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Sample records for level responding therapeutically

  1. Insulin resistance in clomiphene responders and non-responders with polycystic ovarian disease and therapeutic effects of metformin.

    Science.gov (United States)

    Parsanezhad, M E; Alborzi, S; Zarei, A; Dehbashi, S; Omrani, G

    2001-10-01

    To evaluate the clinical features, endocrine and metabolic profiles in clomiphene (CC) responders and non-responders with polycystic ovarian disease (PCOD), and to examine the effects of metformin (MTF) on the above parameters of CC resistance. A prospective clinical trial was undertaken at the infertility division of a university teaching hospital. Forty-one CC responders were selected and their hormonal and clinical features were determined. Forty-one CC-resistant PCOD women were also selected and clinical features; metabolic and hormonal profiles before and after treatment with MTF 1500 mg/day for 6-8 weeks were evaluated. Women who failed to conceive were treated by CC while continuing to take MTF. CC responders had higher insulin levels while non-responders were hyperinsulinemic. Menstrual irregularities improved in 30%. Mean+/-S.D. area under curve of insulin decreased from 297.58+/-191.33 to 206+/-0.1 mIU/ml per min (P=0.005). Only 39.39% ovulated and 24.24% conceived. PCOD is associated with insulin resistance (IR) particularly in CC-resistant women. Insulin resistance and androgen levels are significantly higher in obese patients. MTF therapy improved hyperandrogenemia, IR, and pregnancy rate.

  2. Perceived levels of burnout of Veterans Administration therapeutic recreation personnel.

    Science.gov (United States)

    Wade-Campbell, K N; Anderson, S C

    1987-01-01

    This study investigated the relationship between work-related variables and perceived levels of burnout of therapeutic recreation personnel who work with long-term psychiatric patients in Veterans Administration hospitals. Subjects completed a three-part instrument composed of a demographic questionnaire, the Maslach Burnout Inventory and the Work Environment Scale. Of the 511 subjects surveyed, 287 (56%) responded with usable questionnaires. The demographic, job- and profession-related variables were found to be significantly related to burnout. The eta values were somewhat low. The WES variables accounted for 20.9% of the variance in the burnout measures. The WES variables accounted for 20.9% of the variance in the burnout measures. The most salient relationships emerged between the emotional exhaustion and the depersonalization subscales and clarity, supervisor support, involvement, work pressure, autonomy, innovation, peer cohesion, task orientation and physical comfort. In comparison with other groups of human service professionals, therapeutic recreation personnel experienced low levels of emotional exhaustion, moderate levels of depersonalization, and somewhat lower levels of personal accomplishment.

  3. Responding to changes in sea level: engineering implications

    National Research Council Canada - National Science Library

    National Research Council Staff; Marine Board; Commission on Engineering and Technical Systems; Division on Engineering and Physical Sciences; National Research Council

    1987-01-01

    ... Mean Sea Level Marine Board Commission on Engineering and Technical Systems National Research Council National Academy Press Washington, D.C. 1987 Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from other this and of recom...

  4. Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

    Science.gov (United States)

    Smoliak, Olga; Le Couteur, Amanda; Quinn-Nilas, Christopher

    2018-03-08

    Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy. © 2018 American Association for Marriage and Family Therapy.

  5. Using pharmacokinetic-pharmacodynamic modelling as a tool for prediction of therapeutic effective plasma levels of antipsychotics

    DEFF Research Database (Denmark)

    Olsen, Christina Kurre; Brennum, Lise Tøttrup; Kreilgaard, Mads

    2008-01-01

    response behaviour correlates well with the relationship between human dopamine D2 receptor occupancy and clinical effect. The aim of the present study was to evaluate how pharmacokinetic/pharmacodynamic (PK/PD) predictions of therapeutic effective steady-state plasma levels by means of conditioned...... the rat dopamine D2 receptor occupancy levels providing 50% response in the conditioned avoidance response test and the dopamine D2 receptor occupancy levels reported from responding schizophrenic patients treated with antipsychotics. Predictions of therapeutically effective steady-state levels...... for sertindole (+dehydrosertindole) and olanzapine were 3-4-fold too high whereas for haloperidol, clozapine and risperidone the predicted steady-state EC50 in conditioned avoidance responding rats correlated well with the therapeutically effective plasma levels observed in patients. Accordingly, the proposed PK...

  6. Vital analysis: annotating sensed physiological signals with the stress levels of first responders in action.

    Science.gov (United States)

    Gomes, P; Kaiseler, M; Queirós, C; Oliveira, M; Lopes, B; Coimbra, M

    2012-01-01

    First responders such as firefighters are exposed to extreme stress and fatigue situations during their work routines. It is thus desirable to monitor their health using wearable sensing but this is a complex and still unsolved research challenge that requires large amounts of properly annotated physiological signals data. In this paper we show that the information gathered by our Vital Analysis Framework can support the annotation of these vital signals with the stress levels perceived by the target user, confirmed by the analysis of more than 4600 hours of data collected from real firefighters in action, including 717 answers to event questionnaires from a total of 454 different events.

  7. Therapeutic CPAP Level Predicts Upper Airway Collapsibility in Patients With Obstructive Sleep Apnea.

    Science.gov (United States)

    Landry, Shane A; Joosten, Simon A; Eckert, Danny J; Jordan, Amy S; Sands, Scott A; White, David P; Malhotra, Atul; Wellman, Andrew; Hamilton, Garun S; Edwards, Bradley A

    2017-06-01

    Upper airway collapsibility is a key determinant of obstructive sleep apnea (OSA) which can influence the efficacy of certain non-continuous positive airway pressure (CPAP) treatments for OSA. However, there is no simple way to measure this variable clinically. The present study aimed to develop a clinically implementable tool to evaluate the collapsibility of a patient's upper airway. Collapsibility, as characterized by the passive pharyngeal critical closing pressure (Pcrit), was measured in 46 patients with OSA. Associations were investigated between Pcrit and data extracted from patient history and routine polysomnography, including CPAP titration. Therapeutic CPAP level, demonstrated the strongest relationship to Pcrit (r2=0.51, p CPAP level (6.2 ± 0.6 vs. 10.3 ± 0.4 cmH2O, p -2 cmH2O). A therapeutic CPAP level ≤8.0 cmH2O was sensitive (89%) and specific (84%) for detecting a mildly collapsible upper airway. When applied to the independent validation data set (n = 74), this threshold maintained high specificity (91%) but reduced sensitivity (75%). Our data demonstrate that a patient's therapeutic CPAP requirement shares a strong predictive relationship with their Pcrit and may be used to accurately differentiate OSA patients with mild airway collapsibility from those with moderate-to-severe collapsibility. Although this relationship needs to be confirmed prospectively, our findings may provide clinicians with better understanding of an individual patient's OSA phenotype, which ultimately could assist in determining which patients are most likely to respond to non-CPAP therapies. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  8. Responding to excessive alcohol consumption in third-level (REACT): a study protocol.

    Science.gov (United States)

    Davoren, Martin P; Calnan, Susan; Mulcahy, Judith; Lynch, Emily; Perry, Ivan J; Byrne, Michael

    2018-05-11

    Problem alcohol use is an ongoing, worldwide phenomenon of considerable concern. Throughout the past 20 years, national policies have noted the importance of students when tackling alcohol consumption. Considering alcohol is a multifaceted issue, a multi-component response is required to combat its excessive use. This protocol sets out the approach used for developing, implementing and evaluating the REACT (Responding to Excessive Alcohol Consumption in Third-level) Programme. This evaluation will provide the evidence base for programme development, implementation and improvement. Stage one involved defining the multi-component intervention. This was developed following a systematic review of existing literature and a Delphi-consensus workshop involving university students, staff and relevant stakeholders. Following this, the programme is being implemented across the Higher Education sector in Ireland. A number of Higher Education Institutes have declined the invitation to participate in the programme. These institutions will act as control sites. Each intervention site will have a steering committee whose membership will include a mix of students and academic and student service staff. This steering committee will report to the REACT research team on the implementation of mandatory and optional action points at local sites. An online cross-sectional study at baseline and two-years post intervention will be utilised to determine the impact of the REACT programme. The impact assessment will focus on (1) whether the intervention has reduced alcohol consumption among third-level students (2); whether the programme altered students attitudes toward alcohol and (3) whether the programme has decreased the second-hand effects associated with excessive consumption. Finally, qualitative research will focus on factors influencing the take-up and implementation of this programme as well as students' views on the initiative. Alcohol consumption has remained on the policy

  9. Sub therapeutic drug levels among HIV/TB co-infected patients ...

    African Journals Online (AJOL)

    Daniel W. Gunda

    2016-11-01

    Nov 1, 2016 ... NVP based regimen was associated with sub-therapeutic drug levels on uni- ... a number of important challenges including induction of sub- therapeutic levels of .... ARV plasma levels in the univariate model with p-values less than 0.05 .... clearance of ARVs.56 This may be one of the explanations that.

  10. The Role of Theory-Specific Techniques and Therapeutic Alliance in Promoting Positive Outcomes: Integrative Psychotherapy for World Trade Center Responders.

    Science.gov (United States)

    Haugen, Peter Tejas; Werth, Aditi Sinha; Foster, Alyce Lauren; Owen, Jesse

    2016-12-01

    World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes.

  11. Optometrists Association Australia Universal (entry-level) and Therapeutic Competency Standards for Optometry 2008.

    Science.gov (United States)

    Kiely, Patricia M

    2009-07-01

    Competency standards for entry-level to the profession of optometry in Australia were first developed in 1993, revised in 1997 and expanded in 2000 to include therapeutic competency standards. The entry-level standards cover the competencies required by a person entering the profession without therapeutic endorsement of their registration. The therapeutic competency standards address the additional competencies required for therapeutic endorsement of registration. This paper presents a revised version of the universal (entry-level) and therapeutic competency standards for the profession of optometry in Australia in 2008. Expert members of the profession and representatives from schools of optometry, registration boards in Australia, state divisions of Optometrists Association Australia and the New Zealand Association of Optometrists were consulted in the process of updating the standards. Three new elements of competency have been added to the standards. Twenty-three new performance criteria with associated indicators have been added. Some performance criteria from the earlier document have been combined. Substantial alterations were made to the presentation of indicators throughout the document. The updated entry-level (universal) and therapeutic competency standards were adopted on behalf of the profession by the National Council of Optometrists Association Australia in November 2008. Competency standards are used by Australian and New Zealand registration authorities for the purposes of registration and therapeutic endorsement of registration via the Optometry Council of Australia and New Zealand accreditation and assessment processes. They have also been used as the basis of the World Council of Optometry Global Competency-Based Model.

  12. Interpersonal Movement Synchrony Responds to High- and Low-Level Conversational Constraints

    Directory of Open Access Journals (Sweden)

    Alexandra Paxton

    2017-07-01

    Full Text Available Much work on communication and joint action conceptualizes interaction as a dynamical system. Under this view, dynamic properties of interaction should be shaped by the context in which the interaction is taking place. Here we explore interpersonal movement coordination or synchrony—the degree to which individuals move in similar ways over time—as one such context-sensitive property. Studies of coordination have typically investigated how these dynamics are influenced by either high-level constraints (i.e., slow-changing factors or low-level constraints (i.e., fast-changing factors like movement. Focusing on nonverbal communication behaviors during naturalistic conversation, we analyzed how interacting participants' head movement dynamics were shaped simultaneously by high-level constraints (i.e., conversation type; friendly conversations vs. arguments and low-level constraints (i.e., perceptual stimuli; non-informative visual stimuli vs. informative visual stimuli. We found that high- and low-level constraints interacted non-additively to affect interpersonal movement dynamics, highlighting the context sensitivity of interaction and supporting the view of joint action as a complex adaptive system.

  13. Eutrophic lichens respond to multiple forms of N: implications for critical levels and critical loads research

    Science.gov (United States)

    Sarah Jovan; Jennifer Riddell; Pamela E Padgett; Thomas Nash

    2012-01-01

    Epiphytic lichen communities are highly sensitive to excess nitrogen (N), which causes the replacement of native floras by N-tolerant, ‘‘weedy’’ eutrophic species. This shift is commonly used as the indicator of ecosystem ‘‘harm’’ in studies developing empirical critical levels (CLE) for ammonia (NH3) and critical loads (CLO) for N. To be most...

  14. Gene expression and plant hormone levels in two contrasting rice genotypes responding to brown planthopper infestation.

    Science.gov (United States)

    Li, Changyan; Luo, Chao; Zhou, Zaihui; Wang, Rui; Ling, Fei; Xiao, Langtao; Lin, Yongjun; Chen, Hao

    2017-02-28

    The brown planthopper (BPH; Nilaparvata lugens Stål) is a destructive piercing-sucking insect pest of rice. The plant hormones salicylic acid (SA) and jasmonic acid (JA) play important roles in plant-pest interactions. Many isolated rice genes that modulate BPH resistance are involved in the metabolism or signaling pathways of SA, JA and ethylene. 'Rathu Heenati' (RH) is a rice cultivar with a high-level, broad-spectrum resistance to all BPH biotypes. Here, RH was used as the research material, while a BPH-susceptible rice cultivar 'Taichung Native 1' (TN1) was the control. A cDNA microarray analysis illuminated the resistance response at the genome level of RH under BPH infestation. The levels of SA and JA in RH and TN1 seedlings after BPH infestation were also determined. The expression pattern clustering indicated that 1467 differential probe sets may be associated with constitutive resistance and 67 with the BPH infestation-responsive resistance of RH. A Venn diagram analysis revealed 192 RH-specific and BPH-inducible probe sets. Finally, 23 BPH resistance-related gene candidates were selected based on the expression pattern clustering and Venn diagram analysis. In RH, the SA content significantly increased and the JA content significantly decreased after BPH infestation, with the former occurring prior to the latter. In RH, the differential genes in the SA pathway were synthesis-related and were up-regulated after BPH infestation. The differential genes in the JA pathway were also up-regulated. They were jasmonate ZIM-domain transcription factors, which are important negative regulators of the JA pathway. Comparatively, genes involved in the ET pathway were less affected by a BPH infestation in RH. DNA sequence analysis revealed that most BPH infestation-inducible genes may be regulated by the genetic background in a trans-acting manner, instead of by their promoters. We profiled the analysis of the global gene expression in RH and TN1 under BPH infestation

  15. Reef Fishes at All Trophic Levels Respond Positively to Effective Marine Protected Areas

    Science.gov (United States)

    Soler, German A.; Edgar, Graham J.; Thomson, Russell J.; Kininmonth, Stuart; Campbell, Stuart J.; Dawson, Terence P.; Barrett, Neville S.; Bernard, Anthony T. F.; Galván, David E.; Willis, Trevor J.; Alexander, Timothy J.; Stuart-Smith, Rick D.

    2015-01-01

    Marine Protected Areas (MPAs) offer a unique opportunity to test the assumption that fishing pressure affects some trophic groups more than others. Removal of larger predators through fishing is often suggested to have positive flow-on effects for some lower trophic groups, in which case protection from fishing should result in suppression of lower trophic groups as predator populations recover. We tested this by assessing differences in the trophic structure of reef fish communities associated with 79 MPAs and open-access sites worldwide, using a standardised quantitative dataset on reef fish community structure. The biomass of all major trophic groups (higher carnivores, benthic carnivores, planktivores and herbivores) was significantly greater (by 40% - 200%) in effective no-take MPAs relative to fished open-access areas. This effect was most pronounced for individuals in large size classes, but with no size class of any trophic group showing signs of depressed biomass in MPAs, as predicted from higher predator abundance. Thus, greater biomass in effective MPAs implies that exploitation on shallow rocky and coral reefs negatively affects biomass of all fish trophic groups and size classes. These direct effects of fishing on trophic structure appear stronger than any top down effects on lower trophic levels that would be imposed by intact predator populations. We propose that exploitation affects fish assemblages at all trophic levels, and that local ecosystem function is generally modified by fishing. PMID:26461104

  16. Reef Fishes at All Trophic Levels Respond Positively to Effective Marine Protected Areas.

    Directory of Open Access Journals (Sweden)

    German A Soler

    Full Text Available Marine Protected Areas (MPAs offer a unique opportunity to test the assumption that fishing pressure affects some trophic groups more than others. Removal of larger predators through fishing is often suggested to have positive flow-on effects for some lower trophic groups, in which case protection from fishing should result in suppression of lower trophic groups as predator populations recover. We tested this by assessing differences in the trophic structure of reef fish communities associated with 79 MPAs and open-access sites worldwide, using a standardised quantitative dataset on reef fish community structure. The biomass of all major trophic groups (higher carnivores, benthic carnivores, planktivores and herbivores was significantly greater (by 40% - 200% in effective no-take MPAs relative to fished open-access areas. This effect was most pronounced for individuals in large size classes, but with no size class of any trophic group showing signs of depressed biomass in MPAs, as predicted from higher predator abundance. Thus, greater biomass in effective MPAs implies that exploitation on shallow rocky and coral reefs negatively affects biomass of all fish trophic groups and size classes. These direct effects of fishing on trophic structure appear stronger than any top down effects on lower trophic levels that would be imposed by intact predator populations. We propose that exploitation affects fish assemblages at all trophic levels, and that local ecosystem function is generally modified by fishing.

  17. Requirement of trained first responders and national level preparedness for prevention and response to radiological terrorism

    International Nuclear Information System (INIS)

    Sharma, R.; Pradeepkumar, K.S.

    2011-01-01

    The increase in the usage of radioactive sources in various fields and the present scenario of adopting various means of terrorism indicates a possible environment for malicious usage of radioactive sources. Many nations, India inclusive, have to strengthen further it's capability to deal with Nuclear/Radiological Emergencies. The probable radiological emergency scenario in public domain involves inadvertent melting of radioactive material, transport accident involving radioactive material/sources and presence of orphan sources as reported elsewhere. Explosion of Radiological Dispersal Device (RDDs) or Improvised Nuclear Devices (IND) leading to spread of radioactive contamination in public places have been identified by IAEA as probable radiological threats. The IAEA documents put lot of emphasis, at national level, on training and educational issues related with Radiological Emergencies. The agencies and institutions dealing with radioactive sources have few personnel trained in radiation protection. Experience so far indicates that public awareness is also not adequate in the field of radiological safety which may create difficulties during emergency response in public domain. The major challenges are associated with mitigation, monitoring methodology, contaminated and overexposed casualties, decontamination and media briefing. In this paper, we have identified the educational needs for response to radiological emergency in India with major thrust on training. The paper has also enumerated the available educational and training infrastructure, the human resources, as well as the important stake holders for development of sustainable education and training programme. (author)

  18. Single Enteral Loading Dose of Phenobarbital for Achieving Its Therapeutic Serum Levels in Neonates

    Science.gov (United States)

    Turhan, Ali H.; Atici, Aytug; Okuyaz, Cetin; Uysal, Sercan

    2010-01-01

    Aim To investigate whether therapeutic serum drug levels may be achieved with a single enteral loading dose of phenobarbital. Methods The study was performed at the Mersin University Hospital in Turkey between April 2004 and August 2006, and included 29 newborn babies with seizure. After the acute treatment of the seizure with midazolam at a dose of 0.1 mg/kg, phenobarbital was administered by orogastric route at a loading dose of 20 mg/kg. Serum phenobarbital concentrations were measured at 0.5, 3, 6, and 12 hours after the loading. Serum phenobarbital levels between 10-30 μg/mL were considered as the therapeutic range. Results The serum phenobarbital levels reached therapeutic values in 9 (31%), 19 (66%), 21 (72%), and 23 (79%) patients at 0.5, 3, 6, and 12 hours after loading, respectively, while they did not reach therapeutic values in 6 patients (21%) after 12 hours. Four of the patients in whom there was no increase in serum phenobarbital levels had hypoxic-ischemic encephalopathy. Conclusion Enteral loading of phenobarbital can achieve therapeutic serum levels in the large majority of newborn babies with seizure and may be safely used in babies with the intact gastrointestinal tract. PMID:20564764

  19. The Role of Metformin Response in Lipid Metabolism in Patients with Recent-Onset Type 2 Diabetes: HbA1c Level as a Criterion for Designating Patients as Responders or Nonresponders to Metformin.

    Directory of Open Access Journals (Sweden)

    Zahra Kashi

    Full Text Available In this study, we investigated whether response to metformin, the most frequently drug for diabetes treatment, influences the therapeutic effects of antilipidemic medication in newly diagnosed patients with type 2 diabetes mellitus (T2DM.A total of 150 patients with T2DM were classified into two groups following 3 months of metformin therapy (1000 mg twice daily: responders (patients showing ≥1% reduction in HbA1c from baseline and nonresponders (patients showing <1% reduction in HbA1c from baseline. The patients received atorvastatin 20 mg, gemfibrozil 300 mg, or atorvastatin 20 mg and gemfibrozil 300 mg daily.HbA1c and fasting glucose levels were significantly different between baseline and 3 months among responders receiving atorvastatin; however, these differences were not statistically significant in nonresponders. Atherogenic ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C; p = 0.002, total cholesterol to HDL-C (TC/HDL-C; p<0.001 and AIP (the atherogenic index of plasma; p = 0.004 decreased significantly in responders receiving atorvastatin than in nonresponders. Moreover, responders receiving atorvastatin showed a significant increase in HDL-C levels but nonresponders receiving atorvastatin did not (p = 0.007. The multivariate model identified a significant association between metformin response (as the independent variable and TG, TC, HDL-C and LDL-C (dependent variables; Wilk's λ = 0.927, p = 0.036.Metformin response affects therapeutic outcomes of atorvastatin on atherogenic lipid markers in patients newly diagnosed with T2DM. Metformin has a greater impact on BMI in responders of metformin compared to nonresponders. Adoption of better therapeutic strategies for reducing atherogenic lipid markers may be necessary for metformin nonresponders.

  20. Trace levels of innate immune response modulating impurities (IIRMIs) synergize to break tolerance to therapeutic proteins.

    Science.gov (United States)

    Verthelyi, Daniela; Wang, Vivian

    2010-12-22

    Therapeutic proteins such as monoclonal antibodies, replacement enzymes and toxins have significantly improved the therapeutic options for multiple diseases, including cancer and inflammatory diseases as well as enzyme deficiencies and inborn errors of metabolism. However, immune responses to these products are frequent and can seriously impact their safety and efficacy. Of the many factors that can impact protein immunogenicity, this study focuses on the role of innate immune response modulating impurities (IIRMIs) that could be present despite product purification and whether these impurities can synergize to facilitate an immunogenic response to therapeutic proteins. Using lipopolysaccharide (LPS) and CpG ODN as IIRMIs we showed that trace levels of these impurities synergized to induce IgM, IFNγ, TNFα and IL-6 expression. In vivo, trace levels of these impurities synergized to increase antigen-specific IgG antibodies to ovalbumin. Further, whereas mice treated with human erythropoietin showed a transient increase in hematocrit, those that received human erythropoietin containing low levels of IIRMIs had reduced response to erythropoietin after the 1(st) dose and developed long-lasting anemia following subsequent doses. This suggests that the presence of IIRMIs facilitated a breach in tolerance to the endogenous mouse erythropoietin. Overall, these studies indicate that the risk of enhancing immunogenicity should be considered when establishing acceptance limits of IIRMIs for therapeutic proteins.

  1. Trace levels of innate immune response modulating impurities (IIRMIs synergize to break tolerance to therapeutic proteins.

    Directory of Open Access Journals (Sweden)

    Daniela Verthelyi

    Full Text Available Therapeutic proteins such as monoclonal antibodies, replacement enzymes and toxins have significantly improved the therapeutic options for multiple diseases, including cancer and inflammatory diseases as well as enzyme deficiencies and inborn errors of metabolism. However, immune responses to these products are frequent and can seriously impact their safety and efficacy. Of the many factors that can impact protein immunogenicity, this study focuses on the role of innate immune response modulating impurities (IIRMIs that could be present despite product purification and whether these impurities can synergize to facilitate an immunogenic response to therapeutic proteins. Using lipopolysaccharide (LPS and CpG ODN as IIRMIs we showed that trace levels of these impurities synergized to induce IgM, IFNγ, TNFα and IL-6 expression. In vivo, trace levels of these impurities synergized to increase antigen-specific IgG antibodies to ovalbumin. Further, whereas mice treated with human erythropoietin showed a transient increase in hematocrit, those that received human erythropoietin containing low levels of IIRMIs had reduced response to erythropoietin after the 1(st dose and developed long-lasting anemia following subsequent doses. This suggests that the presence of IIRMIs facilitated a breach in tolerance to the endogenous mouse erythropoietin. Overall, these studies indicate that the risk of enhancing immunogenicity should be considered when establishing acceptance limits of IIRMIs for therapeutic proteins.

  2. Academics respond

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2015-01-01

    Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK......Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK...

  3. Transcriptomic analysis of monocytes and macrophages derived from CLL patients which display differing abilities to respond to therapeutic antibody immune complexes

    Directory of Open Access Journals (Sweden)

    M. Burgess

    2016-03-01

    Full Text Available Chronic lymphocytic leukemia (CLL is the most common adult leukemia. While therapeutic antibodies show clinical activity in CLL patients, resistance inevitably develops resulting in treatment failure. Identifying mechanisms of antibody resistance and methods to reduce resistance would be valuable in managing CLL. Monocyte derived cells (MDCs, also known as nurse like cells (NLCs in CLL [1,2], are known to be crucial components of the CLL microenvironment network and following “maturation” in in vitro culture systems are able to provide support for the survival of the malignant B cells from CLL patients. In addition to their protective role, MDCs are key effector cells in mediating responses to therapeutic antibody therapies [3]. We have determined that macrophages from patients with early stable CLL are able to elicit superior cytotoxic response to therapeutic antibodies than macrophages derived from patients with progressive CLL. We have exploited this unique finding to gain insight into antibody resistance. Thus, we have profiled monocytes on day 0 and MDCs on day 7 from antibody sensitive and antibody resistant CLL patients (GEO accession number GEO: GSE71409. We show that there are no significant differences in transcriptomes from the monocytes or MDCs derived from sensitive or resistant patient samples. However, we show that MDCs acquire an M2-like macrophage transcriptomic signature following 7 days culture regardless of whether they were derived from sensitive or resistant patient samples. Keywords: Chronic lymphocytic leukemia, Monocyte derived cells, Antibody resistance, Microarray

  4. The effect of a therapeutic lithium level on a stroke-related cerebellar tremor.

    Science.gov (United States)

    Orleans, Rachel A; Dubin, Marc J; Kast, Kristopher A

    2018-01-24

    Lithium is a mood stabiliser used in the treatment of acute mania, bipolar disorder and as augmentation for unipolar major depression. Tremor is a common adverse effect associated with lithium at both therapeutic and toxic serum levels. We present a case of dose-dependent changes in the quality and intensity of a stroke-related, chronic cerebellar tremor with lithium treatment at serum levels within the therapeutic range. On admission, the patient in this case had a baseline fine, postural tremor, which increased in frequency and evolved to include myoclonic jerks once lithium therapy was initiated. Although the patient's serum lithium level was never in the toxic range, his tremor returned to baseline on reduction of his serum lithium level. This case highlights that a pre-existing, baseline tremor may lower the threshold for developing myoclonus. It also suggests that caution may be warranted with lithium therapy in the setting of known cerebellar disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Observational Study to Assess the Therapeutic Value of Four Ovarian Hyperstimulation Protocols in IVF After Pituitary Suppression with GnRH Antagonists in Normally Responding Women

    OpenAIRE

    Ana, Monzó; Vicente, Montañana; María, Rubio José; Trinidad, García-Gimeno; Alberto, Romeu

    2011-01-01

    Objective To compare the clinical results of four different protocols of COH for IVF-ICSI in normovulatory women, using in all cases pituitary suppression with GnRH antagonists. Materials/methods A single center, open label, parallel-controlled, prospective, post-authorization study under the approved conditions for use where 305 normal responders women who were candidates to COH were assigned to r-FSH + hp-hMG (n = 51, Group I), hp-hMG (n = 61, Group II), fixed-dose r-FSH (n = 118, Group III...

  6. Observational Study to Assess the Therapeutic Value of Four Ovarian Hyperstimulation Protocols in IVF After Pituitary Suppression with GnRH Antagonists in Normally Responding Women.

    Science.gov (United States)

    Ana, Monzó; Vicente, Montañana; María, Rubio José; Trinidad, García-Gimeno; Alberto, Romeu

    2011-02-22

    To compare the clinical results of four different protocols of COH for IVF-ICSI in normovulatory women, using in all cases pituitary suppression with GnRH antagonists. A single center, open label, parallel-controlled, prospective, post-authorization study under the approved conditions for use where 305 normal responders women who were candidates to COH were assigned to r-FSH +hp-hMG (n = 51, Group I), hp-hMG (n = 61, Group II), fixed-dose r-FSH (n = 118, Group III), and r-FSH with potential dose adjustment (n = 75, Group IV) to subsequently undergo IVF-ICSI. During stimulation, Group IV needed significantly more days of stimulation as compared to Group II [8.09 ± 1.25 vs. 7.62 ± 1.17; P women undergoing pituitary suppression with GnRH antagonists.

  7. Observational Study to Assess the Therapeutic Value of Four Ovarian Hyperstimulation Protocols in IVF after Pituitary Suppression with GnRH Antagonists in Normally Responding Women

    Directory of Open Access Journals (Sweden)

    Monzó Ana

    2011-01-01

    Full Text Available Objective To compare the clinical results of four different protocols of COH for IVF-ICSI in normovulatory women, using in all cases pituitary suppression with GnRH antagonists. Materials/methods A single center, open label, parallel-controlled, prospective, post-authorization study under the approved conditions for use where 305 normal responders women who were candidates to COH were assigned to r-FSH + hp-hMG (n = 51, Group I, hp-hMG (n = 61, Group II, fixed-dose r-FSH (n = 118, Group III, and r-FSH with potential dose adjustment (n = 75, Group IV to subsequently undergo IVF-ICSI. Results During stimulation, Group IV needed significantly more days of stimulation as compared to Group II [8.09 ± 1.25 vs. 7.62 ± 1.17; P < 0.05], but was the group in which more oocytes were recovered [Group I: 9.43 ± 4.99 vs. Group II: 8.96 ± 4.82 vs. Group III: 8.78 ± 3.72 vs. Group IV: 11.62 ± 5.80; P < 0.05]. No significant differences were seen between the groups in terms of clinical and ongoing pregnancy, but among patients in whom two embryos with similar quality parameters (ASEBIR were transferred, the group treated with hp-hMG alone achieved a significantly greater clinical pregnancy rate as compared to all other groups [Group I: 31.6%, Group II: 56.4%, Group III: 28.7%, Group IV: 32.7%; P < 0.05]. Conclusions Although randomized clinical trials should be conducted to achieve a more reliable conclusion, these observations support the concept that stimulation with hp-hMG could be beneficial in normal responders women undergoing pituitary suppression with GnRH antagonists.

  8. Human metastatic melanoma cell lines express high levels of growth hormone receptor and respond to GH treatment

    Energy Technology Data Exchange (ETDEWEB)

    Sustarsic, Elahu G. [Edison Biotechnology Institute, 1 Watertower Drive, Athens, OH (United States); Department of Biological Sciences, Ohio University, Athens, OH (United States); Junnila, Riia K. [Edison Biotechnology Institute, 1 Watertower Drive, Athens, OH (United States); Kopchick, John J., E-mail: kopchick@ohio.edu [Edison Biotechnology Institute, 1 Watertower Drive, Athens, OH (United States); Department of Biological Sciences, Ohio University, Athens, OH (United States); Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH (United States)

    2013-11-08

    Highlights: •Most cancer types of the NCI60 have sub-sets of cell lines with high GHR expression. •GHR is highly expressed in melanoma cell lines. •GHR is elevated in advanced stage IV metastatic tumors vs. stage III. •GH treatment of metastatic melanoma cell lines alters growth and cell signaling. -- Abstract: Accumulating evidence implicates the growth hormone receptor (GHR) in carcinogenesis. While multiple studies show evidence for expression of growth hormone (GH) and GHR mRNA in human cancer tissue, there is a lack of quantification and only a few cancer types have been investigated. The National Cancer Institute’s NCI60 panel includes 60 cancer cell lines from nine types of human cancer: breast, CNS, colon, leukemia, melanoma, non-small cell lung, ovarian, prostate and renal. We utilized this panel to quantify expression of GHR, GH, prolactin receptor (PRLR) and prolactin (PRL) mRNA with real-time RT qPCR. Both GHR and PRLR show a broad range of expression within and among most cancer types. Strikingly, GHR expression is nearly 50-fold higher in melanoma than in the panel as a whole. Analysis of human metastatic melanoma biopsies confirmed GHR gene expression in melanoma tissue. In these human biopsies, the level of GHR mRNA is elevated in advanced stage IV tumor samples compared to stage III. Due to the novel finding of high GHR in melanoma, we examined the effect of GH treatment on three NCI60 melanoma lines (MDA-MB-435, UACC-62 and SK-MEL-5). GH increased proliferation in two out of three cell lines tested. Further analysis revealed GH-induced activation of STAT5 and mTOR in a cell line dependent manner. In conclusion, we have identified cell lines and cancer types that are ideal to study the role of GH and PRL in cancer, yet have been largely overlooked. Furthermore, we found that human metastatic melanoma tumors express GHR and cell lines possess active GHRs that can modulate multiple signaling pathways and alter cell proliferation. Based on

  9. Systems-level thinking for nanoparticle-mediated therapeutic delivery to neurological diseases.

    Science.gov (United States)

    Curtis, Chad; Zhang, Mengying; Liao, Rick; Wood, Thomas; Nance, Elizabeth

    2017-03-01

    Neurological diseases account for 13% of the global burden of disease. As a result, treating these diseases costs $750 billion a year. Nanotechnology, which consists of small (~1-100 nm) but highly tailorable platforms, can provide significant opportunities for improving therapeutic delivery to the brain. Nanoparticles can increase drug solubility, overcome the blood-brain and brain penetration barriers, and provide timed release of a drug at a site of interest. Many researchers have successfully used nanotechnology to overcome individual barriers to therapeutic delivery to the brain, yet no platform has translated into a standard of care for any neurological disease. The challenge in translating nanotechnology platforms into clinical use for patients with neurological disease necessitates a new approach to: (1) collect information from the fields associated with understanding and treating brain diseases and (2) apply that information using scalable technologies in a clinically-relevant way. This approach requires systems-level thinking to integrate an understanding of biological barriers to therapeutic intervention in the brain with the engineering of nanoparticle material properties to overcome those barriers. To demonstrate how a systems perspective can tackle the challenge of treating neurological diseases using nanotechnology, this review will first present physiological barriers to drug delivery in the brain and common neurological disease hallmarks that influence these barriers. We will then analyze the design of nanotechnology platforms in preclinical in vivo efficacy studies for treatment of neurological disease, and map concepts for the interaction of nanoparticle physicochemical properties and pathophysiological hallmarks in the brain. WIREs Nanomed Nanobiotechnol 2017, 9:e1422. doi: 10.1002/wnan.1422 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.

  10. A mathematical model of metabolism an regulation provides a systems-level view of how Escherichia coli responds to oxigen

    NARCIS (Netherlands)

    Ederer, M.; Steinsiek, S.; Stagge, S.; Rolfe, M.D.; ter Beek, A.; Knies, D.; Teixeira De Mattos, M.J.; Sauter, T.; Green, J.; Poole, R.K.; Bettenbrock, K.; Sawodny, O.

    2014-01-01

    The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon, and redox metabolism. The measurement of transcript levels, metabolite

  11. Serum PCSK9 Levels Distinguish Individuals Who Do Not Respond to High-Dose Statin Therapy with the Expected Reduction in LDL-C

    Directory of Open Access Journals (Sweden)

    Beth A. Taylor

    2014-01-01

    Full Text Available The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin type 9 (PCSK9 levels differ in individuals who do not exhibit expected reductions in low density lipoprotein cholesterol (LDL-C with statin therapy. Eighteen nonresponder subjects treated with 80 mg atorvastatin treatment for 6 months without substantial reductions in LDL-C (ΔLDL-C: 2.6 ± 11.4% were compared to age- and gender-matched atorvastatin responders (ΔLDL-C: 50.7 ± 8.5% and placebo-treated subjects (ΔLDL-C: 9.9 ± 21.5%. Free PCSK9 was marginally higher in nonresponders at baseline (P=0.07 and significantly higher in atorvastatin responders after 6 months of treatment (P=0.04. The change in free PCSK9 over 6 months with statin treatment was higher (P<0.01 in atorvastatin responders (134.2 ± 131.5 ng/mL post- versus prestudy than in either the nonresponders (39.9 ± 87.8 ng/mL or placebo subjects (27.8 ± 97.6 ng/mL. Drug compliance was not lower in the nonresponders as assessed by pill counts and poststudy plasma atorvastatin levels. Serum PCSK9 levels, both at baseline and in response to statin therapy, may differentiate individuals who do versus those who do not respond to statin treatment.

  12. Comparing vegetation types and anthropic disturbance levels in the Atlantic forest: how do Pentatomoidea (Hemiptera: Heteroptera) assemblages respond?

    Science.gov (United States)

    Bianchi, F M; Mendonça, M S; Campos, L A

    2014-12-01

    The Atlantic Forest (AF) is considered the most fragmented and endangered Brazilian biome. The diversity of phytophagous insects increases after disturbances in forests, and it was hypothesized the Pentatomidae can furnish ecologically reliable information in terms of diversity in response to the changes occurring in AF. Our aim was to quantify the response of assemblages of Pentatomoidea to gradient of human disturbance in two vegetation types of the AF-dense ombrophilous forest (DOF) and mixed ombrophilous forest (MOF). Twelve transects were grouped into environmental classes, namely open, intermediate, and closed. Overall, 1,017 pentatomoids were sampled, representing 64 species. The open environment was more abundant than closed environment, though it is expected that Pentatomoidea respond with increasing abundance when under light or moderate disturbance. The MOF was more abundant than DOF, and the composition differed between both of them. Given the differences in composition between MOF and DOF, abiotic variables are important factors acting as environmental filters for Pentatomoidea, not just directly on the insects, but probably also on the nutritional support of their host plants.

  13. Therapeutic infliximab drug level in a child born to a woman with ulcerative colitis treated until gestation week 31

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Al-Khalaf, Magid; Ainsworth, Mark A

    2012-01-01

    A 26 year old woman with ulcerative colitis was treated with regular infliximab (IFX) infusions until gestation week 31, and gave birth to a healthy child at gestation week 37. Maternal IFX trough level was relatively high during the course of pregnancy. In the infant, therapeutic level of IFX...

  14. Delta/mu opioid receptor interactions in operant conditioning assays of pain-depressed responding and drug-induced rate suppression: assessment of therapeutic index in male Sprague Dawley rats.

    Science.gov (United States)

    Cone, Katherine; Lanpher, Janell; Kinens, Abigail; Richard, Philomena; Couture, Sarah; Brackin, Rebecca; Payne, Emily; Harrington, Kylee; Rice, Kenner C; Stevenson, Glenn W

    2018-05-01

    Although delta/mu receptor interactions vary as a function of behavioral endpoint, there have been no assessments of these interactions using assays of pain-depressed responding. This is the first report of delta/mu interactions using an assay of pain-depressed behavior. A mult-cycle FR10 operant schedule was utilized in the presence of (nociception) and in the absence of (rate suppression) a lactic acid inflammatory pain-like manipulation. SNC80 and methadone were used as selective/high efficacy delta and mu agonists, respectively. Both SNC80 and methadone alone produced a dose-dependent restoration of pain-depressed responding and dose-dependent response rate suppression. Three fixed ratio mixtures, based on the relative potencies of the drugs in the nociception assay, also produced dose-dependent antinociception and sedation. Isobolographic analysis indicated that all three mixtures produced supra-additive antinociceptive effects and simply additive sedation effects. The therapeutic index (TI) inversely varied as a function of amount of SNC80 in the mixture, such that lower amounts of SNC80 produced a higher TI, and larger amounts produced a lower TI. Compared to literature using standard pain-elicited assays, the orderly relationship between SNC80 and TI reported here may be a unique function of assessing pain-depressed behavior.

  15. A Mathematical Model of Metabolism and Regulation Provides a Systems-Level View of How Escherichia coli Responds to Oxygen

    Directory of Open Access Journals (Sweden)

    Michael eEderer

    2014-03-01

    Full Text Available The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon and redox metabolism. The measurement of transcript levels, metabolite concentrations and metabolic fluxes per se gives an incomplete picture. An appreciation of the interdependencies between the different measurement values is essential for systems-level understanding. Mathematical modeling has the potential to provide a coherent and quantitative description of the interplay between gene expression, metabolite concentrations and metabolic fluxes. Escherichia coli undergoes major adaptations in central metabolism when the availability of oxygen changes. Thus, an integrated description of the oxygen response provides a benchmark of our understanding of carbon, energy and redox metabolism. We present the first comprehensive model of the central metabolism of E. coli that describes steady-state metabolism at different levels of oxygen availability. Variables of the model are metabolite concentrations, gene expression levels, transcription factor activities, metabolic fluxes and biomass concentration. We analyze the model with respect to the production capabilities of central metabolism of E. coli. In particular, we predict how precursor and biomass concentration are affected by product formation.

  16. Responding to Sea Level Rise: Does Short-Term Risk Reduction Inhibit Successful Long-Term Adaptation?

    Science.gov (United States)

    Keeler, A. G.; McNamara, D. E.; Irish, J. L.

    2018-04-01

    Most existing coastal climate-adaptation planning processes, and the research supporting them, tightly focus on how to use land use planning, policy tools, and infrastructure spending to reduce risks from rising seas and changing storm conditions. While central to community response to sea level rise, we argue that the exclusive nature of this focus biases against and delays decisions to take more discontinuous, yet proactive, actions to adapt—for example, relocation and aggressive individual protection investments. Public policies should anticipate real estate market responses to risk reduction to avoid large costs—social and financial—when and if sea level rise and other climate-related factors elevate the risks to such high levels that discontinuous responses become the least bad alternative.

  17. A Study of Pre-Service Information and Communication Teachers' Efficacy Levels for Analyzing and Responding to Cyberbullying Cases

    Science.gov (United States)

    Kavuk, Melike; Bulu, Sanser; Keser, Hafize

    2016-01-01

    This case study was conducted to investigate efficacy levels of preservice Information and Communication Teachers' to identify, prevent and intervene to cyberbullying cases. Fifty participants were interviewed and 56 cyberbullying cases, which the participants experienced or witnessed, were collected to evaluate their cyberbullying readiness.…

  18. Some Misconceptions in Meiosis Shown by Students Responding to an Advanced Level Practical Examination Question in Biology.

    Science.gov (United States)

    Brown, C. R.

    1990-01-01

    Discussed are problems revealed in student responses to a practical task which formed part of an advanced level examination. The frequencies with which some misconceptions about cell reproduction and genetics occurred are presented. The nature of these misconceptions is analyzed and their implications discussed. (CW)

  19. A Study of Pre-Service Information and Communication Teachers’ Efficacy Levels for Analyzing and Responding to Cyberbullying Cases

    Directory of Open Access Journals (Sweden)

    Melike Kavuk

    2016-07-01

    Full Text Available This case study was conducted to investigate efficacy levels of preservice Information and Communication Teachers’ to identify, prevent and intervene to cyberbullying cases. Fifty participants were interviewed and 56 cyberbullying cases, which the participants experienced or witnessed, were collected to evaluate their cyberbullying readiness. Based on the content analysis and the expert ratings, preservice teachers found to have problems for identifying cyberbullying cases, suggesting appropriate prevention strategies for cyberbullying, judging intervention strategies, and suggesting appropriate intervention methods.

  20. Testosterone Responders to Continuous Androgen Deprivation Therapy Show Considerable Variations in Testosterone Levels on Followup: Implications for Clinical Practice.

    Science.gov (United States)

    Sayyid, Rashid K; Sayyid, Abdallah K; Klaassen, Zachary; Fadaak, Kamel; Goldberg, Hanan; Chandrasekar, Thenappan; Ahmad, Ardalanejaz; Leao, Ricardo; Perlis, Nathan; Chadwick, Karen; Hamilton, Robert J; Kulkarni, Girish S; Finelli, Antonio; Zlotta, Alexandre R; Fleshner, Neil E

    2018-01-01

    We determined whether men on continuous androgen deprivation therapy who achieve testosterone less than 0.7 nmol/l demonstrate subsequent testosterone elevations during followup and whether such events predict worse oncologic outcomes. We evaluated a random, retrospective sample of 514 patients with prostate cancer treated with continuous androgen deprivation therapy in whom serum testosterone was less than 0.7 nmol/l at University Health Network between 2007 and 2016. Patients were followed from the date of the first testosterone measurement of less than 0.7 nmol/l to progression to castrate resistance, death or study period end. Study outcomes were the development of testosterone elevations greater than 0.7, greater than 1.1 and greater than 1.7 nmol/l, and progression to a castrate resistant state. Survival curves were constructed to determine the rate of testosterone elevations. Multivariate Cox regression analysis was done to assess whether elevations predicted progression to castrate resistance. Median patient age was 74 years and median followup was 20.3 months. Within 5 years of followup 82%, 45% and 18% of patients had subsequent testosterone levels greater than 0.7, greater than 1.1 and greater than 1.7 nmol/l, respectively. In 96% to 100% of these patients levels less than 0.7 nmol/l were subsequently reestablished within 5 years. No patient baseline characteristic was associated with elevations and elevations were not a significant predictor of progression to a castrate resistant state. Men on continuous androgen deprivation therapy in whom initial testosterone is less than 0.7 nmol/l frequently show subsequent elevations in serum testosterone. Such a development should not trigger an immediate response from physicians as these events are prognostically insignificant with regard to oncologic outcomes. Levels are eventually reestablished at less than 0.7 nmol/l. Copyright © 2018 American Urological Association Education and Research, Inc. Published by

  1. Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations

    Science.gov (United States)

    2013-01-01

    Background Deaf and hard-of-hearing (Deaf/HH) individuals have been underserved before and during emergencies. This paper will assess Deaf/HH related emergency preparedness training needs for state emergency management agencies and deaf-serving community-based organizations (CBOs). Methods Four approaches were used: 1) a literature review; 2) results from 50 key informant (KI) interviews from state and territorial-level emergency management and public health agencies; 3) results from 14 KI interviews with deaf-serving CBOs in the San Francisco Bay Area; and 4) a pilot program evaluation of an emergency responder training serving the Deaf/HH in one urban community. Results Results from literature review and state and territorial level KIs indicate that there is a substantive gap in emergency preparedness training on serving Deaf/HH provided by state agencies. In addition, local KI interviews with 14 deaf-serving CBOs found gaps in training within deaf-serving CBOs. These gaps have implications for preparing for and responding to all-hazards emergencies including weather-related or earthquake-related natural disasters, terrorist attacks, and nuclear-chemical disasters. Conclusion Emergency preparedness trainings specific to responding to or promoting preparedness of the Deaf/HH is rare, even for state agency personnel, and frequently lack standardization, evaluation, or institutionalization in emergency management infrastructure. This has significant policy and research implications. Similarly, CBOs are not adequately trained to serve the needs of their constituents. PMID:23497178

  2. Natural radioactivity levels in mineral, therapeutic and spring waters in Tunisia

    Energy Technology Data Exchange (ETDEWEB)

    Labidi, S., E-mail: labidisalam@yahoo.f [Institut Superieur des Technologies Medicales de Tunis (ISTMT), 9 Avenue du Docteur Z.Essafi, Tunis 1006 (Tunisia); Mahjoubi, H. [Institut Superieur des Technologies Medicales de Tunis (ISTMT), 9 Avenue du Docteur Z.Essafi, Tunis 1006 (Tunisia); Essafi, F. [Faculte de Medecine de Tunis. Section de Biophysique, Tunis (Tunisia); Ben Salah, R. [Faculte de Medecine de Sousse, 270, Sahloul II, 4054 Sousse (Tunisia)

    2010-12-15

    Radioactivity measurements were carried out in 26 groundwater samples from Tunisia. Activity concentrations of uranium were studied by radiochemical separation procedures followed by alpha spectrometry and that for radium isotopes by gamma-ray spectrometry. The results show that, the concentrations in water samples range from 1.2 to 69 mBq/L.1, 1.3 to 153.4 mBq/L, 2.0 to 1630.0 mBq/L and 2.0 to 1032.0 mBq/L for {sup 238}U, {sup 234}U, {sup 226}Ra and {sup 228}Ra, respectively. The U and Ra activity concentrations are low and similar to those published for other regions in the world. The natural radioactivity levels in the investigated samples are generally increased from mineral waters through therapeutic to the spring waters. The results show that a correlation between total dissolved solids (TDS) values and the {sup 226}Ra concentrations was found to be high indicating that {sup 266}Ra has a high affinity towards the majority of mineral elements dissolved in these waters. High correlation coefficients were also observed between {sup 226}Ra content and chloride ions for Cl{sup -}Na{sup +} water types. This can be explained by the fact that radium forms a complex with chloride and in this form is more soluble. The isotopic ratio of {sup 234}U/{sup 238}U and {sup 226}Ra/{sup 234}U varies in the range from 0.8 to 2.6 and 0.6 to 360.8, respectively, in all investigated waters, which means that there is no radioactive equilibrium between the two members of the {sup 238}U series. The fractionation of isotopes of a given element may occur because of preferential leaching of one, or by the direct action of recoil during radioactive decay. The annual effective doses due to ingestion of the mineral waters have been estimated to be well below the 0.1 mSv/y reference dose level.

  3. How the University of Texas system responded to the need for interim storage of low-level radioactive waste materials.

    Science.gov (United States)

    Emery, Robert J

    2012-11-01

    Faced with the prospect of being unable to permanently dispose of low-level radioactive wastes (LLRW) generated from teaching, research, and patient care activities, component institutions of the University of Texas System worked collaboratively to create a dedicated interim storage facility to be used until a permanent disposal facility became available. Located in a remote section of West Texas, the University of Texas System Interim Storage Facility (UTSISF) was licensed and put into operation in 1993, and since then has provided safe and secure interim storage for up to 350 drums of dry solid LLRW at any given time. Interim storage capability provided needed relief to component institutions, whose on-site waste facilities could have possibly become overburdened. Experiences gained from the licensing and operation of the site are described, and as a new permanent LLRW disposal facility emerges in Texas, a potential new role for the storage facility as a surge capacity storage site in times of natural disasters and emergencies is also discussed.

  4. Identifying and engineering promoters for high level and sustainable therapeutic recombinant protein production in cultured mammalian cells.

    Science.gov (United States)

    Ho, Steven C L; Yang, Yuansheng

    2014-08-01

    Promoters are essential on plasmid vectors to initiate transcription of the transgenes when generating therapeutic recombinant proteins expressing mammalian cell lines. High and sustained levels of gene expression are desired during therapeutic protein production while gene expression is useful for cell engineering. As many finely controlled promoters exhibit cell and product specificity, new promoters need to be identified, optimized and carefully evaluated before use. Suitable promoters can be identified using techniques ranging from simple molecular biology methods to modern high-throughput omics screenings. Promoter engineering is often required after identification to either obtain high and sustained expression or to provide a wider range of gene expression. This review discusses some of the available methods to identify and engineer promoters for therapeutic recombinant protein expression in mammalian cells.

  5. Social climate along the pathway of care in women's secure mental health service: variation with level of security, patient motivation, therapeutic alliance and level of disturbance.

    Science.gov (United States)

    Long, C G; Anagnostakis, K; Fox, E; Silaule, P; Somers, J; West, R; Webster, A

    2011-07-01

    Social climate has been measured in a variety of therapeutic settings, but there is little information about it in secure mental health services, or how it may vary along a gender specific care pathway. To assess social climate in women's secure wards and its variation by level of security and ward type, therapeutic alliance, patient motivation, treatment engagement and disturbed behaviour. Three-quarters (80, 76%) of staff and nearly all (65, 92%) of patients in the two medium-security wards and two low-security wards that comprised the unit completed the Essen Climate Evaluation Schema (EssenCES) and the California Psychotherapy Alliance Scale (CALPAS); patients also completed the Patient Motivation Inventory (PMI). Pre-assessment levels of disturbed behaviour and treatment engagement were recorded. Social climate varied according to ward type and level of security. EssenCES ratings indicative of positive social climate were associated with lower levels of security; such ratings were also associated with lower behavioural disturbance and with higher levels of motivation, treatment engagement and therapeutic alliance. This serial cross-sectional survey indicated that use of the EssenCES alone might be a good practical measure of treatment progress/responsivity. A longitudinal study would be an important next step in establishing the extent to which it would be useful in this regard. Copyright © 2010 John Wiley & Sons, Ltd.

  6. The DUNDRUM-1 structured professional judgment for triage to appropriate levels of therapeutic security: retrospective-cohort validation study.

    LENUS (Irish Health Repository)

    Flynn, Grainne

    2011-01-01

    The assessment of those presenting to prison in-reach and court diversion services and those referred for admission to mental health services is a triage decision, allocating the patient to the appropriate level of therapeutic security. This is a critical clinical decision. We set out to improve on unstructured clinical judgement. We collated qualitative information and devised an 11 item structured professional judgment instrument for this purpose then tested for validity.

  7. A possible method using baseline hormonal levels to prescribe the appropriate oral therapeutic radioiodine dosage for Graves' disease

    International Nuclear Information System (INIS)

    Nakajo, Masayuki; Tsuchimochi, Shinsaku; Jinguji, Megumi; Tanabe, Hiroaki; Umanodan, Tomoichi; Nakabeppu, Yoshiaki

    2007-01-01

    The purpose of this study was to retrospectively examine the correlations of hormonal ratios with radioiodine I-131 therapeutic parameters and the potentiality of prescribing the therapeutic I-131 target dosage for an individual patient with Graves' disease using baseline serum levels of thyroid hormones. Serum T3, T4, and FT4 levels 6 and 12 months after I-131 therapy/baseline levels (hormonal ratios) were calculated for a total of 68 therapeutic courses in 57 patients with Graves' disease. The therapeutic parameters were absorbed dose (Gy), dose concentration (μCi/g) and oral dose (mCi). Linear regression analysis was performed for correlating hormonal ratios (X) and therapeutic parameters (Y). Significant (P<0.05) negative correlations of the hormonal ratios were observed with absorbed dose (R -0.50 for T3, -0.61 for T4, and -0.46 for FT4 at 6 months, and -0.29 for T3, -0.44 for T4 at 12 months) and dose concentration (R -0.57 for T3, -0.58 for T4, and -0.49 for FT4 at 6 months and -0.27 for T3, -0.27 for T4 at 12 months), but not with oral dose at 6 months and 12 months or the absorbed dose and dose concentration for FT4 at 12 months. The correlations were higher at 6 months than at 12 months and in serum T4 than in serum T3 and FT4. The formulae for serum T4 at 6 months were as follows: Y (Gy)=109-53X and Y (μCi/g)=109-52X. These results suggest that the hormonal ratios are significantly correlated with the absorbed dose and dose concentration. The formulae for serum T4 at 6 months may serve to prescribe the individual oral dosage for Graves' disease, although the correlation coefficients are about -0.6. (author)

  8. Currently used dosage regimens of vancomycin fail to achieve therapeutic levels in approximately 40% of intensive care unit patients.

    Science.gov (United States)

    Obara, Vitor Yuzo; Zacas, Carolina Petrus; Carrilho, Claudia Maria Dantas de Maio; Delfino, Vinicius Daher Alvares

    2016-01-01

    This study aimed to assess whether currently used dosages of vancomycin for treatment of serious gram-positive bacterial infections in intensive care unit patients provided initial therapeutic vancomycin trough levels and to examine possible factors associated with the presence of adequate initial vancomycin trough levels in these patients. A prospective descriptive study with convenience sampling was performed. Nursing note and medical record data were collected from September 2013 to July 2014 for patients who met inclusion criteria. Eighty-three patients were included. Initial vancomycin trough levels were obtained immediately before vancomycin fourth dose. Acute kidney injury was defined as an increase of at least 0.3mg/dL in serum creatinine within 48 hours. Considering vancomycin trough levels recommended for serious gram-positive infection treatment (15 - 20µg/mL), patients were categorized as presenting with low, adequate, and high vancomycin trough levels (35 [42.2%], 18 [21.7%], and 30 [36.1%] patients, respectively). Acute kidney injury patients had significantly greater vancomycin trough levels (p = 0.0055, with significance for a trend, p = 0.0023). Surprisingly, more than 40% of the patients did not reach an effective initial vancomycin trough level. Studies on pharmacokinetic and dosage regimens of vancomycin in intensive care unit patients are necessary to circumvent this high proportion of failures to obtain adequate initial vancomycin trough levels. Vancomycin use without trough serum level monitoring in critically ill patients should be discouraged.

  9. Immune defense of wild-caught Norway rats is characterized by increased levels of basal activity but reduced capability to respond to further immune stimulation.

    Science.gov (United States)

    Mirkov, Ivana; Popov Aleksandrov, Aleksandra; Subota, Vesna; Kataranovski, Dragan; Kataranovski, Milena

    2018-03-01

    Studies of wild animals' immunity often use comparison with laboratory-raised individuals. Using such an approach, various data were obtained concerning wild Norway rat's immunity. Lower or higher potential of immune system cells to respond to activation stimuli were shown, because of analysis of disparate parameters and/ or small number of analyzed individuals. Inconsistent differences between laboratory and wild rats were shown too, owing to great response variability in wild rats. We hypothesized that wild rats will express more intense immune activity compared to their laboratory counterparts which live in a less demanding environment. To test this, we analyzed the circulating levels of inflammatory cytokine interleukin-6 (IL-6), a mediator which has a central role in host immune defense. In addition, we examined the activity of the central immune organ, the spleen, including cell proliferation and production of pro-inflammatory cytokines interferon-γ (IFN-γ) and interleukin-17 (IL-17), which are major effectors of cellular adaptive immune response. In order to obtain reasonable insight into the immunity of wild Norway rats, analysis was conducted on a much larger number of individuals compared to other studies. Higher levels of plasma IL-6, higher spleen mass, cellularity and basal IFN-γ production concomitantly with lower basal production of anti-inflammatory cytokine interleukin-10 (IL-10) revealed more intense immune activity in the wild compared to laboratory rats. However, lower responsiveness of their spleen cells' proinflammatory cytokine production to concanavalin A (ConA) stimulation, along with preserved capacity of IL-10 response, might be perceived as an indication of wild rats' reduced capability to cope with incoming environmental stimuli, but also as a means to limit tissue damage. © 2017 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

  10. Role of Therapeutic Plasma Exchange in Treatment of Tumefactive Multiple Sclerosis-Associated Low CD4 and CD8 Levels

    Directory of Open Access Journals (Sweden)

    Kristen Lew

    2016-08-01

    Full Text Available We report a 35-year-old healthy male who developed central nervous system inflammatory demyelinating disease consistent with tumefactive multiple sclerosis. About 2 weeks after onset of symptoms and prior to initiation of therapy, the patient had lymphopenia and low CD4 and CD8 levels. His lymphocyte count was 400 cells/µl (850–3,900 cells/µl, CD4 was 193 cells/µl (490–1,740 cells/µl and CD8 was 103 cells/µl (180–1,170 cells/µl. He was treated with intravenous methylprednisolone followed by therapeutic plasma exchange, the levels of CD4 and CD8 normalized, and ultimately, he recovered completely.

  11. Responding to Mechanical Antigravity

    Science.gov (United States)

    Millis, Marc G.; Thomas, Nicholas E.

    2006-01-01

    Based on the experiences of the NASA Breakthrough Propulsion Physics Project, suggestions are offered for constructively responding to proposals that purport breakthrough propulsion using mechanical devices. Because of the relatively large number of unsolicited submissions received (about 1 per workday) and because many of these involve similar concepts, this report is offered to help the would-be submitters make genuine progress as well as to help reviewers respond to such submissions. Devices that use oscillating masses or gyroscope falsely appear to create net thrust through differential friction or by misinterpreting torques as linear forces. To cover both the possibility of an errant claim and a genuine discovery, reviews should require that submitters meet minimal thresholds of proof before engaging in further correspondence; such as achieving sustained deflection of a level-platform pendulum in the case of mechanical thrusters.

  12. Effect of therapeutic Swedish massage on anxiety level and vital signs of Intensive Care Unit patients.

    Science.gov (United States)

    Alves da Silva, Tatiana; Stripari Schujmann, Debora; Yamada da Silveira, Leda Tomiko; Caromano, Fátima Aparecida; Fu, Carolina

    2017-07-01

    To evaluate how Swedish massage affects the level of anxiety and vital signs of Intensive Care Unit (ICU) patients. Quasi-experimental study. ICU patients, 18-50 years old, cooperative, respiratory and hemodynamic stable, not under invasive mechanical ventilation. allergic to massage oil, vascular or orthopedic post-operative, skin lesions, thrombosis, fractures. A 30-min Swedish massage was applied once. arterial pressure, heart rate, respiratory rate, S-STAI questionnaire. Timing of evaluation: pre-massage, immediately post-massage, 30 min post-massage. Comparison: T-test, corrected by Bonferroni method, level of significance of 5%, confidence interval of 95%. 48 patients included, 30 (62.5%) female, mean age 55.46 (15.70) years old. Mean S-STAI pre-massage: 42.51 (9.48); immediately post-massage: 29.34 (6.37); 30 min post-massage: 32.62 (8.56), p < 0.001 for all comparison. Mean vital signs achieved statistical significance between pre-massage and immediately post-massage. Swedish massage reduced anxiety of ICU patients immediately and 30 min post-massage. Vital signs were reduced immediately post-massage. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Serum immunoglobulin levels in humans exposed to therapeutic total-body gamma irradiation

    International Nuclear Information System (INIS)

    Chaskes, S.; Kingdon, G.C.; Balish, E.

    1975-01-01

    Reduced serum immunoglobulin (IgA, IgG, IgM) levels developed in the majority of 27 patients with hematologic disorders after treatment with 100 to 350 R total-body gamma-ray exposures at a dose rate of either 1.5 R/min to 1.5 R/hr. A reduction in IgA of 20 percent or more was found in 66 percent of the cases, while 56 percent showed an IgM decrease, and 49 percent an IgG decrease of 20 percent. The severity of immunoglobulin depression was influenced by the total radiation dose and the patient's primary disease. The occurrence of IgG and IgM depression was greater when the radiation was given at 1.5 R/hr than when the dose rate was 1.5 R/min. Substantial but incomplete recovery toward preirradiation immunoglobulin levels was found for most patients by 7 wk after total-body irradiation (TBI). (U.S.)

  14. Therapeutic effect of forearm low level light treatment on blood flow, oxygenation, and oxygen consumption

    Science.gov (United States)

    Wang, Pengbo; Sun, Jiajing; Meng, Lingkang; Li, Zebin; Li, Ting

    2018-02-01

    Low level light/laser therapy (LLLT) is considered as a novel, non-invasive, and potential therapy in a variety of psychological and physical conditions, due to its effective intricate photobiomodulation. The mechanism of LLLT is that when cells are stimulated by photons, mitochondria produce a large quantity of ATP, which accelerates biochemical responses in the cell. It is of great significance to gain a clear insight into the change or interplay of various physiological parameters. In this study, we used functional near-infrared spectroscopy (fNIRS) and venous-occlusion plethysmography to measure the LLLT-induced changes in blood flow, oxygenation, and oxygen consumption in human forearms in vivo. Six healthy human participants (4 males and 2 females) were administered with 810-nm light emitted by LED array in ten minutes and blood flow, oxygenation and oxygen consumption were detected in the entire experiment. We found that LLLT induced an increase of blood flow and oxygen consumption on the treated site. Meanwhile, LLLT took a good role in promoting oxygenation of regional tissue, which was indicated by a significant increase of oxygenated hemoglobin concentration (Δ[HbO2]), a nearly invariable deoxygenated hemoglobin concentration (Δ[Hb]) and a increase of differential hemoglobin concentration (Δ[HbD] = Δ[HbO2] - Δ[Hb]). These results not only demonstrate enormous potential of LLLT, but help to figure out mechanisms of photobiomodulation.

  15. Treatment response in Kawasaki disease is associated with sialylation levels of endogenous but not therapeutic intravenous immunoglobulin G.

    Directory of Open Access Journals (Sweden)

    Shohei Ogata

    Full Text Available Although intravenous immunoglobulin (IVIG is highly effective in Kawasaki disease (KD, mechanisms are not understood and 10-20% of patients are treatment-resistant, manifesting a higher rate of coronary artery aneurysms. Murine models suggest that α2-6-linked sialic acid (α2-6Sia content of IVIG is critical for suppressing inflammation. However, pro-inflammatory states also up-regulate endogenous levels of β-galactoside:α2-6 sialyltransferase-I (ST6Gal-I, the enzyme that catalyzes addition of α2-6Sias to N-glycans. We asked whether IVIG failures correlated with levels of α2-6Sia on infused IVIG or on the patient's own endogenous IgG.We quantified levels of α2-6Sia in infused IVIG and endogenous IgG from 10 IVIG-responsive and 10 resistant KD subjects using multiple approaches. Transcript levels of ST6GAL1, in patient whole blood and B cell lines were evaluated by RT-PCR. Plasma soluble (sST6Gal-I levels were measured by ELISA.There was no consistent difference in median sialylation levels of infused IVIG between groups. However, α2-6Sia levels in endogenous IgG, ST6GAL1 transcript levels, and ST6Gal-I protein in serum from IVIG-resistant KD subjects were lower than in responsive subjects at both pre-treatment and one-year time points (p <0.001, respectively.Our data indicate sialylation levels of therapeutic IVIG are unrelated to treatment response in KD. Rather, lower sialylation of endogenous IgG and lower blood levels of ST6GALI mRNA and ST6Gal-I enzyme predict therapy resistance. These differences were stable over time, suggesting a genetic basis. Because IVIG-resistance increases risk of coronary artery aneurysms, our findings have important implications for the identification and treatment of such individuals.

  16. Post-therapeutic recovery of serum interleukin-35 level might predict positive response to immunosuppressive therapy in pediatric aplastic anemia.

    Science.gov (United States)

    Huang, Zhen; Tong, Hongfei; Li, Yuan; Zhou, Haixia; Qian, Jiangchao; Wang, Juxiang; Ruan, Jichen

    2017-08-01

    The predictive value of interleukin-35 (IL-35) on efficacy of immunosuppressive therapy (IST) in aplastic anemia (AA) has not been well investigated. The aim of the study was to evaluate the association between serum IL-35 level and response to IST in pediatric AA. A total of 154 children with AA and 154 controls were included between January 2012 and December 2013. Blood and bone marrow fluid specimens were collected. Serum level of IL-35 was determined by enzyme-linked immunosorbent assay. Patients were treated with IST, and response to therapy was evaluated during 180-day follow-up period after starting therapy. Serum levels of IL-35 at admission decreased significantly in patients compared with that in controls (10.9 ± 5.5 pg ml -1 and 45.3 ± 8.8 pg ml -1 , p < 0.001). After starting IST, serum levels of IL-35 in patients recovered 30.7 ± 9.7 pg ml -1 in the first 28 days (p < 0.001). During the follow-up period, increased range of serum IL-35 level ≥30.7 pg ml -1 in the first 28 days was associated with effective response to therapy (odds ratio 7.97, 95% confidence interval 3.82-16.79). In addition, Fas/FasL protein expression in bone marrow mononuclear cells dropped significantly in the same group of patients in the first 28 days (p < 0.05). The study revealed that post-therapeutic recovery of circulating IL-35 concentration might be an independent predictor for effective response to IST in pediatric AA. Moreover, apoptosis might be involved in such a forecasting process.

  17. Raised Plasma Neurofilament Light Protein Levels Are Associated with Abnormal MRI Outcomes in Newborns Undergoing Therapeutic Hypothermia

    Directory of Open Access Journals (Sweden)

    Divyen K. Shah

    2018-03-01

    Full Text Available Aims and hypothesisHypoxic-ischemic encephalopathy (HIE remains an important cause of death and disability in newborns. Mild therapeutic hypothermia (TH is safe and effective; however, there are no tissue biomarkers available at the bedside to select babies for treatment. The aim of this study was to show that it is feasible to study plasma neurofilament light (NfL levels from newborns and to evaluate their temporal course. Hypothesis: Raised plasma NFL protein levels from newborns who undergo TH after HIE are associated with abnormal MRI outcomes.MethodsBetween February 2014 and January 2016, term newborns with HIE treated with TH for 72 h had plasma samples taken at three time points: (i after the infant had reached target temperature, (ii prior to commencing rewarming, and (iii after completing rewarming. Infants with mild HIE who did not receive TH had a single specimen taken. NfL protein was analyzed using an enzyme-linked immunosorbent assay.ResultsTwenty-six newborns with moderate–severe HIE treated with TH were studied. Half of these had cerebral MRI predictive of an unfavorable outcome. Plasma NfL levels were significantly higher in the TH group with unfavorable outcome (median age 18 h compared to levels from both the mild HIE group and TH group with favorable outcome (F = 25.83, p < 0.0001. Newborns who had MRIs predictive of unfavorable outcome had significantly higher NfL levels compared to those with favorable outcomes, at all three time points (mixed models, F = 27.63, p < 0.001. A cutoff NfL level >29 pg/mL at 24 h is predictive of an unfavorable outcome [sensitivity 77%, specificity 69%, positive predictive value (PPV 67%, negative predictive value (NPV 72%] with increasing predictive value until after rewarming (sensitivity 92%, specificity 92%, PPV 92%, NPV 86%.Interpretation of researchPlasma NfL protein levels may be a useful biomarker of unfavorable MRI outcomes in newborns with moderate

  18. Achievement of Target Blood Pressure Levels among Japanese Workers with Hypertension and Healthy Lifestyle Characteristics Associated with Therapeutic Failure.

    Directory of Open Access Journals (Sweden)

    Nagako Kudo

    Full Text Available Few studies have examined Japanese with regard to the achievement rates for target blood pressure levels, or the relationship between these rates and healthy lifestyle characteristics in patients with hypertension as defined by the newly established hypertension management guidelines (JSH2014. The aim of this study was to elucidate achievement rates and examine healthy lifestyle characteristics associated with achievement status among Japanese.This cross-sectional study, conducted in January-December 2012, examined blood pressure control and healthy lifestyle characteristics in 8,001 Japanese workers with hypertension (mean age, 57.0 years; 78.8% were men who participated in a workplace health checkup. Data were collected from workplace medical checkup records and participants' self-administered questionnaires. We divided into 5 groups [G1; young, middle-aged, and early-phase elderly patients (65-74 years old without diabetes mellitus or chronic kidney disease (CKD (<140/90 mmHg, G2; late-phase elderly patients (≥75 years old without diabetes mellitus or CKD (<150/90 mmHg, G3; diabetic patients (<130/80 mmHg, G4; patients with CKD (<130/80 mmHg, and G5; patients with cerebrovascular and/or coronary artery diseases (<140/90 mmHg] according to JSH2014. And then, achievement rates were calculated in each group. Multivariate analysis identified healthy lifestyle characteristics associated with "therapeutic failure" of target blood pressure.Target blood pressures were achieved by 60.2% of young, middle-aged, and early-phase elderly patients (G1, 71.4% of late-phase elderly patients (G2, 30.5% of diabetic patients (G3, 33.4% of those with chronic kidney disease (G4, and 66.0% of those with cerebrovascular and/or coronary artery diseases (G5. A body mass index of 18.5-24.9 and non-daily alcohol consumption were protective factors, and adequate sleep was found to contribute to therapeutic success.We found low achievement rates for treatment goals

  19. The DUNDRUM-1 structured professional judgment for triage to appropriate levels of therapeutic security: retrospective-cohort validation study

    Directory of Open Access Journals (Sweden)

    O'Neill Conor

    2011-03-01

    Full Text Available Abstract Background The assessment of those presenting to prison in-reach and court diversion services and those referred for admission to mental health services is a triage decision, allocating the patient to the appropriate level of therapeutic security. This is a critical clinical decision. We set out to improve on unstructured clinical judgement. We collated qualitative information and devised an 11 item structured professional judgment instrument for this purpose then tested for validity. Methods All those assessed following screening over a three month period at a busy remand committals prison (n = 246 were rated in a retrospective cohort design blind to outcome. Similarly, all those admitted to a mental health service from the same prison in-reach service over an overlapping two year period were rated blind to outcome (n = 100. Results The 11 item scale had good internal consistency (Cronbach's alpha = 0.95 and inter-rater reliability. The scale score did not correlate with the HCR-20 'historical' score. For the three month sample, the receiver operating characteristic area under the curve (AUC for those admitted to hospital was 0.893 (95% confidence interval 0.843 to 0.943. For the two year sample, AUC distinguished at each level between those admitted to open wards, low secure units or a medium/high secure service. Open wards v low secure units AUC = 0.805 (95% CI 0.680 to 0.930; low secure v medium/high secure AUC = 0.866, (95% CI 0.784 to 0.949. Item to outcome correlations were significant for all 11 items. Conclusions The DUNDRUM-1 triage security scale and its items performed to criterion levels when tested against the real world outcome. This instrument can be used to ensure consistency in decision making when deciding who to admit to secure forensic hospitals. It can also be used to benchmark admission thresholds between services and jurisdictions. In this study we found some divergence between assessed need and actual placement

  20. The DUNDRUM-1 structured professional judgment for triage to appropriate levels of therapeutic security: retrospective-cohort validation study

    Science.gov (United States)

    2011-01-01

    Background The assessment of those presenting to prison in-reach and court diversion services and those referred for admission to mental health services is a triage decision, allocating the patient to the appropriate level of therapeutic security. This is a critical clinical decision. We set out to improve on unstructured clinical judgement. We collated qualitative information and devised an 11 item structured professional judgment instrument for this purpose then tested for validity. Methods All those assessed following screening over a three month period at a busy remand committals prison (n = 246) were rated in a retrospective cohort design blind to outcome. Similarly, all those admitted to a mental health service from the same prison in-reach service over an overlapping two year period were rated blind to outcome (n = 100). Results The 11 item scale had good internal consistency (Cronbach's alpha = 0.95) and inter-rater reliability. The scale score did not correlate with the HCR-20 'historical' score. For the three month sample, the receiver operating characteristic area under the curve (AUC) for those admitted to hospital was 0.893 (95% confidence interval 0.843 to 0.943). For the two year sample, AUC distinguished at each level between those admitted to open wards, low secure units or a medium/high secure service. Open wards v low secure units AUC = 0.805 (95% CI 0.680 to 0.930); low secure v medium/high secure AUC = 0.866, (95% CI 0.784 to 0.949). Item to outcome correlations were significant for all 11 items. Conclusions The DUNDRUM-1 triage security scale and its items performed to criterion levels when tested against the real world outcome. This instrument can be used to ensure consistency in decision making when deciding who to admit to secure forensic hospitals. It can also be used to benchmark admission thresholds between services and jurisdictions. In this study we found some divergence between assessed need and actual placement. This provides fertile

  1. Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20.

    LENUS (Irish Health Repository)

    Davoren, Mary

    2012-07-01

    We examined whether new structured professional judgment instruments for assessing need for therapeutic security, treatment completion and recovery in forensic settings were related to moves from higher to lower levels of therapeutic security and added anything to assessment of risk.

  2. Altered operant responding for motor reinforcement and the determination of benchmark doses following perinatal exposure to low-level 2,3,7,8-tetrachlorodibenzo-p-dioxin.

    Science.gov (United States)

    Markowski, V P; Zareba, G; Stern, S; Cox, C; Weiss, B

    2001-06-01

    Pregnant Holtzman rats were exposed to a single oral dose of 0, 20, 60, or 180 ng/kg 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the 18th day of gestation. Their adult female offspring were trained to respond on a lever for brief opportunities to run in specially designed running wheels. Once they had begun responding on a fixed-ratio 1 (FR1) schedule of reinforcement, the fixed-ratio requirement for lever pressing was increased at five-session intervals to values of FR2, FR5, FR10, FR20, and FR30. We examined vaginal cytology after each behavior session to track estrous cyclicity. Under each of the FR values, perinatal TCDD exposure produced a significant dose-related reduction in the number of earned opportunities to run, the lever response rate, and the total number of revolutions in the wheel. Estrous cyclicity was not affected. Because of the consistent dose-response relationship at all FR values, we used the behavioral data to calculate benchmark doses based on displacements from modeled zero-dose performance of 1% (ED(01)) and 10% (ED(10)), as determined by a quadratic fit to the dose-response function. The mean ED(10) benchmark dose for earned run opportunities was 10.13 ng/kg with a 95% lower bound of 5.77 ng/kg. The corresponding ED(01) was 0.98 ng/kg with a 95% lower bound of 0.83 ng/kg. The mean ED(10) for total wheel revolutions was calculated as 7.32 ng/kg with a 95% lower bound of 5.41 ng/kg. The corresponding ED(01) was 0.71 ng/kg with a 95% lower bound of 0.60. These values should be viewed from the perspective of current human body burdens, whose average value, based on TCDD toxic equivalents, has been calculated as 13 ng/kg.

  3. Severe Valproic Acid Intoxication Responding to Hemodialysis

    Directory of Open Access Journals (Sweden)

    Ali Ertuğ Arslanköylü

    2017-08-01

    Full Text Available Valproic acid is a commonly used antiepileptic drug which causes intoxication easily due to its narrow therapeutic window. Here, we present a child with valproic acid poisoning who responded to hemodialysis. A 14-year-old male patient with epilepsy and mental motor retardation was admitted to the pediatric intensive care unit due to valproic acid intoxication. Plasma valproic acid level was 710 µg/mL. The patient’s vital signs were stable and a decrease was observed in the valproic acid and ammonia levels with supportive treatment at the beginning. On the third day of the admission, hemodynamic and mental status of the patient deteriorated, plasma ammonia and lactate levels elevated, thus, we decided to perform hemodialysis. After hemodialysis, the patient’s hemodynamic status and mental function improved in conjunction with the reduction in valproic acid, ammonia and lactate levels. Thus he was transferred to the pediatric ward. Hemodialysis may be considered an effective treatment choice for severe valproic acid intoxication. Here, it was shown that hemodialysis may also be effective in patients with deteriorated general status under supportive treatment in the late phase of valproic acid intoxication.

  4. Cell ATP level of Saccharomyces cerevisiae sensitively responds to culture growth and drug-inflicted variations in membrane integrity and PDR pump activity

    Czech Academy of Sciences Publication Activity Database

    Krasowska, A.; Lukaszewicz, M.; Bartosiewicz, D.; Sigler, Karel

    2010-01-01

    Roč. 395, č. 1 (2010), s. 51-55 ISSN 0006-291X R&D Projects: GA MŠk 1M0570 Institutional research plan: CEZ:AV0Z50200510 Keywords : S. cerevisiae * ABC transporters * ATP level Subject RIV: EE - Microbiology, Virology Impact factor: 2.595, year: 2010

  5. Circulating levels of endocannabinoids respond acutely to voluntary exercise, are altered in mice selectively bred for high voluntary wheel running, and differ between the sexes.

    Science.gov (United States)

    Thompson, Zoe; Argueta, Donovan; Garland, Theodore; DiPatrizio, Nicholas

    2017-03-01

    The endocannabinoid system serves many physiological roles, including in the regulation of energy balance, food reward, and voluntary locomotion. Signaling at the cannabinoid type 1 receptor has been specifically implicated in motivation for rodent voluntary exercise on wheels. We studied four replicate lines of high runner (HR) mice that have been selectively bred for 81 generations based on average number of wheel revolutions on days five and six of a six-day period of wheel access. Four additional replicate lines are bred without regard to wheel running, and serve as controls (C) for random genetic effects that may cause divergence among lines. On average, mice from HR lines voluntarily run on wheels three times more than C mice on a daily basis. We tested the general hypothesis that circulating levels of endocannabinoids (i.e., 2-arachidonoylglycerol [2-AG] and anandamide [AEA]) differ between HR and C mice in a sex-specific manner. Fifty male and 50 female mice were allowed access to wheels for six days, while another 50 males and 50 females were kept without access to wheels (half HR, half C for all groups). Blood was collected by cardiac puncture during the time of peak running on the sixth night of wheel access or no wheel access, and later analyzed for 2-AG and AEA content by ultra-performance liquid chromatography coupled to tandem mass spectrometry. We observed a significant three-way interaction among sex, linetype, and wheel access for 2-AG concentrations, with females generally having lower levels than males and wheel access lowering 2-AG levels in some but not all subgroups. The number of wheel revolutions in the minutes or hours immediately prior to sampling did not quantitatively predict plasma 2-AG levels within groups. We also observed a trend for a linetype-by-wheel access interaction for AEA levels, with wheel access lowering plasma concentrations of AEA in HR mice, while raising them in C mice. In addition, females tended to have higher AEA

  6. Collaboration of local government and experts responding to increase in environmental radiation level due to the nuclear disaster: focusing on their activities and latest radiological discussion

    International Nuclear Information System (INIS)

    Iimoto, T.; Nunokawa, J.; Fujii, H.; Takashima, R.; Hashimoto, M.; Fukuhara, T.; Yajima, T.; Matsuzawa, H.; Kurosawa, K.; Yanagawa, Y.; Someya, S.

    2015-01-01

    Activities were introduced in Kashiwa city in the Tokyo metropolitan area to correspond to the elevated environmental radiation level after the disaster of the Fukushima Daiichi nuclear power plant. These were based on a strong cooperation between local governments and experts. Ambient dose rate and radioactivity of foodstuff produced inside of the city have been monitored. Representative ambient dose rates around living environments have almost already become their original levels of the pre-accident because of the decontamination activity, natural washout and effective half-lives of radioactivity. The internal annual dose due to radioactive cesium under the policy of 'Local Production for Local Consumption' is estimated as extremely low comparing the variation range due to natural radioactivity. Systematic survey around a retention basin has been started. All of these latest monitoring data would be one of the core information for the policy making as well as a cost-benefit discussion and risk communication. (authors)

  7. Peripheral Blood Cells from Patients with Autoimmune Addison's Disease Poorly Respond to Interferons In Vitro, Despite Elevated Serum Levels of Interferon-Inducible Chemokines.

    Science.gov (United States)

    Edvardsen, Kine; Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S; Bratland, Eirik

    2015-10-01

    Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10.

  8. Peripheral Blood Cells from Patients with Autoimmune Addison's Disease Poorly Respond to Interferons In Vitro, Despite Elevated Serum Levels of Interferon-Inducible Chemokines

    Science.gov (United States)

    Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S.; Bratland, Eirik

    2015-01-01

    Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10. PMID:25978633

  9. Chlamydia trachomatis responds to heat shock, penicillin induced persistence, and IFN-gamma persistence by altering levels of the extracytoplasmic stress response protease HtrA

    Directory of Open Access Journals (Sweden)

    Mathews Sarah A

    2008-11-01

    Full Text Available Abstract Background Chlamydia trachomatis, an obligate intracellular human pathogen, is the most prevalent bacterial sexually transmitted infection worldwide and a leading cause of preventable blindness. HtrA is a virulence and stress response periplasmic serine protease and molecular chaperone found in many bacteria. Recombinant purified C. trachomatis HtrA has been previously shown to have both activities. This investigation examined the physiological role of Chlamydia trachomatis HtrA. Results The Chlamydia trachomatis htrA gene complemented the lethal high temperature phenotype of Escherichia coli htrA- (>42°C. HtrA levels were detected to increase by western blot and immunofluorescence during Chlamydia heat shock experiments. Confocal laser scanning microscopy revealed a likely periplasmic localisation of HtrA. During penicillin induced persistence of Chlamydia trachomatis, HtrA levels (as a ratio of LPS were initially less than control acute cultures (20 h post infection but increased to more than acute cultures at 44 h post infection. This was unlike IFN-γ persistence where lower levels of HtrA were observed, suggesting Chlamydia trachomatis IFN-γ persistence does not involve a broad stress response. Conclusion The heterologous heat shock protection for Escherichia coli, and increased HtrA during cell wall disruption via penicillin and heat shock, indicates an important role for HtrA during high protein stress conditions for Chlamydia trachomatis.

  10. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  11. Comparison of the therapeutic effect between a transforminal along with a caudal epidural injection, as well as two-level transforaminal epidural injections ina radiculopathy patient

    International Nuclear Information System (INIS)

    Hwang, Jung Han; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keun Won; Kim, Young Joong; Seo, Jae Young; Lim, Seong Joo; Kang, Byeong Seong

    2017-01-01

    The aim of this study was to evaluate the therapeutic effect of a transforaminal epidural steroid injection (TFESI) along with a caudal epidural steroid injection (ESI), compared to two-level TFESIs in a multi-level radiculopathy patient. A total of 895 lumbar ESIs were performed in 492 patients with multi-level radiculopathy from January 2012 to January 2015. Before injections were performed, the initial Numeric Rating Scale (NRS) score was assessed in all patients, categorized into no pain (excellent), mild (good, NRS: 1-3), moderate (fair, NRS: 4-6), and severe pain (poor, NRS: 7-10). Therapeutic effects were examined for two groups: one-level TFESI along with caudal and ESI two-level TFESIs. Patient outcomes were assessed by NRS in a serial follow-up at one, three, and six months. One TFESI along with caudal ESI was performed in 274 patients and two TFESIs for 218. For the former group with one TFESI along with caudal ESI, excellent results were shown: 219 (79.9%) patients after one month, 200 (72.9%) after three, and 193 (70.4%) after six months. In the patient group with two TFESIs (n = 218) the outcomes were also very good: 152 (69.7%) after one month, 131 (60.0%) after three months, and 123 (56.4%) patients after six months. The therapeutic effect of one TFESI along with caudal ESI was better than two TFESIs in for one, threes, and six months (p < 0.01). Transforaminal epidural steroid with caudal epidural injection is a more effective tool for lumbosacral radiculopathy than two level transforaminal injections in multi-level radiculopathy patients

  12. Comparison of the therapeutic effect between a transforminal along with a caudal epidural injection, as well as two-level transforaminal epidural injections ina radiculopathy patient

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jung Han; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keun Won; Kim, Young Joong; Seo, Jae Young; Lim, Seong Joo [Dept. of Diagnostic Radiology, Konyang University Hospital, Deajeon (Korea, Republic of); Kang, Byeong Seong [Dept. of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan (Korea, Republic of)

    2017-01-15

    The aim of this study was to evaluate the therapeutic effect of a transforaminal epidural steroid injection (TFESI) along with a caudal epidural steroid injection (ESI), compared to two-level TFESIs in a multi-level radiculopathy patient. A total of 895 lumbar ESIs were performed in 492 patients with multi-level radiculopathy from January 2012 to January 2015. Before injections were performed, the initial Numeric Rating Scale (NRS) score was assessed in all patients, categorized into no pain (excellent), mild (good, NRS: 1-3), moderate (fair, NRS: 4-6), and severe pain (poor, NRS: 7-10). Therapeutic effects were examined for two groups: one-level TFESI along with caudal and ESI two-level TFESIs. Patient outcomes were assessed by NRS in a serial follow-up at one, three, and six months. One TFESI along with caudal ESI was performed in 274 patients and two TFESIs for 218. For the former group with one TFESI along with caudal ESI, excellent results were shown: 219 (79.9%) patients after one month, 200 (72.9%) after three, and 193 (70.4%) after six months. In the patient group with two TFESIs (n = 218) the outcomes were also very good: 152 (69.7%) after one month, 131 (60.0%) after three months, and 123 (56.4%) patients after six months. The therapeutic effect of one TFESI along with caudal ESI was better than two TFESIs in for one, threes, and six months (p < 0.01). Transforaminal epidural steroid with caudal epidural injection is a more effective tool for lumbosacral radiculopathy than two level transforaminal injections in multi-level radiculopathy patients.

  13. Responding to Children's Drawings

    Science.gov (United States)

    Watts, Robert

    2010-01-01

    This article aims to explore the issues that face primary school teachers when responding to children's drawings. Assessment in art and design is an ongoing concern for teachers with limited experience and confidence in the area and, although children's drawings continue to be a focus of much research, the question of what it is that teachers say…

  14. Responding to Tragedy

    Science.gov (United States)

    Coopman, J. T.

    2009-01-01

    In this article, the author, a superintendent of Clark-Pleasant School Corporation in Whiteland, Indiana, relates how she and the school community responded to a car accident that killed two students. The author stresses the need to develop a comprehensive crisis plan. It is also important to be sensitive to the needs of family members who are…

  15. Responding to Misbehavior

    OpenAIRE

    Telep, Valya Goodwin, 1955-

    2009-01-01

    This series of lessons was prepared for parents like you - parents who want to do a better job of disciplining their children. The lessons were especially written for parents of preschool children, ages two to six, but some of the discipline methods are appropriate for older children, too. This lesson focuses on responding to misbehavior.

  16. Prostate specific antigen levels during and after external beam radiotherapy for localized carcinoma of the prostate: Predictor of therapeutic efficancy

    International Nuclear Information System (INIS)

    Rodrigus, P.; Landeghem, A.A.J. van

    1992-01-01

    For 105 patients with locoregional carcinoma of the prostate, prostate specific antigen (PSA) levels were evaluated before, during and after external beam radiotherapy. The median follow-up is 17 months. In 51 patients (48.5%) initial PSA levels exceeded the maximum normal value of 20 ng/ml. Nine patients kept non-declining high levels just after radiotherapy. Only one of these is free of disease. Assuming PSA levels decrease exponentially during radiotherapy, a mean half-life of 62 days (median 54, SD 26 days) was calculated. Three out of five patients with a PSA half-life of more than 88 days relapsed as compared to a 8% (3/37) relapse rate in patients with a 'normal' half-life. Prolonged PSA half-life suggests residual disease. PSA levels are expected to further decrease after radiation. Six months after irradiation persistent high PSA levels were found in 14/51 (27.5%) patients. Only four of them had no evidence of manifest disease. Important negative prognostic factors for disease control in our series were non-declining high levels of PSA, a PSA serum half-life exceeding 88 days and persistence of elevated PSA values longer than six months after treatment. In our opinion, PSA is a valuable marker in the follow-up of prostate cancer patients during and after radiotherapy. (orig.) [de

  17. Treatment response in Kawasaki disease is associated with sialylation levels of endogenous but not therapeutic intravenous immunoglobulin G.

    Science.gov (United States)

    Ogata, Shohei; Shimizu, Chisato; Franco, Alessandra; Touma, Ranim; Kanegaye, John T; Choudhury, Biswa P; Naidu, Natasha N; Kanda, Yutaka; Hoang, Long T; Hibberd, Martin L; Tremoulet, Adriana H; Varki, Ajit; Burns, Jane C

    2013-01-01

    Although intravenous immunoglobulin (IVIG) is highly effective in Kawasaki disease (KD), mechanisms are not understood and 10-20% of patients are treatment-resistant, manifesting a higher rate of coronary artery aneurysms. Murine models suggest that α2-6-linked sialic acid (α2-6Sia) content of IVIG is critical for suppressing inflammation. However, pro-inflammatory states also up-regulate endogenous levels of β-galactoside:α2-6 sialyltransferase-I (ST6Gal-I), the enzyme that catalyzes addition of α2-6Sias to N-glycans. We asked whether IVIG failures correlated with levels of α2-6Sia on infused IVIG or on the patient's own endogenous IgG. We quantified levels of α2-6Sia in infused IVIG and endogenous IgG from 10 IVIG-responsive and 10 resistant KD subjects using multiple approaches. Transcript levels of ST6GAL1, in patient whole blood and B cell lines were evaluated by RT-PCR. Plasma soluble (s)ST6Gal-I levels were measured by ELISA. There was no consistent difference in median sialylation levels of infused IVIG between groups. However, α2-6Sia levels in endogenous IgG, ST6GAL1 transcript levels, and ST6Gal-I protein in serum from IVIG-resistant KD subjects were lower than in responsive subjects at both pre-treatment and one-year time points (p treatment response in KD. Rather, lower sialylation of endogenous IgG and lower blood levels of ST6GALI mRNA and ST6Gal-I enzyme predict therapy resistance. These differences were stable over time, suggesting a genetic basis. Because IVIG-resistance increases risk of coronary artery aneurysms, our findings have important implications for the identification and treatment of such individuals.

  18. Resilience among first responders | Pietrantoni | African Health ...

    African Journals Online (AJOL)

    Nine hundred and sixty-one first responders filled out an on-line questionnaire, containing measure of sense of community, collective efficacy, self-efficacy and work-related mental health outcomes (compassion fatigue, burnout and compassion satisfaction). Results. First responders reported high level of compassion ...

  19. Preclinical studies identify non-apoptotic low-level caspase-3 as therapeutic target in pemphigus vulgaris.

    Directory of Open Access Journals (Sweden)

    Camille Luyet

    Full Text Available The majority of pemphigus vulgaris (PV patients suffer from a live-threatening loss of intercellular adhesion between keratinocytes (acantholysis. The disease is caused by auto-antibodies that bind to desmosomal cadherins desmoglein (Dsg 3 or Dsg3 and Dsg1 in mucous membranes and skin. A currently unresolved controversy in PV is whether apoptosis is involved in the pathogenic process. The objective of this study was to perform preclinical studies to investigate apoptotic pathway activation in PV pathogenesis with the goal to assess its potential for clinical therapy. For this purpose, we investigated mouse and human skin keratinocyte cultures treated with PV antibodies (the experimental Dsg3 monospecific antibody AK23 or PV patients IgG, PV mouse models (passive transfer of AK23 or PVIgG into adult and neonatal mice as well as PV patients' biopsies (n=6. A combination of TUNEL assay, analyses of membrane integrity, early apoptotic markers such as cleaved poly-ADP-ribose polymerase (PARP and the collapse of actin cytoskeleton failed to provide evidence for apoptosis in PV pathogenesis. However, the in vitro and in vivo PV models, allowing to monitor progression of lesion formation, revealed an early, transient and low-level caspase-3 activation. Pharmacological inhibition confirmed the functional implication of caspase-3 in major events in PV such as shedding of Dsg3, keratin retraction, proliferation including c-Myc induction, p38MAPK activation and acantholysis. Together, these data identify low-level caspase-3 activation downstream of disrupted Dsg3 trans- or cis-adhesion as a major event in PV pathogenesis that is non-synonymous with apoptosis and represents, unlike apoptotic components, a promising target for clinical therapy. At a broader level, these results posit that an impairment of adhesive functions in concert with low-level, non-lethal caspase-3 activation can evoke profound cellular changes which may be of relevance for other

  20. Therapeutic efficacy of inosine against radiation-induced damage at cellular, biochemical and chromosomal levels in swiss albino mice

    International Nuclear Information System (INIS)

    El-Shamy, E.; Sallam, M. H.

    2010-01-01

    Inosine has been used for treatment of various diseases and disorders in medicine. Modulator effect of inosine against γ radiation-induced histological alterations in testis, reduced glutathione (GSH), lipid peroxidation (LPO), acid and alkaline phosphatases activities (AP and ALP) and chromosomal aberrations (CA) in mice was studied at various experimental intervals between 1 and 30 days. Mice exposed to 8 Gy γ-rays showed acute radiation sickness including marked testis histological changes and chromosomal aberrations (CA) in bone marrow cells with 100 % mortality within 22 days. When inosine was given orally at a dose of 80 mg/ kg body wt for 15 consecutive days after exposure to γ-rays, death in radiation + inosine group was reduced to 70 % at 30 days. The radiation - dose reduction factor (DRF) was 1.43. There was significantly lesser degree of damage to testis tissue architecture and various cell populations including spermatogonia, spermatids and leydig cells. Correspondingly, a significant decrease in the LPO and increase in the GSH levels were observed in testis of radiation + inosine group. Similarly, a significant decrease in level of AP and increase in level of ALP were observed. Inosine treatment significantly prevented γ-rays-induced CA frequency in bone marrow cells.

  1. Distribution of trace levels of therapeutic gallium in bone as mapped by synchrotron X-ray microscopy

    International Nuclear Information System (INIS)

    Bockman, R.S.; Repo, M.A.; Warrell, R.P. Jr.; Pounds, J.G.; Schidlovsky, G.; Gordon, B.M.; Jones, K.W.

    1990-01-01

    Gallium nitrate, a drug that inhibits calcium release from bone, has been proven a safe and effective treatment for the accelerated bone resorption associated with cancer. Though bone is a target organ for gallium, the kinetics, sites, and effects of gallium accumulation in bone are not known. The authors have used synchrotron X-ray microscopy to map the distribution of trace levels of gallium in bone. After short-term in vivo administration of gallium nitrate to rats, trace (nanogram) amounts of gallium preferentially localized to the metabolically active regions in the metaphysis as well as the endosteal and periosteal surfaces of diaphyseal bone, regions where new bone formation and modeling were occurring. The amounts measured were well below the levels known to be cytotoxic. Iron and zinc, trace elements normally found in bone, were decreased in amount after in vivo administration of gallium. These studies represent a first step toward understanding the mechanism(s) of action of gallium in bone by suggesting the possible cellular, structural, and elemental targets of gallium

  2. Incidence of milrinone blood levels outside the therapeutic range and their relevance in children after cardiac surgery for congenital heart disease.

    Science.gov (United States)

    Garcia Guerra, Gonzalo; Joffe, Ari R; Senthilselvan, Ambikaipakan; Kutsogiannis, Demetrios J; Parshuram, Christopher S

    2013-05-01

    To evaluate whether variability in milrinone blood levels (MBL) occurs during administration to critically ill children after surgical repair of congenital heart disease, and the clinical relevance of this variability. Prospective cohort study conducted in the pediatric intensive care unit of a tertiary care teaching and referral hospital. MBL were measured at three time periods after starting milrinone infusion (9-12, 18-24, 40-48 h) and at the end of the infusion. MBL were categorized as within (100-300 ng/ml) or outside the therapeutic range. Low cardiac output syndrome was defined by elevation of either lactate (>2 mmol/l) or arteriovenous oxygen difference (>30%). Five other clinical outcomes were evaluated. Regression analyses evaluated the relationships between MBL and outcomes. Sixty-three patients were included with a total of 220 MBL. Quantification of MBL was by high-performance liquid chromatography. Overall, 114 (52%) MBL were outside the therapeutic range: 78 (36%) subtherapeutic, and 36 (16%) supratherapeutic. Repeated-measures analysis found a significant association between supratherapeutic MBL and low cardiac output syndrome (p = 0.02), and supratherapeutic MBL were associated with arterial-central venous oxygen saturation difference >30% at time 3 (p = 0.007). In this cohort, nontherapeutic MBL were common. Further investigation of milrinone dosing recommendations may improve the postoperative outcomes of children.

  3. Preconditioning With Low-Level Laser Irradiation Enhances the Therapeutic Potential of Human Adipose-derived Stem Cells in a Mouse Model of Photoaged Skin.

    Science.gov (United States)

    Liao, Xuan; Li, Sheng-Hong; Xie, Guang-Hui; Xie, Shan; Xiao, Li-Ling; Song, Jian-Xing; Liu, Hong-Wei

    2018-02-19

    This study was conducted to explore the therapeutic potential of human adipose-derived stem cells (ADSCs) irradiated with a low-level laser (LLL). Cultured ADSCs were treated with 650-nm GaAlAs laser irradiation at 2, 4 and 8 J cm -2 . Cell proliferation was quantified by MTT assays, cytokine secretion was determined by enzyme-linked immunosorbent assays, and adipogenic differentiation was examined by oil red O staining. Additionally, the expression profiles of putative ADSC surface markers were analyzed by quantitative real-time PCR. In addition, a mouse photoaged skin model was established by UVB irradiation. Effects of GaAlAs laser-treated ADSCs on the thicknesses of the epidermis and dermis were analyzed by hematoxylin and eosin staining. The results showed that GaAlAs laser treatment of cells at a radiant exposure of 4 J cm -2 enhanced ADSC proliferation and adipogenic differentiation and increased secretion of growth factors. Furthermore, GaAlAs laser irradiation upregulated the expression of putative ADSC surface markers. In the mouse model of photoaged skin, ADSCs treated with GaAlAs laser irradiation had markedly decreased the epidermal thickness and increased the dermal thickness of photoaged mouse skin. Our data indicate that LLL irradiation is an effective biostimulator of ADSCs and might enhance the therapeutic potential of ADSCs for clinical use. © 2018 The American Society of Photobiology.

  4. Systemic Administration of Glibenclamide Fails to Achieve Therapeutic Levels in the Brain and Cerebrospinal Fluid of Rodents.

    Directory of Open Access Journals (Sweden)

    Carolina Lahmann

    Full Text Available Activating mutations in the Kir6.2 (KCNJ11 subunit of the ATP-sensitive potassium channel cause neonatal diabetes (ND. Patients with severe mutations also suffer from neurological complications. Glibenclamide blocks the open KATP channels and is the treatment of choice for ND. However, although glibenclamide successfully restores normoglycaemia, it has a far more limited effect on the neurological problems. To assess the extent to which glibenclamide crosses the blood-brain barrier (BBB in vivo, we quantified glibenclamide concentrations in plasma, cerebrospinal fluid (CSF, and brain tissue of rats, control mice, and mice expressing a human neonatal diabetes mutation (Kir6.2-V59M selectively in neurones (nV59M mice. As only small sample volumes can be obtained from rodents, we developed a highly sensitive method of analysis, using liquid chromatography tandem mass spectrometry acquisition with pseudo-selected reaction monitoring, achieving a quantification limit of 10ng/ml (20nM glibenclamide in a 30μl sample. Glibenclamide was not detectable in the CSF or brain of rats after implantation with subcutaneous glibenclamide pellets, despite high plasma concentrations. Further, one hour after a suprapharmacological glibenclamide dose was administered directly into the lateral ventricle of the brain, the plasma concentration was twice that of the CSF. This suggests the drug is rapidly exported from the CSF. Elacridar, an inhibitor of P-glycoprotein and breast cancer resistance protein (major multidrug resistance transporters at the BBB, did not affect glibenclamide levels in CSF and brain tissue. We also identified a reduced sensitivity to volatile anaesthetics in nV59M mice and showed this was not reversed by systemic delivery of glibenclamide. Our results therefore suggest that little glibenclamide reaches the central nervous system when given systemically, that glibenclamide is rapidly removed across the BBB when given intracranioventricularly

  5. Therapeutic hypothermia for neonatal encephalopathy: a UK survey of opinion, practice and neuro-investigation at the end of 2007.

    Science.gov (United States)

    Kapetanakis, Andrew; Azzopardi, Denis; Wyatt, John; Robertson, Nicola J

    2009-04-01

    The 2007 Cochrane review of therapeutic hypothermia for neonatal encephalopathy (NE) indicates a significant reduction in adverse outcome. UK National Institute for Clinical Excellence guidelines are awaited. To benchmark current opinion and practice to inform future strategies for optimal knowledge transfer for therapeutic hypothermia. A web based questionnaire (30 sections related to opinion and practice of management of NE) sent to the clinical leads of Level I, II and III neonatal units throughout the UK in November/December 2007. One hundred and twenty-five (out of 195) UK neonatal units responded (response rate 66%). Ten percent, 37.5% and 51.5% responses were from level I, II and III units respectively. Twenty eight percent of all units provided therapeutic hypothermia locally (52% of level III units), however 80% of responders would offer therapeutic hypothermia if there was the facility. Overall, 57% of responders considered therapeutic hypothermia effective or very effective - similar for all unit levels; 43% considered more data are required. Regional availability of therapeutic hypothermia exists in 55% of units and 41% of units offer transfer to a regional centre for therapeutic hypothermia. In the UK in 2007, access to therapeutic hypothermia was widespread although not universal. More than half of responders considered therapeutic hypothermia effective. Fifty-five percent of perinatal networks have the facility to offer therapeutic hypothermia. The involvement of national bodies may be necessary to ensure the adoption of therapeutic hypothermia according to defined protocols and standards; registration is important and will help ensure universal neurodevelopmental follow up.

  6. Optimization of scAAVIL-1ra In Vitro and In Vivo to Deliver High Levels of Therapeutic Protein for Treatment of Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Laurie R Goodrich

    2013-01-01

    Full Text Available Osteoarthritis (OA affects over 40 million people annually. We evaluated interleukin-1 receptor antagonist (IL-1ra gene transfer in an equine model based on IL-1ra protein therapy which inhibits inflammation through blocking IL-1. Using the self-complementary adeno-associated virus (scAAVIL-1ra equine gene as a starting construct, we optimized the transgene cassette by analyzing promoters (cytomegalovirus (CMV versus chicken β-actin hybrid (CBh, coding sequences (optimized versus unoptimized, vector capsid (serotype 2 versus chimeric capsid, and biological activity in vitro. AAV serotypes 2 and 2.5 CMV scAAVoptIL-1ra were tested in equine joints. We evaluated two doses of scAAVIL-1ra, scAAVGFP, and saline. We developed a novel endoscopy procedure and confirmed vector-derived transgene expression (GFP in chondrocytes 6 months post-injection. AAVIL-1ra therapeutic protein levels were 200–800 ng/ml of synovial fluid over 23 and 186 days, respectively. No evidence of intra-articular toxicity was detected and no vector genomes were found in contralateral joints based on GFP fluorescence microscopy and quantitative PCR. Finally, we assayed vector-derived IL-1ra activity based on functional assays which supported anti-inflammatory activity of our protein. These studies represent the first large animal intra-articular gene transfer approach with a therapeutic gene using scAAV and demonstrate high levels of protein production over extended time supporting further clinical investigation using scAAV gene therapy for OA.

  7. Responding to global warming

    International Nuclear Information System (INIS)

    Read, Peter

    1994-01-01

    This book discusses the fragile climate system, political decisions in an uncertain world, sustainable fuel technology, and economic theory and the environment. The economics of pollution policy, the economics of controlling greenhouse gas levels, national interests and the road to Rio are examined in detail. (UK)

  8. Prediction of therapeutic response in steroid-treated pulmonary sarcoidosis. Evaluation of clinical parameters, bronchoalveolar lavage, gallium-67 lung scanning, and serum angiotensin-converting enzyme levels

    International Nuclear Information System (INIS)

    Hollinger, W.M.; Staton, G.W. Jr.; Fajman, W.A.; Gilman, M.J.; Pine, J.R.; Check, I.J.

    1985-01-01

    To find a pretreatment predictor of steroid responsiveness in pulmonary sarcoidosis the authors studied 21 patients before and after steroid treatment by clinical evaluation, pulmonary function tests, bronchoalveolar lavage (BAL), gallium-67 lung scan, and serum angiotensin-converting enzyme (SACE) level. Although clinical score, forced vital capacity (FVC), BAL percent lymphocytes (% lymphs), quantitated gallium-67 lung uptake, and SACE levels all improved with therapy, only the pretreatment BAL % lymphs correlated with the improvement in FVC (r = 0.47, p less than 0.05). Pretreatment BAL % lymphs of greater than or equal to 35% predicted improvement in FVC of 10/11 patients, whereas among 10 patients with BAL % lymphs less than 35%, 5 patients improved and 5 deteriorated. Clinical score, pulmonary function parameters, quantitated gallium-67 lung uptake, and SACE level used alone, in combination with BAL % lymphs or in combination with each other, did not improve this predictive value. The authors conclude that steroid therapy improves a number of clinical and laboratory parameters in sarcoidosis, but only the pretreatment BAL % lymphs are useful in predicting therapeutic responsiveness

  9. Comparative analysis of the number of neurofilaments in rat sciatic nerve undergoing neuropraxia treated by low-level laser and therapeutic ultrasound

    International Nuclear Information System (INIS)

    Matamala, F; Cornejo, R; Paredes, M; Farfan, E; Garrido, O. S; Alves, N

    2014-01-01

    Therapy by low-level laser (LLL) or ultrasound (US) are commonly used as treatment after nerve crush. The aim of this study was to determine the effectiveness of such treatments to repair the neuronal cytoskeleton evaluating the variation in the number of neurofilaments. For this an experimental design was performed, which involved 30 rats divided into 6 groups: 1 - control healthy; 2 - control injured; 3 - irradiated by LLL 2 J/cm2; 4 - irradiated by LLL 10 J/cm2; 5 - irradiated by US 0.5 W/cm2 and 6 - irradiated by US 1W/cm2. With the exception of group 1 all specimens were anesthetized and underwent right sciatic nerve compression using 40N pressure for 45 seconds. Twenty-four hours after compression irradiation was started by LLL and US according protocol. In our research we found that the increase in the number of neurofilaments was related to the applied dose of LLL and US. The average value of neurofilaments / 0.25 mm2 obtained in each group was: 1 - 128; 2-100; 3-156; 4-140; 5-100; 6-148. We concluded that the application of LLL and therapeutic US increases the number of neurofilaments in rat sciatic nerve undergoing neuropraxia, with LLL being more effective compared to the US. Furthermore we concluded that the effectiveness of therapies to induce regeneration of injured nerve is related to the type of protocol used, demonstrating the need to establish an adequate radiation dose with the purpose of obtaining the best therapeutic response, thus achieving successful treatment [es

  10. The Therapeutic Effects of a Medicinal Plant Mixture in Capsule Form on Catalase Levels in the Semen of Men with Oligospermia

    Directory of Open Access Journals (Sweden)

    Alizadeh Hasti

    2015-01-01

    Full Text Available Objective: In the present study, the therapeutic effects of mixed herbs (onion, ginger, basil, cinnamon, orange peel, yellow and red watermelon seeds, and carrot seed on catalase levels in the semen of men with oligospermia were evaluated. About 50% of recognized infertility factors are male-related factors, and are mainly the result of oligospermia, astenospermia, and teratozoospermia. Materials and Methods: The study participants included 40 males with oligospermia and infertility. The studied medicine were 700 mg capsules containing onion, ginger, basil, cinnamon, orange peel, yellow and red watermelon seeds, and carrot seed (100 mg of each. Catalase activity was measured by Aebi method. Results: A significant increase was observed in catalase level in semen as a result of using the medicinal plant mixture (P < 0.001. Conclusion: Free radicals play an important role in male infertility. Antioxidants can prevent the damaging effects they have on sperm. Oxidative stress reduction can increase the chances of natural fertility or assisted reproductive technology (ART. Medicinal plants have low costs, complications, and easy availability, and cause an increase in semen plasma antioxidants and subsequent improvement in semen parameters. Thus, they can be the source of new hopes for the treatment of infertility.

  11. Macromolecular therapeutics.

    Science.gov (United States)

    Yang, Jiyuan; Kopeček, Jindřich

    2014-09-28

    This review covers water-soluble polymer-drug conjugates and macromolecules that possess biological activity without attached low molecular weight drugs. The main design principles of traditional and backbone degradable polymer-drug conjugates as well as the development of a new paradigm in nanomedicines - (low molecular weight) drug-free macromolecular therapeutics are discussed. To address the biological features of cancer, macromolecular therapeutics directed to stem/progenitor cells and the tumor microenvironment are deliberated. Finally, the future perspectives of the field are briefly debated. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Therapeutic Nanodevices

    Science.gov (United States)

    Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

    Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

  13. First Responders and Criticality Accidents

    Energy Technology Data Exchange (ETDEWEB)

    Valerie L. Putman; Douglas M. Minnema

    2005-11-01

    Nuclear criticality accident descriptions typically include, but do not focus on, information useful to first responders. We studied these accidents, noting characteristics to help (1) first responders prepare for such an event and (2) emergency drill planners develop appropriate simulations for training. We also provide recommendations to help people prepare for such events in the future.

  14. Exceptional Responders Initial Feasibility Results

    Science.gov (United States)

    A pilot study evaluating identification of cancer patients who respond to treatment that is ineffective in at least 90 percent of patients found that it was indeed able to confirm a majority of proposed patients as exceptional responders based on clinical

  15. Factors predicting emotional cue-responding behaviors of nurses in Taiwan: An observational study.

    Science.gov (United States)

    Lin, Mei-Feng; Lee, An-Yu; Chou, Cheng-Chen; Liu, Tien-Yu; Tang, Chia-Chun

    2017-10-01

    Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer. This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE. A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE. This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Responder Technology Alert (February 2015)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-04-10

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  17. Therapeutic hemoglobin levels after gene transfer in β-thalassemia mice and in hematopoietic cells of β-thalassemia and sickle cells disease patients.

    Directory of Open Access Journals (Sweden)

    Laura Breda

    Full Text Available Preclinical and clinical studies demonstrate the feasibility of treating β-thalassemia and Sickle Cell Disease (SCD by lentiviral-mediated transfer of the human β-globin gene. However, previous studies have not addressed whether the ability of lentiviral vectors to increase hemoglobin synthesis might vary in different patients.We generated lentiviral vectors carrying the human β-globin gene with and without an ankyrin insulator and compared their ability to induce hemoglobin synthesis in vitro and in thalassemic mice. We found that insertion of an ankyrin insulator leads to higher, potentially therapeutic levels of human β-globin through a novel mechanism that links the rate of transcription of the transgenic β-globin mRNA during erythroid differentiation with polysomal binding and efficient translation, as reported here for the first time. We also established a preclinical assay to test the ability of this novel vector to synthesize adult hemoglobin in erythroid precursors and in CD34(+ cells isolated from patients affected by β-thalassemia and SCD. Among the thalassemic patients, we identified a subset of specimens in which hemoglobin production can be achieved using fewer copies of the vector integrated than in others. In SCD specimens the treatment with AnkT9W ameliorates erythropoiesis by increasing adult hemoglobin (Hb A and concurrently reducing the sickling tetramer (Hb S.Our results suggest two major findings. First, we discovered that for the purpose of expressing the β-globin gene the ankyrin element is particularly suitable. Second, our analysis of a large group of specimens from β-thalassemic and SCD patients indicates that clinical trials could benefit from a simple test to predict the relationship between the number of vector copies integrated and the total amount of hemoglobin produced in the erythroid cells of prospective patients. This approach would provide vital information to select the best candidates for these

  18. Dishonest responding or true virtue?

    DEFF Research Database (Denmark)

    Zettler, Ingo; Hilbig, Benjamin E.; Moshagen, Morten

    2015-01-01

    but troubling proposition that high scores in impression management scales actually reflect honesty rather than dishonest responding. In line with findings indicating that respondents answer to personality questionnaires rather accurately in typical low demand situations, we herein suggest that high impression...... management scores indeed reflect true virtues rather than dishonesty under such conditions. We found support for this idea by replicating previous correlations between impression management scores and virtue-related basic personality traits (including honesty-humility), and additionally provided conclusive...

  19. Therapeutic ultrasound

    International Nuclear Information System (INIS)

    Crum, Lawrence A

    2004-01-01

    The use of ultrasound in medicine is now quite commonplace, especially with the recent introduction of small, portable and relatively inexpensive, hand-held diagnostic imaging devices. Moreover, ultrasound has expanded beyond the imaging realm, with methods and applications extending to novel therapeutic and surgical uses. These applications broadly include: tissue ablation, acoustocautery, lipoplasty, site-specific and ultrasound mediated drug activity, extracorporeal lithotripsy, and the enhancement of natural physiological functions such as wound healing and tissue regeneration. A particularly attractive aspect of this technology is that diagnostic and therapeutic systems can be combined to produce totally non-invasive, imageguided therapy. This general lecture will review a number of these exciting new applications of ultrasound and address some of the basic scientific questions and future challenges in developing these methods and technologies for general use in our society. We shall particularly emphasize the use of High Intensity Focused Ultrasound (HIFU) in the treatment of benign and malignant tumors as well as the introduction of acoustic hemostasis, especially in organs which are difficult to treat using conventional medical and surgical techniques. (amum lecture)

  20. The association of the effect of lithium in the maintenance treatment of bipolar disorder with lithium plasma levels : a post hoc analysis of a double-blind study comparing switching to lithium or placebo in patients who responded to quetiapine (Trial 144)

    NARCIS (Netherlands)

    Nolen, Willem A.; Weisler, Richard H.

    Nolen WA, Weisler RH. The association of the effect of lithium in the maintenance treatment of bipolar disorder with lithium plasma levels: a post hoc analysis of a double-blind study comparing switching to lithium or placebo in patients who responded to quetiapine (Trial 144). Bipolar Disord 2012:

  1. Sex-specific mechanisms for responding to stress.

    Science.gov (United States)

    Bangasser, Debra A; Wicks, Brittany

    2017-01-02

    Posttraumatic stress disorder and major depression share stress as an etiological contributor and are more common in women than in men. Traditionally, preclinical studies investigating the neurobiological underpinnings of stress vulnerability have used only male rodents; however, recent studies that include females are finding sex-specific mechanisms for responding to stress. This Mini-Review examines recent literature using a framework developed by McCarthy and colleagues (2012; J Neurosci 32:2241-2247) that highlights different types of sex differences. First, we detail how learned fear responses in rats are sexually dimorphic. Then, we contrast this finding with fear extinction, which is similar in males and females at the behavioral level but at the circuitry level is associated with sex-specific cellular changes and, thus, exemplifies a sex convergence. Next, sex differences in stress hormones are detailed. Finally, the effects of stress on learning, attention, and arousal are used to highlight the concept of a sex divergence in which the behavior of males and females is similar at baseline but diverges following stressor exposure. We argue that appreciating and investigating the diversity of sex differences in stress response systems will improve our understanding of vulnerability and resilience to stress-related psychiatric disorders and likely lead to the development of novel therapeutics for better treatment of these disorders in both men and women. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Responding to Bullying: What Works?

    Science.gov (United States)

    Craig, Wendy; Pepler, Debra; Blais, Julie

    2007-01-01

    Children who are bullied are often told to "solve the problems themselves"; however, when bullying is repeated over time, it becomes increasingly difficult for victimized children to stop the torment because of their relative lack of power. We examine the ways in which children respond to bullying and their evaluations of the…

  3. Testosterone for Poor Ovarian Responders

    DEFF Research Database (Denmark)

    Polyzos, Nikolaos P; Davis, Susan R; Drakopoulos, Panagiotis

    2016-01-01

    Testosterone, an androgen that directly binds to the androgen receptor, has been shown in previous small randomized controlled trials to increase the reproductive outcomes of poor ovarian responders. In most of these studies, transdermal testosterone in relatively high doses was administered before...... ovarian stimulation with a duration varying from 5 to 21 days. Nevertheless, the key question to be asked is whether, based on ovarian physiology and testosterone pharmacokinetics, a short course of testosterone administration of more than 10 mg could be expected to have any beneficial effect...... stages. In addition, extreme testosterone excess is not only likely to induce adverse events but has also the potential to be ineffective and even detrimental. Thus, evidence from clinical studies is not enough to either "reopen" or "close" the "androgen chapter" in poor responders, mainly because...

  4. Saddleworth, Responding to a Landscape

    OpenAIRE

    Murray, Matthew

    2017-01-01

    Matthew Murray's Landscape publication Saddleworth, Responding To A Landscape. Forward by Martin Barnes Senior Curator of Photographs at The Victoria and Albert Museum, London, Artist Richard Billingham and Maartje van den Heuvel Curator Photography and Media Culture -Leiden Institute. \\ud \\ud ‘Every trip I have taken to Saddleworth Moor over four years has encapsulated each season, weather and cloud pattern, rain, sunshine, snow, early morning clear skies and the sense of the bitter cold of ...

  5. Biodetection Technologies for First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Baird, Cheryl L.; Seiner, Derrick R.; Ozanich, Richard M.; Bartholomew, Rachel A.; Colburn, Heather A.; Straub, Tim M.; Bruckner-Lea, Cindy J.

    2012-10-24

    In a white powder scenario, there are a large number of field-deployable assays that can be used to determine if the suspicious substance contains biological material and warrants further investigation. This report summarizes commercially available technologies that are considered hand portable and can be used by first responders in the field. This is not meant to be an exhaustive list, nor do the authors endorse any of the technologies described herein. Rather, it is meant to provide useful information about available technologies to help end-users make informed decisions about biodetection technology procurement and use.

  6. Responding book banning in indonesia

    Science.gov (United States)

    Aji, RNB; Artono; Liana, C.

    2018-01-01

    The prohibition of books conducted by the government through its apparatus without any due process of law is unfortunate. The Constitutional Court of the Republic of Indonesia (MKRI) in 2010 was decided that book banning is contradictory to the 1945 Constitution (UUD 1945). The purpose of this paper is to know Indonesia, according to the Constitutional Court must absolutely carry out the function of due process of law that is law enforcement in a judicial system when it wants to prohibit printed material which is a book, whether it is a book that is considered criticism and books that teach radicalism. It would be wise for anyone who disagrees with a book, and then responds by writing through a book. The result of this article is to support and suggest that the government and its apparatus in the state of the law should not arbitrarily impose a book ban. Likewise, people should not take violence action to respond this issue. In historical records, the prohibition of books without due process of law is always followed by the withdrawal of books and make people unable to deal with differences, especially in knowledge. That’s why, the government and its apparatus must create a conducive situation and support the creation of various perspectives in the framework of the progress of science through a book. It would implicate that people can respect in any perspective and thought.

  7. The acquisition of conditioned responding.

    Science.gov (United States)

    Harris, Justin A

    2011-04-01

    This report analyzes the acquisition of conditioned responses in rats trained in a magazine approach paradigm. Following the suggestion by Gallistel, Fairhurst, and Balsam (2004), Weibull functions were fitted to the trial-by-trial response rates of individual rats. These showed that the emergence of responding was often delayed, after which the response rate would increase relatively gradually across trials. The fit of the Weibull function to the behavioral data of each rat was equaled by that of a cumulative exponential function incorporating a response threshold. Thus, the growth in conditioning strength on each trial can be modeled by the derivative of the exponential--a difference term of the form used in many models of associative learning (e.g., Rescorla & Wagner, 1972). Further analyses, comparing the acquisition of responding with a continuously reinforced stimulus (CRf) and a partially reinforced stimulus (PRf), provided further evidence in support of the difference term. In conclusion, the results are consistent with conventional models that describe learning as the growth of associative strength, incremented on each trial by an error-correction process.

  8. The therapeutic relationship after psychiatric admission.

    LENUS (Irish Health Repository)

    Roche, Eric

    2014-03-01

    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

  9. Therapeutic significance of a D-dimer cut-off level of >3 μg/ml in colorectal cancer patients treated with standard chemotherapy plus bevacizumab

    International Nuclear Information System (INIS)

    Mochizuki, Satoshi; Yoshino, Takayuki; Kojima, Takashi

    2010-01-01

    The risk of venous thromboembolism has been reported to increase when receiving bevacizumab. Many cancer patients are reported to have elevated D-dimer levels. It is not clear what D-dimer level might indicate an increased risk of venous thromboembolism in the colorectal cancer patients treated with bevacizumab-containing chemotherapy. The D-dimer levels and any event concurrent with an elevated D-dimer level were evaluated in patients receiving bevacizumab. The D-dimer cut-off level was determined using the receiver-operating characteristic analysis. The selection criteria were as follows: histologically proven metastatic and unresectable colorectal adenocarcinoma; no prior chemotherapy containing bevacizumab; D-dimer test performed repetitively on the baseline and during bevacizumab administration; no venous thromboembolism identified at the baseline; and enhanced computed tomographic scan performed every 2 months. Sixty-nine patients were included. The chemotherapy regimens with bevacizumab included the regimen of 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX), the regimen of 5-fluorouracil, leucovorin and irinotecan (FOLFIRI), and leucovorin-modulated 5-fluorouracil. The median baseline D-dimer level was 1.2 μg/ml. The appropriate D-dimer cut-off level was 3 μg/ml with the negative predictive value of 98% and relative risk of 6.9. Twenty-one of 69 patients showed elevated D-dimer levels of >3 μg/ml, with 11 patients for unknown reasons, 6 with tumor progression, 3 with venous thromboembolism and 1 with sepsis. In the remaining 48 patients whose D-dimer levels were ≤3 μg/ml, only one patient developed a venous thromboembolism. A D-dimer cut-off level of 3 μg/ml might be a useful indicator level to exclude venous thromboembolism or show an increased risk for venous thromboembolism in colorectal cancer patients treated with bevacizumab-containing chemotherapy. (author)

  10. Therapeutic effects of ellagic acid on memory, hippocampus electrophysiology deficits, and elevated TNF-α level in brain due to experimental traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Shahram Mashhadizadeh

    2017-04-01

    Full Text Available Objective(s: Cognitive defects such as learning and memory impairment are amongst the most repetitious sequelae after sever and moderate traumatic brain injury (TBI. It was suggested that ellagic acid (EA, an innate phenol product, display neuroprotective properties against oxidative and inflammatory damages after brain injury. The object of the current study was therapeutic properties of EA on blood-brain barrier (BBB interruption and elevated content of TNF-α in brain tissue followed by neurologic aftereffects, cognitive and brain electrophysiology deficits as outcomes of diffuse TBI in rat. Materials and Methods: TBI was induced by a 200 g weight falling by a 2-m height through a free-falling tube onto the head of anesthetized rat. TBI rats treated immediately after trauma with EA             (100 mg/kg, IP once every 8 hr until 48 hr later. Neurologic outcomes, passive avoidance task (PAT, hippocampal long-term potentiation (LTP, BBB permeability and content of TNF-α in brain tissue were evaluated. Results: TBI induced significant impairments in neurological score, BBB function, PAT and hippocampal LTP in TBI+Veh group in compare with Sham+Veh (P

  11. Acute Chemical Incidents With Injured First Responders, 2002-2012.

    Science.gov (United States)

    Melnikova, Natalia; Wu, Jennifer; Yang, Alice; Orr, Maureen

    2018-04-01

    IntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents. We analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends. The percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers' injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training. All responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211-221).

  12. Postvaccination C-Reactive Protein and C5/gp41732-744 Antibody Level Fold-Changes Over Baseline Are Independent Predictors of Therapeutic HIV Vaccine Effect in a Phase 2 Clinical Study of Vacc-4x.

    Science.gov (United States)

    Huang, Yunda; Zhang, Lily; Jolliffe, Darren; Sanchez, Brittany; Stjernholm, Grete; Jelmert, Øyvind; Ökvist, Mats; Sommerfelt, Maja A

    2018-03-01

    Therapeutic vaccination has the potential to contribute to functional HIV cure strategies. However, to show functional HIV cure, study participants must be taken off combination antiretroviral therapy (cART). The availability of suitable biomarkers that can predict viral load (VL) or CD4 count outcomes following therapeutic HIV vaccination would reduce the risks associated with cART interruption in such studies. This report sought to determine baseline and postvaccination biomarker predictors of vaccine effect (VE) on VL and CD4 counts following cART interruption in a double-blind, randomized phase 2 study of the peptide-based therapeutic HIV vaccine, Vacc-4x (n = 93), versus placebo (n = 43). Antibody responses to a novel envelope glycoprotein antigen, C5/gp41 732-744 , and three safety marker measurements [C-reactive protein (CRP), white blood cell, and lactate dehydrogenase] were considered. Interaction tests in univariate and multivariate linear regression models were used to estimate the effect of biomarkers on VE, defined as the VL or CD4 count difference in Vacc-4x versus placebo groups. The reported q-values (considered significant for hypothesis-generating purposes if ≤0.2) accounted for multiple comparisons using the false discovery rate method. Data were analyzed from all available 58 Vacc-4x and 25 placebo recipients before cART resumption. Lower postvaccination fold-change over baseline of CRP concentration (interaction p- (q-) value = 0.005 (0.11) for VL) and higher fold-change of anti-C5/gp41 732-744 antibody levels (0.005 (0.11) for VL and 0.009 (0.20) for CD4) were associated with Vacc-4x benefit. These findings suggest potential roles for inflammation and immune activation markers in predicting therapeutic HIV VE.

  13. Plasma homovanillic acid levels and therapeutic outcome in schizophrenics: comparisons of neuroleptic-naive first-episode patients and patients with disease exacerbation due to neuroleptic discontinuance.

    Science.gov (United States)

    Akiyama, K; Tsuchida, K; Kanzaki, A; Ujike, H; Hamamura, T; Kondo, K; Mutoh, S; Miyanagi, K; Kuroda, S; Otsuki, S

    1995-11-15

    Plasma homovanillic acid (pHVA) levels were measured and the Brief Psychiatric Rating Scale (BPRS) scores were evaluated in 26 schizophrenic patients who had either never been medicated (neuroleptic-naive, first-episode subjects) or whose condition had become exacerbated following neuroleptic discontinuance (exacerbated subjects). All the subjects received medication with a fixed dose of a neuroleptic (haloperidol or fluphenazine, both 9 mg/day) for the first week and variable doses for the subsequent 4 weeks. In the neuroleptic-naive subjects, pHVA levels increased significantly 1 week after starting the protocol; this increase correlated significantly with clinical improvement of the BPRS positive symptom scores at week 5. In the neuroleptic-naive subjects, pHVA levels had declined to the baseline level by week 5. In the exacerbated subjects, there were no significant correlations between pHVA level changes at week 1 and later improvements of the BPRS positive symptom scores. These results suggest that the rise in pHVA levels occurring within 1 week after starting a fixed neuroleptic dose may predict a favorable clinical response in neuroleptic-naive schizophrenic patients.

  14. Bioinformatic analysis of patient-derived ASPS gene expressions and ASPL-TFE3 fusion transcript levels identify potential therapeutic targets.

    Directory of Open Access Journals (Sweden)

    David G Covell

    Full Text Available Gene expression data, collected from ASPS tumors of seven different patients and from one immortalized ASPS cell line (ASPS-1, was analyzed jointly with patient ASPL-TFE3 (t(X;17(p11;q25 fusion transcript data to identify disease-specific pathways and their component genes. Data analysis of the pooled patient and ASPS-1 gene expression data, using conventional clustering methods, revealed a relatively small set of pathways and genes characterizing the biology of ASPS. These results could be largely recapitulated using only the gene expression data collected from patient tumor samples. The concordance between expression measures derived from ASPS-1 and both pooled and individual patient tumor data provided a rationale for extending the analysis to include patient ASPL-TFE3 fusion transcript data. A novel linear model was exploited to link gene expressions to fusion transcript data and used to identify a small set of ASPS-specific pathways and their gene expression. Cellular pathways that appear aberrantly regulated in response to the t(X;17(p11;q25 translocation include the cell cycle and cell adhesion. The identification of pathways and gene subsets characteristic of ASPS support current therapeutic strategies that target the FLT1 and MET, while also proposing additional targeting of genes found in pathways involved in the cell cycle (CHK1, cell adhesion (ARHGD1A, cell division (CDC6, control of meiosis (RAD51L3 and mitosis (BIRC5, and chemokine-related protein tyrosine kinase activity (CCL4.

  15. Correlation between total vitamin D levels and psychotic psychopathology in patients with schizophrenia: therapeutic implications for add-on vitamin D augmentation.

    Science.gov (United States)

    Yüksel, Rabia Nazik; Altunsoy, Neslihan; Tikir, Baise; Cingi Külük, Merve; Unal, Kubranur; Goka, Sema; Aydemir, Cigdem; Goka, Erol

    2014-12-01

    Vitamin D deficiency is one of the implicated factors in ethio-pathogenesis of schizophrenia. Low serum vitamin D levels have been reported in many schizophrenia studies. However, the question is still not answered: Is there a correlation between disease activity and serum vitamin D levels? This is the first study evaluating the relationship between serum total vitamin D levels and disease activity, by comparing total vitamin D levels in two schizophrenia groups abruptly different in terms of disease activity. 41 patients with schizophrenia in remission, 40 patients with schizophrenia those in an acute episode and 40 age- and sex -matched controls with no major psychopatology were recruited in this study. Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression - Severety scale (CGI-S) were used to evaluate disease activity. A demographic data form that included entries on age, gender, ethnicity, weight, skin color, daily duration of sun exposure and nutritional assessment were used. Blood samples were taken from all patients and controls. Total vitamin D (D2+D3), calcium, phosphor, parathyroid hormone values were measured. Patients in an acute episode had significantly lower vitamin D levels compared to patients in remission and to healthy controls (in terms of median values respectively, 7.18, 15.03, 15.02, p vitamin D levels and CGI scores (r = -0.624, p vitamin D levels and PANNS scores (r = -0.508, p vitamin D levels. Even though important factors for vitamin D synthesis were similar, there was severe vitamin D deficiency in patients presenting with an acute episode, significantly different from those in remission. Is vitamin D deficiency the result or the cause of an acute episode? Our results contribute to the idea that vitamin D deficiency and schizophrenia may have interactions with an unknown pathway. Present data points out a possible influence at a genomic level. Future trials may investigate this association with longer follow up

  16. Fundamental problem of high-level radioactive waste disposal policy in Japan. Critical analysis responding to the publication of 'Nationwide Map of Scientific Features for Geological Disposal' by the Japanese government

    International Nuclear Information System (INIS)

    Juraku, Kohta

    2017-01-01

    The government explains that 'Scientific Characteristic Map' (hereinafter 'Map') shows the scientific characteristics of sites that are thought necessary to be taken into account when choosing the place to implement geological disposal and their geographical distribution on the Japanese map for the convenience to 'roughly overlook.' Nuclear Waste Management Organization of Japan (NUMO) as the implementing agency for geological disposal and the government (Agency for Natural Resources and Energy of Ministry of Economy, Trade and Industry) stress that this Map does not indicate so-called 'optimum land,' but it is the 'first step of a long way to realize disposal' for high-level radioactive waste (HLW). However, there clearly lurks a debate about the acceptance of the location of geological disposal in the future. The author has pointed out that the essence of the HLW disposal problem is a problem of 'value selection' that should be decided prior to the location of disposal site. The author believes that it is the competence of society how to identify the path of countermeasures by reconciling in a high degree the justice of the policies supported by scientific and professional knowledge and the justice of social decision making through a democratic duty process. However, the government is trying to forward HLW disposal only from the viewpoint of location problems, while neglecting the problem of 'value selection.' (A.O.)

  17. Clinical profile, level of affection and therapeutic management of patients with osteoarthritis in primary care: The Spanish multicenter study EVALÚA.

    Science.gov (United States)

    Castaño Carou, Ana; Pita Fernández, Salvador; Pértega Díaz, Sonia; de Toro Santos, Francisco Javier

    2015-01-01

    To determine the clinical profile, degree of involvement and management in patients with knee, hip or hand osteoarthritis. Observational study (health centers from 14 autonomous regions, n=363 primary care physicians), involving patients with clinical and/or radiological criteria for osteoarthritis from the American College of Rheumatology, consecutively selected (n=1,258). Sociodemographic variables, clinical and radiological findings, comorbidity and therapeutic management were analyzed. Mean age was 68.0±9.5 years old; 77.8% were women and 47.6% obese. Distribution by location was: 84.3% knee, 23.4% hip, 14.7% hands. All patients reported pain. The most frequent radiographic Kellgren-Lawrence grade was stage 3 for knee and hip (42.9% and 51.9%, respectively), and 3 (37.2%) and 2 (34.5%) for hip. Time since onset of osteoarthritis symptoms was 9.4±7.5 years, with a mean age at onset of around 60 years old and a family history of osteoarthritis in 66.0%. The most frequent comorbidities were: hypertension (55.1%), depression/anxiety (24.7%) and gastroduodenal diseases (22.9%). A total of 97.6% of the patients received pharmacological treatment, with oral analgesics (paracetamol) (70.5%) and oral NSAIDs (67.9%) being the most frequent drugs. Bilateral osteoarthritis was present in 76.9% of patients with knee osteoarthritis, 59.3% in hip and 94.7% in hands. Female gender and time since onset were associated with bilateral knee and hip osteoarthritis. The profile of the osteoarthritis patient is female, >65 years old, overweight/obese, with comorbidity, frequent symptoms and moderate radiologic involvement. Most of patients had bilateral osteoarthritis, associated with female gender and time since onset of disease. Paracetamol was the most common pharmacological treatment. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. Infant differential behavioral responding to discrete emotions.

    Science.gov (United States)

    Walle, Eric A; Reschke, Peter J; Camras, Linda A; Campos, Joseph J

    2017-10-01

    Emotional communication regulates the behaviors of social partners. Research on individuals' responding to others' emotions typically compares responses to a single negative emotion compared with responses to a neutral or positive emotion. Furthermore, coding of such responses routinely measure surface level features of the behavior (e.g., approach vs. avoidance) rather than its underlying function (e.g., the goal of the approach or avoidant behavior). This investigation examined infants' responding to others' emotional displays across 5 discrete emotions: joy, sadness, fear, anger, and disgust. Specifically, 16-, 19-, and 24-month-old infants observed an adult communicate a discrete emotion toward a stimulus during a naturalistic interaction. Infants' responses were coded to capture the function of their behaviors (e.g., exploration, prosocial behavior, and security seeking). The results revealed a number of instances indicating that infants use different functional behaviors in response to discrete emotions. Differences in behaviors across emotions were clearest in the 24-month-old infants, though younger infants also demonstrated some differential use of behaviors in response to discrete emotions. This is the first comprehensive study to identify differences in how infants respond with goal-directed behaviors to discrete emotions. Additionally, the inclusion of a function-based coding scheme and interpersonal paradigms may be informative for future emotion research with children and adults. Possible developmental accounts for the observed behaviors and the benefits of coding techniques emphasizing the function of social behavior over their form are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. CB decontamination for first responders

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, M.D.G.; Purdon, J.G.; Burczyk, A. [Defence Research and Development Canada Suffield, Ralston, AB (Canada)

    2006-07-01

    The Universal Containment System (UCS) is designed to contain, mitigate and decontaminate chemical, biological and radiological warfare agents. The UCS consists of a lightweight, tent-like enclosure filled with a water-based surface decontaminating foam (SDF). The Canadian government funded a project to advance the understanding of the behaviour of the UCS. This paper described the success of the project as well as the technological advances in the UCS formulation and equipment. Vapour desorption experiments were conducted in which SDF was applied onto 12 surfaces found in a typical office environment. Both mustard and nerve agent were studied on the test surfaces. Both scrubbing and non-scrubbing decontamination methods were tested. SDF effectively decontaminated the non-porous substances, particularly when the scrubbing procedure was used. Results were more complicated for the non-porous samples. A dye added to the agent was useful for determining the fate of the agent. Liquid phase studies were conducted in which the reaction between SDF and various agents were studied in the liquid phase in order to estimate the rate of reaction, the stoichiometry and the reaction products formed. Both SDF and the commercial decontamination agent CASCAD were found to effectively kill 100 per cent of anthrax spores. The significance of this project to first responders was considerable. Changes to the formulation and equipment of UCS will increase its usefulness and safety. Users will also have a better knowledge of the amount of decontamination needed for complete effectiveness in specific situations. Recommendations have been made for use of the product on a range of indoor surfaces. Field trials have shown the blast mitigation and agent decontamination ability of the foam under explosive situations. 15 refs., 4 tabs.

  20. Drug use among complete responders, partial responders and non-responders in a longitudinal survey of nonagenarians

    DEFF Research Database (Denmark)

    Wastesson, Jonas W; Rasmussen, Lotte; Oksuzyan, Anna

    2017-01-01

    PURPOSE: In observational studies, non-response can limit representativity and introduce bias. We aimed to investigate the longitudinal changes in the number of used drugs among complete responders, partial responders, and non-responders in a whole birth cohort of Danish nonagenarians participati...

  1. Response rate of fibrosarcoma cells to cytotoxic drugs on the expression level correlates to the therapeutic response rate of fibrosarcomas and is mediated by regulation of apoptotic pathways

    International Nuclear Information System (INIS)

    Lehnhardt, Marcus; Mueller, Oliver; Klein-Hitpass, Ludger; Kuhnen, Cornelius; Homann, Heinz Herbert; Daigeler, Adrien; Steinau, Hans Ulrich; Roehrs, Sonja; Schnoor, Laura; Steinstraesser, Lars

    2005-01-01

    Because of the high resistance rate of fibrosarcomas against cytotoxic agents clinical chemotherapy of these tumors is not established. A better understanding of the diverse modes of tumor cell death following cytotoxic therapies will provide a molecular basis for new chemotherapeutic strategies. In this study we elucidated the response of a fibrosarcoma cell line to clinically used cytostatic agents on the level of gene expression. HT1080 fibrosarcoma cells were exposed to the chemotherapeutic agents doxorubicin, actinomycin D or vincristine. Total RNA was isolated and the gene expression patterns were analyzed by microarray analysis. Expression levels for 46 selected candidate genes were validated by quantitative real-time PCR. The analysis of the microarray data resulted in 3.309 (actinomycin D), 1.019 (doxorubicin) and 134 (vincristine) probesets that showed significant expression changes. For the RNA synthesis blocker actinomycin D, 99.4% of all differentially expressed probesets were under-represented. In comparison, probesets down-regulated by doxorubicin comprised only 37.4% of all genes effected by this agent. Closer analysis of the differentially regulated genes revealed that doxorubicin induced cell death of HT1080 fibrosarcoma cells mainly by regulating the abundance of factors mediating the mitochondrial (intrinsic) apoptosis pathway. Furthermore doxorubicin influences other pathways and crosstalk to other pathways (including to the death receptor pathway) at multiple levels. We found increased levels of cytochrome c, APAF-1 and members of the STAT-family (STAT1, STAT3), while Bcl-2 expression was decreased. Caspase-1, -3, -6, -8, and -9 were increased indicating that these proteases are key factors in the execution of doxorubicin mediated apoptosis. This study demonstrates that chemotherapy regulates the expression of apoptosis-related factors in fibrosarcoma cells. The number and the specific pattern of the genes depend on the used cytotoxic drug

  2. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-12-01

    Full Text Available http://dx.doi.org/10.5007/1984-784X.2013v13n19p13 Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube.   Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  3. Gaucher iPSC-derived macrophages produce elevated levels of inflammatory mediators and serve as a new platform for therapeutic development.

    Science.gov (United States)

    Panicker, Leelamma M; Miller, Diana; Awad, Ola; Bose, Vivek; Lun, Yu; Park, Tea Soon; Zambidis, Elias T; Sgambato, Judi A; Feldman, Ricardo A

    2014-09-01

    Gaucher disease (GD) is an autosomal recessive disorder caused by mutations in the acid β-glucocerebrosidase (GCase; GBA) gene. The hallmark of GD is the presence of lipid-laden Gaucher macrophages, which infiltrate bone marrow and other organs. These pathological macrophages are believed to be the sources of elevated levels of inflammatory mediators present in the serum of GD patients. The alteration in the immune environment caused by GD is believed to play a role in the increased risk of developing multiple myeloma and other malignancies in GD patients. To determine directly whether Gaucher macrophages are abnormally activated and whether their functional defects can be reversed by pharmacological intervention, we generated GD macrophages by directed differentiation of human induced pluripotent stem cells (hiPSC) derived from patients with types 1, 2, and 3 GD. GD hiPSC-derived macrophages expressed higher levels of tumor necrosis factor α, IL-6, and IL-1β than control cells, and this phenotype was exacerbated by treatment with lipopolysaccharide. In addition, GD hiPSC macrophages exhibited a striking delay in clearance of phagocytosed red blood cells, recapitulating the presence of red blood cell remnants in Gaucher macrophages from bone marrow aspirates. Incubation of GD hiPSC macrophages with recombinant GCase, or with the chaperones isofagomine and ambroxol, corrected the abnormal phenotypes of GD macrophages to an extent that reflected their known clinical efficacies. We conclude that Gaucher macrophages are the likely source of the elevated levels of inflammatory mediators in the serum of GD patients and that GD hiPSC are valuable new tools for studying disease mechanisms and drug discovery. © 2014 AlphaMed Press.

  4. 29 CFR 98.1000 - Respondent.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Respondent. 98.1000 Section 98.1000 Labor Office of the Secretary of Labor GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 98.1000 Respondent. Respondent means a person against whom an agency has initiated a debarment or suspension action. ...

  5. The change of metabotropic glutamate receptor 5 expression level in rats with late-stage traumatic brain injury and the therapeutic effect of taurine

    Directory of Open Access Journals (Sweden)

    Ying CAI

    2016-08-01

    Full Text Available Objective To investigate the change of metabotropic glutamate receptor 5 (mGluR5 expression level in rats with late-stage (the 7th day traumatic brain injury (TBI and the role of taurine. Methods The left cerebral TBI rat models were made by using lateral fluid percussion method. A total of 30 specific pathogen free (SPF male Sprague-Dawley (SD rats were randomly divided into 3 groups: sham operation group (control group, TBI model group (TBI group and taurine treatment group (taurine group. Wet and dry weight method was used to measure the brain water content. Real-time fluorescent quantitative polymerase chain reaction (PCR and Western blotting were used to detect the change of mRNA and protein expression of aquaporin 4 (AQP4 and mGluR5 in each group.  Results Compared with control group, the brain water content (t = 4.893, P = 0.002, AQP4 mRNA (t = 6.523, P = 0.000 and protein (t = 4.366, P = 0.008 expression were upregulated, while mGluR5 mRNA (t = 5.776, P = 0.001 and protein (t = 3.945, P = 0.014 expression were downregulated in TBI group. After taurine treatment, the brain water content (t = 2.151, P = 0.140, AQP4 mRNA (t = 1.144,P = 0.432 and protein (t = 0.367, P = 0.804 decreased to normal, while mGluR5 mRNA (t = 1.824, P = 0.216 and protein (t = 1.185, P = 0.414 increased to normal. Correlation analysis showed brain water content was negatively correlated with mGluR5 mRNA (r = -0.617, P = 0.014 and mGluR5 protein (r = -0.665, P = 0.007, while it was positively correlated with AQP4 protein (r = 0.658, P = 0.008.  Conclusions Taurine can significantly increase the mGluR5 expression level of brain issue in the late-stage (the 7th day of TBI and decline brain edema and brain water content. It may be a potential protective agent as an inhibitory neurotransmitter. DOI: 10.3969/j.issn.1672-6731.2016.08.008

  6. The anticoagulant effect of therapeutic levels of dabigatran in atrial fibrillation evaluated by thrombelastography (TEG®), Hemoclot Thrombin Inhibitor (HTI) assay and Ecarin Clotting Time (ECT)

    DEFF Research Database (Denmark)

    Solbeck, Sacha; Jensen, Annette Schophuus; Maschmann, Christian

    2018-01-01

     min), mean dabigatran concentration of 179.2 ng/mL by HTI (range 26-687 ng/mL) and by ECT 225.1 ng/mL (range 42-1020 ng/mL). The two dosage groups had comparable anticoagulation demonstrated by equally prolonged TEG® R (p = .909), HTI (p = .707) and ECT (p = .567). No difference in creatinine levels...... Time (ECT) in patients with non-valvular atrial fibrillation (NVAF). Blood samples from 35 AF patients receiving either 110 mg (n 19) or 150 mg (n 16) dabigatran twice daily were analyzed with TEG®, HTI and ECT 2-3 h after dabigatran intake. All patients had prolonged TEG® R. The patients receiving...... dabigatran 110 mg ×2 had a TEG® R mean 14.2 min (range 9.1-25), a mean dabigatran concentration measured by HTI of 268.5 ng/mL (range 54-837 ng/mL) and by ECT of 355.7 ng/mL (range 40-1020 ng/mL). The corresponding numbers for patients receiving dabigatran 150 mg ×2 were TEG® R mean of 12.5 min (range 9.2-23.2...

  7. Laser de baixa intensidade em deiscência aguda de safenectomia: proposta terapêutica Low level laser therapy in acute dehiscence saphenectomy: therapeutic proposal

    Directory of Open Access Journals (Sweden)

    Nathali Cordeiro Pinto

    2009-03-01

    Full Text Available Deiscência é uma complicação temida em cirurgias de grande porte. Paciente submetida a revascularização miocárdica evoluiu com deiscência de safenectomia em membro inferior, edema e dor no 15º dia pós-operatório (PO, tendo sido realizado inicialmente o tratamento convencional no ambulatório sem melhora clínica. No 30º PO, aplicou-se somente Laser de Baixa Intensidade (LBI ao redor da borda da ferida, pontualmente. A lesão respondeu com tecido de granulação, diminuição do processo inflamatório e analgesia desde a primeira aplicação. Neste estudo piloto, a laserterapia mostrou ter um papel importante como agente facilitador de cicatrização, por meio de uma terapia nãoinvasiva, eficaz e segura.Dehiscence is a feared complication after major surgeries. Patient who had undergone coronary artery bypass grafting developed saphenectomy's dehiscence on lower limb with edema and pain on the 15th postoperative day. Conventional treatment had been initially performed without clinical improvement. On the 30th postoperative day only Low Level Laser Therapy (LLLT was applied punctually around surgical wounds edge. The results revealed granulated tissue, reduction of inflammatory process and analgesic effect since the first application. In this pilot study, LLLT has shown a considerable role as a wound healing agent, through a new proposal for efficient, safe and noninvasive therapy.

  8. Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20

    Directory of Open Access Journals (Sweden)

    Davoren Mary

    2012-07-01

    Full Text Available Abstract Background We examined whether new structured professional judgment instruments for assessing need for therapeutic security, treatment completion and recovery in forensic settings were related to moves from higher to lower levels of therapeutic security and added anything to assessment of risk. Methods This was a prospective naturalistic twelve month observational study of a cohort of patients in a forensic hospital placed according to their need for therapeutic security along a pathway of moves from high to progressively less secure units in preparation for discharge. Patients were assessed using the DUNDRUM-1 triage security scale, the DUNDRUM-3 programme completion scale and the DUNDRUM-4 recovery scale and assessments of risk of violence, self harm and suicide, symptom severity and global function. Patients were subsequently observed for positive moves to less secure units and negative moves to more secure units. Results There were 86 male patients at baseline with mean follow-up 0.9 years, 11 positive and 9 negative moves. For positive moves, logistic regression indicated that along with location at baseline, the DUNDRUM-1, HCR-20 dynamic and PANSS general symptom scores were associated with subsequent positive moves. The receiver operating characteristic was significant for the DUNDRUM-1 while ANOVA co-varying for both location at baseline and HCR-20 dynamic score was significant for DUNDRUM-1. For negative moves, logistic regression showed DUNDRUM-1 and HCR-20 dynamic scores were associated with subsequent negative moves, along with DUNDRUM-3 and PANSS negative symptoms in some models. The receiver operating characteristic was significant for the DUNDRUM-4 recovery and HCR-20 dynamic scores with DUNDRUM-1, DUNDRUM-3, PANSS general and GAF marginal. ANOVA co-varying for both location at baseline and HCR-20 dynamic scores showed only DUNDRUM-1 and PANSS negative symptoms associated with subsequent negative moves. Conclusions

  9. Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20.

    Science.gov (United States)

    Davoren, Mary; O'Dwyer, Sarah; Abidin, Zareena; Naughton, Leena; Gibbons, Olivia; Doyle, Elaine; McDonnell, Kim; Monks, Stephen; Kennedy, Harry G

    2012-07-13

    We examined whether new structured professional judgment instruments for assessing need for therapeutic security, treatment completion and recovery in forensic settings were related to moves from higher to lower levels of therapeutic security and added anything to assessment of risk. This was a prospective naturalistic twelve month observational study of a cohort of patients in a forensic hospital placed according to their need for therapeutic security along a pathway of moves from high to progressively less secure units in preparation for discharge. Patients were assessed using the DUNDRUM-1 triage security scale, the DUNDRUM-3 programme completion scale and the DUNDRUM-4 recovery scale and assessments of risk of violence, self harm and suicide, symptom severity and global function. Patients were subsequently observed for positive moves to less secure units and negative moves to more secure units. There were 86 male patients at baseline with mean follow-up 0.9 years, 11 positive and 9 negative moves. For positive moves, logistic regression indicated that along with location at baseline, the DUNDRUM-1, HCR-20 dynamic and PANSS general symptom scores were associated with subsequent positive moves. The receiver operating characteristic was significant for the DUNDRUM-1 while ANOVA co-varying for both location at baseline and HCR-20 dynamic score was significant for DUNDRUM-1. For negative moves, logistic regression showed DUNDRUM-1 and HCR-20 dynamic scores were associated with subsequent negative moves, along with DUNDRUM-3 and PANSS negative symptoms in some models. The receiver operating characteristic was significant for the DUNDRUM-4 recovery and HCR-20 dynamic scores with DUNDRUM-1, DUNDRUM-3, PANSS general and GAF marginal. ANOVA co-varying for both location at baseline and HCR-20 dynamic scores showed only DUNDRUM-1 and PANSS negative symptoms associated with subsequent negative moves. Clinicians appear to decide moves based on combinations of current and

  10. Mechanisms of Plasma Therapeutics

    Science.gov (United States)

    Graves, David

    2015-09-01

    In this talk, I address research directed towards biomedical applications of atmospheric pressure plasma such as sterilization, surgery, wound healing and anti-cancer therapy. The field has seen remarkable growth in the last 3-5 years, but the mechanisms responsible for the biomedical effects have remained mysterious. It is known that plasmas readily create reactive oxygen species (ROS) and reactive nitrogen species (RNS). ROS and RNS (or RONS), in addition to a suite of other radical and non-radical reactive species, are essential actors in an important sub-field of aerobic biology termed ``redox'' (or oxidation-reduction) biology. It is postulated that cold atmospheric plasma (CAP) can trigger a therapeutic shielding response in tissue in part by creating a time- and space-localized, burst-like form of oxy-nitrosative stress on near-surface exposed cells through the flux of plasma-generated RONS. RONS-exposed surface layers of cells communicate to the deeper levels of tissue via a form of the ``bystander effect,'' similar to responses to other forms of cell stress. In this proposed model of CAP therapeutics, the plasma stimulates a cellular survival mechanism through which aerobic organisms shield themselves from infection and other challenges.

  11. Identification of V-ATPase as a molecular sensor of SOX11-levels and potential therapeutic target for mantle cell lymphoma

    International Nuclear Information System (INIS)

    Emruli, Venera Kuci; Olsson, Roger; Ek, Fredrik; Ek, Sara

    2016-01-01

    Mantle cell lymphoma (MCL) is an aggressive disease with short median survival. Molecularly, MCL is defined by the t(11;14) translocation leading to overexpression of the CCND1 gene. However, recent data show that the neural transcription factor SOX11 is a disease defining antigen and several involved signaling pathways have been pin-pointed, among others the Wnt/β-catenin pathway that is of importance for proliferation in MCL. Therefore, we evaluated a compound library focused on the Wnt pathway with the aim of identifying Wnt-related targets that regulate growth and survival in MCL, with particular focus on SOX11-dependent growth regulation. An inducible SOX11 knock-down system was used to functionally screen a library of compounds (n = 75) targeting the Wnt signaling pathway. A functionally interesting target, vacuolar-type H + -ATPase (V-ATPase), was further evaluated by western blot, siRNA-mediated gene silencing, immunofluorescence, and flow cytometry. We show that 15 out of 75 compounds targeting the Wnt pathway reduce proliferation in all three MCL cell lines tested. Furthermore, three substances targeting two different targets (V-ATPase and Dkk1) showed SOX11-dependent activity. Further validation analyses were focused on V-ATPase and showed that two independent V-ATPase inhibitors (bafilomycin A1 and concanamycin A) are sensitive to SOX11 levels, causing reduced anti-proliferative response in SOX11 low cells. We further show, using fluorescence imaging and flow cytometry, that V-ATPase is mainly localized to the plasma membrane in primary and MCL cell lines. We show that SOX11 status affect V-ATPase dependent pathways, and thus may be involved in regulating pH in intracellular and extracellular compartments. The plasma membrane localization of V-ATPase indicates that pH regulation of the immediate extracellular compartment may be of importance for receptor functionality and potentially invasiveness in vivo. The online version of this article (doi:10

  12. Monitoring low molecular weight heparins at therapeutic levels: dose-responses of, and correlations and differences between aPTT, anti-factor Xa and thrombin generation assays.

    Directory of Open Access Journals (Sweden)

    Owain Thomas

    Full Text Available Low molecular weight heparins (LMWH's are used to prevent and treat thrombosis. Tests for monitoring LMWH's include anti-factor Xa (anti-FXa, activated partial thromboplastin time (aPTT and thrombin generation. Anti-FXa is the current gold standard despite LMWH's varying affinities for FXa and thrombin.To examine the effects of two different LMWH's on the results of 4 different aPTT-tests, anti-FXa activity and thrombin generation and to assess the tests' concordance.Enoxaparin and tinzaparin were added ex-vivo in concentrations of 0.0, 0.5, 1.0 and 1.5 anti-FXa international units (IU/mL, to blood from 10 volunteers. aPTT was measured using two whole blood methods (Free oscillation rheometry (FOR and Hemochron Jr (HCJ and an optical plasma method using two different reagents (ActinFSL and PTT-Automat. Anti-FXa activity was quantified using a chromogenic assay. Thrombin generation (Endogenous Thrombin Potential, ETP was measured on a Ceveron Alpha instrument using the TGA RB and more tissue-factor rich TGA RC reagents.Methods' mean aPTT at 1.0 IU/mL LMWH varied between 54s (SD 11 and 69s (SD 14 for enoxaparin and between 101s (SD 21 and 140s (SD 28 for tinzaparin. ActinFSL gave significantly shorter aPTT results. aPTT and anti-FXa generally correlated well. ETP as measured with the TGA RC reagent but not the TGA RB reagent showed an inverse exponential relationship to the concentration of LMWH. The HCJ-aPTT results had the weakest correlation to anti-FXa and thrombin generation (Rs0.62-0.87, whereas the other aPTT methods had similar correlation coefficients (Rs0.80-0.92.aPTT displays a linear dose-response to LMWH. There is variation between aPTT assays. Tinzaparin increases aPTT and decreases thrombin generation more than enoxaparin at any given level of anti-FXa activity, casting doubt on anti-FXa's present gold standard status. Thrombin generation with tissue factor-rich activator is a promising method for monitoring LMWH's.

  13. Combination of nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy as a novel therapeutic application to manage the pain and treat many clinical conditions

    Science.gov (United States)

    Halasa, Salaheldin; Dickinson, Eva

    2014-02-01

    From hypertension to diabetes, cancer to HIV, stroke to memory loss and learning disorders to septic shock, male impotence to tuberculosis, there is probably no pathological condition where nitric oxide does not play an important role. Nitric oxide is an analgesic, immune-modulator, vasodilator, anti-apoptotic, growth modulator, angiogenetic, anti-thrombotic, anti-inflammatory and neuro-modulator. Because of the above actions of nitric oxide, many clinical conditions associated with abnormal Nitric oxide (NO) production and bioavailability. Our novel therapeutic approach is to restore the homeostasis of nitric oxide and replace the lost cells by combining nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy.

  14. Differences in change in coping styles between good responders, moderate responders and non-responders to pulmonary rehabilitation.

    Science.gov (United States)

    Stoilkova-Hartmann, Ana; Janssen, Daisy J A; Franssen, Frits M E; Wouters, Emiel F M

    2015-12-01

    Pulmonary rehabilitation (PR) improves exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). Data on the effects of PR on coping styles are limited. Aim of the present study was to compare changes in coping styles between patients who had a good, moderate and no improvement in either exercise tolerance or health status after PR. Coping styles of 439 COPD patients undergoing PR were assessed by the Utrecht Coping List (UCL) at baseline and after PR. Patients' pulmonary function, six-minute walking distance (6MWD), St. George's Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS-A and HADS-D) were recorded. Good, moderate and non-responders were defined on the basis of minimally clinically important difference (MCID) for SGRQ total score and/or 6MWD. Overall, 54.0% of the patients fulfilled the criteria for good responders, while 22.1% were moderate responders. Change in passive reaction pattern coping style differed significantly between good responders and non-responders following PR (p styles after PR occurred among the good responders, whereas the majority of moderate responders' and non-responders' coping styles were not significantly influenced by PR. Good responders decreased their passive reaction pattern coping style in contrast to non-responders after PR. In general, PR did not change the coping among moderate and non-responders. Further research is warranted to determine whether including interventions targeting coping styles may modify coping behaviour of COPD patients, as well as improvement in exercise tolerance or health status after PR. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. A Therapeutic Communication Study of Families with Children Suffering from Cancer

    Directory of Open Access Journals (Sweden)

    Devie Rahmawati

    2017-12-01

    Full Text Available Therapeutic communication is a relatively new area of research in Indonesia. It is widely known that the success of therapeutic communication is largely influenced by the medical providers’ communication effectiveness when dealing with their clients. This paper reports on research that aimed to explore the connection between therapeutic communication and satisfaction and dissatisfaction as experienced by families of child cancer patients. It used a quantitative approach with a cross-sectional design. The sample was the families of child cancer patients who were acccompanying the patients during hospital stay treatment at an Indonesian public hospital in Jakarta over the period December of   2014 – March 2015. There were 23 respondents for the research. The statistical test used was chi-square with an 0.05 level of significance. The result indicated that 56.5% of the respondents were satisfied with the therapeutic communication provided by nursing staff and that those who praticed therapeutic communication well, were 22 times more likely to provide a satisfactory level to the families  of   child  cancer  patients  compared  with  those who  did not  apply good therapeutic communication  (the value of p=0.003 and Odds ratio= 22. Thus, the research indicated that the medical providers’ communication effectiveness was associated with the patients’ satisfaction. We suggest that medical providers be given workshops on how to improve their communication skills to make their clients more satisfied with the medical services.

  16. Defense Technology Opportunities for First Responders

    National Research Council Canada - National Science Library

    White, Rodney; Bedard, Louis; Derrah, Scott; Boucher, Robert

    2004-01-01

    For this study, the US and Canadian governments assessed the potential for technology transfer of five technologies, which were developed to meet military requirements, to civilian first responders...

  17. Yessotoxin, a Promising Therapeutic Tool

    Directory of Open Access Journals (Sweden)

    Amparo Alfonso

    2016-01-01

    Full Text Available Yessotoxin (YTX is a polyether compound produced by dinoflagellates and accumulated in filter feeding shellfish. No records about human intoxications induced by this compound have been published, however it is considered a toxin. Modifications in second messenger levels, protein levels, immune cells, cytoskeleton or activation of different cellular death types have been published as consequence of YTX exposure. This review summarizes the main intracellular pathways modulated by YTX and their pharmacological and therapeutic implications.

  18. Mobile-Only Web Survey Respondents

    NARCIS (Netherlands)

    Lugtig, P.J.|info:eu-repo/dai/nl/304824658; Toepoel, V.|info:eu-repo/dai/nl/304576034; amin, alerk

    2016-01-01

    Web surveys are no longer completed on just a desktop or laptop computer. Respondents increasingly use mobile devices, such as tablets and smartphones to complete web surveys. In this article, we study how respondents in the American Life Panel complete surveys using varying devices. We show that

  19. 7 CFR 3017.1000 - Respondent.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Respondent. 3017.1000 Section 3017.1000 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 3017.1000 Respondent...

  20. Evaluation of respondent-driven sampling.

    Science.gov (United States)

    McCreesh, Nicky; Frost, Simon D W; Seeley, Janet; Katongole, Joseph; Tarsh, Matilda N; Ndunguse, Richard; Jichi, Fatima; Lunel, Natasha L; Maher, Dermot; Johnston, Lisa G; Sonnenberg, Pam; Copas, Andrew J; Hayes, Richard J; White, Richard G

    2012-01-01

    Respondent-driven sampling is a novel variant of link-tracing sampling for estimating the characteristics of hard-to-reach groups, such as HIV prevalence in sex workers. Despite its use by leading health organizations, the performance of this method in realistic situations is still largely unknown. We evaluated respondent-driven sampling by comparing estimates from a respondent-driven sampling survey with total population data. Total population data on age, tribe, religion, socioeconomic status, sexual activity, and HIV status were available on a population of 2402 male household heads from an open cohort in rural Uganda. A respondent-driven sampling (RDS) survey was carried out in this population, using current methods of sampling (RDS sample) and statistical inference (RDS estimates). Analyses were carried out for the full RDS sample and then repeated for the first 250 recruits (small sample). We recruited 927 household heads. Full and small RDS samples were largely representative of the total population, but both samples underrepresented men who were younger, of higher socioeconomic status, and with unknown sexual activity and HIV status. Respondent-driven sampling statistical inference methods failed to reduce these biases. Only 31%-37% (depending on method and sample size) of RDS estimates were closer to the true population proportions than the RDS sample proportions. Only 50%-74% of respondent-driven sampling bootstrap 95% confidence intervals included the population proportion. Respondent-driven sampling produced a generally representative sample of this well-connected nonhidden population. However, current respondent-driven sampling inference methods failed to reduce bias when it occurred. Whether the data required to remove bias and measure precision can be collected in a respondent-driven sampling survey is unresolved. Respondent-driven sampling should be regarded as a (potentially superior) form of convenience sampling method, and caution is required

  1. Evaluation of Respondent-Driven Sampling

    Science.gov (United States)

    McCreesh, Nicky; Frost, Simon; Seeley, Janet; Katongole, Joseph; Tarsh, Matilda Ndagire; Ndunguse, Richard; Jichi, Fatima; Lunel, Natasha L; Maher, Dermot; Johnston, Lisa G; Sonnenberg, Pam; Copas, Andrew J; Hayes, Richard J; White, Richard G

    2012-01-01

    Background Respondent-driven sampling is a novel variant of link-tracing sampling for estimating the characteristics of hard-to-reach groups, such as HIV prevalence in sex-workers. Despite its use by leading health organizations, the performance of this method in realistic situations is still largely unknown. We evaluated respondent-driven sampling by comparing estimates from a respondent-driven sampling survey with total-population data. Methods Total-population data on age, tribe, religion, socioeconomic status, sexual activity and HIV status were available on a population of 2402 male household-heads from an open cohort in rural Uganda. A respondent-driven sampling (RDS) survey was carried out in this population, employing current methods of sampling (RDS sample) and statistical inference (RDS estimates). Analyses were carried out for the full RDS sample and then repeated for the first 250 recruits (small sample). Results We recruited 927 household-heads. Full and small RDS samples were largely representative of the total population, but both samples under-represented men who were younger, of higher socioeconomic status, and with unknown sexual activity and HIV status. Respondent-driven-sampling statistical-inference methods failed to reduce these biases. Only 31%-37% (depending on method and sample size) of RDS estimates were closer to the true population proportions than the RDS sample proportions. Only 50%-74% of respondent-driven-sampling bootstrap 95% confidence intervals included the population proportion. Conclusions Respondent-driven sampling produced a generally representative sample of this well-connected non-hidden population. However, current respondent-driven-sampling inference methods failed to reduce bias when it occurred. Whether the data required to remove bias and measure precision can be collected in a respondent-driven sampling survey is unresolved. Respondent-driven sampling should be regarded as a (potentially superior) form of convenience

  2. Muscle myeloid type I interferon gene expression may predict therapeutic responses to rituximab in myositis patients.

    Science.gov (United States)

    Nagaraju, Kanneboyina; Ghimbovschi, Svetlana; Rayavarapu, Sree; Phadke, Aditi; Rider, Lisa G; Hoffman, Eric P; Miller, Frederick W

    2016-09-01

    To identify muscle gene expression patterns that predict rituximab responses and assess the effects of rituximab on muscle gene expression in PM and DM. In an attempt to understand the molecular mechanism of response and non-response to rituximab therapy, we performed Affymetrix gene expression array analyses on muscle biopsy specimens taken before and after rituximab therapy from eight PM and two DM patients in the Rituximab in Myositis study. We also analysed selected muscle-infiltrating cell phenotypes in these biopsies by immunohistochemical staining. Partek and Ingenuity pathway analyses assessed the gene pathways and networks. Myeloid type I IFN signature genes were expressed at higher levels at baseline in the skeletal muscle of rituximab responders than in non-responders, whereas classic non-myeloid IFN signature genes were expressed at higher levels in non-responders at baseline. Also, rituximab responders have a greater reduction of the myeloid and non-myeloid type I IFN signatures than non-responders. The decrease in the type I IFN signature following administration of rituximab may be associated with the decreases in muscle-infiltrating CD19(+) B cells and CD68(+) macrophages in responders. Our findings suggest that high levels of myeloid type I IFN gene expression in skeletal muscle predict responses to rituximab in PM/DM and that rituximab responders also have a greater decrease in the expression of these genes. These data add further evidence to recent studies defining the type I IFN signature as both a predictor of therapeutic responses and a biomarker of myositis disease activity. Published by Oxford University Press on behalf British Society for Rheumatology 2016. This work is written by US Government employees and is in the public domain in the US.

  3. Platelet "first responders" in wound response, cancer, and metastasis.

    Science.gov (United States)

    Menter, David G; Kopetz, Scott; Hawk, Ernest; Sood, Anil K; Loree, Jonathan M; Gresele, Paolo; Honn, Kenneth V

    2017-06-01

    Platelets serve as "first responders" during normal wounding and homeostasis. Arising from bone marrow stem cell lineage megakaryocytes, anucleate platelets can influence inflammation and immune regulation. Biophysically, platelets are optimized due to size and discoid morphology to distribute near vessel walls, monitor vascular integrity, and initiate quick responses to vascular lesions. Adhesion receptors linked to a highly reactive filopodia-generating cytoskeleton maximizes their vascular surface contact allowing rapid response capabilities. Functionally, platelets normally initiate rapid clotting, vasoconstriction, inflammation, and wound biology that leads to sterilization, tissue repair, and resolution. Platelets also are among the first to sense, phagocytize, decorate, or react to pathogens in the circulation. These platelet first responder properties are commandeered during chronic inflammation, cancer progression, and metastasis. Leaky or inflammatory reaction blood vessel genesis during carcinogenesis provides opportunities for platelet invasion into tumors. Cancer is thought of as a non-healing or chronic wound that can be actively aided by platelet mitogenic properties to stimulate tumor growth. This growth ultimately outstrips circulatory support leads to angiogenesis and intravasation of tumor cells into the blood stream. Circulating tumor cells reengage additional platelets, which facilitates tumor cell adhesion, arrest and extravasation, and metastasis. This process, along with the hypercoagulable states associated with malignancy, is amplified by IL6 production in tumors that stimulate liver thrombopoietin production and elevates circulating platelet numbers by thrombopoiesis in the bone marrow. These complex interactions and the "first responder" role of platelets during diverse physiologic stresses provide a useful therapeutic target that deserves further exploration.

  4. A comparison of physical and psychological features of responders and non-responders to cervical facet blocks in chronic whiplash

    Science.gov (United States)

    2013-01-01

    Background Cervical facet block (FB) procedures are often used as a diagnostic precursor to radiofrequency neurotomies (RFN) in the management of chronic whiplash associated disorders (WAD). Some individuals will respond to the FB procedures and others will not respond. Such responders and non-responders provided a sample of convenience to question whether there were differences in their physical and psychological features. This information may inform future predictive studies and ultimately the clinical selection of patients for FB procedures. Methods This cross-sectional study involved 58 individuals with chronic WAD who responded to cervical FB procedures (WAD_R); 32 who did not respond (WAD_NR) and 30 Healthy Controls (HC)s. Measures included: quantitative sensory tests (pressure; thermal pain thresholds; brachial plexus provocation test); nociceptive flexion reflex (NFR); motor function (cervical range of movement (ROM); activity of the superficial neck flexors during the cranio-cervical flexion test (CCFT). Self-reported measures were gained from the following questionnaires: neuropathic pain (s-LANSS); psychological distress (General Health Questionnaire-28), post-traumatic stress (PDS) and pain catastrophization (PCS). Individuals with chronic whiplash attended the laboratory once the effects of the blocks had abated and symptoms had returned. Results Following FB procedures, both WAD groups demonstrated generalized hypersensitivity to all sensory tests, decreased neck ROM and increased superficial muscle activity with the CCFT compared to controls (p 0.05). Both WAD groups demonstrated psychological distress (GHQ-28; p < 0.05), moderate post-traumatic stress symptoms and pain catastrophization. The WAD_NR group also demonstrated increased medication intake and elevated PCS scores compared to the WAD_R group (p < 0.05). Conclusions Chronic WAD responders and non-responders to FB procedures demonstrate a similar presentation of sensory disturbance, motor

  5. Criticality Safety Basics for INL Emergency Responders

    Energy Technology Data Exchange (ETDEWEB)

    Valerie L. Putman

    2012-08-01

    This document is a modular self-study guide about criticality safety principles for Idaho National Laboratory emergency responders. This guide provides basic criticality safety information for people who, in response to an emergency, might enter an area that contains much fissionable (or fissile) material. The information should help responders understand unique factors that might be important in responding to a criticality accident or in preventing a criticality accident while responding to a different emergency.

    This study guide specifically supplements web-based training for firefighters (0INL1226) and includes information for other Idaho National Laboratory first responders. However, the guide audience also includes other first responders such as radiological control personnel.

    For interested readers, this guide includes clearly marked additional information that will not be included on tests. The additional information includes historical examples (Been there. Done that.), as well as facts and more in-depth information (Did you know …).

    INL criticality safety personnel revise this guide as needed to reflect program changes, user requests, and better information. Revision 0, issued May 2007, established the basic text. Revision 1 incorporates operation, program, and training changes implemented since 2007. Revision 1 increases focus on first responders because later responders are more likely to have more assistance and guidance from facility personnel and subject matter experts. Revision 1 also completely reorganized the training to better emphasize physical concepts behind the criticality controls that help keep emergency responders safe. The changes are based on and consistent with changes made to course 0INL1226.

  6. The therapeutic collaboration in life design counselling: The case of ...

    African Journals Online (AJOL)

    The collaboration coding system enables the assessment of each therapeutic exchange within and outside of the client's therapeutic zone of proximal development, defined as the space between the client's actual therapeutic developmental level and his/her potential developmental level fomented by a collaborative ...

  7. Responder Technology Alert Monthly (January 2015)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-01

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  8. Responder Technology Alert Monthly (December 2014)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-13

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  9. Reactor-produced therapeutic radioisotopes

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.

    2002-01-01

    The significant worldwide increase in therapeutic radioisotope applications in nuclear medicine, oncology and interventional cardiology requires the dependable production of sufficient levels of radioisotopes for these applications (Reba, 2000; J. Nucl. Med., 1998; Nuclear News, 1999; Adelstein and Manning, 1994). The issues associated with both accelerator- and reactor-production of therapeutic radioisotopes is important. Clinical applications of therapeutic radioisotopes include the use of both sealed sources and unsealed radiopharmaceutical sources. Targeted radiopharmaceutical agents include those for cancer therapy and palliation of bone pain from metastatic disease, ablation of bone marrow prior to stem cell transplantation, treatment modalities for mono and oligo- and polyarthritis, for cancer therapy (including brachytherapy) and for the inhibition of the hyperplastic response following coronary angioplasty and other interventional procedures (For example, see Volkert and Hoffman, 1999). Sealed sources involve the use of radiolabeled devices for cancer therapy (brachytherapy) and also for the inhibition of the hyperplasia which is often encountered after angioplasty, especially with the exponential increase in the use of coronary stents and stents for the peripheral vasculature and other anatomical applications. Since neutron-rich radioisotopes often decay by beta decay or decay to beta-emitting daughter radioisotopes which serve as the basis for radionuclide generator systems, reactors are expected to play an increasingly important role for the production of a large variety of therapeutic radioisotopes required for these and other developing therapeutic applications. Because of the importance of the availability of reactor-produced radioisotopes for these applications, an understanding of the contribution of neutron spectra for radioisotope production and determination of those cross sections which have not yet been established is important. This

  10. Just-in-time learning is effective in helping first responders manage weapons of mass destruction events.

    Science.gov (United States)

    Motola, Ivette; Burns, William A; Brotons, Angel A; Withum, Kelly F; Rodriguez, Richard D; Hernandez, Salma; Rivera, Hector F; Issenberg, Saul Barry; Schulman, Carl I

    2015-10-01

    Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time training to first responders en route to a CBRNE event. This study assessed the efficacy and usability of the mobile training. Ninety first responders were randomized to a control or an intervention group. All participants completed a pretest to measure knowledge of CBRNE topics. The intervention group then viewed personal protective equipment and weapons of mass destruction field management videos as an overview. Both groups were briefed on a disaster scenario (chemical nerve agent, radiologic, or explosives) requiring them to triage, assess, and manage a patient. Intervention group participants watched a mobile training video corresponding to the scenario. The control group did not receive prescenario video training. Observers rated participant performance in each scenario. After completing the scenarios, all participants answered a cognitive posttest. Those in the intervention group also answered a questionnaire on their impressions of the training. The intervention group outperformed the control group in the explosives and chemical nerve agent scenarios; the differences were statistically significant (explosives, mean of 26.32 for intervention and 22.85 for control, p just-in-time training improved first-responder knowledge of CBRNE events and is an effective tool in helping first responders manage simulated explosive and chemical agent scenarios. Therapeutic/care management study, level II.

  11. Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan

    International Nuclear Information System (INIS)

    Jeong, Hwan Jeong; Lim, Seok Tae; Youn, Hyun Jo; Sohn, Myung-Hee

    2008-01-01

    Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Fifty eight patients (M:F=13;45, age 44.5±11.5 yrs) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, forty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were 154±25 mCi in stage I (n=9), 175±50 mCi in stage II (n=4), 149±21 mCi in stage III (n=38), and 161±20 mCi in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with 149±26 mCi of I-131, 9 patients (17.3%) having 2≤ sTG <5 ng/mL with 156±17 mCi, 5 patients (9.6%) having 5≤ sTG <10 ng/mL with 156±13 mCi, 7 patients (13.5%) having 10≤ sTG <50 ng/mL with 147±24 mCi, and 6 patients (11.5%) having above 50 ng/mL with 175±42 mCi. The statistical significance between sTG level and TD (p=0.252) was not shown. In conclusion, PS and sTG could not replace the

  12. Dependent Interviewing and Sub-Optimal Responding

    Directory of Open Access Journals (Sweden)

    Johannes Eggs

    2015-02-01

    Full Text Available With proactive dependent interviewing (PDI respondents are reminded of the answer they gave in the previous interview, before being asked about their current status. PDI is used in panel surveys to assist respondent recall and reduce spurious changes in responses over time. PDI may however provide scope for new errors if respondents falsely accept the previous information as still being an accurate description of their current situation. In this paper we use data from the German Labour Market and Social Security panel study, in which an error was made with the preload data for a PDI question about receipt of welfare benefit. The survey data were linked to individual administrative records on receipt of welfare benefit. A large proportion of respondents accepted the false preload. This behaviour seems mainly driven by the difficulty of the response task: respondents with a more complex history of receipt according to the records were more likely to confirm the false preload. Personality also seemed related to the probability of confirming. Predictors of satisficing, indicators of satisficing on other items in the survey, and characteristics of the survey and interviewer were not predictive of confirming the false preload.

  13. Mischievous responding in Internet Gaming Disorder research.

    Science.gov (United States)

    Przybylski, Andrew K

    2016-01-01

    The most recent update to the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group's research call to estimate the extent to which mischievous responding-a known problematic pattern of participant self-report responding in questionnaires-is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (n tot = 11,908) provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area.

  14. What is wrong with non-respondents?

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Ekholm, Ola; Gray, Linsay

    2015-01-01

    AIM: Response rates in health surveys have diminished over the last two decades, making it difficult to obtain reliable information on health and health-related risk factors in different population groups. This study compared cause-specific mortality and morbidity among survey respondents and dif...

  15. Responding to Children Victimized by Their Peers

    Science.gov (United States)

    Nickerson, Amanda B.; Brock, Stephen E.; Chang, Yiping; O'Malley, Meagan D.

    2006-01-01

    Because victimization results from the dynamic interplay between the victim and his or her parents, peers, and teachers, responding to this problem should involve both direct and indirect interventions. This paper describes and reviews empirically supported direct interventions with victims, as well as indirect interventions with parents, peers,…

  16. Responding with Care to Students Facing Trauma

    Science.gov (United States)

    Souers, Kristin

    2018-01-01

    Exposure to trauma--which many experts view as include ongoing life stressors like poverty, parents divorcing, death of a family member, or drug abuse in the home--is prevalent among school-aged children. Teachers know that facing trauma impedes students' ability to focus and learn, but it can be challenging to keep responding caringly to a…

  17. The Forgotten Disaster Victim: Reducing Responder Injury

    Science.gov (United States)

    2017-03-01

    Approved by: Anke Richter Thesis Advisor Michael Petrie EMS Bureau, County of Monterey Second Reader Erik Dahl Associate Chair for Instruction...RESPONDERS IN DISASTERS .............20 1. Oklahoma City Bombing .............................................................20 2. World Trade Center...Categories, 2008–2014..................................................................................................19 Figure 4. Oklahoma City Bombing

  18. Suspected Child Maltreatment: Recognize and Respond

    Science.gov (United States)

    Kemple, Kristen Mary; Kim, Hae Kyoung

    2011-01-01

    Early childhood educators spend extensive amounts of time with young children, so they are often the first adults to notice signs that a child may be abused or neglected. All educators are required by law to report suspected maltreatment, and can play an important role in preventing and responding to abuse and neglect of young children. What is…

  19. Methods for Handling Missing Secondary Respondent Data

    Science.gov (United States)

    Young, Rebekah; Johnson, David

    2013-01-01

    Secondary respondent data are underutilized because researchers avoid using these data in the presence of substantial missing data. The authors reviewed, evaluated, and tested solutions to this problem. Five strategies of dealing with missing partner data were reviewed: (a) complete case analysis, (b) inverse probability weighting, (c) correction…

  20. Responding to Children's Fears: A Partnership Approach.

    Science.gov (United States)

    Sorin, Reesa

    2002-01-01

    Describes a study into children's fears and suggests that forging partnerships between parents, children, and teachers is one positive step toward addressing fear in young children. Defines partnerships and asserts that they can help in better recognizing fear displays in young children and in sharing ideas about best practice in responding to…

  1. Editorial: How to respond to reviewers' comments

    African Journals Online (AJOL)

    Soji, Zimkhitha

    Is the content and writing satisfactory enough to make it worth reviewing? Not adequately addressing concerns raised by the reviewers and/or editors does not help the peer-review and publishing processes. Poor judgement when responding to reviewers'/editors' comments often produces a undesirable outcome. Merely ...

  2. 42 CFR 93.225 - Respondent.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Respondent. 93.225 Section 93.225 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH...

  3. School Principals and Racism: Responding to Aveling

    Science.gov (United States)

    Charles, Claire; Mahoney, Caroline; Fox, Brandi; Halse, Christine

    2016-01-01

    This study responds to Nado Aveling's call in "Anti-racism in Schools: A question of leadership?" ("Discourse: Studies in the Cultural Politics of Education," 2007, 28(1), 69-85) for further investigation into racism in Australian schools. Aveling's interview study concluded that an overwhelming number of school principals…

  4. Does the Length of Fielding Period Matter? Examining Response Scores of Early Versus Late Responders

    Directory of Open Access Journals (Sweden)

    Sigman Richard

    2014-12-01

    Full Text Available This article discusses the potential effects of a shortened fielding period on an employee survey’s item and index scores and respondent demographics. Using data from the U.S. Office of Personnel Management’s 2011 Federal Employee Viewpoint Survey, we investigate whether early responding employees differ from later responding employees. Specifically, we examine differences in item and index scores related to employee engagement and global satisfaction. Our findings show that early responders tend to be less positive, even after adjusting their weights for nonresponse. Agencies vary in their prevalence of late responders, and score differences become magnified as this proportion increases. We also examine the extent to which early versus late responders differ on demographic characteristics such as grade level, supervisory status, gender, tenure with agency, and intention to leave, noting that nonminorities and females are the two demographic characteristics most associated with responding early.

  5. Responding to the challenge of antimalarial drug resistance by routine monitoring to update national malaria treatment policies

    DEFF Research Database (Denmark)

    Vestergaard, Lasse S; Ringwald, Pascal

    2007-01-01

    of rational and updated malaria treatment policies, but defining and updating such policies requires a sufficient volume of high-quality drug-resistance data collected at national and regional levels. Three main tools are used for drug resistance monitoring, including therapeutic efficacy tests, in vitro...... additional information about changing patterns of resistance. However, some of the tests are technically demanding, and thus there is a need for more resources for training and capacity building in endemic countries to be able to adequately respond to the challenge of drug resistance.......Reduced sensitivity of Plasmodium falciparum to formerly recommended cheap and well-known antimalarial drugs places an increasing burden on malaria control programs and national health systems in endemic countries. The high costs of the new artemisinin-based combination treatments underline the use...

  6. Occupational health surveillance: Pulmonary function testing in emergency responders

    Directory of Open Access Journals (Sweden)

    James D McCluskey

    2014-01-01

    Full Text Available Emergency responders may be exposed to a variety of fumes, gases, and particulates during the course of their job that can affect pulmonary function (PF and require the use of respiratory protection. This investigation used occupational health monitoring examination data to characterize PF in a population currently employed as emergency responders. PF tests for workers who required health examinations to ensure fitness for continued respirator use were compared to the National Health and Nutrition Examination Survey (NHANES III Raw Spirometry database to determine if decreased PF was associated with employment as an emergency responder. The results of this research indicated that the emergency responders experienced a modest, but statistically significant, increase in forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC mean values over the NHANES III population in both total and stratified analyses, including stratification by age, gender, height, and smoking history. Results are likely due to a combination of effectively controlled exposures in the workplace, and the healthy worker effect among long-term workers. PF testing required by the Occupational and Safety Health Administration (OSHA has substantial utility for conducting occupational surveillance at the population level. In this investigation, we were able to quickly evaluate if abnormal PF existed in an industrial sector known to have exposures that, when uncontrolled, can lead to PF impairment.

  7. Engineering responsive supramolecular biomaterials: Toward smart therapeutics.

    Science.gov (United States)

    Webber, Matthew J

    2016-09-01

    Engineering materials using supramolecular principles enables generalizable and modular platforms that have tunable chemical, mechanical, and biological properties. Applying this bottom-up, molecular engineering-based approach to therapeutic design affords unmatched control of emergent properties and functionalities. In preparing responsive materials for biomedical applications, the dynamic character of typical supramolecular interactions facilitates systems that can more rapidly sense and respond to specific stimuli through a fundamental change in material properties or characteristics, as compared to cases where covalent bonds must be overcome. Several supramolecular motifs have been evaluated toward the preparation of "smart" materials capable of sensing and responding to stimuli. Triggers of interest in designing materials for therapeutic use include applied external fields, environmental changes, biological actuators, applied mechanical loading, and modulation of relative binding affinities. In addition, multistimuli-responsive routes can be realized that capture combinations of triggers for increased functionality. In sum, supramolecular engineering offers a highly functional strategy to prepare responsive materials. Future development and refinement of these approaches will improve precision in material formation and responsiveness, seek dynamic reciprocity in interactions with living biological systems, and improve spatiotemporal sensing of disease for better therapeutic deployment.

  8. Avian Diagnostic and Therapeutic Antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, David Sherman [UND SMHS

    2012-12-31

    A number of infectious agents have the potential of causing significant clinical symptomology and even death, but dispite this, the number of incidence remain below the level that supports producing a vaccine. Therapeutic antibodies provide a viable treatment option for many of these diseases. We proposed that antibodies derived from West Nile Virus (WNV) immunized geese would be able to treat WNV infection in mammals and potential humans. We demonstrated that WNV specific goose antibodies are indeed successful in treating WNV infection both prophylactically and therapeutically in a golden hamster model. We demonstrated that the goose derived antibodies are non-reactogenic, i.e. do not cause an inflammatory response with multiple exposures in mammals. We also developed both a specific pathogen free facility to house the geese during the antibody production phase and a patent-pending purification process to purify the antibodies to greater than 99% purity. Therefore, the success of these study will allow a cost effective rapidly producible therapeutic toward clinical testing with the necessary infrastructure and processes developed and in place.

  9. Therapeutic HIV Peptide Vaccine

    DEFF Research Database (Denmark)

    Fomsgaard, Anders

    2015-01-01

    Therapeutic vaccines aim to control chronic HIV infection and eliminate the need for lifelong antiretroviral therapy (ART). Therapeutic HIV vaccine is being pursued as part of a functional cure for HIV/AIDS. We have outlined a basic protocol for inducing new T cell immunity during chronic HIV-1...... infection directed to subdominant conserved HIV-1 epitopes restricted to frequent HLA supertypes. The rationale for selecting HIV peptides and adjuvants are provided. Peptide subunit vaccines are regarded as safe due to the simplicity, quality, purity, and low toxicity. The caveat is reduced immunogenicity...

  10. Mischievous responding in Internet Gaming Disorder research

    Directory of Open Access Journals (Sweden)

    Andrew K. Przybylski

    2016-09-01

    Full Text Available The most recent update to the American Psychiatric Association’s (APA Diagnostic and Statistical Manual of Mental Disorders (DSM-5 included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group’s research call to estimate the extent to which mischievous responding—a known problematic pattern of participant self-report responding in questionnaires—is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (ntot = 11,908 provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area.

  11. Amitriptyline Intoxication Responded to Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    Güldem Turan

    2012-04-01

    Full Text Available The most severe effects in amitriptiline intoxications are related with central nervous system and cardiovascular system. Amitriptiline intoxication especially with high doses has severe cardiac effects and can result in cardiac arrest. Most favorable responses can be achieved with efficient and prolonged cardiopulmonary resuscitation. We wanted to present a case ingested high dose of amitriptiline for attempt to suicide and responded to prolonged cardiopulmonary resuscitation.

  12. Nuclear Fallout Decision Tool for First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Archibald, E. J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Buddemeier, B. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2010-08-11

    If terrorists detonated an improvised nuclear device (IND) in an urban area, thousands of people would die from the blast, and many more would become sick or die from exposure to fallout radiation. Proper sheltering and evacuation can protect people from fallout and save lives. This project provides guidance to first responders as to when to evacuate and what route to take to protect themselves against fallout radiation.

  13. Responding to the Challenge of True Uncertainty

    DEFF Research Database (Denmark)

    Hallin, Carina Antonia; Andersen, Torben Juul

    We construe a conceptual framework for responding effectively to true uncertainty in the business environment. We drill down to the essential micro-foundational capabilities - sensing and seizing of dynamic capabilities - and link them to classical strategic issue management theory with suggestions...... on how to operationalize these essential capabilities. By definition true uncertainty represents environmental conditions that are hard to foresee, which can catch the unprepared by surprise while presenting opportunities to the conscious organization. We demonstrate that organizations relying...

  14. Exubera. Inhale therapeutic systems.

    Science.gov (United States)

    Bindra, Sanjit; Cefalu, William T

    2002-05-01

    Inhale, in colaboration with Pfizer and Aventis Pharma (formerly Hoechst Marion Roussel; HMR), is developing an insulin formulation utilizing its pulmonary delivery technology for macromolecules for the potential treatment of type I and II diabetes. By July 2001, the phase III program had been completed and the companies had begun to assemble data for MAA and NDA filings; however, it was already clear at this time that additional data might be required for filing. By December 2001, it had been decided that the NDA should include an increased level of controlled, long-term pulmonary safety data in diabetic patients and a major study was planned to be completed in 2002, with the NDA filed thereafter (during 2002). US-05997848 was issued to Inhale Therapeutic Systems in December 1999, and corresponds to WO-09524183, filed in February 1995. Equivalent applications have appeared to date in Australia, Brazil, Canada, China, Czech Republic, Europe, Finland, Hungary, Japan, Norway, New Zealand, Poland and South Africa. This family of applications is specific to pulmonary delivery of insulin. In February 1999, Lehman Brothers gave this inhaled insulin a 60% probability of reaching market, with a possible launch date of 2001. The analysts estimated peak sales at $3 billion in 2011. In May 2000, Aventis predicted that estimated peak sales would be in excess of $1 billion. In February 2000, Merrill Lynch expected product launch in 2002 and predicted that it would be a multibillion-dollar product. Analysts Merril Lynch predicted, in September and November 2000, that the product would be launched by 2002, with sales in that year of e75 million, rising to euro 500 million in 2004. In April 2001, Merrill Lynch predicted that filing for this drug would occur in 2001. Following the report of the potential delay in regulatory filing, issued in July 2001, Deutsche Banc Alex Brown predicted a filing would take place in the fourth quarter of 2002 and launch would take place in the first

  15. Marketing therapeutic recreation services.

    Science.gov (United States)

    Thorn, B E

    1984-01-01

    The use of marketing strategies can enhance the delivery of therapeutic recreation services. This article discusses how agencies can adapt marketing techniques and use them to identify potential markets, improve image, evaluate external pressures, and maximize internal strengths. Four variables that can be controlled and manipulated in a proposed marketing plan are product, price, place and promotion.

  16. Therapeutic Recombinant Monoclonal Antibodies

    Science.gov (United States)

    Bakhtiar, Ray

    2012-01-01

    During the last two decades, the rapid growth of biotechnology-derived techniques has led to a myriad of therapeutic recombinant monoclonal antibodies with significant clinical benefits. Recombinant monoclonal antibodies can be obtained from a number of natural sources such as animal cell cultures using recombinant DNA engineering. In contrast to…

  17. Therapeutic applications of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Baker, W.J.; Datz, F.L.; Beightol, R.W.

    1987-01-01

    Whether a radiopharmaceutical has diagnostic or therapeutic application depends on both the isotope and pharmaceutical used. For diagnostic applications, the isotope should undergo only γ-decay, since usually only γ-radiation is detected by nuclear medicine cameras. The half-life should be just long enough to allow the procedure to be performed. In contrast, the isotope needed for therapeutic purposes should have particulate radiation, such as a β-particle (electron), since these are locally absorbed an increase the local radiation dose. γ-Radiation, which penetrates the tissues, produces less radiation dose than do Β-particles. Several references dealing with radioactive decay, particulate interactions, and diagnostic and therapeutic applications of radiopharmaceuticals are available. Radiopharmaceuticals can legally be used only by physicians who are qualified by specific training in the safe handling of radionuclides. The experience and training of these physicians must be approved by the Nuclear Regulatory Commission or Agreement State Agency authorized to license the use of radiopharmaceuticals. A list of all byproduct material and procedures is available in the Code of Federal Regulations. Of the many radiopharmaceuticals available for diagnostic and therapeutic use, only those commonly used are discussed in this chapter

  18. Weathering the storm: Improving therapeutic interventions for cytokine storm syndromes by targeting disease pathogenesis.

    Science.gov (United States)

    Weaver, Lehn K; Behrens, Edward M

    2017-03-01

    Cytokine storm syndromes require rapid diagnosis and treatment to limit the morbidity and mortality caused by the hyperinflammatory state that characterizes these devastating conditions. Herein, we discuss the current knowledge that guides our therapeutic decision-making and personalization of treatment for patients with cytokine storm syndromes. Firstly, ICU-level supportive care is often required to stabilize patients with fulminant disease while additional diagnostic evaluations proceed to determine the underlying cause of cytokine storm. Pharmacologic interventions should be focused on removing the inciting trigger of inflammation and initiation of an individualized immunosuppressive regimen when immune activation is central to the underlying disease pathophysiology. Monitoring for a clinical response is required to ensure that changes in the therapeutic regimen can be made as clinically warranted. Escalation of immunosuppression may be required if patients respond poorly to the initial therapeutic interventions, while a slow wean of immunosuppression in patients who improve can limit medication-related toxicities. In certain scenarios, a decision must be made whether an individual patient requires hematopoietic cell transplantation to prevent recurrence of disease. Despite these interventions, significant morbidity and mortality remains for cytokine storm patients. Therefore, we use this review to propose a clinical schema to guide current and future attempts to design rational therapeutic interventions for patients suffering from these devastating conditions, which we believe speeds the diagnosis of disease, limits medication-related toxicities, and improves clinical outcomes by targeting the heterogeneous and dynamic mechanisms driving disease in each individual patient.

  19. Therapeutics of Ebola hemorrhagic fever: whole-genome transcriptional analysis of successful disease mitigation.

    Science.gov (United States)

    Yen, Judy Y; Garamszegi, Sara; Geisbert, Joan B; Rubins, Kathleen H; Geisbert, Thomas W; Honko, Anna; Xia, Yu; Connor, John H; Hensley, Lisa E

    2011-11-01

    The mechanisms of Ebola (EBOV) pathogenesis are only partially understood, but the dysregulation of normal host immune responses (including destruction of lymphocytes, increases in circulating cytokine levels, and development of coagulation abnormalities) is thought to play a major role. Accumulating evidence suggests that much of the observed pathology is not the direct result of virus-induced structural damage but rather is due to the release of soluble immune mediators from EBOV-infected cells. It is therefore essential to understand how the candidate therapeutic may be interrupting the disease process and/or targeting the infectious agent. To identify genetic signatures that are correlates of protection, we used a DNA microarray-based approach to compare the host genome-wide responses of EBOV-infected nonhuman primates (NHPs) responding to candidate therapeutics. We observed that, although the overall circulating immune response was similar in the presence and absence of coagulation inhibitors, surviving NHPs clustered together. Noticeable differences in coagulation-associated genes appeared to correlate with survival, which revealed a subset of distinctly differentially expressed genes, including chemokine ligand 8 (CCL8/MCP-2), that may provide possible targets for early-stage diagnostics or future therapeutics. These analyses will assist us in understanding the pathogenic mechanisms of EBOV infection and in identifying improved therapeutic strategies.

  20. Therapeutic Symptomatic Strategies in the Parasomnias.

    Science.gov (United States)

    Manni, Raffaele; Toscano, Gianpaolo; Terzaghi, Michele

    2018-06-05

    The purpose of this review was to discuss the currently available pharmacologic and non-pharmacologic treatment options for parasomnias. Recent pathophysiological findings about sleep structure in parasomnias helped understanding several drug mechanisms of action. Serotoninergic theory accounts for the effect of serotoninergic drugs. Study about spectral analysis of sleep showed the effect of clonazepam on spectral bands. Cannabinoids proved to be effective in some of parasomnias, as in many other neurological disorders. A series of therapeutic strategies were analyzed and compared. Benzodiazepines, antidepressant drugs, and L-5-hydroxytryptophan may be beneficial in DOA. SSRI and topiramate are effective in SRED. RBD responds to clonazepam, melatonin, and to a lesser extent to dopaminergic and anticholinergic agents. Prazosin and cannabinoids are effective in nightmare disorder. Sleep paralysis may respond to antidepressant agents. Tricyclic antidepressant may be effective in sleep-related hallucinations and exploding head syndrome. Sleep enuresis may be successfully treated with desmopressin, anticholinergic drugs, and imipramine.

  1. Using respondent uncertainty to mitigate hypothetical bias in a stated choice experiment

    Science.gov (United States)

    Richard C. Ready; Patricia A. Champ; Jennifer L. Lawton

    2010-01-01

    In a choice experiment study, willingness to pay for a public good estimated from hypothetical choices was three times as large as willingness to pay estimated from choices requiring actual payment. This hypothetical bias was related to the stated level of certainty of respondents. We develop protocols to measure respondent certainty in the context of a choice...

  2. Beauty from the beast: Avoiding errors in responding to client questions.

    Science.gov (United States)

    Waehler, Charles A; Grandy, Natalie M

    2016-09-01

    Those rare moments when clients ask direct questions of their therapists likely represent a point when they are particularly open to new considerations, thereby representing an opportunity for substantial therapeutic gains. However, clinical errors abound in this area because clients' questions often engender apprehension in therapists, causing therapists to respond with too little or too much information or shutting down the discussion prematurely. These response types can damage the therapeutic relationship, the psychotherapy process, or both. We explore the nature of these clinical errors in response to client questions by providing examples from our own clinical work, suggesting potential reasons why clinicians may not make optimal use of client questions, and discussing how the mixed psychological literature further complicates the issue. We also present four guidelines designed to help therapists, trainers, and supervisors respond constructively to clinical questions in order to create constructive interactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Transcriptional changes induced by bevacizumab combination therapy in responding and non-responding recurrent glioblastoma patients

    DEFF Research Database (Denmark)

    Urup, Thomas; Staunstrup, Line Maersk; Michaelsen, Signe Regner

    2017-01-01

    Background: Bevacizumab combined with chemotherapy produces clinical durable response in 25-30% of recurrent glioblastoma patients. This group of patients has shown improved survival and quality of life. The aim of this study was to investigate changes in gene expression associated with response...... and resistance to bevacizumab combination therapy.Methods: Recurrent glioblastoma patients who had biomarker-accessible tumor tissue surgically removed both before bevacizumab treatment and at time of progression were included. Patients were grouped into responders (n = 7) and non-responders (n = 14). Gene...... expression profiling of formalin-fixed paraffin-embedded tumor tissue was performed using RNA-sequencing.Results: By comparing pretreatment samples of responders with those of non-responders no significant difference was observed. In a paired comparison analysis of pre- and posttreatment samples of non...

  4. L-059: EPR-First responders: Radiological emergency manual for first responders

    International Nuclear Information System (INIS)

    2011-01-01

    This conference is an emergency manual review about the first responders knowledge. The IAEA safety standard manuals, the medical gestion, the security forces and the fast communications are very important in a radiological emergency

  5. Responding to the Housing and Financial Crises

    DEFF Research Database (Denmark)

    Scanlon, Kathleen; Lunde, Jens; Whitehead, Christine

    2011-01-01

    The long period of house price growth in markets across the world ended with the US and global financial crisis of 2007/08. The crisis and the consequent recession had profound effects on mortgage market actors – including households, institutions and governments – in most advanced economies......, whether or not they participated in this rapid house price growth. Many of the trends observed during the boom, especially the innovations in financial instruments, were reversed. This paper presents evidence on how mortgage markets and stakeholders responded in the initial period after the crash...

  6. NARAC Dispersion Model Product Integration With RadResponder

    Energy Technology Data Exchange (ETDEWEB)

    Aluzzi, Fernando [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-09-30

    Work on enhanced cooperation and interoperability of Nuclear Incident Response Teams (NIRT) is a joint effort between DHS/FEMA, DOE/NNSA and EPA. One such effort was the integration between the RadResponder Network, a resource sponsored by FEMA for the management of radiological data during an emergency, and the National Atmospheric Advisory Center (NARAC), a DOE/NNSA modeling resource whose predictions are used to aid radiological emergency preparedness and response. Working together under a FEMA-sponsored project these two radiological response assets developed a capability to read and display plume model prediction results from the NARAC computer system in the RadResponder software tool. As a result of this effort, RadResponder users have been provided with NARAC modeling predictions of contamination areas, radiological dose levels, and protective action areas (e.g., areas warranting worker protection or sheltering/evacuation) to help guide protective action decisions and field monitoring surveys, and gain key situation awareness following a radiological/nuclear accident or incident (e.g., nuclear power plant accident, radiological dispersal device incident, or improvised nuclear detonation incident). This document describes the details of this integration effort.

  7. Bats respond to very weak magnetic fields.

    Directory of Open Access Journals (Sweden)

    Lan-Xiang Tian

    Full Text Available How animals, including mammals, can respond to and utilize the direction and intensity of the Earth's magnetic field for orientation and navigation is contentious. In this study, we experimentally tested whether the Chinese Noctule, Nyctalus plancyi (Vespertilionidae can sense magnetic field strengths that were even lower than those of the present-day geomagnetic field. Such field strengths occurred during geomagnetic excursions or polarity reversals and thus may have played an important role in the evolution of a magnetic sense. We found that in a present-day local geomagnetic field, the bats showed a clear preference for positioning themselves at the magnetic north. As the field intensity decreased to only 1/5th of the natural intensity (i.e., 10 μT; the lowest field strength tested here, the bats still responded by positioning themselves at the magnetic north. When the field polarity was artificially reversed, the bats still preferred the new magnetic north, even at the lowest field strength tested (10 μT, despite the fact that the artificial field orientation was opposite to the natural geomagnetic field (P<0.05. Hence, N. plancyi is able to detect the direction of a magnetic field even at 1/5th of the present-day field strength. This high sensitivity to magnetic fields may explain how magnetic orientation could have evolved in bats even as the Earth's magnetic field strength varied and the polarity reversed tens of times over the past fifty million years.

  8. Bats Respond to Very Weak Magnetic Fields

    Science.gov (United States)

    Tian, Lan-Xiang; Pan, Yong-Xin; Metzner, Walter; Zhang, Jin-Shuo; Zhang, Bing-Fang

    2015-01-01

    How animals, including mammals, can respond to and utilize the direction and intensity of the Earth’s magnetic field for orientation and navigation is contentious. In this study, we experimentally tested whether the Chinese Noctule, Nyctalus plancyi (Vespertilionidae) can sense magnetic field strengths that were even lower than those of the present-day geomagnetic field. Such field strengths occurred during geomagnetic excursions or polarity reversals and thus may have played an important role in the evolution of a magnetic sense. We found that in a present-day local geomagnetic field, the bats showed a clear preference for positioning themselves at the magnetic north. As the field intensity decreased to only 1/5th of the natural intensity (i.e., 10 μT; the lowest field strength tested here), the bats still responded by positioning themselves at the magnetic north. When the field polarity was artificially reversed, the bats still preferred the new magnetic north, even at the lowest field strength tested (10 μT), despite the fact that the artificial field orientation was opposite to the natural geomagnetic field (Preversed tens of times over the past fifty million years. PMID:25922944

  9. PYTHIOSIS: A THERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    C. M. C. Falcão

    2015-10-01

    Full Text Available Pythiosis, a disease caused by the oomycete Pythium insidiosum, often presents inefficient response to chemotherapy. It is a consensus that, in spite the several therapeutic protocols, a combination of surgery, chemotherapy and immunotherapy should be used. Surgical excision requires the removal of the entire affected area, with a wide margin of safety. The use of antifungal drugs has resulted in variable results, both in vitro and in vivo, and presents low therapeutic efficiency due to differences in the agent characteristics, which differ from true fungi. Immunotherapy is a non-invasive alternative for the treatment of pythiosis, which aims at modifying the immune response of the host, thereby producing an effective response to the agent. Photodynamic therapy has emerged as a promising technique, with good activity against P. insidiosum in vitro and in vivo. However, more studies are necessary to increase the efficiency of the current treatment protocols and consequently improve the cure rates. This paper aims to conduct a review covering the conventional and recent therapeutic methods against P. insidiosum infections

  10. Overview of Hazard Assessment and Emergency Planning Software of Use to RN First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Waller, E; Millage, K; Blakely, W F; Ross, J A; Mercier, J R; Sandgren, D J; Levine, I H; Dickerson, W E; Nemhauser, J B; Nasstrom, J S; Sugiyama, G; Homann, S; Buddemeier, B R; Curling, C A; Disraelly, D S

    2008-08-26

    There are numerous software tools available for field deployment, reach-back, training and planning use in the event of a radiological or nuclear (RN) terrorist event. Specialized software tools used by CBRNe responders can increase information available and the speed and accuracy of the response, thereby ensuring that radiation doses to responders, receivers, and the general public are kept as low as reasonably achievable. Software designed to provide health care providers with assistance in selecting appropriate countermeasures or therapeutic interventions in a timely fashion can improve the potential for positive patient outcome. This paper reviews various software applications of relevance to radiological and nuclear (RN) events that are currently in use by first responders, emergency planners, medical receivers, and criminal investigators.

  11. The relationship between patients' knowledge of diabetes therapeutic goals and self-management behaviour, including adherence.

    Science.gov (United States)

    Waheedi, Mohammad; Awad, Abdelmoneim; Hatoum, Hind T; Enlund, Hannes

    2017-02-01

    Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeutic targets with adherence to self-care measures in a sample of patients with type 2 diabetes in Kuwait. Setting Primary care chronic care clinics within the Ministry of Health of Kuwait. Methods A cross sectional survey was carried out with 238 patients from six clinics. A multistage stratified clustered sampling method was used to first randomly select the clinics and the patients. Self-reported adherence to three behaviours: medication taking, diet and physical activity. Results Respondents were able to correctly report a mean (SD) of 1.6 (1.3) out of 5 of the pre-specified treatment targets. Optimal adherence to physical activity, diet and medications was reported in 25, 33 and 47 % of the study cohort, respectively. A structural equation model analysis showed better knowledge of therapeutic goals and own current levels translated into better adherence to medications, diet and physical activity. Conclusion Knowledge of therapeutic goals and own recent levels is associated with adherence to medications, diet, or physical activity in this Kuwaiti cohort of patients with diabetes. Low adherence to self-care management and poor overall knowledge of diabetes is a big challenge to successful diabetes care in Kuwait.

  12. Discriminant cognitive factors in responder and non-responder patients with schizophrenia.

    Science.gov (United States)

    Stip, E; Lussier, I; Ngan, E; Mendrek, A; Liddle, P

    1999-12-01

    To identify which improvements in cognitive function are associated with symptom resolution in schizophrenic patients treated with atypical antipsychotics. a prospective open trial with atypical neuroleptics (risperidone, clozapine, quetiapine). Inpatient and outpatient units, Institute of Psychiatry. Thirty-nine patients with schizophrenia according to DSM-IV criteria were included. Clinical and cognitive assessment were done at baseline (T0) and again after six months of treatment (T2). Twenty-five patients completed the trial. New-generation antipsychotics during six months. Patients were considered as responders if their PANSS score decreased at least 20% (n = 15) and non-responders if it did not (n = 10). a computerized cognitive assessment comprised tests of short-term-memory (digit span), explicit long-term memory (word pair learning), divided attention, selective attention and verbal fluency (orthographic and semantic). Clinical assessment included PANSS and ESRS. A discriminant function analysis was performed to determine which changes in cognitive performance predicted symptomatic response status. Semantic fluency and orthographic fluency were significant predictors. Together they correctly predicted responder status in 88% of cases. Memory was not a significant predictor of symptomatic response. Verbal fluency discriminated the responder from the non-responder group during a pharmacological treatment.

  13. Immunotherapy, an evolving approach for the management of triple negative breast cancer: Converting non-responders to responders.

    Science.gov (United States)

    Tolba, Mai F; Omar, Hany A

    2018-02-01

    Immunotherapy comprises a promising new era in cancer therapy. Immune checkpoint inhibitors targeting either the programmed death (PD)-1 receptor or its ligand PD-L1 were first approved by the Food and Drug Administration (FDA) for the management of metastatic melanoma in 2011. The approval of this class is being extended to include other types of immunogenic tumors. Although breast cancer (BC) was first categorized as non-immunogenic tumor type, there are certain subsets of BC that showed a high level of tumor infiltrating lymphocytes (TILs). Those subsets include the triple negative breast cancer (TNBC) and HER-2 positive breast tumors. Preliminary data from clinical trials presented promising outcomes for patients with advanced stage/metastatic TNBC. While the objective response rate (ORR) was relatively low, it is still promising because of the observation that the patients who respond to the treatment with immune checkpoint blockade have favorable prognosis and often show a significant increase in the overall survival. Therefore, the main challenge is to find ways to enhance the tumor response to such therapy and to convert the non-responders to responders. This will consequently bring new hopes for patients with advanced stage metastatic TNBC and help to decrease death tolls from this devastating disease. In the current review, we are highlighting and discussing the up-to-date strategies adopted at either the preclinical or the clinical settings to enhance tumor responsiveness to immunotherapy. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. First responders and psychological first aid.

    Science.gov (United States)

    Pekevski, Jordan

    2013-01-01

    Emergencies and disasters are common and occur on a daily basis. Although most survivors will not experience any long-term negative mental health effects, some will. First responders tend to have first contact with the survivors and, therefore, are in a position to provide needed mental health assistance to survivors. Psychological first aid (PFA) is an evidence-informed approach to providing support to survivors following a serious crisis event, and it aims to reduce the initial distress of the traumatic event and to promote adaptive functioning and coping. PFA has gained a great deal of attention lately, likely due to the fact that it is easy to provide. This article discusses the potential negative effects of emergencies and disasters on mental health, provides a description of PFA and discusses its application, and provides an overview of the research base of PFA and a discussion on the need for future research.

  15. Responding to Indigenous Australian Sexual Assault

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2014-01-01

    Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.

  16. Biodetection Technologies for First Responders: 2014 Edition

    Energy Technology Data Exchange (ETDEWEB)

    Ozanich, Richard M.; Baird, Cheryl L.; Bartholomew, Rachel A.; Colburn, Heather A.; Straub, Tim M.; Bruckner-Lea, Cindy J.

    2014-03-28

    This report summarizes commercially-available, hand-portable technologies that can be used by first responders in the field. This is not meant to be an exhaustive list, nor an endorsement of any technology described herein. Rather, this report is meant to provide useful information about available technologies to help end-users make informed decisions about biodetection technology procurement and use. Information listed in this report is primarily vendor-provided; however, where possible it has been supplemented with additional information obtained from publications, reports, and websites. Manufacturers were given the chance to review summaries of their technologies from August through November 2013 to verify the accuracy of technical specifications, available references, and pricing.

  17. How to define responders in osteoarthritis

    Science.gov (United States)

    Cooper, Cyrus; Adachi, Jonathan D.; Bardin, Thomas; Berenbaum, Francis; Flamion, Bruno; Jonsson, Helgi; Kanis, John A.; Pelousse, Franz; Lems, Willem F.; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Reiter, Susanne; Reginster, Jean-Yves; Rizzoli, René; Bruyère, Olivier

    2013-01-01

    Background Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process. PMID:23557069

  18. Therapeutic drug monitoring in pregnancy.

    Science.gov (United States)

    Matsui, Doreen M

    2012-10-01

    Therapeutic drug monitoring (TDM) is commonly recommended to optimize drug dosing regimens of various medications. It has been proposed to guide therapy in pregnant women, in whom physiological changes may lead to altered pharmacokinetics resulting in difficulty in predicting the appropriate drug dosage. Ideally, TDM may play a role in enhancing the effectiveness of treatment while minimizing toxicity of both the mother and fetus. Monitoring of drug levels may also be helpful in assessing adherence to prescribed therapy in selected cases. Limitations exist as therapeutic ranges have only been defined for a limited number of drugs and are based on data obtained in nonpregnant patients. TDM has been suggested for anticonvulsants, antidepressants, and antiretroviral drugs, based on pharmacokinetic studies that have shown reduced drug concentrations. However, there is only relatively limited (and sometimes inconsistent) information regarding the clinical impact of these pharmacokinetic changes during pregnancy and the effect of subsequent dose adjustments. Further studies are required to determine whether implementation of TDM during pregnancy improves outcome and is associated with any benefit beyond that achieved by clinical judgment alone. The cost effectiveness of TDM programs during pregnancy also remains to be examined.

  19. Stroke and Therapeutic Hypothermia

    Directory of Open Access Journals (Sweden)

    Ozlem Ozkan Kuscu

    2016-09-01

    Full Text Available Stroke is significant cause of morbidity and mortality caused by disruption of blood flow. Neural injury occurs with two stage; while primary neural injury occurs with disruption of blood flow, after days and hours with metabolic processes secondary injury develops in tissues which is non injured in the first stage. Therefore it is important to prevent and treat the secondary injury as much as preventing and treating the primary neural injury. In this article developing pathophysiological changes after stroke, mechanisms of therapeutic hypothermia, application methods, the factors that determine the effectiveness, side effects and complications were reviewed. [Archives Medical Review Journal 2016; 25(3.000: 351-368

  20. Pharmacogenetics approach to therapeutics.

    Science.gov (United States)

    Koo, Seok Hwee; Lee, Edmund Jon Deoon

    2006-01-01

    1. Pharmacogenetics refers to the study of genetically controlled variations in drug response. Functional variants caused by single nucleotide polymorphisms (SNPs) in genes encoding drug-metabolising enzymes, transporters, ion channels and drug receptors have been known to be associated with interindividual and interethnic variation in drug response. Genetic variations in these genes play a role in influencing the efficacy and toxicity of medications. 2. Rapid, precise and cost-effective high-throughput technological platforms are essential for performing large-scale mutational analysis of genetic markers involved in the aetiology of variable responses to drug therapy. 3. The application of a pharmacogenetics approach to therapeutics in general clinical practice is still far from being achieved today owing to various constraints, such as limited accessibility of technology, inadequate knowledge, ambiguity of the role of variants and ethical concerns. 4. Drug actions are determined by the interplay of several genes encoding different proteins involved in various biochemical pathways. With rapidly emerging SNP discovery technological platforms and widespread knowledge on the role of SNPs in disease susceptibility and variability in drug response, the pharmacogenetics approach to therapeutics is anticipated to take off in the not-too-distant future. This will present profound clinical, economic and social implications for health care.

  1. Therapeutic nuclear medicine

    International Nuclear Information System (INIS)

    Baum, Richard P.

    2014-01-01

    Discusses all aspects of radionuclide therapy, including basic principles, newly available treatments, regulatory requirements, and future trends. Provides the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Explains the role of the therapeutic nuclear physician in effectively coordinating a diverse multidisciplinary team. Written by leading experts. The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. The selective irradiation of tumor cells through molecular biological mechanisms is now permitting the radiopharmaceutical control of tumors that are unresectable and unresponsive to either chemotherapy or conventional radiotherapy. In this up-to-date, comprehensive book, world-renowned experts discuss the basic principles of radionuclide therapy, explore in detail the available treatments, explain the regulatory requirements, and examine likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the important role of the therapeutic nuclear physician in delivering the effective coordination of a diverse multidisciplinary team that is essential to the safe provision of treatment.

  2. Therapeutic nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Richard P. (ed.) [ENETS Center of Excellence, Bad Berka (Germany). THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging

    2014-07-01

    Discusses all aspects of radionuclide therapy, including basic principles, newly available treatments, regulatory requirements, and future trends. Provides the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Explains the role of the therapeutic nuclear physician in effectively coordinating a diverse multidisciplinary team. Written by leading experts. The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. The selective irradiation of tumor cells through molecular biological mechanisms is now permitting the radiopharmaceutical control of tumors that are unresectable and unresponsive to either chemotherapy or conventional radiotherapy. In this up-to-date, comprehensive book, world-renowned experts discuss the basic principles of radionuclide therapy, explore in detail the available treatments, explain the regulatory requirements, and examine likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the important role of the therapeutic nuclear physician in delivering the effective coordination of a diverse multidisciplinary team that is essential to the safe provision of treatment.

  3. Pregabalin in fibromyalgia - responder analysis from individual patient data

    Directory of Open Access Journals (Sweden)

    Paine Jocelyn

    2010-07-01

    Full Text Available Abstract Background Population mean changes are difficult to use in clinical practice. Responder analysis may be better, but needs validating for level of response and treatment duration. A consensus group has defined what constitutes minimal, moderate, and substantial benefit based on pain intensity and Patient Global Impression of Change scores. Methods We obtained individual patient data from four randomised double blind trials of pregabalin in fibromyalgia lasting eight to 14 weeks. We calculated response for all efficacy outcomes using any improvement (≥ 0%, minimal improvement (≥ 15%, moderate improvement (≥ 30%, substantial improvement (≥ 50%, and extensive improvement (≥ 70%, with numbers needed to treat (NNT for pregabalin 300 mg, 450 mg, and 600 mg daily compared with placebo. Results Information from 2,757 patients was available. Pain intensity and sleep interference showed reductions with increasing level of response, a significant difference between pregabalin and placebo, and a trend towards lower (better NNTs at higher doses. Maximum response rates occurred at 4-6 weeks for higher levels of response, and were constant thereafter. NNTs (with 95% confidence intervals for ≥ 50% improvement in pain intensity compared with placebo after 12 weeks were 22 (11 to 870 for pregabalin 300 mg, 16 (9.3 to 59 for pregabalin 450 mg, and 13 (8.1 to 31 for pregabalin 600 mg daily. NNTs for ≥ 50% improvement in sleep interference compared with placebo after 12 weeks were 13 (8.2 to 30 for pregabalin 300 mg, 8.4 (6.0 to 14 for pregabalin 450 mg, and 8.4 (6.1 to 14 for pregabalin 600 mg. Other outcomes had fewer respondents at higher response levels, but generally did not discriminate between pregabalin and placebo, or show any dose response. Shorter duration and use of 'any improvement' over-estimated treatment effect compared with longer duration and higher levels of response. Conclusions Responder analysis is useful in fibromyalgia

  4. WS-020: EPR-First Responders: Cards of response measures for first responders

    International Nuclear Information System (INIS)

    2011-01-01

    The purpose of this working session is that the participants know how to use the cards of response measures for first responders. In a radiological emergency is useful to have cards which contains a list of the steps to be followed as well as the protection instructions and risk evaluation

  5. Therapeutic Drug Monitoring of Lithium

    DEFF Research Database (Denmark)

    Mose, Tina; Damkier, Per; Petersen, Magnus

    2015-01-01

    BACKGROUND: Serum lithium is monitored to ensure levels within the narrow therapeutic window. This study examines the interlaboratory variation and inaccuracy of lithium monitoring in Denmark. METHODS: In 16 samples consisting of (1) control materials (n = 4), (2) pooled patient serum (n = 5......), and (3) serum from individual patients (n = 7), lithium was measured in 19 laboratories using 20 different instruments. The lithium concentrations were targeted by a reference laboratory. Ion-selective electrode (n = 5), reflective spectrophotometric (RSM, n = 5), and spectrophotometric (n = 10) methods...... of >12%. Seven of these instruments had a systematic positive or negative bias and more so at lower lithium concentrations. Three poorly calibrated instruments were found in the ion-selective electrode group, 3 in the spectrophotometric group, and 2 in the RSM group. The instruments using reflectance...

  6. Therapeutic apheresis for severe hypertriglyceridemia in pregnancy.

    Science.gov (United States)

    Basar, Rafet; Uzum, Ayse Kubat; Canbaz, Bulent; Dogansen, Sema Ciftci; Kalayoglu-Besisik, Sevgi; Altay-Dadin, Senem; Aral, Ferihan; Ozbey, Nese Colak

    2013-05-01

    During pregnancy, a progressive increase in serum triglyceride (TG) and cholesterol levels is observed whereas TG levels mostly remain hypertriglyceridemia, pregnancy may cause extremely elevated TG levels leading to potentially life-threatening pancreatitis attacks and chylomicronemia syndrome. The only safe medical treatment option during pregnancy is ω-3 fatty acids, which have moderate TG lowering effects. Therapeutic apheresis could be used as primary treatment approach during pregnancy. We reported the effect of double filtration apheresis in one pregnant women with severe hypertriglyceridemia, therapeutic plasmapheresis and double filtration methods in the other severe hypertriglyceridemic pregnant woman; a 32-year-old pregnant woman (patient 1) with a history of hypertriglyceridemia-induced acute pancreatitis during pregnancy and a 30-year-old pregnant woman with extremely high TG levels (12,000 mg/dl) leading to chylomicronemia syndrome (patient 2). Medical nutrition therapy and ω-3 fatty acids were also provided. Double filtration apheresis (patient 1) and plasmapheresis + double filtration apheresis (patient 2) were used. When we calculated the TG levels before and after therapeutic apheresis, maximum decrease achieved with double filtration apheresis was 46.3 % for patient 1 and 37.3 % for patient 2. However, with plasmapheresis TG level declined by 72 % in patient 2. Plasmapheresis seemed to be more efficient to decrease TG levels. Iron deficiency anemia was the main complication apart from technical difficulties by lipemic obstruction of tubing system. Healthy babies were born. Delivery led to decreases in TG levels. It is concluded that during pregnancy therapeutic apheresis is an effective method to decrease extremely high TG levels and risks of its potentially life-threatening complications.

  7. Capacity of old trees to respond to environmental change.

    Science.gov (United States)

    Phillips, Nathan G; Buckley, Thomas N; Tissue, David T

    2008-11-01

    Atmospheric carbon dioxide [CO2] has increased dramatically within the current life spans of long-lived trees and old forests. Consider that a 500-year-old tree in the early twenty-first century has spent 70% of its life growing under pre-industrial levels of [CO2], which were 30% lower than current levels. Here we address the question of whether old trees have already responded to the rapid rise in [CO2] occurring over the past 150 years. In spite of limited data, aging trees have been shown to possess a substantial capacity for increased net growth after a period of post-maturity growth decline. Observations of renewed growth and physiological function in old trees have, in some instances, coincided with Industrial Age increases in key environmental resources, including [CO2], suggesting the potential for continued growth in old trees as a function of continued global climate change.

  8. Acquisition of peak responding: what is learned?

    Science.gov (United States)

    Balci, Fuat; Gallistel, Charles R; Allen, Brian D; Frank, Krystal M; Gibson, Jacqueline M; Brunner, Daniela

    2009-01-01

    We investigated how the common measures of timing performance behaved in the course of training on the peak procedure in C3H mice. Following fixed interval (FI) pre-training, mice received 16 days of training in the peak procedure. The peak time and spread were derived from the average response rates while the start and stop times and their relative variability were derived from a single-trial analysis. Temporal precision (response spread) appeared to improve in the course of training. This apparent improvement in precision was, however, an averaging artifact; it was mediated by the staggered appearance of timed stops, rather than by the delayed occurrence of start times. Trial-by-trial analysis of the stop times for individual subjects revealed that stops appeared abruptly after three to five sessions and their timing did not change as training was prolonged. Start times and the precision of start and stop times were generally stable throughout training. Our results show that subjects do not gradually learn to time their start or stop of responding. Instead, they learn the duration of the FI, with robust temporal control over the start of the response; the control over the stop of response appears abruptly later.

  9. Utilities respond to nuclear station blackout rule

    International Nuclear Information System (INIS)

    Rubin, A.M.; Beasley, B.; Tenera, L.P.

    1990-01-01

    The authors discuss how nuclear plants in the United States have taken actions to respond to the NRC Station Blackout Rule, 10CFR50.63. The rule requires that each light water cooled nuclear power plant licensed to operate must be able to withstand for a specified duration and recover from a station blackout. Station blackout is defined as the complete loss of a-c power to the essential and non-essential switch-gear buses in a nuclear power plant. A station blackout results from the loss of all off-site power as well as the on-site emergency a-c power system. There are two basic approaches to meeting the station blackout rule. One is to cope with a station blackout independent of a-c power. Coping, as it is called, means the ability of a plant to achieve and maintain a safe shutdown condition. The second approach is to provide an alternate a-c power source (AAC)

  10. Comparison of MicroRNAs Mediated in Reactivation of the γ-Globin in β-Thalassemia Patients, Responders and Non-Responders to Hydroxyurea.

    Science.gov (United States)

    Hojjati, Mohammad T; Azarkeivan, Azita; Pourfathollah, Ali A; Amirizadeh, Naser

    2017-03-01

    Drug induction of Hb F seems to be an ideal therapy for patients with hemoglobin (Hb) disorders, and many efforts have been made to reveal the mechanism behind it. Thus, we examined in vivo expression of some microRNAs (miRNAs) that are thought to be involved in this process. Among β-thalassemia (β-thal) patients who were undergoing hydroxyurea (HU) therapy in the past 3 months and five healthy individuals, five responders and five non-responders, were also included in the study. Erythroid progenitors were isolated by magnetic activated cell sorting (MACS) and miRNA expression analyzed using reverse transcription-polymerase chain reaction (RT-PCR). We showed that γ-globin, miR-210 and miR-486-3p had higher levels in the responders than the non-responders group. Moreover, miR-150 and miR-320 had higher levels in the healthy group than both non-responders and responders groups, but the expression of miR-96 did not show any significant difference between the study groups. To the best of our knowledge, this is the first study proposing that 'induction of cellular hypoxic condition by Hb F inducing agents' could be the milestone of possible mechanisms that explain why responders are able to reactivate γ-globin genes and subsequently, more production of Hb F, in response to these agents in comparison to non-responders. However, further investigations need to be performed to verify this hypothesis.

  11. The Relational Responding Task: Toward a New Implicit Measure of Beliefs

    Directory of Open Access Journals (Sweden)

    Jan eDe Houwer

    2015-03-01

    Full Text Available We introduce the Relational Responding Task (RRT as a tool for capturing beliefs at the implicit level. Flemish participants were asked to respond as if they believed that Flemish people are more intelligent than immigrants (e.g., respond true to the statement Flemish people are wiser than immigrants or to respond as if they believed that immigrants are more intelligent than Flemish people (e.g., respond true to the statement Flemish people are dumber than immigrants. The difference in performance between these two tasks correlated with ratings of the extent to which participants explicitly endorsed the belief that Flemish people are more intelligent than immigrants and with questionnaire measures of subtle and blatant racism. The current study provides a first step towards validating RRT effects as a viable measure of implicit beliefs.

  12. Socio Economic Assessment of Urban Forestry Respondents ...

    African Journals Online (AJOL)

    user

    KEY WORDS: Income, urban forest, education, age ... at the various levels of his education, his endeavours ... conservation developmental activities should be ... tourism. Well-maintained trees improve residential. “curb appeal” and increase ...

  13. Antibody Engineering and Therapeutics

    Science.gov (United States)

    Almagro, Juan Carlos; Gilliland, Gary L; Breden, Felix; Scott, Jamie K; Sok, Devin; Pauthner, Matthias; Reichert, Janice M; Helguera, Gustavo; Andrabi, Raiees; Mabry, Robert; Bléry, Mathieu; Voss, James E; Laurén, Juha; Abuqayyas, Lubna; Barghorn, Stefan; Ben-Jacob, Eshel; Crowe, James E; Huston, James S; Johnston, Stephen Albert; Krauland, Eric; Lund-Johansen, Fridtjof; Marasco, Wayne A; Parren, Paul WHI; Xu, Kai Y

    2014-01-01

    The 24th Antibody Engineering & Therapeutics meeting brought together a broad range of participants who were updated on the latest advances in antibody research and development. Organized by IBC Life Sciences, the gathering is the annual meeting of The Antibody Society, which serves as the scientific sponsor. Preconference workshops on 3D modeling and delineation of clonal lineages were featured, and the conference included sessions on a wide variety of topics relevant to researchers, including systems biology; antibody deep sequencing and repertoires; the effects of antibody gene variation and usage on antibody response; directed evolution; knowledge-based design; antibodies in a complex environment; polyreactive antibodies and polyspecificity; the interface between antibody therapy and cellular immunity in cancer; antibodies in cardiometabolic medicine; antibody pharmacokinetics, distribution and off-target toxicity; optimizing antibody formats for immunotherapy; polyclonals, oligoclonals and bispecifics; antibody discovery platforms; and antibody-drug conjugates. PMID:24589717

  14. Therapeutic and diagnostic nanomaterials

    CERN Document Server

    Devasena T

    2017-01-01

    This brief highlights nanoparticles used in the diagnosis and treatment of prominent diseases and toxic conditions. Ecofriendly methods which are ideal for the synthesis of medicinally valued nanoparticles are explained and the characteristic features of these particles projected. The role of these particles in the therapeutic field, and the induced biological changes in some diseases are discussed. The main focus is on inflammation, oxidative stress and cellular membrane integrity alterations. The effect of nanoparticles on these changes produced by various agents are highlighted using in vitro and in vivo models. The mechanism of nanoparticles in ameliorating the biological changes is supported by relevant images and data. Finally, the brief demonstrates recent developments on the use of nanoparticles in diagnosis or sensing of some biological materials and biologically hazardous environmental materials.

  15. [Therapeutic education didactic techniques].

    Science.gov (United States)

    Valverde, Maite; Vidal, Mercè; Jansa, Margarida

    2012-10-01

    This article includes an introduction to the role of Therapeutic Education for Diabetes treatment according to the recommendations of the American Diabetes Association (ADA), the Diabetes Education Study Group (DESG) of the "European Association for Study of Diabetes (EASD) and the clinical Practice Guidelines (CPG) of the Spanish Ministry of Health. We analyze theoretical models and the differences between teaching vs. learning as well as current trends (including Internet), that can facilitate meaningful learning of people with diabetes and their families and relatives. We analyze the differences, similarities, advantages and disadvantages of individual and group education. Finally, we describe different educational techniques (metaplan, case method, brainstorming, role playing, games, seminars, autobiography, forums, chats,..) applicable to individual, group or virtual education and its application depending on the learning objective.

  16. Towards an understanding of resilience: responding to health systems shocks.

    Science.gov (United States)

    Hanefeld, Johanna; Mayhew, Susannah; Legido-Quigley, Helena; Martineau, Frederick; Karanikolos, Marina; Blanchet, Karl; Liverani, Marco; Yei Mokuwa, Esther; McKay, Gillian; Balabanova, Dina

    2018-04-01

    The recent outbreak of Ebola Virus Disease (EVD) in West Africa has drawn attention to the role and responsiveness of health systems in the face of shock. It brought into sharp focus the idea that health systems need not only to be stronger but also more 'resilient'. In this article, we argue that responding to shocks is an important aspect of resilience, examining the health system behaviour in the face of four types of contemporary shocks: the financial crisis in Europe from 2008 onwards; climate change disasters; the EVD outbreak in West Africa 2013-16; and the recent refugee and migration crisis in Europe. Based on this analysis, we identify '3 plus 2' critical dimensions of particular relevance to health systems' ability to adapt and respond to shocks; actions in all of these will determine the extent to which a response is successful. These are three core dimensions corresponding to three health systems functions: 'health information systems' (having the information and the knowledge to make a decision on what needs to be done); 'funding/financing mechanisms' (investing or mobilising resources to fund a response); and 'health workforce' (who should plan and implement it and how). These intersect with two cross-cutting aspects: 'governance', as a fundamental function affecting all other system dimensions; and predominant 'values' shaping the response, and how it is experienced at individual and community levels. Moreover, across the crises examined here, integration within the health system contributed to resilience, as does connecting with local communities, evidenced by successful community responses to Ebola and social movements responding to the financial crisis. In all crises, inequalities grew, yet our evidence also highlights that the impact of shocks is amenable to government action. All these factors are shaped by context. We argue that the '3 plus 2' dimensions can inform pragmatic policies seeking to increase health systems resilience.

  17. Responding to Students' Learning Preferences in Chemistry

    Science.gov (United States)

    Lewthwaite, Brian; Wiebe, Rick

    2014-04-01

    This paper reports on a teacher's and his students' responsiveness to a new tetrahedral-oriented (Mahaffy in J Chem Educ 83(1):49-55, 2006) curriculum requiring more discursive classroom practices in the teaching of chemistry. In this instrumental case study, we identify the intentions of this learner-centered curriculum and a teacher's development in response to this curriculum. We also explore the tensions this teacher experiences as students subsequently respond to his adjusted teaching. We use a Chemistry Teacher Inventory (Lewthwaite and Wiebe in Res Sci Educ 40(11):667-689, 2011; Lewthwaite and Wiebe in Can J Math Sci Technol Educ 12(1):36-61, 2012; Lewthwaite in Chem Educ Res Pract. doi:10.1039/C3RP00122A, 2014) to assist the teacher in monitoring how he teaches and how he would like to improve his teaching. We also use a student form of the instrument, the Chemistry Classroom Inventory and Classroom Observation Protocol (Lewthwaite and Wiebe 2011) to verify the teacher's teaching and perception of student preferences for his teaching especially in terms of the discursive processes the curriculum encourages. By so doing, the teacher is able to use both sets of data as a foundation for critical reflection and work towards resolution of the incongruence in data arising from students' preferred learning orientations and his teaching aspirations. Implications of this study in regards to the authority of students' voice in triggering teachers' pedagogical change and the adjustments in `teachering' and `studenting' required by such curricula are considered.

  18. Response to a combination of oxygen and a hypnotic as treatment for obstructive sleep apnoea is predicted by a patient's therapeutic CPAP requirement.

    Science.gov (United States)

    Landry, Shane A; Joosten, Simon A; Sands, Scott A; White, David P; Malhotra, Atul; Wellman, Andrew; Hamilton, Garun S; Edwards, Bradley A

    2017-08-01

    Upper airway collapsibility predicts the response to several non-continuous positive airway pressure (CPAP) interventions for obstructive sleep apnoea (OSA). Measures of upper airway collapsibility cannot be easily performed in a clinical context; however, a patient's therapeutic CPAP requirement may serve as a surrogate measure of collapsibility. The present work aimed to compare the predictive use of CPAP level with detailed physiological measures of collapsibility. Therapeutic CPAP levels and gold-standard pharyngeal collapsibility measures (passive pharyngeal critical closing pressure (P crit ) and ventilation at CPAP level of 0 cmH 2 O (V passive )) were retrospectively analysed from a randomized controlled trial (n = 20) comparing the combination of oxygen and eszopiclone (treatment) versus placebo/air control. Responders (9/20) to treatment were defined as those who exhibited a 50% reduction in apnoea/hypopnoea index (AHI) plus an AHICPAP requirement compared with non-responders (6.6 (5.4-8.1)  cmH 2 O vs 8.9 (8.4-10.4) cmH 2 O, P = 0.007), consistent with their reduced collapsibility (lower P crit , P = 0.017, higher V passive P = 0.025). Therapeutic CPAP level provided the highest predictive accuracy for differentiating responders from non-responders (area under the curve (AUC) = 0.86 ± 0.9, 95% CI: 0.68-1.00, P = 0.007). However, both P crit (AUC = 0.83 ± 0.11, 95% CI: 0.62-1.00, P = 0.017) and V passive (AUC = 0.77 ± 0.12, 95% CI: 0.53-1.00, P = 0.44) performed well, and the difference in AUC for these three metrics was not statistically different. A therapeutic CPAP level ≤8 cmH 2 O provided 78% sensitivity and 82% specificity (positive predictive value = 78%, negative predictive value = 82%) for predicting a response to these therapies. Therapeutic CPAP requirement, as a surrogate measure of pharyngeal collapsibility, predicts the response to non-anatomical therapy (oxygen and

  19. Applications of inorganic nanoparticles as therapeutic agents

    Science.gov (United States)

    Kim, Taeho; Hyeon, Taeghwan

    2014-01-01

    During the last decade, various functional nanostructured materials with interesting optical, magnetic, mechanical and chemical properties have been extensively applied to biomedical areas including imaging, diagnosis and therapy. In therapeutics, most research has focused on the application of nanoparticles as potential delivery vehicles for drugs and genes, because nanoparticles in the size range of 2-100 nm can interact with biological systems at the molecular level, and allow targeted delivery and passage through biological barriers. Recent investigations have even revealed that several kinds of nanomaterials are intrinsically therapeutic. Not only can they passively interact with cells, but they can also actively mediate molecular processes to regulate cell functions. This can be seen in the treatment of cancer via anti-angiogenic mechanisms as well as the treatment of neurodegenerative diseases by effectively controlling oxidative stress. This review will present recent applications of inorganic nanoparticles as therapeutic agents in the treatment of disease.

  20. [Predictors of the therapeutic discharge in patients with dual pathology admitted to a therapeutic community with a psychiatric unit].

    Science.gov (United States)

    Madoz-Gúrpide, Agustín; García Vicent, Vicente; Luque Fuentes, Encarnación; Ochoa Mangado, Enriqueta

    2013-01-01

    This study aims to analyze the variables on which depends therapeutic discharge, in patients with a severe dual diagnosis admitted to a professional therapeutic community where their pathology is treated. 325 patients admitted between June 2000 and June 2009 to the therapeutic community. This is a retrospective, cross-sectional study with no control group, based on the detailed analysis of the information collected in a model of semi-structured clinical interview designed in the therapeutic community. The 29.5% of the individuals included in the sample were therapeutically discharged. Of all the variables introduced in this analysis the most significant ones were gender, age at the beginning of treatment, education level, opiate dependence, polidrug abuse, and the presence of psychotic disorders and borderline personality disorder. In our study, gender determines the type of discharge, being therapeutic discharge more frequent among women. A higher educational also increases a better prognosis with a higher rate of therapeutic discharge among individuals with higher education level. A later age at the beginning of the treatment reduces the likelihood of therapeutic discharge. Likewise, polidrug abuse, diagnosis of psychotic disorders and borderline personality disorder are associated to a lower rate of therapeutic discharge. Recognizing these characteristics will allow the early identification of those patients more at risk of dropping treatment hastily, while trying to prevent it by increasing the therapeutic intensity.

  1. First aid skill retention of first responders within the workplace

    Directory of Open Access Journals (Sweden)

    Masse Jeff

    2011-02-01

    Full Text Available Abstract Background Recent literature states that many necessary skills of CPR and first aid are forgotten shortly after certification. The purpose of this study was to determine the skill and knowledge decay in first aid in those who are paid to respond to emergency situations within a workplace. Methods Using a choking victim scenario, the sequence and accuracy of events were observed and recorded in 257 participants paid to act as first responders in large industrial or service industry settings. A multiple choice exam was also written to determine knowledge retention. Results First aid knowledge was higher in those who were trained at a higher level, and did not significantly decline over time. Those who had renewed their certificate one or more times performed better than those who had learned the information only once. During the choking scenario many skills were performed poorly, regardless of days since last training, such as hand placement and abdominal thrusts. Compressions following the victim becoming unconscious also showed classic signs of skill deterioration after 30 days. Conclusions As many skills deteriorate rapidly over the course of the first 90 days, changing frequency of certification is not necessarily the most obvious choice to increase retention of skill and knowledge. Alternatively, methods of regularly "refreshing" a skill should be explored that could be delivered at a high frequency - such as every 90 days.

  2. Hospital Preparedness to Respond to Biological and Chemical Terrorist Attack

    International Nuclear Information System (INIS)

    Florin, P.

    2007-01-01

    There is a growing concern about the terrorist use of chemical or biological agents against civilian population. A large proportion of hospitals are probably poorly prepared to handle victims of chemical or biological terrorism. At national level, starting with 2008 hospitals will be under the administration and control of local authorities. That is good opportunities for local authorities and public health office to tailor the activity of the hospitals to the real needs in the area of responsibility, and to allocate the suitable budget for them. Commonly hospitals are not fully prepared to respond to massive casualty disaster of any kind, either i their capacity to care for large numbers of victims or in their ability to provide care in coordination with a regional or national incident command structure. Preparedness activities to respond properly to chemical or biological attack including the adequate logistic, the principle of training and drill for the hospital emergency units and medical personal, communication and integration of the hospital team in local and regional civil response team are developed by the author.(author)

  3. Mycobacterium tuberculosis Transcription Machinery: Ready To Respond to Host Attacks

    Science.gov (United States)

    Flentie, Kelly; Garner, Ashley L.

    2016-01-01

    Regulating responses to stress is critical for all bacteria, whether they are environmental, commensal, or pathogenic species. For pathogenic bacteria, successful colonization and survival in the host are dependent on adaptation to diverse conditions imposed by the host tissue architecture and the immune response. Once the bacterium senses a hostile environment, it must enact a change in physiology that contributes to the organism's survival strategy. Inappropriate responses have consequences; hence, the execution of the appropriate response is essential for survival of the bacterium in its niche. Stress responses are most often regulated at the level of gene expression and, more specifically, transcription. This minireview focuses on mechanisms of regulating transcription initiation that are required by Mycobacterium tuberculosis to respond to the arsenal of defenses imposed by the host during infection. In particular, we highlight how certain features of M. tuberculosis physiology allow this pathogen to respond swiftly and effectively to host defenses. By enacting highly integrated and coordinated gene expression changes in response to stress, M. tuberculosis is prepared for battle against the host defense and able to persist within the human population. PMID:26883824

  4. Please respond ASAP: workplace telepressure and employee recovery.

    Science.gov (United States)

    Barber, Larissa K; Santuzzi, Alecia M

    2015-04-01

    Organizations rely heavily on asynchronous message-based technologies (e.g., e-mail) for the purposes of work-related communications. These technologies are primary means of knowledge transfer and building social networks. As a by-product, workers might feel varying levels of preoccupations with and urges for responding quickly to messages from clients, coworkers, or supervisors--an experience we label as workplace telepressure. This experience can lead to fast response times and thus faster decisions and other outcomes initially. However, research from the stress and recovery literature suggests that the defining features of workplace telepressure interfere with needed work recovery time and stress-related outcomes. The present set of studies defined and validated a new scale to measure telepressure. Study 1 tested an initial pool of items and found some support for a single-factor structure after problematic items were removed. As expected, public self-consciousness, techno-overload, and response expectations were moderately associated with telepressure in Study 1. Study 2 demonstrated that workplace telepressure was distinct from other personal (job involvement, affective commitment) and work environment (general and ICT work demands) factors and also predicted burnout (physical and cognitive), absenteeism, sleep quality, and e-mail responding beyond those factors. Implications for future research and workplace practices are discussed. (c) 2015 APA, all rights reserved).

  5. First Responders Guide to Computer Forensics: Advanced Topics

    National Research Council Canada - National Science Library

    Nolan, Richard; Baker, Marie; Branson, Jake; Hammerstein, Josh; Rush, Kris; Waits, Cal; Schweinsberg, Elizabeth

    2005-01-01

    First Responders Guide to Computer Forensics: Advanced Topics expands on the technical material presented in SEI handbook CMU/SEI-2005-HB-001, First Responders Guide to Computer Forensics [Nolan 05...

  6. A Study of Ethics Education within Therapeutic Recreation Curriculum.

    Science.gov (United States)

    Nisbett, Nancy; Brown-Welty, Sharon; O'Keefe, Cathy

    2002-01-01

    Explored the status of ethics education within therapeutic recreation. Researchers surveyed all entry-level undergraduate and graduate therapeutic recreation training programs in one state, examining responses for differences in content and delivery. Programs appeared consistent with regard to ethics instruction, integrating similar content…

  7. [Nuclear transfer and therapeutic cloning].

    Science.gov (United States)

    Xu, Xiao-Ming; Lei, An-Min; Hua, Jin-Lian; Dou, Zhong-Ying

    2005-03-01

    Nuclear transfer and therapeutic cloning have widespread and attractive prospects in animal agriculture and biomedical applications. We reviewed that the quality of oocytes and nuclear reprogramming of somatic donor cells were the main reasons of the common abnormalities in cloned animals and the low efficiency of cloning and showed the problems and outlets in therapeutic cloning, such as some basic problems in nuclear transfer affected clinical applications of therapeutic cloning. Study on isolation and culture of nuclear transfer embryonic stem (ntES) cells and specific differentiation of ntES cells into important functional cells should be emphasized and could enhance the efficiency. Adult stem cells could help to cure some great diseases, but could not replace therapeutic cloning. Ethics also impeded the development of therapeutic cloning. It is necessary to improve many techniques and reinforce the research of some basic theories, then somatic nuclear transfer and therapeutic cloning may apply to agriculture reproduction and benefit to human life better.

  8. Neural progenitor cells but not astrocytes respond distally to thoracic spinal cord injury in rat models

    Directory of Open Access Journals (Sweden)

    Tara Nguyen

    2017-01-01

    Full Text Available Traumatic spinal cord injury (SCI is a detrimental condition that causes loss of sensory and motor function in an individual. Many complex secondary injury cascades occur after SCI and they offer great potential for therapeutic targeting. In this study, we investigated the response of endogenous neural progenitor cells, astrocytes, and microglia to a localized thoracic SCI throughout the neuroaxis. Twenty-five adult female Sprague-Dawley rats underwent mild-contusion thoracic SCI (n = 9, sham surgery (n = 8, or no surgery (n = 8. Spinal cord and brain tissues were fixed and cut at six regions of the neuroaxis. Immunohistochemistry showed increased reactivity of neural progenitor cell marker nestin in the central canal at all levels of the spinal cord. Increased reactivity of astrocyte-specific marker glial fibrillary acidic protein was found only at the lesion epicenter. The number of activated microglia was significantly increased at the lesion site, and activated microglia extended to the lumbar enlargement. Phagocytic microglia and macrophages were significantly increased only at the lesion site. There were no changes in nestin, glial fibrillary acidic protein, microglia and macrophage response in the third ventricle of rats subjected to mild-contusion thoracic SCI compared to the sham surgery or no surgery. These findings indicate that neural progenitor cells, astrocytes and microglia respond differently to a localized SCI, presumably due to differences in inflammatory signaling. These different cellular responses may have implications in the way that neural progenitor cells can be manipulated for neuroregeneration after SCI. This needs to be further investigated.

  9. Molecularly targeted therapeutic radiopharmaceuticals

    International Nuclear Information System (INIS)

    Saw, M.M.

    2007-01-01

    Full text: It is generally agreed that current focus of nuclear medicine development should be on molecular imaging and therapy. Though, the widespread use of the terminology 'molecular imaging' is quite recent, nuclear medicine has used molecular imaging techniques for more than 20 years ago. A variety of radiopharmaceuticals have been introduced for the internal therapy of malignant and inflammatory lesions in nuclear medicine. In the field of bio/medical imaging, nuclear medicine is one of the disciplines which has the privilege of organized and well developed chemistry/ pharmacy section; radio-chemistry/radiopharmacy. Fundamental principles have been developed more than 40 years ago and advanced research is going well into postgenomic era. The genomic revolution and dramatically increased insight in the molecular mechanisms underlying pathology have led to paradigm shift in drug development. Likewise does in the nuclear medicine. Here, the author will present current clinical and pre-clinical therapeutic radiopharmaceuticals based on molecular targets such as membrane-bound receptors, enzymes, nucleic acids, sodium iodide symporter, etc, in correlation with fundamentals of radiopharmacy. (author)

  10. Physiologically Based Pharmacokinetic Modeling of Therapeutic Proteins.

    Science.gov (United States)

    Wong, Harvey; Chow, Timothy W

    2017-09-01

    Biologics or therapeutic proteins are becoming increasingly important as treatments for disease. The most common class of biologics are monoclonal antibodies (mAbs). Recently, there has been an increase in the use of physiologically based pharmacokinetic (PBPK) modeling in the pharmaceutical industry in drug development. We review PBPK models for therapeutic proteins with an emphasis on mAbs. Due to their size and similarity to endogenous antibodies, there are distinct differences between PBPK models for small molecules and mAbs. The high-level organization of a typical mAb PBPK model consists of a whole-body PBPK model with organ compartments interconnected by both blood and lymph flows. The whole-body PBPK model is coupled with tissue-level submodels used to describe key mechanisms governing mAb disposition including tissue efflux via the lymphatic system, elimination by catabolism, protection from catabolism binding to the neonatal Fc (FcRn) receptor, and nonlinear binding to specific pharmacological targets of interest. The use of PBPK modeling in the development of therapeutic proteins is still in its infancy. Further application of PBPK modeling for therapeutic proteins will help to define its developing role in drug discovery and development. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  11. Rethinking Therapeutic Misconception in Biobanking

    DEFF Research Database (Denmark)

    Tupasela, Aaro; Snell, Karoliina; Cañada, Jose

    2017-01-01

    Some authors have noted that in biobank research participants may be guided by what is called therapeutic misconception, whereby participants attribute therapeutic intent to research procedures.This article argues that the notion of therapeutic misconception is increasingly less justified when...... underpinnings for the need to separate research and treatment, and thus the notion of therapeutic misconception in the fi rst place. We call this tension between research and treatment ambivalent research advancement to highlight the difficulties that various actors have in managing such shifts within...

  12. Therapeutic cloning: The ethical limits

    International Nuclear Information System (INIS)

    Whittaker, Peter A.

    2005-01-01

    A brief outline of stem cells, stem cell therapy and therapeutic cloning is given. The position of therapeutic cloning with regard to other embryonic manipulations - IVF-based reproduction, embryonic stem formation from IVF embryos and reproductive cloning - is indicated. The main ethically challenging stages in therapeutic cloning are considered to be the nuclear transfer process including the source of eggs for this and the destruction of an embryo to provide stem cells for therapeutic use. The extremely polarised nature of the debate regarding the status of an early human embryo is noted, and some potential alternative strategies for preparing immunocompatible pluripotent stem cells are indicated

  13. Therapeutic cloning in the mouse

    Science.gov (United States)

    Mombaerts, Peter

    2003-01-01

    Nuclear transfer technology can be applied to produce autologous differentiated cells for therapeutic purposes, a concept termed therapeutic cloning. Countless articles have been published on the ethics and politics of human therapeutic cloning, reflecting the high expectations from this new opportunity for rejuvenation of the aging or diseased body. Yet the research literature on therapeutic cloning, strictly speaking, is comprised of only four articles, all in the mouse. The efficiency of derivation of embryonic stem cell lines via nuclear transfer is remarkably consistent among these reports. However, the efficiency is so low that, in its present form, the concept is unlikely to become widespread in clinical practice. PMID:12949262

  14. CIRUN: Climate Information Responding to User Needs

    Science.gov (United States)

    Busalacchi, A. J.

    2009-12-01

    The Earth System will experience real climate change over the next 50 years, exceeding the scope of natural climate variability. A paramount question facing society is how to adapt to this certainty of climate variability and change. In response, OSTP and NOAA are considering how comprehensive climate services would best inform decisions about adaptation. Similarly, NASA is considering the optimal configuration of the next generation of Earth, environmental, and climate observations to be deployed over the coming 10-20 years. Moreover, much of the added-value information for specific climate-related decisions will be provided by private, academic and non-governmental organizations. In this context, over the past several years the University of Maryland has established the CIRUN (Climate Information: Responding to User Needs) initiative to identify the nature of national needs for climate information and services from a decision support perspective. To date, CIRUN has brought together decisionmakers in a number of sectors to help understand their perspectives on climate with the goal of improving the usefulness of climate information, observations and prediction products to specific user communities. CIRUN began with a major workshop in October 2007 that convened 430 participants in agriculture, parks and recreation, terrestrial ecosystems, insurance/investment, energy, national security, state/local/municipal, water, human health, commerce and manufacturing, transportation, and coastal/marine sectors. Plenary speakers such as Norman Augustine, R. James Woolsey, James Mahoney, and former Senator Joseph Tydings, breakout panel sessions, and participants provided input based on the following: - How would you characterize the exposure or vulnerability to climate variability or change impacting your organization? - Does climate variability and/or change currently factor into your organization's objectives or operations? - Are any of your existing plans being affected by

  15. The Relationship between Therapeutic Alliance and Service User Satisfaction in Mental Health Inpatient Wards and Crisis House Alternatives: A Cross-Sectional Study

    Science.gov (United States)

    Sweeney, Angela; Fahmy, Sarah; Nolan, Fiona; Morant, Nicola; Fox, Zoe; Lloyd-Evans, Brynmor; Osborn, David; Burgess, Emma; Gilburt, Helen; McCabe, Rosemarie; Slade, Mike; Johnson, Sonia

    2014-01-01

    Background Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses. Methods and Findings Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically. Results We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy. Conclusions and Implications We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute

  16. Purinergic Signalling: Therapeutic Developments

    Directory of Open Access Journals (Sweden)

    Geoffrey Burnstock

    2017-09-01

    Full Text Available Purinergic signalling, i.e., the role of nucleotides as extracellular signalling molecules, was proposed in 1972. However, this concept was not well accepted until the early 1990’s when receptor subtypes for purines and pyrimidines were cloned and characterised, which includes four subtypes of the P1 (adenosine receptor, seven subtypes of P2X ion channel receptors and 8 subtypes of the P2Y G protein-coupled receptor. Early studies were largely concerned with the physiology, pharmacology and biochemistry of purinergic signalling. More recently, the focus has been on the pathophysiology and therapeutic potential. There was early recognition of the use of P1 receptor agonists for the treatment of supraventricular tachycardia and A2A receptor antagonists are promising for the treatment of Parkinson’s disease. Clopidogrel, a P2Y12 antagonist, is widely used for the treatment of thrombosis and stroke, blocking P2Y12 receptor-mediated platelet aggregation. Diquafosol, a long acting P2Y2 receptor agonist, is being used for the treatment of dry eye. P2X3 receptor antagonists have been developed that are orally bioavailable and stable in vivo and are currently in clinical trials for the treatment of chronic cough, bladder incontinence, visceral pain and hypertension. Antagonists to P2X7 receptors are being investigated for the treatment of inflammatory disorders, including neurodegenerative diseases. Other investigations are in progress for the use of purinergic agents for the treatment of osteoporosis, myocardial infarction, irritable bowel syndrome, epilepsy, atherosclerosis, depression, autism, diabetes, and cancer.

  17. Dental therapeutic systems.

    Science.gov (United States)

    Iqbal, Zeenat; Jain, Nilu; Jain, Gaurav K; Talegaonkar, Sushama; Ahuja, Alka; Khar, Roop K; Ahmad, Farhan J

    2008-01-01

    The recognition of periodontal diseases as amenable to local antibiotherapy has resulted in a paradigmatic shift in treatment modalities of dental afflictions. Moreover the presence of antimicrobial resistance, surfacing of untoward reactions owing to systemic consumption of antibiotics has further advocated the use of local delivery of physiologically active substances into the periodontal pocket. While antimicrobials polymerized into acrylic strips, incorporated into biodegradable collagen and hollow permeable cellulose acetate fibers, multiparticulate systems, bio-absorbable dental materials, biodegradable gels/ointments, injectables, mucoadhesive microcapsules and nanospheres will be more amenable for direct placement into the periodontal pockets the lozenges, buccoadhesive tablets, discs or gels could be effectively used to mitigate the overall gingival inflammation. Whilst effecting controlled local delivery of a few milligram of an antibacterial agent within the gingival crevicular fluid for a longer period of time, maintaining therapeutic concentrations such delivery devices will circumvent all adverse effects to non- oral sites. Since the pioneering efforts of Goodson and Lindhe in 1989, delivery at gingival and subgingival sites has witnessed a considerable progress. The interest in locally active systems is evident from the patents being filed and granted. The present article shall dwell in reviewing the recent approaches being proffered in the field. Patents as by Shefer, et al. US patent, 6589562 dealing with multicomponent biodegradable bioadhesive controlled release system for oral care products, Lee, et al. 2001, US patent 6193994, encompassing a locally administrable, biodegradable and sustained-release pharmaceutical composition for periodontitis and process for preparation thereof and method of treating periodontal disease as suggested by Basara in 2004via US patent 6830757, shall be the types of intellectual property reviewed and presented in

  18. Responding to the Consequences of Climate Change

    Science.gov (United States)

    Hildebrand, Peter H.

    2011-01-01

    The talk addresses the scientific consensus concerning climate change, and outlines the many paths that are open to mitigate climate change and its effects on human activities. Diverse aspects of the changing water cycle on Earth are used to illustrate the reality climate change. These include melting snowpack, glaciers, and sea ice; changes in runoff; rising sea level; moving ecosystems, an more. Human forcing of climate change is then explained, including: greenhouse gasses, atmospheric aerosols, and changes in land use. Natural forcing effects are briefly discussed, including volcanoes and changes in the solar cycle. Returning to Earth's water cycle, the effects of climate-induced changes in water resources is presented. Examples include wildfires, floods and droughts, changes in the production and availability of food, and human social reactions to these effects. The lk then passes to a discussion of common human reactions to these forecasts of climate change effects, with a summary of recent research on the subject, plus several recent historical examples of large-scale changes in human behavior that affect the climate and ecosystems. Finally, in the face for needed action on climate, the many options for mitigation of climate change and adaptation to its effects are presented, with examples of the ability to take affordable, and profitable action at most all levels, from the local, through national.

  19. Therapeutical aspect of trichomoniasis

    Directory of Open Access Journals (Sweden)

    Vukićević Jelica

    2003-01-01

    Full Text Available Trichomoniasis is frequent, parasitic and sexually transmitted infection of genitourinary tract. It is treated by metronidazole (5-nitroimidazole according to protocol recommended by Center for Disease Control (CDC formerly called: Communicable Disease Center [19]. The resistance of Trichomonas vaginalis (TV strains to metronidazole (MND was described in USA in 1960, and later on in many European countries [8, 9, 10, 11, 12, 13]. In these cases, due to persistent trichomonas infection, it is necessary to repeat MND treatment with moderate modification of dose and/or length of its application. Nevertheless, oncogenic and toxic effects of MND have to be taken into consideration. OBJECT The aim of this study was to investigate and analyze the incidence of TV in STD and lower susceptibility of certain TV strains to MND were analyzed. MATERIAL AND METHODS In three-year period (1999-2001 612 patients (244 females and 368 males suspected of STD were examined clinically and microbiologically at the Institute of Dermatovenereology in Belgrade. The patients detected for TV were treated according to CDC protocol. The affected were considered cured if there was no manifest clinical infection, and no TV verified by microbiological test. Results TV was isolated in 216 patients (35.29 % of all subjects. Trichomonas infection was found in 90 (36.88 % out of 244 tested females and in 126 (32.34 % of 368 males. Clinically manifested infection, with extensive urethral and vaginal secretion, was recorded in 161 patients, while the asymptomatic form was found in 55 subjects. This result indicates the predominance of manifested trichomonas infections (75.54 % of cases. The difference of distribution of clinical forms of trichomoniasis, in relation to sex, was not statistically significant (c2=0.854; p>0.05. The patients with verified trichomonas infection were treated by metronidazole according to CDC protocol. The recommended therapeutical scheme consisted of three

  20. IAEA responds to cancer crisis in Tanzania

    International Nuclear Information System (INIS)

    2006-01-01

    doctors and other health workers to operate them - are needed to help low and middle income countries fight cancer. Currently, only about 2,500 radiotherapy machines are operating. Moreover, most developing countries lack effective public health policies and comprehensive diagnostic programmes that are essential to managing the growing cancer epidemic. On World Cancer Day, the IAEA is pleased to announce its decision to install a MDS Nordion Equinox cancer therapy system at the Tanzanian clinic as part of a larger PACT effort to help the country advance its National Cancer Strategy and Action Plan, which will now for the first time include not only curative treatment but also cancer surveillance, prevention, early detection, and palliation.'The need to respond to this cancer crisis is clear and compelling,' MDS Nordion President Steve West said. 'We are proud to be part of PACT and the global response to improve cancer care in Tanzania and ultimately throughout the developing world.' The International Union Against Cancer (UICC) and its member organizations in over 80 countries are dedicating World Cancer Day 2006 to fighting childhood cancers by focusing on early detection and equal access to treatment. More than 80% of children affected by cancer live in low-income countries, where the cure rate is very low and most receive no treatment. The UICC advocates a coordinated strategy by the global cancer control community - one that combines innovative science and sound public health policies. This approach can save a large proportion of the 90,000 children lost every year to cancer. Cancer Treatment in Tanzania: The majority of cancers prevalent in Tanzania today require radiotherapy treatment. PACT will establish its first Centre of Excellence at the Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. The ORCI estimates that each year there are over 20,000 new patients with cancer in Tanzania. Currently, ORCI can treat only about 2,500 patients per year - only a

  1. Therapeutic Drug Monitoring in Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    NG Hoi-Yan Alexandra

    2016-12-01

    Full Text Available The ultimate goal of treating rheumatic disease is to achieve rapid suppression of inflammation, while at the same time minimizing the toxicities from rheumatic drugs. Different patients have different individual pharmacokinetics that can affect the drug level. Moreover, different factors, such as renal function, age or even different underlying diseases, can affect the drug level. Therefore, giving the same dosage of drugs to different patients may result in different drug levels. This article will review the usefulness of therapeutic drug monitoring in maximizing drug efficacy, while reducing the risk of toxicities in Hydroxychloroquine, Mycophenolate Mofetil, Tacrolimus and Tumor Necrosis Factor inhibitors (TNF Inhibitors.

  2. Chronic blockade or constitutive deletion of the serotonin transporter reduces operant responding for food reward.

    Science.gov (United States)

    Sanders, Amy Cecilia; Hussain, Ali J; Hen, René; Zhuang, Xiaoxi

    2007-11-01

    The therapeutic effects of chronic selective serotonin reuptake inhibitors (SSRIs) are well documented, yet the elementary behavioral processes that are affected by such treatment have not been fully investigated. We report here the effects of chronic fluoxetine treatment and genetic deletion of the serotonin transporter (SERT) on food reinforced behavior in three paradigms: the progressive ratio operant task, the concurrent choice operant task, and the Pavlovian-to-Instrumental transfer task. We consistently find that chronic pharmacological blockade or genetic deletion of SERT result in similar behavioral consequences: reduced operant responding for natural reward. This is in line with previous studies reporting declines in operant responding for drugs and intracranial self-stimulation with fluoxetine treatment, suggesting that the effect of SERT blockade can be generalized to different reward types. Detailed analyses of behavioral parameters indicate that this reduction in operant responding affect both goal-directed and non-goal-directed behaviors without affecting the Pavlovian cue-triggered excessive operant responding. In addition, both pharmacological and genetic manipulations reduce locomotor activity in the open field novel environment. Our data contrast with the effect of dopamine in increasing operant responding for natural reward specifically in goal-directed behaviors and in increasing Pavlovian cue-triggered excessive operant responding. Serotonin and dopamine have been proposed to serve opposing functions in motivational processes. Our data suggest that their interactions do not result in simple opponency. The fact that pharmacological blockade and genetic deletion of SERT have similar behavioral consequences reinforces the utility of the SERT null mice for investigation of the mechanisms underlying chronic SSRIs treatment.

  3. Acromegaly said to respond to proton therapy

    Energy Technology Data Exchange (ETDEWEB)

    Raymond, C.A.

    1988-02-12

    A news article is presented which discusses a new use for proton therapy. As physicians and physicists continue to refine the clinical applications for charged particles, they can point to at least one notable success story: the treatment of acromegaly, a disorder that afflicts an estimated 250 persons in the United States each year. Bernard Kliman, MD, reported at the annual Endocrine Society meeting in Indianapolis that his group at Harvard Medical School, Boston, and the Harvard cyclotron has cured 479 (85.5%) of 560 patients with acromegaly or gigantism. Cure is defined as reducing growth hormone level to less than 5 ..mu..g/L and shrinking the soft tissue growth characteristic of the disease.

  4. Acromegaly said to respond to proton therapy

    International Nuclear Information System (INIS)

    Raymond, C.A.

    1988-01-01

    A news article is presented which discusses a new use for proton therapy. As physicians and physicists continue to refine the clinical applications for charged particles, they can point to at least one notable success story: the treatment of acromegaly, a disorder that afflicts an estimated 250 persons in the United States each year. Bernard Kliman, MD, reported at the annual Endocrine Society meeting in Indianapolis that his group at Harvard Medical School, Boston, and the Harvard cyclotron has cured 479 (85.5%) of 560 patients with acromegaly or gigantism. Cure is defined as reducing growth hormone level to less than 5 μg/L and shrinking the soft tissue growth characteristic of the disease

  5. Therapeutic Inertia and Treatment Intensification.

    Science.gov (United States)

    Josiah Willock, Robina; Miller, Joseph B; Mohyi, Michelle; Abuzaanona, Ahmed; Muminovic, Meri; Levy, Phillip D

    2018-01-29

    This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations. Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

  6. Huntington disease: Experimental models and therapeutic perspectives

    International Nuclear Information System (INIS)

    Serrano Sanchez, Teresa; Blanco Lezcano, Lisette; Garcia Minet, Rocio; Alberti Amador, Esteban; Diaz Armesto, Ivan and others

    2011-01-01

    Huntington's disease (HD) is a degenerative dysfunction of hereditary origin. Up to date there is not, an effective treatment to the disease which having lapsed 15 or 20 years advances inexorably, in a slow form, toward the total inability or death. This paper reviews the clinical and morphological characteristics of Huntington's disease as well as the experimental models more commonly used to study this disease, having as source the articles indexed in Medline data base, published in the last 20 years. Advantages and disadvantages of all experimental models to reproduce the disease as well as the perspectives to therapeutic assay have been also considered. the consent of outline reported about the toxic models, those induced by neurotoxins such as quinolinic acid, appears to be the most appropriate to reproduce the neuropathologic characteristic of the disease, an genetic models contributing with more evidence to the knowledge of the disease etiology. Numerous treatments ameliorate clinical manifestations, but none of them has been able to stop or diminish the affectations derived from neuronal loss. At present time it is possible to reproduce, at least partially, the characteristics of the disease in experimentation animals that allow therapy evaluation in HD. from the treatment view point, the more promissory seems to be transplantation of no neuronal cells, taking into account ethical issues and factibility. On the other hand the new technology of interference RNA emerges as a potential therapeutic tool for treatment in HD, and to respond basic questions on the development of the disease.

  7. Myasthenia gravis: subgroup classification and therapeutic strategies.

    Science.gov (United States)

    Gilhus, Nils Erik; Verschuuren, Jan J

    2015-10-01

    Myasthenia gravis is an autoimmune disease that is characterised by muscle weakness and fatigue, is B-cell mediated, and is associated with antibodies directed against the acetylcholine receptor, muscle-specific kinase (MUSK), lipoprotein-related protein 4 (LRP4), or agrin in the postsynaptic membrane at the neuromuscular junction. Patients with myasthenia gravis should be classified into subgroups to help with therapeutic decisions and prognosis. Subgroups based on serum antibodies and clinical features include early-onset, late-onset, thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis. Agrin-associated myasthenia gravis might emerge as a new entity. The prognosis is good with optimum symptomatic, immunosuppressive, and supportive treatment. Pyridostigmine is the preferred symptomatic treatment, and for patients who do not adequately respond to symptomatic therapy, corticosteroids, azathioprine, and thymectomy are first-line immunosuppressive treatments. Additional immunomodulatory drugs are emerging, but therapeutic decisions are hampered by the scarcity of controlled studies. Long-term drug treatment is essential for most patients and must be tailored to the particular form of myasthenia gravis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Therapeutic benefits of cannabis: a patient survey.

    Science.gov (United States)

    Webb, Charles W; Webb, Sandra M

    2014-04-01

    Clinical research regarding the therapeutic benefits of cannabis ("marijuana") has been almost non-existent in the United States since cannabis was given Schedule I status in the Controlled Substances Act of 1970. In order to discover the benefits and adverse effects perceived by medical cannabis patients, especially with regards to chronic pain, we hand-delivered surveys to one hundred consecutive patients who were returning for yearly re-certification for medical cannabis use in Hawai'i. The response rate was 94%. Mean and median ages were 49.3 and 51 years respectively. Ninety-seven per cent of respondents used cannabis primarily for chronic pain. Average pain improvement on a 0-10 pain scale was 5.0 (from 7.8 to 2.8), which translates to a 64% relative decrease in average pain. Half of all respondents also noted relief from stress/anxiety, and nearly half (45%) reported relief from insomnia. Most patients (71%) reported no adverse effects, while 6% reported a cough or throat irritation and 5% feared arrest even though medical cannabis is legal in Hawai'i. No serious adverse effects were reported. These results suggest that Cannabis is an extremely safe and effective medication for many chronic pain patients. Cannabis appears to alleviate pain, insomnia, and may be helpful in relieving anxiety. Cannabis has shown extreme promise in the treatment of numerous medical problems and deserves to be released from the current Schedule I federal prohibition against research and prescription.

  9. Therapeutic effects of probiotics on neonatal jaundice

    OpenAIRE

    Liu, Wenbin; Liu, Huajun; Wang, Taisen; Tang, Xueqing

    2015-01-01

    Objective: To evaluate the therapeutic effects of probiotics on neonatal jaundice and the safety. Methods: Sixty-eight neonates with jaundice were divided into a control group and a treatment group (n=34) randomly, and treated by blue light phototherapy and that in combination with probiotics. The serum bilirubin levels were detected before and 1, 4, 7 days after treatment. The time when therapy showed effects and jaundice faded, clinical outcomes as well as adverse reactions were recorded. T...

  10. Blue whales respond to anthropogenic noise.

    Directory of Open Access Journals (Sweden)

    Mariana L Melcón

    Full Text Available Anthropogenic noise may significantly impact exposed marine mammals. This work studied the vocalization response of endangered blue whales to anthropogenic noise sources in the mid-frequency range using passive acoustic monitoring in the Southern California Bight. Blue whales were less likely to produce calls when mid-frequency active sonar was present. This reduction was more pronounced when the sonar source was closer to the animal, at higher sound levels. The animals were equally likely to stop calling at any time of day, showing no diel pattern in their sensitivity to sonar. Conversely, the likelihood of whales emitting calls increased when ship sounds were nearby. Whales did not show a differential response to ship noise as a function of the time of the day either. These results demonstrate that anthropogenic noise, even at frequencies well above the blue whales' sound production range, has a strong probability of eliciting changes in vocal behavior. The long-term implications of disruption in call production to blue whale foraging and other behaviors are currently not well understood.

  11. Prospects for therapeutic mitochondrial transplantation.

    Science.gov (United States)

    Gollihue, Jenna L; Rabchevsky, Alexander G

    2017-07-01

    Mitochondrial dysfunction has been implicated in a multitude of diseases and pathological conditions- the organelles that are essential for life can also be major players in contributing to cell death and disease. Because mitochondria are so well established in our existence, being present in all cell types except for red blood cells and having the responsibility of providing most of our energy needs for survival, then dysfunctional mitochondria can elicit devastating cellular pathologies that can be widespread across the entire organism. As such, the field of "mitochondrial medicine" is emerging in which disease states are being targeted therapeutically at the level of the mitochondrion, including specific antioxidants, bioenergetic substrate additions, and membrane uncoupling agents. New and compelling research investigating novel techniques for mitochondrial transplantation to replace damaged or dysfunctional mitochondria with exogenous healthy mitochondria has shown promising results, including tissue sparing accompanied by increased energy production and decreased oxidative damage. Various experimental techniques have been attempted and each has been challenged to accomplish successful transplantation. The purpose of this review is to present the history of mitochondrial transplantation, the different techniques used for both in vitro and in vivo delivery, along with caveats and pitfalls that have been discovered along the way. Results from such pioneering studies are promising and could be the next big wave of "mitochondrial medicine" once technical hurdles are overcome. Copyright © 2017 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  12. An audit of therapeutic drug monitoring services of anticonvulsants at a tertiary care hospital in India.

    Science.gov (United States)

    Taur, Santosh R; Kulkarni, Namrata B; Gogtay, Nithya J; Thatte, Urmila M

    2013-04-01

    Therapeutic drug monitoring (TDM) is an important adjunct to the treatment of epilepsy. However, few studies have actually correlated plasma levels of antiepileptic drugs (AEDs) with treatment response. The present audit aimed to study (i) the association between seizure control and number of AEDs, plasma AED concentration, and concomitant use of antitubercular drugs; (ii) the pattern of indications for TDM requisitions; and (iii) the association between referral for toxicity and plasma AED concentration. This observational and retrospective study was carried out to analyze the TDM data of patients referred between January 2008 and December 2011. As per the International League Against Epilepsy Task Force 2009, patients were categorized into responders and nonresponders. Plasma AED levels were interpreted as below, within, and above the reference range. Of 3206 TDM requisitions, 67% were monotherapy and 33% were 2 or more AEDs. Only 8% were responders as against 92% nonresponders. Of 95 patients on concomitant antituberculosis treatment, 72 were nonresponders, with odds ratio (95% confidence interval) 3.71 [2.19 to 6.23]. Breakthrough seizure (37%) was the most common indication followed by suspected toxicity and routine monitoring in 22% each and suspected nonadherence in 11% of the total requests. In 52% of patients, plasma levels were below the reference range, and they were equally distributed amongst responders and nonresponders. Among patients referred for suspected phenytoin toxicity, only 59% (50.6 to 67.8) had plasma concentrations above the reference range. TDM continues to remain an important tool to support dose individualization when the patient is receiving multiple AEDs or other drugs such as antitubercular medicines, to assess compliance, and to monitor and treat toxicity.

  13. Therapeutic bond judgments: Congruence and incongruence.

    Science.gov (United States)

    Atzil-Slonim, Dana; Bar-Kalifa, Eran; Rafaeli, Eshkol; Lutz, Wolfgang; Rubel, Julian; Schiefele, Ann-Kathrin; Peri, Tuvia

    2015-08-01

    The present study had 2 aims: (a) to implement West and Kenny's (2011) Truth-and-Bias model to simultaneously assess the temporal congruence and directional discrepancy between clients' and therapists' ratings of the bond facet of the therapeutic alliance, as they cofluctuate from session to session; and (b) to examine whether symptom severity and a personality disorder (PD) diagnosis moderate congruence and/or discrepancy. Participants included 213 clients treated by 49 therapists. At pretreatment, clients were assessed for a PD diagnosis and completed symptom measures. Symptom severity was also assessed at the beginning of each session, using client self-reports. Both clients and therapists rated the therapeutic bond at the end of each session. Therapists and clients exhibited substantial temporal congruence in their session-by-session bond ratings, but therapists' ratings tended to be lower than their clients' across sessions. Additionally, therapeutic dyads whose session-by-session ratings were more congruent also tended to have a larger directional discrepancy (clients' ratings being higher). Pretreatment symptom severity and PD diagnosis did not moderate either temporal congruence or discrepancy at the dyad level; however, during sessions when clients were more symptomatic, therapist and client ratings were both farther apart and tracked each other less closely. Our findings are consistent with a "better safe than sorry" pattern, which suggests that therapists are motivated to take a vigilant approach that may lead both to underestimation and to attunement to fluctuations in the therapeutic bond. (c) 2015 APA, all rights reserved).

  14. Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey

    Directory of Open Access Journals (Sweden)

    Vikas N. O’Reilly-Shah

    2017-09-01

    Full Text Available Background Respondent fatigue, also known as survey fatigue, is a common problem in the collection of survey data. Factors that are known to influence respondent fatigue include survey length, survey topic, question complexity, and open-ended question type. There is a great deal of interest in understanding the drivers of physician survey responsiveness due to the value of information received from these practitioners. With the recent explosion of mobile smartphone technology, it has been possible to obtain survey data from users of mobile applications (apps on a question-by-question basis. The author obtained basic demographic survey data as well as survey data related to an anesthesiology-specific drug called sugammadex and leveraged nonresponse rates to examine factors that influenced respondent fatigue. Methods Primary data were collected between December 2015 and February 2017. Surveys and in-app analytics were collected from global users of a mobile anesthesia calculator app. Key independent variables were user country, healthcare provider role, rating of importance of the app to personal practice, length of time in practice, and frequency of app use. Key dependent variable was the metric of respondent fatigue. Results Provider role and World Bank country income level were predictive of the rate of respondent fatigue for this in-app survey. Importance of the app to the provider and length of time in practice were moderately associated with fatigue. Frequency of app use was not associated. This study focused on a survey with a topic closely related to the subject area of the app. Respondent fatigue rates will likely change dramatically if the topic does not align closely. Discussion Although apps may serve as powerful platforms for data collection, responses rates to in-app surveys may differ on the basis of important respondent characteristics. Studies should be carefully designed to mitigate fatigue as well as powered with the

  15. Responding to the real needs of women.

    Science.gov (United States)

    Arango, H

    1994-01-01

    INPPARES, the International Planned Parenthood Federation affiliate in Peru, has provided family planning and other services to the Peruvian population since 1976. The organization concentrates upon interventions targeted to women of low socioeconomic status. One of the group's most important strategies has been to distribute contraceptives at the community level in rural and peri-urban areas of the country through a network of centers managed by promoters. These promoters are virtually all female. The organization in 1993 supplied 812 distribution centers. Promoters and their supervisors have received training in contraception, basic data recording, community work, and related topics. INPPARES, however, suspected that the quality of the project would be improved if promoters and supervisors were trained about the role of women in the community and their rights and identity as women. The personnel would then be able to better understand the role of contraception and reproductive health in women's lives. To that end, INPPARES in 1992-93 developed a project in coordination with the Manuela Ramos Association, a Peruvian women's organization. A questionnaire was given to forty promoters on issues related to women's roles, values, attitudes, the place of women in society and the family, family planning, sexual relations, and decision making. Their responses pointed to a real need to provide promoters and supervisors with more information through workshops on women in Peruvian society, women's identity and roles, women's sexual rights, and the quality of care in service provision. Four pamphlets were drafted from a seminar of fifty supervisors from both organizations to be used in a series of twelve workshops for 256 promoters. Post-intervention evaluation of the original forty participants confirm the significant effectiveness of both subjects covered and materials used in achieving desired project goals. Four workshops were subsequently held in which project results

  16. How does yeast respond to pressure?

    Directory of Open Access Journals (Sweden)

    Fernandes P.M.B.

    2005-01-01

    Full Text Available The brewing and baking yeast Saccharomyces cerevisiae has been used as a model for stress response studies of eukaryotic cells. In this review we focus on the effect of high hydrostatic pressure (HHP on S. cerevisiae. HHP exerts a broad effect on yeast cells characteristic of common stresses, mainly associated with protein alteration and lipid bilayer phase transition. Like most stresses, pressure induces cell cycle arrest. Below 50 MPa (500 atm yeast cell morphology is unaffected whereas above 220 MPa wild-type cells are killed. S. cerevisiae cells can acquire barotolerance if they are pretreated with a sublethal stress due to temperature, ethanol, hydrogen peroxide, or pressure. Nevertheless, pressure only leads to protection against severe stress if, after pressure pretreatment, the cells are also re-incubated at room pressure. We attribute this effect to the inhibition of the protein synthesis apparatus under HHP. The global genome expression analysis of S. cerevisiae cells submitted to HHP revealed a stress response profile. The majority of the up-regulated genes are involved in stress defense and carbohydrate metabolism while most repressed genes belong to the cell cycle progression and protein synthesis categories. However, the signaling pathway involved in the pressure response is still to be elucidated. Nitric oxide, a signaling molecule involved in the regulation of a large number of cellular functions, confers baroprotection. Furthermore, S. cerevisiae cells in the early exponential phase submitted to 50-MPa pressure show induction of the expression level of the nitric oxide synthase inducible isoform. As pressure becomes an important biotechnological tool, studies concerning this kind of stress in microorganisms are imperative.

  17. Responding to the Pandemic of Falsified Medicines

    Science.gov (United States)

    Nayyar, Gaurvika M. L.; Attaran, Amir; Clark, John P.; Culzoni, M. Julia; Fernandez, Facundo M.; Herrington, James E.; Kendall, Megan; Newton, Paul N.; Breman, Joel G.

    2015-01-01

    Over the past decade, the number of countries reporting falsified (fake, spurious/falsely labeled/counterfeit) medicines and the types and quantities of fraudulent drugs being distributed have increased greatly. The obstacles in combating falsified pharmaceuticals include 1) lack of consensus on definitions, 2) paucity of reliable and scalable technology to detect fakes before they reach patients, 3) poor global and national leadership and accountability systems for combating this scourge, and 4) deficient manufacturing and regulatory challenges, especially in China and India where fake products often originate. The major needs to improve the quality of the world's medicines fall into three main areas: 1) research to develop and compare accurate and affordable tools to identify high-quality drugs at all levels of distribution; 2) an international convention and national legislation to facilitate production and utilization of high-quality drugs and protect all countries from the criminal and the negligent who make, distribute, and sell life-threatening products; and 3) a highly qualified, well-supported international science and public health organization that will establish standards, drug-quality surveillance, and training programs like the U.S. Food and Drug Administration. Such leadership would give authoritative guidance for countries in cooperation with national medical regulatory agencies, pharmaceutical companies, and international agencies, all of which have an urgent interest and investment in ensuring that patients throughout the world have access to good quality medicines. The organization would also advocate strongly for including targets for achieving good quality medicines in the United Nations Millennium Development Goals and Sustainable Development Goals. PMID:25897060

  18. Dissociating indifferent, directional, and extreme responding in personality data

    DEFF Research Database (Denmark)

    Zettler, Ingo; Lang, Jonas W B; Hülsheger, Ute R

    2015-01-01

    - and observer reports of personality traits. The three-process model captures indifferent, directional, and extreme responding. Substantively, we hypothesize that, and test whether, trait Honesty-Humility is negatively linked to extreme responding. METHOD: We applied the three-process model to personality data......-process model. Second, we show that the various response processes show a pattern of correlations across traits and rating sources which is in line with the idea that indifferent and extreme responding are person-specific tendencies, whereas directional responding is content-specific. Third, we report findings...... of N = 577 dyads (self- and observer reports of the HEXACO Personality Inventory-Revised) of Dutch and German respondents. RESULTS: First, we provide evidence that indifferent, directional, and extreme responding can be separated from each other in personality data through the use of the three...

  19. Therapeutic inertia amongst general practitioners with interest in diabetes.

    Science.gov (United States)

    Seidu, Samuel; Than, Tun; Kar, Deb; Lamba, Amrit; Brown, Pam; Zafar, Azhar; Hussain, Rizwan; Amjad, Ahmed; Capehorn, Mathew; Martin, Elizabeth; Fernando, Kevin; McMoran, Jim; Millar-Jones, David; Kahn, Shahzada; Campbell, Nigel; Brice, Richard; Mohan, Rahul; Mistry, Mukesh; Kanumilli, Naresh; St John, Joan; Quigley, Richard; Kenny, Colin; Khunti, Kamlesh

    2018-02-01

    As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists. In this retrospective audit, we assessed the prevalence of the phenomenon of therapeutic inertia amongst primary care physicians with an interest in diabetes in UK. We also assessed the predictive abilities of various patient level characteristics on therapeutic inertia amongst this group of clinicians. Out of the 240 patients reported on, therapeutic inertia was judged to have occurred in 53 (22.1%) of patients. The full model containing all the selected variables was not statistically significant, p=0.59. So the model was not able to distinguish between situations in which therapeutic inertia occurred and when it did not occur. None of the patient level characteristics on its own was predictive of therapeutic inertia. Therapeutic inertia was present only in about a fifth of patient patients with diabetes being managed by primary care physicians with an interest in diabetes. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  20. Human Factor in Therapeutic Relationship

    Directory of Open Access Journals (Sweden)

    Ramazan Akdogan

    2011-03-01

    Full Text Available herapeutic relationship is a professional relationship that has been structured based on theoretical props. This relationship is a complicated, wide and unique relationship which develops between two people, where both sides' personality and attitudes inevitably interfere. Therapist-client relationship experienced through transference and counter transference, especially in psychodynamic approaches, is accepted as the main aspect of therapeutic process. However, the approaches without dynamic/deterministic tendency also take therapist-client relationship into account seriously and stress uniqueness of interaction between two people. Being a person and a human naturally sometimes may negatively influence the relationship between the therapist and client and result in a relationship going out of the theoretical frame at times. As effective components of a therapeutic process, the factors that stem from being human include the unique personalities of the therapist and the client, their values and their attitude either made consciously or subconsciously. Literature has shown that the human-related factors are too effective to be denied in therapeutic relationship process. Ethical and theoretical knowledge can be inefficient to prevent the negative effects of these factors in therapeutic process at which point a deep insight and supervision would have a critical role in continuing an acceptable therapeutic relationship. This review is focused on the reflection of some therapeutic factors resulting from being human and development of counter transference onto the therapeutic process.

  1. Sharka: how do plants respond to Plum pox virus infection?

    Science.gov (United States)

    Clemente-Moreno, María J; Hernández, José A; Diaz-Vivancos, Pedro

    2015-01-01

    Plum pox virus (PPV), the causal agent of sharka disease, is one of the most studied plant viruses, and major advances in detection techniques, genome characterization and organization, gene expression, transmission, and the description of candidate genes involved in PPV resistance have been described. However, information concerning the plant response to PPV infection is very scarce. In this review, we provide an updated summary of the research carried out to date in order to elucidate how plants cope with PPV infection and their response at different levels, including the physiological, biochemical, proteomic, and genetic levels. Knowledge about how plants respond to PPV infection can contribute to the development of new strategies to cope with this disease. Due to the fact that PPV induces an oxidative stress in plants, the bio-fortification of the antioxidative defences, by classical or biotechnological approaches, would be a useful tool to cope with PPV infection. Nevertheless, there are still some gaps in knowledge related to PPV-plant interaction that remain to be filled, such as the effect of PPV on the hormonal profile of the plant or on the plant metabolome. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  2. Recruiting an Internet Panel Using Respondent-Driven Sampling

    Directory of Open Access Journals (Sweden)

    Schonlau Matthias

    2014-06-01

    Full Text Available Respondent-driven sampling (RDS is a network sampling technique typically employed for hard-to-reach populations when traditional sampling approaches are not feasible (e.g., homeless or do not work well (e.g., people with HIV. In RDS, seed respondents recruit additional respondents from their network of friends. The recruiting process repeats iteratively, thereby forming long referral chains.

  3. [End therapeutic nihilism towards COPD].

    Science.gov (United States)

    Juergens, Uwe R

    2007-03-15

    Prevention of COPD requires appropriate patient education, especially of adolescents, as well as the establishment of an effective national health policy. The new GOLD guidelines represent the current standard of knowledge on the management of chronic, progressive, obstructive pulmonary diseases. It points out that COPD is avoidable and treatable,and hence, there is no reason for therapeutic nihilism. Chronic bronchitis preceding a progressive respiratory obstruction cannot be improved with the presently available respiratory therapeutics. For this reason, therapeutic measures concentrate on the avoidance of exacerbations, which are primarily responsible for the severity of the course of COPD.

  4. Frontiers in nano-therapeutics

    CERN Document Server

    Tasnim, Nishat; Sai Krishna, Katla; Kalagara, Sudhakar; Narayan, Mahesh; Noveron, Juan C; Joddar, Binata

    2017-01-01

    This brief highlights recent research advances in the area of nano-therapeutics. Nanotechnology holds immense potential for application in a wide range of biological and engineering applications such as molecular sensors for disease diagnosis, therapeutic agents for the treatment of diseases, a vehicle for delivering therapeutics and imaging agents for theranostic applications, both in-vitro and in-vivo. The brief is grouped into the following sections namely, A) Discrete Nanosystems ; B) Anisotropic Nanoparticles; C) Nano-films/coated/layered and D) Nano-composites.

  5. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  6. Medication-Related Osteonecrosis of Jaws: A Low-Level Laser Therapy and Antimicrobial Photodynamic Therapy Case Approach

    Directory of Open Access Journals (Sweden)

    Mariana Comparotto Minamisako

    2016-01-01

    Full Text Available Medication-related osteonecrosis of the jaws (MRONJ can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT, and photodynamic therapy (PDT up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required. Besides the recommended conventional treatment protocol, LLLT and PDT are important tools to contribute to healing and improvement of patient’s quality of life.

  7. Hostile attributional bias, negative emotional responding, and aggression in adults: moderating effects of gender and impulsivity.

    Science.gov (United States)

    Chen, Pan; Coccaro, Emil F; Jacobson, Kristen C

    2012-01-01

    The current study examined the main effects of hostile attributional bias (HAB) and negative emotional responding on a variety of aggressive behaviors in adults, including general aggression, physical aggression, relational aggression, and verbal aggression. Effects of both externalizing (anger) and internalizing (embarrassment/upset) negative emotions were considered. In addition, the moderating roles of gender and impulsivity on the effects of HAB and negative emotional responding were explored. Multilevel models were fitted to data from 2,749 adult twins aged 20-55 from the PennTwins cohort. HAB was positively associated with all four forms of aggression. There was also a significant interaction between impulsivity and HAB for general aggression. Specifically, the relationship between HAB and general aggression was only significant for individuals with average or above-average levels of impulsivity. Negative emotional responding was also found to predict all measures of aggression, although in different ways. Anger was positively associated with all forms of aggression, whereas embarrassment/upset predicted decreased levels of general, physical, and verbal aggression but increased levels of relational aggression. The associations between negative emotional responding and aggression were generally stronger for males than females. The current study provides evidence for the utility of HAB and negative emotional responding as predictors of adult aggression and further suggests that gender and impulsivity may moderate their links with aggression. © 2011 Wiley Periodicals, Inc.

  8. Hostile Attributional Bias, Negative Emotional Responding, and Aggression in Adults: Moderating Effects of Gender and Impulsivity

    Science.gov (United States)

    Chen, Pan; Coccaro, Emil F.; Jacobson, Kristen C.

    2012-01-01

    The current study examined the main effects of hostile attributional bias (HAB) and negative emotional responding on a variety of aggressive behaviors in adults, including general aggression, physical aggression, relational aggression, and verbal aggression. Effects of both externalizing (anger) and internalizing (embarrassment/upset) negative emotions were considered. In addition, the moderating roles of gender and impulsivity on the effects of HAB and negative emotional responding were explored. Multilevel models were fitted to data from 2,749 adult twins aged 20–55 from the PennTwins cohort. HAB was positively associated with all four forms of aggression. There was also a significant interaction between impulsivity and HAB for general aggression. Specifically, the relationship between HAB and general aggression was only significant for individuals with average or above-average levels of impulsivity. Negative emotional responding was also found to predict all measures of aggression, although in different ways. Anger was positively associated with all forms of aggression, whereas embarrassment/upset predicted decreased levels of general, physical, and verbal aggression but increased levels of relational aggression. The associations between negative emotional responding and aggression were generally stronger for males than females. The current study provides evidence for the utility of HAB and negative emotional responding as predictors of adult aggression and further suggests that gender and impulsivity may moderate their links with aggression. PMID:24833604

  9. Nonthermal effects of therapeutic ultrasound: the frequency resonance hypothesis.

    Science.gov (United States)

    Johns, Lennart D

    2002-07-01

    To present the frequency resonance hypothesis, a possible mechanical mechanism by which treatment with non-thermal levels of ultrasound stimulates therapeutic effects. The review encompasses a 4-decade history but focuses on recent reports describing the effects of nonthermal therapeutic levels of ultrasound at the cellular and molecular levels. A search of MEDLINE from 1965 through 2000 using the terms ultrasound and therapeutic ultrasound. The literature provides a number of examples in which exposure of cells to therapeutic ultrasound under nonthermal conditions modified cellular functions. Nonthermal levels of ultrasound are reported to modulate membrane properties, alter cellular proliferation, and produce increases in proteins associated with inflammation and injury repair. Combined, these data suggest that nonthermal effects of therapeutic ultrasound can modify the inflammatory response. The concept of the absorption of ultrasonic energy by enzymatic proteins leading to changes in the enzymes activity is not novel. However, recent reports demonstrating that ultrasound affects enzyme activity and possibly gene regulation provide sufficient data to present a probable molecular mechanism of ultrasound's nonthermal therapeutic action. The frequency resonance hypothesis describes 2 possible biological mechanisms that may alter protein function as a result of the absorption of ultrasonic energy. First, absorption of mechanical energy by a protein may produce a transient conformational shift (modifying the 3-dimensional structure) and alter the protein's functional activity. Second, the resonance or shearing properties of the wave (or both) may dissociate a multimolecular complex, thereby disrupting the complex's function. This review focuses on recent studies that have reported cellular and molecular effects of therapeutic ultrasound and presents a mechanical mechanism that may lead to a better understanding of how the nonthermal effects of ultrasound may be

  10. Design Considerations in Therapeutic Exergaming

    OpenAIRE

    Doyle, Julie; Kelly, Daniel; Caulfield, B.

    2011-01-01

    In this paper we discuss the importance of feedback in therapeutic exergaming. It is widely believed that exergaming benefits the patient in terms of encouraging adherence and boosting the patient’s confidence of correct execution and feedback is essential in achieving these. However, feedback and in particular visual feedback, may also have potential negative effects on the quality of the exercise. We describe in this paper a prototype single-sensor therapeutic exergame that we have develope...

  11. Evaluation of therapeutic patient education

    OpenAIRE

    D'Ivernois , Jean-François; Gagnayre , Rémi; Assal , Jean-Philippe; Golay , Alain; Libion , France; Deccache , Alain

    2006-01-01

    9 pages; These guidelines mainly focus on the principles of evaluating Therapeutic Patient Education; Over the past thirty years, therapeutic patient education (TPE) has become an essential part of the treatment of long-term diseases. Evaluations of this new practice are expected, and are sometimes imposed according to protocols and criteria that do not always reflect the complexity of changes taking place within patients and healthcare providers. Sometimes, expected results are not achieved ...

  12. Profiling Prostate Cancer Therapeutic Resistance

    OpenAIRE

    Cameron A. Wade; Natasha Kyprianou

    2018-01-01

    The major challenge in the treatment of patients with advanced lethal prostate cancer is therapeutic resistance to androgen-deprivation therapy (ADT) and chemotherapy. Overriding this resistance requires understanding of the driving mechanisms of the tumor microenvironment, not just the androgen receptor (AR)-signaling cascade, that facilitate therapeutic resistance in order to identify new drug targets. The tumor microenvironment enables key signaling pathways promoting cancer cell survival ...

  13. PREVALENCE, RISK FACTORS, PROPHYLACTIC BEHAVIOR, THERAPEUTIC BEHAVIOR AND STATE OF KNOWLEDGE REGARDING URINARY TRACT INFECTIONS AMONG CHOSEN POPULATION OF NURSING/MIDWIFERY STUDENTS AND QUALIFIED NURSES/MIDWIFES FROM MEDICAL UNIVERSITY OF ¸ÓDè

    Directory of Open Access Journals (Sweden)

    Aleksandra Grzelewska

    2010-03-01

    Full Text Available evalence, risk factors, therapeutic behavior, knowledge level, prophylactic and treatment methods regarding uncomplicated urinary tract infections (UTI. Materials and methods: Anonymous, closed, previously validated questionnaire, consisting of 12 questions on UTI in women was used in 267 adult nursing/midwifery students and nurses/midwifes from many different clinics/wards of the Medical University of Lodz. Results: 83% of respondents reported UTI at least once in a lifetime, 80% of them periodically, with cystitis being a main diagnosis. 40% of respondents reported periodical presence of UTI signs and symptoms without physician diagnosis confirmation. Main UTI causes were body cooling and cold water baths. 40% of respondents had symptoms suggesting UTI in the past but no diagnosis by physician. The risk of UTI symptoms disregarding or self-treatment prevalence decreased with time of professional practice, and in respondents with UTI symptoms connected with sexual activity, antibiotics treatment or sufficient level of knowledge of UTI. 64% UTI positive respondents had mothers with history of UTI. Conclusions: Cystitis is an important problem in Lodz Medical University students and nurses, however their knowledge level regarding risk factors, prophylactic and management of UTI are insufficient what may lead to underdiagnosis and undertreatment.

  14. Predictive and therapeutic markers in ovarian cancer

    Science.gov (United States)

    Gray, Joe W.; Guan, Yinghui; Kuo, Wen-Lin; Fridlyand, Jane; Mills, Gordon B.

    2013-03-26

    Cancer markers may be developed to detect diseases characterized by increased expression of apoptosis-suppressing genes, such as aggressive cancers. Genes in the human chromosomal regions, 8q24, 11q13, 20q11-q13, were found to be amplified indicating in vivo drug resistance in diseases such as ovarian cancer. Diagnosis and assessment of amplification levels certain genes shown to be amplified, including PVT1, can be useful in prediction of poor outcome of patient's response and drug resistance in ovarian cancer patients with low survival rates. Certain genes were found to be high priority therapeutic targets by the identification of recurrent aberrations involving genome sequence, copy number and/or gene expression are associated with reduced survival duration in certain diseases and cancers, specifically ovarian cancer. Therapeutics to inhibit amplification and inhibitors of one of these genes, PVT1, target drug resistance in ovarian cancer patients with low survival rates is described.

  15. Understanding and Responding to Adolescent Girls' Online Cruelty

    Science.gov (United States)

    Sokal, Laura

    2012-01-01

    Many school counsellors have identified "cyber-bullying" among adolescent girls as a growing concern. In order to respond to this issue, this article begins with a new model of cyber-communications from the unique perspective of adolescent girls. Next, it explores the limitations of responding to this model, based on current understandings of…

  16. Collaboration and interaction of first responders with the general public

    NARCIS (Netherlands)

    Emmerik, M. van; Dinesen, C.; Rijk, R. van; Bird, M.; Wester, M.; Hansen, L.J.; Vinther-Larsen, L.; Padron, C.; Boswinkel, R.; Ven, J. van de

    2016-01-01

    There is an increased focus on the need for collaboration between first responders and the general public. This type of collaboration requires soft skills that are not necessarily included in more traditional command and control trainings for first responders. Learning to collaborate with the

  17. Interviewer-Respondent Interactions in Conversational and Standardized Interviewing

    Science.gov (United States)

    Mittereder, Felicitas; Durow, Jen; West, Brady T.; Kreuter, Frauke; Conrad, Frederick G.

    2018-01-01

    Standardized interviewing (SI) and conversational interviewing are two approaches to collect survey data that differ in how interviewers address respondent confusion. This article examines interviewer-respondent interactions that occur during these two techniques, focusing on requests for and provisions of clarification. The data derive from an…

  18. Training Law Enforcement Officials on Responding to Equine Calls

    Science.gov (United States)

    Anderson, Kathleen P.; Stauffer, Gary; Stauffer, Monte; Anderson, Doug; Biodrowski, Kristie

    2016-01-01

    The occurrence of equine abuse/neglect cases is an ongoing issue. However, officials responding to equine cases are rarely experienced in handling horses. Therefore, workshops teaching basic horse husbandry were offered to better equip and prepare officials to respond to equine cases. Trainings consisted of both classroom and hands-on sessions.…

  19. Transforming Higher Education in the Information Age: Presidents Respond.

    Science.gov (United States)

    Breslin, Richard D.; And Others

    1991-01-01

    College presidents respond to an article by Richard Nolan challenging college and university presidents and chancellors to transform their campuses for survival and competitive advantage in the information age. Respondents include Richard D. Breslin, David M. Clarke, Joseph Cronin, Thomas Ehrlich, Donald N. Langenberg, Harold McAninch, and Donald…

  20. Increasing Poverty: How Do Leaders in One Suburban District Respond?

    Science.gov (United States)

    Spencer, Jennifer Dawn

    2014-01-01

    This dissertation addresses the question of how suburban school district leaders in one large Midwestern school district respond to increasing student poverty. The purpose of this study was to determine how suburban school district leaders respond to increasing student poverty in their decision making and actions. Data for this study came from one…

  1. Therapeutic strategies in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Leonello eFuso

    2011-04-01

    Full Text Available Pulmonary hypertension (PH is a life-threatening condition characterized by elevated pulmonary arterial pressure. It is clinically classified into five groups: patients in the first group are considered to have pulmonary arterial hypertension (PAH whereas patients of the other groups have PH that is due to cardiopulmonary or other systemic diseases. The management of patients with PH has advanced rapidly over the last decade and the introduction of specific treatments especially for PAH has lead to an improved outcome. However, despite the progress in the treatment, the functional limitation and the survival of these patients remain unsatisfactory and there is no cure for PAH. Therefore the search for an ideal therapy still goes on. At present, two levels of treatment can be identified: primary and specific therapy. Primary therapy is directed at the underlying cause of the PH. It also includes a supportive therapy consisting in oxygen supplementation, diuretics, and anticoagulation which should be considered in all patients with PH. Specific therapy is directed at the PH itself and includes treatment with vasodilatators such as calcium channel blockers and with vasodilatator and pathogenetic drugs such as prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors. These drugs act in several pathogenetic mechanisms of the PH and are specific for PAH although they might be used also in the other groups of PH. Finally, atrial septostomy and lung transplantation are reserved for patients refractory to medical therapy. Different therapeutic approaches can be considered in the management of patients with PH. Therapy can be established on the basis of both the clinical classification and the functional class. It is also possible to adopt a goal-oriented therapy in which the timing of treatment escalation is determined by inadequate response to known prognostic indicators.

  2. Implementation of nanoparticles in therapeutic radiation oncology

    Science.gov (United States)

    Beeler, Erik; Gabani, Prashant; Singh, Om V.

    2017-05-01

    Development and progress of cancer is a very complex disease process to comprehend because of the multiple changes in cellular physiology, pathology, and pathophysiology resulting from the numerous genetic changes from which cancer originates. As a result, most common treatments are not directed at the molecular level but rather at the tissue level. While personalized care is becoming an increasingly aim, the most common cancer treatments are restricted to chemotherapy, radiation, and surgery, each of which has a high likelihood of resulting in rather severe adverse side effects. For example, currently used radiation therapy does not discriminate between normal and cancerous cells and greatly relies on the external targeting of the radiation beams to specific cells and organs. Because of this, there is an immediate need for the development of new and innovative technologies that help to differentiate tumor cells and micrometastases from normal cells and facilitate the complete destruction of those cells. Recent advancements in nanoscience and nanotechnology have paved a way for the development of nanoparticles (NPs) as multifunctional carriers to deliver therapeutic radioisotopes for tumor targeted radiation therapy, to monitor their delivery, and improve the therapeutic index of radiation and tumor response to the treatment. The application of NPs in radiation therapy has aimed to improve outcomes in radiation therapy by increasing therapeutic effect in tumors and reducing toxicity on normal tissues. Because NPs possess unique properties, such as preferential accumulation in tumors and minimal uptake in normal tissues, it makes them ideal for the delivery of radiotherapy. This review provides an overview of the recent development of NPs for carrying and delivering therapeutic radioisotopes for systemic radiation treatment for a variety of cancers in radiation oncology.

  3. Therapeutic interventions in severe asthma.

    Science.gov (United States)

    Canonica, Giorgio Walter; Senna, Gianenrico; Mitchell, Patrick D; O'Byrne, Paul M; Passalacqua, Giovanni; Varricchi, Gilda

    2016-01-01

    The present paper addresses severe asthma which is limited to 5-10% of the overall population of asthmatics. However, it accounts for 50% or more of socials costs of the disease, as it is responsible for hospitalizations and Emergency Department accesses as well as expensive treatments. The recent identification of different endotypes of asthma, based on the inflammatory pattern, has led to the development of tailored treatments that target different inflammatory mediators. These are major achievements in the perspective of Precision Medicine: a leading approach to the modern treatment strategy. Omalizumab, an anti-IgE antibody, has been the only biologic treatment available on the market for severe asthma during the last decade. It prevents the linkage of the IgE and the receptors, thereby inhibiting mast cell degranulation. In clinical practice omalizumab significantly reduced the asthma exacerbations as well as the concomitant use of oral glucocorticoids. In the "Th2-high asthma" phenotype, the hallmarks are increased levels of eosinophils and other markers (such as periostin). Because anti-IL-5 in this condition plays a crucial role in driving eosinophil inflammation, this cytokine or its receptors on the eosinophil surface has been studied as a potential target for therapy. Two different anti-IL-5 humanized monoclonal antibodies, mepolizumab and reslizumab, have been proven effective in this phenotype of asthma (recently they both came on the market in the United States), as well as an anti-IL-5 receptor alpha (IL5Rα), benralizumab. Other monoclonal antibodies, targeting different cytokines (IL-13, IL-4, IL-17 and TSLP) are still under evaluation, though the preliminary results are encouraging. Finally, AIT, Allergen Immunotherapy, a prototype of Precision Medicine, is considered, also in light of the recent evidences of Sublingual Immunotherapy (SLIT) tablet efficacy and safety in mite allergic asthma patients. Given the high costs of these therapies

  4. Careless responding in internet-based quality of life assessments.

    Science.gov (United States)

    Schneider, Stefan; May, Marcella; Stone, Arthur A

    2018-04-01

    Quality of life (QoL) measurement relies upon participants providing meaningful responses, but not all respondents may pay sufficient attention when completing self-reported QoL measures. This study examined the impact of careless responding on the reliability and validity of Internet-based QoL assessments. Internet panelists (n = 2000) completed Patient-Reported Outcomes Measurement Information System (PROMIS®) short-forms (depression, fatigue, pain impact, applied cognitive abilities) and single-item QoL measures (global health, pain intensity) as part of a larger survey that included multiple checks of whether participants paid attention to the items. Latent class analysis was used to identify groups of non-careless and careless responders from the attentiveness checks. Analyses compared psychometric properties of the QoL measures (reliability of PROMIS short-forms, correlations among QoL scores, "known-groups" validity) between non-careless and careless responder groups. Whether person-fit statistics derived from PROMIS measures accurately discriminated careless and non-careless responders was also examined. About 7.4% of participants were classified as careless responders. No substantial differences in the reliability of PROMIS measures between non-careless and careless responder groups were observed. However, careless responding meaningfully and significantly affected the correlations among QoL domains, as well as the magnitude of differences in QoL between medical and disability groups (presence or absence of disability, depression diagnosis, chronic pain diagnosis). Person-fit statistics significantly and moderately distinguished between non-careless and careless responders. The results support the importance of identifying and screening out careless responders to ensure high-quality self-report data in Internet-based QoL research.

  5. Chemical spill responder's use of website data bases

    International Nuclear Information System (INIS)

    Turpin, R.; Betsinger, G.

    2001-01-01

    The Emergency Response Team (ERT) of the US Environmental Protection Agency provides technical assistance to state and local government agencies. It has also provided hazardous waste and emergency response assistance to countries in North America, Central America, South America, Europe, Africa and Asia. In order to address the increased level of involvement in multi-governmental response activities and counter terrorist incidents, ERT has developed a responder's technical assistance website. The site contains 6 links that can be divided into the following three information support areas: (1) generation information about ERT, (2) a response resources site which provides information regarding air sampling, monitoring plans, phytoremediation, and information related to oil spill incidents where physical and chemical properties of specific petroleum products are needed. The health and safety section of this site links to the Environment Canada Emergencies Science Division (ESD) website. The ESD site has a document entitled Properties of Crude Oils and Oil Products which provides information on Louisiana crude. This site also provides links to all Federal agency websites that have hazardous waste operations and emergency response requirements or guidelines, and (3) the Weather Information Program (WIP) and Response Operation and Validation Retriever (ROVR) service which provides interactive response pages for Federal on-scene coordinators, remedial project managers and the general public. This paper also described the next generation of ROVR and WIP interactive function involving real-time on-site air plume modeling

  6. [Organization of occupational therapeutic service, dynamics and structure of occupational morbidity in Krasnoyarsk area].

    Science.gov (United States)

    Tereshchenko, Iu A; Zakharinskaia, O N

    2010-01-01

    The authors present organizational and functional structure of occupational therapeutic service in Krasnoyarsk area, major functional divisions of the territorial occupational therapeutic center and their activities. The article covers analysis of changes in levels and structure of occupational morbidity, defines main ways to optimize occupational therapeutic service for the territorial workers.

  7. High responders and low responders: factors associated with individual variation in response to standardized training.

    Science.gov (United States)

    Mann, Theresa N; Lamberts, Robert P; Lambert, Michael I

    2014-08-01

    The response to an exercise intervention is often described in general terms, with the assumption that the group average represents a typical response for most individuals. In reality, however, it is more common for individuals to show a wide range of responses to an intervention rather than a similar response. This phenomenon of 'high responders' and 'low responders' following a standardized training intervention may provide helpful insights into mechanisms of training adaptation and methods of training prescription. Therefore, the aim of this review was to discuss factors associated with inter-individual variation in response to standardized, endurance-type training. It is well-known that genetic influences make an important contribution to individual variation in certain training responses. The association between genotype and training response has often been supported using heritability estimates; however, recent studies have been able to link variation in some training responses to specific single nucleotide polymorphisms. It would appear that hereditary influences are often expressed through hereditary influences on the pre-training phenotype, with some parameters showing a hereditary influence in the pre-training phenotype but not in the subsequent training response. In most cases, the pre-training phenotype appears to predict only a small amount of variation in the subsequent training response of that phenotype. However, the relationship between pre-training autonomic activity and subsequent maximal oxygen uptake response appears to show relatively stronger predictive potential. Individual variation in response to standardized training that cannot be explained by genetic influences may be related to the characteristics of the training program or lifestyle factors. Although standardized programs usually involve training prescribed by relative intensity and duration, some methods of relative exercise intensity prescription may be more successful in creating

  8. Effects of Intranasal Oxytocin on Aggressive Responding in Antisocial Personality Disorder.

    Science.gov (United States)

    Alcorn, Joseph L; Rathnayaka, Nuvan; Swann, Alan C; Moeller, F Gerard; Lane, Scott D

    2015-12-01

    The oxytocin receptor is important in several domains of social behavior, and administration of oxytocin modulates social responding in several mammalian species, including humans. Oxytocin has both therapeutic and scientific potential for elucidating the neural and behavioral mechanisms governing social behavior. In the present study, operationally-defined aggressive behavior of six males with Antisocial Personality Disorder (ASPD) was measured following acute intranasal oxytocin dosing (12, 24, and 48 international units) and placebo, using a well-validated laboratory task of human aggression (Point-Subtraction Aggression Paradigm, or PSAP). The PSAP provides participants with concurrently available monetary-earning and operationally-defined aggressive response options, maintained by fixed ratio schedules of consequences. Shifts in response rates and inter-response time (IRT) distributions were observed on the aggressive response option following oxytocin doses, relative to placebo. Few changes were observed in monetary-reinforced responding. However, across participants the direction and magnitude of changes in aggressive responding were not systematically related to dose. No trends were observed between psychometric or physiological data and oxytocin dosing or aggressive behavior. While this report is to our knowledge the first to examine the acute effects of oxytocin in this population at high risk for violence and other forms of antisocial behavior, several limitations in the experimental design and the results cast the study as a preliminary report. Strategies for more extensive future projects are discussed.

  9. Responders and non-responders to drug treatment in social phobia : Differences at baseline and prediction of response

    NARCIS (Netherlands)

    Slaap, BR; Westenberg, HGM; DenBoer, JA

    1996-01-01

    Differences between responders and non-responders to drug therapy were investigated in social phobia. Two previously published studies were pooled to obtain data of 30 patients who were treated for 12 weeks with brofaromine or fluvoxamine. Four criterion variables were used to divide patients in

  10. L-038: EPR-First Responders: Forces / safety equipment. Action Guides

    International Nuclear Information System (INIS)

    2011-01-01

    This conference is about the actions carry out by the forces and the safety equipment in a radiological emergency. The security area, the victims, the hospitals, the police vehicles area, the safety cordon, the evacuation, the contamination level and the risk of life are important aspects to be considered by the first responders.

  11. Climate change and pastoralists: investing in people to respond to adversity

    Energy Technology Data Exchange (ETDEWEB)

    Hesse, Ced; Cotula, Lorenzo

    2006-10-15

    While climatic fluctuations have always been a defining feature of dryland areas, and pastoralists have developed resilient livelihood systems to cope with difficult climates, global climate change is raising new challenges for pastoral systems in Africa and elsewhere. Action at local, national and international levels is needed to prevent destitution and help pastoral groups respond to the changing environment.

  12. L-040: EPR-First Responders: Forensic Evidence Management group. Action Guides

    International Nuclear Information System (INIS)

    2011-01-01

    This conference is about the forensic evidence managed by the radiological emergency group. The protection guides, the evidences, the fingerprints, the experience, the strategies, the contamination level, the monitoring, the photography and the interrogation are important aspects to be considered by the first responders.

  13. Responding in Real Time: Creating a Social Media Crisis Simulator for the Classroom

    Science.gov (United States)

    Anderson, Betsy; Swenson, Rebecca; Kinsella, John

    2014-01-01

    This article describes a realistic online crisis unit, in which students practice: (1) responding to fast-paced information on multiple social media channels; (2) coordinating and making team decisions; and (3) creating effective responses. These skills are required for entry-level positions such as digital specialists and community managers,…

  14. Do birds in flight respond to (ultra)violet lighting?

    Institute of Scientific and Technical Information of China (English)

    Roel May; Jens Åström; Øyvind Hamre; Espen Lie Dahl

    2017-01-01

    Background: Concerns for bird collisions with wind turbines affect the deployment of onshore and offshore wind-power plants. To avoid delays in consenting processes and to streamline the construction and operation phase, func-tional mitigation measures are required which efficiently reduces bird mortality. Vision is the primary sensory system in birds, which for a number of species also includes the ultraviolet spectrum. Many bird species that are known to collide with offshore wind turbines are sensitive in the violet or ultraviolet spectrum. For species that are mainly active at lower ambient light levels, lighting may deter birds from the lit area. Utilizing (ultra)violet lights may in addition not disturb humans. However, we do not know whether UV-sensitive birds in flight actually respond behaviourally to UV lights. Methods: We therefore tested the efficacy of two types of lights within the violet (400 nm) and ultraviolet (365 nm) spectrum to deter birds from the lit area. These lights were placed vertically and monitored continuously between dusk and dawn using an avian radar system. Results: Relative to control nights, bird flight activity (abundance) was 27% lower when the ultraviolet light was on. Violet light resulted in a 12% decrease in overall abundance, and in addition, a vertical displacement was seen, increasing the average flight altitude by 7 m. Although temporal changes occurred, this effect persisted over the season below 40 m above sea level. Conclusions: Although the results from this pilot study are promising, we argue there still is a long way to go before a potentially functional design to mitigate collisions that has proven to be effective in situ may be in place.

  15. First responder tracking and visualization for command and control toolkit

    Science.gov (United States)

    Woodley, Robert; Petrov, Plamen; Meisinger, Roger

    2010-04-01

    In order for First Responder Command and Control personnel to visualize incidents at urban building locations, DHS sponsored a small business research program to develop a tool to visualize 3D building interiors and movement of First Responders on site. 21st Century Systems, Inc. (21CSI), has developed a toolkit called Hierarchical Grid Referenced Normalized Display (HiGRND). HiGRND utilizes three components to provide a full spectrum of visualization tools to the First Responder. First, HiGRND visualizes the structure in 3D. Utilities in the 3D environment allow the user to switch between views (2D floor plans, 3D spatial, evacuation routes, etc.) and manually edit fast changing environments. HiGRND accepts CAD drawings and 3D digital objects and renders these in the 3D space. Second, HiGRND has a First Responder tracker that uses the transponder signals from First Responders to locate them in the virtual space. We use the movements of the First Responder to map the interior of structures. Finally, HiGRND can turn 2D blueprints into 3D objects. The 3D extruder extracts walls, symbols, and text from scanned blueprints to create the 3D mesh of the building. HiGRND increases the situational awareness of First Responders and allows them to make better, faster decisions in critical urban situations.

  16. International Scavenging for First Responder Guidance and Tools: IAEA Products

    Energy Technology Data Exchange (ETDEWEB)

    Stern, W. [Brookhaven National Lab. (BNL), Upton, NY (United States); Berthelot, L. [Brookhaven National Lab. (BNL), Upton, NY (United States); Bachner, K. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2017-05-05

    In fiscal years (FY) 2016 and 2017, with support from the U.S. Department of Homeland Security (DHS), Brookhaven National Laboratory (BNL) examined the International Atomic Energy Agency (IAEA) radiological emergency response and preparedness products (guidance and tools) to determine which of these products could be useful to U.S. first responders. The IAEA Incident and Emergency Centre (IEC), which is responsible for emergency preparedness and response, offers a range of tools and guidance documents for responders in recognizing, responding to, and recovering from radiation emergencies and incidents. In order to implement this project, BNL obtained all potentially relevant tools and products produced by the IAEA IEC and analyzed these materials to determine their relevance to first responders in the U.S. Subsequently, BNL organized and hosted a workshop at DHS National Urban Security Technology Laboratory (NUSTL) for U.S. first responders to examine and evaluate IAEA products to consider their applicability to the United States. This report documents and describes the First Responder Product Evaluation Workshop, and provides recommendations on potential steps the U.S. federal government could take to make IAEA guidance and tools useful to U.S. responders.

  17. Responder Technology Alert Monthly (Oct-Nov 2014)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-01-21

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  18. Potential therapeutic applications of biosurfactants.

    Science.gov (United States)

    Gudiña, Eduardo J; Rangarajan, Vivek; Sen, Ramkrishna; Rodrigues, Lígia R

    2013-12-01

    Biosurfactants have recently emerged as promising molecules for their structural novelty, versatility, and diverse properties that are potentially useful for many therapeutic applications. Mainly due to their surface activity, these molecules interact with cell membranes of several organisms and/or with the surrounding environments, and thus can be viewed as potential cancer therapeutics or as constituents of drug delivery systems. Some types of microbial surfactants, such as lipopeptides and glycolipids, have been shown to selectively inhibit the proliferation of cancer cells and to disrupt cell membranes causing their lysis through apoptosis pathways. Moreover, biosurfactants as drug delivery vehicles offer commercially attractive and scientifically novel applications. This review covers the current state-of-the-art in biosurfactant research for therapeutic purposes, providing new directions towards the discovery and development of molecules with novel structures and diverse functions for advanced applications. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. RNAi Therapeutics in Autoimmune Disease

    Directory of Open Access Journals (Sweden)

    Seunghee Cha

    2013-03-01

    Full Text Available Since the discovery of RNA interference (RNAi, excitement has grown over its potential therapeutic uses. Targeting RNAi pathways provides a powerful tool to change biological processes post-transcriptionally in various health conditions such as cancer or autoimmune diseases. Optimum design of shRNA, siRNA, and miRNA enhances stability and specificity of RNAi-based approaches whereas it has to reduce or prevent undesirable immune responses or off-target effects. Recent advances in understanding pathogenesis of autoimmune diseases have allowed application of these tools in vitro as well as in vivo with some degree of success. Further research on the design and delivery of effectors of RNAi pathway and underlying molecular basis of RNAi would warrant practical use of RNAi-based therapeutics in human applications. This review will focus on the approaches used for current therapeutics and their applications in autoimmune diseases, including rheumatoid arthritis and Sjögren’s syndrome.

  20. Conflicts in the therapeutic field

    Directory of Open Access Journals (Sweden)

    Antonino Aprea

    2012-06-01

    Full Text Available How the analytical knowledge that compare human consciousness with that, even more disturbing, moving behind his fifth can be said to be “for peace”? It can be - and this will be the contribution of the proposal - the same tortuous and enigmatic of therapeutic practice, with its hesitations and his impulses, to outline a path crossing and overcoming the conflict? May, finally, peace, in the sense of feasibility of intra-and interpersonal dialectic instead of tearing and hostileconfrontation with oneself and with the other, to be a reference in some crucial pivot of ethical therapeutic work? To these questions the intervention seeks to answer retracing some of the highlights of almost three years of therapeutic work with a young woman and her family.

  1. [Therapeutic touch and anorexia nervosa].

    Science.gov (United States)

    Satori, Nadine

    2016-01-01

    An innovative practice, therapeutic touch has been used for around ten years in the treatment of eating disorders. Delivered by nurse clinicians having received specific training, this approach is based on nursing diagnoses which identify the major symptoms of this pathology. The support is built around the body and its perceptions. Through the helping relationship, it mobilises the patient's resources to favour a relationship of trust, a letting-go, physical, psychological and emotional relaxation, and improves the therapeutic alliance. Copyright © 2016. Published by Elsevier Masson SAS.

  2. Relationships Among Attention Networks and Physiological Responding to Threat

    Science.gov (United States)

    Sarapas, Casey; Weinberg, Anna; Langenecker, Scott A.

    2016-01-01

    Although researchers have long hypothesized a relationship between attention and anxiety, theoretical and empirical accounts of this relationship have conflicted. We attempted to resolve these conflicts by examining relationships of attentional abilities with responding to predictable and unpredictable threat, related but distinct motivational process implicated in a number of anxiety disorders. Eighty-one individuals completed a behavioral task assessing efficiency of three components of attention – alerting, orienting, and executive control (Attention Network Test - Revised). We also assessed startle responding during anticipation of both predictable, imminent threat (of mild electric shock) and unpredictable contextual threat. Faster alerting and slower disengaging from non-emotional attention cues were related to heightened responding to unpredictable threat, whereas poorer executive control of attention was related to heightened responding to predictable threat. This double dissociation helps to integrate models of attention and anxiety and may be informative for treatment development. PMID:27816781

  3. Enhancing Syndromic Surveillance With Online Respondent-Driven Detection

    NARCIS (Netherlands)

    Stein, Mart L; van Steenbergen, Jim E; Buskens, Vincent; van der Heijden, Peter G M; Koppeschaar, Carl E; Bengtsson, Linus; Thorson, Anna; Kretzschmar, MEE

    OBJECTIVES: We investigated the feasibility of combining an online chain recruitment method (respondent-driven detection) and participatory surveillance panels to collect previously undetected information on infectious diseases via social networks of participants. METHODS: In 2014, volunteers from 2

  4. Enhancing syndromic surveillance with online respondent-driven detection

    NARCIS (Netherlands)

    Stein, Mart L.; Van Steenbergen, Jim E.; Buskens, Vincent; Van Der Heijden, Peter G M; Koppeschaar, Carl E.; Bengtsson, Linus; Thorson, Anna; Kretzschmar, Mirjam E E

    2015-01-01

    Objectives. We investigated the feasibility of combining an online chain recruitment method (respondent-driven detection) and participatory surveillance panels to collect previously undetected information on infectious diseases via social networks of participants. Methods. In 2014, volunteers from 2

  5. Public transportation's role in responding to climate change

    Science.gov (United States)

    2010-01-01

    This paper details the role public transportation has in responding to the challenge of climate change. It collects and analyzes data from across the country on public transportation fuel use, vehicles deployed, rides taken, and other key metrics, dr...

  6. Climate change 101 : understanding and responding to global climate change

    Science.gov (United States)

    2009-01-01

    To inform the climate change dialogue, the Pew Center on Global Climate Change and the Pew Center on the States have developed a series of brief reports entitled Climate Change 101: Understanding and Responding to Global Climate Change. These reports...

  7. Responding to Destructive Interpersonal Interactions: A way forward ...

    African Journals Online (AJOL)

    Responding to Destructive Interpersonal Interactions: A way forward for ... cultural intolerance and other destructive interpersonal interactions and relationships clearly ... This work is licensed under a Creative Commons Attribution 3.0 License.

  8. Tips for Disaster Responders: Preventing and Managing Stress

    Science.gov (United States)

    ... actions to prevent stress and to strengthen your stress management skills is before your disaster assignment. Responder stress ... the disaster role, developing a personal toolkit of stress management skills, and preparing yourself and your loved ones. ...

  9. Emergency First Responders' Experience with Colorimetric Detection Methods

    Energy Technology Data Exchange (ETDEWEB)

    Sandra L. Fox; Keith A. Daum; Carla J. Miller; Marnie M. Cortez

    2007-10-01

    Nationwide, first responders from state and federal support teams respond to hazardous materials incidents, industrial chemical spills, and potential weapons of mass destruction (WMD) attacks. Although first responders have sophisticated chemical, biological, radiological, and explosive detectors available for assessment of the incident scene, simple colorimetric detectors have a role in response actions. The large number of colorimetric chemical detection methods available on the market can make the selection of the proper methods difficult. Although each detector has unique aspects to provide qualitative or quantitative data about the unknown chemicals present, not all detectors provide consistent, accurate, and reliable results. Included here, in a consumer-report-style format, we provide “boots on the ground” information directly from first responders about how well colorimetric chemical detection methods meet their needs in the field and how they procure these methods.

  10. Strengthening Capacity to Respond to Computer Security Incidents ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... in the form of spam, improper access to confidential data and cyber theft. ... These teams are usually known as computer security incident response teams ... regional capacity for preventing and responding to cyber security incidents in Latin ...

  11. The influence of indirect collective trauma on first responders' alcohol use.

    Science.gov (United States)

    Homish, Gregory G; Frazer, Bonita S; Carey, Mary G

    2012-01-01

    Previous research has suggested increased risk for negative outcomes such as increased alcohol use among first responders who are involved with the response to a community disaster; however it is not clear how indirect exposure to a critical incident impacts first responders. This work examined the impact of secondary or indirect trauma on changes in alcohol use among urban firefighters who were not directly involved in the response to a large scale community-level disaster. Firefighters enrolled in larger trial of health outcomes whose interview period coincided with the crash of a commercial airplane were the basis for the current report. Aggregate level data on changes in alcohol consumption for these firefighters were examined pre- and post-incident. There was a significant increase in alcohol use following the critical incident. This increase did not occur immediately; it was observed within several days and peaked about 8 days post-incident. Post-hoc analyses revealed that the increased alcohol consumption persisted for several months, finally returning to pre-incident levels by 8 months post-incident. Indirect trauma effects, likely operationalized in part through the "brotherhood" of the firefighters, clearly placed firefighters at risk for negative outcomes following a disaster. Intervention/prevention efforts aimed at distress reduction among first responders should not solely focus on responders with direct involvement in a disaster.

  12. CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders.

    Science.gov (United States)

    Legerstee, Jeroen S; Tulen, Joke H M; Dierckx, Bram; Treffers, Philip D A; Verhulst, Frank C; Utens, Elisabeth M W J

    2010-02-01

    This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder were included in the present study. Children received a standardized stepped-care CBT. Three treatment response groups were distinguished: initial responders (anxiety disorder free after phase one: child-focused CBT), secondary responders (anxiety disorder free after phase two: child-parent-focused CBT), and treatment non-responders. Treatment response was determined using a semi-structured clinical interview. Children performed a pictorial dot-probe task before and after stepped-care CBT (i.e., before phase one and after phase two CBT). Changes in selective attention to severely threatening pictures, but not to mildly threatening pictures, were significantly associated with treatment success. At pre-treatment assessment, initial responders selectively attended away from severely threatening pictures, whereas secondary responders selectively attended toward severely threatening pictures. After stepped-care CBT, initial and secondary responders did not show any selectivity in the attentional processing of severely threatening pictures. Treatment non-responders did not show any changes in selective attention due to CBT. Initial and secondary treatment responders showed a reduction of their predisposition to selectively attend away or toward severely threatening pictures, respectively. Treatment non-responders did not show any changes in selective attention. The pictorial dot-probe task can be considered a potentially valuable tool in assigning children to appropriate treatment formats as well as for monitoring changes in selective attention during the course of CBT.

  13. Sense and Respond Logistics: Integrating Prediction, Responsiveness, and Control Capabilities

    Science.gov (United States)

    2006-01-01

    location. In the current environment, increased ambiguity has diminished this advantage and increased the need for a sense and respond combat...readily be applied to system dynamics prob- lems in business and organization processes. ABMs bring the “natu- ralness” advantage (which allows more...negotiation) as part of eCommerce applications being achieved by 2007. In the general opinion of AgentLink’s respondents, as well as our technology

  14. The Future of Responder Family Preparedness: The New Normal

    Science.gov (United States)

    2013-12-01

    smart practices. Though responder family preparedness measures may be occurring on a very limited basis, it was found that nothing was prevalent in the...family preparedness for their employees. If any such programs exist, they are not well known or prevalent in the literature. First responders are... Beaver and Harriet Nelson of Father Knows Best. This predominant family structure was the societal norm and framed Killian’s problem and analysis

  15. A Simulation Learning Approach to Training First Responders for Radiological Emergencies

    International Nuclear Information System (INIS)

    Sanders, Robert Lon; Rhodes, Graham S.

    2007-01-01

    This paper describes the application of simulation learning technology, popularized by the emerging serious games industry, for training first responders to properly act in the event of a radiological emergency. Using state-of-the-art video game production tools and runtime engines as an enabling technology, simulation learning combines interactive virtual worlds based on validated engineering models with engaging storylines and scenarios that invoke the emotional response-and the corresponding human stress level-that first responders would encounter during a real-world emergency. For the application discussed here, in addition to providing engaging instruction about the fundamentals of radiological environments and the proper usage of radiological equipment, simulation learning prepares first responders to perform effectively under high stress and enables them to practice in teams

  16. Vital analysis: field validation of a framework for annotating biological signals of first responders in action.

    Science.gov (United States)

    Gomes, P; Lopes, B; Coimbra, M

    2012-01-01

    First responders are professionals that are exposed to extreme stress and fatigue during extended periods of time. That is why it is necessary to research and develop technological solutions based on wearable sensors that can continuously monitor the health of these professionals in action, namely their stress and fatigue levels. In this paper we present the Vital Analysis smartphone-based framework, integrated into the broader Vital Responder project, that allows the annotation and contextualization of the signals collected during real action. After a contextual study we have implemented and deployed this framework in a firefighter team with 5 elements, from where we have collected over 3300 hours of annotations during 174 days, covering 382 different events. Results are analysed and discussed, validating the framework as a useful and usable tool for annotating biological signals of first responders in action.

  17. Etiology and Therapeutic Approach to Elevated Lactate Levels

    DEFF Research Database (Denmark)

    Wiuff Andersen, Lars; Mackenhauer, Julie; Roberts, Jonathan C

    2013-01-01

    on a comprehensive PubMed search between the dates of January 1, 1960, to April 30, 2013, using the search term lactate or lactic acidosis combined with known associations, such as shock, sepsis, cardiac arrest, trauma, seizure, ischemia, diabetic ketoacidosis, thiamine, malignancy, liver, toxins, overdose...

  18. The Influence of Agreeableness and Ego Depletion on Emotional Responding.

    Science.gov (United States)

    Finley, Anna J; Crowell, Adrienne L; Harmon-Jones, Eddie; Schmeichel, Brandon J

    2017-10-01

    Agreeable individuals report more intense withdrawal-oriented negative emotions across aversive situations. Two studies tested the hypothesis that self-regulatory depletion (i.e., ego depletion) moderates the relationship between trait Agreeableness and negative emotional responding. Ego depletion was manipulated using a writing task. Emotional responding was measured with startle eye-blink responses (Study 1, N = 71) and self-reported valence, arousal, and empathic concern (Study 2, N = 256) during emotional picture viewing. Trait Agreeableness was measured using a questionnaire. In Study 1, Agreeableness predicted especially large startle responses during aversive images and especially small startles during appetitive images. After exercising self-control, the relationship between startle magnitudes and Agreeableness decreased. In Study 2, Agreeableness predicted more empathic concern for aversive images, which in turn predicted heightened self-reported negative emotions. After exercising self-control, the relationship between Agreeableness and empathic concern decreased. Agreeable individuals exhibit heightened negative emotional responding. Ego depletion reduced the link between Agreeableness and negative emotional responding in Study 1 and moderated the indirect effect of Agreeableness on negative emotional responding via empathic concern in Study 2. Empathic concern appears to be a resource-intensive process underlying heightened responding to aversive stimuli among agreeable persons. © 2016 Wiley Periodicals, Inc.

  19. Methodology for Assessing Radiation Detectors Used by Emergency Responders

    International Nuclear Information System (INIS)

    Piotr Wasiolek; April Simpson

    2008-01-01

    The threat of weapons of mass destruction terrorism resulted in the U.S. Department of Homeland Security deploying large quantities of radiation detectors throughout the emergency responder community. However, emergency responders specific needs were not always met by standard health physics instrumentation used in radiation facilities. Several American National Standards Institute standards were developed and approved to evaluate the technical capabilities of detection equipment. Establishing technical capability is a critical step, but it is equally important to emergency responders that the instruments are easy to operate and can withstand the rugged situations they encounter. The System Assessment and Validation for Emergency Responders (SAVER) Program (managed by the U.S. Department of Homeland Security, Office of Grants and Training, Systems Support Division) focuses predominantly on the usability, ergonomics, readability, and other features of the detectors, rather than performance controlled by industry standards and the manufacturers. National Security Technologies, LLC, as a SAVER Technical Agent, conducts equipment evaluations using active emergency responders who are familiar with the detection equipment and knowledgeable of situations encountered in the field, which provides more relevant data to emergency responders

  20. A new therapeutic assessment score for advanced hepatocellular carcinoma patients receiving hepatic arterial infusion chemotherapy.

    Directory of Open Access Journals (Sweden)

    Issei Saeki

    Full Text Available Hepatic arterial infusion chemotherapy (HAIC is an option for treating advanced hepatocellular carcinoma (HCC. Because of the poor prognosis in HAIC non-responders, it is important to identify patients who may benefit from continuous HAIC treatment; however, there are currently no therapeutic assessment scores for this identification. Therefore, we aimed to establish a new therapeutic assessment score for such patients.We retrospectively analyzed 90 advanced HCC patients with elevated baseline alpha-fetoprotein (AFP and/or des-gamma-carboxy prothrombin (DCP levels and analyzed various parameters for their possible use as predictors of response and survival. AFP and DCP responses were assessed after half a course of HAIC (2 weeks; a positive-response was defined as a reduction of ≥ 20% from baseline.Multivariate analysis identified DCP response (odds ratio 16.03, p < 0.001 as an independent predictor of treatment response. In multivariate analysis, Child-Pugh class A (hazard ratio [HR] 1.99, p = 0.018, AFP response (HR 2.17, p = 0.007, and DCP response (HR 1.90, p = 0.030 were independent prognostic predictors. We developed an Assessment for Continuous Treatment with HAIC (ACTH score, including the above 3 factors, which ranged from 0 to 3. Patients stratified into two groups according to this score showed significantly different prognoses (≤ 1 vs. ≥ 2 points: median survival time, 15.1 vs. 8.7 months; p = 0.003.The ACTH score may be useful in the therapeutic assessment of HCC patients receiving HAIC.

  1. Defining the therapeutic time window for suppressing the inflammatory prostaglandin E2 signaling after status epilepticus

    Science.gov (United States)

    Du, Yifeng; Kemper, Timothy; Qiu, Jiange; Jiang, Jianxiong

    2016-01-01

    Neuroinflammation is a common feature in nearly all neurological and some psychiatric disorders. Resembling its extraneural counterpart, neuroinflammation can be both beneficial and detrimental depending on the responding molecules. The overall effect of inflammation on disease progression is highly dependent on the extent of inflammatory mediator production and the duration of inflammatory induction. The time-dependent aspect of inflammatory responses suggests that the therapeutic time window for quelling neuroinflammation might vary with molecular targets and injury types. Therefore, it is important to define the therapeutic time window for anti-inflammatory therapeutics, as contradicting or negative results might arise when different treatment regimens are utilized even in similar animal models. Herein, we discuss a few critical factors that can help define the therapeutic time window and optimize treatment paradigm for suppressing the cyclooxygenase-2/prostaglandin-mediated inflammation after status epilepticus. These determinants should also be relevant to other anti-inflammatory therapeutic strategies for the CNS diseases. PMID:26689339

  2. Therapy Talk: Analyzing Therapeutic Discourse

    Science.gov (United States)

    Leahy, Margaret M.

    2004-01-01

    Therapeutic discourse is the talk-in-interaction that represents the social practice between clinician and client. This article invites speech-language pathologists to apply their knowledge of language to analyzing therapy talk and to learn how talking practices shape clinical roles and identities. A range of qualitative research approaches,…

  3. Therapeutic approaches to genetic disorders

    African Journals Online (AJOL)

    salah

    Although prevention is the ideal goal for genetic disorders, various types of therapeutic ... The patient being ... pirical or aimed at controlling or mediating signs and symptoms without care. ... plications and gene therapy approaches .... genes family, have opened a wide and .... cancer where nanoparticles are used to.

  4. Medical therapeutic effect of hyperthyroidism

    International Nuclear Information System (INIS)

    Lee, K.B.

    1980-01-01

    In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ( 131 I) and 31 patients with treatment of 131 I alone. (author)

  5. A Feedback-Controlled Mandibular Positioner Identifies Individuals With Sleep Apnea Who Will Respond to Oral Appliance Therapy.

    Science.gov (United States)

    Remmers, John E; Topor, Zbigniew; Grosse, Joshua; Vranjes, Nikola; Mosca, Erin V; Brant, Rollin; Bruehlmann, Sabina; Charkhandeh, Shouresh; Zareian Jahromi, Seyed Abdolali

    2017-07-15

    Mandibular protruding oral appliances represent a potentially important therapy for obstructive sleep apnea (OSA). However, their clinical utility is limited by a less-than-ideal efficacy rate and uncertainty regarding an efficacious mandibular position, pointing to the need for a tool to assist in delivery of the therapy. The current study assesses the ability to prospectively identify therapeutic responders and determine an efficacious mandibular position. Individuals (n = 202) with OSA participated in a blinded, 2-part investigation. A system for identifying therapeutic responders was developed in part 1 (n = 149); the predictive accuracy of this system was prospectively evaluated on a new population in part 2 (n = 53). Each participant underwent a 2-night, in-home feedback-controlled mandibular positioner (FCMP) test, followed by treatment with a custom oral appliance and an outcome study with the oral appliance in place. A machine learning classification system was trained to predict therapeutic outcome on data obtained from FCMP studies on part 1 participants. The accuracy of this trained system was then evaluated on part 2 participants by examining the agreement between prospectively predicted outcome and observed outcome. A predicted efficacious mandibular position was derived from each FCMP study. Predictive accuracy was as follows: sensitivity 85%; specificity 93%; positive predictive value 97%; and negative predictive value 72%. Of participants correctly predicted to respond to therapy, the predicted mandibular protrusive position proved efficacious in 86% of cases. An unattended, in-home FCMP test prospectively identifies individuals with OSA who will respond to oral appliance therapy and provides an efficacious mandibular position. The trial that this study reports on is registered on www.clinicaltrials.gov, ID NCT03011762, study name: Feasibility and Predictive Accuracy of an In-Home Computer Controlled Mandibular Positioner in Identifying Favourable

  6. Rat embryonic palatal shelves respond to TCDD in organ culture

    International Nuclear Information System (INIS)

    Abbott, B.D.; Birnbaum, L.S.

    1990-01-01

    TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin), a highly toxic environmental contaminant, is teratogenic in mice, inducing cleft palate (CP) and hydronephrosis at doses which are not overtly maternally or embryo toxic. Palatal shelves of embryonic mice respond to TCDD, both in vivo and in organ culture, with altered differentiation of medial epithelial cells. By contrast, in the rat TCDD produces substantial maternal, embryonic, and fetal toxicity, including fetal lethality, with few malformations. In this study the possible effects of maternal toxicity on induction of cleft palate were eliminated by exposure of embryonic rat palatal shelves in organ culture. The shelves were examined for specific TCDD-induced alterations in differentiation of the medial cells. On Gestation Day (GD) 14 or 15 palatal shelves from embryonic F344 rats were placed in organ culture for 2 to 3 days (IMEM:F12 medium, 5% FBS, 0.1% DMSO) containing 0, 1 x 10(-8), 1 x 10(-9), 1 x 10(-10), or 5 x 10(-11) M TCDD. The medial epithelial peridermal cells degenerated on shelves exposed to control media or 5 x 10(-11) M TCDD. Exposure to 10(-10), 10(-9), and 10(-8) M TCDD inhibited this degeneration in 20, 36, and 60% of the shelves, respectively, and was statistically significant at the two highest doses. A normally occurring decrease in [3H]TdR incorporation was inhibited in some GD 15 shelves cultured with 10(-10) and 10(-9) M TCDD. The medial cells of TCDD-exposed shelves continued to express high levels of immunohistochemically detected EGF receptors. The altered differentiation of rat medial epithelium is similar to that reported for TCDD-exposed mouse medial cells in vivo and in vitro. However, in order to obtain these responses, the cultured rat shelves require much higher concentrations of TCDD than the mouse shelves

  7. Toll-like receptors as therapeutic targets in cystic fibrosis.

    LENUS (Irish Health Repository)

    Greene, Catherine M

    2008-12-01

    Background: Toll-like receptors (TLRs) are pattern recognition receptors that act as a first-line of defence in the innate immune response by recognising and responding to conserved molecular patterns in microbial factors and endogenous danger signals. Cystic fibrosis (CF)-affected airways represent a milieu potentially rich in TLR agonists and the chronic inflammatory phenotype evident in CF airway epithelial cells is probably due in large part to activation of TLRs. Objective\\/methods: To examine the prospects of developing novel therapies for CF by targeting TLRs. We outline the expression and function of TLRs and explore the therapeutic potential of naturally-occurring and synthetic TLR inhibitors for CF. Results\\/conclusion: Modulation of TLRs has therapeutic potential for the inflammatory lung manifestations of CF.

  8. Neuroimaging revolutionizes therapeutic approaches to chronic pain

    Directory of Open Access Journals (Sweden)

    Borsook David

    2007-09-01

    Full Text Available Abstract An understanding of how the brain changes in chronic pain or responds to pharmacological or other therapeutic interventions has been significantly changed as a result of developments in neuroimaging of the CNS. These developments have occurred in 3 domains : (1 Anatomical Imaging which has demonstrated changes in brain volume in chronic pain; (2 Functional Imaging (fMRI that has demonstrated an altered state in the brain in chronic pain conditions including back pain, neuropathic pain, and complex regional pain syndromes. In addition the response of the brain to drugs has provided new insights into how these may modify normal and abnormal circuits (phMRI or pharmacological MRI; (3 Chemical Imaging (Magnetic Resonance Spectroscopy or MRS has helped our understanding of measures of chemical changes in chronic pain. Taken together these three domains have already changed the way in which we think of pain – it should now be considered an altered brain state in which there may be altered functional connections or systems and a state that has components of degenerative aspects of the CNS.

  9. Amitriptyline converts non-responders into responders to low-frequency electroacupuncture-induced analgesia in rats.

    Science.gov (United States)

    Fais, Rafael S; Reis, G M; Rossaneis, A C; Silveira, J W S; Dias, Q M; Prado, W A

    2012-07-26

    The purpose of this study was to examine whether the use of intraperitoneal or intrathecal amitriptyline combined with electroacupuncture modifies the tail-flick reflex and incision pain in rats that normally do not have analgesia to electroacupuncture in the tail-flick test (non-responder rats). Changes in the nociceptive threshold of intraperitoneal or intrathecal saline- or amitriptyline-treated non-responder rats were evaluated using the tail-flick or incision pain tests before, during and after a 20-min period of electroacupuncture, applied at 2 Hz to the Zusanli and Sanynjiao acupoints. Amitriptyline was used at doses of 0.8 mg/kg or 30 μg/kg by intraperitoneal or intrathecal route, respectively. At these doses, amitriptyline has no effect against thermal or incision pain in rats. Rats selected as non-responders to the analgesic effect of electroacupuncture 2 Hz in tail-flick and incision pain tests become responders after an intraperitoneal or intrathecal injection of amitriptyline. Amitriptyline converts non-responder rats to rats that respond to electroacupuncture with analgesia in a model of thermal phasic pain and anti-hyperalgesia in a model of incision pain. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. A method for selecting cis-acting regulatory sequences that respond to small molecule effectors

    Directory of Open Access Journals (Sweden)

    Allas Ülar

    2010-08-01

    Full Text Available Abstract Background Several cis-acting regulatory sequences functioning at the level of mRNA or nascent peptide and specifically influencing transcription or translation have been described. These regulatory elements often respond to specific chemicals. Results We have developed a method that allows us to select cis-acting regulatory sequences that respond to diverse chemicals. The method is based on the β-lactamase gene containing a random sequence inserted into the beginning of the ORF. Several rounds of selection are used to isolate sequences that suppress β-lactamase expression in response to the compound under study. We have isolated sequences that respond to erythromycin, troleandomycin, chloramphenicol, meta-toluate and homoserine lactone. By introducing synonymous and non-synonymous mutations we have shown that at least in the case of erythromycin the sequences act at the peptide level. We have also tested the cross-activities of the constructs and found that in most cases the sequences respond most strongly to the compound on which they were isolated. Conclusions Several selected peptides showed ligand-specific changes in amino acid frequencies, but no consensus motif could be identified. This is consistent with previous observations on natural cis-acting peptides, showing that it is often impossible to demonstrate a consensus. Applying the currently developed method on a larger scale, by selecting and comparing an extended set of sequences, might allow the sequence rules underlying the activity of cis-acting regulatory peptides to be identified.

  11. Evidence Based Digoxin Therapeutic Monitoring - A Lower and Narrower Therapeutic Range

    Directory of Open Access Journals (Sweden)

    Amine BENLMOUDEN

    2016-06-01

    Full Text Available Cardiac glycosides have been used for congestive heart failure and certain cardiac arrhythmias for more than 200 years. Despite the introduction of a variety of new classes of drugs for the management of heart failure, specifically angiotensin-converting enzyme (ACE inhibitors, b-adrenergic antagonists (bblockers, and the aldosterone antagonist spironolactone, digoxin continues to have an important role in long-term outpatient management. However, a narrow margin exists between therapeutic and toxic doses of digoxin, resulting in a high incidence of digoxin toxicity in clinical practice.A wide variety of placebo-controlled clinical trials have unequivocally shown that treatment with digoxin can improve symptoms, quality of life, and exercise tolerance in patients with mild, moderate, or severe heart failure. The clinical relevance of digoxin therapeutic monitoring is also proved but the SDC (Serum Digoxin Conentrations required for optimal clinical efficacy and acceptable toxicity remains controversial. In the last years, international guidelines recommend 1.2 ng/mL as acceptable high level.In this bibliographic synthesis, we aim to collect pertinent informations from MedLine database about exposure-effect relationship in order to assess the evidence level scientific of new digoxin therapeutic monitoring. 

  12. The probability of reinforcement per trial affects posttrial responding and subsequent extinction but not within-trial responding.

    Science.gov (United States)

    Harris, Justin A; Kwok, Dorothy W S

    2018-01-01

    During magazine approach conditioning, rats do not discriminate between a conditional stimulus (CS) that is consistently reinforced with food and a CS that is occasionally (partially) reinforced, as long as the CSs have the same overall reinforcement rate per second. This implies that rats are indifferent to the probability of reinforcement per trial. However, in the same rats, the per-trial reinforcement rate will affect subsequent extinction-responding extinguishes more rapidly for a CS that was consistently reinforced than for a partially reinforced CS. Here, we trained rats with consistently and partially reinforced CSs that were matched for overall reinforcement rate per second. We measured conditioned responding both during and immediately after the CSs. Differences in the per-trial probability of reinforcement did not affect the acquisition of responding during the CS but did affect subsequent extinction of that responding, and also affected the post-CS response rates during conditioning. Indeed, CSs with the same probability of reinforcement per trial evoked the same amount of post-CS responding even when they differed in overall reinforcement rate and thus evoked different amounts of responding during the CS. We conclude that reinforcement rate per second controls rats' acquisition of responding during the CS, but at the same time, rats also learn specifically about the probability of reinforcement per trial. The latter learning affects the rats' expectation of reinforcement as an outcome of the trial, which influences their ability to detect retrospectively that an opportunity for reinforcement was missed, and, in turn, drives extinction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Conversational evidence in therapeutic dialogue.

    Science.gov (United States)

    Strong, Tom; Busch, Robbie; Couture, Shari

    2008-07-01

    Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

  14. [Therapeutic use of cannabis derivatives].

    Science.gov (United States)

    Benyamina, Amine; Reynaud, Michel

    2014-02-01

    The therapeutic use of cannabis has generated a lot of interest in the past years, leading to a better understanding of its mechanisms of action. Countries like the United States and Canada have modified their laws in order to make cannabinoid use legal in the medical context. It's also the case in France now, where a recent decree was issued, authorizing the prescription of medication containing "therapeutic cannabis" (decree no. 2013-473, June 5, 2013). Cannabinoids such as dronabinol, Sativex and nabilone have been tested for the treatment of acute and chronic pain. These agents are most promising to relieve chronic pain associated with cancer, with human immunodeficiency virus infection and with multiple sclerosis. However, longer-term studies are required to determine potential long-term adverse effects and risks of misuse and addiction.

  15. Therapeutic Dancing for Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Lorenna Pryscia Carvalho Aguiar

    2016-06-01

    Full Text Available Therapeutic dancing has been advocated as an effective adjunct to conventional physical therapies for people living with Parkinson's disease (PD. This systematic review evaluates studies on the outcomes of different dance genres on mobility and quality of life in PD. We searched databases including CINHAL (1982–2015, Medline (1922–2015, Scopus (1996–2015, Web of Science (2002–2015, Embase (2007–2015, PEDro (1999–2015 and the Cochrane Library (1996–2015. The key words were: Parkinson's disease, Parkinson*, Parkinsonism, dance, dance therapy, dance genres, safety, feasibility, and quality of life. Two independent investigators reviewed the texts. Only randomized controlled trials, quasirandomized controlled trials, and case series studies were included. There was emerging evidence that therapeutic dance can be safe and feasible for people with mild to moderately severe PD, with beneficial effects on walking, freezing of gait, and health related quality of life.

  16. Therapeutic approaches for celiac disease

    Science.gov (United States)

    Plugis, Nicholas M.; Khosla, Chaitan

    2015-01-01

    Celiac disease is a common, lifelong autoimmune disorder for which dietary control is the only accepted form of therapy. A strict gluten-free diet is burdensome to patients and can be limited in efficacy, indicating there is an unmet need for novel therapeutic approaches to supplement or supplant dietary therapy. Many molecular events required for disease pathogenesis have been recently characterized and inspire most current and emerging drug-discovery efforts. Genome-wide association studies (GWAS) confirm the importance of human leukocyte antigen genes in our pathogenic model and identify a number of new risk loci in this complex disease. Here, we review the status of both emerging and potential therapeutic strategies in the context of disease pathophysiology. We conclude with a discussion of how genes identified during GWAS and follow-up studies that enhance susceptibility may offer insight into developing novel therapies. PMID:26060114

  17. Sinigrin and Its Therapeutic Benefits

    Directory of Open Access Journals (Sweden)

    Anisha Mazumder

    2016-03-01

    Full Text Available Sinigrin (allyl-glucosinolate or 2-propenyl-glucosinolate is a natural aliphatic glucosinolate present in plants of the Brassicaceae family, such as broccoli and brussels sprouts, and the seeds of Brassica nigra (mustard seeds which contain high amounts of sinigrin. Since ancient times, mustard has been used by mankind for its culinary, as well as medicinal, properties. It has been systematically described and evaluated in the classical Ayurvedic texts. Studies conducted on the pharmacological activities of sinigrin have revealed anti-cancer, antibacterial, antifungal, antioxidant, anti-inflammatory, wound healing properties and biofumigation. This current review will bring concise information about the known therapeutic activities of sinigrin. However, the information on known biological activities is very limited and, hence, further studies still need to be conducted and its molecular mechanisms also need to be explored. This review on the therapeutic benefits of sinigrin can summarize current knowledge about this unique phytocompounds.

  18. The Balanced Inventory of Desirable Responding Short Form (BIDR-16

    Directory of Open Access Journals (Sweden)

    Claire M. Hart

    2015-12-01

    Full Text Available Self-report studies often call for assessment of socially desirable responding. Many researchers use the Marlowe–Crowne Scale for its brief versions; however, this scale is outdated, and contemporary models of social desirability emphasize its multi-dimensional nature. The 40-item Balanced Inventory of Desirable Responding (BIDR incorporates Self-Deceptive Enhancement (honest but overly positive responding and Impression Management (bias toward pleasing others. However, its length limits its practicality. This article introduces the BIDR-16. In four studies, we shorten the BIDR from 40 items to 16 items, while retaining its two-factor structure, reliability, and validity. This short form will be invaluable to researchers wanting to assess social desirability when time is limited.

  19. Bridging the radiation science divide between scientists and first responders

    International Nuclear Information System (INIS)

    Musolinol, V.; Stephen, A.; Frederick, B.; Harper, T.; Schlueck, C. Richard

    2018-01-01

    To be prepared for a response to a complex radiological or nuclear emergency, the first responder community must incorporate radiation protection principles, and be able to conduct tactical operational measurements, assess data, and determine associated health risks. While these actions must occur promptly in the first hours of an unfolding crisis, the on-scene responders must do so with no scientific support from radiation protection experts, such as from the central government. To further the challenges to effectively perform these actions, local hazardous material (HAZMAT) response teams, which are usually the source of technical expertise at the scene of a hazardous materials release, rarely encounter radiological materials or respond to large-scale radiological or nuclear emergencies

  20. How to respond to referee comments for scientific articles?

    Science.gov (United States)

    Kalemci, Mustafa Serdar; Turna, Burak

    2013-09-01

    Currently, the increasing number of article submissions to scientific journals forces editors to be more selective in their acceptance of papers. Consequently, editors have increased the frequency of their use of scientific referee mechanisms. For many researchers, the publication of a scientific article in a high impact factor journal is a gradual and difficult process. After preparation and submission of a manuscript, one of the most important issue is responding to the comments of referees. However, there is a paucity of published reports in the literature describing how to respond to these comments. The aim of this review is to assist researchers/authors in responding to referee comments as part of the publication process for scientific articles.

  1. Nanomedicine therapeutics and diagnostics are the goal.

    Science.gov (United States)

    Miller, Andrew D

    2016-07-01

    Understanding and exploiting molecular mechanisms in biology is central to chemical biology. In 20 years, chemical biology research has advanced from simple mechanistic studies using isolated biological macromolecules to molecular-level and nanomolecular-level mechanistic studies involving whole organisms. This review documents the best of my personal and collaborative academic research work that has made use of a solid organic chemistry and chemical biology approach toward nanomedicine, in which my focus has been on the design, creation and use of synthetic, self-assembly lipid-based nanoparticle technologies for the functional delivery of active pharmaceutical ingredients to target cells in vivo. This research is now leading to precision therapeutics approaches (PTAs) for the treatment of diseases that may define the future of nanomedicine.

  2. Organoid technology for brain and therapeutics research.

    Science.gov (United States)

    Wang, Zhi; Wang, Shu-Na; Xu, Tian-Ying; Miao, Zhu-Wei; Su, Ding-Feng; Miao, Chao-Yu

    2017-10-01

    Brain is one of the most complex organs in human. The current brain research is mainly based on the animal models and traditional cell culture. However, the inherent species differences between humans and animals as well as the gap between organ level and cell level make it difficult to study human brain development and associated disorders through traditional technologies. Recently, the brain organoids derived from pluripotent stem cells have been reported to recapitulate many key features of human brain in vivo, for example recapitulating the zone of putative outer radial glia cells. Brain organoids offer a new platform for scientists to study brain development, neurological diseases, drug discovery and personalized medicine, regenerative medicine, and so on. Here, we discuss the progress, applications, advantages, limitations, and prospects of brain organoid technology in neurosciences and related therapeutics. © 2017 John Wiley & Sons Ltd.

  3. Potential Therapeutic Effects of Psilocybin.

    Science.gov (United States)

    Johnson, Matthew W; Griffiths, Roland R

    2017-07-01

    Psilocybin and other 5-hydroxytryptamine 2A agonist classic psychedelics have been used for centuries as sacraments within indigenous cultures. In the mid-twentieth century they were a focus within psychiatry as both probes of brain function and experimental therapeutics. By the late 1960s and early 1970s these scientific inquires fell out of favor because classic psychedelics were being used outside of medical research and in association with the emerging counter culture. However, in the twenty-first century, scientific interest in classic psychedelics has returned and grown as a result of several promising studies, validating earlier research. Here, we review therapeutic research on psilocybin, the classic psychedelic that has been the focus of most recent research. For mood and anxiety disorders, three controlled trials have suggested that psilocybin may decrease symptoms of depression and anxiety in the context of cancer-related psychiatric distress for at least 6 months following a single acute administration. A small, open-label study in patients with treatment-resistant depression showed reductions in depression and anxiety symptoms 3 months after two acute doses. For addiction, small, open-label pilot studies have shown promising success rates for both tobacco and alcohol addiction. Safety data from these various trials, which involve careful screening, preparation, monitoring, and follow-up, indicate the absence of severe drug-related adverse reactions. Modest drug-related adverse effects at the time of medication administration are readily managed. US federal funding has yet to support therapeutic psilocybin research, although such support will be important to thoroughly investigate efficacy, safety, and therapeutic mechanisms.

  4. Cell kinetics and therapeutic efficiency

    International Nuclear Information System (INIS)

    Andreeff, M.; Abenhardt, W.; Gruner, B.; Stoffner, D.; Mainz Univ.

    1976-01-01

    The study shows that cell kinetics effects correlate with the effects of cytostatic drugs in the tumour model investigated here. It should, however, be noted that even genetically related tumour cell types may react differently to the same cytostatic drug, and that the cell kinetics effects, due to the changes in the cell cycle, cannot be predicted but should be followed with a very fast method, e.g. sequential flan fluorescence cytophotometry, for optimal therapeutic results. (orig./GSE) [de

  5. Hemodynamics and vasopressor support in therapeutic hypothermia after cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Søholm, Helle

    2014-01-01

    AIM: Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level of vasopres......AIM: Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level...

  6. Cytokinin levels and signaling respond to wounding and the perception of herbivore elicitors in Nicotiana attenuata

    Czech Academy of Sciences Publication Activity Database

    Schäfer, M.; Meza-Canales, I.D.; Navarro-Quezada, A.; Brütting, C.; Vaňková, Radomíra; Baldwin, I.T.; Meldau, S.

    2015-01-01

    Roč. 57, č. 2 (2015), s. 198-212 ISSN 1672-9072 R&D Projects: GA ČR GA206/09/2062 Institutional support: RVO:61389030 Keywords : Arabidopsis thaliana * cytokinin * herbivore-associated molecular patterns Subject RIV: ED - Physiology Impact factor: 3.670, year: 2015

  7. Global plant-responding mechanisms to salt stress: physiological and molecular levels and implications in biotechnology.

    Science.gov (United States)

    Tang, Xiaoli; Mu, Xingmin; Shao, Hongbo; Wang, Hongyan; Brestic, Marian

    2015-01-01

    The increasing seriousness of salinization aggravates the food, population and environmental issues. Ameliorating the salt-resistance of plants especially the crops is the most effective measure to solve the worldwide problem. The salinity can cause damage to plants mainly from two aspects: hyperosmotic and hyperionic stresses leading to the restrain of growth and photosynthesis. To the adverse effects, the plants derive corresponding strategies including: ion regulation and compartmentalization, biosynthesis of compatible solutes, induction of antioxidant enzymes and plant hormones. With the development of molecular biology, our understanding of the molecular and physiology knowledge is becoming clearness. The complex signal transduction underlying the salt resistance is being illuminated brighter and clearer. The SOS pathway is the central of the cell signaling in salt stress. The accumulation of the compatible solutes and the activation of the antioxidant system are the effective measures for plants to enhance the salt resistance. How to make full use of our understanding to improve the output of crops is a huge challenge for us, yet the application of the genetic engineering makes this possible. In this review, we will discuss the influence of the salt stress and the response of the plants in detail expecting to provide a particular account for the plant resistance in molecular, physiological and transgenic fields.

  8. Requirement of trained first responders and national level preparedness for prevention and response to radiological terrorism

    International Nuclear Information System (INIS)

    Sharma, R.; Pradeepkumar, K.S.

    2010-01-01

    In this paper we have identified the educational needs for response to radiological emergency in India with major thrust on training. The paper has also enumerated the available educational and training infrastructure, the human resources, as well as the important stake holders for development of sustainable education and training programme. The training of emergency response personnel will help in quick decision making, planning and effective response during such emergencies. Medical Emergency management requires planning by hospitals which includes up-gradation of earmarked hospitals, development of mobile hospitals and mobile medical teams supported by communication backups and adequate medical logistics for radiological emergency. Department of Atomic Energy (DAE) is a nodal agency for advising authorities for any nuclear/radiological emergency in public domain. DAE through the various ERCs have already developed technical expertise, systems, software and methodology for quick impact assessment which may be required for the implementation of countermeasures if required following any nuclear disaster/radiological emergency

  9. Cost per responder of TNF-α therapies in Germany.

    Science.gov (United States)

    Gissel, Christian; Repp, Holger

    2013-12-01

    Tumor necrosis factor α (TNF-α) inhibitors ranked highest in German pharmaceutical expenditure in 2011. Their most important application is the treatment of rheumatoid arthritis (RA). Our objective is to analyze cost per responder of TNF-α inhibitors for RA from the German Statutory Health Insurance funds' perspective. We aim to conduct the analysis based on randomized comparative effectiveness studies of the relevant treatments for the German setting. For inclusion of effectiveness studies, we require results in terms of response rates as defined by European League Against Rheumatism (EULAR) or American College of Rheumatology (ACR) criteria. We identify conventional triple therapy as the relevant comparator. We calculate cost per responder based on German direct medical costs. Direct clinical comparisons could be identified for both etanercept and infliximab compared to triple therapy. For infliximab, cost per responder was 216,392 euros for ACR50 and 432,784 euros for ACR70 responses. For etanercept, cost per ACR70 responder was 321,527 euros. Cost was lower for response defined by EULAR criteria, but data was only available for infliximab. Cost per responder is overestimated by 40% due to inclusion of taxes and mandatory rebates in German drugs' list prices. Our analysis shows specific requirements for cost-effectiveness analysis in Germany. Cost per responder for TNF-α treatment in the German setting is more than double the cost estimated in a similar analysis for the USA, which measured against placebo. The difference in results shows the critical role of the correct comparator for a specific setting.

  10. Conotoxins that confer therapeutic possibilities

    KAUST Repository

    Essack, Magbubah

    2012-06-04

    Cone snails produce a distinctive repertoire of venom peptides that are used both as a defense mechanism and also to facilitate the immobilization and digestion of prey. These peptides target a wide variety of voltage- and ligand-gated ion channels, which make them an invaluable resource for studying the properties of these ion channels in normal and diseased states, as well as being a collection of compounds of potential pharmacological use in their own right. Examples include the United States Food and Drug Administration (FDA) approved pharmaceutical drug, Ziconotide (Prialt; Elan Pharmaceuticals, Inc.) that is the synthetic equivalent of the naturally occurring ?-conotoxin MVIIA, whilst several other conotoxins are currently being used as standard research tools and screened as potential therapeutic drugs in pre-clinical or clinical trials. These developments highlight the importance of driving conotoxin-related research. A PubMed query from 1 January 2007 to 31 August 2011 combined with hand-curation of the retrieved articles allowed for the collation of 98 recently identified conotoxins with therapeutic potential which are selectively discussed in this review. Protein sequence similarity analysis tentatively assigned uncharacterized conotoxins to predicted functional classes. Furthermore, conotoxin therapeutic potential for neurodegenerative disorders (NDD) was also inferred. 2012 by the authors; licensee MDPI.

  11. Diagnostic and therapeutic peroral cholangioscopy

    Directory of Open Access Journals (Sweden)

    Jong Ho Moon

    2012-01-01

    Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

  12. Conotoxins that confer therapeutic possibilities

    KAUST Repository

    Essack, Magbubah; Bajic, Vladimir B.; Archer, John A.C.

    2012-01-01

    Cone snails produce a distinctive repertoire of venom peptides that are used both as a defense mechanism and also to facilitate the immobilization and digestion of prey. These peptides target a wide variety of voltage- and ligand-gated ion channels, which make them an invaluable resource for studying the properties of these ion channels in normal and diseased states, as well as being a collection of compounds of potential pharmacological use in their own right. Examples include the United States Food and Drug Administration (FDA) approved pharmaceutical drug, Ziconotide (Prialt; Elan Pharmaceuticals, Inc.) that is the synthetic equivalent of the naturally occurring ?-conotoxin MVIIA, whilst several other conotoxins are currently being used as standard research tools and screened as potential therapeutic drugs in pre-clinical or clinical trials. These developments highlight the importance of driving conotoxin-related research. A PubMed query from 1 January 2007 to 31 August 2011 combined with hand-curation of the retrieved articles allowed for the collation of 98 recently identified conotoxins with therapeutic potential which are selectively discussed in this review. Protein sequence similarity analysis tentatively assigned uncharacterized conotoxins to predicted functional classes. Furthermore, conotoxin therapeutic potential for neurodegenerative disorders (NDD) was also inferred. 2012 by the authors; licensee MDPI.

  13. [Limitation of the therapeutic effort].

    Science.gov (United States)

    Herreros, B; Palacios, G; Pacho, E

    2012-03-01

    The limitation of the therapeutic effort (LTE) consists in not applying extraordinary or disproportionate measures for therapeutic purposes that are proposed for a patient with poor life prognosis and/or poor quality of life. There are two types. The first is to not initiate certain measures or to withdraw them when they are established. A decision of the LTE should be based on some rigorous criteria, so that we make the following proposal. First, it is necessary to know the most relevant details of the case to make a decision: the preferences of the patient, the preferences of the family when pertinent, the prognosis (severity), the quality of life and distribution of the limited resources. After, the decision should be made. In this phase, participatory deliberation should be established to clarify the end of the intervention. Finally, if it is decided to perform an LTE, it should be decided how to do it. Special procedures, disproportionate measures, that are useless and vain should not be initiated for the therapeutic objective designed (withdraw them if they have been established). When it has been decided to treat a condition (interim measures), the treatment should be maintained. This complex phase may need stratification of he measures. Finally, the necessary palliative measures should be established. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  14. Resilience and distress: Israelis respond to the disengagement from Gaza and the second Lebanese war.

    Science.gov (United States)

    Ben-Zur, Hasida; Gilbar, Ora

    2011-10-01

    Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations.

  15. Gender, Sexual Orientation, and Rape Myth Acceptance: Preliminary Findings From a Sample of Primarily LGBQ-Identified Survey Respondents.

    Science.gov (United States)

    Schulze, Corina; Koon-Magnin, Sarah

    2017-02-01

    This study is among the first to examine the relationship between sexual orientation and rape myth adherence using a nationwide survey of primarily lesbian, gay, bisexual, and queer (LGBQ) respondents (n = 184). The more established Illinois Rape Myth Acceptance Scale and a modified Male Rape Survey serve as the primary instruments to test both rape myth adherence and instrument-appropriateness. Results suggest that respondents were most likely to support myths that discredit sexual assault allegations or excuse rape as a biological imperative and least likely to support myths related to physical resistance. Consistent with previous work, men exhibited higher levels of rape myth adherence than women. Regarding sexual orientation, respondents who identified as queer consistently exhibited lower levels of rape myth adherence than respondents who identified as gay.

  16. Effects on stereotypy and other challenging behavior of matching rates of instruction to free-operant rates of responding.

    Science.gov (United States)

    Johnson, Jesse W; Van Laarhoven, Toni; Repp, Alan C

    2002-01-01

    Research has shown that when individuals are in situations that do not occasion one form of motoric responding, they will engage in another so that the overall level of motoric responding is homeostatic. The purpose of this study was to test whether students would substitute task-related behaviors for stereotypic or other challenging behaviors when the opportunity for active responding did or did not match the level of motoric responding in a free-operant baseline. Four students with mental retardation participated. Results showed that they did substitute behaviors, with stereotypic and other challenging behaviors occurring 1.5-14 times as much in the Non-matched condition for the four students. Further analysis showed considerably more of these behaviors in passive than in active tasks (by a factor up to 21 times as much). Results were discussed in terms of homeostasis, functional assessment, and opportunities to improve educational behaviors.

  17. Fast Responding Voltage Regulator and Dynamic VAR Compensator

    Energy Technology Data Exchange (ETDEWEB)

    Divan, Deepak [Varentec, Incorporated, San Jose, CA (United States); Moghe, Rohit [Varentec, Incorporated, San Jose, CA (United States); Tholomier, Damien [Varentec, Incorporated, San Jose, CA (United States)

    2014-12-31

    The objectives of this project were to develop a dynamic VAR compensator (DVC) for voltage regulation through VAR support to demonstrate the ability to achieve greater levels of voltage control on electricity distribution networks, and faster response compared to existing grid technology. The goal of the project was to develop a prototype Fast Dynamic VAR Compensator (Fast DVC) hardware device, and this was achieved. In addition to developing the dynamic VAR compensator device, Varentec in partnership with researchers at North Carolina State University (NCSU) successfully met the objectives to model the potential positive impact of such DVCs on representative power networks. This modeling activity validated the ability of distributed dynamic VAR compensators to provide fast voltage regulation and reactive power control required to respond to grid disturbances under high penetration of fluctuating and intermittent distributed energy resources (DERs) through extensive simulation studies. Specifically the following tasks were set to be accomplished: 1) Development of dynamic VAR compensator to support dynamic voltage variations on the grid through VAR control 2) Extensive testing of the DVC in the lab environment 3) Present the operational DVC device to the DOE at Varentec’s lab 4) Formulation of a detailed specification sheet, unit assembly document, test setup document, unit bring-up plan, and test plan 5) Extensive simulations of the DVC in a system with high PV penetration. Understanding the operation with many DVC on a single distribution system 6) Creation and submittal of quarterly and final reports conveying the design documents, unit performance data, modeling simulation charts and diagrams, and summary explanations of the satisfaction of program goals. This report details the various efforts that led to the development of the Fast DVC as well as the modeling & simulation results. The report begins with the introduction in Section II which outlines the

  18. Sub-therapeutic doses of fluvastatin and valsartan are more effective than therapeutic doses in providing beneficial cardiovascular pleiotropic effects in rats: A proof of concept study.

    Science.gov (United States)

    Janić, Miodrag; Lunder, Mojca; France Štiglic, Alenka; Jerin, Aleš; Skitek, Milan; Černe, Darko; Marc, Janja; Drevenšek, Gorazd; Šabovič, Mišo

    2017-12-01

    Statins and sartans can, in therapeutic doses, induce pleiotropic cardiovascular effects. Similar has recently been shown also for sub-therapeutic doses. We thus explored and compared the cardiovascular pleiotropic efficacy of sub-therapeutic vs. therapeutic doses. Wistar rats were randomly divided into 7 groups receiving fluvastatin, valsartan and their combination in sub-therapeutic and therapeutic doses, or saline. After 6weeks, the animals were euthanised, their hearts and thoracic aortas isolated, and blood samples taken. Endothelium-dependent relaxation of the thoracic aortae and ischaemic-reperfusion injury of the isolated hearts were assessed along with the related serum parameters and genes expression. Fluvastatin and valsartan alone or in combination were significantly more effective in sub-therapeutic than therapeutic doses. The sub-therapeutic combination greatly increased thoracic aorta endothelium-dependent relaxation and maximally protected the isolated hearts against ischaemia-reperfusion injury and was thus most effective. Beneficial effects were accompanied by increased levels of nitric oxide (NO) and decreased levels of asymmetric dimethylarginine (ADMA) in the serum (again prominently induced by the sub-therapeutic combination). Furthermore, nitric oxide synthase 3 (NOS3) and endothelin receptor type A (EDNRA) genes expression increased, but only in both combination groups and without significant differences between them. In the therapeutic dose groups, fluvastatin and valsartan decreased cholesterol values and systolic blood pressure. Sub-therapeutic doses of fluvastatin and valsartan are more effective in expressing cardiovascular pleiotropic effects than therapeutic doses of fluvastatin and/or valsartan. These results could be of significant clinical relevance. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Type 2 diabetes: what therapeutic strategy?].

    Science.gov (United States)

    Grimaldi, A; Hartemann-Heurtier, A

    2001-02-17

    GOAL OF TREATMENT: Prevention of diabetic micro and macroangiopathy is the goal of treatment in type 2 diabetes mellitus. A well-controlled glucose level is the key to prevention of microangiopathy; there is no threshold level. Antihypertensive treatment, with the goal of blood pressure below 130/80 mmHg is also beneficial in preventing aggravation of microangiopathy. For macroangiopathy, prevention is based in priority on treatment of other risk factors for cardiovascular disease; the threshold level for drug treatment and the therapeutic objective are those defined for secondary prevention in non-diabetic patients, i.e. blood pressure below 140/80 mmHg and LDL cholesterol under 1.30 g/l. The beneficial effect of lower glucose levels on preventing macrovascular risk was not formally demonstrated by the UKPDS, probably because the difference between the control and the treatment group HbA1c levels was minimal, 0.9 points. REVISITING STRATEGY: It is thus time to revisit the preventive strategy for type 2 diabetes mellitus, i.e. step-by-step increments, as currently proposed for worsening glucose levels. Metformine should be prescribed if the HbA1c is above normal in order to achieve the demonstrated benefit in prevention of microangiopathy and in the hope, motivated by pathophysiology data, of preventing insulin failure. Slow-release insulin at bedtime should be added to the oral hypoglycemiants if fasting glucose exceeds 1.60 or 1.80 g/l, even if the HbA1c remains below 8%. NEW HYPOGLYCEMIANTS: The role of these new agents in this more "aggressive" strategy remains to be defined. Glinides will have to demonstrate their superiority over sulfamides (fewer episodes of hypoglycemia with comparable efficacy) to justify their high cost. Glitazones will have to demonstrate a beneficial effect in second intention combination with metformine on cardiovascular morbidity mortality in type 2 diabetes patients with a metabolic insulin-resistance syndrome and visceral obesity

  20. Learning as change: Responding to socio-scientific issues through informal education

    Science.gov (United States)

    Allen, Lauren Brooks

    Informal learning is an important venue for educating the general public about complex socio-scientific issues: intersections of scientific understanding and society. My dissertation is a multi-tiered analysis of how informal education, and particularly informal educators, can leverage learning to respond to one particular socio-scientific issue: climate change. Life-long, life-wide, and life-deep learning not only about the science of climate change, but how communities and society as a whole can respond to it in ways that are commensurate with its scale are necessary. In my three-article dissertation, I investigated the changes in practice and learning that informal educators from a natural history museum underwent in the process of implementing a new type of field trip about climate change. This study focused on inquiry-based learning principles taken on by the museum educators, albeit in different ways: learner autonomy, conversation, and deep investigation. My second article, a short literature review, makes the argument that climate change education must have goals beyond simply increasing learners' knowledge of climate science, and proposes three research-based principles for such learning: participation, relevance, and interconnectedness. These principles are argued to promote learning to respond to climate change as well as increased collective efficacy, necessary for responding. Finally, my third article is an in-depth examination of a heterogeneous network of informal educators and environmental professionals who worked together to design and implement a city-wide platform for informal climate change learning. By conceptualizing climate change learning at the level of the learning ecology, educators and learners are able to see how it can be responded to at the community level, and understand how climate change is interconnected with other scientific, natural, and social systems. I briefly discuss a different socio-scientific issue to which these

  1. Acute Organophosphate Poisonings: Therapeutic Dilemmas and New Potential Therapeutic Agents

    International Nuclear Information System (INIS)

    Vucinic, S.; Jovanovic, D.; Vucinic, Z.; Todorovic, V.; Segrt, Z.

    2007-01-01

    It has been six decades since synthesis of organophosphates, but this chapter has not yet come to a closure. Toxic effects of organophosphates are well known and the current therapeutic scheme includes supportive therapy and antidotes. There is a dilemma on whether and when to apply gastric lavage and activated charcoal. According to Position Statement (by EAPCCT) it should be applied only if the patient presents within one hour of ingestion, with potentially lethal ingested dose. Atropine, a competitive antagonist of acetylcholine at m-receptors, which antagonizes bronchosecretion and bronchoconstriction, is the corner stone of acute organophosphate poisoning therapy. There were many attempts to find a more efficient drug, including glycopyrrolate which has been used even in clinical trials, but it still can not replace atropine. The only dilemma about atropine usage which still exists, concerns usage of high atropine dose and scheme of application. The most efficient atropinization is achieved with bolus doses of 1-2mg of atropine i.v push, with repeating the dose on each 5 minutes until signs of atropinization are registered. Diazepam, with its GABA stabilizing effect, reduces central nervous system damage and central respiratory weakness. Oximes reactivate phosphorylated acetylcholinesterase, which still has not gone ageing, reducing acetylcholine concentration and cholinergic crisis. These effects are clearly demonstrated in experimental conditions, but the clinical significance of oximes is still unclear and there are still those who question oxime therapy. For those who approve it, oxime dosage, duration of therapy, the choice of oxime for certain OP is still an open issue. We need new, more efficient antidotes, and those that are in use are only the small part of the therapy which could be used. Experimental studies show favorable therapeutic effect of many agents, but none of them has been introduced in standard treatment of OPI poisoning in the last 30

  2. L-026: EPR-First Responders: Action Guides Extinguishing Fire Brigades

    International Nuclear Information System (INIS)

    2011-01-01

    This conference will cover how and when to apply the Fire Brigades. Instructions and guidelines within the IAEA-EPR-First Responders to be used to guide the fire fighting brigade in a radiological emergency response to radioactive material in a manner that will minimize risks while performing the task. It will take into consideration the use of several types of monitoring equipment such as oxygen level meters, sight explosive, chemical meters and radiation detectors

  3. Meeting the challenge of responding to stakeholder information needs: A program model

    Energy Technology Data Exchange (ETDEWEB)

    Birkland, V.L. [Boeing Computer Services Co., Richland, WA (United States)

    1992-09-01

    In a dynamic, changing environment, effective decision-making is reached at the lower levels of an organization. With this concept in mind, Westinghouse Hanford Company designed a comprehensive information release program to manage information as close as possible to the original source. This paper will describe that program and the issues associated with implementing its objectives: improve the release process to respond to stakeholder requirements and liability for noncompliance.

  4. Thirty-seven transcription factor genes differentially respond to a ...

    Indian Academy of Sciences (India)

    Plant transcription factors and insect defence si. Thirty-seven transcription factor genes differentially respond to a harpin protein and affect resistance to the green peach aphid in Arabidopsis. HUNLIN. PIN. RUOXUE LIŲ, BEIBEI LÜ, XIAOMENG WANG, CHUNLING ZHANG, SHUPING ZHANG, JUN QIAN, LEI CHEN,.

  5. 45 CFR 5.24 - Responding to your request.

    Science.gov (United States)

    2010-10-01

    ... information on paper, we will do this if it is the only way to respond to a request. Nor are we required to... copying them all. Moreover, we are required to furnish only one copy of a record and usually impose that limit. If information exists in different forms, we will provide the record in the form that best...

  6. Plant Reproduction: AMOR Enables Males to Respond to Female Signals.

    Science.gov (United States)

    Dresselhaus, Thomas; Coimbra, Silvia

    2016-04-25

    The pollen tube of flowering plants undertakes a long journey to transport two sperm cells for double fertilization. New work on pollen tube guidance has identified an arabinogalactan-derived ovular factor that primes tubes to respond to female gametophyte-secreted attraction signals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. WS-009: EPR-First Responders: Personnel protection guidelines

    International Nuclear Information System (INIS)

    2011-01-01

    The purpose of this working session is that the participants can apply their knowledge in a laboratory explosion with radioactive material and a contamination risks by cobalt source. The first responder have to identify the incident commander, the type of response required, the risks of the emergency, the requirements for transporting the victims to the hospital and the actors involved in a radiological emergency

  8. Editor's Note Responding to suggestions from the research ...

    African Journals Online (AJOL)

    Admin

    Responding to suggestions from the research fellowship of the Institute of African Studies for a re-branding of the. Research Review, which began publication in the early 1960s soon after the establishment of the Institute, the old title has now been replaced with a new title — Contemporary Journal of African Studies. This is ...

  9. Responding to Individual Differences in Inclusive Classrooms in Australia

    Science.gov (United States)

    van Kraayenoord, Christina E.; Waterworth, David; Brady, Trish

    2014-01-01

    Responding to individual differences in classrooms in which there is increasing diversity is one of the challenges of inclusive education in Australia. The linking of Universal Design for Learning (UDL) and assistive technologies (ATs) is one way in which this challenge can be addressed. This article describes an initiative, known as…

  10. Policy options to respond to rapid climate change

    NARCIS (Netherlands)

    Swart, R.J.; Marinova, N.A.; Bakker, S.; Tilburg, van X.

    2009-01-01

    Ongoing research on climate change indicates that we cannot rule out the possibility of extreme climatic changes, beyond current IPCC scenarios. The thinking about policy responses to address these risks is still in its infancy. This study explores the possibilities for responding to extreme

  11. Communication: Listening and Responding. Affective 4.0.

    Science.gov (United States)

    Borgers, Sherry B., Comp.; Ward, G. Robert, Comp.

    This module is designed to provide practice in listening effectively and in responding to messages sent by another. The module is divided into two sets of activities, the first is the formation of a triad enabling the student to investigate the following: do you listen, listening and the unrelated response, incomplete listening, listening for…

  12. The Self as a Responding-and Responsible-Artifact

    OpenAIRE

    Dennett, Daniel C.

    2003-01-01

    The powerful illusion of a unified, Cartesian self responsible for intentional action is contrasted with the biologically sounder model of competitive processes that yield an only partially coherent agency, and the existence of the illusion of self is explained as an evolved feature of communicating agents, capable of responding to requests and queries about their own decisions and actions.

  13. 16 CFR 5.62 - Hearing rights of respondent.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Hearing rights of respondent. 5.62 Section 5.62 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE STANDARDS OF CONDUCT Disciplinary Actions Concerning Postemployment Conflict of Interest § 5.62 Hearing...

  14. Serial Killers: Academic Libraries Respond to Soaring Costs.

    Science.gov (United States)

    McCarthy, Paul

    1994-01-01

    Discusses ways in which academic libraries are responding to rising costs of serials. Topics addressed include pricing by publishers; the effect of journal cancellations on research activities; interlibrary loans and document delivery services; coordinated cancelling; electronic journals; and experiences at the University of Arizona. (LRW)

  15. Ethnicity, desirable responding, and self-reports of abuse: a comparison of European- and Asian-ancestry undergraduates.

    Science.gov (United States)

    Meston, C M; Heiman, J R; Trapnell, P D; Carlin, A S

    1999-02-01

    One thousand fifty-two (582 non-Asian, 470 Asian) university students were assessed regarding levels of physical abuse, emotional abuse, sexual abuse, neglect, and socially desirable responding. Differences between Asian-ancestry and European-ancestry students in self-reported incidence and expression of abuse were evaluated, as was gender and the relation between self-reported abuse and socially desirable responding. Asian-ancestry men and women reported higher levels of physical abuse, emotional abuse, and neglect than did their Euro-ancestry counterparts, and Euro-ancestry women reported a higher incidence of sexual abuse than did Asian-ancestry women. Across ethnicity, men reported higher levels of physical abuse and neglect but lower levels of sexual abuse than did women. Socially desirable responding was not related to measures of abuse. Findings are discussed in terms of cultural influences on child-rearing and disciplinary practices.

  16. Therapeutic time window and underlying therapeutic mechanism of breviscapine injection against cerebral ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Guo, Chao; Zhu, Yanrong; Weng, Yan; Wang, Shiquan; Guan, Yue; Wei, Guo; Yin, Ying; Xi, Miaomaio; Wen, Aidong

    2014-01-01

    Breviscapine injection is a Chinese herbal medicine standardized product extracted from Erigeron breviscapus (Vant.) Hand.-Mazz. It has been widely used for treating cardiovascular and cerebrovascular diseases. However, the therapeutic time window and the action mechanism of breviscapine are still unclear. The present study was designed to investigate the therapeutic time window and underlying therapeutic mechanism of breviscapine injection against cerebral ischemic/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion for 2h followed by 24h of reperfusion. Experiment part 1 was used to investigate the therapeutic time window of breviscapine. Rats were injected intravenously with 50mg/kg breviscapine at different time-points of reperfusion. After 24h of reperfusion, neurologic score, infarct volume, brain water content and serum level of neuron specific enolase (NSE) were measured in a masked fashion. Part 2 was used to explore the therapeutic mechanism of breviscapine. 4-Hydroxy-2-nonenal (4-HNE), 8-hydroxyl-2'- deoxyguanosine (8-OHdG) and the antioxidant capacity of ischemia cortex were measured by ELISA and ferric-reducing antioxidant power (FRAP) assay, respectively. Immunofluorescence and western blot analysis were used to analyze the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). Part 1: breviscapine injection significantly ameliorated neurologic deficit, reduced infarct volume and water content, and suppressed the levels of NSE in a time-dependent manner. Part 2: breviscapine inhibited the increased levels of 4-HNE and 8-OHdG, and enhanced the antioxidant capacity of cortex tissue. Moreover, breviscapine obviously raised the expression of Nrf2 and HO-1 proteins after 24h of reperfusion. The therapeutic time window of breviscapine injection for cerebral ischemia/reperfusion injury seemed to be within 5h after reperfusion. By up-regulating the expression of Nrf2/HO-1 pathway

  17. Therapeutic physical exercise in neural injury: friend or foe?

    Science.gov (United States)

    Park, Kanghui; Lee, Seunghoon; Hong, Yunkyung; Park, Sookyoung; Choi, Jeonghyun; Chang, Kyu-Tae; Kim, Joo-Heon; Hong, Yonggeun

    2015-12-01

    [Purpose] The intensity of therapeutic physical exercise is complex and sometimes controversial in patients with neural injuries. This review assessed whether therapeutic physical exercise is beneficial according to the intensity of the physical exercise. [Methods] The authors identified clinically or scientifically relevant articles from PubMed that met the inclusion criteria. [Results] Exercise training can improve body strength and lead to the physiological adaptation of skeletal muscles and the nervous system after neural injuries. Furthermore, neurophysiological and neuropathological studies show differences in the beneficial effects of forced therapeutic exercise in patients with severe or mild neural injuries. Forced exercise alters the distribution of muscle fiber types in patients with neural injuries. Based on several animal studies, forced exercise may promote functional recovery following cerebral ischemia via signaling molecules in ischemic brain regions. [Conclusions] This review describes several types of therapeutic forced exercise and the controversy regarding the therapeutic effects in experimental animals versus humans with neural injuries. This review also provides a therapeutic strategy for physical therapists that grades the intensity of forced exercise according to the level of neural injury.

  18. A systematic review of therapeutic modalities used in sleep bruxism

    Directory of Open Access Journals (Sweden)

    May Wathiq Al-Khudhairy

    2015-01-01

    Full Text Available Aim: Sleep bruxism (SB has been present for over a century. There are many treatment modalities in the literature. The objective of this systematic review of randomized controlled clinical therapeutic trials of SB in adults diagnosed by clinical and/or electromyogram and/or polysomnography of SB is to elucidate the most effective of treatment modalities via documentation of the levels of evidence. Materials and Method: This review conducted electronically on PubMed included only English Full text human clinical trials with or without randomization. Twenty-one articles were included in this review. The therapeutic modalities of SB were classified into behavioral therapy, appliance therapy, local pharmacotherapy, and systemic pharmacotherapy. Each article was further allotted a level of evidence. Results: This review suggests that Oral appliances expressed the most positive outcome on SB episodes per hour of sleep. Conclusion: There is still not sufficient evidence to support behavioral and pharmaco-therapeutic approach

  19. Medial Orbitofrontal Cortex Mediates Effort-related Responding in Rats.

    Science.gov (United States)

    Münster, Alexandra; Hauber, Wolfgang

    2017-11-17

    The medial orbitofrontal cortex (mOFC) is known to support flexible control of goal-directed behavior. However, limited evidence suggests that the mOFC also mediates the ability of organisms to work with vigor towards a selected goal, a hypothesis that received little consideration to date. Here we show that excitotoxic mOFC lesion increased responding under a progressive ratio (PR) schedule of reinforcement, that is, the highest ratio achieved, and increased the preference for the high effort-high reward option in an effort-related decision-making task, but left intact outcome-selective Pavlovian-instrumental transfer and outcome-specific devaluation. Moreover, pharmacological inhibition of the mOFC increased, while pharmacological stimulation reduced PR responding. In addition, pharmacological mOFC stimulation attenuated methylphenidate-induced increase of PR responding. Intact rats tested for PR responding displayed higher numbers of c-Fos positive mOFC neurons than appropriate controls; however, mOFC neurons projecting to the nucleus accumbens did not show a selective increase in neuronal activation implying that they may not play a major role in regulating PR responding. Collectively, these results suggest that the mOFC plays a major role in mediating effort-related motivational functions. Moreover, our data demonstrate for the first time that the mOFC modulates effort-related effects of psychostimulant drugs. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Nucleus accumbens core and shell are necessary for reinforcer devaluation effects on Pavlovian conditioned responding

    Directory of Open Access Journals (Sweden)

    Teghpal eSingh

    2010-10-01

    Full Text Available The nucleus accumbens (NA has been hypothesized to be part of a circuit in which cue-evoked information about expected outcomes is mobilized to guide behavior. Here we tested this hypothesis using a Pavlovian reinforcer devaluation task, previously applied to assess outcome-guided behavior after damage to regions such as the orbitofrontal cortex and amygdala that send projections to NA. Rats with sham lesions or neurotoxic lesions of either the core or shell subdivision of NA were trained to associate a 10 sec CS+ with delivery of three food pellets. After training, half of the rats in each lesion group received food paired with illness induced by LiCl injections; the remaining rats received food and illness unpaired. Subsequently, responding to the CS+ was assessed in an extinction probe test. Both sham and lesioned rats conditioned to the CS+ and formed a conditioned taste aversion. However only sham rats reduced their conditioned responding as a result of reinforcer devaluation; devalued rats with lesions of either core or shell showed levels of responding that were similar to lesioned, non-devalued rats. This impairment was not due to the loss of motivational salience conferred to the CS+ in lesioned rats as both groups responded similarly for the cue in conditioned reinforcement testing. These data suggest that NA core and shell are part of a circuit necessary for the use of cue-evoked information about expected outcomes to guide behavior.

  1. Assessment of nuclear medicine capabilities in responding to a radiological terrorism event. Technical memorandum

    Energy Technology Data Exchange (ETDEWEB)

    Stodilka, R.Z. [Univ. of Western Ontario, Schulich School of Medicine, London, Ontario (Canada); Wilkinson, D

    2006-09-15

    Substantial effort has been placed into enhancing federal capabilities for responding to a Chemical, Biological, Radiological, or Nuclear (CBRN) terrorist attack. However, little emphasis has been placed on including the local-level medical responders in these efforts. In effecting response to a radiological incident, potentially useful resources to access are health care professionals with training in matters of ionizing radiation, namely: nuclear medicine physicians, radiologists, radiation oncologists, medical physicists, and technologists. In this report, we focus on Nuclear Medicine expertise in Canada, and place this expertise into the context of assisting with a radiological terrorist incident. Nuclear Medicine expertise, along with its supporting infrastructure has already been deployed in proportion to the distribution of the civilian population. Given the expectations that the civilian population places in these health care professionals, their immediate access to specialized equipment, and the delay between a radiological terrorist incident and the arrival of federal expert capabilities, it is likely that these health care professionals will play important roles in emergency response. These roles will likely be: identifying the nature of the incident, triage, decontamination, coordinating with First Responders, and communicating with the media. Acknowledging the potential value of these professionals in responding to a radiological terrorist incident, steps should be taken to enlist their support and integrate them into a coherent national strategy. (author)

  2. Assessment of nuclear medicine capabilities in responding to a radiological terrorism event. Technical memorandum

    International Nuclear Information System (INIS)

    Stodilka, R.Z.; Wilkinson, D.

    2006-09-01

    Substantial effort has been placed into enhancing federal capabilities for responding to a Chemical, Biological, Radiological, or Nuclear (CBRN) terrorist attack. However, little emphasis has been placed on including the local-level medical responders in these efforts. In effecting response to a radiological incident, potentially useful resources to access are health care professionals with training in matters of ionizing radiation, namely: nuclear medicine physicians, radiologists, radiation oncologists, medical physicists, and technologists. In this report, we focus on Nuclear Medicine expertise in Canada, and place this expertise into the context of assisting with a radiological terrorist incident. Nuclear Medicine expertise, along with its supporting infrastructure has already been deployed in proportion to the distribution of the civilian population. Given the expectations that the civilian population places in these health care professionals, their immediate access to specialized equipment, and the delay between a radiological terrorist incident and the arrival of federal expert capabilities, it is likely that these health care professionals will play important roles in emergency response. These roles will likely be: identifying the nature of the incident, triage, decontamination, coordinating with First Responders, and communicating with the media. Acknowledging the potential value of these professionals in responding to a radiological terrorist incident, steps should be taken to enlist their support and integrate them into a coherent national strategy. (author)

  3. Individualised cancer therapeutics: dream or reality? Therapeutics construction.

    Science.gov (United States)

    Shen, Yuqiao; Senzer, Neil; Nemunaitis, John

    2005-11-01

    The analysis of DNA microarray and proteomic data, and the subsequent integration into functional expression sets, provides a circuit map of the hierarchical cellular networks responsible for sustaining the viability and environmental competitiveness of cancer cells, that is, their robust systematics. These technologies can be used to 'snapshot' the unique patterns of molecular derangements and modified interactions in cancer, and allow for strategic selection of therapeutics that best match the individual profile of the tumour. This review highlights technology that can be used to selectively disrupt critical molecular targets and describes possible vehicles to deliver the synthesised molecular therapeutics to the relevant cellular compartments of the malignant cells. RNA interference (RNAi) involves a group of evolutionarily conserved gene silencing mechanisms in which small sequences of double-stranded RNA or intrinsic antisense RNA trigger mRNA cleavage or translational repression, respectively. Although RNAi molecules can be synthesised to 'silence' virtually any gene, even if upregulated, a mechanism for selective delivery of RNAi effectors to sites of malignant disease remains challenging. The authors will discuss gene-modified conditionally replicating viruses as candidate vehicles for the delivery of RNAi.

  4. Unexplored therapeutic opportunities in the human genome.

    Science.gov (United States)

    Oprea, Tudor I; Bologa, Cristian G; Brunak, Søren; Campbell, Allen; Gan, Gregory N; Gaulton, Anna; Gomez, Shawn M; Guha, Rajarshi; Hersey, Anne; Holmes, Jayme; Jadhav, Ajit; Jensen, Lars Juhl; Johnson, Gary L; Karlson, Anneli; Leach, Andrew R; Ma'ayan, Avi; Malovannaya, Anna; Mani, Subramani; Mathias, Stephen L; McManus, Michael T; Meehan, Terrence F; von Mering, Christian; Muthas, Daniel; Nguyen, Dac-Trung; Overington, John P; Papadatos, George; Qin, Jun; Reich, Christian; Roth, Bryan L; Schürer, Stephan C; Simeonov, Anton; Sklar, Larry A; Southall, Noel; Tomita, Susumu; Tudose, Ilinca; Ursu, Oleg; Vidovic, Dušica; Waller, Anna; Westergaard, David; Yang, Jeremy J; Zahoránszky-Köhalmi, Gergely

    2018-05-01

    A large proportion of biomedical research and the development of therapeutics is focused on a small fraction of the human genome. In a strategic effort to map the knowledge gaps around proteins encoded by the human genome and to promote the exploration of currently understudied, but potentially druggable, proteins, the US National Institutes of Health launched the Illuminating the Druggable Genome (IDG) initiative in 2014. In this article, we discuss how the systematic collection and processing of a wide array of genomic, proteomic, chemical and disease-related resource data by the IDG Knowledge Management Center have enabled the development of evidence-based criteria for tracking the target development level (TDL) of human proteins, which indicates a substantial knowledge deficit for approximately one out of three proteins in the human proteome. We then present spotlights on the TDL categories as well as key drug target classes, including G protein-coupled receptors, protein kinases and ion channels, which illustrate the nature of the unexplored opportunities for biomedical research and therapeutic development.

  5. Long-term delivery of protein therapeutics.

    Science.gov (United States)

    Vaishya, Ravi; Khurana, Varun; Patel, Sulabh; Mitra, Ashim K

    2015-03-01

    Proteins are effective biotherapeutics with applications in diverse ailments. Despite being specific and potent, their full clinical potential has not yet been realized. This can be attributed to short half-lives, complex structures, poor in vivo stability, low permeability, frequent parenteral administrations and poor adherence to treatment in chronic diseases. A sustained release system, providing controlled release of proteins, may overcome many of these limitations. This review focuses on recent development in approaches, especially polymer-based formulations, which can provide therapeutic levels of proteins over extended periods. Advances in particulate, gel-based formulations and novel approaches for extended protein delivery are discussed. Emphasis is placed on dosage form, method of preparation, mechanism of release and stability of biotherapeutics. Substantial advancements have been made in the field of extended protein delivery via various polymer-based formulations over last decade despite the unique delivery-related challenges posed by protein biologics. A number of injectable sustained-release formulations have reached market. However, therapeutic application of proteins is still hampered by delivery-related issues. A large number of protein molecules are under clinical trials, and hence, there is an urgent need to develop new methods to deliver these highly potent biologics.

  6. The therapeutic journey of benzimidazoles: a review.

    Science.gov (United States)

    Bansal, Yogita; Silakari, Om

    2012-11-01

    Presence of benzimidazole nucleus in numerous categories of therapeutic agents such as antimicrobials, antivirals, antiparasites, anticancer, anti-inflammatory, antioxidants, proton pump inhibitors, antihypertensives, anticoagulants, immunomodulators, hormone modulators, CNS stimulants as well as depressants, lipid level modulators, antidiabetics, etc. has made it an indispensable anchor for development of new therapeutic agents. Varied substitutents around the benzimidazole nucleus have provided a wide spectrum of biological activities. Importance of this nucleus in some activities like, Angiotensin I (AT(1)) receptor antagonism and proton-pump inhibition is reviewed separately in literature. Even some very short reviews on biological importance of this nucleus are also known in literature. However, owing to fast development of new drugs possessing benzimidazole nucleus many research reports are generated in short span of time. So, there is a need to couple the latest information with the earlier information to understand the current status of benzimidazole nucleus in medicinal chemistry research. In the present review, various derivatives of benzimidazole with different pharmacological activities are described on the basis of substitution pattern around the nucleus with an aim to help medicinal chemists for developing an SAR on benzimidazole derived compounds for each activity. This discussion will further help in the development of novel benzimidazole compounds. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Improved preclinical cardiovascular therapeutic indices with long-term inhibition of norepinephrine reuptake using reboxetine

    NARCIS (Netherlands)

    Fossa, Anthony A.; Wisialowski, Todd A.; Cremers, Thomas; van der Hart, Marieke; Tseng, Elaine; Deng, Shibing; Rollema, Hans; Wang, Ellen Q.

    2012-01-01

    Norepinephrine reuptake inhibitors (NRIs) acutely increase norepinephrine (NE) levels, but therapeutic antidepressant activity is only observed after weeks of treatment because central NE levels progressively increase during continued drug exposure. Similarly, while NRIs acutely increase blood

  8. Therapeutic irradiation and brain injury

    International Nuclear Information System (INIS)

    Sheline, G.E.; Wara, W.M.; Smith, V.

    1980-01-01

    This is a review and reanalysis of the literature on adverse effects of therapeutic irradiation on the brain. Reactions have been grouped and considered according to time of appearance. The emphasis of the analysis is on delayed reactions, especially those that occur from a few months to several years after irradiation. All dose specifications were converted into equivalent megavoltage rads. The data were analyzed in terms of total dose, overall treatment time and number of treatment fractions. Also discussed were acute radiation reactions, early delayed radiation reactions, somnolence and leukoencephalopathy post-irradiation/chemotherapy and combined effects of radiation and chemotherapy

  9. Enactments in Psychoanalysis: Therapeutic Benefits.

    Science.gov (United States)

    Stern, Stanley

    The therapeutic benefits of enactments are addressed. Relevant literature reveals disparate conceptions about the nature and use of enactments. Clarification of the term is discussed. This analyst's theoretical and technical evolution is addressed; it is inextricably related to using enactments. How can it not be? A taxonomy of enactments is presented. The article considers that enactments may be fundamental in the evolution from orthodox to contemporary analytic technique. Assumptions underlying enactments are explored, as are guidelines for using enactments. Finally, the article posits that enactments have widened the scope of analysis and contributed to its vitality.

  10. EXETRA Perspectives: Concepts in Therapeutic Recreation.

    Science.gov (United States)

    Neal, Larry L.; Edginton, Christopher R.

    Fifteen papers address issues in therapeutic recreation for disabled persons from the perspectives of practitioners, educators, and students. The following papers are presented. "Therapeutic Recreation Service: The Past and Challenging Present" (H. Sessoms); "Therapeutic Recreatiion in an Era of Limits: A Crisis...A Challenge... An Opportunity"…

  11. Survey sustainability Biomass. Appendix. Results of the international respondents

    Energy Technology Data Exchange (ETDEWEB)

    Bergsma, G.C.; Groot, M.I.

    2006-06-15

    As part of an array of strategies to combat climate change, biomass is being used increasingly as a substitute for fossil fuels. It is important that the sustainability benefits thus accruing to the Netherlands are not at the expense of sustainable development in producer countries. Against this background the 'Sustainable biomass imports' project group is developing a set of criteria for evaluating the sustainability of biomass projects. To assess support for such criteria, CE conducted an internet survey among the various stakeholders (NGOs, industry, government), drawing a total of 104 responses. This report presents all the results and conclusions of the survey, for each category of stakeholders and overall. Among the most striking conclusions are the following: The majority of respondents see a sustainability audit on biomass as feasible, provided the sustainability criteria are adequate for the purpose (68%); Almost all the respondents are of the opinion that such sustainability criteria should apply to all applications of biomass (90%); On the issue of whether these criteria should vary according to the producer region concerned, respondents were divided (50% for, 50% against); Many NGOs state there should be different sustainability criteria in force for different biomass flows (50%), in contrast to industry, which argues for a uniform set of criteria for all flows; Most respondents hold that any biomass criteria should apply to both subsidised and unsubsidised projects; At the same time, a sizable majority of respondents state that subsidisation of biomass projects should depend on the degree of sustainability (72%) and in particular on the CO2 emission cuts achieved, this being regarded as the single most important factor; When it comes to the issue of GMO, opinions differ markedly between NGOs and industry, with some 75% of NGOs wanting this aspect included, but only 10% of industry; Respondents also commented on a number of additional issues

  12. Therapeutic Self-Disclosure within DBT, Schema Therapy, and CBASP: Opportunities and Challenges.

    Science.gov (United States)

    Köhler, Stephan; Guhn, Anne; Betzler, Felix; Stiglmayr, Christian; Brakemeier, Eva-Lotta; Sterzer, Philipp

    2017-01-01

    In recent years, various therapeutic interventions have been established that extended behavior and cognitive behavior therapy (CBT) by so-called "third-wave" strategies. In order to address specific therapeutic challenges in certain subgroups of patients who do not sufficiently respond to "classical CBT," some of these third-wave strategies put particular emphasis on therapist self-disclosure. This article highlights therapeutic self-disclosure as a means to address interpersonal problems by comparing three third-wave strategies: (a) acceptance and change strategies as used in Dialectical Behavioral Therapy (DBT), (b) the concept of "limited reparenting" as used in Schema Therapy (ST), and (c) disciplined personal involvement as used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). On the basis of a critical discussion on opportunities and challenges within these three concepts, self-disclosure is proposed to be a promising therapeutic tool that is worth to be investigated in more depth in future studies.

  13. The therapeutic evaluation and mechanism on treating bronchial ...

    African Journals Online (AJOL)

    ... the level of bronchial responsiveness, which proved a better curative effect of Chinese medicine. The mechanism is probably due to relieving the airway inflammation by keeping the balance between Th1 and Th2 cells. Keywords: Ziyinqingre prescription; cough; bronchial hyper-responsiveness; therapeutic mechanism ...

  14. Effects of experimental lead exposure and the therapeutic effect of ...

    African Journals Online (AJOL)

    Effects of experimental lead exposure and the therapeutic effect of defatted Moringa oleifera seed meal on serum electrolytes levels of Wistar rats. IS Idoko, IC Ugochukwu, SE Abalaka, AM Adamu, PK Columbus, YA Kwabugge, RE Edeh, S Adamu, B Muhammed ...

  15. The Relationships between Verbal and Nonverbal Communication of Therapeutic Effectiveness.

    Science.gov (United States)

    Proefrock, David W.; Bloom, Robert

    The relationship between a therapist's verbal and nonverbal communication of therapeutic effectiveness was investigated. In a design intended to eliminate many of the methodological problems which exist in this area of research, subjects (N=102) were asked to rate videotaped segments showing combinations of three different levels of both verbal…

  16. Diagnostic and therapeutic radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Russell, W J [Radiation Effects Research Foundation, Hiroshima (Japan)

    1975-09-01

    Diagnostic and therapeutic radiology were studied as possible contaminants in the evaluations of A-bomb survivors in the ABCC-JNIH Adult Health Study for radiation effects. Hiroshima and Nagasaki subjects received X-ray examinations elsewhere within three months of their ABCC visits at rates of 23 and 12%, respectively. Medical X-ray examinations were more frequent among survivors than comparison subjects. Hiroshima and Nagasaki radiologic practice steadily increased since 1948, and differed markedly by city. From 1946-70 the Hiroshima and Nagasaki X-ray bone marrow doses were 2,300 and 1,000 g-rads, respectively. By 1970, cumulated medical X-ray doses approximated A-bomb doses at distances from the hypocenters of 2,000 m in Hiroshima and 2,800 m in Nagasaki. ABCC X-ray examination doses per subject are routinely updated for comparison with A-bomb doses. Each subject's reported fluoroscopy, photofluorography and radiation therapy exposure elsewhere are for future reference. Dental radiography, though increasing, was not currently an important contributor to survivors' overall exposure. Radiation therapy exposures of 137 subjects were confirmed, and doses estimated for most. Two-thirds the treatments were for malignancies; therapy differed markedly by city; and five cancers possibly arose from earlier radiation therapy. This underscores the importance of considering diagnostic and therapeutic radiology when attributing diseases to the atomic bombs.

  17. [Therapeutic Aggressiveness and Liquid Oncology].

    Science.gov (United States)

    Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

    2017-01-01

    Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

  18. Understanding music’s therapeutic efficacy: Implications for music education

    Directory of Open Access Journals (Sweden)

    Diane Thram

    2014-11-01

    Full Text Available In the current era of electronic domination of human experience, be it via cell phone and/or computer addiction, or the ubiquitous television, actual participation in music- making is less and less common for the average person, child or adult. Passive participation through listening is most often cited by people as their major experience with music in their lives. When asked if listening has therapeutic effects, it is rare for anyone to respond in the negative. Likewise, for performers/active participants in music- making, be it solitary or as part of a group, invariably an enhanced sense of well-being from the act of making music is reported. This paper addresses therapeutic aspects of musical participation (singing, clapping, playing an instrument, dancing, listening by providing a historical overview (12th c to present of attitudes toward music’s therapeutic effects. It argues that music exists through the interaction of our biological capacity to make music with our cultural circumstances. How individuals benefit in all aspects their being – physical, mental and emotional – from engaging in the act of making music is illustrated with examples from field research in southern Africa. Finally implications for Music Education are explored which emphasize how more comprehensive integration of music into the curriculum can serve as an antidote to the increasing isolation and alienation of modern life.

  19. Impacts of the Human Gut Microbiome on Therapeutics.

    Science.gov (United States)

    Vázquez-Baeza, Yoshiki; Callewaert, Chris; Debelius, Justine; Hyde, Embriette; Marotz, Clarisse; Morton, James T; Swafford, Austin; Vrbanac, Alison; Dorrestein, Pieter C; Knight, Rob

    2018-01-06

    The human microbiome contains a vast source of genetic and biochemical variation, and its impacts on therapeutic responses are just beginning to be understood. This expanded understanding is especially important because the human microbiome differs far more among different people than does the human genome, and it is also dramatically easier to change. Here, we describe some of the major factors driving differences in the human microbiome among individuals and populations. We then describe some of the many ways in which gut microbes modify the action of specific chemotherapeutic agents, including nonsteroidal anti-inflammatory drugs and cardiac glycosides, and outline the potential of fecal microbiota transplant as a therapeutic. Intriguingly, microbes also alter how hosts respond to therapeutic agents through various pathways acting at distal sites. Finally, we discuss some of the computational and practical issues surrounding use of the microbiome to stratify individuals for drug response, and we envision a future where the microbiome will be modified to increase everyone's potential to benefit from therapy.

  20. Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

    Science.gov (United States)

    Kurtoğlu, Selim; Özdemir, Ahmet

    2017-01-01

    Fetal and neonatal hyperthyroidism may occur in mothers with Graves’ disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th–20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7–17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism. PMID:28439194

  1. Characterization of Chemical Suicides in the United States and Its Adverse Impact on Responders and Bystanders

    Directory of Open Access Journals (Sweden)

    Ayana R. Anderson

    2016-11-01

    Full Text Available Introduction: A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.. Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S. Methods: The author analyzed data from 2011-2013 from state health departments participating in the Agency for Toxic Substances and Disease Registry’s National Toxic Substance Incidents Program (NTSIP. NTSIP is a web-based chemical incident surveillance system that tracks the public health consequences (e.g., morbidity, mortality from acute chemical releases. Reporting sources for NTSIP incidents typically include first responders, hospitals, state environmental agencies, and media outlets. To find chemical suicide incidents in NTSIP’s database, the author queried open text fields in the comment, synopsis, and contributing factors variables for potential incidents. Results: Five of the nine states participating in NTSIP reported a total of 22 chemical suicide incidents or attempted suicides during 2011-2013. These states reported a total of 43 victims: 15 suicide victims who died, seven people who attempted suicide but survived, eight responders, and four employees working at a coroner’s office; the remainder were members of the general public. None of the injured responders reported receiving HazMat technician-level training, and none had documented appropriate personal protective equipment. Conclusion: Chemical suicides produce lethal gases that can pose a threat to responders and bystanders. Describing the characteristics of these incidents can help raise awareness among responders and the public about the dangers of

  2. Development and evaluation of first responder equipment for nuclear forensics

    International Nuclear Information System (INIS)

    Tsuchiya, Ken'ichi; Kurosawa, Kenji; Akiba, Norimitsu; Kuroki, Kenro; Schwantes, Jon M.; Pierson, Richard; Piper, Roman K.

    2014-01-01

    Nuclear forensics are the technical means by which nuclear and other radioactive materials used in illegal activities are characterized as to physical and chemical condition, provenance, and history. Sampling for traditional forensics evidence (e.g. fingerprints, DNA, hair, fibers, and digital evidence) contaminated by radionuclides, and categorization of nuclear and other radioactive materials by on-sight measurement are required for first responders. Portable radiological equipment and radiation protection for first responders to achieve emergency tasks safely at the incident sites have been developed and evaluated in National Research Institute of Police Science. In this report, we introduce wireless network dosimetry system and neutron protection shield with water under sampling and categorization. Described next in this report are evaluation tests of active personal dosimeters using neutron irradiation field in Pacific Northwest National Laboratory. We evaluated them under fast and thermal neutron field. We confirmed the large fluctuation of the response for each dosimeter caused by the energy dependence of the detectors. (author)

  3. Dehydroepiandrosterone (DHEA) supplementation and IVF outcome in poor responders.

    Science.gov (United States)

    Triantafyllidou, Olga; Sigalos, George; Vlahos, Nikos

    2017-06-01

    Ovarian stimulation of poor ovarian responders still remains a challenging issue. The incidence of poor responders among infertile women is reported in 9-24% IVF cycles and is associated with very low clinical pregnancy rates. Different treatments have been reported in the literature in an attempt to identify the best stimulation protocol for those patients. Administration of dehydroepiandrosterone acetate (DHEA) was suggested as a promising treatment. It is well known that androgens can influence ovarian follicular growth, augment steroidogenesis, promote follicular recruitment and increase the number of primary and pre-antral follicles. The purpose of this review is to evaluate the effect of DHEA supplementation on women with diminished ovarian reserve. Because of the uncertainty of published data, we suggest that well-designed multicentre RCTs are required to provide more insight on the effectiveness of DHEA. The absence of significant side effects should not be considered as an argument to support DHEA treatment.

  4. An alternative framework for responding to the amphibian crisis

    Science.gov (United States)

    Muths, Erin L.; Fisher, Robert N.

    2017-01-01

    Volumes of data illustrate the severity of the crisis affecting amphibians, where > 32% of amphibians worldwide are threatened with declining populations. Although there have been isolated victories, the current approach to the issue is unsuccessful. We suggest that a radically different approach, something akin to human emergency response management (i.e. the Incident Command System), is one alternative to addressing the inertia and lack of cohesion in responding to amphibian issues. We acknowledge existing efforts and the useful research that has been conducted, but we suggest that a change is warranted and that the identification of a new amphibian chytrid provides the impetus for such a change. Our goal is to recognize that without a centralized effort we (collectively) are likely to fail in responding to this challenge.

  5. Train-the-trainer training for EV first responders

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2011-11-15

    This paper presents Electrical Line magazine. The magazine covers new product releases, provides expert opinion on solving problems posted by readers, has updated industry news and posts event calendars, among other features. This paper discusses industry news and various topics on electric vehicles. Nova Scotia Power is researching the convenience of electric charging and the readiness of the provincial electric grid to support electric vehicles as well as their cost effectiveness and performance. The paper describes how Hydro-Quebec is supporting the use of such vehicles through the selection of ten Boucherville businesses to participate in an electric vehicles trial program. The ten company names are listed. Recently, the national alternative fuels training consortium (NAFTC) conducted a safety-training workshop for electric drive vehicle first responders at the Tesla Motors headquarters in California. The aim was to ensure that first responders had the opportunity to enhance their knowledge of electric drive vehicle accident response procedures.

  6. How Did Climate and Humans Respond to Past Volcanic Eruptions?

    Science.gov (United States)

    Toohey, Matthew; Ludlow, Francis; Legrande, Allegra N.

    2016-01-01

    To predict and prepare for future climate change, scientists are striving to understand how global-scale climatic change manifests itself on regional scales and also how societies adapt or don't to sometimes subtle and complex climatic changes. In this regard, the strongest volcanic eruptions of the past are powerful test cases, showcasing how the broad climate system responds to sudden changes in radiative forcing and how societies have responded to the resulting climatic shocks. These issues were at the heart of the inaugural workshop of the Volcanic Impacts on Climate and Society (VICS) Working Group, convened in June 2016 at the Lamont-Doherty Earth Observatory of Columbia University in Palisades, N.Y. The 3-day meeting gathered approximately 50 researchers, who presented work intertwining the history of volcanic eruptions and the physical processes that connect eruptions with human and natural systems on a global scale.

  7. Respondent-Driven Sampling – Testing Assumptions: Sampling with Replacement

    Directory of Open Access Journals (Sweden)

    Barash Vladimir D.

    2016-03-01

    Full Text Available Classical Respondent-Driven Sampling (RDS estimators are based on a Markov Process model in which sampling occurs with replacement. Given that respondents generally cannot be interviewed more than once, this assumption is counterfactual. We join recent work by Gile and Handcock in exploring the implications of the sampling-with-replacement assumption for bias of RDS estimators. We differ from previous studies in examining a wider range of sampling fractions and in using not only simulations but also formal proofs. One key finding is that RDS estimates are surprisingly stable even in the presence of substantial sampling fractions. Our analyses show that the sampling-with-replacement assumption is a minor contributor to bias for sampling fractions under 40%, and bias is negligible for the 20% or smaller sampling fractions typical of field applications of RDS.

  8. Recurrent intraoperative silent ST depression responding to phenylephrine

    Directory of Open Access Journals (Sweden)

    P M Singh

    2012-01-01

    Full Text Available Intraoperative myocardial ischemia is attributed to decreased myocardial oxygen supply. We present an unusual case of recurrent, symptomless inferior wall ischemia in an apparently healthy male with no history of coronary artery disease after a spinal block. The recurring episodes were linked to tachycardia and presented with significant ST depression in Lead II with reciprocal elevation in lead aVL. The episodes responded to phenylephrine and subsided without residual sequelae.

  9. Reliability of a method for establishing the capacity of individuals with an intellectual disability to respond to Likert scales.

    Science.gov (United States)

    Cuskelly, Monica; Moni, Karen; Lloyd, Jan; Jobling, Anne

    2013-12-01

    The study reported here was an examination of the reliability of a method for determining acquiescent responding and the capacity to respond to items using a Likert scale response format by adults with an intellectual disability. Reliability of the outcomes of these procedures was investigated using a test-retest design. Associations with receptive vocabulary were examined. The majority of the participants did not demonstrate acquiescent responding. Individuals' responses to the Likert-type discrimination tasks were consistent, although this varied somewhat depending upon the abstractness of the task. There was some association between receptive language age equivalence scores and respondent performance. It is recommended that the pretest protocol (a) be modified to improve its reliability, and (b) this modified version be used with study participants who have an intellectual disability to ascertain the appropriate level of choice to be used for items that use a Likert response format.

  10. Responding to oil spills in the open ocean environment

    International Nuclear Information System (INIS)

    Wood, A.E.

    1994-01-01

    The primary objectives in responding to any oil spill is to control the source of the spill, then, contain, collect, and recover the spilled product. Accomplishing those objectives is an immense challenge. It becomes much more difficult when attempted in the open ocean environment due to the more complex logistical and communications problems one encounters when operating miles from the nearest land. Often times, too, the response must be coordinated with either a salvage operation, a fire-fighting operation, a well control operation or a combination of any of these. There have been volumes of papers comparing the relative merits of mechanical recovery, in-situ burning, dispersant application, and bioremediation in responding to open ocean spills. Although each approach deserves special consideration in different circumstances, this presentation focuses on mechanical methods; the specialized equipment and operational tactics that are best utilized in responding to a major spill in the open ocean. This paper is divided into two sections. The first section, Equipment Used in Open Ocean Spills, addresses in general terms, the special equipment required in an offshore response operation. The second section, entitled Operational Tactics Used In Open Ocean Spills offers an overview of the tactics employed to achieve the general objectives of containment, collection, recovery, and temporary storage

  11. Phosphine Exposure Among Emergency Responders - Amarillo, Texas, January 2017.

    Science.gov (United States)

    Hall, Emily M; Patel, Ketki; Victory, Kerton R; Calvert, Geoffrey M; Nogueira, Leticia M; Bojes, Heidi K

    2018-04-06

    Phosphine is a highly toxic gas that forms when aluminum phosphide, a restricted-use pesticide* typically used in agricultural settings, reacts with water. Acute exposure can lead to a wide range of respiratory, cardiovascular, and gastrointestinal symptoms, and can be fatal (1). On January 2, 2017, the Texas Department of State Health Services (DSHS) was notified by the Texas Panhandle Poison Center of an acute phosphine exposure incident in Amarillo, Texas. DSHS investigated potential occupational phosphine exposures among the 51 on-scene emergency responders; 40 (78.4%) did not use respiratory protection during response operations. Fifteen (37.5%) of these 40 responders received medical care for symptoms or as a precaution after the incident, and seven (17.5%) reported new or worsening symptoms consistent with phosphine exposure within 24 hours of the incident. Emergency response organizations should ensure that appropriate personal protective equipment (PPE) is used during all incidents when an unknown hazardous substance is suspected. Additional evaluation is needed to identify targeted interventions that increase emergency responder PPE use during this type of incident.

  12. Distinct populations of neurons respond to emotional valence and arousal in the human subthalamic nucleus.

    Science.gov (United States)

    Sieger, Tomáš; Serranová, Tereza; Růžička, Filip; Vostatek, Pavel; Wild, Jiří; Štastná, Daniela; Bonnet, Cecilia; Novák, Daniel; Růžička, Evžen; Urgošík, Dušan; Jech, Robert

    2015-03-10

    Both animal studies and studies using deep brain stimulation in humans have demonstrated the involvement of the subthalamic nucleus (STN) in motivational and emotional processes; however, participation of this nucleus in processing human emotion has not been investigated directly at the single-neuron level. We analyzed the relationship between the neuronal firing from intraoperative microrecordings from the STN during affective picture presentation in patients with Parkinson's disease (PD) and the affective ratings of emotional valence and arousal performed subsequently. We observed that 17% of neurons responded to emotional valence and arousal of visual stimuli according to individual ratings. The activity of some neurons was related to emotional valence, whereas different neurons responded to arousal. In addition, 14% of neurons responded to visual stimuli. Our results suggest the existence of neurons involved in processing or transmission of visual and emotional information in the human STN, and provide evidence of separate processing of the affective dimensions of valence and arousal at the level of single neurons as well.

  13. Chronic Pseudomonas aeruginosa lung infection is more severe in Th2 responding BALB/c mice compared to Th1 responding C3H/HeN mice

    DEFF Research Database (Denmark)

    Moser, C; Johansen, H K; Song, Z

    1997-01-01

    model of this infection was established in two strains of mice: C3H/HeN and BALB/c, generally known as Th1 and Th2 responders, respectively, which were challenged with alginate-embedded P. aeruginosa. Mortality was significantly lower in C3H/HeN compared to BALB/c mice (p ... was cleared more efficiently in C3H/HeN mice and significantly more C3H/HeN mice showed normal lung histopathology (p BALB/c mice (p ... from the two strains of mice, the interferon-(IFN-) gamma levels were higher, whereas IL-4 levels were lower in C3H/HeN mice than in BALB/c mice. The implications of these findings for CF patients with chronic P. aeruginosa lung infection are discussed....

  14. Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry.

    Science.gov (United States)

    Alsharif, Naser Z.; And Others

    1997-01-01

    Explains structurally based therapeutic evaluation of drugs, which uses seven therapeutic criteria in translating chemical and structural knowledge into therapeutic decision making in pharmaceutical care. In a Creighton University (Nebraska) medicinal chemistry course, students apply the approach to solve patient-related therapeutic problems in…

  15. Stomata of the CAM plant Tillandsia recurvata respond directly to humidity.

    Science.gov (United States)

    Lange, O L; Medina, E

    1979-01-01

    Under controlled conditions, CO 2 exchange of Tillandsia recurvata showed all characteristics of CAM. During the phase of nocturnal CO 2 fixation stomata of the plant responded sensitively to changes in ambient air humidity. Dry air resulted in an increase, moist air in a decrease of diffusion resistance. The evaporative demand of the air affected the level of stomatal resistance during the entire night period. Due to stomatal closure, the total nocturnal water loss of T. recurvata was less at low than at high humidity. It is concluded that stomata respond directly to humidity and not via bulk tissue water conditions of the leaves. Such control of transpiration may optimize water use efficiency for this almost rootless, extreme epiphyte.

  16. Novel therapeutic approaches in chondrosarcoma.

    Science.gov (United States)

    Polychronidou, Genovefa; Karavasilis, Vasilios; Pollack, Seth M; Huang, Paul H; Lee, Alex; Jones, Robin L

    2017-03-01

    Chondrosarcoma is a malignant tumor of bones, characterized by the production of cartilage matrix. Due to lack of effective treatment for advanced disease, the clinical management of chondrosarcomas is exceptionally challenging. Current research focuses on elucidating the molecular events underlying the pathogenesis of this rare bone malignancy, with the goal of developing new molecularly targeted therapies. Signaling pathways suggested to have a role in chondrosarcoma include Hedgehog, Src, PI3k-Akt-mTOR and angiogenesis. Mutations in IDH1/2, present in more than 50% of primary conventional chondrosarcomas, make the development of IDH inhibitors a promising treatment option. The present review discusses the preclinical and early clinical data on novel targeted therapeutic approaches in chondrosarcoma.

  17. Toxin-Based Therapeutic Approaches

    Directory of Open Access Journals (Sweden)

    Itai Benhar

    2010-10-01

    Full Text Available Protein toxins confer a defense against predation/grazing or a superior pathogenic competence upon the producing organism. Such toxins have been perfected through evolution in poisonous animals/plants and pathogenic bacteria. Over the past five decades, a lot of effort has been invested in studying their mechanism of action, the way they contribute to pathogenicity and in the development of antidotes that neutralize their action. In parallel, many research groups turned to explore the pharmaceutical potential of such toxins when they are used to efficiently impair essential cellular processes and/or damage the integrity of their target cells. The following review summarizes major advances in the field of toxin based therapeutics and offers a comprehensive description of the mode of action of each applied toxin.

  18. Toxin-Based Therapeutic Approaches

    Science.gov (United States)

    Shapira, Assaf; Benhar, Itai

    2010-01-01

    Protein toxins confer a defense against predation/grazing or a superior pathogenic competence upon the producing organism. Such toxins have been perfected through evolution in poisonous animals/plants and pathogenic bacteria. Over the past five decades, a lot of effort has been invested in studying their mechanism of action, the way they contribute to pathogenicity and in the development of antidotes that neutralize their action. In parallel, many research groups turned to explore the pharmaceutical potential of such toxins when they are used to efficiently impair essential cellular processes and/or damage the integrity of their target cells. The following review summarizes major advances in the field of toxin based therapeutics and offers a comprehensive description of the mode of action of each applied toxin. PMID:22069564

  19. Angiogenesis and Its Therapeutic Opportunities

    Directory of Open Access Journals (Sweden)

    So Young Yoo

    2013-01-01

    Full Text Available Angiogenesis plays critical roles in human physiology that range from reproduction and fetal growth to wound healing and tissue repair. The sophisticated multistep process is tightly regulated in a spatial and temporal manner by “on-off switch signals” between angiogenic factors, extracellular matrix components, and endothelial cells. Uncontrolled angiogenesis may lead to several angiogenic disorders, including vascular insufficiency (myocardial or critical limb ischemia and vascular overgrowth (hemangiomas, vascularized tumors, and retinopathies. Thus, numerous therapeutic opportunities can be envisaged through the successful understanding and subsequent manipulation of angiogenesis. Here, we review the clinical implications of angiogenesis and discuss pro- and antiangiogenic agents that offer potential therapy for cancer and other angiogenic diseases.

  20. Therapeutic target for protozoal diseases

    Science.gov (United States)

    Rathore, Dharmendar [Blacksburg, VA; Jani, Dewal [Blacksburg, VA; Nagarkatti, Rana [Blacksburg, VA

    2008-10-21

    A novel Fasciclin Related Adhesive Protein (FRAP) from Plasmodium and related parasites is provided as a target for therapeutic intervention in diseases caused by the parasites. FRAP has been shown to play a critical role in adhesion to, or invasion into, host cells by the parasite. Furthermore, FRAP catalyzes the neutralization of heme by the parasite, by promoting its polymerization into hemozoin. This invention provides methods and compositions for therapies based on the administration of protein, DNA or cell-based vaccines and/or antibodies based on FRAP, or antigenic epitopes of FRAP, either alone or in combination with other parasite antigens. Methods for the development of compounds that inhibit the catalytic activity of FRAP, and diagnostic and laboratory methods utilizing FRAP are also provided.

  1. Therapeutic Plasmapheresis in Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Zeynep Kendi Celebi

    2013-02-01

    Full Text Available In 1960's, with succesfully renal transplantations, acute rejection became to be a serious problem for graft survival. From 1965 to 2010, with the introduction of new immunosuppressant agents such as cyclosporine, mycophenolate mofetile and tacrolimus, the acute rejection rates declined from 80% to 10% . There is an ongoing gradual improvement in allograft survival. Use of Therapeutic plasma exchange (TPE is not evidence based treatment, but TPE is necessary for pre- and also post transplantation in patients with DSA. TPE is also a main treatment for antibody mediated rejection (AMR , but in clinical practice the duration and frequency of TPE and individual difference of antibody production is unclear. There is a requirement for more specific antibody elimination. Further randomised controlled studies are needed to elucidate TPE use before and after kidney transplantation. [Dis Mol Med 2013; 1(1.000: 8-10

  2. Therapeutical uses of 131I

    International Nuclear Information System (INIS)

    Lago, Graciela.

    1994-01-01

    Physiology of thyroid gland, pathology of thyroid , papillary, follicular cancer is considered together as differentiated thyroid cancer with very good results under therapy with iodine, invitro determination of calcitonin, search of metastasis, anaplastic carcinoma, as indifferentiated carcinoma with similar results as medullary carcinoma. This work gives a protocol for therapeutical use of 131I , in hyperthyroidism due to Graves-Basedow disease, thyrotoxic adenoma or Plummer disease, toxic multi nodular goiter, subacute thyroiditis. Is studied too the treatment with pharmaceuticals, surgery and radioactive iodine. A recommended use of each and protocol for iodine administration, fixed dose technique, dose estimation,absorbed dose, recommendations about when to use and not use 131I are included in this work

  3. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

  4. Guidelines for Rational Cancer Therapeutics

    Directory of Open Access Journals (Sweden)

    Byunghee Yoo

    2017-12-01

    Full Text Available Traditionally, cancer therapy has relied on surgery, radiation therapy, and chemotherapy. In recent years, these interventions have become increasingly replaced or complemented by more targeted approaches that are informed by a deeper understanding of the underlying biology. Still, the implementation of fully rational patient-specific drug design appears to be years away. Here, we present a vision of rational drug design for cancer that is defined by two major components: modularity and image guidance. We suggest that modularity can be achieved by combining a nanocarrier and an oligonucleotide component into the therapeutic. Image guidance can be incorporated into the nanocarrier component by labeling with a specific imaging reporter, such as a radionuclide or contrast agent for magnetic resonance imaging. While limited by the need for additional technological advancement in the areas of cancer biology, nanotechnology, and imaging, this vision for the future of cancer therapy can be used as a guide to future research endeavors.

  5. Therapeutic options for lip augmentation.

    Science.gov (United States)

    Segall, Lorne; Ellis, David A F

    2007-11-01

    Aesthetic ideals vary with emerging fashion trends and within different cultures. However, over the past few decades, fuller lips have been considered a desirable trait. Many younger patients are presenting for lip augmentation to achieve the sought-after look commonly seen in many fashion magazines. In addition, as individuals age, they lose lip volume, with a thinning of the red lip, some effacement of the vermillion border, and elongation and flattening of the white portion of the lip. Rejuvenation of the lips plays a key role in restoring a more youthful appearance. As a result, lip augmentation appeals to a wide spectrum of patients who present with various different aesthetic goals and expectations. Numerous therapeutic options exist for aesthetic lip augmentation, ranging from temporary and permanent injectable fillers to implants and other surgical techniques.

  6. The characteristics of non-respondents and respondents of a mental health survey among evacuees in a disaster: The Fukushima Health Management Survey.

    Science.gov (United States)

    Horikoshi, Naoko; Iwasa, Hajime; Yasumura, Seiji; Maeda, Masaharu

    2017-12-19

    The Fukushima Medical University conducted a mental health care program for evacuees after the Fukushima Daiichi nuclear power plant accident. However, the mental health status of non-respondents has not been considered for surveys using questionnaires. Therefore, the aim of this study was to clarify the characteristics of non-respondents and respondents. The target population of the survey (FY2011-2013) is people living in the nationally designated evacuation zone of Fukushima prefecture. Among these, the participants were 967 people (20 years or older). We examined factors that affected the difference between the groups of participants (i.e., non-respondents and respondents) using multivariate logistic regression analysis. Employment was higher in non-respondents (p=0.022) and they were also more socially isolated (p=0.047) when compared to respondents; non-respondents had a higher proportional risk of psychological distress compared to respondents (pemployment status (OR=1.99, 95% confidence interval [CI]:1.12-3.51) and psychological distress (OR=2.17, 95% CI:1.01-4.66). We found that non-respondents had a significantly higher proportion of psychological distress compared to the respondents. Although the non-respondents were the high-risk group, it is not possible to grasp the complexity of the situation by simply using questionnaire surveys. Therefore, in the future it is necessary to direct our efforts towards the mental health of non-respondents and respondents alike.

  7. The multifaceted therapeutic potential of benfotiamine.

    Science.gov (United States)

    Balakumar, Pitchai; Rohilla, Ankur; Krishan, Pawan; Solairaj, Ponnu; Thangathirupathi, Arunachalam

    2010-06-01

    Thiamine, known as vitamin B(1), plays an essential role in energy metabolism. Benfotiamine (S-benzoylthiamine O-monophoshate) is a synthetic S-acyl derivative of thiamine. Once absorbed, benfotiamine is dephosphorylated by ecto-alkaline phosphatase to lipid-soluble S-benzoylthiamine. Transketolase is an enzyme that directs the precursors of advanced glycation end products (AGEs) to pentose phosphate pathway. Benfotiamine administration increases the levels of intracellular thiamine diphosphate, a cofactor necessary for the activation transketolase, resulting in the reduction of tissue level of AGEs. The elevated level of AGEs has been implicated in the induction and progression of diabetes-associated complications. Chronic hyperglycemia accelerates the reaction between glucose and proteins leading to the formation of AGEs, which form irreversible cross-links with many macromolecules such as collagen. In diabetes, AGEs accumulate in tissues at an accelerated rate. Experimental studies have elucidated that binding of AGEs to their specific receptors (RAGE) activates mainly monocytes and endothelial cells and consequently induces various inflammatory events. Moreover, AGEs exaggerate the status of oxidative stress in diabetes that may additionally contribute to functional changes in vascular tone control observed in diabetes. The anti-AGE property of benfotiamine certainly makes it effective for the treatment of diabetic neuropathy, nephropathy and retinopathy. Interestingly, few recent studies demonstrated additional non-AGE-dependent pharmacological actions of benfotiamine. The present review critically analyzed the multifaceted therapeutic potential of benfotiamine. (c) 2010 Elsevier Ltd. All rights reserved.

  8. Role of therapeutic fasting along with other Naturopathy and Yoga Modalities in addressing acne vulgaris – A single case report

    Directory of Open Access Journals (Sweden)

    Pushparaj Ameya

    2017-09-01

    Full Text Available A 23 year old female diagnosed as acne vulgaris underwent Therapeutic fasting (TF and other naturopathy and yoga modalities for 30 days. She presented with eruptions all over her face and the face was edematous. She was given a modified diet for initial 3 days which included fresh fruits and juices along with cooked vegetables and sorghum roti. Additionally Naturopathy treatments like Swedish massage, steam bath, warm water enema and hip bath were given along with some yogic postures, pranayam and kriyas (Cleansing procedures. The patient responded well to the therapeutic fasting. By the end of 30 days there were no eruptions in her face and her skin also was clear. All the treatments were based on the principle of naturopathic medicine that the body has its own power to heal itself. TF has shown to attenuate inflammatory status of the body by suppressing pro-inflammatory cytokine expression and decreasing body fat and circulating levels of leukocytes. This is the first study to report the non pharmacological approach towards treating acne. To conclude fasting along with other naturopathy and yoga modalities has shown noteworthy changes in reducing the inflammatory response in acne vulgaris. However large scale studies are warranted.

  9. Identification of MALT1 as both a prognostic factor and a potential therapeutic target of regorafenib in cholangiocarcinoma patients.

    Science.gov (United States)

    Yeh, Chun-Nan; Chang, Yu-Chan; Su, Yeu; Shin-Shian Hsu, Dennis; Cheng, Chi-Tung; Wu, Ren-Chin; Chung, Yi-Hsiu; Chiang, Kun-Chun; Yeh, Ta-Sen; Lu, Meng-Lun; Liu, Chun-Yu; Mu-Hsin Chang, Peter; Chen, Ming-Han; Huang, Chi-Ying F; Hsiao, Michael; Chen, Ming-Huang

    2017-12-26

    Intrahepatic cholangiocarcinoma (CCA) is an aggressive cancer that lacks an effective targeted therapy. Here, we assessed the therapeutic efficacy of regorafenib in CCA, as well as elucidated its underlying mechanism. We first demonstrated that regorafenib not only inhibited growth but also induced apoptosis in human CCA cells. Subsequently, we used in silico approaches to identify MALT1 (Mucosa-associated lymphoid tissue protein 1), which plays an important role in activating NF-κB, as a potential target of regorafenib. Overexpression of Elk-1, but not Ets-1, in HuCCT1 cells markedly reduced their sensitivity to regorafenib, which might be attributed to a significant increase in MALT1 levels. Our results further demonstrated that this drug drastically inhibited MALT1 expression by suppressing the Raf/Erk/Elk-1 pathway. The efficacy of regorafenib in decreasing in vivo CCA growth was confirmed in animal models. Regorafenib efficacy was observed in two MALT1-positive CCA patients who failed to respond to several other lines of therapy. Finally, MALT1 was also identified as an independent poor prognostic factor for patients with intrahepatic CCA. In conclusion, our study identified MALT1 to be a downstream mediator of the Raf/Erk/Elk-1 pathway and suggested that MALT1 may be a new therapeutic target for successful treatment of CCA by regorafenib.

  10. Randomised study versus control group of customised therapeutic education for patients in follow-up for rheumatoid arthritis.

    Science.gov (United States)

    Pot-Vaucel, Marianne; Aubert, Marie-Pierre; Guillot, Pascale; Glémarec, Joëlle; Berthelot, Jean-Marie; Le Goff, Benoit; Maugars, Yves

    2016-03-01

    We have evaluated customized objectives, predefined during a therapeutic education session for rheumatoid arthritis (RA). Fifty-four RA patients were randomised into patient therapeutic education (PTE) group versus waiting list (WL). The final comparative evaluation involved solving 3 predefined problems. Fifty-four were evaluated after 6 months. The main criterion was defined for all three of the chosen themes at 76.9% in the PTE group and 42.4% in the WL group. Among the other positively evaluated criteria were: less corticotherapy, more occupational therapy, more demand for social aid, more physical activity, knowledge of the recognition of an RA attack and how to cope with it. On the other hand, knowledge of the treatments did not differ between the 2 groups nor did the RAPID scores, fatigue, stiffness, depression, compliance, number of consultations and hospitalisations. Patient satisfaction was excellent (between 85.3 and 93.9%). This study is a good illustration of the position occupied and value of PTE in solving the problems specific to each RA case, the resulting high level of patient satisfaction and its independently complementary aspects relative to the purely medical treatment of RA. Customized PTE could better respond to specific patients problems in RA. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  11. Value correlates of the motivations to respond without prejudice / Correlatos valorativos das motivações para responder sem preconceito

    Directory of Open Access Journals (Sweden)

    Valdiney V. Gouveia

    2006-01-01

    Full Text Available The current study aimed at establishing to what extent both internal and external motivations to respond without prejudice towards Blacks would correlate with human values. As many as 308 subjects from João Pessoa – comprising high school and university students as well as individuals from the community as a whole – were considered. The Basic Values Questionnaire, the Impression Management Scale and the Scale of Internal and External Motivation to Respond without Prejudice, and also demographic questions were applied. Results showed that the internal motivation was positively correlated with the suprapersonal values, specifically maturity, beauty and knowledge. Moreover, the external motivation did correlate, predominantly, with the achievement values, specifically those of prestige and privacy. Such results are in line with those found in the literature, which indicate the opposition between egalitarianism (suprapersonal vs. protestant ethic (achievement values so as to explicate the prejudice and the motivations that would prevent such attitude.

  12. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review

    Directory of Open Access Journals (Sweden)

    Kornhaber R

    2016-10-01

    Full Text Available Rachel Kornhaber,1 Kenneth Walsh,1,2 Jed Duff,1,3 Kim Walker1,3 1School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW, 2Tasmanian Health Services – Southern Region, Hobart, TAS, 3St Vincent’s Private Hospital, Sydney, NSW, Australia Abstract: Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician–patient experiences. Therapeutic interpersonal relationships have the capacity to transform and enrich the patients’ experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships. Keywords: health, acute care, therapeutic interpersonal relationships, relational care integrative review 

  13. Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada.

    Science.gov (United States)

    Hamilton, Hayley A; Brands, Bruna; Ialomiteanu, Anca R; Mann, Robert E

    2017-09-14

    To investigate the prevalence of therapeutic cannabis use within a general population sample of adults and to describe various characteristics associated with use. Data were derived from the 2013 and 2014 CAMH Monitor Survey of adults in Ontario, Canada. This repeated cross-sectional survey employed a regionally stratified design and utilized computer-assisted telephone interviewing. Analyses were based on 401 respondents who reported using cannabis. The data indicated that 28.8% of those who used cannabis in the past year self-reported using cannabis for therapeutic purposes. Of therapeutic users, 15.2% reported having medical approval to use cannabis for therapeutic purposes. Cannabis use for therapeutic purposes was associated with more frequent use of cannabis, a moderate to high risk of problematic cannabis use, and a greater likelihood of using prescription opioids for medical purposes. There was little difference in cannabis use for therapeutic purposes according to sex, age, and marital status after adjusting for opioid use and problematic cannabis use. Findings suggest some potential negative consequences of cannabis use for therapeutic purposes; however, further research is needed to better understand the range and patterns of use and their corresponding vulnerabilities.

  14. [Opinion of professionals in an intensive care unit on the limitations of therapeutic effort].

    Science.gov (United States)

    González-Castro, A; Azcune, O; Peñasco, Y; Rodríguez, J C; Domínguez, M J; Rojas, R

    2016-01-01

    To determine the opinion held by professionals in an intensive care unit on the limitation of therapeutic effort process at the end-of-life (LTE). To collect this information, and then use it to improve the basic aspects that the LTE have on the quality of care by intensive care unit staff. A prospective descriptive study was carried out in the Intensive Care Unit of a third level public university hospital. A questionnaire was prepared that included questions on their demographic profile and others to provide an ethical valuation profile, as well as to find out the knowledge and information that the professional had on the LTE. Descriptive study of the sample and comparative statistics were performed using the chi-squared statistical test. A total of 65 valid questionnaires were obtained from a convenience sample of 70 professionals. Almost all of them (98%) were in favour of the limitation of therapeutic effort. The LTE was considered as some kind of euthanasia (active or passive) in up to 28% of the replies, valuations by professional categories is shown in. More than three-quarters (77%) had the belief that not to start treatment was not the same as withdrawing an already established treatment. Just over half (52%) of the respondents believe the value that should have more weight when considering LET would be the prognosis of the current illness of the patient, and 46% the future quality of life of the patient. The economic cost of treatment to be applied was not considered in any case. The LTE is approved by the majority of professionals in our Intensive Care Unit. Although a non-negligible percentage understood it as a form of euthanasia. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Applications of inorganic nanoparticles as therapeutic agents

    International Nuclear Information System (INIS)

    Kim, Taeho; Hyeon, Taeghwan

    2014-01-01

    During the last decade, various functional nanostructured materials with interesting optical, magnetic, mechanical and chemical properties have been extensively applied to biomedical areas including imaging, diagnosis and therapy. In therapeutics, most research has focused on the application of nanoparticles as potential delivery vehicles for drugs and genes, because nanoparticles in the size range of 2–100 nm can interact with biological systems at the molecular level, and allow targeted delivery and passage through biological barriers. Recent investigations have even revealed that several kinds of nanomaterials are intrinsically therapeutic. Not only can they passively interact with cells, but they can also actively mediate molecular processes to regulate cell functions. This can be seen in the treatment of cancer via anti-angiogenic mechanisms as well as the treatment of neurodegenerative diseases by effectively controlling oxidative stress. This review will present recent applications of inorganic nanoparticles as therapeutic agents in the treatment of disease. (topical review)

  16. Peptide chemistry toolbox - Transforming natural peptides into peptide therapeutics.

    Science.gov (United States)

    Erak, Miloš; Bellmann-Sickert, Kathrin; Els-Heindl, Sylvia; Beck-Sickinger, Annette G

    2018-06-01

    The development of solid phase peptide synthesis has released tremendous opportunities for using synthetic peptides in medicinal applications. In the last decades, peptide therapeutics became an emerging market in pharmaceutical industry. The need for synthetic strategies in order to improve peptidic properties, such as longer half-life, higher bioavailability, increased potency and efficiency is accordingly rising. In this mini-review, we present a toolbox of modifications in peptide chemistry for overcoming the main drawbacks during the transition from natural peptides to peptide therapeutics. Modifications at the level of the peptide backbone, amino acid side chains and higher orders of structures are described. Furthermore, we are discussing the future of peptide therapeutics development and their impact on the pharmaceutical market. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. An Approach to Optimise Therapeutic Vancomycin Dosage in a Haemodialysis Population

    LENUS (Irish Health Repository)

    Gunning, H

    2016-10-01

    Haemodialysis patients are at risk of gram-positive bacteraemia and commonly require intravenous vancomycin. Intravenously administered vancomycin is primarily excreted by the kidney and exhibits complex pharmacokinetics in haemodialysis patients; achieving therapeutic levels can be challenging. An audit in our unit showed current practises of vancomycin administration resulted in a high proportion of sub-therapeutic levels. A new protocol was developed with fixed weight-based loading and subsequent dosing guided by pre-dialysis levels, target levels were 10-20mg\\/L. Its effectiveness was prospectively evaluated between 24th September 2012, and 8th February 2013. During this period 25 patients commenced vancomycin, 15 were included. In total, 112 vancomycin levels were taken, 94 (84%) were therapeutic, this was a significant improvement compared to previous practise (odds ratio 5.4, CI 3.1-9.4, p < 0.0001). In conclusion, our study shows this protocol can consistently and reliably achieve therapeutic vancomycin levels

  18. Called to respond: The potential of unveiling hiddens

    Directory of Open Access Journals (Sweden)

    Alison L Black

    2014-12-01

    Full Text Available Interested in exploring how personal stories and aesthetic modes of representing experiences can nudge open academic and educational spaces, this article/collection of particles seeks to document our encounters of being affected and called to respond to things the other has written and represented. As a way of engaging with questions about what research and research data might be and become, our attention has been drawn to stories and images from our lives that we have not shaken off – and to how, as we have opened these to the other, making once private moments public, our hiddens have morphed tenderly into a shared knowing and being. As we have acted on the call we have felt to respond we have found ourselves entering spaces of collaboration, communion, contemplation, and conversation – spaces illuminated by what we have not been able to – and cannot – set aside. Using visual and poetic materials we explore heartfelt and heartbroken aspects of our educational worlds and lives, to be present with each other and our (reemerging personal and professional meanings. We see the shared body (of work, of writing, of image that develops from the taking of brave steps and the risky slipping off of academic masks and language, as a manifestation of the trusted and nurturing spaces that can be generated through collaborative opportunities to gather together. These steps towards unveiling hiddens are producing in us and of us a friendship, fluency, and fluidity as we write new ways of becoming. In turn, we hope the uncovering and revealing of our dialogue in the public gathering of this journal might supports readers’ telling of their own life stories through what calls them to respond.

  19. How Do Business Interest Groups Respond to Political Challenges?

    DEFF Research Database (Denmark)

    Paster, Thomas

    2018-01-01

    adaptation. The paper illustrates these two response strategies with four episodes of political conflict in the political-economic history of Germany: (i) the adoption of social insurance under Bismarck, (ii) the adoption of unemployment insurance in the 1920s, (iii) the adoption of board...... their interests, using four episodes of political conflict in Germany. The paper elaborates a model of response strategies and their likely impact on political outcomes. The model suggests that business interest groups can respond to political challenges in two ways: by seeking confrontation or by pursuing...

  20. The growing importance of mental health: are medical curricula responding?

    Science.gov (United States)

    Azhar, M Z

    2002-12-01

    Mental health is becoming an important issue. Several local and international studies have proven that the incidence of mental illness is on the rise. Doctors have also been able to make more accurate diagnoses and treat mental disorders more reliably with the aid of recent research and newer drugs. As such it is necessary for the medical curricula to respond to this shift. Medical students must now be exposed to new psychiatric disorders and ways of managing them. The time spent in psychiatry and the mode of teaching must also be revised and modified to the current needs of patients.

  1. How To Respond to Catastrophic Events in Supply Chain Management

    OpenAIRE

    Choi, Sooyeon

    2011-01-01

    In March of 2011, a massive earthquake and tsunami struck into Japan. Soon after this event, Toyota in the UK announced that their production had to been halted caused by disruption on supply chain relationship with Japan. Like this, a catastrophic event disturbs not only domestic situation but also international business. Supply chain is one of the most affected areas and also capable to control on business at the same time when a disaster occurs. In this work, how to respond supply chain sy...

  2. A Hospital-Based Therapeutic Lifestyle Program for Women With Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Hei-Jen Jou

    2010-12-01

    Conclusion: The therapeutic lifestyle program with diet control and regular exercise improves most markers of MetS except for levels of high density lipoprotein cholesterol. Therapeutic lifestyle intervention may be the best way of reducing the risk of cardiovascular disease in women with MetS.

  3. Dual-color bioluminescent sensor proteins for therapeutic drug monitoring of antitumor antibodies

    NARCIS (Netherlands)

    van Rosmalen, M.; Ni, Y.; Vervoort, D.F.M.; Arts, R.; Ludwig, S.K.J.; Merkx, M.

    2018-01-01

    Monitoring the levels of therapeutic antibodies in individual patients would allow patient-specific dose optimization, with the potential for major therapeutic and financial benefits. Our group recently developed a new platform of bioluminescent sensor proteins (LUMABS; LUMinescent AntiBody Sensor)

  4. Manual for first responders to a radiological emergency. Emergency preparedness and response. Publication date: June 2007

    International Nuclear Information System (INIS)

    2007-08-01

    Under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), one function of the IAEA is to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and results of research relating to response to nuclear or radiological emergencies. As stated in IAEA Safety Standards Series No. GS-R-2 'Preparedness and Response for a Nuclear or Radiological Emergency', which establishes the requirements for an adequate level of preparedness for and response to a nuclear or radiological emergency in any State, 'first responders shall take all practicable and appropriate actions to minimize the consequences of a nuclear or radiological emergency'. The IAEA General Conference, in resolution GC(49)/RES/9, continues to encourage Member States 'to adopt the relevant Agency standards, procedures and practical tools' and underlines 'the need for first responders to have appropriate training for dealing with ionizing radiation during nuclear and radiological emergencies'. This publication is intended to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. Its aim is to provide practical guidance for those who will respond during the first few hours to a radiological emergency (referred to here as 'first responders') and for national officials who would support this early response. It provides guidance in the form of action guides, instructions, and supporting data that can be easily applied by a State to build a basic capability to respond to a radiological emergency. This guidance should be adapted to fit the user State's organizational arrangements, language, terminology, concept of operation and capabilities. This report, published as part of the IAEA Emergency Preparedness and Response Series, replaces and builds on IAEA-TECDOC-1162 in the area of early response and first responders' actions. It takes account of the

  5. Manual for first responders to a radiological emergency. Emergency preparedness and response. Publication date: October 2006

    International Nuclear Information System (INIS)

    2006-10-01

    Under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), one function of the IAEA is to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and results of research relating to response to nuclear or radiological emergencies. As stated in IAEA Safety Standards Series No. GS-R-2 'Preparedness and Response for a Nuclear or Radiological Emergency', which establishes the requirements for an adequate level of preparedness for and response to a nuclear or radiological emergency in any State, 'first responders shall take all practicable and appropriate actions to minimize the consequences of a nuclear or radiological emergency'. The IAEA General Conference, in resolution GC(49)/RES/9, continues to encourage Member States 'to adopt the relevant Agency standards, procedures and practical tools' and underlines 'the need for first responders to have appropriate training for dealing with ionizing radiation during nuclear and radiological emergencies'. This publication is intended to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. Its aim is to provide practical guidance for those who will respond during the first few hours to a radiological emergency (referred to here as 'first responders') and for national officials who would support this early response. It provides guidance in the form of action guides, instructions, and supporting data that can be easily applied by a State to build a basic capability to respond to a radiological emergency. This guidance should be adapted to fit the user State's organizational arrangements, language, terminology, concept of operation and capabilities. This report, published as part of the IAEA Emergency Preparedness and Response Series, replaces and builds on IAEA-TECDOC-1162 in the area of early response and first responders' actions. It takes account of the

  6. Manual for first responders to a radiological emergency. Emergency preparedness and response

    International Nuclear Information System (INIS)

    2008-01-01

    Under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), one function of the IAEA is to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and results of research relating to response to nuclear or radiological emergencies. As stated in IAEA Safety Standards Series No. GS-R-2 'Preparedness and Response for a Nuclear or Radiological Emergency', which establishes the requirements for an adequate level of preparedness for and response to a nuclear or radiological emergency in any State, 'first responders shall take all practicable and appropriate actions to minimize the consequences of a nuclear or radiological emergency'. The IAEA General Conference, in resolution GC(49)/RES/9, continues to encourage Member States 'to adopt the relevant Agency standards, procedures and practical tools' and underlines 'the need for first responders to have appropriate training for dealing with ionizing radiation during nuclear and radiological emergencies'. This publication is intended to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. Its aim is to provide practical guidance for those who will respond during the first few hours to a radiological emergency (referred to here as 'first responders') and for national officials who would support this early response. It provides guidance in the form of action guides, instructions, and supporting data that can be easily applied by a State to build a basic capability to respond to a radiological emergency. This guidance should be adapted to fit the user State's organizational arrangements, language, terminology, concept of operation and capabilities. This report, published as part of the IAEA Emergency Preparedness and Response Series, replaces and builds on IAEA-TECDOC-1162 in the area of early response and first responders' actions. It takes account of the

  7. Developing a programme theory to explain how primary health care teams learn to respond to intimate partner violence: a realist case-study.

    Science.gov (United States)

    Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel; Vives-Cases, Carmen; Marchal, Bruno

    2015-06-09

    Despite the progress made on policies and programmes to strengthen primary health care teams' response to Intimate Partner Violence, the literature shows that encounters between women exposed to IPV and health-care providers are not always satisfactory, and a number of barriers that prevent individual health-care providers from responding to IPV have been identified. We carried out a realist case study, for which we developed and tested a programme theory that seeks to explain how, why and under which circumstances a primary health care team in Spain learned to respond to IPV. A realist case study design was chosen to allow for an in-depth exploration of the linkages between context, intervention, mechanisms and outcomes as they happen in their natural setting. The first author collected data at the primary health care center La Virgen (pseudonym) through the review of documents, observation and interviews with health systems' managers, team members, women patients, and members of external services. The quality of the IPV case management was assessed with the PREMIS tool. This study found that the health care team at La Virgen has managed 1) to engage a number of staff members in actively responding to IPV, 2) to establish good coordination, mutual support and continuous learning processes related to IPV, 3) to establish adequate internal referrals within La Virgen, and 4) to establish good coordination and referral systems with other services. Team and individual level factors have triggered the capacity and interest in creating spaces for team leaning, team work and therapeutic responses to IPV in La Virgen, although individual motivation strongly affected this mechanism. Regional interventions did not trigger individual and/ or team responses but legitimated the workings of motivated professionals. The primary health care team of La Virgen is involved in a continuous learning process, even as participation in the process varies between professionals. This

  8. Translational nanomedicine--through the therapeutic window.

    Science.gov (United States)

    Pierce, Robin L

    2015-01-01

    Translational nanomedicine occurs only through the successful integration of multiple inputs and iterative modifications. The therapeutic window plays a pivotal role in the trajectory of translational nanomedicine. Often defined in terms of the range of dosage for safe and effective therapeutic effect, a second definition of the therapeutic window refers to the often narrow temporal window in which a therapeutic effect can be obtained. Expanding the second definition to explicitly include the spatial dimension, this article explores aspects of the therapeutic spaces created by nanomedicine that shift the traditional dimensions of symptom, sign and pathology. This article analyzes three aspects of the therapeutic window in nanomedicine - temporal, spatial and manner of construction and their impact on the dimensions of modern medicine.

  9. Bone morphogenetic protein-15 in follicle fluid combined with age may differentiate between successful and unsuccessful poor ovarian responders

    Directory of Open Access Journals (Sweden)

    Wu Yan-Ting

    2012-12-01

    Full Text Available Abstract Background The counselling of poor ovarian responders about the probability of pregnancy remains a puzzle for gynaecologists. The aim of this study was to optimise the management of poor responders by investigating the role of the oocyte-derived factor bone morphogenetic protein-15 (BMP-15 combined with chronological age in the prediction of the outcome of in-vitro fertilisation-embryo transfer (IVF-ET in poor responders. Methods A retrospective study conducted in a university hospital. A total of 207 poor ovarian responders who reached the ovum pick-up stage undergoing IVF/intracytoplasmic sperm injection (ICSI with three or fewer follicles no less than 14 mm on the day of oocyte retrieval were recruited from July 1, 2008 to December 31, 2009. Another 215 coinstantaneous cycles with normal responses were selected as controls. The BMP-15 levels in the follicular fluid (FF of the 207 poor responders were analysed by western blot. Based on the FF BMP-15 level and age, poor responders were sub-divided into four groups. The main outcome measures were the FF BMP-15 level, implantation rate, pregnancy rate, and live birth rate. Results The implantation rate (24.2% vs. 15.3%, chemical pregnancy rate (40% vs. 23.7%, clinical pregnancy rate (36.5% vs. 20.4% and live birth rate (29.4% vs. 15.1% in the high BMP-15 group were significantly higher than those in the low BMP-15 group. Furthermore, poor responders aged less than or equal to 35 years with a higher FF BMP-15 level had the best implantation, pregnancy and live birth rates, which were comparable with those of normal responders. Conclusions Our study suggests a potential role of BMP-15 in the prediction of the IVF outcome. A high FF BMP-15 combined with an age less than or equal to 35 years may be used as a potential indicator for repeating IVF cycles in poor ovarian responders.

  10. Reasons anglers did not respond to an internet survey and evaluation of data quality

    Science.gov (United States)

    Gigliotti, Larry M.; Henderson, Kjetil R.

    2015-01-01

    Natural resource management agencies have traditionally used statewide mail surveys to gather information from anglers, but cost savings and faster returns occur using the internet. This study examined mail or internet fishery survey return rates and associated data by license type of South Dakota resident anglers. Junior anglers (ages 16-18; Junior Combination license) had the lowest internet and mail survey return rates (20% and 28%, respectively), followed by adult anglers (ages 19-64; Adult Fishing and Adult Combination licenses; 30% and 39%, respectively), and senior anglers (ages 65+; Senior Fishing and Senior Combination licenses; 42% and 66%, respectively). The three age groups were significantly different on three email use characteristics (shared email, frequency of use, and comfort level). The primary reason for not responding to the internet survey was not receiving or noticing the email request, and secondarily, being too busy to respond. Although having a relatively low response rate, data collected by the internet compared to follow-up mail surveys of internet non-respondents were similar.

  11. Effect of risperidone versus haloperidol on emotional responding in schizophrenic patients.

    Science.gov (United States)

    Fakra, E; Khalfa, S; Da Fonseca, D; Besnier, N; Delaveau, P; Azorin, J M; Blin, O

    2008-10-01

    Studies on emotional processing report that schizophrenic patients present a specific pattern of emotional responding that usually includes deficits in emotional expressiveness, increased feelings of unpleasant emotion but decreased feelings of pleasant emotion, and increased physiological reactivity. However, studies have rarely controlled the nature of antipsychotic medication. Yet, the influence of these drugs on emotional response is uncertain and could vary depending on their pharmacological profile. This prospective and randomized study aimed to compare the effects of an atypical antipsychotic, risperidone, to a typical one, haloperidol, on patients' emotional responding during an emotional induction task. Twenty-five schizophrenic patients underwent two emotional and clinical evaluations: one before treatment initiation and a second 4 weeks after. Emotional states of fear, sadness, anger, joy, and disgust were induced, as well as a neutral baseline state. Video recordings of patients during the induction task allowed for assessment of emotional expressiveness. Self-reports and measures of skin conductance and heart rate were performed to determine both subjective and physiological reactions to emotional experience. Compared to haloperidol, risperidone did not reduce patients' facial expressiveness, decreased physiological reactivity, and decreased experience of unpleasant emotion but maintained experience of pleasant emotion. Emotional expressiveness was negatively correlated to parkisonism. Our preliminary results suggest that atypical antipsychotics allow for better-adapted patterns of emotional responding than typical ones do. We suggest that this effect is due to reduced striatal D2 blockade, therefore, attenuating akinesia, coupled with increased 5HT and DA levels in prefrontal cortex, which improves emotional regulation.

  12. A nationwide pharmacy chain responds to the opioid epidemic.

    Science.gov (United States)

    Shafer, Emily; Bergeron, Nyahne; Smith-Ray, Renae; Robson, Chester; O'Koren, Rachel

    To describe the 3-pronged approach taken by a large national retail pharmacy chain to address the opioid epidemic and associated overdoses. Large national retail pharmacy chain with more than 8200 stores in 50 states. Eight million customer interactions daily through in-store and digital settings. This is a company with a long history of responding to public health crises. Initiated 3 programs to respond to the opioid crisis: 1) provide safe medication disposal kiosks; 2) expand national access to naloxone; and 3) provide education on the risk and avoidance of opioid overdose. Used the RE-AIM framework to evaluate and enhance the quality, speed, and public health impact of the interventions. Not applicable. Early results are safe medication disposal kiosks in more than 43 states, naloxone-dispensing program in 33 states, and patient and support system education using the Opioid Overdose Toolkit from the Substance Abuse and Mental Health Services Administration. The availability of safe drug-disposal kiosks, naloxone dispensing at pharmacies, and patient education are key prevention initiatives to address the opioid epidemic and reduce the increasing national burden of opioid overdose. Early results are quantitatively and qualitatively promising. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  13. MINER - A Mobile Imager of Neutrons for Emergency Responders

    Energy Technology Data Exchange (ETDEWEB)

    Goldsmith, John E. M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brennan, James S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gerling, Mark D [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kiff, Scott D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mascarenhas, Nicholas [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Van De Vreugde, James L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-10-01

    We have developed a mobile fast neutron imaging platform to enhance the capabilities of emergency responders in the localization and characterization of special nuclear material. This mobile imager of neutrons for emergency responders (MINER) is based on the Neutron Scatter Camera, a large segmented imaging system that was optimized for large-area search applications. Due to the reduced size and power requirements of a man-portable system, MINER has been engineered to fit a much smaller form factor, and to be operated from either a battery or AC power. We chose a design that enabled omnidirectional (4π) imaging, with only a ~twofold decrease in sensitivity compared to the much larger neutron scatter cameras. The system was designed to optimize its performance for neutron imaging and spectroscopy, but it does also function as a Compton camera for gamma imaging. This document outlines the project activities, broadly characterized as system development, laboratory measurements, and deployments, and presents sample results in these areas. Additional information can be found in the documents that reside in WebPMIS.

  14. A Simple Evacuation Modeling and Simulation Tool for First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Koch, Daniel B [ORNL; Payne, Patricia W [ORNL

    2015-01-01

    Although modeling and simulation of mass evacuations during a natural or man-made disaster is an on-going and vigorous area of study, tool adoption by front-line first responders is uneven. Some of the factors that account for this situation include cost and complexity of the software. For several years, Oak Ridge National Laboratory has been actively developing the free Incident Management Preparedness and Coordination Toolkit (IMPACT) to address these issues. One of the components of IMPACT is a multi-agent simulation module for area-based and path-based evacuations. The user interface is designed so that anyone familiar with typical computer drawing tools can quickly author a geospatially-correct evacuation visualization suitable for table-top exercises. Since IMPACT is designed for use in the field where network communications may not be available, quick on-site evacuation alternatives can be evaluated to keep pace with a fluid threat situation. Realism is enhanced by incorporating collision avoidance into the simulation. Statistics are gathered as the simulation unfolds, including most importantly time-to-evacuate, to help first responders choose the best course of action.

  15. Strategies in responding to a hostile takeover bid

    International Nuclear Information System (INIS)

    Shaw, R.

    1997-01-01

    This paper examines the steps to be taken by a corporation and its board in order to be properly prepared before a hostile takeover bid is made. The procedures and steps to be followed in responding to a bid with a view to maximizing value for shareholders are also outlined. Reasons why a company may become target for a hostile takeover bid are reviewed, followed by a more detailed examination of the responsibilities of a board in responding to a takeover bid. These responsibilities include the adoption of a shareholders' rights plan ('poison pill'), review of executive employment contracts, making sure that a corporate indemnification agreement and directors' and officers' liability insurance plan are in place, implementation of structural deterrents, investor communication plans, preparing the 'black book', creating or updating the list of 'white knights', designating a data room, entering into confidentiality agreements with white knights, preparation of a response timetable, review of recent takeover bids, strategies for dealing with hostile bidders, strategies for enticing one or more a white knights to enter the bidding. Sample copy of a confidentiality agreement is contained in Schedule A. A list of break-up fees in recent Canadian mergers and acquisitions transactions is provided in Schedule B. 24 refs

  16. Adhesion and migration of cells responding to microtopography.

    Science.gov (United States)

    Estévez, Maruxa; Martínez, Elena; Yarwood, Stephen J; Dalby, Matthew J; Samitier, Josep

    2015-05-01

    It is known that cells respond strongly to microtopography. However, cellular mechanisms of response are unclear. Here, we study wild-type fibroblasts responding to 25 µm(2) posts and compare their response to that of FAK(-/-) fibroblasts and fibroblasts with PMA treatment to stimulate protein kinase C (PKC) and the small g-protein Rac. FAK knockout cells modulated adhesion number and size in a similar way to cells on topography; that is, they used more, smaller adhesions, but migration was almost completely stalled demonstrating the importance of FAK signaling in contact guidance and adhesion turnover. Little similarity, however, was observed to PKC stimulated cells and cells on the topography. Interestingly, with PKC stimulation the cell nuclei became highly deformable bringing focus on these surfaces to the study of metastasis. Surfaces that aid the study of cellular migration are important in developing understanding of mechanisms of wound healing and repair in aligned tissues such as ligament and tendon. © 2014 Wiley Periodicals, Inc.

  17. Enabling complex genetic circuits to respond to extrinsic environmental signals.

    Science.gov (United States)

    Hoynes-O'Connor, Allison; Shopera, Tatenda; Hinman, Kristina; Creamer, John Philip; Moon, Tae Seok

    2017-07-01

    Genetic circuits have the potential to improve a broad range of metabolic engineering processes and address a variety of medical and environmental challenges. However, in order to engineer genetic circuits that can meet the needs of these real-world applications, genetic sensors that respond to relevant extrinsic and intrinsic signals must be implemented in complex genetic circuits. In this work, we construct the first AND and NAND gates that respond to temperature and pH, two signals that have relevance in a variety of real-world applications. A previously identified pH-responsive promoter and a temperature-responsive promoter were extracted from the E. coli genome, characterized, and modified to suit the needs of the genetic circuits. These promoters were combined with components of the type III secretion system in Salmonella typhimurium and used to construct a set of AND gates with up to 23-fold change. Next, an antisense RNA was integrated into the circuit architecture to invert the logic of the AND gate and generate a set of NAND gates with up to 1168-fold change. These circuits provide the first demonstration of complex pH- and temperature-responsive genetic circuits, and lay the groundwork for the use of similar circuits in real-world applications. Biotechnol. Bioeng. 2017;114: 1626-1631. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Hazardous materials responder training in the new millennium

    Energy Technology Data Exchange (ETDEWEB)

    Turpin, R.D.; Betsinger, G.B. [U.S. Environmental Protection Agency, Edison, NJ (United States). Environmental Response Team; Merchant, S. [Environmental Tectonics Corp., Orlando, FL (United States)

    2001-07-01

    The Environmental Response Team (ERT) of the U.S. Environmental Protection Agency was created to provide on-site professional expertise as well as health and safety guidance to Federal on-scene coordinators during accidental oil and chemical releases. ERT provides practical technical solutions to response activities based on theory as well as actual experience. Its creation in 1978 fulfilled the requirements of the U.S. National Contingency Plan. Members of the team have developed a 40-hour Hazardous Waste Responders training course and have themselves, attended a hands-on chemical and biological warfare personnel protective clothing course provided by the U.S. Army. The course demonstrated decontamination showers, moon suits, and entry procedures to a contaminated battlefield situation. ERT continues to emphasize the importance of hands-on training and exercises. Various training programs are underway where students can learn real-time monitoring techniques and respond to simulated hazardous waste incidents. They also learn how to assess environmental, public and occupational health and safety information on the Internet. The students also run air plume models and perform wet bench chemistry experiments. With the advent of more powerful computers, the current objective is to continue with these training activities using Instructor Controlled Interactive Computer Training (ICICT).

  19. LH Pretreatment as a Novel Strategy for Poor Responders

    Directory of Open Access Journals (Sweden)

    Anna Pia Ferraretti

    2014-01-01

    Full Text Available Introduction. Poor response to ovarian stimulation is still a major problem in IVF. The study presents a new stimulation protocol evaluated in a suppopulation of very difficult young poor ovarian responders. Material and Methods. The study consists in two sections. The first includes data from a randomized controlled study involving forty-three young patients with a poor ovarian response in at least two previous cycles (intended as cycle cancellation or with ≤3 collected oocytes. Patients were randomized in two groups: group A (control received FSH (400 IU/day, while group B received the new stimulation protocol consisting in a sequential association of 150 IU r-LH for 4 days followed by 400 IU r-FSH/after downregulation with daily GnRh agonist. The second includes data from the overall results in 65 patients treated with the new protocol compared to their previous performance with conventional cycles (historical control. Results. Both in the RCT and in the historical control study, LH pretreatment was able to decrease the cancellation rate, to improve the in vitro performance, and to significantly increase the live birth rates. Conclusions. LH pretreatment improved oocyte quantity and quality in young repeated poor responders selected in accordance with the Bologna criteria.

  20. Therapeutic cloning in individual parkinsonian mice

    Science.gov (United States)

    Tabar, Viviane; Tomishima, Mark; Panagiotakos, Georgia; Wakayama, Sayaka; Menon, Jayanthi; Chan, Bill; Mizutani, Eiji; Al-Shamy, George; Ohta, Hiroshi; Wakayama, Teruhiko; Studer, Lorenz

    2009-01-01

    Cell transplantation with embryonic stem (ES) cell progeny requires immunological compatibility with host tissue. ‘Therapeutic cloning’ is a strategy to overcome this limitation by generating nuclear transfer (nt)ES cells that are genetically matched to an individual. Here we establish the feasibility of treating individual mice via therapeutic cloning. Derivation of 187 ntES cell lines from 24 parkinsonian mice, dopaminergic differentiation, and transplantation into individually matched host mice showed therapeutic efficacy and lack of immunological response. PMID:18376409

  1. Therapeutic Sleep for Traumatic Brain Injury

    Science.gov (United States)

    2017-06-01

    AWARD NUMBER: W81XWH-16-1-0166 TITLE: Therapeutic Sleep for Traumatic Brain Injury PRINCIPAL INVESTIGATOR: Ravi Allada CONTRACTING...1. REPORT DATE June 2017 2. REPORT TYPE Annual 3. DATES COVERED 1June2016 - 31May2017 4. TITLE AND SUBTITLE Therapeutic Sleep for Traumatic Brain ...proposal will test the hypothesis that correcting sleep disorders can have a therapeutic effect onTraumatic Brain Injury (TBI) The majority of TBI

  2. Therapeutic potential of curcumin in gastrointestinal diseases

    OpenAIRE

    Rajasekaran, Sigrid A

    2011-01-01

    Curcumin, also known as diferuloylmethane, is derived from the plant Curcuma longa and is the active ingredient of the spice turmeric. The therapeutic activities of curcumin for a wide variety of diseases such as diabetes, allergies, arthritis and other chronic and inflammatory diseases have been known for a long time. More recently, curcumin’s therapeutic potential for preventing and treating various cancers is being recognized. As curcumin’s therapeutic promise is being explored more system...

  3. Therapeutic Value of Medical Marijuana in New Jersey Patients: A Community Partnership Research Endeavor.

    Science.gov (United States)

    Crowell, Tara L

    2017-01-01

    The Public Health Program at Stockton University partnered with the Compassionate Care Foundation to ascertain the impact of medical marijuana on patients in New Jersey. Patients volunteered to complete a survey once a month for 8 months. The survey explored their use, form, and strain of medical marijuana and its influence on pain and 12 other physical and mental health variables. Also, an increase or decrease in other medication taken and any unexpected outcomes were recorded. From a total of 955 patients, patients responding to the surveys varied from 501 for visit 1, 290 for visit 2, to 179 for visit 3. Results provide insight into the diagnoses for which patients used medical marijuana. Results indicate increased mood, general overall condition, and energy as the highest consequences; level of pain in the middle range; and most frequent usage as 3 to 4 times a day. Repeated measures done after visit 2 showed eight statistically significant differences for patients after using medical marijuana: an increase in general quality of life, mobility, and mood, with a decrease in inflammation, intraocular pressure, spasms, seizures, and pain. Results after visit 3 indicated seven significant differences compared to visit 1: decreased seizures, intraocular pressure, spasms, nausea, and pain, along with increased energy and mobility. No differences were found by patient diagnosis or age, but sex-related differences occurred in inflammation, mood, and energy. Results support positive therapeutic benefits of medical marijuana, and despite methodological limitations, our study contributes to the growing body of literature.

  4. Intersections of pathways involving biotin and iron relative to therapeutic mechanisms for progressive multiple sclerosis.

    Science.gov (United States)

    Heidker, Rebecca M; Emerson, Mitchell R; LeVine, Steven M

    2016-12-01

    While there are a variety of therapies for relapsing remitting multiple sclerosis (MS), there is a lack of treatments for progressive MS. An early study indicated that high dose biotin therapy has beneficial effects in approximately 12-15% of patients with progressive MS. The mechanisms behind the putative improvements seen with biotin therapy are not well understood, but have been postulated to include: 1) improving mitochondrial function which is impaired in MS, 2) increasing synthesis of lipids and cholesterol to facilitate remyelination, and 3) affecting gene expression. We suggest one reason that a greater percentage of patients with MS didn't respond to biotin therapy is the inaccessibility or lack of other nutrients, such as iron. In addition to biotin, iron (or heme) is necessary for energy production, biosynthesis of cholesterol and lipids, and for some protective mechanisms. Both biotin and iron are required for myelination during development, and by inference, remyelination. However, iron can also play a role in the pathology of MS. Increased deposition of iron can occur in some CNS structures possibly promoting oxidative damage while low iron levels can occur in other areas. Thus, the potential, detrimental effects of iron need to be considered together with the need for iron to support metabolic demands associated with repair and/or protective processes. We propose the optimal utilization of iron may be necessary to maximize the beneficial effects of biotin. This review will examine the interactions between biotin and iron in pathways that may have therapeutic or pathogenic implications for MS.

  5. Molecular biology of castration-resistant prostate cancer: basis for the novel therapeutic targets.

    Science.gov (United States)

    Mellado, Begoña; Marin Aguilera, Mercedes; Pereira, Maria Veronica

    2013-06-01

    Prostate cancer cells express the androgen receptor (AR) and need the presence of androgens to survive. Androgen suppression is the gold standard first-line therapy for metastatic disease. Almost all prostate cancer patients initially respond to hormonal therapy, but most of them gradually develop castration-resistant progression. Recent evidence has shown that progression at the castration resistant prostate cancer (CRPC) stage is often mediated by AR signalling. Importantly, subsequent AR androgen inhibition, by abiraterone acetate or enzalutamide, has shown to improve patients' survival. Several mechanisms that enhance AR signalling in an androgen-depleted environment have been elucidated:(1) AR mutations that allow activation by low androgen levels or by other endogenous steroids, (2) AR amplification and/or overexpression,(3)increased local intracrine synthesis of androgens, (4) changes in AR cofactors and (5) cross-talk with cytokines and growth factors. Today, there are under development a number of novel agents targeting the AR signaling pathway. This article reviews the postulated mechanisms of AR-driven resistance to androgen suppression that have contributed to the development of new hormonal therapeutic strategies in prostate cancer.

  6. Therapeutic targets in liver fibrosis.

    Science.gov (United States)

    Fallowfield, Jonathan A

    2011-05-01

    Detailed analysis of the cellular and molecular mechanisms that mediate liver fibrosis has provided a framework for therapeutic approaches to prevent, slow down, or even reverse fibrosis and cirrhosis. A pivotal event in the development of liver fibrosis is the activation of quiescent hepatic stellate cells (HSCs) to scar-forming myofibroblast-like cells. Consequently, HSCs and the factors that regulate HSC activation, proliferation, and function represent important antifibrotic targets. Drugs currently licensed in the US and Europe for other indications target HSC-related components of the fibrotic cascade. Their deployment in the near future looks likely. Ultimately, treatment strategies for liver fibrosis may vary on an individual basis according to etiology, risk of fibrosis progression, and the prevailing pathogenic milieu, meaning that a multiagent approach could be required. The field continues to develop rapidly and starts to identify exciting potential targets in proof-of-concept preclinical studies. Despite this, no antifibrotics are currently licensed for use in humans. With epidemiological predictions for the future prevalence of viral, obesity-related, and alcohol-related cirrhosis painting an increasingly gloomy picture, and a shortfall in donors for liver transplantation, the clinical urgency for new therapies is high. There is growing interest from stakeholders keen to exploit the market potential for antifibrotics. However, the design of future trials for agents in the developmental pipeline will depend on strategies that enable equal patient stratification, techniques to reliably monitor changes in fibrosis over time, and the definition of clinically meaningful end points.

  7. Therapeutic communities, old and new.

    Science.gov (United States)

    Jones, M

    1979-01-01

    The author attempts to clarify two largely different uses of term, Therapeutic Community (TC). By "old" TC he describes a movement which originated in psychiatry in the United Kingdom at the end of World War II. This was an attempt to establish a democratic system in hospitals where the domination of the doctors was replaced by open communication of content and feeling, information sharing, shared decision making, and problem solving shared as far as possible with all patients and staff. Daily meetings of all patients and staff formed the nucleus of this process. In recent years developments in the areas of systems theory, learning theory, and organization development have contributed to a better understanding of social organization and change. The "new" TCs derive from the more recent developments in the treatment of substance abuse. Central to this movement is Synanon and its many modification which use the clients' peer group to solve their own problems, largely eliminating mental health professionals. Linked with these "new" TCs is the development of Asklepieion units in prisons, which use Synanon "games" along with transactional analysis. An attempt is made to distinguish the methodologies used in TCs, "old" and "new".

  8. Therapeutic drug monitoring of antimicrobials

    Science.gov (United States)

    Roberts, Jason A; Norris, Ross; Paterson, David L; Martin, Jennifer H

    2012-01-01

    Optimizing the prescription of antimicrobials is required to improve clinical outcome from infections and to reduce the development of antimicrobial resistance. One such method to improve antimicrobial dosing in individual patients is through application of therapeutic drug monitoring (TDM). The aim of this manuscript is to review the place of TDM in the dosing of antimicrobial agents, specifically the importance of pharmacokinetics (PK) and pharmacodynamics (PD) to define the antimicrobial exposures necessary for maximizing killing or inhibition of bacterial growth. In this context, there are robust data for some antimicrobials, including the ratio of a PK parameter (e.g. peak concentration) to the minimal inhibitory concentration of the bacteria associated with maximal antimicrobial effect. Blood sampling of an individual patient can then further define the relevant PK parameter value in that patient and, if necessary, antimicrobial dosing can be adjusted to enable achievement of the target PK/PD ratio. To date, the clinical outcome benefits of a systematic TDM programme for antimicrobials have only been demonstrated for aminoglycosides, although the decreasing susceptibility of bacteria to available antimicrobials and the increasing costs of pharmaceuticals, as well as emerging data on pharmacokinetic variability, suggest that benefits are likely. PMID:21831196

  9. Therapeutic embolization in pulmonary hemorrhage

    International Nuclear Information System (INIS)

    Gasparini, D.

    1989-01-01

    The author's purpose was to evaluate the efficacy of therapeutic embolization in pulmonary hemorrage performed with fibrin foam (Spongostan) suspended in sclerosing agents (hidroxy-poliethoxy-dodecano 3%, or natrium morruate 5%), and electrocoagulation (Bitrol, spa) as an alternative to surgery. Twenty patients were embolized: 17 with fibrin foam and sclerosing agents only, 2 with the addition of electrocoagulation and a Gianturco coil respectively, and 1 with electrocoagulation alone. The follow-up ranges from 3 to 42 months (average 22). A patient affected by aspergilloma died a few days after hemoptysis. The patient treated by electrocoagulation alone suffers from periodical hematic expectoration (spitting). The remaining 18 patients have not shown any pathological findings. In 2 cases the arterial occlusion was confirmed by angiography, while in 1 case partial arterial recanalization was observed. Such a finding was due to the vessel dimensions and to hyperflux values. In similar cases, obstruction must be completed different techniques (e.g. Gianturco coils, electrocoagulation, detachable balloons, etc.). The absence of flux resulting from embolization improves electrocoagulation efficiency, which should be considered as the technique of choice. Even though additional trials are needed, the techniques have proven quite reliable and suitable to replace surgery in low-aggression lesions

  10. Insulin resistance in therapeutic clinic

    Directory of Open Access Journals (Sweden)

    Anna V. Pashentseva

    2017-09-01

    Full Text Available Today an obesity became the global epidemic striking both children, and adults and represents one of the most important problems of health care worldwide. Excess accumulation of fatty tissue is resulted by insulin resistance and a compensatory hyperinsulinaemia which are the main predictors of development of a diabetes mellitus type 2. Insulin resistance is also one of key links of a pathogenesis of such diseases as cardiovascular pathology, not-alcoholic fatty liver disease, a polycystic ovary syndrome, gestational diabetes and many others. Depression of sensitivity of tissues to insulin can be physiological reaction of an organism to stress factors and pathological process. The endogenic reasons also take part in development of insulin resistance besides factors of the external environment. The role of genetic predisposition, a subclinical inflammation of fatty tissue, thyroid hormones, adipokines and vitamin D in formation of this pathological process is studied. As insulin resistance takes part in a pathogenesis of various diseases, methods of its diagnostics and correction are of great importance in therapeutic practice. At purpose of treatment it is worth giving preference to the drugs which are positively influencing sensitivity of tissues to insulin.

  11. Therapeutic management of premenstrual syndrome.

    Science.gov (United States)

    Freeman, Ellen W

    2010-12-01

    Premenstrual syndrome (PMS) is among the most common health problems reported by reproductive-age women. Estimates indicate that up to 25% of women may warrant treatment for the distress or impaired functioning associated with the symptoms. The primary focus of this review is the clinical condition of PMS and randomized, placebo-controlled trials of PMS treatment. A literature search in PubMed was conducted for these topics. The most recent reports of specific treatments in controlled treatment studies and all meta-analyses were selected. Reports consistently indicate that serotonergic antidepressants reduce PMS symptoms compared to a placebo. Hormonal treatments are the most widely prescribed medical treatment. Some oral contraceptives and gonadotropin-releasing hormone analogs have demonstrated efficacy, particularly for women who want contraception and PMS symptom control. Numerous non-pharmacologic treatments are utilized, but efficacy is reported only for calcium supplements, Vitex agnus castus (chasteberry), and cognitive-behavioral therapies. Further research to develop new therapies for the 40% of women with PMS who do not respond to the currently available treatments is needed. There are treatments with demonstrated efficacy for PMS, and the majority of women can be helped.

  12. Responding to families with complex needs: a national survey of child and family health nurses.

    Science.gov (United States)

    Rossiter, Chris; Schmied, Virginia; Kemp, Lynn; Fowler, Cathrine; Kruske, Sue; Homer, Caroline S E

    2017-02-01

    The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally. © 2016 John Wiley & Sons Ltd.

  13. Correlatos valorativos das motivações para responder sem preconceito Value correlates of the motivations to respond without prejudice

    Directory of Open Access Journals (Sweden)

    Valdiney V. Gouveia

    2006-01-01

    Full Text Available O presente estudo teve como objetivo principal conhecer em que medida as motivações interna e externa para responder sem preconceito frente aos negros se correlacionam com os valores humanos. Para tanto, contou-se com a participação de 308 pessoas da cidade de João Pessoa (PB, distribuídas entre estudantes do ensino médio e universitário, bem como pessoas da população geral. Estes responderam, além de questões demográficas, o Questionário dos Valores Básicos, Escala de Desejabilidade Social e a Escala de Motivação Interna e Externa para Responder sem Preconceito. De acordo com os resultados, a motivação interna se correlacionou de modo positivo principalmente com os valores suprapessoais, como maturidade, beleza e conhecimento. No caso da motivação externa, esta o fez unicamente com os valores de realização, destacando-se entre eles prestígio e privacidade. Estes resultados são coerentes com aqueles apresentados na literatura, que indicam a oposição entre os valores de igualitarismo (suprapessoais vs. ética protestante (realização para explicar o preconceito e as motivações para não apresentar este tipo de atitude.The current study aimed at establishing to what extent both internal and external motivations to respond without prejudice towards Blacks would correlate with human values. As many as 308 subjects from João Pessoa - comprising high school and university students as well as individuals from the community as a whole - were considered. The Basic Values Questionnaire, the Impression Management Scale and the Scale of Internal and External Motivation to Respond without Prejudice, and also demographic questions were applied. Results showed that the internal motivation was positively correlated with the suprapersonal values, specifically maturity, beauty and knowledge. Moreover, the external motivation did correlate, predominantly, with the achievement values, specifically those of prestige and privacy. Such

  14. How Do Marine Pelagic Species Respond to Climate Change? Theories and Observations

    Science.gov (United States)

    Beaugrand, Grégory; Kirby, Richard R.

    2018-01-01

    In this review, we show how climate affects species, communities, and ecosystems, and why many responses from the species to the biome level originate from the interaction between the species’ ecological niche and changes in the environmental regime in both space and time. We describe a theory that allows us to understand and predict how marine species react to climate-induced changes in ecological conditions, how communities form and are reconfigured, and so how biodiversity is arranged and may respond to climate change. Our study shows that the responses of species to climate change are therefore intelligible—that is, they have a strong deterministic component and can be predicted.

  15. The practical implication of comparing how adults with and without intellectual disability respond to music

    DEFF Research Database (Denmark)

    Hooper, Jeff; Wigram, Tony; Carson, Derek

    2011-01-01

    Previous researchers who compared how people with, and without, an intellectual disability respond to music focused on musical aptitude, but not on arousal. This paper presents the background, methodology, and results of a study that selected fifteen different pieces of music, and compared...... the arousal response of adults with (n = 48), and without (n = 48), an intellectual disability. There was a very strong significant positive correlation (rho = 0.831, N = 15, P ... an intellectual disability, can be used appropriately in an intervention predicated for lowering the arousal levels of the intellectually disabled population....

  16. A prospective study of hepatitis B vaccination - a comparison of responders versus nonresponders.

    LENUS (Irish Health Repository)

    Brown, Catherine M

    2012-02-01

    Herein we present one of the largest single-center reports of the response of hemodialysis patients to a two-vaccine hepatitis B virus vaccination protocol in a European dialysis population. A hepatitis B recombinant DNA vaccine, HBvaxPRO, was given at a dose of 40 microg intramuscularly using a four-dose schedule at 0, 1, 2, and 12 months. Responses were (1) a titer >100 mIU\\/mL = patient immune, (2) a titer level 10-99 mIU\\/mL = give a booster dose and recheck level 2 months later, and (3) 0 <\\/= 10 mIU\\/mL = repeat vaccination course using a different vaccine, Engerix-B. We compared responder groups in terms of titer levels for each vaccine and variables including age, gender, serum albumin, parathyroid hormone (PTH), calcium, phosphate, hemoglobin, years on dialysis, and type of dialysis access. Of the 176 patients who received the first vaccine course, 71 patients achieved immunity, that is, 40% uptake for the first vaccine. Of the 105 who failed, 72 received the second vaccine with 46 responders, that is, 64% uptake for the second vaccine. Overall, 143 of the 176 patients who entered the vaccination program completed the protocol with 117 achieving immunity, representing an 82% success rate. The only variable overall to show significance in achieving seroconversion was serum albumin (p = 0.03). Using a two-vaccine protocol, hepatitis B vaccination response was high in our population of end-stage renal disease patients.

  17. Plasma cytokine profiles in depressed patients who fail to respond to selective serotonin reuptake inhibitor therapy.

    LENUS (Irish Health Repository)

    O'Brien, Sinead M

    2012-02-03

    OBJECTIVE: Approximately 30% of patients with depression fail to respond to a selective serotonin reuptake inhibitor (SSRI). Few studies have attempted to define these patients from a biological perspective. Studies suggest that overall patients with depression show increased production of proinflammatory cytokines. We examined pro- and anti-inflammatory cytokine levels in patients who were SSRI resistant. METHODS: Plasma concentrations of IL-6, IL-8, IL-10, TNF-alpha and sIL-6R were measured with enzyme linked immunosorbent assays (ELISA) in DSM-1V major depressives who were SSRI resistant, in formerly SSRI resistant patients currently euthymic and in healthy controls. RESULTS: Patients with SSRI-resistant depression had significantly higher production of the pro-inflammatory cytokines IL-6 (p=0.01) and TNF-alpha (p=0.004) compared to normal controls. Euthymic patients who were formerly SSRI resistant had proinflammatory cytokine levels which were similar to the healthy subject group. Anti-inflammatory cytokine levels did not differ across the 3 groups. CONCLUSION: Suppression of proinflammatory cytokines does not occur in depressed patients who fail to respond to SSRIs and is necessary for clinical recovery.

  18. A prospective study of hepatitis B vaccination - a comparison of responders versus nonresponders.

    LENUS (Irish Health Repository)

    Brown, Catherine M

    2011-01-01

    Herein we present one of the largest single-center reports of the response of hemodialysis patients to a two-vaccine hepatitis B virus vaccination protocol in a European dialysis population. A hepatitis B recombinant DNA vaccine, HBvaxPRO, was given at a dose of 40 µg intramuscularly using a four-dose schedule at 0, 1, 2, and 12 months. Responses were (1) a titer >100 mIU\\/mL = patient immune, (2) a titer level 10-99 mIU\\/mL = give a booster dose and recheck level 2 months later, and (3) 0 ≤ 10 mIU\\/mL = repeat vaccination course using a different vaccine, Engerix-B. We compared responder groups in terms of titer levels for each vaccine and variables including age, gender, serum albumin, parathyroid hormone (PTH), calcium, phosphate, hemoglobin, years on dialysis, and type of dialysis access. Of the 176 patients who received the first vaccine course, 71 patients achieved immunity, that is, 40% uptake for the first vaccine. Of the 105 who failed, 72 received the second vaccine with 46 responders, that is, 64% uptake for the second vaccine. Overall, 143 of the 176 patients who entered the vaccination program completed the protocol with 117 achieving immunity, representing an 82% success rate. The only variable overall to show significance in achieving seroconversion was serum albumin (p = 0.03). Using a two-vaccine protocol, hepatitis B vaccination response was high in our population of end-stage renal disease patients.

  19. A new therapeutic community: development of a compassion-focussed and contextual behavioural environment.

    Science.gov (United States)

    Veale, David; Gilbert, Paul; Wheatley, Jon; Naismith, Iona

    2015-01-01

    Social relationships and communities provide the context and impetus for a range of psychological developments, from genetic expression to the development of core self-identities. This suggests a need to think about the therapeutic changes and processes that occur within a community context and how communities can enable therapeutic change. However, the 'therapeutic communities' that have developed since the Second World War have been under-researched. We suggest that the concept of community, as a change process, should be revisited within mainstream scientific research. This paper briefly reviews the historical development of therapeutic communities and critically evaluates their current theory, practice and outcomes in a systematic review. Attention is drawn to recent research on the nature of evolved emotion regulation systems, the way these are entrained by social relationships, the importance of affiliative emotions in the regulation of threat and the role of fear of affiliative emotions in psychopathology. We draw on concepts from compassion-focussed therapy, social learning theory and functional analytical psychotherapy to consider how members of a therapeutic community can be aware of each other's acts of courage and respond using compassion. Living in structured and affiliative-orientated communities that are guided by scientific models of affect and self-regulation offers potential therapeutic advantages over individual outpatient therapy for certain client groups. This conclusion should be investigated further. Key Practitioner Message Current therapeutic community practice is not sufficiently evidence based and may not be maximizing the potential therapeutic value of a community. Compassion-focussed therapy and social learning theory offer new approaches for a therapeutic environment, involving an understanding of the role, nature and complexities of compassionate and affiliative relationships from staff and members, behavioural change guided by

  20. Therapeutic action of ghrelin in a mouse model of colitis.

    Science.gov (United States)

    Gonzalez-Rey, Elena; Chorny, Alejo; Delgado, Mario

    2006-05-01

    Ghrelin is a novel growth hormone-releasing peptide with potential endogenous anti-inflammatory activities ameliorating some pathologic inflammatory conditions. Crohn's disease is a chronic debilitating disease characterized by severe T helper cell (Th)1-driven inflammation of the colon. The aim of this study was to investigate the therapeutic effect of ghrelin in a murine model of colitis. We examined the anti-inflammatory action of ghrelin in the colitis induced by intracolonic administration of trinitrobenzene sulfonic acid. Diverse clinical signs of the disease were evaluated, including weight loss, diarrhea, colitis, and histopathology. We also investigated the mechanisms involved in the potential therapeutic effect of ghrelin, such as inflammatory cytokines and chemokines, Th1-type response, and regulatory factors. Ghrelin ameliorated significantly the clinical and histopathologic severity of the trinitrobenzene sulfonic acid-induced colitis; abrogating body weight loss, diarrhea, and inflammation; and increasing survival. The therapeutic effect was associated with down-regulation of both inflammatory and Th1-driven autoimmune response through the regulation of a wide spectrum of inflammatory mediators. In addition, a partial involvement of interluekin-10/transforming growth factor-beta1-secreting regulatory T cells in this therapeutic effect was demonstrated. Importantly, the ghrelin treatment was therapeutically effective in established colitis and avoided the recurrence of the disease. Our data demonstrate novel anti-inflammatory actions for ghrelin in the gastrointestinal tract, ie, the capacity to deactivate the intestinal inflammatory response and to restore mucosal immune tolerance at multiple levels. Consequently, ghrelin administration represents a novel possible therapeutic approach for the treatment of Crohn's disease and other Th1-mediated inflammatory diseases, such as rheumatoid arthritis and multiple sclerosis.

  1. Geriatric Respondents and Non-Respondents To Probiotic Intervention Can Be Differentiated By Inherent Gut Microbiome Composition

    Directory of Open Access Journals (Sweden)

    Suja eSenan

    2015-09-01

    Full Text Available Scope: Probiotic interventions are known to have been shown to influence the composition of the intestinal microbiota in geriatrics. The growing concern is the apparent variation in response to identical strain dosage among human volunteers. One factor that governs this variation is the host gut microbiome. In this study, we attempted to define a core gut metagenome which could act as a predisposition signature marker of inherent bacterial community that can help predict the success of a probiotic intervention. Methods and Results: To characterize the geriatric gut microbiome we designed primers targeting the 16S rRNA hypervariable region V2-V3 followed by semiconductor sequencing using Ion Torrent PGM. Among respondents and non- respondents the chief genera of phylum Firmicutes that showed significant differences are Lactobacillus, Clostridium, Eubacterium, and Blautia (q< 0.002 while in the genera of phylum Proteobacteria included Shigella, Escherichia, Burkholderia and Camphylobacter (q <0.002. Conclusion: We have identified potential microbial biomarkers and taxonomic patterns that correlate with a positive response to probiotic intervention in geriatric volunteers. Future work with larger cohorts of geriatrics with diverse dietary influences could reveal the potential of the signature patterns of microbiota for personalized nutrition.

  2. Pediatric health, medicine, and therapeutics

    Directory of Open Access Journals (Sweden)

    Claire E Wainwright

    2011-03-01

    Full Text Available Claire E Wainwright1,21Royal Children’s Hospital, Brisbane and Queensland, Queensland, Australia; 2Queensland Children’s Medical Research Institute, The University of Queensland, Brisbane, AustraliaThe idea of children as small adults with health care needs that can be managed by extrapolation from adult studies has now largely been abandoned. We now recognize that adult health and disease are closely linked to childhood factors and the critical and ethical importance of clinical research in pediatrics is increasingly being recognized.  While funding and output from pediatric clinical research continues to lag behind health research in adults, particularly in the area of therapeutics, the last decade has thankfully seen a dramatic increase in the number of pediatric studies and particularly randomized controlled clinical trials (RCTs. Since the 1997 Food and Drug Administration (FDA Modernization Act in the United States (US and the subsequent changes in drug registration regulatory systems in the US and Europe, there has been a huge increase in the number of pediatric studies sponsored by pharmaceutical companies. In the United Kingdom, the Medicine for Children’s Research Network was established in 2005 to address the lack of clinical studies in pediatrics. Over the first five years they reported an exciting increase in the number of high quality clinical studies and on their website they have a current portfolio of over 200 pediatric studies, half of which are RCTs and half are sponsored by pharmaceutical companies. Other countries particularly across Europe are also establishing similar programs. 

  3. Responding to the refusal of care in the emergency department.

    Science.gov (United States)

    Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

    2014-01-01

    The emergency department (ED) serves as the primary gateway for acute care and the source of health care of last resort. Emergency physicians are commonly expected to rapidly assess and treat patients with a variety of life-threatening conditions. However, patients do refuse recommended therapy, even when the consequences are significant morbidity and even mortality. This raises the ethical dilemma of how emergency physicians and ED staff can rapidly determine whether patient refusal of treatment recommendations is based on intact decision-making capacity and how to respond in an appropriate manner when the declining of necessary care by the patient is lacking a basis in informed judgment. This article presents a case that illustrates the ethical tensions raised by the refusal of life-sustaining care in the ED and how such situations can be approached in an ethically appropriate manner.

  4. Facing Change in Southeastern North Carolina: How Do We Respond?

    Directory of Open Access Journals (Sweden)

    Leslie Hossfeld

    2009-10-01

    Full Text Available Once referred to as the "vale of humility between two mountains of conceit," North Carolina has transformed itself from its humble origins to a progressive state embracing the new millennium. From the boom of the Research Triangle to the financial banking hub of Charlotte, the state stands out on many indicators of progress, prosperity and leadership. Yet the very problems that have plagued the state for centuries endure, and the residue of these is the very issue Southeastern North Carolinians must address. Persistent poverty, affordable housing, low incomes and enduring racial inequalities are the age-old problems plaguing our region. Coupled with remarkable population growth and a growing immigrant population, the face of Down East is changing – and how we respond is critical to our future. A number of suggestions on economic development for areas of poverty are suggested.

  5. Respondent-driven sampling as Markov chain Monte Carlo.

    Science.gov (United States)

    Goel, Sharad; Salganik, Matthew J

    2009-07-30

    Respondent-driven sampling (RDS) is a recently introduced, and now widely used, technique for estimating disease prevalence in hidden populations. RDS data are collected through a snowball mechanism, in which current sample members recruit future sample members. In this paper we present RDS as Markov chain Monte Carlo importance sampling, and we examine the effects of community structure and the recruitment procedure on the variance of RDS estimates. Past work has assumed that the variance of RDS estimates is primarily affected by segregation between healthy and infected individuals. We examine an illustrative model to show that this is not necessarily the case, and that bottlenecks anywhere in the networks can substantially affect estimates. We also show that variance is inflated by a common design feature in which the sample members are encouraged to recruit multiple future sample members. The paper concludes with suggestions for implementing and evaluating RDS studies.

  6. Responding to emergencies: How organization and management make a difference

    International Nuclear Information System (INIS)

    Metlay, D.S.; Haber, S.B.; Luckas, W.J.

    1989-01-01

    There is an observable and definable process that occurs during the course of responding to an abnormal event at a nuclear power plant. Each of the elements that comprise that process involves collective action and consequently is influenced by the character and effectiveness of organizational and managerial arrangements. Factors which affect each element include overt ones like the allocation of authority and responsibility and the skill of personnel, as well as covert factors like the methods used to resolve uncertainty. The purpose of this research project is to examine the process of response that occurs to an abnormal event at a nuclear power plant and where possible to identify the organizational and management factors that influence that process

  7. Responding to emergencies: How organization and management make a difference

    International Nuclear Information System (INIS)

    Metlay, D.S.; Haber, S.B.; Luckas, W.J.

    1990-01-01

    There is an observable and definable process that occurs during the course of responding to an abnormal event at a nuclear power plant. Each of the elements that comprise that process involves collective action and consequently is influenced by the character and effectiveness of organizational and managerial arrangements. Factors which affect each element include overt ones like the allocation of authority and responsibility and the skill of personnel, as well as covert factors like the methods used to resolve uncertainty. The purpose of this research project is to examine the process of response that occurs to an abnormal event at a nuclear power plant and where possible to identify the organizational and management factors that influence that process

  8. Considerations in physical therapy management of a non-responding patient with low back pain.

    Science.gov (United States)

    Madson, Timothy J

    2017-09-01

    Case Study. Low back pain is a common condition managed by physical therapists (PT). Screening tools have been developed to assist the PT with medical screening of patients for serious disease. Sinister pathologies may present as musculoskeletal symptoms during the patient examination. It is important for the PT to frequently reevaluate their patient's response to therapeutic interventions and refer for further evaluation if they are not responding to conservative care. This case reports on the history and examination findings of a 36-year-old male presenting with recurrent low back pain. An emphasis is placed on the therapist's understanding and use of screening tools when interviewing patients and determining when medical referral may be indicated based on the patients history and examination findings. A review of the evidence on the diagnostic accuracy of screening strategies for malignancy in patients presenting with low back pain is presented. Sinister causes for low back pain are extremely rare. It is important that PTs be familiar with specific signs and symptoms that may indicate serious pathology when evaluating patients with low back pain. Identification of two red flags from this patient's history leads the clinician to refer the patient back to their primary care provider (PCP) for further investigation. They included: 1) the patient's inability to improve after one month and 2) clinicians' judgment. Use of "clinical judgment" may assist the PT in determining if their patient needs further investigation.

  9. Understanding how adolescents with autism respond to facial expressions in virtual reality environments.

    Science.gov (United States)

    Bekele, Esubalew; Zheng, Zhi; Swanson, Amy; Crittendon, Julie; Warren, Zachary; Sarkar, Nilanjan

    2013-04-01

    Autism Spectrum Disorders (ASD) are characterized by atypical patterns of behaviors and impairments in social communication. Among the fundamental social impairments in the ASD population are challenges in appropriately recognizing and responding to facial expressions. Traditional intervention approaches often require intensive support and well-trained therapists to address core deficits, with many with ASD having tremendous difficulty accessing such care due to lack of available trained therapists as well as intervention costs. As a result, emerging technology such as virtual reality (VR) has the potential to offer useful technology-enabled intervention systems. In this paper, an innovative VR-based facial emotional expression presentation system was developed that allows monitoring of eye gaze and physiological signals related to emotion identification to explore new efficient therapeutic paradigms. A usability study of this new system involving ten adolescents with ASD and ten typically developing adolescents as a control group was performed. The eye tracking and physiological data were analyzed to determine intragroup and intergroup variations of gaze and physiological patterns. Performance data, eye tracking indices and physiological features indicated that there were differences in the way adolescents with ASD process and recognize emotional faces compared to their typically developing peers. These results will be used in the future for an online adaptive VR-based multimodal social interaction system to improve emotion recognition abilities of individuals with ASD.

  10. Freeze-all cycle for all normal responders?

    Science.gov (United States)

    Roque, Matheus; Valle, Marcello; Guimarães, Fernando; Sampaio, Marcos; Geber, Selmo

    2017-02-01

    The purpose of this study is to evaluate the freeze-all strategy in subgroups of normal responders, to assess whether this strategy is beneficial regardless of ovarian response, and to evaluate the possibility of implementing an individualized embryo transfer (iET) based on ovarian response. This was an observational, cohort study performed in a private IVF center. A total of 938 IVF cycles were included in this study. The patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and a cleavage-stage day 3 embryo transfer. We performed a comparison of outcomes between the fresh embryo transfer (n = 523) and the freeze-all cycles (n = 415). The analysis was performed in two subgroups of patients based on the number of retrieved oocytes: Group 1 (4-9 oocytes) and Group 2 (10-15 oocytes). In Group 1 (4-9 retrieved oocytes), the implantation rates (IR) were 17.9 and 20.5% (P = 0.259) in the fresh and freeze-all group, respectively; the ongoing pregnancy rates (OPR) were 31 and 33% (P = 0.577) in the fresh and freeze-all group, respectively. In Group 2 (10-15 oocytes), the IR were 22.1 and 30.1% (P = 0.028) and the OPR were 34 and 47% (P = 0.021) in the fresh and freeze-all groups, respectively. Although the freeze-all policy may be related to better in vitro fertilization (IVF) outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy.

  11. Primate dental ecology: How teeth respond to the environment.

    Science.gov (United States)

    Cuozzo, Frank P; Ungar, Peter S; Sauther, Michelle L

    2012-06-01

    Teeth are central for the study of ecology, as teeth are at the direct interface between an organism and its environment. Recent years have witnessed a rapid growth in the use of teeth to understand a broad range of topics in living and fossil primate biology. This in part reflects new techniques for assessing ways in which teeth respond to, and interact with, an organism's environment. Long-term studies of wild primate populations that integrate dental analyses have also provided a new context for understanding primate interactions with their environments. These new techniques and long-term field studies have allowed the development of a new perspective-dental ecology. We define dental ecology as the broad study of how teeth respond to, or interact with, the environment. This includes identifying patterns of dental pathology and tooth use-wear, as they reflect feeding ecology, behavior, and habitat variation, including areas impacted by anthropogenic disturbance, and how dental development can reflect environmental change and/or stress. The dental ecology approach, built on collaboration between dental experts and ecologists, holds the potential to provide an important theoretical and practical framework for inferring ecology and behavior of fossil forms, for assessing environmental change in living populations, and for understanding ways in which habitat impacts primate growth and development. This symposium issue brings together experts on dental morphology, growth and development, tooth wear and health, primate ecology, and paleontology, to explore the broad application of dental ecology to questions of how living and fossil primates interact with their environments. Copyright © 2012 Wiley Periodicals, Inc.

  12. Therapeutic effects of probiotics on neonatal jaundice.

    Science.gov (United States)

    Liu, Wenbin; Liu, Huajun; Wang, Taisen; Tang, Xueqing

    2015-01-01

    To evaluate the therapeutic effects of probiotics on neonatal jaundice and the safety. Sixty-eight neonates with jaundice were divided into a control group and a treatment group (n=34) randomly, and treated by blue light phototherapy and that in combination with probiotics. The serum bilirubin levels were detected before and 1, 4, 7 days after treatment. The time when therapy showed effects and jaundice faded, clinical outcomes as well as adverse reactions were recorded. The categorical data were expressed as (±s) and compared by t test. The numerical data were expressed as (case, %) and compared by χ² test. P0.05). The levels significantly decreased 1, 4 and 7 days after treatment (P0.05). The treatment group underwent more significant decreases on the 4th and 7th days than the control group did (P=0.002, 0.001). In the treatment group, the therapy exerted effects on (1.0±0.5) d and jaundice faded on (3.8±1.7) d, which were (2.6±0.6) d and (5.3±2.1) d respectively in the control group (P=0.001, 0.002). The effective rate of the treatment group significantly exceeded that of the control group (P=0.002). There were no obvious adverse reactions in either group. Probiotics lowered the serum bilirubin levels of neonates with jaundice rapidly, safely and significantly, and accelerated jaundice fading as well. This method is worthy of application in clinical practice.

  13. [A therapeutic education tool in paediatric dentistry].

    Science.gov (United States)

    Marquillier, Thomas; Trentesaux, Thomas; Catteau, Céline; Delfosse, Caroline

    Therapeutic education for children is developing in the treatment of dental caries. The Elmy pathway, a pedagogical game aiming to improve children's oral health skills, has been designed. The qualitative assessment of this tool seems to confirm its benefit for use in therapeutic education sessions. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Woodland in Practical Skills Therapeutic Education

    Science.gov (United States)

    Mata, Paula; Gibons, Kenneth; Mata, Fernando

    2016-01-01

    Modern urban life provides less opportunities to contact with nature, which is a potential cause of developmental deviances in children. We investigated the potential therapeutic effect of woodlands, within the context of Practical Skills Therapeutic Education at the Ruskin Mill College, UK. Data on physical and emotional perceptions were…

  15. Translational nanomedicine : Through the therapeutic window

    NARCIS (Netherlands)

    Pierce, Robin

    2015-01-01

    Translational nanomedicine occurs only through the successful integration of multiple inputs and iterative modifications. The therapeutic window plays a pivotal role in the trajectory of translational nanomedicine. Often defined in terms of the range of dosage for safe and effective therapeutic

  16. [Therapeutic education of total laryngectomy patients: Influence of social factors].

    Science.gov (United States)

    Woisard, V; Galtier, A; Baumann, L; Delpierre, C; Puech, M; Balaguer, M

    Current health policies promote patient education, parti­cu­lar­ly in oncology. Therapeutic education program must be tailo­red to the characteristics, needs and expectations of the population. In the ENT Department of Head and Neck Surgery, Larrey Hospital in Toulouse, a therapeutic education program for patient with total laryngectomy has been experienced since 2011. But its propagation remains difficult. The aim of this study is to determine if social factors are nfluencing the parti­cipation of the laryngectomized population in the program. The brochure explaining this program and a registration form coupled with a survey questionnaire were distributed to the regio­nal population of patient with total laryngectomy. After two months of investigation we collected 42 responses. It is clear from their analysis that social factors underlie partici­pa­tion, particularly educational level, available financial resources level and the socio-professional group.

  17. The potential of prison-based democratic therapeutic communities.

    Science.gov (United States)

    Bennett, Jamie; Shuker, Richard

    2017-03-13

    Purpose The purpose of this paper is to describe the work of HMP Grendon, the only prison in the UK to operate entirely as a series of democratic therapeutic communities and to summarise the research of its effectiveness. Design/methodology/approach The paper is both descriptive, providing an overview of the work of a prison-based therapeutic community, and offers a literature review regarding evidence of effectiveness. Findings The work of HMP Grendon has a wide range of positive benefits including reduced levels of disruption in prison, reduced self-harm, improved well-being, an environment that is experienced as more humane and reduced levels of reoffending. Originality/value The work of HMP Grendon offers a well established and evidenced approach to managing men who have committed serious violent and sexually violent offences. It also promotes and embodies a progressive approach to managing prisons rooted in the welfare tradition.

  18. The effects of therapeutic touch on pain.

    Science.gov (United States)

    Monroe, Carolyn Magdalen

    2009-06-01

    To better understand how Therapeutic Touch can be used in today's health care arena, this integrative literature review will examine current research that will help answer the question, Does Therapeutic Touch reduce pain? An extensive search was conducted of the online databases MEDLINE, CINAHL, Cochrane Library, EMBASE, PsychLIT, and PubMed to retrieve research articles published from 1997 to 2007. Seven studies that were conducted between 1997 and 2004 were found and only five of the seven were included as pertinent evidence to answer the question. All of the research that was reviewed to answer whether Therapeutic Touch could significantly reduce pain revealed a majority of statistically significant positive results for implementing this intervention. Because there are no identified risks to Therapeutic Touch as a pain relief measure, it is safe to recommend despite the limitations of current research. Therapeutic Touch should be considered among the many possible nursing interventions for the treatment of pain.

  19. [Health security--GMOs in therapeutics].

    Science.gov (United States)

    Trouvin, J-H

    2003-03-01

    The recent progress in human therapeutics has been made possible thanks to molecular biology and its use in producing proteins having the same sequence and structure as that of human proteins. The use of GMOs allows production of proteins with high added value in therapeutics, which are of satisfactory quality. GMOs may also be directly administered to patients as gene therapy vectors. However, the use of GMOs in therapeutics must take into consideration some risks, particularly those of microbiological contamination, of neo-antigenicity as well as environmental risks with regard to the way of use of the GMO. Nevertheless, those risks are taken in due consideration in the development of these new medicinal products; solutions have been found to allow their use in therapeutics with a very positive benefit/risk ratio. Medicinal products from biotechnology have enabled considerable therapeutic progress without compromising health security.

  20. Opioid withdrawal syndrome: emerging concepts and novel therapeutic targets.

    Science.gov (United States)

    Rehni, Ashish K; Jaggi, Amteshwar S; Singh, Nirmal

    2013-02-01

    Opioid withdrawal syndrome is a debilitating manifestation of opioid dependence and responds poorly to the available clinical therapies. Studies from various in vivo and in vitro animal models of opioid withdrawal syndrome have led to understanding of its pathobiology which includes complex interrelated pathways leading to adenylyl cyclase superactivation based central excitation. Advancements in the elucidation of opioid withdrawal syndrome mechanisms have revealed a number of key targets that have been hypothesized to modulate clinical status. The present review discusses the neurobiology of opioid withdrawal syndrome and its therapeutic target recptors like calcitonin gene related peptide receptors (CGRP), N-methyl-D-aspartate (NMDA) receptors, gamma aminobutyric acid receptors (GABA), G-proteingated inwardly rectifying potassium (GIRK) channels and calcium channels. The present review further details the potential role of second messengers like calcium (Ca2+) / calmodulin-dependent protein kinase (CaMKII), nitric oxide synthase, cytokines, arachidonic acid metabolites, corticotropin releasing factor, fos and src kinases in causing opioid withdrawal syndrome. The exploitation of these targets may provide effective therapeutic agents for the management of opioid dependence-induced abstinence syndrome.