bacterial Adhesion on the Titanium and Stainless-Steel Surfaces Undergone Two Different Treatment Methods: Polishing and Ultrafast Laser Treatment

    Science.gov (United States)

    Chik, N.; Zain, W. S. Wan Md; Mohamad, A. J.; Sidek, M. Z.; Ibrahim, W. H. Wan; Reif, A.; Rakebrandt, J. H.; Pfleging, W.; Liu, X.

    2018-05-01

    Bacterial adhesion has become a significant problem in many industries causing billions of dollars for its complicated removal treatment and maintenance. In this study, metal surfaces undergone treatment with ultrafast laser with varies power. The microstructure produced on its original surfaces were expected to prevent the adhesion of Escherichia coli (E. coli) ATCC 8739 and Staphylococcus aureus (S. aureus) ATCC 6838. The laser treatment was performed at 380 fs pulse duration, 515 µm central wavelength and a repetition rate of 200 kHz. Stainless steel AISI 316L was treated with an average laser power of 0.04 W (SS-0.04) and 0.11 W (SS-0.11), while Grade 5 titanium alloy was tested with high laser power 0.11 W (T-0.11). The adhesion was observed after 16 hours and the number of adhering bacteria was counted per cm2. The result achieved shows that, increasing the average laser power is leading to an enhanced S. aureus adhesion while E. coli adhesion is reduced which is due to the hydrophobicity interaction and difference in surface texture. Meanwhile, the laser treatment showed significant reduction of the bacterial adhesion on its surface compared to the polished surfaces. Thus, ultrafast laser texturing can be suggested as a promising method to reduce the bacterial adhesion, which reduced the adhesion of >80% for E. coli and >20% for S. aureus.

  7. Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Zheng-Yu, E-mail: linsinlan@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Chen, Jin, E-mail: snow8968851@163.com [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Deng, Xiu-Fen, E-mail: dxf197286@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China)

    2012-11-15

    Objective: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation. Methods: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35 {+-} 1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels ({>=}3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels. Results: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1 {+-} 6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased. Conclusion: The 1.5T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.

  8. Achieving a table-like magnetocaloric effect and large refrigerant capacity in in situ multiphase Gd65Mn25Si10 alloys obtained by crystallization treatment

    International Nuclear Information System (INIS)

    Shen, X Y; Zhong, X C; Huang, X W; Mo, H Y; Feng, X L; Liu, Z W; Jiao, D L

    2017-01-01

    In situ multiphase structure Gd 65 Mn 25 Si 10 alloys were fabricated by melt spinning and subsequent crystallization treatment. In the process of crystallization, the α -Gd, GdMn 2 and Gd 5 Si 3 phases precipitate in the amorphous matrix in turn. The Curie temperature ( T C ) values for the α -Gd crystallization phase and amorphous matrix can be tailored by tuning the crystallization treatment time. All three multiphase alloys obtained by crystallization treatment at 637 K for 20, 30 and 40 min, respectively, undergo multiple successive magnetic phase transitions. A table-like magnetic entropy change over a wide temperature range (∼90–120 K) and a large full width at half maximum (Δ T FWHM ) magnetic entropy change (∼230 K) were achieved in the above-mentioned crystallized alloys, resulting in large refrigerant capacities (RCs). The enhanced RCs of the three crystallized alloys for a magnetic field change of 0–5 T are in the range of 541–614 J kg −1 . Large Δ T FWHM and RC values and a table-like (−Δ S M ) max feature obtained in in situ multiphase Gd 65 Mn 25 Si 10 crystallized alloys make them suitable for potential application in efficient Ericsson-cycle magnetic refrigeration working in a temperature range from 74 to 310 K. (paper)

  9. Laparoscopic repair of large suprapubic hernias.

    Science.gov (United States)

    Sikar, Hasan Ediz; Çetin, Kenan; Eyvaz, Kemal; Kaptanoglu, Levent; Küçük, Hasan Fehmi

    2017-09-01

    Suprapubic hernia is the term to describe ventral hernias located less than 4 cm above the pubic arch in the midline. Hernias with an upper margin above the arcuate line encounter technical difficulties, and the differences in repair methods forced us to define them as large suprapubic hernias. To present our experience with laparoscopic repair of large suprapubic hernias that allows adequate mesh overlap. Nineteen patients with suprapubic incisional hernias who underwent laparoscopic repair between May 2013 and January 2015 were included in the study. Patients with laparoscopic extraperitoneal repair who had a suprapubic hernia with an upper margin below the arcuate line were excluded. Two men and 17 women, with a mean age of 58.2, underwent laparoscopic repair. Most of the incisions were midline vertical (13/68.4%). Twelve (63.1%) of the patients had previous incisional hernia repair (PIHR group); the mean number of previous incisional hernia repair was 1.4. Mean defect size of the PIHR group was higher than in patients without previous repair - 107.3 cm 2 vs. 50.9 cm 2 (p < 0.05). Mean operating time of the PIHR group was higher than in patients without repair - 126 min vs. 77.9 min (p < 0.05). Although all complications occurred in the PIHR group, there was no statistically significant difference. Laparoscopic repair of large suprapubic hernias can be considered as the first option in treatment. The low recurrence rates reported in the literature and the lack of recurrence, as observed in our study, support this view.

  10. The effect of five different wetting treatments on the nutrient content and microbial concentration in hay for horses.

    Directory of Open Access Journals (Sweden)

    Meriel Jean Scott Moore-Colyer

    Full Text Available Five different hays were used to determine the effect of 5 different soaking and steaming treatments on the water soluble carbohydrate and microbial (bacteria and mould contents of UK hay. Hays were subjected to the following 5 treatments: 1. Dry; 2. Steamed for 50 minutes in the Haygain- 600 steamer; 3. Soaked in water at 16°C for 9 hours; 4. Steamed then soaked and 5. Soaked then steamed. Post treatment hays were tested for water soluble carbohydrates, bacteria and mould contents. Differences between means were determined using ANOVA and least significant difference with hay (5, bale (3 and treatment (5 as fixed factors, thus n = 75. Protein and ash proportions were unaltered in any of the treatments. Soaked, steamed then soaked and soaked then steamed treatments were all equally effective at reducing water soluble carbohydrates, with significantly (P<0.05 lower mean contents (79-83 g/kg DM compared with 126 and 122 g/kg dry matter (DM for dry and steamed respectively. Steamed and soaked then steamed had significantly (P<0.05 less bacteria (1.04×103 and 4.9×102 CFU/g DM compared with soaked which increased CFU/g DM from 6.0×104 in dry hay up to 3.5×105. Mould contents CFU/g DM were significantly (P<0.05 reduced by steaming (2 and soaking then steaming (1.9 but no difference was seen between dry (1148, soaked (692 or steamed then soaked (501. Soaking for 9 hours followed by steaming for 50 minutes in the Haygain steamer was the most effective method for reducing water soluble carbohydrates and microbial contamination in hay. Soaking or steaming+soaking lowered water soluble carbohydrates but significantly reduced the hygienic quality of the hay which could potentially compromise the health of the horse.

  11. Responses of growth of lady’s fingers ([i]Abelmoschus esculentus [/i]L. to different treatments methods of dairy wastewater

    Directory of Open Access Journals (Sweden)

    Rana Ibrahim Al-Dulaimi

    2014-03-01

    Full Text Available Introduction and objective. Water is one of the most important precious resources found on the earth, and are most often affected by anthropogenic activities and by industry. Pollution caused by human beings and industries is a serious concern throughout the world. Population growth, massive urbanization, rapid rate of industrialization and modern techniques in agriculture have accelerated water pollution and led to the gradual deterioration of its quality. A large quantity of waste water disposed of at sea or on land has caused environmental problems which have led to environmental pollution, economic losses and chemical risks caused by the wastewater, and its impact on agriculture. However, waste water which contain nutrients and organic matter has possible advantages for agricultural purposes. Therefore, the presented study was undertaken to assess the impact of Dairy Effluent (treated and untreated waste water on seed germination, seedling growth, dry matter production and the biochemical parameters of lady’s fingers ([i]Abelmoschus esculentus[/i] L.. Materials and methods. A field experiment in a green house was conducted to use raw and treated dairy wastewater for watering lady’s fingers (Abelmoschus esculentus L.. The plants were watered using (WW raw dairy wastewater, (T1 chemicals treatment, (T2 physical treatment, (T3 dilution method treatment and tap water (TW in pot experiments. Ten plants of each treatment /3 replicate were randomly selected and labelled for the collection of data. The data was collected sequentially, starting with chlorophyll content pre-harvest, vegetative qualities (shoot, root and seedling length and dry matter quality (shoot and root dry matter pos-tharvest. Results. The effect was seen on the germination seed and growth of the plant. The results showed inhibitory effect from dairy effluent (WW on seed germination and plant growth. Treatment with chemicals showed statistically significant differences with

  12. Concentration of polycyclic aromatic hydrocarbons in water samples from different stages of treatment

    Science.gov (United States)

    Pogorzelec, Marta; Piekarska, Katarzyna

    2017-11-01

    The aim of this study was to analyze the presence and concentration of selected polycyclic aromatic hydrocarbons in water samples from different stages of treatment and to verify the usefulness of semipermeable membrane devices for analysis of drinking water. For this purpose, study was conducted for a period of 5 months. Semipermeable membrane devices were deployed in a surface water treatment plant located in Lower Silesia (Poland). To determine the effect of water treatment on concentration of PAHs, three sampling places were chosen: raw water input, stream of water just before disinfection and treated water output. After each month of sampling SPMDs were changed for fresh ones and prepared for further analysis. Concentrations of fifteen polycyclic aromatic hydrocarbons were determined by high performance liquid chromatography (HPLC). Presented study indicates that the use of semipermeable membrane devices can be an effective tool for the analysis of aquatic environment, including monitoring of drinking water, where organic micropollutants are present at very low concentrations.

  13. Concentration of polycyclic aromatic hydrocarbons in water samples from different stages of treatment

    Directory of Open Access Journals (Sweden)

    Pogorzelec Marta

    2017-01-01

    Full Text Available The aim of this study was to analyze the presence and concentration of selected polycyclic aromatic hydrocarbons in water samples from different stages of treatment and to verify the usefulness of semipermeable membrane devices for analysis of drinking water. For this purpose, study was conducted for a period of 5 months. Semipermeable membrane devices were deployed in a surface water treatment plant located in Lower Silesia (Poland. To determine the effect of water treatment on concentration of PAHs, three sampling places were chosen: raw water input, stream of water just before disinfection and treated water output. After each month of sampling SPMDs were changed for fresh ones and prepared for further analysis. Concentrations of fifteen polycyclic aromatic hydrocarbons were determined by high performance liquid chromatography (HPLC. Presented study indicates that the use of semipermeable membrane devices can be an effective tool for the analysis of aquatic environment, including monitoring of drinking water, where organic micropollutants are present at very low concentrations.

  14. Effect of different heat treatments and disinfectants on the survival of Prototheca zopfii.

    Science.gov (United States)

    Lassa, Henryka; Jagielski, Tomasz; Malinowski, Edward

    2011-03-01

    Bovine mastitis caused by the yeast-like alga Prototheca zopfii represents a serious veterinary problem and may result in heavy economic losses to particular dairy farms. The purpose of this study was to evaluate the survival of 50 isolates of P. zopfii in milk subjected to different heat treatments and the survival of further 106 P. zopfii isolates after exposure to three classes of teat disinfectants: iodine (Dipal), quaternary ammonium compounds (Teat), and dodecylbenzenesulphonic acid (Blu-gard). Of the 50 isolates tested for thermal tolerance, 29 (58%) survived heat treatment at 62 °C for 30 s and 13 (26% of all isolates) of those survived after heat treatment at 72 °C for 15 s. None of the 106 isolates were able to withstand the in-use concentrations of the three disinfectants tested. The highest disinfectant concentrations that permitted survival of at least one isolate were dilutions: 1:1,000 for Dipal (survival rate of 52.8-57.5%), 1:100 for Teat (88.7-90.6%), and 1:10 for Blu-gard (100%). No differences in the survival rates of P. zopfii were observed with respect to the duration of exposure to disinfectant. The results of this study support the previous findings that P. zopfii may resist high-temperature treatments, including that applied in the high-temperature, short-time (HTST) pasteurization process. The obtained data also demonstrate the efficacy of the three classes of teat disinfectants against P. zopfii, with the efficacy of iodine being most pronounced. The study emphasizes the necessity of using higher temperatures in the pasteurization of raw milk to kill the Prototheca algae, as well as the particular suitability of the iodine for the control procedures of protothecal mastitis.

  15. Effect of different surface treatments on roughness of IPS Empress 2 ceramic.

    Science.gov (United States)

    Kara, Haluk Baris; Dilber, Erhan; Koc, Ozlem; Ozturk, A Nilgun; Bulbul, Mehmet

    2012-03-01

    The aim of this study was to evaluate the influence of different surface treatments (air abrasion, acid etching, laser irradiation) on the surface roughness of a lithium-disilicate-based core ceramic. A total of 40 discs of lithium disilicate-based core ceramic (IPS Empress 2; Ivoclar Vivadent, Schaan, Liechtenstein) were prepared (10 mm in diameter and 1 mm in thickness) according to the manufacturer's instructions. Specimens were divided into four groups (n = 10), and the following treatments were applied: air abrasion with alumina particles (50 μm), acid etching with 5% hydrofluoric acid, Nd:YAG laser irradiation (1 mm distance, 100 mJ, 20 Hz, 2 W) and Er:YAG laser irradiation (1 mm distance, 500 mJ, 20 Hz, 10 W). Following determination of surface roughness (R(a)) by profilometry, specimens were examined with atomic force microscopy. The data were analysed by one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). One-way ANOVA indicated that surface roughness following air abrasion was significantly different from the surface roughness following laser irradiation and acid etching (P 0.05). Air abrasion increased surface roughness of lithium disilicate-based core ceramic surfaces more effectively than acid-etching and laser irradiation.

  16. The effect of different order of purification treatments on the purity of multiwalled carbon nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Ling, Xinlong [College of Materials Science and Engineering, State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, 2999 North People Road, Shanghai 201620 (China); Department of Biological and Chemical Engineering, Guangxi University of Technology, 268 Donghuan Road, Liuzhou 545006 (China); Wei, Yizhe [College of Materials Science and Engineering, State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, 2999 North People Road, Shanghai 201620 (China); Zou, Liming, E-mail: lmzou@dhu.edu.cn [College of Materials Science and Engineering, State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, 2999 North People Road, Shanghai 201620 (China); Xu, Su [College of Materials Science and Engineering, State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, 2999 North People Road, Shanghai 201620 (China)

    2013-07-01

    The multiwalled carbon nanotubes were purified with different order treatments of gas phase and liquid phase. Amorphous carbon and iron catalysts were removed and some oxygen-containing groups were attached to the surface of multiwalled carbon nanotubes after purification. The multiwalled carbon nanotubes were determined and characterized by thermogravimetric analysis, Fourier transform infrared spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy, Boehm's neutralizing titration method and weighing method. The morphology of multiwalled carbon nanotubes was verified using scanning electron microscopy and transmission electron microscopy. The results indicated amorphous carbon and iron catalysts were removed completely while the structure of multiwalled carbon nanotubes was slightly destructed by two treatment methods. Three principal oxygen-containing groups on the surface of multiwalled carbon nanotubes were carboxyl, lactone and phenolic hydroxyl in descending order of their concentrations. The method I including gas phase treatment firstly and then liquid phase treatment, is more effective to purify multiwalled carbon nanotubes and to protect the structure of multiwalled carbon nanotubes than method II including liquid phase treatment firstly and then gas phase treatment.

  17. Large allozyme variation within populations and isozyme differences ...

    African Journals Online (AJOL)

    Significant pair-wise contingency chi-square differences, one isozyme and another fixed allele difference at LDH, were found between the species. Nevertheless, a relatively small genetic distance value (D = 0.134) between the species supports recent morphological and DNA results by other researchers, confirming the ...

  18. The effectiveness of stuttering treatments in Germany.

    Science.gov (United States)

    Euler, Harald A; Lange, Benjamin P; Schroeder, Sascha; Neumann, Katrin

    2014-03-01

    Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable

  19. Precipitation of hydrides in high purity niobium after different treatments

    Energy Technology Data Exchange (ETDEWEB)

    Barkov, F.; Romanenko, A.; Trenikhina, Y.; Grassellino, A.

    2013-01-01

    Precipitation of lossy non-superconducting niobium hydrides represents a known problem for high purity niobium in superconducting applications. Using cryogenic optical and laser confocal scanning microscopy we have directly observed surface precipitation and evolution of niobium hydrides in samples after different treatments used for superconducting RF cavities for particle acceleration. Precipitation is shown to occur throughout the sample volume, and the growth of hydrides is well described by the fast diffusion-controlled process in which almost all hydrogen is precipitated at $T=140$~K within $\\sim30$~min. 120$^{\\circ}$C baking and mechanical deformation are found to affect hydride precipitation through their influence on the number of nucleation and trapping centers.

  20. Tactics and Surgical Treatment of Obstructive Jaundice of Different Etiology

    Directory of Open Access Journals (Sweden)

    V.M. Ratchik

    2014-11-01

    Full Text Available In the department of surgery of the digestive organs of State institution «Institute of gastroenterology of National aca-demy of medical sciences of Ukraine» for the period from 2003 to 2013, 567 patients with pathology of the hepatopancreatobiliary zone of different etiology, complicated with obstructive jaundice, underwent surgery. 197 (34.7 % patients with bilirubinemia more than 200 µmol/l and III degree of liver failure underwent two-stage treatment. Endoscopic (two-step techniques were applied for the treatment of 143 (25.2 % patients with choledocholithiasis. One-step minimally invasive interventions — laparoscopic cholecystectomy, external drainage of the common bile duct, lithoextraction, balloon dilatation of the sphincter of Oddi — implemented in 41 (10.4 % patients. In complications chronic pancreatitis, draining surgeries were performed in 20 (25.6 % patients and resection-draining — in 39 (50.0 %, with the correction of bile outflow, as well as endoscopic, laparoscopic and minimally invasive puncture-draining operations were carried out. 2 (2.6 % patients underwent pancreatoduodenectomy by Whipple. Two-stage surgeries were performed in 26 (33.3 % patients. At tumors of cholangiopancreatoduodenal zone, 18 (30.5 % patients underwent percutaneous endobiliary reducing interventions followed by radical surgery in 10 (16.9 % patients.

  1. The treatment of differences in developmental, psychomotor and critical curricula for physical education

    Directory of Open Access Journals (Sweden)

    Pedro Xavier Russo Bonetto

    2017-05-01

    Full Text Available Difference, as cultural identity, appears as an urgent demand in the curricula for all school subjects. Therefore, this paper aims at identifying the treatment given to differences by some of the most relevant proposals in the physical education area. Three Brazilian works were analyzed for having influenced the dissemination of psychomotor (FREIRE, 1989, developmental (TANI et al., 1988 and critical-overcoming (SOARES et al., 1992 curricula. The results revealed a conservative perspective based (a on the assimilation of differences or (b on the humanistic appropriation supported by the belief of the equality principle disregarding issues such as ethnicity, genre or sexuality. The conclusion is that, in both cases, integrating the different cultural groups to the dominant culture is sought so that everybody can compete as equals in the modern capitalist society.

  2. Effect of different treatments on 110m Ag plant uptake in various soil types

    International Nuclear Information System (INIS)

    Szerbin, P.; Koblinger-Bokori, E.

    1996-01-01

    110m Ag contamination may occur as a result of atmospheric release either during normal operation of nuclear power plants or in accidental circumstances. The gamma peaks of 110m Ag and radiocaesium are very close, and not every laboratory could make distinction between them. Therefore very few references are available on 110m Ag environmental behaviour and plant uptake. In the present study plant uptake of 110m Ag from four different types of soil was investigated, and the results are presented in relation to major soil characteristics. In addition, effects of two different treatments (phosphate and organic matter fertilizations) are determined in each type of soil. Our study clearly demonstrates that a carefully selected post-accident treatment can significantly reduce the environmental consequences of radioactive releases. Methods to be developed on bases of such studies could be used for remedial actions of agricultural lands polluted with radioactive substances

  3. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods

    Energy Technology Data Exchange (ETDEWEB)

    Guerra Liberal, Francisco D. C., E-mail: meb12020@fe.up.pt, E-mail: adriana-tavares@msn.com; Tavares, Adriana Alexandre S., E-mail: meb12020@fe.up.pt, E-mail: adriana-tavares@msn.com; Tavares, João Manuel R. S., E-mail: tavares@fe.up.pt [Instituto de Engenharia Mecânica e Gestão Industrial, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias s/n, Porto 4200-465 (Portugal)

    2014-11-01

    Purpose: Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope. Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods. Methods: Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 ({sup 32}P), strontium-89 ({sup 89}Sr), yttrium-90 ({sup 90}Y ), tin-117 ({sup 117m}Sn), samarium-153 ({sup 153}Sm), holmium-166 ({sup 166}Ho), thulium-170 ({sup 170}Tm), lutetium-177 ({sup 177}Lu), rhenium-186 ({sup 186}Re), rhenium-188 ({sup 188}Re), and radium-223 ({sup 223}Ra). Results: {sup 223}Ra alpha particles, {sup 177}Lu beta minus particles, and {sup 170}Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by {sup 89}Sr and {sup 153}Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than {sup 177}Lu beta minus particles and {sup 223}Ra alpha particles. Conclusions: {sup 223}Ra and {sup 177}Lu hold the highest potential for palliative treatment of bone metastases of all

  4. Leaching of RA-226 contaminated gravel using different aqueous treatments

    Energy Technology Data Exchange (ETDEWEB)

    Mamoon, A; Abulfaraj, W H; Sohsah, M A [King Abdulaziz University, Jeddah, Saudi Arbabia (Saudi Arabia)

    1997-12-31

    Investigation of the efficiencies of different aqueous leaching treatments was carried out on gravel artificially contaminated with Ra-226. The extent of leaching efficiency was determined in terms of Ra-226 and its daughter Rn-222. Liquid scintillation counting using high efficiency mineral oil based liquid scintillator was the technique adopted for measuring Ra-226 and Rn-222 leached off the contaminated gravel. Water, dilute solutions of barium chloride and HCl were used as leachants. Different masses of gravel were leached with 200 mL of leachant for various contact time periods. The leached Rn-222 activity measured was plotted vs the decay factor e; from which Rn-222 and Ra-226 originally present in the sample were determined. Several leaching parameters were tested; namely type of leachant, leachant volume/gravel mass ratio, leachant contact time, effect of varying Ba Cl{sub 2} concentration, and successive leaching. Optimization of the leaching parameters for desorption of Ra-226 off the contaminated gravel under laboratory conditions may help determine the ideal conditions for remediating soil contaminated with radium or chemically similar radionuclides. 7 figs.

  5. Comparison of the effects of different heat treatment processes on rheological properties of cake and bread wheat flours.

    Science.gov (United States)

    Bucsella, Blanka; Takács, Ágnes; Vizer, Viktoria; Schwendener, Urs; Tömösközi, Sándor

    2016-01-01

    Dry and hydrothermal heat treatments are efficient for modifying the technological-functional and shelf-life properties of wheat milling products. Dry heat treatment process is commonly used to enhance the volume of cakes. Hydrothermal heat treatment makes wheat flours suitable as thickener agents. In this study, cake and bread wheat flours that differed in baking properties were exposed to dry (100 °C, 12 min) and hydrothermal (95 °C, 5 min, 5-20 l/h water) heat treatments. Rheological differences caused by the treatments were investigated in a diluted slurry and in a dough matrix. Dry heat treatment resulted in enhanced dough stability. This effect was significantly higher in the cake flour than the bread flour. Altered viscosity properties of the bread flour in the slurry matrix were also observed. The characteristics of hydrothermally treated samples showed matrix dependency: their viscosity increases in the slurry and decreases in the dough matrix. These results can support us to produce flour products with specific techno-functional properties. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Large differences in reanalyses of diabatic heating in the tropical upper troposphere and lower stratosphere

    Science.gov (United States)

    Wright, J. S.; Fueglistaler, S.

    2013-09-01

    We present the time mean heat budgets of the tropical upper troposphere (UT) and lower stratosphere (LS) as simulated by five reanalysis models: the Modern-Era Retrospective Analysis for Research and Applications (MERRA), European Reanalysis (ERA-Interim), Climate Forecast System Reanalysis (CFSR), Japanese 25-yr Reanalysis and Japan Meteorological Agency Climate Data Assimilation System (JRA-25/JCDAS), and National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) Reanalysis 1. The simulated diabatic heat budget in the tropical UTLS differs significantly from model to model, with substantial implications for representations of transport and mixing. Large differences are apparent both in the net heat budget and in all comparable individual components, including latent heating, heating due to radiative transfer, and heating due to parameterised vertical mixing. We describe and discuss the most pronounced differences. Discrepancies in latent heating reflect continuing difficulties in representing moist convection in models. Although these discrepancies may be expected, their magnitude is still disturbing. We pay particular attention to discrepancies in radiative heating (which may be surprising given the strength of observational constraints on temperature and tropospheric water vapour) and discrepancies in heating due to turbulent mixing (which have received comparatively little attention). The largest differences in radiative heating in the tropical UTLS are attributable to differences in cloud radiative heating, but important systematic differences are present even in the absence of clouds. Local maxima in heating and cooling due to parameterised turbulent mixing occur in the vicinity of the tropical tropopause.

  7. Effect of surface treatments on the bond strength between resin cement and differently sintered zirconium-oxide ceramics.

    Science.gov (United States)

    Yenisey, Murat; Dede, Doğu Ömür; Rona, Nergiz

    2016-01-01

    This study investigated the effects of surface treatments on bond strength between resin cement and differently sintered zirconium-oxide ceramics. 220 zirconium-oxide ceramic (Ceramill ZI) specimens were prepared, sintered in two different period (Short=Ss, Long=Ls) and divided into ten treatment groups as: GC, no treatment; GSil, silanized (ESPE-Sil); GSilPen, silane flame treatment (Silano-Pen); GSb, sandblasted; GSbSil, sandblasted+silanized; GSbCoSil, sandblasted+silica coated (CoJet)+silanized; GSbRoSil, sandblasted+silica coated (Rocatech-Plus)+silanized; GSbDSil, sandblasted+diamond particle abraded (Micron MDA)+silanized; GSbSilPen, sandblasted+silane flame treatment+silanized; GSbLSil, sandblasted+Er:Yag (Asclepion-MCL30) laser treated+silanized. The composite resin (Filtek Z-250) cylinders were cemented to the treated ceramic surfaces with a resin cement (Panavia F2.0). Shear bond strength test was performed after specimens were stored in water for 24h and thermo-cycled for 6000 cycles (5-55 °C). Data were statistically analyzed with two-way analysis of variance (ANOVA) and Tamhane's multiple comparison test (α=0.05). According to the ANOVA, sintering time, surface treatments and their interaction were statistically significant (pzirconium-oxide ceramics. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  8. Staff perceptions of organisational values in a large South African manufacturing company: exploring socio-demographic differences

    Directory of Open Access Journals (Sweden)

    Nico Martins

    2011-11-01

    Research purpose: The objective of the study was to explore the perceptions of men and women staff members, as well as members of various race and age groups, in a large South African manufacturing company about the current enactment of organisational values and the importance of these values. Motivation for the study: The challenge of managing multi-cultural work forces from different gender, race and generational backgrounds makes an understanding of how peoples’ values align with those of their organisations, as reflected in their cultures, necessary. Research design, approach and method: Using an organisational values scale, the researchers conducted a quantitative survey on a random sample of 988 participants employed in a large South African manufacturing company. Main findings: ANOVAs and post hoc multiple comparison of means tests revealed that gender, race and age have a significant effect on some of the dimensions of organisational values and that these biographical groups differ significantly in their perceptions of the importance of certain organisational values as well as how their organisations enact them. Practical/mangerial implications: The findings highlight the importance of understanding staff perceptions in creating greater commitment to organisational values as important aspects of an effective organisational culture. Contribution/value-add: This study is original research that contributes new knowledge to the field of organisational psychology and management practices.

  9. Different perspectives of clinicians and patients with severe mental illness on motivation for treatment

    NARCIS (Netherlands)

    Jochems, E.C.; van Dam, A.; Duivenvoorden, H.J.; Scheffer, S.C.M.; van der Feltz-Cornelis, C.M.; Mulder, N.L.

    2016-01-01

    The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model

  10. Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial.

    Science.gov (United States)

    Dogramaci, Yunus; Kalaci, Aydiner; Savaş, Nazan; Duman, I Gokhan; Yanat, A Nedim

    2009-10-01

    To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis. In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition. There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002). In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results.

  11. High-Intensity Focused Ultrasound for the Treatment of Wrinkles and Skin Laxity in Seven Different Facial Areas

    OpenAIRE

    Park, Hyunchul; Kim, Eunjin; Kim, Jeongeun; Ro, Youngsuck; Ko, Jooyeon

    2015-01-01

    Background High-intensity focused ultrasound (HIFU) treatment has recently emerged in response to the increasing demand for noninvasive procedures for skin lifting and tightening. Objective This study was aimed at evaluating the clinical efficacy of and patient satisfaction with HIFU treatment for wrinkles and laxity in seven different areas of the face in Asian skin. Methods Twenty Korean patients with facial wrinkle and laxity were analyzed after a single session of HIFU treatment. Two inde...

  12. Mixing implants of differing metallic composition in the treatment of upper-extremity fractures.

    Science.gov (United States)

    Acevedo, Daniel; Loy, Bo Nasmyth; Loy, Bo Nasymuth; Lee, Brian; Omid, Reza; Itamura, John

    2013-09-01

    Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing. Copyright 2013, SLACK Incorporated.

  13. Effects of different surface treatments and accelerated artificial aging on the bond strength of composite resin repairs

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Veiga de Melo

    2011-12-01

    Full Text Available The purpose of the present study was to assess the bond strength of composite resin repairs subjected to different surface treatments and accelerated artificial aging. 192 cylindrical samples (CSs were prepared and divided into 24 groups (n = 8. Half of the CSs were stored in water for 24 h, and the other half were subjected to C-UV accelerated aging for non-metallic specimens. The treatments were phosphoric acid + silane + adhesive (PSA; phosphoric acid + adhesive (PA; diamond bur + phosphoric acid + silane + adhesive (DPSA; diamond bur + phosphoric acid + adhesive (DPA; air abrasion + phosphoric acid + silane + adhesive (APSA; and air abrasion + phosphoric acid + adhesive (APA. The repair was performed and the specimens were again aged as described above. A control group (n = 8 was established and did not receive any type of aging or surface treatment. The specimens were loaded to failure in shear mode with a crosshead speed of 0.5 mm/min until fracture. Data were analyzed by one-way ANOVA/Tukey's test (p < 0.05. No statistically significant differences were found among DPSA, DPA, APSA, APA, and the control group. The aged PSA and PA achieved low bonding values and were statistically different from the control group, whereas the non-aged PSA and PA presented no statistically significant difference from the control group. Repairs with the proposed surface treatments were viable on both recent and aged restorations; however, phosphoric acid + adhesive alone were effective only on recent restorations.

  14. The difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment

    Directory of Open Access Journals (Sweden)

    Fitri Anissa Syaimima bt. Syaiful Azim

    2018-01-01

    Full Text Available Every child will go through several stages in his or her life. They are different from each other as they are in the process of development of cognition, physics, emotion, and personality. For many children, a visit to the dentist can raise their anxiety. This anxiousness will lead to stress that influences the cardiovascular function in the body. The purpose of this research was to determine the difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment. This research was a clinical trial, pure experimental study. The sample consisted of 30 children within the range of 4-12 years old where they were divided into two groups of age; middle childhood (4-7 years old and late childhood (8-12 years old. The blood pressures were measured before any dental treatment began and the values were recorded. The data were then analyzed using the One-Sample T-Test analysis. The results of blood pressure in middle childhood and late childhood were compared to the average mean values for each age group. It showed that there was a significant difference in the systolic pressure, which was found higher in the middle childhood group compared to the late childhood. From the result can be concluded that there was a difference in the pediatric blood pressure between middle childhood and late childhood prior to dental treatment.

  15. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

    Science.gov (United States)

    Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

    2017-07-01

    The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

  16. Surgical-prosthetic treatment of large mandibular cysts

    Directory of Open Access Journals (Sweden)

    Džambas Ljubiša D.

    2003-01-01

    Full Text Available This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II. After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient’s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis. The patient’s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.

  17. Germination, seed diameter and pregerminative treatments in species with different purposes of use

    Directory of Open Access Journals (Sweden)

    Ricardo Vinicio Abril-Saltos

    2017-09-01

    Full Text Available The evaluation of vegetal species germination consents to know its characteristics and permits to understand the factors that influence this process. The aim of this research was to know the germination’s characteristics of some species, such as Eugenia stipitata McVaugh, Inga edulis Mart, Inga spectabilis (Vahl Wild, Piptocoma discolor (Kunth Pruski, Stachytarpheta cayennensis (Rich. Vahl, and Verbena officinalis L., and also their reaction to pregerminative treatments depending on the seed’s diameter. This study was carried out in Pastaza, Province of Pastaza, Ecuador, between February and June, 2014. Different diameters of seeds and pregerminative treatments were used in species, which did not present germination percentages higher than 40%. In the first practice I. edulis and I. spectabilis exceeded this value without treatment. Other species had lower values. Seeds were classified considering two diameters and two doses of gibberellin acid, this was applied to, and evaluated in the E. stipitata. In addition, scarification with sulfuric acid was done. After 45 days of its application, 100 ppm of gibberellic acid with larger seed diameter reported higher percentages of germination in S. cayenennsis, and in E. stipitata, which also interacted with the scarification. V. officinalis and P. discolor, did not present any response to the applications made. I. edulis and I. spectabilis presented high germination percentages without pregerminative treatments, E. stipitata and S. cayenennsis showed response to seed diameter and the applied treatments, while P discolor and V. officinalis did not show any response.

  18. Mechanisms Underlying the Antidepressant Response and Treatment Resistance

    Directory of Open Access Journals (Sweden)

    Marjorie Rose Levinstein

    2014-06-01

    Full Text Available Depression is a complex and heterogeneous disorder affecting millions of Americans. There are several different medications and other treatments that are available and effective for many patients with depression. However, a substantial percentage of patients fail to achieve remission with these currently available interventions, and relapse rates are high. Therefore, it is necessary to determine both the mechanisms underlying the antidepressant response and the differences between responders and non-responders to treatment. Delineation of these mechanisms largely relies on experiments that utilize animal models. Therefore, this review provides an overview of the various mouse models that are currently used to assess the antidepressant response, such as chronic mild stress, social defeat, and chronic corticosterone. We discuss how these mouse models can be used to advance our understanding of the differences between responders and non-responders to antidepressant treatment. We also provide an overview of experimental treatment modalities that are used for treatment-resistant depression, such as deep brain stimulation and ketamine administration. We will then review the various genetic polymorphisms and transgenic mice that display resistance to antidepressant treatment. Finally, we synthesize the published data to describe a potential neural circuit underlying the antidepressant response and treatment resistance.

  19. Integrated biodosimetry in large scale radiological events. Opportunities for civil military co-operation

    International Nuclear Information System (INIS)

    Port, M.; Eder, S.F.; Lamkowski, A.; Majewski, M.; Abend, M.

    2016-01-01

    Radiological events like large scale radiological or nuclear accidents, terroristic attacks with radionuclide dispersal devices require rapid and precise medical classification (''triage'') and medical management of a large number of patients. Estimates on the absorbed dose and in particular predictions of the radiation induced health effects are mandatory for optimized allocation of limited medical resources and initiation of patient centred treatment. Among the German Armed Forces Medical Services the Bundeswehr Institute of Radiobiology offers a wide range of tools for the purpose of medical management to cope with different scenarios. The forward deployable mobile Medical Task Force has access to state of the art methodologies summarized into approaches such as physical dosimetry (including mobile gammaspectroscopy), clinical ''dosimetry'' (prodromi, H-Modul) and different means of biological dosimetry (e.g. dicentrics, high throughput gene expression techniques, gamma-H2AX). The integration of these different approaches enables trained physicians of the Medical Task Force to assess individual health injuries as well as prognostic evaluation, considering modern treatment options. To enhance the capacity of single institutions, networking has been recognized as an important emergency response strategy. The capabilities of physical, biological and clinical ''dosimetry'' approaches spanning from low up to high radiation exposures will be discussed. Furthermore civil military opportunities for combined efforts will be demonstrated.

  20. Clinician preferences and the estimation of causal treatment differences

    OpenAIRE

    Korn, Edward L.; Baumrind, Sheldon

    1998-01-01

    Clinician treatment preferences affect the ability to perform randomized clinical trials and the ability to analyze observational data for treatment effects. In clinical trials, clinician preferences that are based on a subjective analysis of the patient can make it difficult to define eligibility criteria for which clinicians would agree to randomize all patients who satisfy the criteria. In addition, since each clinician typically has some preference for the choice of treatment for a given ...

  1. Analysis of the Difference of Radon Concentration between Water Treatment Plant and Tap water in house

    International Nuclear Information System (INIS)

    Seo, Jeongil; Yoo, Donghan; Kim, Heereyoung

    2013-01-01

    As importance for the health, measurements and analysis about radon is active recently. Especially, radon concentration measurement about underground water which people drink was been carried out by the environment organizations in Korea and has been hot-issued because of the high radon concentration in water source. In present study, the difference of radon concentration among water source, water treatment plant and tap water in house is analyzed. It makes sense that the radon concentration in water treatment plant can represent the radon concentration in the tap water. Through the above experiments, the difference of the radon concentration between water treatment plant and tap water in house is figured out. It contributes to confirm more specific basis for estimating the annual radon exposure for the public. With further experiments and analysis, it is thought that it will be used as tool to assess more qualitatively for the radon concentration in tap water. Finally, this Fundamental approach will help in making new regulations about radon

  2. Analysis of the Difference of Radon Concentration between Water Treatment Plant and Tap water in house

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeongil; Yoo, Donghan; Kim, Heereyoung [Ulsan National Institute of Science and Technology, Ulsan (Korea, Republic of)

    2013-05-15

    As importance for the health, measurements and analysis about radon is active recently. Especially, radon concentration measurement about underground water which people drink was been carried out by the environment organizations in Korea and has been hot-issued because of the high radon concentration in water source. In present study, the difference of radon concentration among water source, water treatment plant and tap water in house is analyzed. It makes sense that the radon concentration in water treatment plant can represent the radon concentration in the tap water. Through the above experiments, the difference of the radon concentration between water treatment plant and tap water in house is figured out. It contributes to confirm more specific basis for estimating the annual radon exposure for the public. With further experiments and analysis, it is thought that it will be used as tool to assess more qualitatively for the radon concentration in tap water. Finally, this Fundamental approach will help in making new regulations about radon.

  3. Comparison of six different sewage treatment processes-Reduction of estrogenic substances and effects on gene expression in exposed male fish

    International Nuclear Information System (INIS)

    Gunnarsson, L.; Adolfsson-Erici, M.; Bjoerlenius, B.; Rutgersson, C.; Foerlin, L.; Larsson, D.G.J.

    2009-01-01

    Treated sewage effluents often contain a mixture of estrogenic compounds in low concentrations. The total combined activity of these, however, may be sufficiently high to affect the reproduction of aquatic vertebrates. The introduction of advanced treatment technologies has been suggested as a way to remove micro-contaminants, including estrogenic substances. In this study, one municipal influent was treated with six different processes in parallel on a semi-large scale in order to assess their potential to reduce substances that could contribute to estrogenic effects in male fish. The effluent from a conventional, activated sludge treatment line was compared to a similarly treated effluent with a final sand-filtering step. The addition of ozonation (15 g O 3 /m 3 ), a moving bed biofilm reactor (MBBR) or both in combination was also evaluated. There was also a separate treatment line that was based on a membrane bioreactor. A small battery of hepatic estrogen-responsive genes was measured in the exposed fish using quantitative PCR. Concentrations of steroid estrogens and estrogenic phenols in the effluents were measured by GC-ECNI-MS. The ozonated effluents were the only tested effluents for which all measured biological effects in exposed fish were removed. Chemical data suggested that the MBBR technology was equally effective in removing the analyzed estrogens; however, elevated expression of estrogen-responsive genes suggested that some estrogenic substances were still present in the effluent. The membrane bioreactor removed most of the measured estrogens and it reduced the induction of the estrogen-responsive genes. However, fish exposed to this effluent had significantly enlarged livers. Given that the same influent was treated in parallel with a broad set of technologies and that the chemical analyses were combined with an in vivo assessment of estrogenic responses, this study provides valuable input into the assessment of advanced treatment processes for

  4. Effect of Different Surface Treatments on the Bond Strength of Repaired Resin Restorations

    International Nuclear Information System (INIS)

    Engy Fahmy Ismaiel Fekry Abaza

    2010-01-01

    In the last decade, growing demands by patients for mercury-free esthetic restorations had markedly increased the use of resin composites in restorative dentistry. However, despite the continuing development of resin composites with improved properties, several factors, such as discoloration, color mismatch, wear; chipping or bulk fracture might present clinical problems (Mjor and Gordan. 2002, Vichi et al. 2004 and Kolbeck et al. 2006). As a result, the clinician should decide whether to replace or simply repair these restorations. Total replacement of the restoration might be regarded as over-treatment since in most cases, large portions of the restorations might be clinically and radio graphically considered free of failure. Moreover, complete removal of the restoration inevitably resulted in weakening of the tooth, unnecessary removal of intact dental tissues, more money and time consuming. For these reasons, the repair of the restoration instead of its removal would be a favorable procedure (Lucena-Martin et al. 2001, Frankenberger et al. 2003 a and Oztas et al. 2003). The key element in the determination of successful repair procedures was the adequate bond strength between the existing resin composite and the new one. Various methods have been suggested to improve the bond strength of the repaired resin restorations (Tezvergil et al. 2003 and Bonstein et al. 2005). Mechanical and/or chemical treatments had been investigated for preparation of the aged resin restorations to be repaired (Tezvergil et al. 2003, Ozcan et al. 2005 and Hannig et al. 2006). These treatments were introduced to counteract the problems of aged resin restorations which were limited amount of residual free radicals available for reaction with the repair material, contaminated surface, and highly cross-linked resin matrix ( Dall Oca et al. 2006 and Papacchini et al. 2007 a) Previous studies emphasized that mechanical treatments are the most important factor in obtaining optimal repair

  5. The estimated future disease burden of hepatitis C virus in the Netherlands with different treatment paradigms.

    Science.gov (United States)

    Willemse, S B; Razavi-Shearer, D; Zuure, F R; Veldhuijzen, I K; Croes, E A; van der Meer, A J; van Santen, D K; de Vree, J M; de Knegt, R J; Zaaijer, H L; Reesink, H W; Prins, M; Razavi, H

    2015-11-01

    Prevalence of hepatitis C virus (HCV) infection in the Netherlands is low (anti-HCV prevalence 0.22%). All-oral treatment with direct-acting antivirals (DAAs) is tolerable and effective but expensive. Our analysis projected the future HCV-related disease burden in the Netherlands by applying different treatment scenarios. Using a modelling approach, the size of the HCV-viraemic population in the Netherlands in 2014 was estimated using available data and expert consensus. The base scenario (based on the current Dutch situation) and different treatment scenarios (with increased efficacy, treatment uptake, and diagnoses) were modelled and the future HCV disease burden was predicted for each scenario. The estimated number of individuals with viraemic HCV infection in the Netherlands in 2014 was 19,200 (prevalence 0.12%). By 2030, this number is projected to decrease by 4 5% in the base scenario and by 85% if the number of treated patients increases. Furthermore, the number of individuals with hepatocellular carcinoma and liver-related deaths is estimated to decrease by 19% and 27%, respectively, in the base scenario, but may both be further decreased by 68% when focusing on treatment of HCV patients with a fibrosis stage of ≥ F2. A substantial reduction in HCV-related disease burden is possible with increases in treatment uptake as the efficacy of current therapies is high. Further reduction of HCV-related disease burden may be achieved through increases in diagnosis and preventative measures. These results might inform the further development of effective disease management strategies in the Netherlands.

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

    Directory of Open Access Journals (Sweden)

    Grace Montepiedra

    2016-08-01

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

  7. [Treatment of chronic bovine endometritis and factors for treatment success].

    Science.gov (United States)

    Feldmann, M; Tenhagen genannt Emming, S; Hoedemaker, M

    2005-01-01

    In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial treatment, n = 28). Before treatment, uterine swabs for bacteriologic examination and blood samples for determination of serum progesterone concentrations were collected. Two weeks following the first treatment, cows were reexamined. In case no clinical cure was diagnosed, treatment was repeated and control cows were treated for the first time with one of the three treatments mentioned above. The four treatment groups did not differ with respect to the clinical cure or reproductive performance. Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P conception rate and a lower pregnancy index were obtained when the treatment was performed following day 42 postpartum (P size had a negative effect on clinical cure over all groups (first treatment clinical cure: 68.2% (small uteri) vs 44.4% (large uteri); P 0.05). Isolation of Arcanobacterium (A.) pyogenes negatively influenced first treatment clinical cure over all treatment groups (79.0% vs 31.5%) and within treatment groups (P conception increased compared with the other treatment groups, when A. pyogenes was detected. Isolation of unspecific bacteria and the presence or absence of a corpus luteum only had minor effects over all and within the PG, AS and C group. Within the AB group, presence of luteal tissue was connected with a

  8. Effect of different ectopic pregnancy treatments on cryopreserved embryo transfer outcomes: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Bingqian Zhang

    2017-08-01

    Conclusion: There was no significant difference among EP treatment methods with regard to their impacts on CET outcomes in women with EP histories. Bilateral tubal ligation or removal surgery can decrease the miscarriage rate after CET.

  9. Complete remission in a colon cancer patient with a large, irresectable liver metastasis after XELOX/cetuximab/bevacizumab treatment.

    Science.gov (United States)

    Weihrauch, Martin R; Stippel, Dirk; Fries, Jochen W U; Arnold, Dirk; Bovenschulte, Henning; Coutelle, Oliver; Hacker, Ulrich

    2008-09-01

    Stage IV colorectal cancer is usually an incurable disease. However, patients with resectable metastases have 5-year disease-free survival rates of up to 30%. Even with primarily irresectable disease, cure can be achieved in patients who become operable after neoadjuvant treatment. To improve the prognosis of these patients, highly effective neoadjuvant regimens need to be developed. Here, we report the case of a 62-year-old male patient who had been diagnosed with International Union against Cancer (UICC) stage III colon cancer 7 years previously and now presented with a large, irresectable liver metastasis and enlarged perihepatic lymph nodes. After neoadjuvant treatment with cetuximab, bevacizumab and XELOX, the patient showed a complete remission and underwent surgery. Histopathologically, the resected tissue and lymph nodes were free of residual tumor. To our knowledge, this is the first report of a complete pathological response in a patient with irresectable colorectal cancer after intensive chemotherapy/anti-EGFR/ VEGF antibody therapy. This combination regimen may help to improve the survival rates for patients with irresectable disease. Copyright 2008 S. Karger AG, Basel.

  10. Clinical Profile, Etiology, and Treatment of Chronic Pancreatitis in North American Women: Analysis of a Large Multicenter Cohort.

    Science.gov (United States)

    Romagnuolo, Joseph; Talluri, Jyothsna; Kennard, Elizabeth; Sandhu, Bimaljit S; Sherman, Stuart; Cote, Gregory A; Al-Kaade, Samer; Gardner, Timothy B; Gelrud, Andres; Lewis, Michele D; Forsmark, Christopher E; Guda, Nalini M; Conwell, Darwin L; Banks, Peter A; Muniraj, Thiruvengadam; Wisniewski, Stephen R; Tian, Ye; Wilcox, C Mel; Anderson, Michelle A; Brand, Randall E; Slivka, Adam; Whitcomb, David C; Yadav, Dhiraj

    2016-08-01

    Historically, chronic pancreatitis (CP) was considered a disease of alcoholic males, but recent data suggest its etiology to be complex. To better understand CP in women, we compared data on women and men with CP in a large, prospectively ascertained multicenter US cohort. Patients with CP enrolled in the NAPS2 Continuation and Validation study were studied. Information on demographics, etiology, risk factors, phenotype, and treatment(s) used was obtained from detailed questionnaires completed by the patients and physicians. Of 521 cases, 45% were women. Women were significantly (P etiology (30% vs 58.5%) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18%; obstructive, 12% vs 2.4%; genetic, 12.8% vs 7.3%). Demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, CP-related disability, and use of medical therapies were mostly similar in both sexes. Sphincterotomy (biliary, 33% vs 24%; pancreatic, 38% vs 28%; P etiologies. In contrast to many other chronic diseases, clinical phenotype of CP is determined by the disease and is independent of sex.

  11. Time-series analysis in imatinib-resistant chronic myeloid leukemia K562-cells under different drug treatments.

    Science.gov (United States)

    Zhao, Yan-Hong; Zhang, Xue-Fang; Zhao, Yan-Qiu; Bai, Fan; Qin, Fan; Sun, Jing; Dong, Ying

    2017-08-01

    Chronic myeloid leukemia (CML) is characterized by the accumulation of active BCR-ABL protein. Imatinib is the first-line treatment of CML; however, many patients are resistant to this drug. In this study, we aimed to compare the differences in expression patterns and functions of time-series genes in imatinib-resistant CML cells under different drug treatments. GSE24946 was downloaded from the GEO database, which included 17 samples of K562-r cells with (n=12) or without drug administration (n=5). Three drug treatment groups were considered for this study: arsenic trioxide (ATO), AMN107, and ATO+AMN107. Each group had one sample at each time point (3, 12, 24, and 48 h). Time-series genes with a ratio of standard deviation/average (coefficient of variation) >0.15 were screened, and their expression patterns were revealed based on Short Time-series Expression Miner (STEM). Then, the functional enrichment analysis of time-series genes in each group was performed using DAVID, and the genes enriched in the top ten functional categories were extracted to detect their expression patterns. Different time-series genes were identified in the three groups, and most of them were enriched in the ribosome and oxidative phosphorylation pathways. Time-series genes in the three treatment groups had different expression patterns and functions. Time-series genes in the ATO group (e.g. CCNA2 and DAB2) were significantly associated with cell adhesion, those in the AMN107 group were related to cellular carbohydrate metabolic process, while those in the ATO+AMN107 group (e.g. AP2M1) were significantly related to cell proliferation and antigen processing. In imatinib-resistant CML cells, ATO could influence genes related to cell adhesion, AMN107 might affect genes involved in cellular carbohydrate metabolism, and the combination therapy might regulate genes involved in cell proliferation.

  12. Large differences in reanalyses of diabatic heating in the tropical upper troposphere and lower stratosphere

    Directory of Open Access Journals (Sweden)

    J. S. Wright

    2013-09-01

    Full Text Available We present the time mean heat budgets of the tropical upper troposphere (UT and lower stratosphere (LS as simulated by five reanalysis models: the Modern-Era Retrospective Analysis for Research and Applications (MERRA, European Reanalysis (ERA-Interim, Climate Forecast System Reanalysis (CFSR, Japanese 25-yr Reanalysis and Japan Meteorological Agency Climate Data Assimilation System (JRA-25/JCDAS, and National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR Reanalysis 1. The simulated diabatic heat budget in the tropical UTLS differs significantly from model to model, with substantial implications for representations of transport and mixing. Large differences are apparent both in the net heat budget and in all comparable individual components, including latent heating, heating due to radiative transfer, and heating due to parameterised vertical mixing. We describe and discuss the most pronounced differences. Discrepancies in latent heating reflect continuing difficulties in representing moist convection in models. Although these discrepancies may be expected, their magnitude is still disturbing. We pay particular attention to discrepancies in radiative heating (which may be surprising given the strength of observational constraints on temperature and tropospheric water vapour and discrepancies in heating due to turbulent mixing (which have received comparatively little attention. The largest differences in radiative heating in the tropical UTLS are attributable to differences in cloud radiative heating, but important systematic differences are present even in the absence of clouds. Local maxima in heating and cooling due to parameterised turbulent mixing occur in the vicinity of the tropical tropopause.

  13. Tricotillomania: pathopsychology theories and treatment possibilities.

    Science.gov (United States)

    Shoenfeld, Netta; Rosenberg, Oded; Kotler, Moshe; Dannon, Pinhas N

    2012-02-01

    The phenomenon of hair pulling has been recognized for centuries, yet the true prevalence of trichotillomania (TTM) is largely unknown and the topic has been sparsely studied. TTM is classified as an impulse-control disorder despite much debate about its etiology. In this review we summarize the different hypotheses, including impulse-control disorders, obsessive-compulsive disorders, behavioral problems and addiction, and the appropriate treatment methods. The combination of selective serotonin reuptake inhibitors and antipsychotic medications are shown to be most effective. Treatment with anti-addiction drugs seems relevant. Further research is needed to increase our knowledge regarding the etiology of TTM.

  14. Usefulness of IT knife nano for endoscopic submucosal dissection of large colo-rectal lesions.

    Science.gov (United States)

    Suzuki, T; Hara, T; Kitagawa, Y; Yamaguchi, T

    2016-01-01

    Endoscopic submucosal dissection (ESD) is currently widely conducted for the treatment of early gastrointestinal -cancers. Due to the characteristic anatomy of the large intestine, needle- tip type devices such as Dual knife are mainly used in colorectal ESD. On the other hand, the non- needle-tip type IT knife is a unique device with an insulated tip, and has been reported to be safe, efficacious and speedy when used in gastric ESD. A new model of IT knife, IT knife nano, anticipated to be useful for esophageal and colorectal ESD has become available, but its usefulness has not been reported. Therefore, we performed this study to evaluate the usefulness of IT knife nano for ESD of large colorectal lesions. Previous studies have shown that a tumor size of 40 mm or above significantly prolongs treatment time and is a factor of treatment difficulty. We selected colorectal lesions of 40 mm and above, and compared 32 lesions treated with Dual knife alone before IT knife nano was available (No-IT group) and 40 cases treated with IT knife nano as a second knife after IT knife nano became available (IT group). We assessed en bloc resection rate, complete en bloc resection rate, complication rate and treatment time. The en bloc resection rates in No-IT group and IT group were 100% and 97.5%, respectively, with no significant difference. The respective median treatment time was 70 min and 51 min, and was significantly shortened in IT group (P knife nano in ESD for large colorectal -lesions achieves the same levels of efficacy and safety as conventional device, with the additional merit of shortening treatment time. © Acta Gastro-Enterologica Belgica.

  15. Oral antidiabetic therapy in a large Italian sample: drug supply and compliance for different therapeutic regimens

    CERN Document Server

    Vittorino Gaddi, A; Capello, F; Di Pietro, C; Cinconze, E; Rossi, E; De Sando, V; Cevenini, M; D'Alò, G

    2014-01-01

    Objectives: To define the main features of patients treated with oral antidiabetics, evaluating monotherapy (MT), loose-dose combination therapy (LDCT) and fixed-dose combination therapy (FDCT); to describe medication adherence to the different therapies; and to evaluate the differences in compliance with the prescribed therapy regimen among prevalent and incident patient cohorts. Study design: This study was a retrospective cohort analysis based on the ARNO database, a national record that tracks reimbursable prescription claims submitted from selected pharmacies to the Italian national health system. In total, 169,375 subjects, from an overall population of 4,040,624 were included in this study. The patients represented 12 different local health units. Each patient had at least one oral antidiabetic prescription claim (A10B ATC code). Methods: Patients were divided into four groups according to their treatment regimen during the recruitment period (1 January 2008-31 December 2008): MT, FDCT, LDCT and swi...

  16. Isotopic Differences between Forage Consumed by a Large Herbivore in Open, Closed, and Coastal Habitats: New Evidence from a Boreal Study System.

    Directory of Open Access Journals (Sweden)

    Marie-Andrée Giroux

    Full Text Available Documenting habitat-related patterns in foraging behaviour at the individual level and over large temporal scales remains challenging for large herbivores. Stable isotope analysis could represent a valuable tool to quantify habitat-related foraging behaviour at the scale of individuals and over large temporal scales in forest dwelling large herbivores living in coastal environments, because the carbon (δ13C or nitrogen (δ15N isotopic signatures of forage can differ between open and closed habitats or between terrestrial and littoral forage, respectively. Here, we examined if we could detect isotopic differences between the different assemblages of forage taxa consumed by white-tailed deer that can be found in open, closed, supralittoral, and littoral habitats. We showed that δ13C of assemblages of forage taxa were 3.0 ‰ lower in closed than in open habitats, while δ15N were 2.0 ‰ and 7.4 ‰ higher in supralittoral and littoral habitats, respectively, than in terrestrial habitats. Stable isotope analysis may represent an additional technique for ecologists interested in quantifiying the consumption of terrestrial vs. marine autotrophs. Yet, given the relative isotopic proximity and the overlap between forage from open, closed, and supralittoral habitats, the next step would be to determine the potential to estimate their contribution to herbivore diet.

  17. Treatment of complications related to bonded retainers

    DEFF Research Database (Denmark)

    Laursen, Morten Godtfredsen; Rylev, Mette; Melsen, Birte

    different displacement of one lower incisor and gingival recessions. Treatment aimed to improve the periodontium by moving the displaced teeth to the center of the bone prior to mucogingival surgery. Statically determinate segmented appliances were applied to generate large moments with reactive forces low....... Individualized appliance design can be indicated to maintain roots within the alveolar process....

  18. Infectivity to Phlebotomus perniciosus of dogs naturally parasitized with Leishmania infantum after different treatments

    Directory of Open Access Journals (Sweden)

    Descalzo Miguel A

    2011-04-01

    Full Text Available Abstract Background In Europe most dogs with clinical leishmaniosis are treated with leishmanicides, typically antimonials combined with allopurinol and good clinical recovery is observed in a high number of these dogs. Through xenodiagnosis, the capacity of a treated animal to infect the vector of the disease under treatment is assessed as a measure of the chemotherapeutic efficacy of the drug used. The objective of the present study was to evaluate through direct xenodiagnosis the infectivity to Phlebotomus perniciosus of dogs naturally parasitized with Leishmania infantum after treatment, and to follow the clinical and parasite course of disease. Thirty two dogs with clinical leishmaniosis were assigned to one of three treatment groups: meglumine antimoniate plus allopurinol (Group A, meglumine antimoniate (Group B or allopurinol (Group C. During the study, the dogs were examined before treatment (Day 0 and bimonthly thereafter until Day 180 (six months post-treatment onset. Results The three groups were scored over time according to the effects of treatment on clinical signs and clinical-pathological variables. Significant differences in clinical scores were observed between Group A and the other two groups, indicating the combined treatment was the most effective. After treatment, bone marrow cultures were positive for the parasite in 30.8% of dogs in some of the check ups (3 or 25% in Group A, 1 or 11.1% in Group B, and 4 or 80% in Group C. Our xenodiagnosis experiments revealed that 15.4% of treated dogs were still able to infect sand flies at some point after treatment (2 dogs or 16.6% in Group A, 2 or 22.2% in Group B and none in Group C. Only 7.7% of the entire study population could infect sand flies as from the second month post-treatment onset. Conclusion The three treatment regimens tested significantly reduced the infectivity of dogs towards sand flies, thus diminishing the epidemiological risks of treated dogs both for human

  19. Internalizing and externalizing personality subtypes predict differences in functioning and outcomes among veterans in residential substance use disorder treatment.

    Science.gov (United States)

    Blonigen, Daniel M; Bui, Leena; Britt, Jessica Y; Thomas, Katherine M; Timko, Christine

    2016-10-01

    There is a long history of using personality to subtype patients in treatment for substance use disorders (SUD). However, no one has validated a typology of SUD patients using a structural model of normal-range personality, particularly indicating whether subtypes differ on treatment processes and outcomes. We developed a personality-based typology among 196 military veterans enrolled in residential SUD treatment at a Veterans Affairs medical center. Patients were assessed at treatment entry, 1 month into treatment, and at discharge from treatment. Personality was assessed using the Multidimensional Personality Questionnaire-Brief Form at treatment entry. Latent profile analyses identified a 3-group solution consisting of low pathology, internalizing, and externalizing groups. The internalizing group scored lowest on measures of functioning at treatment entry, whereas the externalizing group scored more poorly on treatment processes and outcomes over the course of their residential stay (e.g., more stressful relationships with other residents, lower program alliance). These findings support a clinically meaningful typology of SUD patients based on a 3-factor model of personality and can serve as a guide for future efforts aimed at developing targeted interventions that can address the individual differences of patients in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Racial and ethnic differences in pulmonary arterial hypertension

    OpenAIRE

    Al-Naamani, Nadine; Paulus, Jessica K.; Roberts, Kari E.; Pauciulo, Michael W.; Lutz, Katie; Nichols, William C.; Kawut, Steven M.

    2017-01-01

    This study explores the racial and ethnic differences in presentation, severity, and treatment of patients with pulmonary arterial hypertension (PAH) in a large multicenter registry. African American and Hispanic patients are more likely to present with associated PAH compared to non-Hispanic whites. Hispanic patients with PAH were less likely to be treated with PAH-specific medications compared to non-Hispanic whites.

  1. [Comparative effectiveness of different treatment methods of liver failure].

    Science.gov (United States)

    Kutepov, D E; Vershinina, M G; Pasechnik, I N; Sal'nikov, P S

    2014-01-01

    It was analyzed the results of treatment of 217 patients (139 men, 78 women) with chronic liver failure in case of liver cirrhosis of various etiology for study of degree of hepatic encephalopathyregression. All patients were divided into 3 groups. In the first group the drug therapy was used. In the second group additionallyplasma exchange was performed, in the third group - alsomolecular absorbent recirculating system was used (effectiveness of MARS-therapy).The results showed that the use of extracorporeal treatment techniques can effectively reduce the severity of hepatic encephalopathy in patients with liver cirrhosis. MARS-therapy improved the neurological status of patientsmore significantly in this case. It is considered that the inclusion of MARS-therapy in the combined treatment of patients leads to a significant reduction of hepatic encephalopathyseverity (1-2 points), in comparison with other methods of treatment.

  2. Analysis of covariance with pre-treatment measurements in randomized trials under the cases that covariances and post-treatment variances differ between groups.

    Science.gov (United States)

    Funatogawa, Takashi; Funatogawa, Ikuko; Shyr, Yu

    2011-05-01

    When primary endpoints of randomized trials are continuous variables, the analysis of covariance (ANCOVA) with pre-treatment measurements as a covariate is often used to compare two treatment groups. In the ANCOVA, equal slopes (coefficients of pre-treatment measurements) and equal residual variances are commonly assumed. However, random allocation guarantees only equal variances of pre-treatment measurements. Unequal covariances and variances of post-treatment measurements indicate unequal slopes and, usually, unequal residual variances. For non-normal data with unequal covariances and variances of post-treatment measurements, it is known that the ANCOVA with equal slopes and equal variances using an ordinary least-squares method provides an asymptotically normal estimator for the treatment effect. However, the asymptotic variance of the estimator differs from the variance estimated from a standard formula, and its property is unclear. Furthermore, the asymptotic properties of the ANCOVA with equal slopes and unequal variances using a generalized least-squares method are unclear. In this paper, we consider non-normal data with unequal covariances and variances of post-treatment measurements, and examine the asymptotic properties of the ANCOVA with equal slopes using the variance estimated from a standard formula. Analytically, we show that the actual type I error rate, thus the coverage, of the ANCOVA with equal variances is asymptotically at a nominal level under equal sample sizes. That of the ANCOVA with unequal variances using a generalized least-squares method is asymptotically at a nominal level, even under unequal sample sizes. In conclusion, the ANCOVA with equal slopes can be asymptotically justified under random allocation. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Investigating sex differences in psychological predictors of snack intake among a large representative sample.

    Science.gov (United States)

    Adriaanse, Marieke A; Evers, Catharine; Verhoeven, Aukje A C; de Ridder, Denise T D

    2016-03-01

    It is often assumed that there are substantial sex differences in eating behaviour (e.g. women are more likely to be dieters or emotional eaters than men). The present study investigates this assumption in a large representative community sample while incorporating a comprehensive set of psychological eating-related variables. A community sample was employed to: (i) determine sex differences in (un)healthy snack consumption and psychological eating-related variables (e.g. emotional eating, intention to eat healthily); (ii) examine whether sex predicts energy intake from (un)healthy snacks over and above psychological variables; and (iii) investigate the relationship between psychological variables and snack intake for men and women separately. Snack consumption was assessed with a 7d snack diary; the psychological eating-related variables with questionnaires. Participants were members of an Internet survey panel that is based on a true probability sample of households in the Netherlands. Men and women (n 1292; 45 % male), with a mean age of 51·23 (sd 16·78) years and a mean BMI of 25·62 (sd 4·75) kg/m2. Results revealed that women consumed more healthy and less unhealthy snacks than men and they scored higher than men on emotional and restrained eating. Women also more often reported appearance and health-related concerns about their eating behaviour, but men and women did not differ with regard to external eating or their intentions to eat more healthily. The relationships between psychological eating-related variables and snack intake were similar for men and women, indicating that snack intake is predicted by the same variables for men and women. It is concluded that some small sex differences in psychological eating-related variables exist, but based on the present data there is no need for interventions aimed at promoting healthy eating to target different predictors according to sex.

  4. Behavior of nickel-titanium instruments manufactured with different thermal treatments.

    Science.gov (United States)

    Pereira, Érika Sales Joviano; Viana, Ana Cecília Diniz; Buono, Vicente Tadeu Lopes; Peters, Ove A; Bahia, Maria Guiomar de Azevedo

    2015-01-01

    The purpose of this study was to investigate if nickel-titanium instruments with similar designs manufactured by different thermal treatments would exhibit significantly different in vitro behavior. Thirty-six instruments each of ProTaper Universal (PTU F1; Dentsply Maillefer, Ballaigues, Switzerland), ProFile Vortex (PV; Dentsply Tulsa Dental Specialties, Tulsa, OK), Vortex Blue (VB, Dentsply Tulsa Dental Specialties), and TYPHOON Infinite Flex NiTi (TYP; Clinician's Choice Dental Products, New Milford, CT) (all size 25/.06) were evaluated. Bending resistance, torsion at failure, and dynamic torsional tests were performed with the instruments (n = 12). Analysis of variance and Tukey post hoc tests were applied. Flexibility was significantly higher for TYP compared with the other 3 groups (P .05). The highest mean forces were recorded with PTU (7.02 ± 2.36 N) and the lowest with TYP (1.22 ± 0.40 N). TYP instruments were significantly more flexible than the other instruments tested. The PV group had the highest torsional strength and TYP, despite being the most flexible, showed similar torsional moments to the other instruments, whereas its angular deflection was the highest among the groups. Copyright © 2015 American Association of Endodontists. All rights reserved.

  5. Comparison of pregnancy rates in PCOS patients undergoing clomiphene citrate and IUI treatment with different leading follicular sizes.

    Science.gov (United States)

    Seckin, Berna; Pekcan, Meryem Kuru; Bostancı, Esra Isci; Inal, Hasan Ali; Cicek, Mahmut Nedim

    2016-04-01

    The objective of the study was to compare the pregnancy rates in PCOS patients undergoing clomiphene citrate (CC) and intrauterine insemination (IUI) treatment with different leading follicular sizes. A total of 358 infertile women with PCOS who underwent 563 clomiphene citrate and IUI treatment cycles were included in this prospective study. Treatment cycles were divided into three groups according to leading follicular size on the day of hCG administration: Group I: follicular size 17-18 mm (n = 177), Group II: 19-22 mm (n = 321), and Group III : >22 mm (n = 65). Pregnancy rates were evaluated. Treatment outcomes of the groups were further analyzed related to endometrial thickness measurement on the day of hCG. For this purpose, cycles were placed into three subgroups as follows: endometrial thickness 9 mm. There was no statistically significant difference in clinical pregnancy rate per cycle between the groups (8.5, 10, and 9.2 % for Group I, II, and III, respectively, p = 0.86). In further analyses related to endometrial thickness, no significant difference was also found in pregnancy rate among the groups. This results suggest that pregnancy rate is not related to leading follicle size on the day of hCG administration in PCOS patients treated with CC and IUI. In addition, pregnancy rate in women with different follicular sizes is not influenced by the endometrial thickness.

  6. Link between defoliation and light treatments on root vitality of five understory shrubs with different resistance to insect herbivory.

    Science.gov (United States)

    Karolewski, Piotr; Zadworny, Marcin; Mucha, Joanna; Napierała-Filipiak, Anna; Oleksyn, Jacek

    2010-08-01

    Understory shrubs are frequently attacked by insect herbivores. However, very little is known regarding possible interactions between light condition, defoliation (D) and fine root vitality (% live roots) and metabolic activity, and whether different plant strategies (compensation, trade-off and equilibrium) to defoliation depend on individual species light requirements. To explore the response of roots to such conditions, an experiment was established in which we experimentally removed 50% of leaves in 1-year-old seedlings of Sambucus nigra, Cornus sanguinea, Prunus serotina, Frangula alnus and Corylus avellana grown in 15% and full sunlight. On average, defoliation leads to a 15% reduction in fine root (vitality (% live roots). However, a statistically significant reduction in root vitality after defoliation was detected only in those species that are less herbivorized in nature (48% in S. nigra and 5% in C. sanguinea). On average, shade conditions (L) resulted in 18% decline in root vitality, and the effects of defoliation were also 22% higher than for plants grown in full light. Root vitality in both treatments (D and L) was significantly correlated with their dry mass, concentration of total phenol (TPh) and carbon to nitrogen ratio, and negatively correlated with nitrogen, soluble carbohydrates, starch and total non-structural carbohydrates (TNC). To a large extent, root vitality and chemistry varied by species. Higher root vitality was related to higher concentrations of phenolics, more than to N and TNC concentrations. Concentrations of phenolics also differed significantly between defoliated plants and controls. However, in defoliated plants, an increase in TPh was observed only in two species, which belong to two different groups in light requirements and susceptibility to insect grazing (C. sanguinea and P. serotina). This study indicated that higher vitality of roots occurred in species that are characterized by higher insect defoliation under natural

  7. Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Vijay Shekhar

    2013-01-01

    Full Text Available The aim of this case report is to present two cases where cone beam computed tomography (CBCT was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma from a fluid-filled lesion or cavity (cyst. In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions.

  8. Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

    Science.gov (United States)

    Shekhar, Vijay; Shashikala, K.

    2013-01-01

    The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions. PMID:23762646

  9. Effects of different surface treatments and accelerated artificial aging on the bond strength of composite resin repairs.

    Science.gov (United States)

    Melo, Marco Aurélio Veiga de; Moysés, Marcos Ribeiro; Santos, Saulo Galvão dos; Alcântara, Carlos Eduardo Pinto; Ribeiro, José Carlos Rabelo

    2011-01-01

    The purpose of the present study was to assess the bond strength of composite resin repairs subjected to different surface treatments and accelerated artificial aging. 192 cylindrical samples (CSs) were prepared and divided into 24 groups (n = 8). Half of the CSs were stored in water for 24 h, and the other half were subjected to C-UV accelerated aging for non-metallic specimens. The treatments were phosphoric acid + silane + adhesive (PSA); phosphoric acid + adhesive (PA); diamond bur + phosphoric acid + silane + adhesive (DPSA); diamond bur + phosphoric acid + adhesive (DPA); air abrasion + phosphoric acid + silane + adhesive (APSA); and air abrasion + phosphoric acid + adhesive (APA). The repair was performed and the specimens were again aged as described above. A control group (n = 8) was established and did not receive any type of aging or surface treatment. The specimens were loaded to failure in shear mode with a crosshead speed of 0.5 mm/min until fracture. Data were analyzed by one-way ANOVA/Tukey's test (p aged PSA and PA achieved low bonding values and were statistically different from the control group, whereas the non-aged PSA and PA presented no statistically significant difference from the control group. Repairs with the proposed surface treatments were viable on both recent and aged restorations; however, phosphoric acid + adhesive alone were effective only on recent restorations.

  10. Ultra-large single crystals by abnormal grain growth.

    Science.gov (United States)

    Kusama, Tomoe; Omori, Toshihiro; Saito, Takashi; Kise, Sumio; Tanaka, Toyonobu; Araki, Yoshikazu; Kainuma, Ryosuke

    2017-08-25

    Producing a single crystal is expensive because of low mass productivity. Therefore, many metallic materials are being used in polycrystalline form, even though material properties are superior in a single crystal. Here we show that an extraordinarily large Cu-Al-Mn single crystal can be obtained by abnormal grain growth (AGG) induced by simple heat treatment with high mass productivity. In AGG, the sub-boundary energy introduced by cyclic heat treatment (CHT) is dominant in the driving pressure, and the grain boundary migration rate is accelerated by repeating the low-temperature CHT due to the increase of the sub-boundary energy. With such treatment, fabrication of single crystal bars 70 cm in length is achieved. This result ensures that the range of applications of shape memory alloys will spread beyond small-sized devices to large-scale components and may enable new applications of single crystals in other metallic and ceramics materials having similar microstructural features.Growing large single crystals cheaply and reliably for structural applications remains challenging. Here, the authors combine accelerated abnormal grain growth and cyclic heat treatments to grow a superelastic shape memory alloy single crystal to 70 cm.

  11. Comparison of three different approaches in the treatment of chronic low back pain.

    Science.gov (United States)

    Koldaş Doğan, Sebnem; Sonel Tur, Birkan; Kurtaiş, Yeşim; Atay, Mesut Birol

    2008-07-01

    Our aim is to investigate the effects of three therapeutic approaches in the chronic low back pain on pain, spinal mobility, disability, psychological state, and aerobic capacity. Sixty patients with chronic low back pain were randomized to three groups: group 1, aerobic exercise + home exercise; group 2, physical therapy (hot pack, ultrasound, TENS) + home exercise; group 3, home exercise only. Spinal mobility, pain severity, disability, and psychological disturbance of the patients were assessed before and after the treatment and at 1-month follow-up. Aerobic capacities of the patients were measured before and after treatment. All of the groups showed similar decrease in pain after the treatment and at 1-month follow-up, and there was no significant difference between the groups. In group 2, a significant decrease in Beck Depression Inventory scores was observed with treatment. At 1-month follow-up, group 1 and 2 showed significant decreases in General Health Assessment Questionnaire scores. In group 2, there was also a significant improvement in Roland Morris Disability scores. There were similar improvements in exercise test duration and the MET levels in all the three groups. All of the three therapeutic approaches were found to be effective in diminishing pain and thus increasing aerobic capacity in patients with chronic low back pain. On the other hand, physical therapy + home exercise was found to be more effective regarding disability and psychological disturbance.

  12. Gender-related differences in rhythm control treatment in persistent atrial fibrillation : data of the Rate Control Versus Electrical Cardioversion (RACE) study

    NARCIS (Netherlands)

    Rienstra, Michiel; Van Veldhuisen, Dirk J; Hagens, Vincent E; Ranchor, Adelita V; Veeger, Nic J G M; Crijns, Hendrikus; Van Gelder, Isabelle C

    2005-01-01

    Objectives: This study sought to compare whether gender affects the outcome of rate versus rhythm control treatment in patients with persistent atrial fibrillation (AF). Background: Large trials have shown that rate control is an acceptable alternative to rhythm control. However, the effects of

  13. Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment.

    Science.gov (United States)

    Nordahl, Håkon; Havnen, Audun; Hansen, Bjarne; Öst, Lars-Göran; Kvale, Gerd

    2018-04-01

    Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  14. LOW PRESSURE CARBURIZING IN A LARGE-CHAMBER DEVICE FOR HIGH-PERFORMANCE AND PRECISION THERMAL TREATMENT OF PARTS OF MECHANICAL GEAR

    Directory of Open Access Journals (Sweden)

    Emilia Wołowiec-Korecka

    2017-03-01

    Full Text Available This paper presents the findings of research of a short-pulse low pressure carburizing technology developed for a new large-chamber furnace for high-performance and precision thermal treatment of parts of mechanical gear. Sections of the article discuss the novel constructions of the device in which parts being carburized flow in a stream, as well as the low-pressure carburizing experiment. The method has been found to yield uniform, even and repeatable carburized layers on typical gear used in automotive industry.

  15. Comparison of intelligence quotient in children surviving leukemia who received different prophylactic central nervous system treatments

    OpenAIRE

    Nahid, Reisi; Leila, Khalilian

    2012-01-01

    Background: Neurocognitive deficits and decrease in intelligence quotient (IQ) is one of the complication of prophylactic central nervous system (CNS) treatment in acute lymphoblastic leukemia (ALL) patients. In this study, we compare the IQ in survivors of ALL that were treated with different prophylactic CNS treatments. Materials and Methods : We compared 43 long-term survivors of ALL: 21 survivors with intrathecal methotrexate (IT MTX) as CNS prophylaxis, 22 with IT MTX+1800-2400 rads c...

  16. Are single-parent families different from two-parent families in the treatment of adolescent bulimia nervosa using family-based treatment?

    Science.gov (United States)

    Doyle, Angela Celio; McLean, Carmen; Washington, Blaine N; Hoste, Renee Rienecke; le Grange, Daniel

    2009-03-01

    To examine whether family-based treatment (FBT) for adolescent bulimia nervosa (BN), which emphasizes family involvement in helping to reduce binge eating and purging behaviors, is differentially efficacious in single-parent families versus two-parent families. Forty-one adolescents (97.6% female; 16.0 +/- 1.7 years old) with either BN (n = 18) or subthreshold BN (n = 23) were randomized to FBT as part of a larger randomized controlled trial studying treatments for adolescent BN. Two-parent (n = 27; 65.9%) and single-parent (n = 14; 34.2%) families were compared on demographic variables, presence of comorbid psychiatric illnesses, and symptoms of BN at baseline, post, and 6-month follow-up. ANOVA and chi-square analyses revealed no statistically significant differences between two-parent and single-parent families on any variables with the exception of ethnicity, for which a greater proportion of Caucasians and Hispanic families had two- parent families compared with African-American families (chi(2) = 8.68, p = .01). These findings suggest that FBT may be an appropriate and efficacious treatment for single-parent families as well as two-parent families, despite the reliance on parental intervention to reduce bulimic symptoms and normalize eating patterns.

  17. Visualization and measurement of gas-liquid metal two-phase flow with large density difference using thermal neutrons as microscopic probes

    International Nuclear Information System (INIS)

    Mishima, K.; Hibiki, T.; Saito, Y.; Nishihara, H.; Tobita, Y.; Konishi, K.; Matsubayashi, M.

    1999-01-01

    In a core melt accident of a fast breeder reactor, there is a possibility of boiling of the fuel-steel mixture in the containment pool. In relation to safety evaluation on severe accident, it is indispensable to evaluate the possibility of re-criticality of melted core. Gas-liquid two-phase flow with a large liquid-to-gas density ratio is formed due to the boiling of fuel-steel mixture. Although it is anticipated that the large density ratio may affect the basic characteristics of two-phase flow, little work has been performed so far on two-phase flow with a large liquid-to-gas density ratio. In this study, visualization and void fraction measurement of gas-liquid metal two-phase flow were performed by using neutron radiography and image processing techniques. Then, the effect of large density difference between gas and liquid phases on the basic flow characteristics of two-phase flow was clarified

  18. Methods of Improving Water Treatment Systems for Individual Residential Houses

    Directory of Open Access Journals (Sweden)

    Pavlov Sergey

    2016-01-01

    Full Text Available One of hot topics for ecological management is sewage treatment today in places where there is no sewerage. The volume of country construction in territories, which are not connected to the public sewage system increasing nowadays. Therefore, problem of wastewater treatment take place. Currently, there are a lot of different designs of local waste treatment plants is offered to consumers. However, a large number of negative reviews indicate serious shortcomings in most of the local plants offered in the market. The purpose of this paper is the proposal of improvement of the most common local treatment plants in Russia.

  19. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    Directory of Open Access Journals (Sweden)

    Marieke B. Snijder

    2017-01-01

    Full Text Available Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18–70 y from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31–40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37–53% had HbA1c levels on target (≤7.0%; only Dutch men had HbA1c levels on target more often (67%. Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups.

  20. Thorough Chemical Decontamination with the MEDOC Process : Batch Treatment of Dismantled Pieces or Loop Treatment of Large Components Such as the BR3 Steam Generator and Pressurizer

    International Nuclear Information System (INIS)

    Ponnet, M.; Klein, M.; Massaut, V.; Davain, H.; Aleton, G.

    2003-01-01

    The dismantling of the BR3-PWR reactor leads to the production of large masses of contaminated metallic pieces, including structural materials, primary pipings, tanks and heat exchangers. One of our main objectives is to demonstrate that we can minimize the volume of radioactive waste in an economical way, by the use of alternative waste routes, such as the clearance of materials after thorough decontamination. The SCKoCEN uses its own developed chemical decontamination process, so-called MEDOC (Metal Decontamination by Oxidation with Cerium), based on the use of cerium IV as strong oxidant in sulphuric acid with continuous regeneration using ozone. An industrial installation has been designed and constructed in close collaboration with Framatome-ANP (France). This installation started operation in September 1999 for the treatment of the metallic pieces arising from the dismantling of the BR3 reactor. Since then, more than 25 tons of contaminated material including primary pipes have been treated batchwise with success. 75 % of material could be directly cleared after treatment (Activity lower than 0.1 Bq/g for 60Co) and the other 25% free released after melting activity. The SCKoCEN performed in April 2002 the closed loop decontamination of the BR3 Steam Generator by connection of the MEDOC plant after few adaptations. The decontamination was done within 30 cycles in 3 weeks with consecutive steps like decontamination steps (injection of the solution into the SG) and regeneration steps with ozone. In total, 60 hours of decontamination at 70 C and 130 hours of regeneration were needed to reach the objectives. The tube bundle (600 m2) was attacked and about 10 (micro)m representing more than 41 kg of stainless steel and 2.06 GBq of 60Co was dissolved into the solution. The residual contamination measurements made directly into the water box are still going on, however it seems that the objective to reach the free release criteria after melting is achieved. The next

  1. Treatment and Response to Statins: Gender-related Differences.

    Science.gov (United States)

    Raparelli, Valeria; Pannitteri, Gaetano; Todisco, Tommaso; Toriello, Filippo; Napoleone, Laura; Manfredini, Roberto; Basili, Stefania

    2017-01-01

    Response to drug administration is a primary determinant for treatment success. Sex and gender disparities play a role in determining the efficacy and safety of the most commonly used medications suggesting the need for a sex-tailored approach in prescription. Statins are a cost-effective strategy for cardiovascular disease (CVD) prevention. While statins are similarly effective in secondary CVD prevention, some concerns raised by conflicting data reported in primary CVD prevention clinical trials. The small representation of women in clinical trials and the fewer rates of events due to the lower female baseline CVD risk may have conditioned contradictory meta-analysis findings. Specifically, benefits outweigh disadvantages of statin therapy in women with a high CVD risk, while several doubts exist for the primary prevention of women at low-intermediate CVD risk. Furthermore, disparities between women and men in medication adherence may influence statin efficacy in CVD prevention. The sex-dependent impact of adverse side effects is one of the reasons advocated for explaining the gender gap, but it is not evidence-proved. The present review summarizes the sex and gender differences in the use of statins, pointing out new perspectives and opening issues in sex-tailored CVD prevention strategy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

    Full Text Available Background: Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD. Objective: 1 To describe three main large-scale networks of the human brain; 2 to discuss the functioning of these neural networks in PTSD and related symptoms; and 3 to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method: Literature relevant to this commentary was reviewed. Results: Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network, increased and decreased arousal/interoception (salience network, and an altered sense of self (default mode network. Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions: Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.

  3. [Large vessel vasculitides].

    Science.gov (United States)

    Morović-Vergles, Jadranka; Puksić, Silva; Gracanin, Ana Gudelj

    2013-01-01

    Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in young ages. Although all large arteries can be affected, the aorta, subclavian and carotid arteries are most commonly involved. The most common symptoms included upper extremity claudication, hypertension, pain over the carotid arteries (carotidynia), dizziness and visual disturbances. Early diagnosis and treatment has improved the outcome in patients with TA.

  4. Contrasting trait syndromes in angiosperms and conifers are associated with different responses of tree growth to temperature on a large scale

    OpenAIRE

    Carnicer i Cols, Jofre

    2013-01-01

    Recent large-scale studies of tree growth in the Iberian Peninsula reported contrasting positive and negative effects of temperature in Mediterranean angiosperms and conifers. Here we review the different hypotheses that may explain these trends and propose that the observed contrasting responses of tree growth to temperature in this region could be associated with a continuum of trait differences between angiosperms and conifers. Angiosperm and conifer trees differ in the effects of phenolog...

  5. Contrasting trait syndromes in angiosperms and conifers are associated with different responses of tree growth to temperature on a large scale.

    OpenAIRE

    Jofre eCarnicer; Adria eBarbeta; Dominik eSperlich; Dominik eSperlich; Marta eColl; Josep ePenuelas

    2013-01-01

    Recent large-scale studies of tree growth in the Iberian Peninsula reported contrasting positive and negative effects of temperature in Mediterranean angiosperms and conifers. Here we review the different hypotheses that may explain these trends and propose that the observed contrasting responses of tree growth to temperature in this region could be associated with a continuum of trait differences between angiosperms and conifers. Angiosperm and conifer trees differ in the effects of phenolog...

  6. Advance of study on the influence of different drugs on the efficacy of 131I treatment for Graves' disease

    International Nuclear Information System (INIS)

    Wang Peng; Tan Jian

    2011-01-01

    Graves' disease is the most common cause of hyperthyroidism. 131 I treatment is one main treatment method for Graves' disease, and being used on an increasing scale in China recently. During the peritherapeutic period, however, the application of other drugs may affect the efficacy of 131 I treatment. In this review, the advances of study were summarized on the influence of different drugs on the efficacy of 131 I treatment in recent years. (authors)

  7. Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector computed tomography versus 18FDG positron emission tomography/computed tomography in initial staging and restaging after treatment.

    Science.gov (United States)

    Gómez León, Nieves; Vega, Gema; Rodríguez-Vigil Junco, Beatriz; Suevos Ballesteros, Carlos

    2018-04-25

    To prospectively compare the accuracy in initial staging and end-of-treatment restaging of diffuse large B-cell lymphoma (DLBCL) between 64-slice multidetector computed tomography (64MDCT) and 18FDG positron emission tomography/computed tomography (18FGD PET/CT) with intravenous contrast injection. Randomised and blind controlled clinical multicentric trial that included biopsy-proven DLBCL patients. Seventy-two patients from five different hospitals in the region of Madrid, Spain, were enrolled in the study between January 2012 and June 2015. Thirty-six were randomly allocated to 18FDG PET/TC and the other 36 to 64MDCT for initial staging and end-of-treatment restaging. A nuclear medicine physician and a radiologist independently analysed 18FDG PET/TC images and reached an agreement post-hoc. 64MDCT images were separately evaluated by a different radiologist. Every set of images was compared to the reference standard that included clinical data, complementary tests and follow-up. The study was approved by participating centres' ethics committees and written informed consent was obtained from all the participants. A good agreement was observed between both diagnostic techniques and the reference standard in initial staging [18FDG PET/CT (k=0.5) and 64MDCT (k=0.6)], although only the 18FDG PET/TC showed a good agreement with the reference standard for the end-of-treatment restaging (k=0.7). In DLBCL, both 18FDG PET/TC and 64MDCT have shown good agreement with the reference standard in initial staging. Nevertheless, 18FDG PET/CT has shown to be superior to 64MDCT in end-of-treatment response assessment. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  8. State estimation for large-scale wastewater treatment plants.

    Science.gov (United States)

    Busch, Jan; Elixmann, David; Kühl, Peter; Gerkens, Carine; Schlöder, Johannes P; Bock, Hans G; Marquardt, Wolfgang

    2013-09-01

    Many relevant process states in wastewater treatment are not measurable, or their measurements are subject to considerable uncertainty. This poses a serious problem for process monitoring and control. Model-based state estimation can provide estimates of the unknown states and increase the reliability of measurements. In this paper, an integrated approach is presented for the optimization-based sensor network design and the estimation problem. Using the ASM1 model in the reference scenario BSM1, a cost-optimal sensor network is designed and the prominent estimators EKF and MHE are evaluated. Very good estimation results for the system comprising 78 states are found requiring sensor networks of only moderate complexity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Large scale electrolysers

    International Nuclear Information System (INIS)

    B Bello; M Junker

    2006-01-01

    Hydrogen production by water electrolysis represents nearly 4 % of the world hydrogen production. Future development of hydrogen vehicles will require large quantities of hydrogen. Installation of large scale hydrogen production plants will be needed. In this context, development of low cost large scale electrolysers that could use 'clean power' seems necessary. ALPHEA HYDROGEN, an European network and center of expertise on hydrogen and fuel cells, has performed for its members a study in 2005 to evaluate the potential of large scale electrolysers to produce hydrogen in the future. The different electrolysis technologies were compared. Then, a state of art of the electrolysis modules currently available was made. A review of the large scale electrolysis plants that have been installed in the world was also realized. The main projects related to large scale electrolysis were also listed. Economy of large scale electrolysers has been discussed. The influence of energy prices on the hydrogen production cost by large scale electrolysis was evaluated. (authors)

  10. Pharmacotherapeutic directions of iodine herbal remedies use for different groups of thyroid deseases treatment

    Directory of Open Access Journals (Sweden)

    Інна Миколаївна Владимирова

    2015-11-01

    Full Text Available Recently, the increase of endocrine diseases is observed worldwide. Diabetes mellitus and thyroid gland pathologies are the most widespread. Endocrine diseases can be acute or chronic. In some cases, they are life threatening.There are different reasons of thyroid gland pathologies development. Both poor nutrition and poor quality water use, and unfavorable environmental conditions, including radiation, are among them. Iodine deficiency is determined to be one of the main reasons of these diseases.Aim. Determination of the pharmacotherapeutic directions of iodine herbal remedies use for different groups of thyroid diseases treatment.Methods. Thyroid stimulating action determination (primary screening and model pathology has been carried out by the method of “goiter reaction” in rats at the Central Scientific-Research Laboratory of National University of Pharmacy. Determination of thyroid hormone blood level in rats has been carried out at the Laboratory of Radioactive Endocrinology of the State Institution “Grigoriev Institute for medical Radiology NAMS of Ukraine”.Results. According to the research results generalization, correctness of developed algorithms was confirmed; peculiarities of the influence on pathological processes in thyroid, and prospects of implementation and use of herbs and herbal remedies for thyroid diseases prevention and treatment were determined.Conclusion. Obtained experimental data are actual for the modern medicine, and new scientific research, specifying their place in etiology, pathogenesis and peculiarities of clinical course of many diseases, will improve the efficiency of treatment and prevention of thyroid diseases

  11. How Do Psychiatrists Apply the Minimum Clinically Important Difference to Assess Patient Responses to Treatment?

    Directory of Open Access Journals (Sweden)

    Alan J. McMichael BSc

    2016-11-01

    Full Text Available Symptom report scales are used in clinical practice to monitor patient outcomes. Using them permits the definition of a minimum clinically important difference (MCID beyond which a patient may be judged as having responded to treatment. Despite recommendations that clinicians routinely use MCIDs in clinical practice, statisticians disagree about how MCIDs should be used to evaluate individual patient outcomes and responses to treatment. To address this issue, we asked how clinicians actually use MCIDs to evaluate patient outcomes in response to treatment. Sixty-eight psychiatrists made judgments about whether hypothetical patients had responded to treatment based on their pre- and posttreatment change scores on the widely used Positive and Negative Syndrome Scale. Psychiatrists were provided with the scale’s MCID on which to base their judgments. Our secondary objective was to assess whether knowledge of the patient’s genotype influenced psychiatrists’ responder judgments. Thus, psychiatrists were also informed of whether patients possessed a genotype indicating hyperresponsiveness to treatment. While many psychiatrists appropriately used the MCID, others accepted a far lower posttreatment change as indicative of a response to treatment. When psychiatrists accepted a lower posttreatment change than the MCID, they were less confident in such judgments compared to when a patient’s posttreatment change exceeded the scale’s MCID. Psychiatrists were also less likely to identify patients as responders to treatment if they possessed a hyperresponsiveness genotype. Clinicians should recognize that when judging patient responses to treatment, they often tolerate lower response thresholds than warranted. At least some conflate their judgments with information, such as the patient’s genotype, that is irrelevant to a post hoc response-to-treatment assessment. Consequently, clinicians may be at risk of persisting with treatments that have failed

  12. Patterns of drug treatment entry by Latino male injection drug users from different national/geographical backgrounds.

    Science.gov (United States)

    Reynoso-Vallejo, Humberto; Chassler, Deborah; Witas, Julie; Lundgren, Lena M

    2008-02-01

    This study examined patterns of treatment entry by Puerto Rican, Central American, Dominican, and other Latino male injection drug users (IDUs) in the state of Massachusetts over the time period 1996-2002. Specifically, it explored whether these populations had different patterns relative to three paths: entry into detoxification only, entry into residential treatment, or entry into methadone maintenance. Using a state-level MIS dataset on all substance abuse treatment entries to all licensed treatment programs, bi-variate and logistic regression methods were employed to examine patterns of drug treatment utilization among Latino men residing in Massachusetts. Three logistic regression models, which controlled for age, education, homelessness, employment, history of mental health treatment, health insurance, criminal justice involvement, having injected drugs in the past month, and number of treatment entries, indicated that Puerto Rican men were significantly less likely to only use detoxification services and residential treatment services, and significantly more likely to enter methadone maintenance compared to Latino men from Central American, Dominican, or other Latino backgrounds. For example, Central American men were 2.4 times more likely to enter only detoxification programs and 54% less likely to enter methadone maintenance programs than Puerto Rican male IDUs. For program planning, include the need to (a) develop varied drug treatment services to meet the needs of non-homogenous Latino groups within the population, (b) tailor outreach efforts to effectively reach all Latino groups, and (c) increase awareness among practitioners of differential patterns of treatment utilization.

  13. Dose Distribution over Different Parts of Cancer Patients During Radiotherapy Treatment in Bangladesh

    International Nuclear Information System (INIS)

    Miah, F.K.; Ahmed, M.F.; Begum, Z.; Alam, B.; Chowdhury, Q.

    1998-01-01

    Measurements have been carried out to determine the dose distribution over different parts of the body of 12 cancer patients during radiotherapy treatment. Patients with breast cancer, lung cancer, cervix and larynx cancer treated with either X ray therapy or 60 Co therapy were particularly considered. The doses to the organs and tissues outside the primary beam of the patients under treatment were found to vary with a maximum value of 9096 ± 25 mSv at the neck of a lung cancer patient to a minimum value of 2 ± 0.5 mSv at the right leg of a breast cancer patient. The variation of doses was well explained by the exposure and patient data given for each patient. The measured data in each part of the body have been found to be consistent indicating confidence in the measurements. (author)

  14. Large Retailers’ Financial Services

    OpenAIRE

    Risso, Mario

    2010-01-01

    Over the last few years, large retailers offering financial services have considerably grown in the financial services sector. Retailers are increasing the wideness and complexity of their offer of financial services. Large retail companies provide financial services to their customers following different strategic ways. The provision of financial services in the retailers offer is implemented in several different ways related to the strategies, the structures and the degree of financial know...

  15. Effectiveness of psychotherapy in personality disorders not otherwise specified : A comparison of different treatment modalities

    NARCIS (Netherlands)

    Horn, E.K.; Bartak, A.; Meerman, A.M.M.A.; Rossum, B.V.; Ziegler, U.M.; Thunissen, M.A.G.; Soons, M.; Andrea, H.; Hamers, E.F.M.; Emmelkamp, P.M.G.; Stijnen, T.; Busschbach, J.J.V.; Verheul, R.

    2015-01-01

    Objective Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in

  16. Differences in passenger car and large truck involved crash frequencies at urban signalized intersections: an exploratory analysis.

    Science.gov (United States)

    Dong, Chunjiao; Clarke, David B; Richards, Stephen H; Huang, Baoshan

    2014-01-01

    The influence of intersection features on safety has been examined extensively because intersections experience a relatively large proportion of motor vehicle conflicts and crashes. Although there are distinct differences between passenger cars and large trucks-size, operating characteristics, dimensions, and weight-modeling crash counts across vehicle types is rarely addressed. This paper develops and presents a multivariate regression model of crash frequencies by collision vehicle type using crash data for urban signalized intersections in Tennessee. In addition, the performance of univariate Poisson-lognormal (UVPLN), multivariate Poisson (MVP), and multivariate Poisson-lognormal (MVPLN) regression models in establishing the relationship between crashes, traffic factors, and geometric design of roadway intersections is investigated. Bayesian methods are used to estimate the unknown parameters of these models. The evaluation results suggest that the MVPLN model possesses most of the desirable statistical properties in developing the relationships. Compared to the UVPLN and MVP models, the MVPLN model better identifies significant factors and predicts crash frequencies. The findings suggest that traffic volume, truck percentage, lighting condition, and intersection angle significantly affect intersection safety. Important differences in car, car-truck, and truck crash frequencies with respect to various risk factors were found to exist between models. The paper provides some new or more comprehensive observations that have not been covered in previous studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Microstructure and texture evolution of different high manganese cast steels during hot deformation and subsequent treatment

    Energy Technology Data Exchange (ETDEWEB)

    Lima, M.N.S.; Andrade, C.D.; Abreu, H.F.G. de; Klug, J.; Masoumi, M., E-mail: mohammad@alu.ufc.br [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Depto. de Engenharia Metalurgica e de Materiais; Ferreira, W.M. [Universidade Federal do Piaui (UFPI), Teresina, PI (Brazil). Curso de Engenharia Mecanica

    2016-07-01

    Microstructure and texture evolution were studied in two different austenitic high manganese cast steels in each processing condition. Special attention was paid to the effects of hot deformation and subsequent treatment on grain orientation behavior. The roles of Mn and C elements as well as heat treatment processes were investigated by Thermo-Calc. The texture evolutions in the as-cast, solution heat treatment, as-rolled and subsequent treatment were explored via orientation distribution function. The results showed that face-centred cube austenite was developed in steels. Strong {110}<115> texture component was characterized in as-cast in both alloys. Then, the inhomogeneity microstructure and the pronounced microsegregations were removed by annealing and Brass {110}<112>, {110}<111> and {221}<102> components were formed. Finally, cube {001}<100> component was developed during hot rolling in samples. (author)

  18. Microstructure and texture evolution of different high manganese cast steels during hot deformation and subsequent treatment

    International Nuclear Information System (INIS)

    Lima, M.N.S.; Andrade, C.D.; Abreu, H.F.G. de; Klug, J.; Masoumi, M.; Ferreira, W.M.

    2016-01-01

    Microstructure and texture evolution were studied in two different austenitic high manganese cast steels in each processing condition. Special attention was paid to the effects of hot deformation and subsequent treatment on grain orientation behavior. The roles of Mn and C elements as well as heat treatment processes were investigated by Thermo-Calc. The texture evolutions in the as-cast, solution heat treatment, as-rolled and subsequent treatment were explored via orientation distribution function. The results showed that face-centred cube austenite was developed in steels. Strong {110}<115> texture component was characterized in as-cast in both alloys. Then, the inhomogeneity microstructure and the pronounced microsegregations were removed by annealing and Brass {110}<112>, {110}<111> and {221}<102> components were formed. Finally, cube {001}<100> component was developed during hot rolling in samples. (author)

  19. How differences matter: tracing diversity practices in obesity treatment and health promotion.

    Science.gov (United States)

    Felt, Ulrike; Felder, Kay; Penkler, Michael

    2017-01-01

    Diversity has become a buzzword in medical care, denoting a re-evaluation of what it means to attend to differences among human bodies and lives. Questions about what types of differences matter and how they should be defined have become important normative and analytical challenges. Drawing on two case studies, we show how differences between patients and patient-collectives are not simply waiting to be recognised and addressed but also enacted within situated healthcare practices. Although concerns with diversity are present in both cases, they take different forms. In a Viennese health-promotion project for obese clients, care practices are both based on and reproduce large-scale categories that divide the population into distinct subgroups with specific needs. Conversely, in an outpatient clinic for bariatric surgery patients, a technical fix-oriented procedure leads to concerns over diversity becoming an add-on realised by tending to each patient's idiosyncrasies and personal stories. By tracing the practices of diversity and the tensions they produce, we show how classifications and understandings of human difference are based on infrastructures that enable and constrain them. Furthermore, we discuss how they become consequential in healthcare, thereby indicating the importance of remaining reflexive about the political implications of diversity discourse and practice. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  20. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark.

    Science.gov (United States)

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-02-24

    A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Yearly incidence of meniscal procedures per 100,000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. 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.

  1. Comparison the Efficacy of Four Different Alpha Blockers in the Treatment of Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Fatih Fırat

    2011-05-01

    Full Text Available Aim: Benign prostatic hyperplasia (BPH also known as nodular hyperplasia, benign enlargement of the prostate refers to the increase in size of the prostate in middle aged and elderly men. Although four different types of specific alpha blocker have been used in the treatment of BPH it remains controversial that which alpha adrenergic blocker is effective than others. The aim of this study is to compare the efficacy of 4 different alpha blockers agents on the treatment of BPH. Material and Methods: Between June 2005 and December 2008 a total of 135 consecutive patients with diagnosed of BPH were evaluated in our clinic. Patients were randomized into four groups according to alpha blocker types as fallows: group I, doxazosin 4 mg; group II, tamsulosin 0.4 mg; group III, terazosin 5 mg; and group IV, alfuzosin 10 mg. All patients were followed up with International Prostatic Symptom Score (IPSS, maximal urinary flow rates (Qmax and adverse effects were determined at baseline and again at least 3 months as efficacy parameters. Results: The mean age of the patients were 59.8±5.4 years, 58.9±6.4 years, 58.7±5.1 years, and 59.2±5.5 years in group I, group II, group III, and group IV, respectively (p>0.05. After 3 months treatment with alpha blockers the improvements in IPSS were found as 2.73, 3.73, 3.55 and 4.44 in group I, group II, group III, and group IV, respectively. Maximum urine flow rates increased as 2.81 ml/sec, 3.24 ml/sec, 3.88 ml/sec and 4.49 ml/sec in group I, group II, group III, and group IV, respectively. However, among 4 alpha blockers statistically significant difference was found only between doxazosin and alfuzosin groups according to uroflowmetry and IPSS results. According to these results, when compared adverse effect, the significant difference was observed only in tamsulosine group. Conclusions: As a result we can say that except retrograde ejaculation in tamsulosine group, adverse effects are not different between the

  2. Integration of HIV and TB Services Results in Improved TB Treatment Outcomes and Earlier Prioritized ART Initiation in a Large Urban HIV Clinic in Uganda

    NARCIS (Netherlands)

    Hermans, Sabine M.; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M. A.; Hoepelman, Andy I. M.; Coutinho, Alex; Manabe, Yukari C.

    2012-01-01

    Background: The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to

  3. Preliminary study of steep pulse irreversible electroporation technology in human large cell lung cancer cell lines L9981

    Directory of Open Access Journals (Sweden)

    Song Zuoqing

    2013-01-01

    Full Text Available Our aim was to validate the effectiveness of steep pulse irreversible electroporation technology in human large cell lung cancer cells and to screen the optimal treatment of parameters for human large cell lung cancer cells. Three different sets of steep pulse therapy parameters were applied on the lung cancer cell line L9981. The cell line L9981 inhibition rate and proliferation capacity were detected by Vi-Cell vitality analysis and MTT. Steep pulsed irreversible electroporation technology for large cell lung cancer L9981 presents killing effects with various therapy parameters. The optimal treatment parameters are at a voltage amplitude of 2000V/cm, pulse width of 100μs, pulse frequency of 1 Hz, pulse number 10. With this group of parameters, steep pulse could have the best tumor cell-killing effects.

  4. Large granular lymphocytic leukaemia pathogenesis and management.

    Science.gov (United States)

    Dearden, Claire

    2011-02-01

    The WHO classification recognises three distinct disorders of large granular lymphocytes: T-cell large granular lymphocytic leukaemia (T-LGL), chronic lymphoproliferative disorders of NK-cells (CLPD-NK) and agressive NK-cell leukaemia. Despite the different cell of origin, there is considerable overlap between T-LGL and CLPD-NK in terms of clinical presentation and therapy. Many patients are asymptomatic and do not require treatment. Therapy, with immunosuppressant agents such as low dose methotrexate or ciclosporin, is usually indicated to correct cytopenias. In contrast, aggressive NK-cell leukaemia and the rare CD56(+) aggressive T-LGL leukaemia follow a fulminant clinical course, affect younger individuals and require more intensive combination chemotherapy followed by allogeneic stem cell transplant in eligible patients. The relative rarity of these disorders means that there have been few clinical trials to inform management. However, there is now considerable interest in the pathogenesis of the chronic LGL leukaemias and this has stimulated early trials to evaluate novel agents which target the dysregulated apoptotic pathways characteristic of this disease. © 2010 Blackwell Publishing Ltd.

  5. Gender differences in addiction severity.

    Science.gov (United States)

    Díaz-Mesa, Eva M; García-Portilla, Paz; Fernández-Artamendi, Sergio; Sáiz, Pilar A; Bobes Bascarán, Teresa; Casares, María José; Fonseca, Eduardo; Al-Halabí, Susana; Bobes, Julio

    2016-06-14

    Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.

  6. Rural-Urban Differences in Household Treatment-Seeking Behaviour for Suspected Malaria in Children at Bata District, Equatorial Guinea.

    Directory of Open Access Journals (Sweden)

    Maria Romay-Barja

    Full Text Available Malaria remains a major cause of morbidity and mortality among children under five years old in Equatorial Guinea. However, little is known about the community management of malaria and treatment-seeking patterns. We aimed to assess symptoms of children with reported malaria and treatment-seeking behaviour of their caretakers in rural and urban areas in the Bata District.A cross-sectional study was conducted in the district of Bata and 440 houses were selected from 18 rural villages and 26 urban neighbourhoods. Differences between rural and urban caregivers and children with reported malaria were assessed through the chi-squared test for independence of categorical variables and the t-Student or the non-parametric Mann-Whitney test for normally or not-normally distributed continuous variables, respectively.Differences between rural and urban households were observed in caregiver treatment-seeking patterns. Fever was the main symptom associated with malaria in both areas. Malaria was treated first at home, particularly in rural areas. The second step was to seek treatment outside the home, mainly at hospital and Health Centre for rural households and at hospital and private clinic for urban ones. Artemether monotherapy was the antimalarial treatment prescribed most often. Households waited for more than 24 hours before seeking treatment outside and delays were longest in rural areas. The total cost of treatment was higher in urban than in rural areas in Bata.The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District. Important steps for reducing malaria morbidity and mortality in this area are to provide sufficient supplies of effective antimalarial drugs and to improve malaria treatment skills in households and in both public and private sectors.

  7. Characterization of the oxide grown on Zr-20 Nb with different heat treatments in water at high temperature

    International Nuclear Information System (INIS)

    Olmedo, Ana M.; Bordoni, Roberto; Koenig, Patricia

    2003-01-01

    This work presents the corrosion behaviour of Zr-20 Nb alloy with different heat treatments. All the samples were annealed at 850 C degrees for one hour and cooled in air. After this heat treatment the sample coupons were aged at different temperatures and times. The corrosion kinetic of the different coupon samples were determined in water at 315 C degrees. The microstructure of the oxides were analysed using X-ray diffraction. The oxides grown in water steam at 400 C degrees, in coupons with a β Zr microstructure and in coupons aged in order to obtain a α Zr· + β Nb microstructure were also analysed. The oxides grown at the different temperatures and for all the microstructures were very adherent and black for all the times studied. The corrosion kinetics showed that the aging treatments decrease the corrosion rate of this material in degassed water at 315 C degrees and also in water steam at 400 C degrees. The greatest corrosion resistance is achieved for the equilibrium or near equilibrium microstructure of the samples and the presence of the · phase does not decrease the corrosion resistance of the material. The microstructure analysis of the oxides indicated that oxides grown on samples with β Zr microstructure are composed mainly by a Zr-Nb oxide of the type Nb 2 O 5· 6ZrO 2 , together with a small fraction of monoclinic ZrO 2 . Aging treatments produce an increase of the monoclinic phase and diminish the proportion of the mixed oxide. When the aging treatment gives the equilibrium or near equilibrium microstructure of α Zr· + β Nb , the oxide is composed mainly of monoclinic ZrO 2 , a small proportion of tetragonal component and also Nb 2 O 5 . (author)

  8. Gender Differences in Treatment of Severe Carotid Stenosis After TIA

    Science.gov (United States)

    Poisson, Sharon N.; Johnston, S. Claiborne; Sidney, Stephen; Klingman, Jeffrey G.; Nguyen-Huynh, Mai N.

    2010-01-01

    Background and Purpose Gender differences in carotid endarterectomy (CEA) rates after transient ischemic attack (TIA) are not well studied, though some reports suggest that eligible men are more likely to have CEA than women after stroke. Methods We retrospectively identified all patients diagnosed with TIA and ≥70% carotid stenosis on ultrasound in 2003-2004 from 19 emergency departments. Medical records were abstracted for clinical data, 90-day follow-up events including stroke, cardiovascular events or death, CEA within 6 months, and post-operative 30-day outcomes. We assessed gender as a predictor of CEA and its complications, adjusting for demographic and clinical variables, as well as time to CEA between groups. Results Of 299 patients identified, 47% were women. Women were older with higher presenting SBP and less likely to smoke or to have CAD or diabetes. Fewer women (36.4%) had CEA than men (53.8%) (p=0.004). Reasons for withholding surgical treatment were similar in women and men, and there were no differences in follow-up stroke, CV event, postoperative complications or death. Time to CEA was also significantly delayed in women. Conclusions Women with severe carotid stenosis and recent TIA are less likely to undergo CEA than men, and surgeries are more delayed. PMID:20651270

  9. The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

    Directory of Open Access Journals (Sweden)

    Branden A. Smeester

    2013-01-01

    Full Text Available Osteosarcoma is the most common malignant bone tumor found in children and adolescents and is associated with many complications including cancer pain and metastasis. While cancer patients often seek complementary and alternative medicine (CAM approaches to treat cancer pain and fatigue or the side effects of chemotherapy and treatment, there is little known about the effect of acupuncture treatment on tumor growth and metastasis. Here we evaluate the effects of six different electroacupuncture (EA regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3 beginning at postimplantation day 3 (PID 3. Twice weekly treatment produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7, starting at PID 7, there was a significant increase in tumor growth. We further demonstrate that EA-2X/3 treatment elicits significant reductions in tumor lymphatics, vasculature, and innervation. Lastly, EA-2X/3 treatment produced a marked reduction in pulmonary metastasis, thus providing evidence for EA’s potential antimetastatic capabilities. Collectively, EA-2X/3 treatment was found to reduce both bone tumor growth and lung metastasis, which may be mediated in part through reductions in tumor-associated vasculature, lymphatics, and innervation.

  10. A treatment of expansive soil using different additives

    Directory of Open Access Journals (Sweden)

    Bestun J. Nareeman

    2010-11-01

    Full Text Available There are many factors that govern the expansion behavior of soil. The primary factors are a change in water contentand the amount and type of clay size particles in the soil. Other important factors affecting the expansion behavior include the typeof soil (natural or fill, condition of the soil in terms of dry density and moisture content, magnitude of the surcharge pressure,and amount of no expansive material such as gravel or cobble size particles.In this paper, a swelling soil from the site Hamamuk earth dam, which is located in Koya town north of Iraq, is treated by fourtypes of additives; cement, steel fibers, gasoline fuel and injection by cement grout.The treatment of the expansive soil with 5 % of cement or steel fibers or the injection with cement grout revealed a betterimprovement while 4 % of gasoline oil is sufficient to reveal the optimum treatment by this material. The angle of internal friction is notaffected by the treatment while the cohesion between particles is slightly affected by these additives due to a change in the adhesionbetween the additive and soil particles.

  11. Influence of different surface treatments on the fracture toughness of a commercial ZTA dental ceramic

    Directory of Open Access Journals (Sweden)

    Flavio Teixeira da Silva

    2007-03-01

    Full Text Available The objective of this study was to investigate how mechanical surface treatments performed for removal of excess of molten glass, influence the fracture toughness of a dental zirconia toughened alumina (In-Ceram® Zirconia. Infiltrated ZTA disks were submitted to three different surface treatments (grinding, sandblasting and grinding + sandblasting + annealing. Fracture toughness was accessed through indentation strength test (IS. X ray diffraction was used to investigate the metastability of tetragonal zirconia particles under all treatments proposed. Kruskall-Wallis non-parametrical test and Weibull statistics were used to analyze the results. Grinding (group 1 introduced defects which decreased the fracture toughness and reliability, presenting the lowest K IC. On the other hand, grinding followed by sandblasting and annealing (group 3 presented the highest K IC. Sandblasting (group 2 presented the highest reliability but lower K IC compared to group 3.

  12. Retroflex Versus Bunched in Treatment for Rhotic Misarticulation: Evidence From Ultrasound Biofeedback Intervention

    Science.gov (United States)

    Byun, Tara McAllister; Hitchcock, Elaine R.; Swartz, Michelle T.

    2014-01-01

    Purpose To document the efficacy of ultrasound biofeedback treatment for misarticulation of the North American English rhotic in children. Because of limited progress in the first cohort, a series of two closely related studies was conducted in place of a single study. The studies differed primarily in the nature of tongue-shape targets (e.g., retroflex, bunched) cued during treatment. Method Eight participants received 8 weeks of individual ultrasound biofeedback treatment targeting rhotics. In Study 1, all 4 participants were cued to match a bunched tongue-shape target. In Study 2, participants received individualized cues aimed at eliciting the tongue shape most facilitative of perceptually correct rhotics. Results Participants in Study 1 showed only minimal treatment effects. In Study 2, all participants demonstrated improved production of rhotics in untreated words produced without biofeedback, with large to very large effect sizes. Conclusions The results of Study 2 indicate that with proper parameters of treatment, ultrasound biofeedback can be a highly effective intervention for children with persistent rhotic errors. In addition, qualitative comparison of Studies 1 and 2 suggests that treatment for the North American English rhotic should include opportunities to explore different tongue shapes, to find the most facilitative variant for each individual speaker. PMID:25088034

  13. Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome

    Energy Technology Data Exchange (ETDEWEB)

    Jakobsson, H.; Jernberg, C.; Andersson, A.F.; Sjolund-Karlsson, M.; Jansson, J.K.; Engstrand, L.

    2010-01-15

    Antibiotic administration is the standard treatment for the bacterium Helicobacter pylori, the main causative agent of peptic ulcer disease and gastric cancer. However, the long-term consequences of this treatment on the human indigenous microbiota are relatively unexplored. Here we studied short- and long-term effects of clarithromycin and metronidazole treatment, a commonly used therapy regimen against H. pylori, on the indigenous microbiota in the throat and in the lower intestine. The bacterial compositions in samples collected over a four year period were monitored by analyzing the 16S rRNA gene using 454-based pyrosequencing and terminal-restriction fragment length polymorphism (T-RFLP). While the microbial communities of untreated control subjects were relatively stable over time, dramatic shifts were observed one week after antibiotic treatment with reduced bacterial diversity in all treated subjects in both locations. While the microbiota of the different subjects responded uniquely to the antibiotic treatment some general trends could be observed; such as a dramatic decline in Actinobacteria in both throat and feces immediately after treatment. Although the diversity of the microbiota subsequently recovered to resemble the pre treatment states, the microbiota remained perturbed in some cases for up to four years post treatment. In addition, four years after treatment high levels of the macrolide resistance gene erm(B) were found, indicating that antibiotic resistance, once selected for, can persist for longer periods of time than previously recognized. This highlights the importance of a restrictive antibiotic usage in order to prevent subsequent treatment failure and potential spread of antibiotic resistance.

  14. Effectivity of fluoride treatment on hydrogen and corrosion product generation in temporal implants for different magnesium alloys.

    Science.gov (United States)

    Trinidad, Javier; Arruebarrena, Gurutze; Marco, Iñigo; Hurtado, Iñaki; Sáenz de Argandoña, Eneko

    2013-12-01

    The increasing interest on magnesium alloys relies on their biocompatibility, bioabsorbility and especially on their mechanical properties. Due to these characteristics, magnesium alloys are becoming a promising solution to be used, as temporary implants. However, magnesium alloys must overcome their poor corrosion resistance. This article analyses the corrosion behaviour in phosphate-buffered saline solution of three commercial magnesium alloys (AZ31B, WE43 and ZM21) as well as the influence of fluoride treatment on their corrosion behaviour. It is shown that the corrosion rate of all the alloys is decreased by fluoride treatment. However, fluoride treatment affects each alloy differently.

  15. Effect of Thermal Fields on the Structure of Corrosion-Resistant Steels Under Different Modes of Laser Treatment

    Science.gov (United States)

    Tarasova, T. V.; Gusarov, A. V.; Protasov, K. E.; Filatova, A. A.

    2017-11-01

    The influence of temperature fields on the structure and properties of corrosion-resistant chromium steels under different modes of laser treatment is investigated. A model of heat transfer under laser impact on target is used to plot thermal fields and cycles and cooling rates. It is shown that the model used for computing thermal fields gives tentative geometric sizes of the fusion zones under laser treatment and selective laser fusion. The cooling rate is shown to have decisive influence on the structure of corrosion-resistant steels after laser treatment with surface fusion in devices for pulsed, continuous, and selective laser melting.

  16. Population-level differences in revascularization treatment and outcomes among various United States subpopulations

    Institute of Scientific and Technical Information of China (English)

    Garth Graham; Yang-Yu Karen Xiao; Dan Rappoport; Saima Siddiqi

    2016-01-01

    Despite recent general improvements in health care, significant disparities persist in the cardiovascular care of women and racial/ethnic minorities. This is true even when income, education level, and site of care are taken into consideration. Possible explanations for these disparities include socioeconomic considerations, elements of discrimination and racism that affect socioeconomic status, and access to adequate medical care. Coronary revascularization has become the accepted and recommended treatment for myocardial infarction(MI) today and is one of the most common major medical interventions in the United States, with more than 1 million procedures each year. This review discusses recent data on disparities in co-morbidities and presentation symptoms, care and access to medical resources, and outcomes in revascularization as treatment for acute coronary syndrome, looking especially at women and minority populations in the United States. The data show that revascularization is used less in both female and minority patients. We summarize recent data on disparities in co-morbidities and presentation symptoms related to MI; access to care, medical resources, and treatments; and outcomes in women, blacks, and Hispanics. The picture is complicated among the last group by the many Hispanic/Latino subgroups in the United States. Some differences in outcomes are partially explained by presentation symptoms and co-morbidities and external conditions such as local hospital capacity. Of particular note is the striking differential in both presentation co-morbidities and mortality rates seen in women, compared to men, especially in women ≤ 55 years of age. Surveillance data on other groups in the United States such as American Indians/Alaska Natives and the many Asian subpopulations show disparities in risk factors and co-morbidities, but revascularization as treatment for MI in these populations has not been adequately studied. Significant research is required to

  17. A retrospective analysis of different modalities for treatment of primary orbital non-Hodgkin's lymphomas

    International Nuclear Information System (INIS)

    Esik, Olga; Ikeda, H.; Mukai, K.; Kaneko, A.

    1996-01-01

    We have reviewed 37 patients with primary orbital lymphoma, using the Ann Arbor criteria and the Working Formulation and its modification. Thirty-one patients had stage I disease, four stage II, one stage III and one stage IV. The male to female ratio was 2.7:1. There were 34 low-grade tumours (including 24 mantle zone) and three intermediate-grade. Patients were divided into three groups according to their primary treatment. Group 1: radiotherapy (17 cases); Group 2: surgery alone (13 cases); Group 3: chemotherapy (seven cases). Patients were followed up from 5 months to 24.3 years, with a mean and median of 7.6 and 6.2 years, respectively. The BMDP software package was used for survival estimation (Kaplan-Meier) and determination of prognostic variable (univariate Cox regression). Local relapse-free survival at 10 years was 100% in Group 1, 0% in Group 2 and 42% in Group 3 with a statistically significant difference (p < 0.01) in favour of radiotherapy. Statistically significant good prognostic features were: complete remission (CR) in response to initial treatment, primary radiotherapy and older age. For stage I cases, there was no difference in distant relapse-free survival in the three groups. The overall cause-specific survival for stage I patients at 10 years was 100% for each group and at 20 years was 100, 67 and 0% for Group 1, 2 and 3. The difference between the primary radiotherapy and chemotherapy-treated groups was significant at the p = 0.08 level. Statistically significant prognostic factors were early stage, low-grade histology and primary radiotherapy. In one patient, ptosis and diplopia appeared after surgery. One case of glaucoma required enucleation, one patient suffered severe dry eye syndrome. All patients ((11(11))) in whom the lens received direct radiation developed cataracts of different degrees if follow-up was long enough. Cataract formation was prevented by adequate lens shielding. One patient in CR from a stage I low-grade tumour died

  18. Improvement of Strength-Toughness-Hardness Balance in Large Cross-Section 718H Pre-Hardened Mold Steel

    Science.gov (United States)

    Liu, Hanghang; Fu, Paixian; Liu, Hongwei; Li, Dianzhong

    2018-01-01

    The strength-toughness combination and hardness uniformity in large cross-section 718H pre-hardened mold steel from a 20 ton ingot were investigated with three different heat treatments for industrial applications. The different microstructures, including tempered martensite, lower bainite, and retained austenite, were obtained at equivalent hardness. The microstructures were characterized by using metallographic observations, scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and electron back-scattered diffraction (EBSD). The mechanical properties were compared by tensile, Charpy U-notch impact and hardness uniformity tests at room temperature. The results showed that the test steels after normalizing-quenching-tempering (N-QT) possessed the best strength-toughness combination and hardness uniformity compared with the conventional quenched-tempered (QT) steel. In addition, the test steel after austempering-tempering (A-T) demonstrated the worse hardness uniformity and lower yield strength while possessing relatively higher elongation (17%) compared with the samples after N-QT (14.5%) treatments. The better ductility of A-T steel mainly depended on the amount and morphology of retained austenite and thermal/deformation-induced twined martensite. This work elucidates the mechanisms of microstructure evolution during heat treatments and will highly improve the strength-toughness-hardness trade-off in large cross-section steels. PMID:29642642

  19. Improvement of Strength-Toughness-Hardness Balance in Large Cross-Section 718H Pre-Hardened Mold Steel

    Directory of Open Access Journals (Sweden)

    Hanghang Liu

    2018-04-01

    Full Text Available The strength-toughness combination and hardness uniformity in large cross-section 718H pre-hardened mold steel from a 20 ton ingot were investigated with three different heat treatments for industrial applications. The different microstructures, including tempered martensite, lower bainite, and retained austenite, were obtained at equivalent hardness. The microstructures were characterized by using metallographic observations, scanning electron microscopy (SEM, transmission electron microscopy (TEM, X-ray diffraction (XRD, and electron back-scattered diffraction (EBSD. The mechanical properties were compared by tensile, Charpy U-notch impact and hardness uniformity tests at room temperature. The results showed that the test steels after normalizing-quenching-tempering (N-QT possessed the best strength-toughness combination and hardness uniformity compared with the conventional quenched-tempered (QT steel. In addition, the test steel after austempering-tempering (A-T demonstrated the worse hardness uniformity and lower yield strength while possessing relatively higher elongation (17% compared with the samples after N-QT (14.5% treatments. The better ductility of A-T steel mainly depended on the amount and morphology of retained austenite and thermal/deformation-induced twined martensite. This work elucidates the mechanisms of microstructure evolution during heat treatments and will highly improve the strength-toughness-hardness trade-off in large cross-section steels.

  20. Strength and microstructure of IPS Empress 2 glass-ceramic after different treatments.

    Science.gov (United States)

    Oh, S C; Dong, J K; Lüthy, H; Schärer, P

    2000-01-01

    This investigation was designed to determine whether heat pressing and/or simulated heat treatments affect the flexure strength and microstructure of the lithium disilicate glass-ceramic of the IPS Empress 2 system. Four groups of the lithium disilicate glass-ceramic were prepared as follows: group 1 = as-received material; group 2 = heat-pressed material; group 3 = heat-pressed and stimulated initial heat-treated material; and group 4 = heat-pressed and simulated heat-treated material with full firings for a final restoration. Three-point bending tests and scanning electron microscopy (SEM) analysis were conducted. The flexure strength of group 2 was significantly higher than that of group 1. However, there were no significant differences in strength among groups 2, 3, and 4, or between groups 1 and 4. The SEM micrographs of the lithium disilicate glass-ceramic showed a closely packed, multidirectionally interlocking microstructure of numerous lithium disilicate crystals protruding from the glass matrix. The crystals in the glass matrix of the heat-pressed materials (groups 2, 3, and 4) were a little more homogeneous and about 2 times bigger than those of the as-received material (group 1). These changes of the microstructure were greatest between groups 1 and 2. However, there were no marked differences among groups 2, 3, and 4. Although there were significant increases in the strength and some changes of the microstructure after the heat-pressing operation, the combination of heat pressing and simulated subsequent heat treatments did not produce an increase of strength of IPS Empress 2 glass-ceramic.

  1. Aerobic granular SBR systems applied to the treatment of industrial effluents

    International Nuclear Information System (INIS)

    Rio, V. del; Figueroa, M.; Arrojo, B.; Mosquera-Corral, A.; Campos, J. L.; Garcia-Torriello, G.; Mendez, R.

    2009-01-01

    Systems based on aerobic granular biomass are an alternative to the conventional activated sludge plants for wastewater treatment. Large organic and nitrogen loads are treated in these systems where biomass grown as granules, easy to separate by setting, make unnecessary the construction of secondary settler reducing the surface requirements for the treatment system construction. Furthermore, in aerobic granular reactors simultaneously carbon and nitrogen removal is feasible. These systems have been already applied at laboratory scale for the treatment of different types of industrial and urban wastewater. (Author)

  2. Aerobic granular SBR systems applied to the treatment of industrial effluents

    Energy Technology Data Exchange (ETDEWEB)

    Rio, V. del; Figueroa, M.; Arrojo, B.; Mosquera-Corral, A.; Campos, J. L.; Garcia-Torriello, G.; Mendez, R.

    2009-07-01

    Systems based on aerobic granular biomass are an alternative to the conventional activated sludge plants for wastewater treatment. Large organic and nitrogen loads are treated in these systems where biomass grown as granules, easy to separate by setting, make unnecessary the construction of secondary settler reducing the surface requirements for the treatment system construction. Furthermore, in aerobic granular reactors simultaneously carbon and nitrogen removal is feasible. These systems have been already applied at laboratory scale for the treatment of different types of industrial and urban wastewater. (Author)

  3. Severe Upper Gastrointestinal Hemorrhage from Linear Gastric Ulcers in Large Hiatal Hernias: a Large Prospective Case Series of Cameron Ulcers

    Science.gov (United States)

    Camus, Marine; Jensen, Dennis M.; Ohning, Gordon V.; Kovacs, Thomas O.; Ghassemi, Kevin A.; Jutabha, Rome; Machicado, Gustavo A.; Dulai, Gareth S.; Hines, Joel O.

    2013-01-01

    Background and study aims Cameron ulcers are a rare but clinically significant cause of severe upper gastrointestinal hemorrhage (SUGIH). Our aims were to describe (1) the diagnosis, treatment and outcomes of patients with Cameron ulcers causing hospitalization for SUGIH, (2) the differences between patients with occult vs. overt bleeding and (3) between patients treated surgically and medically. Patients and methods Over the past 17 years, all consecutive patients hospitalized in our two tertiary referral medical centers for severe UGIH or severe obscure GIH and entered into our large prospective databasis were screened for Cameron ulcer diagnosis. Results Cameron ulcers were diagnosed in 25 patients of 3960 patients with SUGIH (0.6%). 21 patients had follow-up (median [IQR] time of 20.4 months [8.5–31.8]). Patients were more often elderly females with chronic anemia, always had large hiatal hernias, and were usually referred for obscure SUGIH. Twelve (57.2%) patients were referred to surgery for rebleeding and recurrent blood loss while treated with high dose of proton pump inhibitors (PPI). 9 (42.8%) other patients continued PPI without any rebleeding during the follow-up. Patients with overt bleeding had significantly more prior hospitalizations for SUGIH, more often stigmata of hemorrhage on ulcers, and more red blood cell transfusions than patients with occult bleeding. However, there was no difference in rebleeding and mortality rates between the two groups. Conclusions Cameron ulcers in large hiatal hernias are an uncommon cause of SUGIH. Most of patients are referred for obscure GIH. The choice of medical vs. surgical therapy should be individualized. PMID:23616128

  4. The effect of different surface treatments of stainless steel crown and different bonding agents on shear bond strength of direct composite resin veneer

    Directory of Open Access Journals (Sweden)

    Ajami B

    2007-01-01

    Full Text Available Background and Aim: Stainless steel crown (SSC is the most durable and reliable restoration for primary teeth with extensive caries but its metalic appearance has always been a matter of concern. With advances in restorative materials and metal bonding processes, composite veneer has enhanced esthetics of these crowns in clinic. The aim of this study was to evaluate the shear bond strength of SSC to composite resin using different surface treatments and adhesives. Materials and Methods: In this experimental study, 90 stainless steel crowns were selected. They were mounted in molds and divided into 3 groups of 30 each (S, E and F. In group S (sandblast, buccal surfaces were sandblasted for 5 seconds. In group E (etch acidic gel was applied for 5 minutes and in group F (fissure bur surface roughness was created by fissure diamond bur. Each group was divided into 3 subgroups (SB, AB, P based on different adhesives: Single Bond, All Bond2 and Panavia F. Composite was then bonded to specimens. Cases were incubated in 100% humidity at 37°C for 24 hours. Shear bond strength was measured by Zwick machine with crosshead speed of 0.5 mm/min. Data were analyzed by ANOVA test with p0.05 so the two variables were studied separately. No significant difference was observed in mean shear bond strength of composite among the three kinds of adhesives (P>0.05. Similar results were obtained regarding surface treatments (P>0.05. Conclusion: Based on the results of this study, treating the SSC surface with bur and using single bond adhesive and composite can be used successfully to obtain esthetic results in pediatric restorative treatments.

  5. Multi-staged robotic stereotactic radiosurgery for large cerebral arteriovenous malformations

    International Nuclear Information System (INIS)

    Ding, Chuxiong; Solberg, Timothy D.; Hrycushko, Brian; Medin, Paul; Whitworth, Louis; Timmerman, Robert D.

    2013-01-01

    Purpose: To investigate a multi-staged robotic stereotactic radiosurgery (SRS) delivery technique for the treatment of large cerebral arteriovenous malformations (AVMs). The treatment planning process and strategies to optimize both individual and composite dosimetry are discussed. Methods: Eleven patients with large (30.7 ± 19.2 cm 3 ) AVMs were selected for this study. A fiducial system was designed for fusion of targets between planar angiograms and simulation CT scans. AVMs were contoured based on single contrast CT, MRI and orthogonal angiogram images. AVMs were divided into 3–8 sub-target volumes (3–7 cm 3 ) for sequential treatment at 1–4 week intervals to a prescription dose of 16–20 Gy. Forward and inversely developed treatment plans were optimized for 95% coverage of the total AVM volume by dose summation from each sub-volume, while minimizing dose to surrounding tissues. Dose-volume analysis was used to evaluate the PTV coverage, dose conformality (CI), and R 50 and V 12Gy parameters. Results: The treatment workflow was commissioned and able to localize within 1 mm. Inverse optimization outperformed forward planning for most patients for each index considered. Dose conformality was shown comparable to staged Gamma Knife treatments. Conclusion: The CyberKnife system is shown to be a practical delivery platform for multi-staged treatments of large AVMs using forward or inverse planning techniques

  6. Using stable isotopes to determine seasonal variations in water uptake of summer maize under different fertilization treatments

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Ying, E-mail: maying@igsnrr.ac.cn [Key Laboratory of Water Cycle and Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 100101 Beijing (China); State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, 210008 Nanjing (China); Song, Xianfang [Key Laboratory of Water Cycle and Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 100101 Beijing (China)

    2016-04-15

    Fertilization and water both affect root water uptake in the nutrient and water cycle of the Soil-Plant-Atmosphere-Continuum (SPAC). In this study, dual stable isotopes (D and {sup 18}O) were used to determine seasonal variations in water uptake patterns of summer maize under different fertilization treatments in Beijing, China during 2013–2014. The contributions of soil water at different depths to water uptake were quantified by the MixSIAR Bayesian mixing model. Water uptake was mainly sourced from soil water in the 0–20 cm depth at the seeding (67.7%), jointing (60.5%), tasseling (47.5%), dough (41.4%), and harvest (43.9%) stages, and the 20–50 cm depth at the milk stage (32.8%). Different levels of fertilization application led to considerable differences in the proportional contribution of soil water at 0–20 cm (6.0–58.5%) and 20–50 cm (6.1–26.3%). There was little difference of contributions in the deep layers (50–200 cm) among treatments in 2013, whereas differences were observed in 50–90 cm at the milk stage and 50–200 cm at the dough stage during 2014. The main water uptake depth was concentrated in the upper soil layers (0–50 cm) during the wet season (2013), whereas a seasonal drought in 2014 promoted the contribution of soil water in deep layers. The contribution of soil water was significantly and positively correlated with the proportions of root length (r = 0.753, p < 0.01). The changes of soil water distribution were consistent with the seasonal variation in water uptake patterns. The present study identified water sources for summer maize under varying fertilization treatments and provided scientific implications for fertilization and irrigation management. - Highlights: • Dual stable isotopes and MixSIAR were coupled to quantify water uptake of maize. • Maize mainly used soil water in 20–50 cm at milk stage and 0–20 cm at other stages. • Fertilization treatments led to distinct water uptake pattern at 0–50 cm

  7. Using stable isotopes to determine seasonal variations in water uptake of summer maize under different fertilization treatments

    International Nuclear Information System (INIS)

    Ma, Ying; Song, Xianfang

    2016-01-01

    Fertilization and water both affect root water uptake in the nutrient and water cycle of the Soil-Plant-Atmosphere-Continuum (SPAC). In this study, dual stable isotopes (D and "1"8O) were used to determine seasonal variations in water uptake patterns of summer maize under different fertilization treatments in Beijing, China during 2013–2014. The contributions of soil water at different depths to water uptake were quantified by the MixSIAR Bayesian mixing model. Water uptake was mainly sourced from soil water in the 0–20 cm depth at the seeding (67.7%), jointing (60.5%), tasseling (47.5%), dough (41.4%), and harvest (43.9%) stages, and the 20–50 cm depth at the milk stage (32.8%). Different levels of fertilization application led to considerable differences in the proportional contribution of soil water at 0–20 cm (6.0–58.5%) and 20–50 cm (6.1–26.3%). There was little difference of contributions in the deep layers (50–200 cm) among treatments in 2013, whereas differences were observed in 50–90 cm at the milk stage and 50–200 cm at the dough stage during 2014. The main water uptake depth was concentrated in the upper soil layers (0–50 cm) during the wet season (2013), whereas a seasonal drought in 2014 promoted the contribution of soil water in deep layers. The contribution of soil water was significantly and positively correlated with the proportions of root length (r = 0.753, p < 0.01). The changes of soil water distribution were consistent with the seasonal variation in water uptake patterns. The present study identified water sources for summer maize under varying fertilization treatments and provided scientific implications for fertilization and irrigation management. - Highlights: • Dual stable isotopes and MixSIAR were coupled to quantify water uptake of maize. • Maize mainly used soil water in 20–50 cm at milk stage and 0–20 cm at other stages. • Fertilization treatments led to distinct water uptake pattern at 0–50 cm depth

  8. Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal

    Directory of Open Access Journals (Sweden)

    Kent David M

    2010-08-01

    Full Text Available Abstract Mounting evidence suggests that there is frequently considerable variation in the risk of the outcome of interest in clinical trial populations. These differences in risk will often cause clinically important heterogeneity in treatment effects (HTE across the trial population, such that the balance between treatment risks and benefits may differ substantially between large identifiable patient subgroups; the "average" benefit observed in the summary result may even be non-representative of the treatment effect for a typical patient in the trial. Conventional subgroup analyses, which examine whether specific patient characteristics modify the effects of treatment, are usually unable to detect even large variations in treatment benefit (and harm across risk groups because they do not account for the fact that patients have multiple characteristics simultaneously that affect the likelihood of treatment benefit. Based upon recent evidence on optimal statistical approaches to assessing HTE, we propose a framework that prioritizes the analysis and reporting of multivariate risk-based HTE and suggests that other subgroup analyses should be explicitly labeled either as primary subgroup analyses (well-motivated by prior evidence and intended to produce clinically actionable results or secondary (exploratory subgroup analyses (performed to inform future research. A standardized and transparent approach to HTE assessment and reporting could substantially improve clinical trial utility and interpretability.

  9. Effect of alkali-treatment on the characteristics of natural zeolites with different compositions.

    Science.gov (United States)

    Ates, Ayten

    2018-08-01

    A series of natural zeolites with different compositions were modified by post-synthesis modification with sodium hydroxide (NaOH) solution. Natural and modified zeolites were characterized by XRD, SEM, nitrogen adsorption, FTIR, zeta potential and temperature programmed desorption of ammonia (NH 3 -TPD). The adsorption capacities of these samples were evaluated by the adsorption of manganese from aqueous solution. The treatment with NaOH led to a decrease in the surface area and microporosity of all natural zeolites as well as partly damage of the zeolite structure depending on zeolite composition. In addition, the amount of weak, medium and strong acid sites in the zeolites was changed significantly by NaOH treatment depending on zeolite composition. The NaOH treatment resulted in a four-fold improvement in adsorption capacity of natural zeolite originated from Bigadic and a twofold decrease in that of the natural zeolite originated from Manisa-Gordes. Although the improved adsorption capacity might be mainly due to modification of porosity in the zeolites and formation of hydroxysodalite, the reduced adsorption capacity of the zeolite might be mainly due to a significant deformation of the zeolite structure. The pseudo-second-order kinetic model for the adsorption of manganese on all natural and modified zeolites fits well. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Efficiency of sewage treatment with septic tanks followed by constructed wetlands with different support materials

    Directory of Open Access Journals (Sweden)

    Delvio Sandri

    2013-04-01

    Full Text Available This study seeks to assess the efficiency of a sewage treatment plant comprised of three compartmentalized septic tanks installed in series followed by three parallel wetlands and seeded with species Typha sp. with subsurface flow, filled with support material of natural gravel, gravel # 2 and washed gravel, respectively. The station treats sewage generated at Unity University for Science and Technology, State University of Goiás – UnUCET/UEG. A total of 20 sewage samples were collected in order to evaluate treatment efficiency from November to December 2010 and March to April 2011. The points of analysis were at the input of the first tank (raw sewage, the output of the third septic tank and the outputs of each of the three wetlands. The total removal efficiencies were: 65.40% for chemical oxygen demand; 79.01% for biochemical oxygen demand; 59.79% for total solids; 87.12% for the total suspended solids; 92.00% for total coliforms; 95.71% for E. coli and 82.54% for turbidity. The system was effective for the treatment of sewage, within the current legislative parameters for pH, turbidity, total solids and biochemical oxygen demand. No significant difference was observed between the three different means of support, suggesting that gravel, natural gravel and washed gravel may potentially be used to fill wetlands.

  11. Investigation of Wear Behaviour of Sewn Assemblies of Viscose Linings with Different Treatment

    Directory of Open Access Journals (Sweden)

    Dainora BAČKAUSKAITĖ

    2011-07-01

    Full Text Available Different types of chemical treatment of textile are widely applied in advanced textile. Finishing of textile can provide additional functional properties for products or/and to improve the appearance of final product as well as to improve their mechanical properties. In this research the influence of the industrial treatment of viscose linings on the parameters of fabric surface friction, on fabric surface appearance as well as on the slippage resistance of yarns at a seam was investigated. Raw, dyed, dyed and softened, dyed and non-slip finished plain weaved linings were investigated. The slippage resistance of yarns at a seam in woven fabrics was evaluated according to standard EN ISO 13936-1:2004. The friction was investigated according to the standard DIN 53375 in a fabric-fabric friction pair. Surface of raw, dyed, dyed and softened viscose lining was investigated using SEM. The obtained results have shown that the friction parameters as well as the parameters of seam slippage resistance of dyed or dyed and softened fabrics were higher than the ones of raw fabric. The highest differences in those parameters were obtained for lining that was dyed and treated with non-slip finishing. That type of finishing influenced the break of lining yarns without typical to the other investigated linings slipping near a stitching line.http://dx.doi.org/10.5755/j01.ms.17.2.485

  12. Social networks and their influence on drinking behaviors: differences related to cognitive impairment in clients receiving alcoholism treatment.

    Science.gov (United States)

    Buckman, Jennifer F; Bates, Marsha E; Cisler, Ron A

    2007-09-01

    Mechanisms of behavioral change that support positive addiction treatment outcomes in individuals with co-occurring alcohol-use disorders and cognitive impairment remain largely unknown. This article combines person- and variable-centered approaches to examine the interrelated influence of cognitive impairment and social support on stability of and changes in drinking behaviors of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) outpatients and aftercare clients (N = 1,726) during the first year after their entry into treatment. Latent class analysis identified homogeneous groups of clients based on the nature and extent of social support for abstinence or drinking at treatment entry. Cognitive impairment and drinking outcomes were compared across latent classes, and the interaction between impairment and social support on drinking outcomes was examined using mixture probit regression. Three independent social support classes (frequent positive, limited positive, and negative) were identified. In the outpatient sample, the frequent positive support class had greater cognitive impairment at treatment entry versus other classes, and extent of impairment significantly predicted improved drinking outcomes in this class. In the aftercare sample, the frequent positive and negative support classes had heightened impairment, yet cognitive impairment significantly predicted relatively poorer drinking outcomes in the negative support class only. Cognitive impairment may increase the influence of the social network on the drinking outcomes of persons receiving treatment for alcohol-use disorders, but more research is needed to understand client characteristics that determine whether this influence is more likely to be manifest as increased salience of helping agents or of hindering agents in the social network.

  13. Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

    Science.gov (United States)

    Standish, Leanna J; Dowd, Fred; Sweet, Erin; Dale, Linda; Andersen, M Robyn

    2018-04-01

    To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor-positive breast cancer appear to have received antiestrogen therapy. Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

  14. Natural organic matter removal by ion exchange at different positions in the drinking water treatment lane

    Directory of Open Access Journals (Sweden)

    A. Grefte

    2013-01-01

    Full Text Available To guarantee a good water quality at the customers tap, natural organic matter (NOM should be (partly removed during drinking water treatment. The objective of this research was to improve the biological stability of the produced water by incorporating anion exchange (IEX for NOM removal. Different placement positions of IEX in the treatment lane (IEX positioned before coagulation, before ozonation or after slow sand filtration and two IEX configurations (MIEX® and fluidized IEX (FIX were compared on water quality as well as costs. For this purpose the pre-treatment plant at Loenderveen and production plant Weesperkarspel of Waternet were used as a case study. Both, MIEX® and FIX were able to remove NOM (mainly the HS fraction to a high extent. NOM removal can be done efficiently before ozonation and after slow sand filtration. The biological stability, in terms of assimilable organic carbon, biofilm formation rate and dissolved organic carbon, was improved by incorporating IEX for NOM removal. The operational costs were assumed to be directly dependent of the NOM removal rate and determined the difference between the IEX positions. The total costs for IEX for the three positions were approximately equal (0.0631 € m−3, however the savings on following treatment processes caused a cost reduction for the IEX positions before coagulation and before ozonation compared to IEX positioned after slow sand filtration. IEX positioned before ozonation was most cost effective and improved the biological stability of the treated water.

  15. RNA-SEQ reveals transcriptional level changes of poplar roots in different forms of nitrogen treatments

    Directory of Open Access Journals (Sweden)

    Chunpu eQu

    2016-02-01

    Full Text Available Poplar has emerged as a model plant for understanding molecular mechanisms of tree growth, development and response to environment. Long-term application of different forms of nitrogen (such as NO3--N and NH4+-N may cause morphological changes of poplar roots; however, the molecular level changes are still not well known. In this study, we analyzed the expression profiling of poplar roots treated by three forms of nitrogen: S1 (NH4+, S2 (NH4NO3 and S3 (NO3- by using RNA-SEQ technique. We found 463 genes significantly differentially expressed in roots by different N treatments, of which a total of 116 genes were found to differentially express between S1 and S2, 173 genes between S2 and S3, and 327 genes between S1 and S3. A cluster analysis shows significant difference in many transcription factor families and functional genes family under different N forms. Through an analysis of Mapman metabolic pathway, we found that the significantly differentially expressed genes are associated with fermentation, glycolysis and tricarboxylic acid cycle (TCA, secondary metabolism, hormone metabolism, and transport processing. Interestingly, we did not find significantly differentially expressed genes in N metabolism pathway, mitochondrial electron transport / ATP synthesis and mineral nutrition. We also found abundant candidate genes (20 transcription factors and 30 functional genes regulating morphology changes of poplar roots under the three N forms. The results obtained are beneficial to a better understanding of the potential molecular and cellular mechanisms regulating root morphology changes under different N treatments.

  16. A clinical distance measure for evaluating treatment plan quality difference with Pareto fronts in radiotherapy

    Directory of Open Access Journals (Sweden)

    Kristoffer Petersson

    2017-07-01

    Full Text Available We present a clinical distance measure for Pareto front evaluation studies in radiotherapy, which we show strongly correlates (r = 0.74 and 0.90 with clinical plan quality evaluation. For five prostate cases, sub-optimal treatment plans located at a clinical distance value of >0.32 (0.28–0.35 from fronts of Pareto optimal plans, were assessed to be of lower plan quality by our (12 observers (p < .05. In conclusion, the clinical distance measure can be used to determine if the difference between a front and a given plan (or between different fronts corresponds to a clinically significant plan quality difference.

  17. Study on emission characteristics and reduction strategy of nitrous oxide during wastewater treatment by different processes.

    Science.gov (United States)

    Sun, Shichang; Bao, Zhiyuan; Sun, Dezhi

    2015-03-01

    Given the inexorable increase in global wastewater treatment, increasing amounts of nitrous oxide are expected to be emitted from wastewater treatment plants and released to the atmosphere. It has become imperative to study the emission and control of nitrous oxide in the various wastewater treatment processes currently in use. In the present investigation, the emission characteristics and the factors affecting the release of nitrous oxide were studied via full- and pilot-scale experiments in anoxic-oxic, sequencing batch reactor and oxidation ditch processes. We propose an optimal treatment process and relative strategy for nitrous oxide reduction. Our results show that both the bio-nitrifying and bio-denitrifying treatment units in wastewater treatment plants are the predominant sites for nitrous oxide production in each process, while the aerated treatment units are the critical sources for nitrous oxide emission. Compared with the emission of nitrous oxide from the anoxic-oxic (1.37% of N-influent) and sequencing batch reactor (2.69% of N-influent) processes, much less nitrous oxide (0.25% of N-influent) is emitted from the oxidation ditch process, which we determined as the optimal wastewater treatment process for nitrous oxide reduction, given the current technologies. Nitrous oxide emissions differed with various operating parameters. Controlling the dissolved oxygen concentration at a proper level during nitrification and denitrification and enhancing the utilization rate of organic carbon in the influent for denitrification are the two critical methods for nitrous oxide reduction in the various processes considered.

  18. The effect of heat treatment on phosphorus segregation in a submerged-arc weld metal

    International Nuclear Information System (INIS)

    Beere, W.B.; Buswell, J.T.

    1999-01-01

    Intergranular fracture (IGF) has been observed in carbon-manganese steels after irradiation or high temperature exposure for prolonged periods. The effect is associated with an increase in the ductile-brittle transition temperature and has been related to phosphorus diffusion to grain boundaries. Phosphorus also diffuses thermally at the temperatures used for post-weld heat treatments such that in principle, the slightly different heat treatments given to different parts of a large vessel could lead to differing grain boundary phosphorus coverage and hence susceptibility to IGF. The effect of typical heat treatments on phosphorus coverage has been investigated using a finite difference model based on a theory that has been fitted to a wide range of constant temperature data. Regardless of previous history, the grain boundary coverage of phosphorus was predicted to depend on the final anneal and cooling rate. These differed insufficiently in the typical heat treatments to produce significant differences in segregation. It was concluded that the ductile-brittle transition temperature in submerged-arc welds would be unaffected in vessels that had seen typical post-weld heat treatments

  19. Non-perturbative treatment of relativistic quantum corrections in large Z atoms

    International Nuclear Information System (INIS)

    Dietz, K.; Weymans, G.

    1983-09-01

    Renormalised g-Hartree-Dirac equations incorporating Dirac sea contributions are derived. Their implications for the non-perturbative, selfconsistent calculation of quantum corrections in large Z atoms are discussed. (orig.)

  20. Functional chest pain responds to biofeedback treatment but functional heartburn does not: what is the difference?

    Science.gov (United States)

    Shapiro, Michael; Shanani, Ram; Taback, Hanna; Abramowich, Dov; Scapa, Eitan; Broide, Efrat

    2012-06-01

    Patients with functional esophageal disorders represent a challenging treatment group. The purpose of this study was to evaluate the role of biofeedback in the treatment of patients with functional esophageal disorders. In this prospective study, patients with typical/atypical symptoms of gastroesophageal reflux disease underwent upper endoscopy and 24-h pH monitoring. All patients filled out gastroesophageal Reflux Disease Symptom, Hospital Anxiety and Depression, and Symptom Stress Rating questionnaires. Patients with functional heartburn and those with functional chest pain were offered biofeedback treatment. A global assessment questionnaire was filled out at the end of treatment and then 2.8 (range 1-4) years later. From January 2006 to December 2009, 22 patients with functional esophageal diseases were included in the study. Thirteen had functional heartburn and nine had functional chest pain. Six patients from each group received biofeedback treatment. After treatment for 1-4 years, patients with functional chest pain showed significant improvements in symptoms compared with those who were not treated. Patients with functional heartburn showed no improvement. Patients with functional chest pain had a longer time of esophageal acid exposure than those with functional heartburn. Patients with functional chest pain have different central and intraesophageal factors associated with symptom generation in comparison with patients with functional heartburn. Biofeedback is a useful tool in the treatment of patients with functional chest pain, but not for those with functional heartburn.