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Sample records for lymphedema develops independently

  1. Lymphedema

    Science.gov (United States)

    ... News Walk to Fight Lymphedema & Lymphatic Diseases About Us Mission History Your Investment Partners and Supporting Members LE&RN ... Archive Walk to Fight Lymphedema & Lymphatic Diseases About Us Mission History Your Investment Partners and Supporting Members LE&RN ...

  2. Prevalence and risk factors for development of lymphedema following breast cancer treatment

    International Nuclear Information System (INIS)

    Deo, S.V.S.; Ray, S.; Kar, M.; Asthana, S.; Rath, G.K.; Shukla, N.K.; Raina, V.

    2004-01-01

    BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area> 1.5 m 2 , presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema. (author)

  3. Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study.

    Science.gov (United States)

    Kim, Paul; Lee, Ju Kang; Lim, Oh Kyung; Park, Heung Kyu; Park, Ki Deok

    2017-12-01

    To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups. Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04-0.46; p=0.001). In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

  4. Lymphedema (PDQ)

    Science.gov (United States)

    ... caused by cancer is rarely treated with surgery . Massage therapy Massage therapy (manual therapy) for lymphedema should begin with ... trained in treating lymphedema. In this type of massage, the soft tissues of the body are lightly ...

  5. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

    Science.gov (United States)

    Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

    2017-01-01

    The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

  6. Exercise barriers self-efficacy: development and validation of a subcale for individuals with cancer-related lymphedema.

    Science.gov (United States)

    Buchan, Jena; Janda, Monika; Box, Robyn; Rogers, Laura; Hayes, Sandi

    2015-03-18

    No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers. A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale. The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC = 0.67, p exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.

  7. Standardized Method for Quantification of Developing Lymphedema in Patients Treated for Breast Cancer

    International Nuclear Information System (INIS)

    Ancukiewicz, Marek; Russell, Tara A.; Otoole, Jean; Specht, Michelle; Singer, Marybeth; Kelada, Alexandra; Murphy, Colleen D.; Pogachar, Jessica; Gioioso, Valeria; Patel, Megha; Skolny, Melissa; Smith, Barbara L.; Taghian, Alphonse G.

    2011-01-01

    Purpose: To develop a simple and practical formula for quantifying breast cancer-related lymphedema, accounting for both the asymmetry of upper extremities' volumes and their temporal changes. Methods and Materials: We analyzed bilateral perometer measurements of the upper extremity in a series of 677 women who prospectively underwent lymphedema screening during treatment for unilateral breast cancer at Massachusetts General Hospital between August 2005 and November 2008. Four sources of variation were analyzed: between repeated measurements on the same arm at the same session; between both arms at baseline (preoperative) visit; in follow-up measurements; and between patients. Effects of hand dominance, time since diagnosis and surgery, age, weight, and body mass index were also analyzed. Results: The statistical distribution of variation of measurements suggests that the ratio of volume ratios is most appropriate for quantification of both asymmetry and temporal changes. Therefore, we present the formula for relative volume change (RVC): RVC = (A 2 U 1 )/(U 2 A 1 ) - 1, where A 1 , A 2 are arm volumes on the side of the treated breast at two different time points, and U 1 , U 2 are volumes on the contralateral side. Relative volume change is not significantly associated with hand dominance, age, or time since diagnosis. Baseline weight correlates (p = 0.0074) with higher RVC; however, baseline body mass index or weight changes over time do not. Conclusions: We propose the use of the RVC formula to assess the presence and course of breast cancer-related lymphedema in clinical practice and research.

  8. Lymphedema secondary to filariasis

    International Nuclear Information System (INIS)

    Leonard, J.C.; Humphrey, G.B.; Basmadjian, G.

    1985-01-01

    A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma

  9. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  10. Treatment of Lymphedema

    Science.gov (United States)

    ... caused by cancer is rarely treated with surgery . Massage therapy Massage therapy (manual therapy) for lymphedema should begin with ... trained in treating lymphedema. In this type of massage, the soft tissues of the body are lightly ...

  11. Development of a Tissue-Engineered Lymphatic Graft Using Nanocomposite Polymer for the Treatment of Secondary Lymphedema.

    Science.gov (United States)

    Kanapathy, Muholan; Kalaskar, Deepak; Mosahebi, Afshin; Seifalian, Alexander M

    2016-03-01

    Damage of the lymphatic vessels, commonly due to surgical resection for cancer treatment, leads to secondary lymphedema. Tissue engineering approach offers a possible solution to reconstruct this damage with the use of lymphatic graft to re-establish the lymphatic flow, hence preventing lymphedema. The aim of this study is to develop a tissue-engineered lymphatic graft using nanocomposite polymer and human dermal lymphatic endothelial cells (HDLECs). A nanocomposite polymer, the polyhedral oligomeric silsequioxane-poly(carbonate-urea)urethane (POSS-PCU), which has enhanced mechanical, chemical, and physical characteristics, was used to develop the lymphatic graft. POSS-PCU has been used clinically for the world's first synthetic trachea, lacrimal duct, and is currently undergoing clinical trial for coronary artery bypass graft. Two designs and fabrication methods were used to manufacture the conduits. The fabrication method, the mechanical and physical properties, as well as the hydraulic conductivity were tested. This is followed by in vitro cell culture analysis to test the cytocompatibility of HDLEC with the polymer surface. Using the casted extrusion method, the nanocomposite lymphatic graft demonstrates desirable mechanical property and hydraulic conductivity to re-establish the lymphatic flow. The conduit has high tensile strength (casted: 74.86 ± 5.74 MPa vs. coagulated: 31.33 ± 3.71 MPa; P nanocomposite polymer. It displays excellent mechanical property and cytocompatibility to HDLECs, offering much promise for clinical applications and as a new treatment option for secondary lymphedema. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  12. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

    International Nuclear Information System (INIS)

    Ryttov, N.; Holm, N.V.; Qvist, N.; Blichert-Toft, M.; Odense Univ. Hospital

    1988-01-01

    The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups was mastectomy and partial axillary dissection. In addition one group received postoperative irradiation plus systemic therapy and another group systemic therapy alone. The incidence of late arm lymphedema/impaired shoulder mobility was 11%/4% in the group of patients undergoing surgery alone, 46%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical mastectomy. Adjuvant systemic therapy can be administered to high risk patients without increasing the risk of late arm lymphedema and shoulder disability. (orig.)

  13. Predictors of Lymphedema Following Breast Cancer Surgery

    National Research Council Canada - National Science Library

    Swenson, Karen K

    2006-01-01

    .... Cases will be identified in the physical therapy or cancer centers. Controls will be identified using the oncology registry and include patients with breast cancer surgery who have not developed lymphedema...

  14. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study.

    Science.gov (United States)

    Togawa, Kayo; Ma, Huiyan; Sullivan-Halley, Jane; Neuhouser, Marian L; Imayama, Ikuyo; Baumgartner, Kathy B; Smith, Ashley Wilder; Alfano, Catherine M; McTiernan, Anne; Ballard-Barbash, Rachel; Bernstein, Leslie

    2014-08-22

    Lymphedema is a potentially debilitating condition that occurs among breast cancer survivors. This study examines the incidence of self-reported lymphedema, timing of lymphedema onset, and associations between sociodemographic, clinical and lifestyle factors and lymphedema risk across racial-ethnic groups using data from a multicenter, multiethnic prospective cohort study of breast cancer survivors, the Health, Eating, Activity and Lifestyle Study. A total of 666 women diagnosed with breast cancer staged as in situ, localized or regional disease at ages 35 to 64 years were recruited through the Surveillance, Epidemiology, and End Results registries in New Mexico (non-Hispanic white and Hispanic white), Los Angeles County (black), and Western Washington (non-Hispanic white) and followed for a median of 10.2 years. We evaluated sociodemographic factors, breast cancer- and treatment-related factors, comorbidities, body mass index (BMI), hormonal factors, and lifestyle factors in relation to self-reported lymphedema by fitting Cox proportional hazards models, estimating hazard ratios (HR) and 95% confidence intervals (CI). Over the follow-up period, 190 women (29%) reported lymphedema. The median time from breast cancer diagnosis to onset of lymphedema was 10.5 months (range: 0.5 to 134.9 months). Factors independently associated with lymphedema were total/modified radical mastectomy (versus partial/less than total mastectomy; HR = 1.37, 95% CI: 1.01 to 1.85), chemotherapy (versus no chemotherapy; HR = 1.48, 95% CI: 1.09 to 2.02), no lymph nodes removed (versus ≥10 lymph nodes removed; HR = 0.17, 95% CI: 0.08 to 0.33), pre-diagnostic BMI ≥30 kg/m2 (versus BMI race/ethnicity showed that hypertension and chemotherapy were lymphedema risk factors only for black women. Breast cancer patients who have undergone extensive surgery or extensive lymph node dissection, or who have a higher BMI should be closely monitored for detection and treatment of lymphedema. Further

  15. Voices from the Shadows: Living with Lymphedema

    Science.gov (United States)

    Ridner, Sheila H.; Bonner, Candace M.; Deng, Jie; Sinclair, Vaughn G.

    2011-01-01

    Background Breast cancer survivors with lymphedema face a lifetime of stressful physical and emotional symptoms and challenging self-care demands. An in-depth understanding of the perceptions and feelings surrounding life with lymphedema is critical to developing effective supportive care approaches. Objective To explore perceptions and feelings related to lymphedema in breast cancer survivors. Method The expressive writings of 39 individuals were evaluated for this descriptive qualitative study. Data were analyzed using conventional content analysis. Results Qualitative analyses produced four major themes: (1) marginalization and minimization; (2) multiplying losses; (3) yearning to return to normal; (4) uplifting resources. Sub-themes for each major theme were also identified. Conclusion The lymphedema experiences of breast cancer survivors reveal perceptions of marginalization from healthcare providers who are not well informed about lymphedema management and minimize its impact. Multiple distressing losses confront these patients on a daily basis, including body image disturbances, loss of functionality and control over time, permanent uncertainty, and adverse effects on relationships. The daily challenges of lymphedema often result in cumulative frustration and resentment that contribute to failure to perform self-care. Normalcy has been lost, never to return. These women find solace, encouragement and hope to meet the challenges of lymphedema through support from others and their spiritual beliefs. Implication for Practice Healthcare providers need greater awareness of the physical and psychosocial effects of lymphedema in breast cancer survivors. Nurses have unique opportunities to serve as advocates for reducing perceived marginalization and promoting effective self-care and other activities that promote psychological well-being and reduce physical deterioration. PMID:21558848

  16. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deng Jie, E-mail: jie.deng@vanderbilt.edu [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Ridner, Sheila H. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Dietrich, Mary S. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee (United States); Wells, Nancy; Wallston, Kenneth A. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A. [Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States)

    2012-11-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  17. Lymphedema Risk Reduction Practices

    Science.gov (United States)

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  18. Radiation Therapy Risk Factors for Development of Lymphedema in Patients Treated With Regional Lymph Node Irradiation for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Ravi A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Miller, Cynthia L. [Harvard Medical School, Boston, Massachusetts (United States); Skolny, Melissa N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-03-15

    Purpose: We previously evaluated the risk of breast cancer-related lymphedema (LE) with the addition of regional lymph node irradiation (RLNR) and found an increased risk when RLNR is used. Here we analyze the association of technical radiation therapy (RT) factors in RLNR patients with the risk of LE development. Methods and Materials: From 2005 to 2012, we prospectively screened 1476 women for LE who underwent surgery for breast cancer. Among 1507 breasts treated, 172 received RLNR and had complete technical data for analysis. RLNR was delivered as supraclavicular (SC) irradiation (69% [118 of 172 patients]) or SC plus posterior axillary boost (PAB) (31% [54 of 172]). Bilateral arm volume measurements were performed pre- and postoperatively. Patients' RT plans were analyzed for SC field lateral border (relative to the humeral head), total dose to SC, RT fraction size, beam energy, and type of tangent (normal vs wide). Cox proportional hazards models were used to analyze associated risk factors for LE. Results: Median postoperative follow-up was 29.3 months (range: 4.9-74.1 months). The 2-year cumulative incidence of LE was 22% (95% confidence interval [CI]: 15%-32%) for SC and 20% (95% CI: 11%-37%) for SC plus PAB (SC+PAB). None of the analyzed variables was significantly associated with LE risk (extent of humeral head: P=.74 for <1/3 vs >2/3, P=.41 for 1/3 to 2/3 vs >2/3; P=.40 for fraction size of 1.8 Gy vs 2.0 Gy; P=.57 for beam energy 6 MV vs 10 MV; P=.74 for tangent type wide vs regular; P=.66 for SC vs SC+PAB). Only pretreatment body mass index (hazard ratio [HR]: 1.09; 95% CI: 1.04-1.15, P=.0007) and the use of axillary lymph node dissection (HR: 7.08, 95% CI: 0.98-51.40, P=.05) were associated with risk of subsequent LE development. Conclusions: Of the RT parameters tested, none was associated with an increased risk of LE development. This study underscores the need for future work investigating alternative RLNR risk factors for LE.

  19. Heavy resistance training and lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Karlsmark, Tonny; Christensen, Karl Bang

    2014-01-01

    BACKGROUND: There is limited knowledge regarding progressive resistance training during adjuvant chemotherapy and the risk of developing breast cancer-related lymphedema (BCRL). Furthermore, no studies have investigated the safety of resistance training with heavy loads (> 80% 1 repetition maximum......) in this population. 'Body and Cancer' is a six-week, nine-hour weekly, supervised, multimodal exercise intervention utilizing progressive resistance training with heavy loads for cancer patients undergoing chemotherapy. The purpose of the present study was to estimate the prevalence of BCRL in former participants......, and identify associations between progressive resistance training with heavy loads, and the development of BCRL. MATERIAL AND METHODS: This was a descriptive study. POPULATION: Women treated for breast cancer (n = 149), who had participated in the 'Body and Cancer' exercise intervention between 1 January 2010...

  20. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Deng Jie; Ridner, Sheila H.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A.

    2012-01-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  1. Factors associated with external and internal lymphedema in patients with head-and-neck cancer.

    Science.gov (United States)

    Deng, Jie; Ridner, Sheila H; Dietrich, Mary S; Wells, Nancy; Wallston, Kenneth A; Sinard, Robert J; Cmelak, Anthony J; Murphy, Barbara A

    2012-11-01

    The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.

    Science.gov (United States)

    Lee, Daegu; Hwang, Ji Hye; Chu, Inho; Chang, Hyun Ju; Shim, Young Hun; Kim, Jung Hyun

    2015-08-01

    The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema. Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups. Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores. Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.

  3. Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India.

    Directory of Open Access Journals (Sweden)

    Victoria Walsh

    2016-08-01

    Full Text Available Over 1.1 billion people worldwide are at risk for lymphatic filariasis (LF, and the global burden of LF-associated lymphedema is estimated at 16 million affected people, yet country-specific estimates are poor.A house-to-house morbidity census was conducted to assess the burden and severity of lymphedema in a population of 1,298,576 persons living in the LF-endemic district of Khurda in Odisha State, India. The burden of lymphedema in Khurda is widespread geographically, and 1.3% (17,036 of the total population report lymphedema. 51.3% of the patients reporting lymphedema were female, mean age 49.4 years (1-99. Early lymphedema (Dreyer stages 1 & 2 was reported in two-thirds of the patients. Poisson regression analysis was conducted in order to determine risk factors for advanced lymphedema (Dreyer stages 4-7. Increasing age was significantly associated with advanced lymphedema, and persons 70 years and older had a prevalence three times greater than individuals ages 15-29 (aPR: 3.21, 95% CI 2.45, 4.21. The number of adenolymphangitis (ADL episodes reported in the previous year was also significantly associated with advanced lymphedema (aPR 4.65, 95% CI 2.97-7.30. This analysis is one of the first to look at potential risk factors for advanced lymphedema using morbidity census data from an entire district in Odisha State, India.These data highlight the magnitude of lymphedema in LF-endemic areas and emphasize the need to develop robust estimates of numbers of individuals with lymphedema in order to identify the extent of lymphedema management services needed in these regions.

  4. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  5. Isolated primary lymphedema tarda of the upper limb.

    Science.gov (United States)

    Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

    2013-03-01

    Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

  6. THE REHABILITATION MANAGEMENT OF LYMPHEDEMA

    Directory of Open Access Journals (Sweden)

    OJOGA Florina

    2015-05-01

    Full Text Available Lymphedema is an important pathology for rehabilitation medecine, especially for the patients who underwent a mastectomy for breast cancer. His frequency is higher when mastectomy is combined with lymph node disection and irradiation of the lymph nodes. Symptoms include heaviness, numbness, pain, stiffness and weakness in the affected limb. Complications of lymphedema include infections such as cellulitis, erysipelas and lymphangitis. Treatment must be instituted as soon as possible and preventive measures are essential. The rehabilitation treatment consists of skin care measures, manual lymphatic massage, elastic compression of the affected limb and kinetotherapy.

  7. Field development finance for independents

    International Nuclear Information System (INIS)

    Whyatt, A.S.

    1995-01-01

    Worldwide, oil and gas reserves are in decline, and independents own relatively little of them, say 13 percent of the oil reserves and 22 percent of the gas reserves. Over the five years 1989-93, the oil reserves of majors declined by 4.5 percent, while those of independents rose 17 percent; each experienced a rise in gas reserves of 6-7 percent. Partly because of this gentle decline in world reserves, but much more because of the decline in oil and gas commodity prices, the value of the reserves, expressed in terms of future production, has been declining substantially. In 1993, when these data were last recorded, the discounted future net cash flows in the United States were 40 percent below their 1990 peak of $135 billion, and foreign net cash flows were 35 percent lower than the 1990 peak of $140 billion. (author)

  8. Upper extremity lymphedema: presence and effect on functioning five years after breast cancer treatment.

    Science.gov (United States)

    Shigaki, Cheryl L; Madsen, Richard; Wanchai, Ausanee; Stewart, Bob R; Armer, Jane M

    2013-11-01

    Our goal was to explore the effects of lymphedema on long-term adjustment among breast cancer survivors, in terms of functioning in important life environments. Limb volume measurements and psychosocial survey data were collected from women shortly after undergoing surgical intervention for breast cancer and annually thereafter. A subset of these women were selected for the current study because they had preoperative limb volume measurement data, which is best suited to determine presence and severity of lymphedema. Our final sample of 61 women had both the arm measurements (preoperative and 5-year) and survey data (baseline and 5-year) needed for this study, which comprises a secondary cross-sectional analysis of longitudinal data. A correlational approach was used to explore associations among lymphedema (presence, severity, and whether the participant met the criteria for lymphedema at any assessment point since their treatment for breast cancer) and outcome variables (physical functioning, vocational functioning, social functioning, domestic functioning, and sexual functioning). Each of the three measures of lymphedema was significantly correlated with domestic functioning, but not with functioning in other common environments. Long-term breast cancer survivors are at risk for developing secondary conditions, such as lymphedema, to which they must learn to adjust and adapt. Lymphedema may increase risk for compromised functioning in everyday environments, a problem which lies at the heart of rehabilitation. Breast cancer survivorship, therefore, fits well within the scope of a rehabilitation framework. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema.

    Science.gov (United States)

    Sohl, Stephanie J; Dietrich, Mary S; Wallston, Kenneth A; Ridner, Sheila H

    2017-07-01

    Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL. Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions. Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy-Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis. There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis. These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.

  10. Gigantic Suprapubic Lymphedema: A Case Study

    Directory of Open Access Journals (Sweden)

    Roozbeh Tanhaeivash

    2016-08-01

    Full Text Available We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg. Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases.

  11. Ethnodrama: An Innovative Knowledge Translation Tool in the Management of Lymphedema.

    Science.gov (United States)

    Ahmed, Shahid; Quinlan, Elizabeth; McMullen, Linda; Thomas, Roanne; Fichtner, Pam; Block, Janice

    2015-01-01

    Lymphedema can cause significant physical impairment and quality-of-life issues. Yet there is a gap in knowledge about lymphedema among breast cancer survivors (BCS), and health care professionals (HCP). Ethnodrama is an innovative knowledge translation strategy that uses theatrical performances for dissemination of research results. We evaluated the impact of live ethnodrama on HCP' and BCS' awareness and attitudes in relation to impact of lymphedema on BCS' lives. Ethnodrama performances were developed by script writers and a theatre director in collaboration with the investigators and BCS using data from published research and pre-performances workshops. Six interactive live performances were given to audiences of BCS, HCP, and community members in four cities across Canada. After watching these live performances, members of the audiences were asked to complete a paper-based questionnaire regarding their knowledge of lymphedema, and their attitudes and practices toward lymphedema. Of 238 audience members who participated in the survey, 55 (23%) were BCS and 85 (37.5%) were HCP. Most members rated the performances as very effective in changing their (84%) or other people's (93%) understanding of lymphedema; 96% reported being motivated to seek additional information on lymphedema, and 72% of HCP anticipated changes in their practices related to lymphedema screening. Overall no significant differences were noted in responses to ethnodrama between BCS and HCP. Open-ended responses were supportive of the findings from the closed-ended questions. Our results indicate that ethnodrama performances effectively convey information and positively affecting changes in HCP' and BCS' attitudes toward lymphedema.

  12. Bioelectrical impedance for detecting and monitoring lymphedema in patients with breast cancer. Preliminary results of the florence nightingale breast study group.

    Science.gov (United States)

    Erdogan Iyigun, Zeynep; Selamoglu, Derya; Alco, Gul; Pilancı, Kezban Nur; Ordu, Cetin; Agacayak, Filiz; Elbüken, Filiz; Bozdogan, Atilla; Ilgun, Serkan; Guler Uysal, Fusun; Ozmen, Vahit

    2015-03-01

    The aim of this study was to evaluate the efficacy of bioimpedance spectroscopy for the follow-up of patients with lymphedema in Turkey and its benefits in the diagnosis of stage 0, 1, and 2 lymphedema in patients who are under treatment for breast cancer. Thirty-seven female patients with breast cancer who underwent surgical procedures in our Breast Health Centre were followed up for lymphedema using bioimpedance, and clinical measurements were taken for a minimum period of 1 year at 3-month intervals. Patients who had been monitored regularly between November, 2011, and September, 2013, were enrolled to the study. In total, 8 patients developed lymphedema with an overall rate of 21.6%. Among the 8 patients who developed lymphedema, 4 had Stage 2, 1 had Stage 1, and 3 had Stage 0 lymphedema. Stage 0 lymphedema could not be detected with clinical measurements. During the patients' 1-year follow-up period using measurements of bioimpedance, a statistically significant relationship was observed between the occurrence of lymphedema and the disease characteristics. including the number of the extracted and remaining lymph nodes and the region of radiotherapy (p=0.042, p=0.024, p=0.040). Bioimpedance analysis seems to be a practical and reliable method for the early diagnosis of lymphedema. It is believed that regular monitoring of patients in the high-risk group using bioimpedance analyses increases the ability to treat lymphedema.

  13. Giant cell angiofibroma or localized periorbital lymphedema?

    Science.gov (United States)

    Lynch, Michael C; Chung, Catherine G; Specht, Charles S; Wilkinson, Michael; Clarke, Loren E

    2013-12-01

    Giant cell angiofibroma represents a rare soft tissue neoplasm with a predilection for the orbit. We recently encountered a mass removed from the lower eyelid of a 56-year-old female that histopathologically resembled giant cell angiofibroma. The process consisted of haphazardly arranged CD34-positive spindled and multinucleated cells within an edematous, densely vascular stroma. However, the patient had recently undergone laryngectomy and radiotherapy for a laryngeal squamous cell carcinoma. A similar mass had arisen on the contralateral eyelid, and both had developed several months post-therapy. Lymphedema of the orbit can present as tumor-like nodules and in some cases may share histopathologic features purported to be characteristic of giant cell angiofibroma. A relationship between giant cell angiofibroma and lymphedema has not been established, but our case suggests there may be one. The potential overlap of these two conditions should be recognized, as should other entities that may enter the differential diagnosis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Ben Salah, H.; Bahri, M.; Jbali, B.; Daoud, J.; Guermazi, M.; Frikha, M.

    2012-01-01

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  15. The prevention of the primary lymphedema

    International Nuclear Information System (INIS)

    Benda, K.; Lebloch, D.; Bendova, M.

    1998-01-01

    The endangered familiar members of the ailing with the primary lymphedema are clinically examined (anamnesis, physical examination of the extremities and biochemical examination) and by radionuclide lymphography of the extremities. For the proved latent stadium of the lymphedema the complex of preventive therapy is recommended. (authors)

  16. Readability, complexity, and suitability analysis of online lymphedema resources.

    Science.gov (United States)

    Tran, Bao Ngoc N; Singh, Mansher; Lee, Bernard T; Rudd, Rima; Singhal, Dhruv

    2017-06-01

    Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend. This, more comprehensive study, expands the previous analysis to include critical elements of health materials beyond readability using assessment tools to report on the complexity and density of data as well as text design, vocabulary, and organization. The top 10 highest ranked websites on lymphedema were identified using the most popular search engine (Google). Website content was analyzed for readability, complexity, and suitability using Simple Measure of Gobbledygook, PMOSE/iKIRSCH, and Suitability Assessment of Materials (SAM), respectively. PMOSE/iKIRSCH and SAM were performed by two independent raters. Fleiss' kappa score was calculated to ensure inter-rater reliability. Online lymphedema literature had a reading grade level of 14.0 (SMOG). Overall complexity score was 6.7 (PMOSE/iKIRSCH) corresponding to "low" complexity and requiring a 8th-12th grade education. Fleiss' kappa score was 80% (P = 0.04, "substantial" agreement). Overall suitability score was 45% (SAM) correlating to the lowest level of "adequate" suitability. Fleiss' kappa score was 76% (P = 0.06, "substantial" agreement). Online resources for lymphedema are above the recommended levels for readability and complexity. The suitability level is barely adequate for the intended audience. Overall, these materials are too sophisticated for the average American adult, whose literacy skills are well documented. Further efforts to revise these materials are needed to improve patient comprehension and understanding. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The Impact of Radiation Therapy on the Risk of Lymphedema After Treatment for Breast Cancer: A Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G.; Miller, Cynthia L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Skolny, Melissa N.; Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean A. [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose/Objective: Lymphedema after breast cancer treatment can be an irreversible condition with a negative impact on quality of life. The goal of this study was to identify radiation therapy-related risk factors for lymphedema. Methods and Materials: From 2005 to 2012, we prospectively performed arm volume measurements on 1476 breast cancer patients at our institution using a Perometer. Treating each breast individually, 1099 of 1501 patients (73%) received radiation therapy. Arm measurements were performed preoperatively and postoperatively. Lymphedema was defined as ≥10% arm volume increase occurring >3 months postoperatively. Univariate and multivariate Cox proportional hazard models were used to evaluate risk factors for lymphedema. Results: At a median follow-up time of 25.4 months (range, 3.4-82.6 months), the 2-year cumulative incidence of lymphedema was 6.8%. Cumulative incidence by radiation therapy type was as follows: 3.0% no radiation therapy, 3.1% breast or chest wall alone, 21.9% supraclavicular (SC), and 21.1% SC and posterior axillary boost (PAB). On multivariate analysis, the hazard ratio for regional lymph node radiation (RLNR) (SC ± PAB) was 1.7 (P=.025) compared with breast/chest wall radiation alone. There was no difference in lymphedema risk between SC and SC + PAB (P=.96). Other independent risk factors included early postoperative swelling (P<.0001), higher body mass index (P<.0001), greater number of lymph nodes dissected (P=.018), and axillary lymph node dissection (P=.0001). Conclusions: In a large cohort of breast cancer patients prospectively screened for lymphedema, RLNR significantly increased the risk of lymphedema compared with breast/chest wall radiation alone. When considering use of RLNR, clinicians should weigh the potential benefit of RLNR for control of disease against the increased risk of lymphedema.

  18. [Exudative enteropathy in congenital lymphedema-lymphangiectasia syndrome].

    Science.gov (United States)

    Heruth, M; Müller, P; Liebscher, L; Kurze, G; Richter, T

    2006-01-01

    Congenital peripheral elephantiasiformic alterations are very rare in paediatric patients. In a patient with lymphangiectasia-lymphedema syndrome we demonstrate over a 8-year follow-up that not only cosmetic and social indications for surgical treatments but also internal care become important during the course. We report on a boy with congenital lymphedemas of the extremities and the genital region, which were several times surgically treated. The patient became symptomatic firstly with tetanic cramps caused by malabsorption syndrome due to intestinal lymphangiectasia at the age of 6 years. Synopsis of clinical and laboratory findings and the patient's course are pointing to a mild Hennekam syndrome with still unknown aetiology. The boy developed adequately with permanent oral substitution of electrolytes and vitamins, protein-rich diet, supplementation of medium-chain fatty acids and compressing bandages. Infusions of human albumin to correct persistent hypalbuminemia as well as cytostatic treatment with cyclophosphamide as a formal trial were ineffective and are not advisable, therefore.

  19. Development of independent walking in toddlers

    NARCIS (Netherlands)

    Ivanenko, Yuri P; Dominici, Nadia; Lacquaniti, Francesco

    Surprisingly, despite millions of years of bipedal walking evolution, the gravity-related pendulum mechanism of walking does not seem to be implemented at the onset of independent walking, requiring each toddler to develop it. We discuss the precursor of the mature locomotor pattern in infants as an

  20. Hereditary lymphedema of the leg – A Case Report

    NARCIS (Netherlands)

    Heinig, Birgit; Lotti, T.; Tchernev, Georgi; Wollina, Uwe

    2017-01-01

    Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist) when he was seven years old. He had never been treated for lymphedema but

  1. Refractory lymphedema of the hand: an unusual presentation of recurrent herpes simplex virus infection

    Directory of Open Access Journals (Sweden)

    Ali Majdzadeh

    2016-07-01

    Full Text Available Introduction: Herpes Simplex Virus (HSV infection of the hand resulting in lymphatic complications such as lymphangitis and lymphedema is exceedingly uncommon. Although these complications typically resolve in 21 days, they can be persistent and may not resolve even with antiviral use, thereby mimicking dyshidrotic eczema or a bacterial event and often being misdiagnosed and inappropriately treated as such. We report a case of frequently recurring HSV infection of the hand over a long period of time resulting in refractory lymphedema which did not resolve with antiviral treatment. We further endeavor to raise awareness about this highly unusual presentation of HSV infection. A comprehensive review of the literature was conducted for similar cases using PubMed and Medline. Case Report: This is the first reported case with nearly a decade-long interval between the onset of primary HSV infection and the development of chronic lymphedema. Although valacyclovir significantly reduced the episodic aggravation of the lymphedema, it did not entirely resolve it. Similar cases of persistent lymphedema also included a long history of untreated and recurrent HSV infection of the hand, suggesting that this lymphatic outcome may be circumvented by prompt treatment with antivirals. Conclusion: This case report not only presents a highly uncommon lymphatic manifestation and unusual timeline of exacerbation of the very common HSV infection, but also highlights the importance and benefits of early initiation of antiviral therapy and the prevention of reactivation.

  2. Development of Independent-type Optical CT

    Science.gov (United States)

    Yamaguchi, Tatsushi; Shiozawa, Daigoro; Rokunohe, Toshiaki; Kida, Junzo; Zhang, Wei

    Optical current transformers (optical CTs) have features that they can be made much smaller and lighter than conventional electromagnetic induction transformers by their simple structure, and contribute to improvement of equipment reliability because of their excellent surge resistance performance. Authors consider optical CTs to be next generation transformers, and are conducting research and development of optical CTs aiming to apply to measuring and protection in electric power systems. Specifically we developed an independent-type optical CT by utilizing basic data of optical CTs accumulated for large current characteristics, temperature characteristics, vibration resistance characteristics, and so on. In performance verification, type tests complying with IEC standards, such as short-time current tests, insulation tests, accuracy tests, and so on, showed good results. This report describes basic principle and configuration of optical CTs. After that, as basic characteristics of optical CTs, conditions and results of verification tests for dielectric breakdown characteristics of sensor fibers, large current characteristics, temperature characteristics, and vibration resistance characteristics are described. Finally, development outline of the independent-type optical CT aiming to apply to all digital substation and its type tests results are described.

  3. Clinical and diagnostic aspects of lymphedema.

    Science.gov (United States)

    Keo, Hong H; Gretener, Silvia B; Staub, Daniel

    2017-07-01

    Lymphedema is a chronic, progressive, and common but often unrecognized condition. The diagnosis of lymphatic disease on clinical grounds alone remains a challenge. Without proper diagnosis, therapy is often delayed, allowing disease progression. There is a need for a practical diagnostic algorithm and its imaging technique to guide clinical decision-making. The aim of this topical review is to provide a practical approach for assessing patients with suspected lymphedema and to give a critical appraisal of currently available imaging modalities that are applied in clinical practice to diagnose and map lymphatic disease.

  4. 48 CFR 731.773 - Independent research and development costs.

    Science.gov (United States)

    2010-10-01

    ... Organizations 731.773 Independent research and development costs. Pending establishment of Government-wide... independent research and development costs. ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Independent research and...

  5. Liquid silicone used for esthetic purposes as a potentiator for occurrence of post-radiotherapy genital lymphedema: case report

    Directory of Open Access Journals (Sweden)

    Raíssa Quaiatti Antonelli

    Full Text Available ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.

  6. Multidisciplinary Approaches to the Management of Breast-Cancer-Related Lymphedema

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2013-07-01

    Full Text Available Breast-cancer-related lymphedema is a significant morbidity mostly observed following primary treatments for breast cancer (surgery, radiation, and chemotherapy (1. Multiple complications might accompany lymphedema including cosmetic deformity, psychological disorders, consistent pain, and consequently decreased quality of life. Treatment  mostly focuses on reducing edema and its subsequent pain; however, no definite treatment has been hitherto introduced (2. Surgical approaches in the management of lymphedema are efficient including physiologic methods (e.g. flap interposition, lymph transfer, and lymphatic bypass and reductive techniques (e.g. liposuction (3. While the former mostly targets at reducing lymphedema through restoring lymphatic drainage, the latter aims at removing fibrofatty tissues which contribute to lymph stasis. Microsurgical variation of lymphatic bypass has gained popularity, in which the accumulated lymph in the lymphedematous limb is redirected. Non-surgical approaches are also practiced in most cases. Comprehensive decongestive therapy, consisting of skin care, exercise, special bandaging and massage, is the most frequently used non-surgical approach efficacy of which could be enhanced in combination with self-management strategies (4. Recently newer techniques have been introduced to tackle lymphedema and its associated pain. Manual lymph drainage, stellate ganglion block, acupuncture, deep oscillation, and pneumatic compression have been efficiently used in several studies. Moreover, significant short-term progress has been reported following other modalities such as low-level laser therapy (5. The complexity of breast-cancer-related lymphedema and its complications necessitates a multidisciplinary approach with the primary goal of easing the burden of the disease on the breast cancer patients. In addition, developing special guidelines encompassing these multidisciplinary approaches and providing educational and

  7. Lymphedema during pregnancy - case study

    Directory of Open Access Journals (Sweden)

    Katarzyna Korabiusz

    2017-06-01

    Full Text Available Pregnancy is a period when woman’s body undergoes a lot of changes in her hormonal balance, lymphatic system, musculoskeletal system and cardiovascular system. As a result of disorders in defense mechanisms, a significant amount of liquid accumulates in spaces between tissues. A clinical manifestation of this condition is swelling located around ankles and lower legs. Sedentary lifestyle, unhealthy eating habits, excessive weight and pregnancy are also well known causes of lymphatic swelling. Comprehensive anti-swelling therapy that is used in treating lymphatic swelling in pregnant patients includes: patients’ education, manual lymphatic drainage, kinesitherapy, multilayer bandaging, skin care, drainage positions and kinesiotaping. Dissertation’s objective: Dissertation’s objective is to evaluate implementation of manual lymphatic drainage and anti-swelling kinesiotaping in pregnant woman with lymphatic swelling of lower legs. Research methods: Research methods were collected basing on: interview with a patient, medical documentation analysis and physical examination conduced before and after therapy. Research was conducted between 34th and 36th week of pregnancy. Case study: 38 year old patient in her fourth singleton pregnancy. Two prior pregnancies in 2009 and 2010 were delivered with C-section and one missed abortion in 2015 occurred. During this pregnancy patient gained over 30kg. She was diagnosed with lymphatic swelling of metatarsus, lower legs and ankles in 34th week of pregnancy. Lymphatic drainage of lower limbs and anti-swelling kinesiotaping was implemented. Results: After two weeks of therapy decrease in swelling was observed in left lower limb: in metatarsus by 8cm, in ankles by 9cm and in lower legs by 6cm. In right lower limb swelling decreased accordingly by 7cm, 10cm and 5cm. Conclusion: Anti-swelling lymphatic drainage, kinesiotherapy and kinesiotaping are effective physiotherapy methods used in treating lymphedema

  8. Financial cost of lymphedema borne by women with breast cancer

    Science.gov (United States)

    Xu, Ying; Kalfa, Senia; Koelmeyer, Louise; Parkinson, Bonny; Mackie, Helen; Viveros, Hector; Gollan, Paul; Taksa, Lucy

    2016-01-01

    Abstract Objective Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. Methods An online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association. Results Both breast cancer and lymphedema result in significant out‐of‐pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P < .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0‐45). Twenty‐five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P < .001). The average out‐of‐pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema. Conclusions This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs. PMID:27479170

  9. Filarial lymphedema is characterized by antigen-specific Th1 and th17 proinflammatory responses and a lack of regulatory T cells.

    Directory of Open Access Journals (Sweden)

    Subash Babu

    Full Text Available Lymphatic filariasis can be associated with development of serious pathology in the form of lymphedema, hydrocele, and elephantiasis in a subset of infected patients.To elucidate the role of CD4(+ T cell subsets in the development of lymphatic pathology, we examined specific sets of cytokines in individuals with filarial lymphedema in response to parasite antigen (BmA and compared them with responses from asymptomatic infected individuals. We also examined expression patterns of Toll-like receptors (TLR1-10 and Nod-like receptors (Nod1, Nod2, and NALP3 in response to BmA. BmA induced significantly higher production of Th1-type cytokines-IFN-gamma and TNF-alpha-in patients with lymphedema compared with asymptomatic individuals. Notably, expression of the Th17 family of cytokines-IL-17A, IL-17F, IL-21, and IL-23-was also significantly upregulated by BmA stimulation in lymphedema patients. In contrast, expression of Foxp3, GITR, TGFbeta, and CTLA-4, known to be expressed by regulatory T cells, was significantly impaired in patients with lymphedema. BmA also induced significantly higher expression of TLR2, 4, 7, and 9 as well Nod1 and 2 mRNA in patients with lymphedema compared with asymptomatic controls.Our findings implicate increased Th1/Th17 responses and decreased regulatory T cells as well as regulation of Toll- and Nod-like receptors in pathogenesis of filarial lymphedema.

  10. Political Attitudes Develop Independently of Personality Traits

    Science.gov (United States)

    Hatemi, Peter K.; Verhulst, Brad

    2015-01-01

    The primary assumption within the recent personality and political orientations literature is that personality traits cause people to develop political attitudes. In contrast, research relying on traditional psychological and developmental theories suggests the relationship between most personality dimensions and political orientations are either not significant or weak. Research from behavioral genetics suggests the covariance between personality and political preferences is not causal, but due to a common, latent genetic factor that mutually influences both. The contradictory assumptions and findings from these research streams have yet to be resolved. This is in part due to the reliance on cross-sectional data and the lack of longitudinal genetically informative data. Here, using two independent longitudinal genetically informative samples, we examine the joint development of personality traits and attitude dimensions to explore the underlying causal mechanisms that drive the relationship between these features and provide a first step in resolving the causal question. We find change in personality over a ten-year period does not predict change in political attitudes, which does not support a causal relationship between personality traits and political attitudes as is frequently assumed. Rather, political attitudes are often more stable than the key personality traits assumed to be predicting them. Finally, the results from our genetic models find that no additional variance is accounted for by the causal pathway from personality traits to political attitudes. Our findings remain consistent with the original construction of the five-factor model of personality and developmental theories on attitude formation, but challenge recent work in this area. PMID:25734580

  11. Political attitudes develop independently of personality traits.

    Science.gov (United States)

    Hatemi, Peter K; Verhulst, Brad

    2015-01-01

    The primary assumption within the recent personality and political orientations literature is that personality traits cause people to develop political attitudes. In contrast, research relying on traditional psychological and developmental theories suggests the relationship between most personality dimensions and political orientations are either not significant or weak. Research from behavioral genetics suggests the covariance between personality and political preferences is not causal, but due to a common, latent genetic factor that mutually influences both. The contradictory assumptions and findings from these research streams have yet to be resolved. This is in part due to the reliance on cross-sectional data and the lack of longitudinal genetically informative data. Here, using two independent longitudinal genetically informative samples, we examine the joint development of personality traits and attitude dimensions to explore the underlying causal mechanisms that drive the relationship between these features and provide a first step in resolving the causal question. We find change in personality over a ten-year period does not predict change in political attitudes, which does not support a causal relationship between personality traits and political attitudes as is frequently assumed. Rather, political attitudes are often more stable than the key personality traits assumed to be predicting them. Finally, the results from our genetic models find that no additional variance is accounted for by the causal pathway from personality traits to political attitudes. Our findings remain consistent with the original construction of the five-factor model of personality and developmental theories on attitude formation, but challenge recent work in this area.

  12. Hereditary Lymphedema of the Leg – A Case Report

    Directory of Open Access Journals (Sweden)

    Birgit Heinig

    2017-07-01

    Full Text Available Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist when he was seven years old. He had never been treated for lymphedema but experienced multiple erysipelas during his life. After diagnostic procedures to exclude other causes of leg swelling, the diagnosis of hereditary lymphedema of the leg, stage III was confirmed. We initialized complex decongestive therapy. During two weeks of intensive treatment, the circumference of the left leg could be reduced by 10 cm. This case illustrates the "natural course" hereditary lymphedema. But it raises the hope that even after decades of ignorance, the patients benefits from complex decongestive treatment. Therapeutic nihilism is unnecessary and poses lymphedema patients to risks of infection and secondary malignancies like Stewart-Trewes syndrome.

  13. Otophyma: a case report and review of the literature of lymphedema (elephantiasis) of the ear.

    Science.gov (United States)

    Carlson, J Andrew; Mazza, Jill; Kircher, Kenneth; Tran, Tien Anh

    2008-02-01

    Phymas (swellings, masses, or bulbs) are considered the end-stage of rosacea and mostly affect the nose (rhinophyma), and rarely involve the chin (gnatophyma), the cheek (metophyma), eyelids (blepharophyma), or ears (otophyma). Herein, we report the case of a 57-year-old man who developed unilateral enlargement of his left ear over 2 years. Biopsy revealed changes of rosaceous lymphedema associated with Demodex infestation. Corticosteroid and minocycline therapies resulted in partial reduction of the ear enlargement. Literature review examining for cases of lymphedema (elephantiasis) of the ear revealed that chronic inflammatory disorders (rosacea (most frequent), psoriasis, eczema), bacterial cellulitis (erysipelas), pediculosis, trauma, and primary (congenital) lymphedema can all lead to localized, lymphedematous enlargement of the ear. Depending on the severity, medical treatment directed at the inflammatory condition for mild, diffuse enlargement to surgical debulking for extensive diffuse enlargement or tumor formation can improve the signs and symptoms of otophyma. Decreased immune surveillance secondary to rosaceous lymphedema may explain why Demodex infestation is common in rosacea and support the suspicion that phymatous skin is predisposed to skin cancer development.

  14. Symptom report in detecting breast cancer-related lymphedema

    Directory of Open Access Journals (Sweden)

    Fu MR

    2015-10-01

    Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97

  15. Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

    Directory of Open Access Journals (Sweden)

    Kanapathy M

    2015-08-01

    Full Text Available Muholan Kanapathy,1 Mark J Portou,1,2 Janice Tsui,1,2 Toby Richards1,21Division of Surgery and Interventional Science, University College London, 2Department of Vascular Surgery, Royal Free London NHS Foundation Trust Hospital, London, UKAbstract: Diabetic foot ulcers (DFUs are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.Keywords: diabetic foot ulcer, lymphedema, chronic wound, wound management

  16. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

    Science.gov (United States)

    Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

    2008-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months

  17. Lymphedema-lymphangiectasia-mental retardation (Hennekam) syndrome: A review

    NARCIS (Netherlands)

    van Balkom, Inge D. C.; Alders, Mariel; Allanson, Judith; Bellini, Carlo; Frank, Ulrich; de Jong, Greetje; Kolbe, Ingeborg; Lacombe, Didier; Rockson, Stan; Rowe, Peter; Wijburg, Frits; Hennekam, Raoul C. M.

    2002-01-01

    The Hennekam syndrome is an infrequently reported heritable entity characterized by lymphedema, lymphangiectasia, and developmental delay. Here we add an additional 8 patients, and compare their findings to the 16 cases from the literature. The lymphedema is usually congenital, can be markedly

  18. Center Independent Research & Developments: JSC IRAD Program

    Data.gov (United States)

    National Aeronautics and Space Administration — JSC provides and applies its preeminent capabilities in science and technology to develop, operate, and integrate human exploration missions.  The center...

  19. [What physiotherapeutic method for the treatment of post-mastectomy lymphedema is the most effective?

    Science.gov (United States)

    Grushina, T I

    We have undertaken the search for the publications of interest in the following databases: Scopus, Web of Science, MedLine, The Cochrane Library, CyberLeninka, and Russian science citation index. In addition, we evaluated the effectiveness of the physical agents and procedures having different mechanisms of action of the known factors responsible for the development of post-mastectomy lymphedema. Such agents and procedures include self-massage, manual lymphatic drainage, therapeutic physical exercises, compression bandaging, wearing elastic compression garments, Kinesio Tex taping, pneumatic compression, ultrasonic, electrostatic, extracorporeal shock wave therapy, electrical muscle stimulation, microcurrent and low-intensity laser therapy. These methods and products were used by the authors of selected publications either separately or in the combined modes taking into consideration the significant differences between effects of the application of individual techniques. The results of the treatment are presented for different time periods, either in absolute units (cm or ml) in the majority of the cases or in relative units (%) only in part of them without information concerning the statistical significance of the results obtained. There is thus far neither the universal classification of post-mastectomy lymphedema nor the generally accepted approaches to its diagnostics and treatment. Therefore, it is impossible to give an unambiguous answer as regards the effectiveness of one or another method for the diagnostics and treatment of this condition. The author of the present article observed 172 patients at the age of 56.8±9.7 years suffering from late grade I-IV lymphedema treated with the use of local low-intensity low-frequency electric and magnetic therapy in the combination with pneumatic compression applied during 15 days. The results of the treatment were evaluated using water and impedance plethysmography. Within 4 weeks after the onset of therapy, the

  20. Prospective Lymphedema Surveillance in a Clinic Setting

    Directory of Open Access Journals (Sweden)

    Janet Chance-Hetzler

    2015-08-01

    Full Text Available The potential impact of breast cancer-related lymphedema (LE is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1 time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ; (2 referral to LE management with limb volume increase (LVI and/or LBCQ symptoms; and (3 cost of LE management at lower LVI (≥5%–≤10% versus traditional (≥10%. Findings revealed a visit timeframe mean of 40.3 min (range = 25–60; 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9. LBCQ symptoms and LVI were significantly (p < 0.001 correlated to LE referral; six of the nine patients referred (67% displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings.

  1. U.S. independent operators step up exploration, development abroad

    International Nuclear Information System (INIS)

    Koen, A.D.

    1996-01-01

    This paper reviews the new trend of independent oil and gas operation expenditures in overseas development. It compares recent trends in production, production revenues, and exploration and development expenditures in both the US and non-US markets. It identifies numerous development projects going on in China, Columbia, Australia, Algeria, and others. It documents the production revenues from the overseas fields compared to the returns on US production. It also documents many of the advantages that the independents have over the major companies to obtain a competitive edge on developments in these regions. A historical perspective is also given which tracks the gradual changes of the way which independents operate

  2. The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Stocks, Meredith E; Freeman, Matthew C; Addiss, David G

    2015-10-01

    Lymphedema of the leg and its advanced form, known as elephantiasis, are significant causes of disability and morbidity in areas endemic for lymphatic filariasis (LF), with an estimated 14 million persons affected worldwide. The twin goals of the World Health Organization's Global Program to Eliminate Lymphatic Filariasis include interrupting transmission of the parasitic worms that cause LF and providing care to persons who suffer from its clinical manifestations, including lymphedema-so-called morbidity management and disability prevention (MMDP). Scaling up of MMDP has been slow, in part because of a lack of consensus about the effectiveness of recommended hygiene-based interventions for clinical lymphedema. We conducted a systemic review and meta-analyses to estimate the effectiveness of hygiene-based interventions on LF-related lymphedema. We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through March 23, 2015 with no restriction on year of publication. Studies were eligible for inclusion if they (1) were conducted in an area endemic for LF, (2) involved hygiene-based interventions to manage lymphedema, and (3) assessed lymphedema-related morbidity. For clinical outcomes for which three or more studies assessed comparable interventions for lymphedema, we conducted random-effects meta-analyses. Twenty-two studies met the inclusion criteria and two meta-analyses were possible. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. Participation in hygiene-based lymphedema management was associated with a lower incidence of acute dermatolymphagioadenitis (ADLA), (Odds Ratio 0.32, 95% CI 0.25-0.40), as well as with a decreased percentage of patients reporting at least one episode of ADLA during follow-up (OR 0.29, 95% CI 0.12-0.47). Limitations included high heterogeneity across studies

  3. The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis.

    Directory of Open Access Journals (Sweden)

    Meredith E Stocks

    2015-10-01

    Full Text Available Lymphedema of the leg and its advanced form, known as elephantiasis, are significant causes of disability and morbidity in areas endemic for lymphatic filariasis (LF, with an estimated 14 million persons affected worldwide. The twin goals of the World Health Organization's Global Program to Eliminate Lymphatic Filariasis include interrupting transmission of the parasitic worms that cause LF and providing care to persons who suffer from its clinical manifestations, including lymphedema-so-called morbidity management and disability prevention (MMDP. Scaling up of MMDP has been slow, in part because of a lack of consensus about the effectiveness of recommended hygiene-based interventions for clinical lymphedema.We conducted a systemic review and meta-analyses to estimate the effectiveness of hygiene-based interventions on LF-related lymphedema. We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through March 23, 2015 with no restriction on year of publication. Studies were eligible for inclusion if they (1 were conducted in an area endemic for LF, (2 involved hygiene-based interventions to manage lymphedema, and (3 assessed lymphedema-related morbidity. For clinical outcomes for which three or more studies assessed comparable interventions for lymphedema, we conducted random-effects meta-analyses. Twenty-two studies met the inclusion criteria and two meta-analyses were possible. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. Participation in hygiene-based lymphedema management was associated with a lower incidence of acute dermatolymphagioadenitis (ADLA, (Odds Ratio 0.32, 95% CI 0.25-0.40, as well as with a decreased percentage of patients reporting at least one episode of ADLA during follow-up (OR 0.29, 95% CI 0.12-0.47. Limitations included high heterogeneity

  4. Helium Neon laser therapy for post mastectomy lymphedema and ...

    African Journals Online (AJOL)

    Mohamed M. Khalaf

    2012-12-08

    Dec 8, 2012 ... mastectomy lymphedema and shoulder mobility. Mohamed M. Khalaf *. ,1 .... neurological and orthopedic problems, or diabetes. The patients were ... included 15 patients who received placebo laser therapy in addition to ...

  5. Modifiable Risk Factors for Lymphedema in Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Rossing, Mary A; Malone, Kathleen E

    2004-01-01

    .... In this study, we will assess whether modifiable factors, including body weight, physical activity, smoking and breast reconstruction, influence risk of arm lymphedema among women treated for breast cancer...

  6. Modifiable Risk Factors for Lymphedema in Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Rossing, Mary

    2003-01-01

    .... In this study, we will assess whether modifiable factors, including body weight, physical activity, smoking and breast reconstruction, influence risk of arm Lymphedema among women treated for breast cancer...

  7. Comparison of the effectiveness of complex decongestive therapy and compression bandaging as a method of treatment of lymphedema in the elderly

    Directory of Open Access Journals (Sweden)

    Zasadzka E

    2018-05-01

    Full Text Available Ewa Zasadzka,1 Tomasz Trzmiel,1 Maria Kleczewska,2 Mariola Pawlaczyk1 1Department of Geriatric Medicine and Gerontology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland; 2Day Rehabilitation Center, Hospicjum Palium, Poznań, Poland Background: Lymphedema is a chronic condition which significantly lowers the quality of patient life, particularly among elderly populations, whose mobility and physical function are often reduced. Objectives: The aim of the study was to compare the effectiveness of multi-layer compression bandaging (MCB and complex decongestive therapy (CDT, and to show that MCB is a cheaper, more accessible and less labor intensive method of treating lymphedema in elderly patients. Patients and methods: The study included 103 patients (85 women and 18 men aged ≥60 years, with unilateral lower limb lymphedema. The subjects were divided into two groups: 50 treated with CDT and 53 with MCB. Pre- and post-treatment BMI, and average and maximum circumference of the edematous extremities were analyzed. Results: Reduction in swelling in both groups was achieved after 15 interventions. Both therapies demonstrated similar efficacy in reducing limb volume and circumference, but MCB showed greater efficacy in reducing the maximum circumference. Conclusion: Compression bandaging is a vital component of CDT. Maximum lymphedema reduction during therapy and maintaining its effect cannot be achieved without it. It also demonstrates its effectiveness as an independent method, which can reduce therapy cost and accessibility. Keywords: lymphedema, elderly, therapy, compression bandaging

  8. Clinical effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema: a systematic review

    Science.gov (United States)

    Jeffs, Eunice; Ream, Emma; Taylor, Cath; Bick, Debra

    2018-01-01

    ABSTRACT Objective: To identify the effect of decongestive lymphedema treatment on excess arm volume or patient-centered outcomes in women presenting within either 12 months or a mean nine months of developing arm lymphedema following breast cancer treatment. Introduction: Lymphedema is a common consequence of breast cancer treatment requiring life-long treatment to reduce symptoms and prevent complications. Currently, evidence to inform the optimal decongestive lymphedema treatment package is lacking. Inclusion criteria: The review included studies on women who received lymphedema treatment within either 12 months or a mean of nine months of developing unilateral breast cancer-related arm lymphedema. The intervention was any decongestive lymphedema treatment delivered with the purpose of reducing arm lymphedema, compared to another form of lymphedema treatment (whether self or practitioner-administered), placebo or no treatment. The clinical outcome was excess arm volume; patient-centered outcomes were health-related quality of life, arm heaviness, arm function, patient-perceived benefit and satisfaction with treatment. Experimental study designs were eligible, including randomized and non-randomized controlled trials, quasi-experimental, prospective and retrospective before and after studies were considered. Methods: A three-step search strategy was utilized to find published and unpublished studies. The search identified studies published from the inception of each database to July 6, 2016. Reference lists were scanned to identify further eligible studies. Studies were critically appraised using appropriate standardized critical appraisal instruments from the Joanna Briggs Institute. Details describing each study and treatment results regarding outcomes of interest were extracted from papers included in the review using appropriate standardized data extraction tools from the Joanna Briggs Institute. Due to heterogeneity in included studies, results for similar

  9. Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

    Directory of Open Access Journals (Sweden)

    Shelley J. E. Hwang

    2017-01-01

    Full Text Available There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.

  10. Surgical treatment of lymphedema of the penis and scrotum

    OpenAIRE

    Modolin,Miguel; Mitre,Anuar Ibrahim; Silva,José Carlos Faes da; Cintra,Wilson; Quagliano,Ana Paula; Arap,Sami; Ferreira,Marcus Castro

    2006-01-01

    PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by r...

  11. Microsurgery for groin lymphocele and lymphedema after oncologic surgery.

    Science.gov (United States)

    Boccardo, Francesco; Dessalvi, Sara; Campisi, Corrado; Molinari, Lidia; Spinaci, Stefano; Talamo, Giuseppina; Campisi, Corradino

    2014-01-01

    Groin lymphocele (GL) is a frequent complication of inguinal lymph node dissection, and conservative treatment is not always successful. Different surgical methods have been used to treat lymphoceles arising from lymphatics injured during groin surgery. However, they all involve the closure of lymphatics merging at the lymphocele, increasing the risk of postoperative lower limb lymphedema or of worsening lymphedema if already clinically evident. We assessed the efficacy of a diagnostic and therapeutic protocol to manage inguinal lymphoceles using lymphoscintigraphy (LS) and microsurgical procedures. Sixteen GL [seven associated with leg lymphedema (LL)] were studied by LS preoperatively and treated by complete excision of lymphocele and microsurgical lymphatic-venous anastomoses between afferent lymphatics and a collateral branch of great saphenous vein. Lower limb lymphatics were identified intraoperatively using Patent Blue dye injection. Nine patients without lymphedema had complete healing of lymphocele and no appearance of lower limb postoperative lymphedema. The other seven patients with associated secondary lymphedema had complete disappearance of lymphocele and a remarkable reduction of leg volume. Four of them completely recovered without the need of any compression garment, after the first year postoperative. Inguinal lymphocele nonresponsive to conservative treatment can be advantageously studied by LS and successfully treated by microsurgical reconstructive procedures, above all if associated to LL. Copyright © 2013 Wiley Periodicals, Inc.

  12. Developing an Independence State: Some Insights from Qalam Publication

    Directory of Open Access Journals (Sweden)

    Norziati Mohd Rosman

    2017-03-01

    Full Text Available This article is to identify a few concepts on independence and proposed a necessary approach in developing an identity of the country by analysing articles written in Qalam periodicals by three figures, Edrus, Dr Burhanuddin al-Helmy and Muhammad Isa Anshary. Qalam is a socio-politics periodical in Jawi script published in Singapore in 1950 until 1969. By analysing the writings, it is believed that proclamation of Indonesian independence in 1945 inspired to the development of Malaysia as a sovereign country and influenced readers in Malaya, Singapore and Brunei in which their countries were still struggling for independence.

  13. Compulsive masturbation and chronic penile lymphedema.

    Science.gov (United States)

    Calabrò, Rocco Salvatore; Galì, Alessandro; Marino, Silvia; Bramanti, Placido

    2012-06-01

    Chronic penile lymphedema arises from the abnormal retention of lymphatic fluid in the subcutaneous tissues and may be secondary to local and systemic medical conditions such as sexually transmitted diseases, filariasis, malignancy, local radiotherapy, and surgery. This case report aims to consider compulsive masturbation as a possible cause of chronic penile edema. A 40-year-old man was referred to our institute for behavioral disturbance, including compulsive masturbation. Neuropsychiatric evaluation showed moderate mental retardation, mild dysarthria and limb incoordination, anxiety, depressed mood, and impulse dyscontrol. Brain MRI pointed out diffuse white matter lesions. Urogenital examination revealed an uncircumcised penis with non-tender edema of the shaft and prepuce with areas of lichenification. Since the most common local and systemic causes of edema were excluded, chronic penile edema due to compulsive masturbation was diagnosed and the compulsive behavior treated with an antidepressant and low-dose neuroleptics. Compulsive masturbation should be taken into account when counselling patients with penile edema.

  14. Lymphoscintigraphy in the diagnosis of extremity lymphedema

    International Nuclear Information System (INIS)

    Yang Meifang; Lu Gang; Li Fang; Tian Jian

    1994-01-01

    Lymphoscintigraphy, using 99m Tc labeled antimony sulfur colloid and 99m Tc labeled dextran, was performed on 25 patients with swelling of upper or lower extremities for diagnosis of lymphedema. Five different lymphoscintigraphic patterns were identified, that is normal (4 cases), collaterals (2 cases), mixed (13 cases), dermal backflow (4 cases) and no backflow pattern (2 cases). Eight patients underwent operations for lympho-venous anastomoses on the involved extremity. The results indicate that lymphoscintigraphy has many advantages, such as simplicity and non-invasiveness, safety and reliability, being able to differentiate properties of extremity edema, to provide the information of morphologic changes and dynamically display lymphatic drainage and obstructive extent in the lymphatic system. The procedure is valuable for determination of the treatment modalities and the selection of patient for lymphatic microsurgery

  15. Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipo-lymphedema.

    Science.gov (United States)

    Wollina, Uwe; Heinig, Birgit; Schönlebe, Jaqueline; Nowak, Andreas

    2014-01-01

    Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas.

  16. Evaluation of Clinical Manifestations in Patients with Severe Lymphedema with and without CCBE1 Mutations

    NARCIS (Netherlands)

    Alders, M.; Mendola, A.; Adès, L.; Al Gazali, L.; Bellini, C.; Dallapiccola, B.; Edery, P.; Frank, U.; Hornshuh, F.; Huisman, S. A.; Jagadeesh, S.; Kayserili, H.; Keng, W. T.; Lev, D.; Prada, C. E.; Sampson, J. R.; Schmidtke, J.; Shashi, V.; van Bever, Y.; van der Aa, N.; Verhagen, J. M.; Verheij, J. B.; Vikkula, M.; Hennekam, R. C.

    2013-01-01

    The lymphedema-lymphangiectasia-intellectual disability (Hennekam) syndrome (HS) is characterised by a widespread congenital lymph vessel dysplasia manifesting as congenital lymphedema of the limbs and intestinal lymphangiectasia, accompanied by unusual facial morphology, variable intellectual

  17. Independent game development – Developers’ reflections in postmortems

    OpenAIRE

    Suorsa, Noora

    2017-01-01

    Independent computer games have gained a lot of popularity in the past few years. Digital distribution methods and networks have made it possible for indie games to find more players, and get an easier access to markets, and get noticed by the consumers, than it was during the traditional brick and mortar shop based retail and console game dominant era. The increased popularity and number of indie games and developers has made indie games an interesting research area. Research of independent ...

  18. Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review.

    Science.gov (United States)

    Hidding, Janine T; Viehoff, Peter B; Beurskens, Carien H G; van Laarhoven, Hanneke W M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J

    2016-12-01

    Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. The purpose of this study was to provide best evidence regarding which measurement instruments are most appropriate in measuring lymphedema in its different stages. The PubMed and Web of Science databases were used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Clinical studies on measurement instruments assessing lymphedema were reviewed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) scoring instrument for quality assessment. Data on reliability, concurrent validity, convergent validity, sensitivity, specificity, applicability, and costs were extracted. Pooled data showed good intrarater intraclass correlation coefficients (ICCs) (.89) for bioimpedance spectroscopy (BIS) in the lower extremities and high intrarater and interrater ICCs for water volumetry, tape measurement, and perometry (.98-.99) in the upper extremities. In the upper extremities, the standard error of measurement was 3.6% (σ=0.7%) for water volumetry, 5.6% (σ=2.1%) for perometry, and 6.6% (σ=2.6%) for tape measurement. Sensitivity of tape measurement in the upper extremities, using different cutoff points, varied from 0.73 to 0.90, and specificity values varied from 0.72 to 0.78. No uniform definition of lymphedema was available, and a gold standard as a reference test was lacking. Items concerning risk of bias were study design, patient selection, description of lymphedema, blinding of test outcomes, and number of included participants. Measurement instruments with evidence for good reliability and validity were BIS, water volumetry, tape measurement, and perometry, where BIS can detect alterations in extracellular fluid in stage 1 lymphedema and the other measurement instruments can detect alterations in volume

  19. Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran.

    Science.gov (United States)

    Honarvar, Behnam; Sayar, Negin; Tahmasebi, Sedigheh; Zakeri, Zeinab; Talei, Asra; Rostami, Sara; Khademi, Sahar; Sabzi Sarvestani, Amene; Sekhavati, Eghbal

    2016-01-01

    Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was 52.3±11.0 years and of the control group was 50.1±10.9 years. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was 4.4±2.5 cm and the difference in volume displacement was 528.7±374.4 milliliters. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI: 2.6-73.3 ), invasiveness of BC (OR =13.7, 95% CI: 7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI: 2.3-7.9), BMI =>25 (OR=4.2, 95% CI: 2-8.7), radiotherapy (OR=3.9, 95% CI: 1.8-8.2 ), past history of limb damage (OR=1.7, 95% CI: 0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI: 1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in

  20. Psychosocial factors associated with adherence for self-management behaviors in women with breast cancer-related lymphedema.

    Science.gov (United States)

    Alcorso, Jessica; Sherman, Kerry A; Koelmeyer, Louise; Mackie, Helen; Boyages, John

    2016-01-01

    Cognitive and affective psychosocial factors have been found to underlie adherence to preventive behaviors in women at risk of developing lymphedema following treatment for breast cancer. The aim of this study was to determine if these factors are associated with adherence to self-management behaviors for women diagnosed with breast cancer-related lymphedema (BCRL). Women with BCRL were recruited through a community-based breast cancer organization and three Australian lymphedema treatment clinics. Participants completed an online questionnaire assessing demographics, medical history, adherence to self-management behaviors, psychosocial variables (personal control, treatment control, consequences, distress, and self-regulation of affect), and knowledge about lymphedema self-management. A total of 166 women participated in the study. Participants reported adhering to a mean of five out of seven behaviors, with 19.5% of participants adhering to all seven behaviors. Adherence to individual behaviors ranged from 65% (self-lymphatic drainage) to 98.2% (skin care). Greater knowledge about lymphedema was significantly correlated with higher adherence. Hierarchical multiple linear regression analysis indicated that only medical history factors (time since diagnosis and having undergone hormone replacement therapy) predicted a significant amount of the variance in adherence. These findings highlight the importance of patient knowledge for optimal adherence to a self-management regimen. In addition, medical history factors may identify if a patient is at risk of nonadherence. The lack of association of adherence with other psychosocial factors considered in this study indicates that factors underlying adherence in affected women differ considerably from those factors prompting preventive behavior adherence in the at-risk population.

  1. Architecture independent environment for developing engineering software on MIMD computers

    Science.gov (United States)

    Valimohamed, Karim A.; Lopez, L. A.

    1990-01-01

    Engineers are constantly faced with solving problems of increasing complexity and detail. Multiple Instruction stream Multiple Data stream (MIMD) computers have been developed to overcome the performance limitations of serial computers. The hardware architectures of MIMD computers vary considerably and are much more sophisticated than serial computers. Developing large scale software for a variety of MIMD computers is difficult and expensive. There is a need to provide tools that facilitate programming these machines. First, the issues that must be considered to develop those tools are examined. The two main areas of concern were architecture independence and data management. Architecture independent software facilitates software portability and improves the longevity and utility of the software product. It provides some form of insurance for the investment of time and effort that goes into developing the software. The management of data is a crucial aspect of solving large engineering problems. It must be considered in light of the new hardware organizations that are available. Second, the functional design and implementation of a software environment that facilitates developing architecture independent software for large engineering applications are described. The topics of discussion include: a description of the model that supports the development of architecture independent software; identifying and exploiting concurrency within the application program; data coherence; engineering data base and memory management.

  2. Surgical treatment of lymphedema of the penis and scrotum.

    Science.gov (United States)

    Modolin, Miguel; Mitre, Anuar Ibrahim; da Silva, José Carlos Faes; Cintra, Wilson; Quagliano, Ana Paula; Arap, Sami; Ferreira, Marcus Castro

    2006-08-01

    Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.

  3. Virology: Independent virus development outside a host

    DEFF Research Database (Denmark)

    Häring, M.; Vestergaard, Gisle Alberg; Rachel, R.

    2005-01-01

    Viruses are thought to be functionally inactive once they are outside and independent of their host cell 1 . Here we describe an exceptional property of a newly discovered virus that infects a hyperthermophilic archaeon growing in acidic hot springs: the lemon-shaped viral particle develops a very...

  4. Fertilization-independent seed development in Arabidopsis thaliana

    OpenAIRE

    Chaudhury, Abdul M.; Ming, Luo; Miller, Celia; Craig, Stuart; Dennis, Elizabeth S.; Peacock, W. James

    1997-01-01

    We report mutants in Arabidopsis thaliana (fertilization-independent seed: fis) in which certain processes of seed development are uncoupled from the double fertilization event that occurs after pollination. These mutants were isolated as ethyl methanesulfonate-induced pseudo-revertants of the pistillata phenotype. Although the pistillata (pi) mutant has short siliques devoid of seed, the fis mutants in the pi background have long siliques containing developing seeds, even though the flowers ...

  5. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...... trial. A total of 160 breast cancer patients with arm lymphedema will be recruited from 3 hospitals and randomized into one of two treatment groups A: Complete Decongestive Therapy including manual drainage or B: Complete Decongestive Therapy without manual lymphatic drainage. The intervention period...... type of treatment is most effective is sparse. The objective of this study is to investigate whether CDT is equally effective if it includes manual lymphatic drainage or not in the treatment of arm lymphedema among patients with breast cancer. METHODS/DESIGN: A randomized, single-blind, equivalence...

  6. Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, F. M., E-mail: gomez_fermun@gva.es; Martinez-Rodrigo, J.; Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain); Santos, E. [University of Pittsburgh, Department of Radiology (United States); Forner, I. [Hospital Universitario y Politecnico La Fe, Servicio de Medicina Fisica y Rehabilitacion (Spain); Lloret, M.; Perez-Enguix, D.; Garcia-Marcos, R. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain)

    2012-12-15

    Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

  7. Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

    International Nuclear Information System (INIS)

    Gómez, F. M.; Martínez-Rodrigo, J.; Martí-Bonmatí, L.; Santos, E.; Forner, I.; Lloret, M.; Pérez-Enguix, D.; García-Marcos, R.

    2012-01-01

    Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4–8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

  8. The use of bioimpedance analysis to evaluate lymphedema.

    Science.gov (United States)

    Warren, Anne G; Janz, Brian A; Slavin, Sumner A; Borud, Loren J

    2007-05-01

    Lymphedema, a chronic disfiguring condition resulting from lymphatic dysfunction or disruption, can be difficult to accurately diagnose and manage. Of particular challenge is identifying the presence of clinically significant limb swelling through simple and noninvasive methods. Many historical and currently used techniques for documenting differences in limb volume, including volume displacement and circumferential measurements, have proven difficult and unreliable. Bioimpedance spectroscopy analysis, a technology that uses resistance to electrical current in comparing the composition of fluid compartments within the body, has been considered as a cost-effective and reproducible alternative for evaluating patients with suspected lymphedema. All patients were recruited through the Beth Israel Deaconess Medical Center Lymphedema Clinic. A total of 15 patients (mean age: 55.2 years) with upper-extremity or lower-extremity lymphedema as documented by lymphoscintigraphy underwent bioimpedance spectroscopy analysis using an Impedimed SFB7 device. Seven healthy medical students and surgical residents (mean age: 26.9 years) were selected to serve as normal controls. All study participants underwent analysis of both limbs, which allowed participants to act as their own controls. The multifrequency bioimpedance device documented impedance values for each limb, with lower values correlating with higher levels of accumulated protein-rich edematous fluid. The average ratio of impedance to current flow of the affected limb to the unaffected limb in lymphedema patients was 0.9 (range: 0.67 to 1.01). In the control group, the average impedance ratio of the participant's dominant limb to their nondominant limb was 0.99 (range: 0.95 to 1.02) (P = 0.01). Bioimpedance spectroscopy can be used as a reliable and accurate tool for documenting the presence of lymphedema in patients with either upper- or lower-extremity swelling. Measurement with the device is quick and simple and results

  9. Giant lymphedema of the penis and scrotum: a case report.

    Science.gov (United States)

    Vives, Franklin; García-Perdomo, Herney Andrés; Ocampo-Flórez, Ginna Marcela

    2016-01-01

    Lymphedema of the penis and scrotum is a rare entity characterized by enlargement of the skin and subcutaneous tissue of the genital region due to lymphatic drainage impairment. This clinical condition is more frequent in tropical countries due to a higher incidence of filariasis, which, in turn, is the main etiology. We describe the case of a 33-year-old man with large lymphedema of the scrotum and penis due to an acute and chronic inflammatory process, foreign body granuloma, and marked hyalinization. Four consecutive surgical interventions were necessary to remove the great part of the affected tissue, which enabled satisfactory results and improved the patient's quality of life.

  10. Giant lymphedema of the penis and scrotum: a case report

    OpenAIRE

    Vives, Franklin; Garc?a-Perdomo, Herney Andr?s; Ocampo-Fl?rez, Ginna Marcela

    2016-01-01

    Lymphedema of the penis and scrotum is a rare entity characterized by enlargement of the skin and subcutaneous tissue of the genital region due to lymphatic drainage impairment. This clinical condition is more frequent in tropical countries due to a higher incidence of filariasis, which, in turn, is the main etiology. We describe the case of a 33-year-old man with large lymphedema of the scrotum and penis due to an acute and chronic inflammatory process, foreign body granuloma, and marked hya...

  11. Developing independent investigators for clinical research relevant for Africa

    LENUS (Irish Health Repository)

    Manabe, Yukari C

    2011-12-29

    Abstract Sustainable research capacity building requires training individuals at multiple levels within a supportive institutional infrastructure to develop a critical mass of independent researchers. At many African medical institutions, a PhD is important for academic promotion and is, therefore, an important focal area for capacity building programs. We examine the training at the Infectious Diseases Institute (IDI) as a model for in-country training based on systems capacity building and attention to the academic environment. PhD training in Africa should provide a strong research foundation for individuals to perform independent, original research and to mentor others. Training the next generation of researchers within excellent indigenous academic centers of excellence with strong institutional infrastructure will empower trainees to ask regionally relevant research questions that will benefit Africans.

  12. Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review

    NARCIS (Netherlands)

    Hidding, J.T.; Viehoff, P.B.; Beurskens, C.H.G.; Laarhoven, H.W. van; Sanden, M.W. van der; Wees, P.J. van der

    2016-01-01

    BACKGROUND: Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. PURPOSE: The purpose of this study was to provide best evidence regarding which measurement

  13. Seroma indicates increased risk of lymphedema following breast cancer treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jørgensen, Mads Gustaf; Haugaard, Karen

    2017-01-01

    in one of the largest retrospective cohort studies. Material and methods We included all patients with unilateral breast cancer treated in the period of 2008-2014. Data regarding treatment and breast cancer characteristics were retrieved from the national breast cancer registry. Data regarding lymphedema...

  14. Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation

    Directory of Open Access Journals (Sweden)

    Fabio Nicoli

    2014-09-01

    Full Text Available Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF. We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.

  15. Breast Cancer-Related Lymphedema: Implications for Family Leisure Participation

    Science.gov (United States)

    Radina, M. Elise

    2009-01-01

    An estimated 20% of breast cancer survivors face the chronic condition of breast cancer-related lymphedema. This study explored the ways in which women with this condition experienced changes in their participation in family leisure as one indicator of family functioning. Participants (N = 27) were interviewed regarding lifestyles before and after…

  16. Fertilization-independent seed development in Arabidopsis thaliana

    Science.gov (United States)

    Chaudhury, Abdul M.; Ming, Luo; Miller, Celia; Craig, Stuart; Dennis, Elizabeth S.; Peacock, W. James

    1997-01-01

    We report mutants in Arabidopsis thaliana (fertilization-independent seed: fis) in which certain processes of seed development are uncoupled from the double fertilization event that occurs after pollination. These mutants were isolated as ethyl methanesulfonate-induced pseudo-revertants of the pistillata phenotype. Although the pistillata (pi) mutant has short siliques devoid of seed, the fis mutants in the pi background have long siliques containing developing seeds, even though the flowers remain free of pollen. The three fis mutations map to loci on three different chromosomes. In fis1 and fis2 seeds, the autonomous endosperm nuclei are diploid and the endosperm develops to the point of cellularization; the partially developed seeds then atrophy. In these two mutants, proembryos are formed in a low proportion of seeds and do not develop beyond the globular stage. When FIS/fis plants are pollinated by pollen from FIS/FIS plants, ≈50% of the resulting seeds contain fully developed embryos; these seeds germinate and form viable seedlings (FIS/FIS). The other 50% of seeds shrivel and do not germinate; they contain embryos arrested at the torpedo stage (FIS/fis). In normal sexual reproduction, the products of the FIS genes are likely to play important regulatory roles in the development of seed after fertilization. PMID:9108133

  17. Fertilization-independent seed development in Arabidopsis thaliana.

    Science.gov (United States)

    Chaudhury, A M; Ming, L; Miller, C; Craig, S; Dennis, E S; Peacock, W J

    1997-04-15

    We report mutants in Arabidopsis thaliana (fertilization-independent seed:fis) in which certain processes of seed development are uncoupled from the double fertilization event that occurs after pollination. These mutants were isolated as ethyl methanesulfonate-induced pseudo-revertants of the pistillata phenotype. Although the pistillata (pi) mutant has short siliques devoid of seed, the fis mutants in the pi background have long siliques containing developing seeds, even though the flowers remain free of pollen. The three fis mutations map to loci on three different chromosomes. In fis1 and fis2 seeds, the autonomous endosperm nuclei are diploid and the endosperm develops to the point of cellularization; the partially developed seeds then atrophy. In these two mutants, proembryos are formed in a low proportion of seeds and do not develop beyond the globular stage. When FIS/fis plants are pollinated by pollen from FIS/FIS plants, approximately 50% of the resulting seeds contain fully developed embryos; these seeds germinate and form viable seedlings (FIS/FIS). The other 50% of seeds shrivel and do not germinate; they contain embryos arrested at the torpedo stage (FIS/fis). In normal sexual reproduction, the products of the FIS genes are likely to play important regulatory roles in the development of seed after fertilization.

  18. [Limb lymphedema as a first manifestation of primary intestinal lymphangiectasia (Waldmann's disease)].

    Science.gov (United States)

    Boursier, V; Vignes, S

    2004-05-01

    Primary intestinal lymphangiectasia (Waldmann's disease) is characterized by protein-losing enteropathy occurring more frequently in childhood. Chronic diarrhea and diffuse edema are the main clinical manifestations. Peripheral lymphedema may also be associated. Lymphedema is usually present at the time of diagnosis or appears later in the course of the disease. We report the observation of a 31-year-old man suffering from an upper, lower limb and genital lymphedema many years before diagnosis of primary intestinal lymphangiectasia was established. Lower limb lymphoscintigraphy confirmed lymphedema and duodenal biopsies lymphangiectasia. Hypoproteinemia, lymphopenia and hypogammaglobulinemia were also noted. Treatment of lymphedema included low stretch bandaging and elastic stocking. No dietary management with a low-fat diet was added. Search for primary intestinal lymphangiectasia with biological parameters would be useful when primary lymphedema is present. Especially since primary intestinal lymphangiectasia may be complicated by occurrence of B cell lymphoma.

  19. Mutations in the VEGFR3 signaling pathway explain 36% of familial lymphedema

    DEFF Research Database (Denmark)

    Mendola, A; Schlögel, M J; Ghalamkarpour, A

    2013-01-01

    Lymphedema is caused by dysfunction of lymphatic vessels, leading to disabling swelling that occurs mostly on the extremities. Lymphedema can be either primary (congenital) or secondary (acquired). Familial primary lymphedema commonly segregates in an autosomal dominant or recessive manner. It can...... of these putative genes. We screened 78 index patients from families with inherited lymphedema for mutations in FLT4, GJC2, FOXC2, SOX18, GATA2, CCBE1, and PTPN14. Altogether, we discovered 28 mutations explaining 36% of the cases. Additionally, 149 patients with sporadic primary lymphedema were screened for FLT4......, FOXC2, SOX18, CCBE1, and PTPN14. Twelve mutations were found that explain 8% of the cases. Still unidentified is the genetic cause of primary lymphedema in 64% of patients with a family history and 92% of sporadic cases. Identification of those genes is important for understanding of etiopathogenesis...

  20. Experience-independent development of the hamster circadian visual system.

    Directory of Open Access Journals (Sweden)

    August Kampf-Lassin

    2011-04-01

    Full Text Available Experience-dependent functional plasticity is a hallmark of the primary visual system, but it is not known if analogous mechanisms govern development of the circadian visual system. Here we investigated molecular, anatomical, and behavioral consequences of complete monocular light deprivation during extended intervals of postnatal development in Syrian hamsters. Hamsters were raised in constant darkness and opaque contact lenses were applied shortly after eye opening and prior to the introduction of a light-dark cycle. In adulthood, previously-occluded eyes were challenged with visual stimuli. Whereas image-formation and motion-detection were markedly impaired by monocular occlusion, neither entrainment to a light-dark cycle, nor phase-resetting responses to shifts in the light-dark cycle were affected by prior monocular deprivation. Cholera toxin-b subunit fluorescent tract-tracing revealed that in monocularly-deprived hamsters the density of fibers projecting from the retina to the suprachiasmatic nucleus (SCN was comparable regardless of whether such fibers originated from occluded or exposed eyes. In addition, long-term monocular deprivation did not attenuate light-induced c-Fos expression in the SCN. Thus, in contrast to the thalamocortical projections of the primary visual system, retinohypothalamic projections terminating in the SCN develop into normal adult patterns and mediate circadian responses to light largely independent of light experience during development. The data identify a categorical difference in the requirement for light input during postnatal development between circadian and non-circadian visual systems.

  1. The effect of prophylactic lymphovenous anastomosis and shunts for preventing cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jørgensen, Mads G; Toyserkani, Navid M; Sørensen, Jens A

    2018-01-01

    BACKGROUND: Lymphedema is one of the most dreaded side effects to any cancer treatment involving lymphadenectomy. Progressed lymphedema is adversely complex and currently there is no widely acknowledged curative treatment. Therefore recent focus has shifted to risk reduction and prevention. It has...... with prophylactic LVA had a significant reduction in lymphedema incidence (Relative risk: 0.33, 95%CI: 0.19 to 0.56) when compared to patients receiving no prophylactic treatment (P 

  2. Ethnodrama: An Innovative Knowledge Translation Tool in the Management of Lymphedema

    OpenAIRE

    Ahmed, Shahid; Quinlan, Elizabeth; McMullen, Linda; Thomas, Roanne; Fichtner, Pam; Block, Janice

    2015-01-01

    Background: Lymphedema can cause significant physical impairment and quality-of-life issues. Yet there is a gap in knowledge about lymphedema among breast cancer survivors (BCS), and health care professionals (HCP). Ethnodrama is an innovative knowledge translation strategy that uses theatrical performances for dissemination of research results. We evaluated the impact of live ethnodrama on HCP' and BCS' awareness and attitudes in relation to impact of lymphedema on BCS' lives. Methods: Ethno...

  3. Development Parenting Model to Increase the Independence of Children

    Science.gov (United States)

    Sunarty, Kustiah; Dirawan, Gufran Darma

    2015-01-01

    This study examines parenting and the child's independence model. The research problem is whether there is a relationship between parenting and the child's independence. The purpose of research is to determine: firstly, the type of parenting in an effort to increase the independence of the child; and the relationship between parenting models and…

  4. Shoulder Pain after Fall, Septic Shock, and Pyomyositis Associated with Breast Cancer Chemotherapy and Lymphedema

    Directory of Open Access Journals (Sweden)

    Hiromitsu Kitayama

    2016-11-01

    Full Text Available Background: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. Case Report: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint. The pain suddenly worsened with septic shock and no apparent local signs. Magnetic resonance imaging revealed myonecrosis, and no pus was yielded by ultrasound-guided needle aspiration. After 2 weeks of recovery by conservative medical management, surgical drainage was performed. Late formulated massive intramuscular pus showed severe neutrophil infiltration and myonecrosis. Conclusion: Pyomyositis can develop into septic shock with poor local signs. Myelosuppression after chemotherapy can cause myonecrosis without macroabscess, and magnetic resonance imaging was useful for the diagnosis of this condition. When unspecified local pain appears during cancer chemotherapy we should consider this disease, too.

  5. Hypohidrotic ectodermal dysplasia, osteopetrosis, lymphedema, and immunodeficiency in an infant with multiple opportunistic infections.

    Science.gov (United States)

    Carlberg, Valerie M; Lofgren, Sabra M; Mann, Julianne A; Austin, Jared P; Nolt, Dawn; Shereck, Evan B; Davila-Saldana, Blachy; Zonana, Jonathan; Krol, Alfons L

    2014-01-01

    Osteopetrosis, lymphedema, hypohidrotic ectodermal dysplasia, and immunodeficiency (OL-HED-ID) is a rare X-linked disorder with only three reported prior cases in the English-language literature. We describe a case of OL-HED-ID in a male infant who initially presented with congenital lymphedema, leukocytosis, and thrombocytopenia of unknown etiology at 7 days of age. He subsequently developed gram-negative sepsis and multiple opportunistic infections including high-level cytomegalovirus viremia and Pneumocystis jiroveci pneumonia. The infant was noted to have mildly xerotic skin, fine sparse hair, and periorbital wrinkling, all features suggestive of ectodermal dysplasia. Skeletal imaging showed findings consistent with osteopetrosis, and immunologic investigation revealed hypogammaglobulinemia and mixed T- and B-cell dysfunction. Genetic testing revealed a novel mutation in the nuclear factor kappa beta (NF-KB) essential modulator (NEMO) gene, confirming the diagnosis of OL-HED-ID. Mutations in the NEMO gene have been reported in association with hypohidrotic ectodermal dysplasia with immunodeficiency (HED-ID), OL-HED-ID, and incontinentia pigmenti. In this case, we report a novel mutation in the NEMO gene associated with OL-HED-ID. This article highlights the dermatologic manifestations of a rare disorder, OL-HED-ID, and underscores the importance of early recognition and prompt intervention to prevent life-threatening infections. © 2013 Wiley Periodicals, Inc.

  6. Therapeutic Effects of Saireito (Chai-Ling-Tang, a Traditional Japanese Herbal Medicine, on Lymphedema Caused by Radiotherapy: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Aiko Nagai

    2013-01-01

    Full Text Available Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50% showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

  7. Imaging findings of adiposis dolorosa vs. massive localized lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Petscavage-Thomas, Jonelle M.; Bernard, Stephanie A.; Bennett, Jennifer [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States)

    2015-06-01

    Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa. A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity. Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90 %. Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these

  8. Adaptive Immune Responses Regulate the Pathophysiology of Lymphedema

    Science.gov (United States)

    2012-09-01

    A, Hennig B (2000) Effect of complex decongestive physiotherapy on gene expression for the inflammatory response in peripheral lymphedema. Lymphology...pharmacologic antagonism of lysophosphatidic acid receptor 1 in a mouse model of scleroderma. Arthritis Rheum 63: 1405-1415. 51. Romani L, Mencacci A, Grohmann...severe disease in collagen-induced arthritis . Arthritis Rheum 48: 1452-1460. 29. Nakamura K, Radhakrishnan K, Wong YM, Rockson SG (2009) Anti

  9. Impact of a community-based lymphedema management program on episodes of Adenolymphangitis (ADLA and lymphedema progression--Odisha State, India.

    Directory of Open Access Journals (Sweden)

    Katherine E Mues

    2014-09-01

    Full Text Available Lymphedema management programs have been shown to decrease episodes of adenolymphangitis (ADLA, but the impact on lymphedema progression and of program compliance have not been thoroughly explored. Our objectives were to determine the rate of ADLA episodes and lymphedema progression over time for patients enrolled in a community-based lymphedema management program. We explored the association between program compliance and ADLA episodes as well as lymphedema progression.A lymphedema management program was implemented in Odisha State, India from 2007-2010 by the non-governmental organization, Church's Auxiliary for Social Action, in consultation with the Centers for Disease Control and Prevention. A cohort of patients was followed over 24 months. The crude 30-day rate of ADLA episodes decreased from 0.35 episodes per person-month at baseline to 0.23 at 24 months. Over the study period, the percentage of patients who progressed to more severe lymphedema decreased (P-value  = 0.0004, while those whose lymphedema regressed increased over time (P-value<0.0001. Overall compliance to lymphedema management, lagged one time point, appeared to have little to no association with the frequency of ADLA episodes among those without entry lesions (RR = 0.87 (0.69, 1.10 and was associated with an increased rate (RR = 1.44 (1.11, 1.86 among those with entry lesions. Lagging compliance two time points, it was associated with a decrease in the rate of ADLA episodes among those with entry lesions (RR = 0.77 (95% CI: 0.59, 0.99 and was somewhat associated among those without entry lesions (RR = 0.83 (95% CI: 0.64, 1.06. Compliance to soap was associated with a decreased rate of ADLA episodes among those without inter-digital entry lesions.These results indicate that a community-based lymphedema management program is beneficial for lymphedema patients for both ADLA episodes and lymphedema. It is one of the first studies to demonstrate an association between program

  10. Diagnostic accuracy of fluorescence microlymphography for detecting limb lymphedema.

    Science.gov (United States)

    Keo, H H; Husmann, M; Groechenig, E; Willenberg, T; Gretener, S B

    2015-04-01

    Fluorescence microlymphography (FML) is a minimally invasive technique for visualization of the cutaneous lymphatic network. The aim of the study was to assess the accuracy and safety of FML in patients with unilateral lymphedema. This was a cross sectional study. Patients with unilateral leg swelling were assessed and compared with the unaffected contralateral limb. FML was performed in all index legs and the contralateral leg by injecting 0.1 mL of fluorescein isothiocyanate (FITC)-labeled dextran intradermally in both limbs at the same level. The most prominent swelling of the affected limb was the anatomical reference. The spread of the dye in the lymphatic capillaries of the skin was measured in all dimensions by epiluminator intravital microscopy and the maximum dye spread value 10 min after injection was used for statistical analysis. The contralateral leg served as control. Test accuracy and receiver operator characteristic (ROC) analysis was performed to assess threshold values that best predict lymphedema. Between March 2008 and February 2014 seventy patients with unilateral chronic leg swelling were clinically diagnosed with lymphedema. The median age was 45 (IQR 27-56) years. Of those, 46 (65.7%) were female and 71.4% had primary and 28.6% secondary lymphedema. Sensitivity, specificity, positive and negative likelihood ratio, and positive and negative predictive value were 94.3%, 78.6%, 4.40, 0.07, 81.5%, and 93.2% for the 12 mm cut off level and 91.4%, 85.7%, 6.40, 0.10, 86.5%, and 90.9% for the 14 mm cut off level, respectively. The area under the ROC curve was 0.89 (95% CI: 0.83-0.95). No major adverse events were observed. FML is an almost atraumatic and safe technique for detecting lymphedema in patients with leg swelling. In this series the greatest accuracy was observed at a cut off level of ≥14 mm maximum spread. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  11. VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

    Science.gov (United States)

    Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

    2003-01-01

    Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphedema: one in the rabbit ear and the other in the mouse tail. In a rabbit model, following local phVEGF-C gene transfer, VEGFR-3 expression was significantly increased. This gene transfer led to a decrease in thickness and volume of lymphedema, improvement of lymphatic function demonstrated by serial lymphoscintigraphy, and finally, attenuation of the fibrofatty changes of the skin, the final consequences of lymphedema. The favorable effect of phVEGF-C on lymphedema was reconfirmed in a mouse tail model. Immunohistochemical analysis using lymphatic-specific markers: VEGFR-3, lymphatic endothelial hyaluronan receptor-1, together with the proliferation marker Ki-67 Ab revealed that phVEGF-C transfection potently induced new lymphatic vessel growth. This study, we believe for the first time, documents that gene transfer of phVEGF-C resolves lymphedema through direct augmentation of lymphangiogenesis. This novel therapeutic strategy may merit clinical investigation in patients with lymphedema. PMID:12618526

  12. Far-Infrared Radiation Thermotherapy Improves Tissue Fibrosis in Chronic Extremity Lymphedema.

    Science.gov (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Sadigh, Parviz; Evans, Verity Joyce; Zhou, Huihong; Gao, Weiqing; Zhang, Yi Xin

    2017-09-29

    Fibrosis can enhance the exacerbation of lymphedema, which becomes obvious in late stage II-III lymphedema. However, whether far-infrared radiation thermotherapy (FIRT) can cure lymphedema fibrosis is still lack of research. This research was to investigate the therapeutic effect of FIRT on tissue fibrosis in the treatment of Late stage II-III lymphedema. Patients accepted only FIRT for a total of 20 sessions. The treatment session duration was 2 hours, and a stable machine temperature of 42°C was maintained throughout treatments. Clinical evaluation and laboratory evaluation were conducted before and after FIRT. Clinical outcome measures included circumference of affected extremity, skin elasticity, ultrasound, patients' subjective assessment, and quality of life (QOL). Laboratory outcome measures included serum and local lymphedema tissue fluid concentrations of fibrosis associated cytokines, tissue growth factor beta-1 (TGF-β1), interleukin (IL)-1β, IL-4, IL-18, and caspase-1. Between 2015 and 2016, clinical evaluation of 64 patients with late stage II-III lymphedema was conducted. From this group, 12 cases (18.75%) underwent simultaneous laboratory evaluation. Circumferences of affected extremities improved significantly following treatment (p pain, discomfort, and numbness (p effective treatment for lymphedema tissue fibrosis; it reduces the concentration of fibrosis cytokines in local lymphedema tissues. Consequently, this treatment can reduce the density of fibrosed tissue in the affected extremity, increase skin elasticity, significantly improve clinical symptoms, and improve QOL of patients.

  13. EMPIRICAL APPROACH UPON THE RELATIONSHIP BETWEEN CENTRAL BANK INDEPENDENCE AND INFLATION IN DEVELOPED AND DEVELOPING COUNTRIES

    Directory of Open Access Journals (Sweden)

    Dumiter Florin Cornel

    2012-07-01

    Full Text Available Central bank independence has become over time one of the key concepts in modern theory and policy. Most economists agree that central bank independence is desirable because it helps achieving and maintaining the long – term goal of price stability. Although one might think about alternative mechanisms to reach lower inflation rates, central bank independence is clearly the most often recomended. The empirical trends upon a more independent central bank with a more transparent and accountable monetary policy regime has emerged in economic literature regarding central banking and monetary economics. In recent years, starting from the Maastricht Treaty central bank independence has become the panacea of the monetary economics and monetary policy approaches. Moreover it is important to analyze and assess the impact of this key issue in central banking upon the inflation performances of the central banks. In this article we provide a qualitative overview upon some recent trends in the central bank independence field: does it still matter? How can be it evaluate and stress it’s impact upon macroeconomic performances, especially upon inflation. As we can observe in the economic literature upon central bank independence there are several approaches to use several indices in order to measure this qualitative and quatitative institutional variables. The most important debate is to eliminate the gap between de jure and de facto independence in order to flatten the measuring of institutional aspects, the legal implication, the constitutional facts and the actual practices of the central banks. Finally, we suggest that according to the new index for measuring central bank independence and inflation targeting index we can evaluate more accurate the degree of the de jure and de facto independence and stress the impact on inflation performance with a case study for ten developed countries and ten developing countries.

  14. Cell therapy for the treatment of lower limb lymphedema. Case report

    International Nuclear Information System (INIS)

    Goicoechea Diaz, Pedro; Hernandez Ramirez, Porfirio; Artaza Sanz, Heriberto

    2010-01-01

    Although lymphedema is a common disabling disease causing significant morbidity for affected patients, treatment for this condition remains limited and largely ineffective. Some reported data suggest that some bone-marrow derived cells may play a role in lymphangiogenesis. It appears that blood vessels and lymphatic vessels might use the same population of cells for vasculogenesis and lymphangiogenesis. Therefore, adult stem cell therapy could be a new useful strategy for the treatment of lymphedema. We report a resolution of a severe lower limb bilateral lymphedema after implantation of autologous adult stem cells derived from bone marrow. As far as we know, this is the first reported case with chronic lower limb lymphedema treated successfully with autologous cell therapy. This procedure is a low-cost, relatively simple and easy to perform option that opens new ways for the treatment of lymphedema

  15. A U.S. developer's introduction to international independent power development

    International Nuclear Information System (INIS)

    Goodwin, L.M.

    1993-01-01

    Because US developers have had significant experience developing independent power projects in the US during the fifteen years since the Public Utility Regulatory Policies Act (''PURPA'') was passed, US developers have been some of the most aggressive participants in the early stages of international independent power development. However, US developers who attempt to transplant their US experience directly to foreign markets may be in for a rude awakening. Despite the similarities, there are significant differences between energy project development within the US and development in international markets. The purpose of this paper is to explore these differences, and to review some of the new considerations that experienced US developers will have to deal with in developing international projects

  16. Development of independent production in Europe: institutional diversity

    International Nuclear Information System (INIS)

    Krause, G.G.

    1995-01-01

    The industrial model of the power sector is being challenged in all but a few countries. Being stable for many years, the power sector is now constrained to evolve to more flexible structures, pushed by financing, political and environmental issues. More so, recent innovations within the financing or entrepreneurial background, as well as in the main equipment suppliers' strategies, have attracted new actors to a formerly closed sector. The independent power production could be seen as a vector leading sector's reforms in several countries, being recognized an a careful path, a way to gradually opening the sector. The analysis of the institutional structures within which the independent production evolves can point out relevant elements and directions of sector's changes. One can find, for instances, within a relatively restraint universe, i.e. that one of the European countries, a variety of situations putting light on the complexity of the debate. This paper aims at discussing the role of the independent power production through such a diversity of institutional structures, avoiding any polarization around themes like privatization or deregulation. (author). 1 fig., 2 tabs., 13 refs

  17. Readability Assessment of Patient Information about Lymphedema and Its Treatment.

    Science.gov (United States)

    Seth, Akhil K; Vargas, Christina R; Chuang, Danielle J; Lee, Bernard T

    2016-02-01

    Patient use of online resources for health information is increasing, and access to appropriately written information has been associated with improved patient satisfaction and overall outcomes. The American Medical Association and the National Institutes of Health recommend that patient materials be written at a sixth-grade reading level. In this study, the authors simulated a patient search of online educational content for lymphedema and evaluated readability. An online search for the term "lymphedema" was performed, and the first 12 hits were identified. User and location filters were disabled and sponsored results were excluded. Patient information from each site was downloaded and formatted into plain text. Readability was assessed using established tests: Coleman-Liau, Flesch-Kincaid, Flesch Reading Ease Index, FORCAST Readability Formula, Fry Graph, Gunning Fog Index, New Dale-Chall Formula, New Fog Count, Raygor Readability Estimate, and Simple Measure of Gobbledygook Readability Formula. There were 152 patient articles downloaded; the overall mean reading level was 12.6. Individual website reading levels ranged from 9.4 (cancer.org) to 16.7 (wikipedia.org). There were 36 articles dedicated to conservative treatments for lymphedema; surgical treatment was mentioned in nine articles across four sites. The average reading level for conservative management was 12.7, compared with 15.6 for surgery (p readability, and surgeons should direct patients to sites appropriate for their level. There is limited information about surgical treatment available on the most popular sites; this information is significantly harder to read than sections on conservative measures.

  18. Incidence and risk factors for lower limb lymphedema after gynecologic cancer surgery with initiation of periodic complex decongestive physiotherapy.

    Science.gov (United States)

    Deura, Imari; Shimada, Muneaki; Hirashita, Keiko; Sugimura, Maki; Sato, Seiya; Sato, Shinya; Oishi, Tetsuro; Itamochi, Hiroaki; Harada, Tasuku; Kigawa, Junzo

    2015-06-01

    Lower limb lymphedema (LLL) is one of the most frequent postoperative complications of retroperitoneal lymphadenectomy for gynecologic cancer. LLL often impairs quality of life, activities of daily living, sleep, and sex in patients with gynecologic cancer. We conducted this study to evaluate the incidence and risk factors for LLL after gynecologic cancer surgery in patients who received assessment and periodic complex decongestive physiotherapy (CDP). We retrospectively reviewed 126 cases of gynecologic cancer that underwent surgery involving retroperitoneal lymphadenectomy at Tottori University Hospital between 2009 and 2012. All patients received physical examinations to detect LLL and underwent CDP by nurse specialists within several months after surgery. The International Society of Lymphology staging of lymphedema severity was used as the diagnostic criteria. Of 126 patients, 57 (45.2%) had LLL, comprising 45 and 12 patients with stage 1 and stage 2 LLL, respectively. No patient had stage 3 LLL. LLL was present in 37 (29.4%) patients at the initial physical examination. Multivariate analysis revealed that adjuvant concurrent chemoradiotherapy and age ≥ 55 years were independent risk factors for ≥ stage 2 LLL. To minimize the incidence of ≥ stage 2 LLL, gynecologic oncologists should be vigilant for this condition in patients who are ≥ 55 years and in those who undergo adjuvant chemoradiotherapy. Patients should be advised to have a physical assessment for LLL and to receive education about CDP immediately after surgery involving retroperitoneal lymphadenectomy for gynecologic cancer.

  19. GB 388 -- An independent's approach to deepwater development

    International Nuclear Information System (INIS)

    Blincow, R.M.; Whittenburg, L.A.; Pickard, R.D.

    1995-01-01

    As the oil industry moves toward greater water depths in search of viable investment opportunities, cost effective, fast track development schemes must be cultivated to overcome the economic obstacles inherent to deepwater field development. While every deepwater development is different and each presents its own unique problems, the dilemma of justifying the costs, minimizing the lead time to first revenue and minimizing the associated risk are common to all projects. The Garden Banks 388 project has successfully utilized the project management concepts, and methodologies presented in this paper to develop a relatively low cost, low risk, fast track approach to deepwater development in the Gulf of Mexico. This paper describes the production system concept, management style and philosophy which have been employed to develop Garden Banks 388. The paper also discusses why the Floating Production System is considered the best alternative for this particular application. Many of the ideas and strategies used in this project can be applied to any project, whether it be deepwater or more conventional types of projects

  20. Competitive bidding for independent power: developments in the United States

    International Nuclear Information System (INIS)

    Kliman, M.

    1995-01-01

    In the United States electric utilities are using competitive bidding programs to procure power supplies from non-utility generators and, in some cases, to establish contracts with energy service companies for the implementation of demand-side management projects. Such programs are viewed as a path to efficient contracts in the private power industry. But bidding programs are complex, subject to pitfalls, and are developing very quickly. This paper reports on that development as of the early 1990s and, as an illustration, briefly describes and analyzes the bidding program of an electric utility in the State of New York. (author). 2 tabs

  1. Becoming Independent Storytellers: Modeling Children's Development of Narrative Macrostructure

    Science.gov (United States)

    Kelly, Kimberly Reynolds; Bailey, Alison Louise

    2013-01-01

    For parents to provide effective support for their children's language development, they must be attuned to their child's changing abilities. This study presents a theoretically driven strategy that addresses a methodological challenge present when tracking longitudinally the cessation or "fading" of behaviors by capturing withdrawal of…

  2. Accurate Prediction of Submental Lymph Nodes Using Magnetic Resonance Imaging for Lymphedema Surgery

    Directory of Open Access Journals (Sweden)

    Mora-Ortiz Asuncion, MD

    2018-03-01

    Conclusions:. The preoperative MRI is a useful tool for the detection of mean 7.2 submental lymph nodes. Mean 72.2% of submental lymph nodes can be successfully transferred for extremity lymphedema with optimal functional recovery.

  3. Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

    Science.gov (United States)

    Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

    2016-03-01

    Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN. © 2015 Japanese Dermatological Association.

  4. Volume and Tissue Composition Changes Measured with Dual-Energy X-Ray Absorptiometry in Melanoma-Related Limb Lymphedema

    DEFF Research Database (Denmark)

    Gjorup, Caroline A; Hendel, Helle W; Zerahn, Bo

    2017-01-01

    Abstracts Background: The aim of this cross-sectional study was to investigate the volume, fat mass, and lean mass in both upper and lower limbs measured with dual-energy X-ray absorptiometry (DXA) in melanoma patients with melanoma-related limb lymphedema. METHODS AND RESULTS: Four hundred thirty...... lymphedema was diagnosed on the basis of history and characteristic physical findings on the clinical examination. The inter-limb differences in volume, fat mass, and lean mass measured with DXA were categorized as none/mild, moderate, or severe according to reference values (taking handedness into account......, and the majority of lymphedemas were categorized as mild. The increase in the volume of limbs with lymphedema was primarily due to an increase in fat mass. CONCLUSION: There is a high prevalence of melanoma-related limb lymphedema. The increase in volume in the limb with lymphedema is primarily due to an increase...

  5. VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

    OpenAIRE

    Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

    2003-01-01

    Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphed...

  6. Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

    OpenAIRE

    STANTON, A.W.B.; MELLOR, R.H.; COOK, G.J.; SVENSSON, W.E.; PETERS, A.M.; LEVICK, J.R.; MORTIMER, P.S.

    2003-01-01

    Background: In arm lymphedema secondary to axillary surgery and radiotherapy (breast cancer-related lymphedema), the swelling is largely epifascial and lymph flow per unit epifascial volume is impaired. The subfascial muscle compartment is not measurably swollen despite the iatrogenic damage to its axillary drainage pathway, but this could be due to its low compliance. Our aim was to test the hypothesis that subfascial lymph drainage too is impaired.

  7. Sensitivity and specificity of fluorescence microlymphography for detecting lymphedema of the lower extremity.

    Science.gov (United States)

    Keo, Hong H; Schilling, Marianne; Büchel, Roland; Gröchenig, Ernst; Engelberger, Rolf P; Willenberg, Torsten; Baumgartner, Iris; Gretener, Silvia B

    2013-06-01

    Fluorescence microlymphography (FML) is used to visualize the lymphatic capillaries. A maximum spread of the fluorescence dye of ≥ 12 mm has been suggested for the diagnosis of lymphedema. However, data on sensitivity and specificity are lacking. The aim of this study was to investigate the accuracy of FML for diagnosing lymphedema in patients with leg swelling. Patients with lower extremity swelling were clinically assessed and separated into lymphedema and non-lymphatic edema groups. FML was studied in all affected legs and the maximum spread of lymphatic capillaries was measured. Test accuracy and receiver operator characteristic (ROC) analysis was performed to assess possible threshold values that predict lymphedema. Between March 2008 and August 2011 a total of 171 patients (184 legs) with a median age of 43.5 (IQR 24, 54) years were assessed. Of those, 94 (51.1%) legs were diagnosed with lymphedema. The sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive value were 87%, 64%, 2.45, 0.20, 72% and 83% for the 12-mm cut-off level and 79%, 83%, 4.72, 0.26, 83% and 79% for the 14-mm cut-off level, respectively. The area under the ROC curve was 0.82 (95% CI: 0.76, 0.88). Sensitivity was higher in the secondary versus primary lymphedema (95.0% vs 74.3%, p = 0.045). No major adverse events were observed. In conclusion, FML is a simple and safe technique for detecting lymphedema in patients with leg swelling. A cut-off level of ≥ 14-mm maximum spread has a high sensitivity and high specificity of detecting lymphedema and should be chosen.

  8. FILAR I AL LYMPHEDEMA LOWER LIMB DEBULKING 34 CASES

    Directory of Open Access Journals (Sweden)

    Baburao

    2015-10-01

    Full Text Available There are various treatment options in the management of filarial lymphedema of the lower extremities. The end point, regardless of the method adopted is a reduction of the girth of the limb, prevention of future increases in limb girth, prevention of recurrent episodes of streptococcal cellulitis; more important the treatment method used should not lead to any secondary problems that may far out shadow the primary co Majority of the methods adopted are mainly of the secondary prevention kind; very few of the procedures to date cure the disease condition. A few of the methods have been historically found to be more effective than the others; this may be real or apparent as the methodology of - reporting swelling in the lower limb may not have been consistent and there are too many variables to consider. This study seeks to evaluate the efficacy of one such treatment protocol for the management of filarial lymphedema of the lower limb 80 patients were admitted for filarial lymphedema of the lower limbs from 2005 to 2015 Of these 42 patients underwent surgical treatment; operative records for 8 of these patients was insufficient to analyse; among the remaining 34 patients 19 patients were unavailable for review. This left us a patient population of 15 for the final analysis . The surgical treatment of all of the 15 patients was identical, after preop preparation by using compression ba n dages to soften the edema along with a period of bed rest debulking of excess skin and subcutaneous tissue and primary closure was done. The intro operative application of Esmarch bandages helped in expelling fluid from the tissues and this ensured that closure was obtained with no tension at the margins. Patients were kept for at least 5 days post op before discharge; the routine use of compression crepe bandages postop along with bed rest ensured that we did not have a single case of skin necrosis or wound disruption in the postop period. All patients were given

  9. The way to achieve independence in China's nuclear power development

    International Nuclear Information System (INIS)

    Lian Peisheng

    1986-04-01

    Very much in need of developing nuclear power, China has found the main problem to be shortage of funds, particularly that of foreign currency. The only way to overcome this difficulty is to increase national share to the utmost extent. Since engineering and management of such complex and capital-intensive projects as NPPs has very important bearing on promoting national participation, much emphasis is placed on acquirement of software technology. Technology transfer is therefore sought in light of this need as well as of China's specific conditions. (author)

  10. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis.

    Science.gov (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin

    2017-04-01

    Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

  11. Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

    OpenAIRE

    Alexandru MIOC; Corina PANTEA

    2013-01-01

    Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectiv...

  12. Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2006-12-15

    A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

  13. Development of the independency of the pupils with hearing impairments during the lessons of technologies

    OpenAIRE

    Kovzan, Daiva

    2006-01-01

    Each live organism is made to adapt to the constantly changing environment. The success of child’s integration into society, his conduct in society depends on the family and school. Frequently, excessive care by their parents prevents a disabled child from developing independency skills. One of the most important tasks for the school is to prepare an individual for independent life and seek his integration into society. The issue of developing independency of a disabled individual has not bee...

  14. 48 CFR 45.303 - Use of Government property on independent research and development programs.

    Science.gov (United States)

    2010-10-01

    ... development programs. The contracting officer may authorize a contractor to use the property on an independent... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Use of Government property on independent research and development programs. 45.303 Section 45.303 Federal Acquisition...

  15. Tricks of the trade: Sharing ideas about independent hydro development in Canada

    International Nuclear Information System (INIS)

    Collins, S.J.

    1992-01-01

    Preparation and patience are the keys to developing independent hydropower projects in Canada. Several individuals who have experience breaking into the business share their advice. Opportunities for independent hydro developers to contribute to electricity production in Canada are increasing, thanks to government and utility support. Site selection, costs, environmental regulations, native rights issues, project approval processes, and time lines are all important issues

  16. 77 FR 4632 - Defense Federal Acquisition Regulation Supplement; Independent Research and Development Technical...

    Science.gov (United States)

    2012-01-30

    ... Federal Acquisition Regulation Supplement; Independent Research and Development Technical Descriptions... Regulation Supplement (DFARS) to require major contractors to report independent research and development (IR... 11414 on March 2, 2011, to revise requirements for reporting IR&D projects to the Defense Technical...

  17. 76 FR 11414 - Defense Federal Acquisition Regulation Supplement; Independent Research and Development Technical...

    Science.gov (United States)

    2011-03-02

    ... Acquisition Regulation Supplement; Independent Research and Development Technical Descriptions (DFARS Case... (DFARS) to require contractors to report independent research and development (IR&D) projects generating... to the Defense Technical Information Center (DTIC). Beginning in the 1990s, DoD reduced its technical...

  18. The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema

    Science.gov (United States)

    Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

    2014-01-01

    The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images ‘spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research. PMID:25197263

  19. The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema.

    Science.gov (United States)

    Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

    2014-08-01

    The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images 'spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research.

  20. Risk of secondary lymphedema in breast cancer survivors is related to serum phospholipid fatty acid desaturation.

    Science.gov (United States)

    Ryu, Eunjung; Yim, Seung Yun; Do, Hyun Ju; Lim, Jae-Young; Yang, Eun Joo; Shin, Min-Jeong; Lee, Seung-Min

    2016-09-01

    Secondary lymphedema is a common irreversible side effect of breast cancer surgery. We investigated if risk of secondary lymphedema in breast cancer survivors was related to changes in serum phospholipid fatty acid composition. Study subjects were voluntarily recruited into the following three groups: breast cancer survivors who had sentinel lymph node biopsy without lymphedema (SLNB), those who had auxillary lymph node dissection without lymphedema (ALND), and those who had ALND with lymphedema (ALND + LE). Body mass index (BMI), serum lipid profiles, bioimpedance data with single-frequency bioimpedance analysis (SFBIA), and serum phospholipid compositions were analyzed and compared among the groups. BMI, serum total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) and SFBIA ratios increased only in the ALND + LE. High polyunsaturated fatty acids (PUFAs) and high C20:4 to C18:2 n-6 PUFAs (arachidonic acid [AA]/linoleic acid [LA]) was detected in the ALND and ALND + LE groups compared to SLNB. The ALND + LE group showed increased activity indices for delta 6 desaturase (D6D) and D5D and increased ratio of AA to eicosapentaenoic acid (AA/EPA) compared to the ALND and SLNB groups. Correlation and regression analysis indicated that D6D, D5D, and AA/EPA were associated with SFBIA ratios. We demonstrated that breast cancer survivors with lymphedema had elevated total PUFAs, fatty acid desaturase activity indices, and AA/EPA in serum phospholipids. Our findings suggested that desaturation extent of fatty acid composition might be related to the risk of secondary lymphedema in breast cancer survivors.

  1. Localized lymphedema (elephantiasis): a case series and review of the literature.

    Science.gov (United States)

    Lu, Song; Tran, Tien Anh; Jones, David M; Meyer, Dale R; Ross, Jeffrey S; Fisher, Hugh A; Carlson, John Andrew

    2009-01-01

    Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor. To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. Case-control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period. We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16-74). Anogenital involvement was most frequent (75%)--mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p elephantiasis.

  2. Effect of Play Group and Biopsychosocial Factors on the Independence Development of Preschool Children in Surakarta

    OpenAIRE

    Iin Tri Marlinawati; Harsono Salimo; Bhisma Murti

    2017-01-01

    Background: The development of children's independence is important for their future competitiveness in the rapidly increasing social changes. Disturbance in the development of children's independence may have a negative future impact in adult life and children become dependent individuals. Efforts are needed to help children develop optimally. Some play groups have been introduced to meet this need in Surakarta, but no studies have been carried out to evaluate its effectiveness. This study a...

  3. Enhancement of Students' Independent Learning through Their Critical Thinking Skills Development

    Science.gov (United States)

    Kopzhassarova, Umit; Akbayeva, Gulden; Eskazinova, Zhanar; Belgibayeva, Gulbarshyn; Tazhikeyeva, Akerke

    2016-01-01

    The article focuses on the problem of developing students' critical thinking skills, which help them become independent learners. Analysis of research works of educators and scholars enable the authors to reveal qualities, necessary for students to enhance their critical thinking skills and become independent learners. Different points of view on…

  4. Dermal collagen and lipid deposition correlate with tissue swelling and hydraulic conductivity in murine primary lymphedema.

    Science.gov (United States)

    Rutkowski, Joseph M; Markhus, Carl Erik; Gyenge, Christina C; Alitalo, Kari; Wiig, Helge; Swartz, Melody A

    2010-03-01

    Primary lymphedema is a congenital pathology of dysfunctional lymphatic drainage characterized by swelling of the limbs, thickening of the dermis, and fluid and lipid accumulation in the underlying tissue. Two mouse models of primary lymphedema, the Chy mouse and the K14-VEGFR-3-Ig mouse, both lack dermal lymphatic capillaries and exhibit a lymphedematous phenotype attributable to disrupted VEGFR-3 signaling. Here we show that the differences in edematous tissue composition between these two models correlated with drastic differences in hydraulic conductivity. The skin of Chy mice possessed significantly higher levels of collagen and fat, whereas K14-VEGFR-3-Ig mouse skin composition was relatively normal, as compared with their respective wild-type controls. Functionally, this resulted in a greatly increased dermal hydraulic conductivity in K14-VEGFR3-Ig, but not Chy, mice. Our data suggest that lymphedema associated with increased collagen and lipid accumulation counteracts an increased hydraulic conductivity associated with dermal swelling, which in turn further limits interstitial transport and swelling. Without lipid and collagen accumulation, hydraulic conductivity is increased and overall swelling is minimized. These opposing tissue responses to primary lymphedema imply that tissue remodeling--predominantly collagen and fat deposition--may dictate tissue swelling and govern interstitial transport in lymphedema.

  5. Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

    Science.gov (United States)

    Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

    2014-07-01

    Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

  6. The effect of mechanical lymph drainage accompanied with heat on lymphedema.

    Science.gov (United States)

    Mariana, Valente Flávia; de Fátima, Guerreiro Godoy Maria; Maria, Pereira de Godoy José

    2011-11-01

    Thermotherapy has been indicated by some researchers as a treatment for lymphedema. A study comparing temperatures demonstrated that a temperature of 40°C significantly increased the transportation of lymph compared to other temperatures assessed. The aim of this study was to evaluate the possible benefits of mechanical lymph drainage accompanied with heat in the treatment of lymphedema of the lower limbs. In a cross-over randomized study, the effect of heat on lymph drainage was evaluated in the treatment of leg lymphedema. The study, performed in the Godoy Clinic in São Jose do Rio Preto, Brazil, involved seven patients (two males and five females) with leg lymphedema. The patients' ages ranged from 18 to 79 years old with a mean of 48.5 years. The subjects underwent a total of 38 assessments including 19 evaluations of mechanical lymph drainage alone and 19 combined with thermotherapy. Heat was applied using an electric blanket which was wrapped around the legs of the patients. The volume of legs was evaluated by water plethysmography before and after treatment sessions. The paired t-test was used for statistical analysis with an alpha error of p = 0.05 being considered as acceptable. No statistically significant differences were evidenced between mechanical lymph drainage alone and lymph drainage combined with thermotherapy. There was no obvious synergic effect in the immediate post-treatment period when heat was combined with mechanical lymph drainage in the treatment of lymphedema.

  7. Physical activity and lower limb lymphedema among uterine cancer survivors.

    Science.gov (United States)

    Brown, Justin C; John, Gabriella M; Segal, Saya; Chu, Christina S; Schmitz, Kathryn H

    2013-11-01

    Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported trend trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

  8. Genetic parameters for chronic progressive lymphedema in Belgian Draught Horses.

    Science.gov (United States)

    De Keyser, K; Janssens, S; Peeters, L M; Foqué, N; Gasthuys, F; Oosterlinck, M; Buys, N

    2014-12-01

    Genetic parameters for chronic progressive lymphedema (CPL)-associated traits in Belgian Draught Horses were estimated, using a multitrait animal model. Clinical scores of CPL in the four limbs/horse (CPLclin ), skinfold thickness and hair samples (hair diameter) were studied. Due to CPLclin uncertainty in younger horses (progressive CPL character), a restricted data set (D_3+) was formed, excluding records from horses under 3 years from the complete data set (D_full). Age, gender, coat colour and limb hair pigmentation were included as fixed, permanent environment and date of recording as random effects. Higher CPLclin certainty (D_3+) increased heritability coefficients of, and genetic correlations between traits, with CPLclin heritabilities (SE) for the respective data sets: 0.11 (0.06) and 0.26 (0.05). A large proportion of the CPLclin variance was attributed to the permanent environmental effect in D_full, but less in D_3+. Date of recording explained a proportion of variance from 0.09 ± 0.03 to 0.61 ± 0.08. Additive genetic correlations between CPLclin and both skinfold thickness and hair diameter showed the latter two traits cannot be used as a direct diagnostic aid for CPL. Due to the relatively low heritability of CPLclin , selection should focus on estimated breeding values (from repeated clinical examinations) to reduce CPL occurrence in the Belgian Draught Horse. © 2014 Blackwell Verlag GmbH.

  9. Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Jang Eun-ha

    2009-12-01

    Full Text Available Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

  10. Upper extremity function and quality of life in patients with breast cancer related lymphedema

    Directory of Open Access Journals (Sweden)

    Bojinović-Rodić Dragana

    2016-01-01

    Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  11. Surgical-site infection following lymph node excision indicates susceptibility for lymphedema

    DEFF Research Database (Denmark)

    Jørgensen, Mads Gustaf; Toyserkani, Navid Mohamadpour; Thomsen, Jørn Bo

    2018-01-01

    BACKGROUND AND OBJECTIVES: Cancer-related lymphedema is a common complication following lymph node excision. Prevention of lymphedema is essential, as treatment options are limited. Known risk factors are firmly anchored to the cancer treatment itself; however potentially preventable factors...... such as seroma and surgical-site infection (SSI) have yet to be asserted. METHODS: All malignant melanoma patients treated with sentinel lymph node biopsy (SNB) and/or complete lymph node dissection (CLND) in the axilla or groin between January 2008 and December 2014 were retrospectively identified. Identified...

  12. The strategic economic plan and the role of independent power in economic development

    International Nuclear Information System (INIS)

    House, D.

    1993-01-01

    Independent power production (IPP) in Newfoundland was examined within the context of the province's Strategic Economic Plan. Provisions of the Plan were summarized, with special reference to the promotion of alternative energy technologies and government efforts to amend regulations to facilitate development of alternative energy sources by independent producers. IPP was considered to be an ideal tool for regional economic development and diversification, assuming that environmental concerns were carefully considered and addressed. Some of the benefits ascribed to IPP included strengthening the private sector, creating new small business opportunities, improving competitiveness, promoting regional development, contributing to import substitution and enhance the province's technology and knowledge base

  13. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  14. Impact of community-based lymphedema management on perceived disability among patients with lymphatic filariasis in Orissa State, India.

    Directory of Open Access Journals (Sweden)

    Philip J Budge

    Full Text Available Lymphatic filariasis (LF infects approximately 120 million people worldwide. As many as 40 million have symptoms of LF disease, including lymphedema, elephantiasis, and hydrocele. India constitutes approximately 45% of the world's burden of LF. The Indian NGO Church's Auxiliary for Social Action (CASA has been conducting a community-based lymphedema management program in Orissa State since 2007 that aims to reduce the morbidity associated with lymphedema and elephantiasis. The objective of this analysis is to evaluate the effects of this program on lymphedema patients' perceived disability.For this prospective cohort study, 370 patients ≥14 years of age, who reported lymphedema lasting more than three months in one or both legs, were recruited from villages in the Bolagarh sub-district, Khurda District, Orissa, India. The World Health Organization Disability Assessment Schedule II was administered to participants at baseline (July, 2009, and then at regular intervals through 24 months (July, 2011, to assess patients' perceived disability. Disability scores decreased significantly (p<0.0001 from baseline to 24 months. Multivariable analysis using mixed effects modeling found that employment and time in the program were significantly associated with lower disability scores after two years of program involvement. Older age, female gender, the presence of other chronic health conditions, moderate (Stage 3 or advanced (Stage 4-7 lymphedema, reporting an adenolymphangitis (ADL episode during the previous 30 days, and the presence of inter-digital lesions were associated with higher disability scores. Patients with moderate or advanced lymphedema experienced greater improvements in perceived disability over time. Patients participating in the program for at least 12 months also reported losing 2.5 fewer work days per month (p<0.001 due to their lymphedema, compared to baseline.These results indicate that community-based lymphedema management programs

  15. Tc-99m-Human Serum Albumin Transit Time as a Measure of Arm Breast Cancer-Related Lymphedema

    DEFF Research Database (Denmark)

    Toyserkani, Navid M; Hvidsten, Svend; Tabatabaeifar, Siavosh

    2017-01-01

    34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent bilateral lymphoscintigraphy using intradermal injection in both hands of technetium-99m-labeled human serum albumin and sequential 5 min imaging for 5 hours. The mean transit time (MTT) in the arms was calculated...... based on time activity curves generated from injection site and arm regions. Visual lymphedema scoring was performed based on dermal backflow and lymph node presence. Excess arm volume was calculated from circumference measurements. RESULTS: The MTT (mean ± SD) was significantly longer in the lymphedema...

  16. Stewart-Treves Syndrome on the Lower Extremity Associated to Idiopathic Chronic Lymphedema Visualized on FDG PET/CT

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Nymark, Tine; Hildebrandt, Malene Grubbe

    2017-01-01

    Angiosarcomas are highly malignant and rare tumors of vascular or lymphatic endothelial cell origin with a poor prognosis. Lymphangiosarcoma associated with chronic lymphedema is known as Stewart-Treves syndrome. Stewart-Treves syndrome is primarily described in patients with lymphedema of an upper...... extremity occurring after breast cancer surgery including radical axillary lymph node dissection and subsequent radiotherapy. It is rarely described in the presence of idiopathic chronic lymphedema of the lower extremities. We present a case of lymphangiosarcoma visualized on F-FDG PET/CT, where Stewart...

  17. Autosomal recessive intestinal lymphangiectasia and lymphedema, with facial anomalies and mental retardation

    NARCIS (Netherlands)

    Hennekam, R. C.; Geerdink, R. A.; Hamel, B. C.; Hennekam, F. A.; Kraus, P.; Rammeloo, J. A.; Tillemans, A. A.

    1989-01-01

    We report on two male and two female relatives with intestinal lymphangiectasia; severe lymphedema of limbs, genitalia, and face; facial anomalies; seizures; mild growth retardation; and moderate mental retardation. Main facial anomalies are a flat face, flat nasal bridge, hypertelorism, small

  18. Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling.

    Science.gov (United States)

    Boyages, John; Kastanias, Katrina; Koelmeyer, Louise A; Winch, Caleb J; Lam, Thomas C; Sherman, Kerry A; Munnoch, David Alex; Brorson, Håkan; Ngo, Quan D; Heydon-White, Asha; Magnussen, John S; Mackie, Helen

    2015-12-01

    This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced lymphedema of the upper and lower extremities. A prospective clinical study was conducted at an Advanced Lymphedema Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 patients attended the ALAC. Eligibility criteria for liposuction included (i) unilateral, non-pitting, International Society of Lymphology stage II/III lymphedema; (ii) limb volume difference greater than 25 %; and (iii) previously ineffective conservative therapies. Of 55 eligible patients, 21 underwent liposuction (15 arm, 6 leg) and had at least 3 months postsurgical follow-up (85.7 % cancer-related lymphedema). Liposuction was performed under general anesthesia using a published technique, and compression garments were applied intraoperatively and advised to be worn continuously thereafter. Limb volume differences, bioimpedance spectroscopy (L-Dex), and symptom and functional measurements (using the Patient-Specific Functional Scale) were taken presurgery and 4 weeks postsurgery, and then at 3, 6, 9, and 12 months postsurgery. Mean presurgical limb volume difference was 45.1 % (arm 44.2 %; leg 47.3 %). This difference reduced to 3.8 % (arm 3.6 %; leg 4.3 %) by 6 months postsurgery, a mean percentage volume reduction of 89.6 % (arm 90.2 %; leg 88.2 %) [p multidisciplinary team is essential.

  19. Effect of lymphedema treatment. The interim report of prospective study at multiple facilities

    International Nuclear Information System (INIS)

    Hamamoto, Takako; Ogata, Minako; Satoh, Kayoko; Ashino, Yoshikazu

    2009-01-01

    We are in the process of analyzing the effect of complex physical therapy (CPT) for the patients of secondary lymphedema associated with cancer treatment. At this time, we present an interim report of the past 3 months started in March 2009. We classified the lymphedema stage into four stages based on the International Society of Lymphology criterion using the imaging diagnosis (ultrasonography (US), CT, etc.) in addition to a conventional observation. We also classified the CPT treatment period into two in accordance with water retention in the subcutaneous adipose tissue of the limbs. CPT was performed by the specialist of lymphedema treatment. We used the change in volume of limbs and quality of life (QOL) evaluation by SF-36 and Skindex29 for analysis. On this report, the volume of limbs, which has lymphedema and an improvement on SF-36, did not change significantly. This may have been resulted from not having enough follow-up period and lack of few cases at each stage in the analysis. However, we confirmed that the general and emotion evaluation on Skindex29 showed a meaningful change. We are still planning to accumulate more cases and study them for further detailed analysis. (author)

  20. MR imaging, proton MR spectroscopy, ultrasonographic, histologic findings in patients with chronic lymphedema.

    Science.gov (United States)

    Fumiere, E; Leduc, O; Fourcade, S; Becker, C; Garbar, C; Demeure, R; Wilputte, F; Leduc, A; Delcour, C

    2007-12-01

    Lymphedema is a progressive disease with multiple alterations occurring in the dermis. We undertook this study using high-frequency ultrasonography (US), magnetic resonance imaging, proton MR spectroscopy and histology to examine structural changes occurring in the subcutaneous tissue and precisely describe the nature of intralobular changes in chronic lymphedema. Four cutaneous and subcutaneous tissue biopsies from patients with chronic lymphedema during lymphonodal transplantation were studied. We performed US with a 13.5 MHz transducer, TSE T1 and TSE T2 magnetic resonance images with and without fat-suppression, MR Chemical Shift Imaging Spectroscopy and histological evaluation on these biopsies. We found that normal subcutaneous septa are seen as hyperechogenic lines in US and hyposignal lines in MRI and that hyperechogenic subcutis in US can be due to interlobular and intralobular water accumulation and/or to interlobular and intralobular fibrosis. Our study also confirms the usefulness of MR spectroscopy to assess water or fat content of soft tissue. Thus, multiple imaging modalities may be necessary to precisely delineate the nature of tissue alterations in chronic lymphedema.

  1. Chylous pleural effusion associated with primary lymphedema and lymphangioma-like malformations

    NARCIS (Netherlands)

    Bresser, P.; Kromhout, J. G.; Reekers, J. A.; Verhage, T. L.

    1993-01-01

    We describe a patient with a chylous pleural effusion associated with primary lymphedema of his right leg and abdominal wall. On evaluation a generalized, severe hypoplasia of the lymphatic system turned out to be associated with hyperplastic, lymphangioma-like malformations

  2. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  3. Development, validity and reliability of the food allergy independent measure (FAIM)

    NARCIS (Netherlands)

    van der Velde, J. L.; Flokstra-de Blok, B. M. J.; Vlieg-Boerstra, B. J.; Oude Elberink, J. N. G.; DunnGalvin, A.; Hourihane, J. O.'B.; Duiverman, E. J.; Dubois, A. E. J.

    2010-01-01

    The Food Allergy Quality of Life Questionnaire-Child Form, -Teenager Form and -Adult Form (FAQLQ-CF, -TF and -AF) have recently been developed. To measure construct validity in the FAQLQs, a suitable independent measure was needed with which FAQLQ scores could be correlated. However, in food

  4. Development, validity and reliability of the food allergy independent measure (FAIM)

    NARCIS (Netherlands)

    van der Velde, J. L.; Flokstra-de Blok, B. M. J.; Vlieg - Boerstra, B. J.; Oude Elberink, J. N. G.; DunnGalvin, A.; Hourihane, J. O'B.; Duiverman, E. J.; Dubois, A. E. J.

    Background: The Food Allergy Quality of Life Questionnaire-Child Form, -Teenager Form and -Adult Form (FAQLQ-CF, -TF and -AF) have recently been developed. To measure construct validity in the FAQLQs, a suitable independent measure was needed with which FAQLQ scores could be correlated. However, in

  5. Risk factors for breast cancer-related upper extremity lymphedema: a meta-analysis

    International Nuclear Information System (INIS)

    Xie Yuhuan; Guo Qi; Liu Fenghua; Zhu Yaqun; Tian Ye

    2014-01-01

    Objective: To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations. Methods: PubMed, Ovid, EMbase, and the Cochrane Library were searched to identify clinical trials published up to December 2012. The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2; the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95% confidence intervals (CI). Results: Twenty-two studies involving 10106 patients were included in the meta-analysis. The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR=2.72, 95% CI=1.06-6.99, P=0.038), hypertension (OR=1.84, 95% CI=1.38-2.44, P=0.000), body mass index (OR=1.68, 95% CI=1.22-2.32, P=0.001), and radiotherapy (OR=1.65, 95% CI=1.20-2.25, P=0.002), while no significant associations were found for such factors as chemotherapy, age, number of positive lymph nodes, and number of dissected lymph nodes. Conclusions: The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment, and axillary lymph node dissection, hypertension,body mass index, and radiotherapy are the main risk factors for lymphedema after breast cancer treatment. (authors)

  6. Lymphedema and employability - Review and results of a survey of Austrian experts.

    Science.gov (United States)

    Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

    2017-03-01

    Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

  7. Development of Network Devices Supporting Communication Independence In NPP I and C Systems

    International Nuclear Information System (INIS)

    Jeong, K.-I.; Suh, Y.S.; Park, G.-O.; Park, J.-Y.

    2013-06-01

    As advanced digital I and C systems of nuclear power plants or research reactors are being introduced to replace analog systems, a data communication network is necessary for data exchanges between I and C systems of nuclear power plants or research reactors. Data communication network technology may have significant impact on I and C systems. As the safety I and C system is composed of redundant channels to enhance the performance of the safety functions and data communication system is used to transmit the data generated by the digital I and C systems, communication independence is required to mitigate the risk of safety I and C system failure. Therefore this paper mainly discusses the issues related to the communication independence and the current status of network devices we designed, developed, and validated to satisfy the requirements of function, performance, and communication independence. (authors)

  8. THE USE OF E-PORTFOLIO TO DEVELOP ENGLISH LANGUAGE LEARNERS' AUTONOMY AND INDEPENDENCE

    Directory of Open Access Journals (Sweden)

    Oksana I. Ivanova

    2017-09-01

    Full Text Available This paper discusses the findings of a research study concerning the use of e-portfolios to develop learners' autonomy and independence, from the perspectives of teachers and students participating in this study. The findings demonstrate many of the benefits of e-portfolio practice regarding learners’ increased sense of ownership, teacher and peer feedback, enriched learning experience at both individual and technological levels, enhanced opportunity for self-improvement and increased awareness of the learning process. Despite many positive aspects of e-portfolios use, the study reveals some challenges facing students, teachers and support staff, mainly connected with technical problems and Internet access, and the necessity for teachers and learners to change their roles to become more independent in the learning process. The author concludes that e-portfolio is a promising tool to stimulate and challenge students to become independent and self-regulated learners that should be implemented in English language learning at higher educational institutions.

  9. Increased Visceral Adipose Tissue Is an Independent Predictor for Future Development of Atherogenic Dyslipidemia.

    Science.gov (United States)

    Hwang, You-Cheol; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Kahn, Steven E; Leonetti, Donna L; Boyko, Edward J

    2016-02-01

    Atherogenic dyslipidemia is frequently observed in persons with a greater amount of visceral adipose tissue (VAT). However, it is still uncertain whether VAT is independently associated with the future development of atherogenic dyslipidemia. The aim of this study was to determine whether baseline and changes in VAT and subcutaneous adipose tissue (SAT) are associated with future development of atherogenic dyslipidemia independent of baseline lipid levels and standard anthropometric indices. Community-based prospective cohort study with 5 years of follow-up. A total of 452 Japanese Americans (240 men, 212 women), aged 34-75 years were assessed at baseline and after 5 years of follow-up. Abdominal fat areas were measured by computed tomography. Atherogenic dyslipidemia was defined as one or more abnormalities in high-density lipoprotein (HDL) cholesterol, triglycerides, or non-HDL cholesterol levels. Baseline VAT and change in VAT over 5 years were independently associated with log-transformed HDL cholesterol, log-transformed triglyceride, and non-HDL cholesterol after 5 years (standardized β = -0.126, 0.277, and 0.066 for baseline VAT, respectively, and -0.095, 0.223, and 0.090 for change in VAT, respectively). However, baseline and change in SAT were not associated with any future atherogenic lipid level. In multivariate logistic regression analysis, incremental change in VAT (odds ratio [95% confidence interval], 1.73 [1.20-2.48]; P = .003), triglycerides (4.01 [1.72-9.33]; P = .001), HDL cholesterol (0.32 [0.18-0.58]; P dyslipidemia independent of age, sex, diastolic blood pressure, homeostasis model assessment insulin resistance, body mass index (BMI), change in BMI, SAT, and baseline atherogenic lipid levels. Baseline and change in VAT were independent predictors for future development of atherogenic dyslipidemia. However, BMI, waist circumference, and SAT were not associated with future development of atherogenic dyslipidemia.

  10. Pilot Study: The Effectiveness of Complex Decongestive Therapy for Lymphedema in Palliative Care Patients with Advanced Cancer.

    LENUS (Irish Health Repository)

    Cobbe, Sinead

    2017-12-05

    Complex decongestive therapy (CDT) is a regimen of physical treatment for lymphedema. Its effectiveness is unknown in advanced cancer patients. This study evaluates effectiveness of CDT in this population.

  11. Usability and feasibility of health IT interventions to enhance Self-Care for Lymphedema Symptom Management in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Mei R. Fu, PhD, RN, FAAN

    2016-09-01

    Conclusions: This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.

  12. Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

    Directory of Open Access Journals (Sweden)

    Alexandru MIOC

    2013-06-01

    Full Text Available Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectives in mind, a series of articles evaluating the effectiveness of manual lymphatic drainage in the case of patients with breast cancer and lymphedema have been studied. The parameters under observation were: duration of lymphedema reduction and improved symptomatology (pain, a feeling of swelling of the upper limb, functional limitation, and patient dissatisfaction towards their body image. Following this analysis, one can conclude that the association of manual lymphatic drainage to physical exercise and physiotherapy has produced changes in the volume of the limb affected by the lymphedema; however, its isolated use has not resulted in significant changes.

  13. Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

    Science.gov (United States)

    Kasawara, Karina Tamy; Mapa, Jéssica Monique Rossetti; Ferreira, Vilma; Added, Marco Aurélio Nemitalla; Shiwa, Silvia Regina; Carvas, Nelson; Batista, Patricia Andrade

    2018-05-01

    Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer. Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale. Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points. KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.

  14. Are Independent Probes Truly Independent?

    Science.gov (United States)

    Camp, Gino; Pecher, Diane; Schmidt, Henk G.; Zeelenberg, Rene

    2009-01-01

    The independent cue technique has been developed to test traditional interference theories against inhibition theories of forgetting. In the present study, the authors tested the critical criterion for the independence of independent cues: Studied cues not presented during test (and unrelated to test cues) should not contribute to the retrieval…

  15. Development of the KINS Safety Culture Maturity Model for Self and Independent Assessment

    International Nuclear Information System (INIS)

    Sheen, C.; Choi, Y.S.

    2016-01-01

    Safety culture of an organization is cultivated and affected not only by societal and regulatory environment of the organization, but by its philosophies, policies, events and activities experienced in the process of accomplishing its mission. The safety culture would be continuously changed by the interactions between its members along with time as an organic entity. In order to perform a systematic self- or independent assessment of safety culture, a safety culture assessment model (SCAM) properly reflecting cultural characteristics should be necessary. In addition, a SCAM should be helpful not only to establish correct directions, goals, and strategies for safety culture development, but should anticipating obstacles against safety culture development in the implementation process derived from the assessment. In practical terms, a SCAM should be useful for deriving effective guidelines and implementing of corrective action programs for the evaluated organization. Korea Institute of Nuclear Safety (KINS) performed a research project for six years to develop a SCAM satisfying the above prerequisites for self- and independent assessment. The KINS SCAM was developed based on the five stage safety culture maturity model proposed by Professor Patrick Hudson and was modified into four stages to reflect existing safety culture assessment experiences at Korean nuclear power plants. In order to define the change mechanism of safety culture for development and reversion, the change model proposed by Prochaska and DiClemente was introduced into KINS SCAM and developed into the Spiral Change Model.

  16. Stakeholder insights on the planning and development of an independent benchmark standard for responsible food marketing.

    Science.gov (United States)

    Cairns, Georgina; Macdonald, Laura

    2016-06-01

    A mixed methods qualitative survey investigated stakeholder responses to the proposal to develop an independently defined, audited and certifiable set of benchmark standards for responsible food marketing. Its purpose was to inform the policy planning and development process. A majority of respondents were supportive of the proposal. A majority also viewed the engagement and collaboration of a broad base of stakeholders in its planning and development as potentially beneficial. Positive responses were associated with views that policy controls can and should be extended to include all form of marketing, that obesity and non-communicable diseases prevention and control was a shared responsibility and an urgent policy priority and prior experience of independent standardisation as a policy lever for good practice. Strong policy leadership, demonstrable utilisation of the evidence base in its development and deployment and a conceptually clear communications plan were identified as priority targets for future policy planning. Future research priorities include generating more evidence on the feasibility of developing an effective community of practice and theory of change, the strengths and limitations of these and developing an evidence-based step-wise communications strategy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Developing a collaboration with the Houston independent school district: testing the generalizability of a partnership model.

    Science.gov (United States)

    Poduska, Jeanne; Gomez, Mary Jane; Capo, Zeph; Holmes, Venita

    2012-07-01

    Moving evidence-based practices into real-world settings is a high priority for education and public health. This paper describes the development of a partnership among the Houston Independent School District, the American Institutes of Research, and the Houston Federation of Teachers to support research on and program sustainability for the Good Behavior Game, a team-based classroom behavior management strategy that has shown positive impact in randomized field trials. The conceptual framework guiding partnership development is presented, followed by an application of the framework in Houston. Lessons learned and implications for the next stage of research and practice are then discussed.

  18. Supervising Model of Independent Enterprise Group (Study of Community Development PT Badak NGL

    Directory of Open Access Journals (Sweden)

    Hermansyah Hermansyah

    2016-06-01

    Full Text Available This research aims to arrange an empowerment model of enterprise group through the program of Community Development in order to be independent and ready to compete, which is begun from the empirical study of the success of Cipta Busana Cooperative.. This research uses the descriptive analysis by using a case study on one enterprise supervised by PT Badak NGL that is Koperasi Cipta Busana (Kocibu. Kocibu is chosen to be the object of research due to its success to achieve the target to be the independent supervised enterprise in the fourth year. The data analysis method used in this research is the explorative analysis. Based on the research, there are some results such as that Kocibu is one of the supervised Micro, Small and Medium Enterprises of PT Badak NGL that could develop and be independent through several supporting programs. Some of key successes of Kocibu are as follows: a high commitment, a good leader, and intensive supervising programs. Besides, a good marketing system also contributes to the key of success. There are some aspects that naturally contribute to the Kocibu improvement and emerge naturally as follows: the leader figure and the high commitment from the stakeholders. While, the aspects emerged by design are: the supervising and training programs, the evaluation, the determination of rules, and the business targets. Hopefully, after this research has been conducted, the aspects appeared naturaly would be realized so early that the success of the public empowerment program will be able to increase. 

  19. Elephantiasis nostras verrucosa or "mossy foot lesions" in lymphedema praecox: report of a case.

    Science.gov (United States)

    Duckworth, Amy L; Husain, Jugnoo; Deheer, Patrick

    2008-01-01

    Elephantiasis nostras verrucosa is a rare disorder that results from chronic obstructive lymphedema. It is characterized clinically by deforming, nonpitting edema; malodorous hyperkeratosis with generalized lichenification; cobblestoned papules; and verrucous changes, that often result in extreme enlargement of the involved body part. Although elephantiasis nostras verrucosa is striking in clinical appearance, biopsy reveals only moderately abnormal findings: pseudoepitheliomatous hyperplasia with dilated lymphatic spaces in the dermis, accompanied by chronic inflammation and fibroblast proliferation. The term elephantiasis nostras (nostras means "from our region") has traditionally been used to differentiate temperate zone disease from the classic disease process, elephantiasis tropica, which is defined by chronic filarial lymphatic obstruction caused by Wuchereria bancrofti, Wuchereria malayi, or Wuchereria pacifica. We present a case report of elephantiasis nostras verrucosa arising as a result of lymphedema praecox.

  20. [Current wound care in patients with elephantiasis--third-stage lymphedema].

    Science.gov (United States)

    Rucigaj, Tanja Planinsek; Slana, Ana; Leskovec, Nada Kecelj

    2012-10-01

    Lymphedema resulting from fluid accumulation due to impairment in the lymphatic system drainage leads to enlargement of the body part involved. If left untreated, in its third stage it results in elephantiasis. Elephantiasis is frequently accompanied by papillomatosis and lymphocutaneous fistulas with lymphorrhoea, erosions and ulcers, frequently with the loss of function in the respective part of the body. Unlike other chronic wounds, wound healing in lymphedema is highly dependent on the use of combined therapies because local treatment with modern supportive dressings and compression therapy with adhesive and non-adhesive short-stretch systems is only part of the complete treatment. This treatment also includes sub-bandage foamy materials, kinesitherapy with tapes (kinesiotaping), intermittent local application of high-pressure oxygen, breathing exercise, and manual lymph drainage and exercises.

  1. Lower limb lymphedema: experiences and perceptions of cancer patients in the late palliative stage.

    Science.gov (United States)

    Frid, Marianne; Strang, Peter; Friedrichsen, Maria J; Johansson, Karin

    2006-01-01

    Lower limb lymphedema (LLL) is a common but neglected problem in palliative cancer patients. No studies have focused on these patients' experiences of lymphedema. The aims of this study were to explore patients' experiences regarding LLL and how they manage to deal with this in the late palliative stage. Thirteen patients with cancer-related LLL were included to satisfy a maximum variation sampling strategy. Interviews were analyzed using a qualitative phenomenographic method. LLL influenced the patients' thoughts about the future. Body image was often strongly influenced. Interactions with other persons were perceived as both positive and negative, and a range of coping strategies were expressed. LLL can exert a considerable influence on the physical experiences and the psychosocial situation of cancer patients in palliative care. Areas in need of increased education, attention, and further research are highlighted.

  2. DEVELOPMENT OF RISK-BASED AND TECHNOLOGY-INDEPENDENT SAFETY CRITERIA FOR GENERATION IV SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    William E. Kastenberg; Edward Blandford; Lance Kim

    2009-03-31

    This project has developed quantitative safety goals for Generation IV (Gen IV) nuclear energy systems. These safety goals are risk based and technology independent. The foundations for a new approach to risk analysis has been developed, along with a new operational definition of risk. This project has furthered the current state-of-the-art by developing quantitative safety goals for both Gen IV reactors and for the overall Gen IV nuclear fuel cycle. The risk analysis approach developed will quantify performance measures, characterize uncertainty, and address a more comprehensive view of safety as it relates to the overall system. Appropriate safety criteria are necessary to manage risk in a prudent and cost-effective manner. This study is also important for government agencies responsible for managing, reviewing, and for approving advanced reactor systems because they are charged with assuring the health and safety of the public.

  3. DEVELOPMENT OF RISK-BASED AND TECHNOLOGY-INDEPENDENT SAFETY CRITERIA FOR GENERATION IV SYSTEMS

    International Nuclear Information System (INIS)

    Kastenberg, William E.; Blandford, Edward; Kim, Lance

    2009-01-01

    This project has developed quantitative safety goals for Generation IV (Gen IV) nuclear energy systems. These safety goals are risk based and technology independent. The foundations for a new approach to risk analysis has been developed, along with a new operational definition of risk. This project has furthered the current state-of-the-art by developing quantitative safety goals for both Gen IV reactors and for the overall Gen IV nuclear fuel cycle. The risk analysis approach developed will quantify performance measures, characterize uncertainty, and address a more comprehensive view of safety as it relates to the overall system. Appropriate safety criteria are necessary to manage risk in a prudent and cost-effective manner. This study is also important for government agencies responsible for managing, reviewing, and for approving advanced reactor systems because they are charged with assuring the health and safety of the public

  4. Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-07-01

    An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy.

  5. Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

    International Nuclear Information System (INIS)

    Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong

    1997-01-01

    An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy

  6. Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema.

    Science.gov (United States)

    Karadibak, Didem; Yavuzsen, Tugba

    2015-06-01

    [Purpose] This study evaluated the functional ability and kinesthetic sense of the hands of women with breast cancer-related lymphedema. [Subjects and Methods] Fifty-seven women experiencing lymphedema after breast surgery and adjuvant radiotherapy were included. The patients were divided into two groups: women with hand edema (HE+, n = 29) and without hand edema (HE-, n = 28) after breast cancer treatment. Arm edema severity, hand size, functional mobility and kinesthetic sense of the hand, and daily living skills were evaluated. [Results] The mean age of the patients was 55.8 years. In both groups, functional mobility, kinesthetic sense, and daily living skills decreased significantly with increasing edema severity. However, there was no significant difference between groups with respect to functional mobility or daily living skills. The kinesthetic sense of the hand was better in the HE- group than the HE+ group. There was a significant negative relationship between the severity of edema and hand function. [Conclusion] Breast cancer-related lymphedema can negatively impact women's functional mobility and kinesthetic sense of the hands as well as daily living skills.

  7. An Overview of DoD Policy for and Administration of Independent Research and Development

    Science.gov (United States)

    1975-05-01

    1969-1970) The Congress became directly involved in IR&D policy matters during the floor debate on the FY 1970 Military Procurement Act. This...trial period the’data bank was restricted to DlOD usirs. However, in December 1974 NASA was granted ’access "to the IR&D Data Dank :. 3,4. IM~D DatA...Subject Matter of S3003," Washington, D. C., 11 February 1970. 54. Deputy Secretary of Defense, "Independent Research and Development/Bid and

  8. he Development of Music Theory as an Independent Discipline: Beginnings, Conflicts, and New Directions

    Directory of Open Access Journals (Sweden)

    Irna Priore

    2013-05-01

    Full Text Available This article asserts that music theory is an independent discipline and proposes to discuss what it is and the issues of modern theory. Contrary to popular believe, music theory goes beyond knowing the fundamentals of music. Just as the alphabet is only a basis for linguistics or literature, the fundamentals of music is only the beginning of understanding music theory, leading, therefore, to the need for more profound study. This article includes a review of the long history of music theory and its scholars. The objective is to recognize the indisputable value of music theory to encourage its users to innovate and promote the development of new fields.

  9. Independent review of Oak Ridge HCTW test program and development of seismic evaluation criteria

    International Nuclear Information System (INIS)

    1995-05-01

    Many of the existing buildings at the Oak Ridge Y-12 Plant are steel frame construction with unreinforced hollow clay tile infill walls (HCTW). The HCTW infill provides some lateral seismic resistance to the design/evaluation basis earthquake; however acceptance criteria for this construction must be developed. The basis for the development of seismic criteria is the Oak Ridge HCTW testing and analysis program and the target performance goals of DOE 5480.28 and DOE-STD-1020-94. This report documents and independent review of the testing and analysis program and development of recommended acceptance criteria for Oak Ridge HCTW construction. The HCTW test program included ''macro'' wall in-plane and out-of-plane tests, full-scale wall in-plane and out-of-plane tests, in-situ out-of-plane test, shake table tests, and masonry component tests

  10. Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

    Science.gov (United States)

    McKey, Katelyn P; Alappattu, Meryl J

    Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

  11. Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

    Science.gov (United States)

    Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

    2016-06-01

    Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, 25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

  12. Development of vendor independent safety analysis capability for nuclear power plants in Taiwan

    International Nuclear Information System (INIS)

    Tang, J.-R.

    2001-01-01

    The Institute of Nuclear Energy Research (INER) and the Taiwan Power Company (TPC) have long-term cooperation to develop vendor independent safety analysis capability to provide support to nuclear power plants in Taiwan in many aspects. This paper presents some applications of this analysis capability, introduces the analysis methodology, and discusses the significance of vendor independent analysis capability now and future. The applications include a safety analysis of core shroud crack for Chinshan BWR/4 Unit 2, a parallel reload safety analysis of the first 18-month extended fuel cycle for Kuosheng BWR/6 Unit 2 Cycle 13, an analysis to support Technical Specification change for Maanshan three-loop PWR, and a design analysis to support the review of Preliminary Safety Analysis Report of Lungmen ABWR. In addition, some recent applications such as an analysis to support the review of BWR fuel bid for Chinshan and Kuosheng demonstrates the needs of further development of the analysis capability to support nuclear power plants in the 21 st century. (authors)

  13. Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Paiva Daniella MF

    2013-02-01

    Full Text Available Abstract Background Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora. Methods We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy, active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment. Results The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p Conclusions The prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that

  14. "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.

    Science.gov (United States)

    Winch, Caleb J; Sherman, Kerry A; Smith, Katriona M; Koelmeyer, Louise A; Mackie, Helen; Boyages, John

    2016-09-01

    Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Development of nonintrusive, scatter-independent techniques for measurement of liquid density inside dense sprays

    Science.gov (United States)

    Hartfield, Roy

    1994-01-01

    A nonintrusive optical technique for measuring the liquid density in sprays used to simulate LOX injector flows is under development. This manuscript is a report on work toward that development which is currently in progress. The technique is a scatter-independent, absorption-based approach which depends on the numerical inversion of a collection of absorption profiles. For the case in which visible radiation passes through liquid-gas interfaces so numerous in sprays, substantial reductions and alterations in the signal result from scattering even in the absence of absorption. To avoid these problems, X-Rays will be used as the absorbed radiation. The experimental process is simulated by integrating the absorption spectrum for a known distribution, adding instrument noise to this 'measurement', creating a projection from the 'measurement', filtering the projection, inverting the projection, and comparing the results with the original prescribed distribution.

  16. High-resolution 3D volumetry versus conventional measuring techniques for the assessment of experimental lymphedema in the mouse hindlimb

    Science.gov (United States)

    Frueh, Florian S.; Körbel, Christina; Gassert, Laura; Müller, Andreas; Gousopoulos, Epameinondas; Lindenblatt, Nicole; Giovanoli, Pietro; Laschke, Matthias W.; Menger, Michael D.

    2016-01-01

    Secondary lymphedema is a common complication of cancer treatment characterized by chronic limb swelling with interstitial inflammation. The rodent hindlimb is a widely used model for the evaluation of novel lymphedema treatments. However, the assessment of limb volume in small animals is challenging. Recently, high-resolution three-dimensional (3D) imaging modalities have been introduced for rodent limb volumetry. In the present study we evaluated the validity of microcomputed tomography (μCT), magnetic resonance imaging (MRI) and ultrasound in comparison to conventional measuring techniques. For this purpose, acute lymphedema was induced in the mouse hindlimb by a modified popliteal lymphadenectomy. The 4-week course of this type of lymphedema was first assessed in 6 animals. In additional 12 animals, limb volumes were analyzed by μCT, 9.4 T MRI and 30 MHz ultrasound as well as by planimetry, circumferential length and paw thickness measurements. Interobserver correlation was high for all modalities, in particular for μCT analysis (r = 0.975, p < 0.001). Importantly, caliper-measured paw thickness correlated well with μCT (r = 0.861), MRI (r = 0.821) and ultrasound (r = 0.800). Because the assessment of paw thickness represents a time- and cost-effective approach, it may be ideally suited for the quantification of rodent hindlimb lymphedema. PMID:27698469

  17. Traumatic brain injury is associated with the development of deep vein thrombosis independent of pharmacological prophylaxis.

    Science.gov (United States)

    Reiff, Donald A; Haricharan, Ramanath N; Bullington, Nathan M; Griffin, Russell L; McGwin, Gerald; Rue, Loring W

    2009-05-01

    Deep venous thrombosis (DVT) is common among trauma patients. If left untreated it may result in lethal pulmonary thromboembolism. Previous studies have suggested that intracranial hemorrhage serves as an independent risk factor for the development of DVT. These studies were not able to exclude anticoagulation therapy as a confounding variable in their analysis. Our objective was to determine the association of traumatic brain injury (TBI) to the formation of DVT irrespective of the use of anticoagulation therapy. All patients admitted to an academic level I Trauma Center between 2000 and 2007 with blunt or penetrating injuries were selected for inclusion in this study. Patients who died or who were discharged within 24 hours of admission were excluded in the analysis. TBI was defined as any intraparenchymal hemorrhage or extra-axial intracranial bleeding identified on radiographic imaging or both. Anticoagulation therapy was defined as the uninterrupted use of either subcutaneous lovenox or heparin. Risk ratios and 95% confidence intervals compared the risk of DVT among patients with and without TBI according to the initiation of anticoagulation therapy (no therapy, 48 hours) adjusted for age, gender, race, injury severity, mechanism of injury, spinal injury, and lower extremity fracture. Irrespective of the time of initiation of pharmacologic prophylaxis, TBI is independently associated with the formation of DVT. A threefold to fourfold increased risk of DVT formation is consistent across all prophylaxis groups among patients with TBI. The incidence of DVT among injured patients with TBI is significantly higher than those patients without head injury independent of anticoagulation therapy. Rigorous surveillance to detect DVT among trauma patients with TBI should be undertaken and where appropriate alternate means for pulmonary thromboembolism prevention used.

  18. Development of a multidimensional balance scale for use with functionally independent older adults.

    Science.gov (United States)

    Rose, Debra J; Lucchese, Nicole; Wiersma, Lenny D

    2006-11-01

    To develop and evaluate the validity and reliability of a multidimensional balance scale-the Fullerton Advanced Balance (FAB) scale-suitable for use with functionally independent older adults. Psychometric evaluation of the scale's content and convergent validity, test-retest and intra- and interrater reliability, and internal rater consistency. Urban community. Forty-six community-residing older adults (mean +/- standard deviation, 75 +/- 6.2 y), with (n = 31) and without identified balance problems (n = 15), participated in the study. Four physical therapists with expertise in the assessment and treatment of balance disorders in older adults also participated in the content validity and/or reliability phases of the study. Not applicable. Spearman rank correlation coefficients for convergent validity, test-retest, intra- and interrater reliability, and homogeneity coefficient values for rater consistency. Test-retest reliability for the total balance scale score was high (rho = .96). Interrater reliability for total score ranged from .94 to .97 whereas intrarater reliability coefficients ranged from .97 to 1.00. Homogeneity (H) coefficients were greater than .90 for 6 of the 10 individual test items and all 10 test items had H coefficients of greater than .75 for both rating sessions. Preliminary results suggest that the FAB scale is a valid and reliable assessment tool that is suitable for use with functionally independent older adults residing in the community.

  19. Budget deficits, monetization, and central-bank independence in developing countries

    NARCIS (Netherlands)

    Sikken, BJ; de Haan, J

    Using various indicators for central bank independence we examine the relationship between central bank independence and government budget deficits. Using a two-stage procedure we also analyze whether central bank independence affects the monetization of deficits. First, the monetization relation in

  20. Excision of Elephantiasis Nostras Verrucosa Lesions in a Patient With Hereditary Lymphedema: Case Report and Review of the Literature.

    Science.gov (United States)

    Pitcher, Austin A; Pagan, Carlos A; Small, Kevin; Otterburn, David M

    2015-01-01

    Elephantiasis nostras verrucosa (ENV) is a rare cutaneous sequela of chronic lymphedema. Treatment of ENV remains poorly elucidated but has historically involved conservative management aimed at relieving the underlying lymphedema, with a few cases managed by surgical intervention. We report a case of a 27-year-old male with primary lymphedema complicated by large painful ENV lesions on his left foot that we excised surgically with good functional and cosmetic results as validated by the patient. To our knowledge, this is the first report of a case of ENV with a pedunculated morphology and the presence of a deep invasive stalk. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Radial glial dependent and independent dynamics of interneuronal migration in the developing cerebral cortex.

    Directory of Open Access Journals (Sweden)

    Yukako Yokota

    2007-08-01

    Full Text Available Interneurons originating from the ganglionic eminence migrate tangentially into the developing cerebral wall as they navigate to their distinct positions in the cerebral cortex. Compromised connectivity and differentiation of interneurons are thought to be an underlying cause in the emergence of neurodevelopmental disorders such as schizophrenia. Previously, it was suggested that tangential migration of interneurons occurs in a radial glia independent manner. Here, using simultaneous imaging of genetically defined populations of interneurons and radial glia, we demonstrate that dynamic interactions with radial glia can potentially influence the trajectory of interneuronal migration and thus the positioning of interneurons in cerebral cortex. Furthermore, there is extensive local interneuronal migration in tangential direction opposite to that of pallial orientation (i.e., in a medial to lateral direction from cortex to ganglionic eminence all across the cerebral wall. This counter migration of interneurons may be essential to locally position interneurons once they invade the developing cerebral wall from the ganglionic eminence. Together, these observations suggest that interactions with radial glial scaffold and localized migration within the expanding cerebral wall may play essential roles in the guidance and placement of interneurons in the developing cerebral cortex.

  2. Common-Lymphoid-Progenitor-Independent Pathways of Innate and T Lymphocyte Development

    Directory of Open Access Journals (Sweden)

    Maryam Ghaedi

    2016-04-01

    Full Text Available All lymphocytes are thought to develop from common lymphoid progenitors (CLPs. However, lymphoid-primed multipotent progenitors (LMPPs are more efficient than CLPs in differentiating into T cells and group 2 innate lymphoid cells (ILC2s. Here, we have divided LMPPs into CD127− (LMPP−s and CD127+ (LMPP+s subsets and compared them with Ly6D− and Ly6D+ CLPs. Adult LMPP+s differentiated into T cells and ILCs more rapidly and efficiently than other progenitors in transplantation assays. The development of T cells and ILC2s is highly active in the neonatal period. Neonatal CLPs are rare and, unlike prominent neonatal LMPP+s, do not efficiently differentiate into T cells and ILC2s. ILC2s generated in the neonatal period are long lived and persist in adult tissues. These results suggest that some ILCs and T cells may develop from LMPP+s via CLP-independent pathways.

  3. UTX and UTY demonstrate histone demethylase-independent function in mouse embryonic development.

    Directory of Open Access Journals (Sweden)

    Karl B Shpargel

    2012-09-01

    Full Text Available UTX (KDM6A and UTY are homologous X and Y chromosome members of the Histone H3 Lysine 27 (H3K27 demethylase gene family. UTX can demethylate H3K27; however, in vitro assays suggest that human UTY has lost enzymatic activity due to sequence divergence. We produced mouse mutations in both Utx and Uty. Homozygous Utx mutant female embryos are mid-gestational lethal with defects in neural tube, yolk sac, and cardiac development. We demonstrate that mouse UTY is devoid of in vivo demethylase activity, so hemizygous X(Utx- Y(+ mutant male embryos should phenocopy homozygous X(Utx- X(Utx- females. However, X(Utx- Y(+ mutant male embryos develop to term; although runted, approximately 25% survive postnatally reaching adulthood. Hemizygous X(+ Y(Uty- mutant males are viable. In contrast, compound hemizygous X(Utx- Y(Uty- males phenocopy homozygous X(Utx- X(Utx- females. Therefore, despite divergence of UTX and UTY in catalyzing H3K27 demethylation, they maintain functional redundancy during embryonic development. Our data suggest that UTX and UTY are able to regulate gene activity through demethylase independent mechanisms. We conclude that UTX H3K27 demethylation is non-essential for embryonic viability.

  4. It is possible: availability of lymphedema case management in each health facility in Togo. Program description, evaluation, and lessons learned.

    Science.gov (United States)

    Mathieu, Els; Dorkenoo, Ameyo M; Datagni, Michael; Cantey, Paul T; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

    2013-07-01

    Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities.

  5. Illustrating the (in)visible: Understanding the impact of loss in adults living with secondary lymphedema after cancer

    Science.gov (United States)

    Thomas, Roanne; Hamilton, Ryan

    2014-01-01

    Life with a disability is often riddled with paradoxes, one of which is being visibly marked, while personal experiences, losses, and challenges remain hidden. Our article draws attention to this paradox among people who live with secondary lymphedema after cancer (SLC). SLC is a relatively unfamiliar chronic condition within medical and lay discourses of cancer, which proves challenging for the many cancer survivors who are in search of information and understanding. Thirteen men and women with SLC were recruited from two research sites (Fredericton, NB, and Ottawa, ON, Canada) to participate in semi-structured interviews about the physical and psychosocial aspects of SLC. Using a methodology of interpretive description, our analysis of participant interviews reveals the complex ways in which men and women felt both visible and invisible within various contexts. We discuss three majors themes: (in)visibility and appearance related to material losses; (in)visibility and action connected to visible losses in function, as well as invisible struggles to care for oneself; and the loss of present and future well-being, as SLC renders some limitations visible while potentially obscuring a hopeful future indefinitely. Our research indicates that timely diagnosis of SLC would be an immediate first step in recognizing the physical and emotional dimensions of the condition. To accomplish this, increased awareness is needed. To enhance quality of life for those living with SLC, the development of new resources and psychosocial supports is also required. PMID:25148936

  6. Flap Lymphedema after Successful Reconstruction of the Chronic Inguinal Wound with a Vertical Rectus Abdominis Flap (VRAM

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci

    2012-07-01

    Full Text Available The reconstruction of extensive and complex wounds represents a challenging problem for reconstructive surgeon. The reconstructive options to provide cover-age following debridment of these complicated wounds are local, distant flaps, or freetissue transfer. Vertical rectus abdominis flaps have been used succes-sully to repair defects in the groin, hip, perineal, trunk, and breast regions. We encountered flap lymphedema after successful reconstruction of the chronic in-guinal wound with a vertical rectus abdominis (VRAM flap. As far as were able to ascertain, there is no report in the literature related to flap lymphedema.

  7. Impact of an educational program on the quality of life of patients with lymphedema: A preliminary evaluation.

    Science.gov (United States)

    Blaise, Sophie; Satger, Bernadette; Pernod, Gilles; Richaud, Cécile; Villemur, Béatrice; Carpentier, Patrick H

    2017-09-01

    We report on the preliminary evaluation of a well-designed program, Living with Lymphedema. This longitudinal cohort study assessed patients' quality of life using questionnaires. Our main objective was to evaluate the satisfaction of the patients and their adherence to the program. This was done using a specific questionnaire of satisfaction as well as by noting patients' adherence to the program (number of patients attending all three consultations). The secondary objective was to assess the effect of the program on the patient's quality of life. The assessment criteria were the evolution of the Medical Outcomes Study 36-Item Short Form Health Survey and EuroQol questionnaire scores between the first (C1) and third (C3) consultations. The Living with Lymphedema program targeted all patients with lymphedema in the Grenoble (France) conurbation and within the GRANTED health care network that includes vascular medicine specialists, primary care physicians, physical therapists, and dietitians in the Alpine region of France. All studied patients were ambulatory patients. The GRANTED network took care only of the educational aspect of the disease. All patients with primary or secondary lymphedema were offered the Living with Lymphedema program, whatever their age and the location of the lymphedema (upper or lower limbs). The collection of patient data conformed to the ethical and administrative regulations of the regional health authority. Grenoble Institutional Review Board (CPP Sud-Est V; No. 5891) approval for the study was specifically obtained for this evaluation on December 24, 2012. The program was built around one-to-one consultations, group workshops, and more specialized appointments. It was complementary to the routine medical care received by the patient (not evaluated in this study). It proposed three individual "educational" consultations, seven group workshops, and two specialized consultations with a dietitian. All the consultations or workshops were

  8. Acetylcholinesterase Regulates Skeletal In Ovo Development of Chicken Limbs by ACh-Dependent and -Independent Mechanisms.

    Directory of Open Access Journals (Sweden)

    Janine Spieker

    Full Text Available Formation of the vertebrate limb presents an excellent model to analyze a non-neuronal cholinergic system (NNCS. Here, we first analyzed the expression of acetylcholinesterase (AChE by IHC and of choline acetyltransferase (ChAT by ISH in developing embryonic chicken limbs (stages HH17-37. AChE outlined formation of bones, being strongest at their distal tips, and later also marked areas of cell death. At onset, AChE and ChAT were elevated in two organizing centers of the limb anlage, the apical ectodermal ridge (AER and zone of polarizing activity (ZPA, respectively. Thereby ChAT was expressed shortly after AChE, thus strongly supporting a leading role of AChE in limb formation. Then, we conducted loss-of-function studies via unilateral implantation of beads into chicken limb anlagen, which were soaked in cholinergic components. After varying periods, the formation of cartilage matrix and of mineralizing bones was followed by Alcian blue (AB and Alizarin red (AR stainings, respectively. Both acetylcholine (ACh- and ChAT-soaked beads accelerated bone formation in ovo. Notably, inhibition of AChE by BW284c51, or by the monoclonal antibody MAB304 delayed cartilage formation. Since bead inhibition of BChE was mostly ineffective, an ACh-independent action during BW284c51 and MAB304 inhibition was indicated, which possibly could be due to an enzymatic side activity of AChE. In conclusion, skeletogenesis in chick is regulated by an ACh-dependent cholinergic system, but to some extent also by an ACh-independent aspect of the AChE protein.

  9. Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

    Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

  10. The Development of Independent Travel in China in the Future and Travel Agents’ Coping Strategies

    OpenAIRE

    Pan, Yulu

    2010-01-01

    Abstract The purpose of this research is to understand the general trend of independent travel in China from tourists’ perspectives and what strategies travel agents should adopt to cope with the increased independent travel. This project is based on both primary research and secondary research. Quantitative and qualitative data are collected and analyzed for deeply exploration about independent travel in order to understand tourists’ attitudes, expectations and perspectives. By this w...

  11. How new power generation technologies will affect the development of independent power

    International Nuclear Information System (INIS)

    Bhan, S.K.

    1999-01-01

    The deregulation of electricity markets in North America have made it possible for independent power producers to generate electricity. This presentation focused on the different factors that should be considered when developing cogeneration projects, including their inherent environmental benefits. Cogeneration is the combined production of thermal energy and electricity. The main requirement for cogeneration is that there should be a market for both electricity as well as thermal energy. This means that any large institutions where steam or hot water is used for heating can qualify for cogeneration of electricity. The development of cogeneration projects has been encouraged by recent advances in technology in gas turbines, micro-turbines, coal-fired generation and fuel cells. Future technologies will include improved circulating fluidized bed boilers, low NO x burners, and selective catalytic reactors. The newest technologies claim to achieve simple cycle efficiency approaching 40 per cent. In the combined cycle, efficiencies of 60 per cent can be achieved, while 80 per cent efficiency can be achieved in cogeneration. This paper described various cogeneration options including: (1) gas turbines with unfired heat recovery steam generators (HRSG), (2) gas turbines with fired HRSG, (3) combined cycle plants, and (4) reciprocating engines. The efficiency of cogeneration makes it a viable option for reducing greenhouse gases (GHGs). 5 tabs

  12. Development of a platform-independent receiver control system for SISIFOS

    Science.gov (United States)

    Lemke, Roland; Olberg, Michael

    1998-05-01

    Up to now receiver control software was a time consuming development usually written by receiver engineers who had mainly the hardware in mind. We are presenting a low-cost and very flexible system which uses a minimal interface to the real hardware, and which makes it easy to adapt to new receivers. Our system uses Tcl/Tk as a graphical user interface (GUI), SpecTcl as a GUI builder, Pgplot as plotting software, a simple query language (SQL) database for information storage and retrieval, Ethernet socket to socket communication and SCPI as a command control language. The complete system is in principal platform independent but for cost saving reasons we are using it actually on a PC486 running Linux 2.0.30, which is a copylefted Unix. The only hardware dependent part are the digital input/output boards, analog to digital and digital to analog convertors. In the case of the Linux PC we are using a device driver development kit to integrate the boards fully into the kernel of the operating system, which indeed makes them look like an ordinary device. The advantage of this system is firstly the low price and secondly the clear separation between the different software components which are available for many operating systems. If it is not possible, due to CPU performance limitations, to run all the software in a single machine,the SQL-database or the graphical user interface could be installed on separate computers.

  13. Development of Boundary Condition Independent Reduced Order Thermal Models using Proper Orthogonal Decomposition

    Science.gov (United States)

    Raghupathy, Arun; Ghia, Karman; Ghia, Urmila

    2008-11-01

    Compact Thermal Models (CTM) to represent IC packages has been traditionally developed using the DELPHI-based (DEvelopment of Libraries of PHysical models for an Integrated design) methodology. The drawbacks of this method are presented, and an alternative method is proposed. A reduced-order model that provides the complete thermal information accurately with less computational resources can be effectively used in system level simulations. Proper Orthogonal Decomposition (POD), a statistical method, can be used to reduce the order of the degree of freedom or variables of the computations for such a problem. POD along with the Galerkin projection allows us to create reduced-order models that reproduce the characteristics of the system with a considerable reduction in computational resources while maintaining a high level of accuracy. The goal of this work is to show that this method can be applied to obtain a boundary condition independent reduced-order thermal model for complex components. The methodology is applied to the 1D transient heat equation.

  14. Independent Contributions of Early Positive Parenting and Mother-Son Coercion on Emerging Social Development.

    Science.gov (United States)

    Akcinar, Berna; Shaw, Daniel S

    2018-06-01

    In the current study, we explored associations between parent-child coercion and positive parenting in the toddler period in relation to children's social-behavioral development during the school-age period. The data were drawn from the Pitt Mother & Child Project, a sample of 310 low-income, ethnically diverse boys. Drawing on tenets of both attachment and social learning theory, it was hypothesized that coercive mother-son interaction would lead to reductions in positive maternal parenting in the toddler period, and that both positive parenting and mother-son coercion in the toddler period would contribute to children's conduct problems at school entry and lower social skills and peer rejection in middle childhood. The results were largely confirmed, such that mother-son coercive interaction at 18 months was related to decreases in positive parenting at 24 months. Additionally, mother-son coercive interaction and positive parenting at 24 months were linked to child conduct problems at age 5, which in turn predicted child social skills and peer rejection during middle childhood. In addition to indirect effects through child conduct problems, mother-son coercion continued to be independently related to school-age peer rejection. The findings are discussed with respect to the importance of early coercive interactions in the growth of child social-behavioral development from early to middle childhood.

  15. Bioimpedance to screen for abdominal fat in patients with breast cancer treatment-related lymphedema.

    Science.gov (United States)

    de Fátima Guerreiro Godoy, Maria; Silva, Edivandra Buzato; de Godoy, Jose Maria Pereira

    2016-07-28

    One of the dreaded complications after the treatment of breast cancer is lymphedema. Therapies used in the treatment of breast cancer such as surgery, radiotherapy, hormone therapy and chemotherapy may be adversely affected by obesity. The objective of this study was to use bioimpedance to assess abdominal fat in women with breast cancer treatment-related lymphedema and suggest this as a screening method. Forty-five female patients with clinical diagnosis of breast cancer treatment-related lymphedema were evaluated in this quantitative cross-sectional study. A control group, composed of 38 patients with varicose veins and women attending a social support group, was matched for age and body mass index (BMI). All participants were submitted to a bioimpedance evaluation (In Body S 10), with particular attention being paid to abdominal fat and their BMI. The unpaired t -test, Fisher Exact test and Mann-Whitney test were used for statistical analysis and an alpha error of 5%. There was no significant difference (p -value = 0.23) in the mean BMI between the study group (27.79 kg∕m2) and the control group (28.80 kg∕m2). The mean abdominal circumference, a measure of abdominal fat, of the women in the study group was 130.54 cm2 and for the control group it was 102.24 cm2 (p -value = 0.0037). Thus the study group had more abdominal fat (p -value = 0.0003). Moreover, on comparing obese patients in the two groups, the study group had more abdominal fat (p -value = 0.02). However, no significant difference was observed comparing non-obese patients (p -value = 0.6). The comparison of obese patients with non-obese patients in the control group identifies an association between obesity and abdominal fat (p -value abdominal fat than the general population with bioimpedance.

  16. Interstitial MR lymphangiography in patients with lower extremity lymphedema: a preliminary report

    International Nuclear Information System (INIS)

    Lu Qing; Xu Jianrong; Liu Ningfei

    2009-01-01

    Objective: To assess the feasibility of interstitial MR lymphangiography (MRL) with subcutaneous injection of a commercially available, non-ionic, extracellular paramagnetic contrast agent, to visualize lymphatic vessels in patients with primary lymphedema. Methods: Forty lower extremities in 31 patients with clinically advanced stages of primary lymphedema were examined with magnetic resonance lymphangiography. A 1 ml mixed liquor of gadobenate dimeglumine and mepivacainhydrochloride were injected subcutaneously into the dorsal aspect of both feet. For MRL, a 3D fast spoiled gradient-recalled echo T 1 -weighted images with a fat saturation technique (T 1 high resolution isotropic volume excitation, THRIVE) were performed after subcutaneous application of the contrast material. To outline lymphatic vessels, source images were used to reconstruct images of MIP. The SNR and CNR of enhanced lymphatic vessels and veins were measured and calculated respectively. The significance of the differences of the data comparisons was assessed using an unpaired student t test. Results: Of the 40 lower extremities, the beaded appearance of dilated lymphatic vessels was detected in 36 lower legs (90.0%) and 17 upper legs (42.5%). The numbers of the dilated lymphatic vessels displayed in all segments of lower extremities added up to 365 and its mean diameter was (3.4±0.1) mm on MRL MIP image. The average SNR and CNR were 257±130, 207±113 in the dilated lymphatic vessels and 218±129, 152±113 in the vein respectively, which was statistically significant (SNR t=-2.649, CNR t=-3.404, P<0.01). Contrast enhancement was observed in 30/40 inguinal lymph node groups (75.0%). In 26 lower extremities (65.0%) collateral vessels with dermal back-flow areas between lymphatic vessels were seen. Conclusions: As a novel tool to image the pathologically modified lymphatic vessels in patients with clinically advanced stage of primary lymphedema, magnetic resonance lymphangiography is a safe

  17. 48 CFR 9904.420 - Accounting for independent research and development costs and bid and proposal costs.

    Science.gov (United States)

    2010-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.420 Accounting for independent research and development costs and bid and proposal costs. ...

  18. A Scintigraphic Method for Quantitation of Lymphatic Function in Arm Lymphedema

    DEFF Research Database (Denmark)

    Hvidsten, Svend; Toyserkani, Navid M; Sørensen, Jens A

    2018-01-01

    ) measure of lymph fluid passing through the arm. METHODS AND RESULTS: Eleven patients, aged 34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent simultaneous bilateral lymphoscintigraphy using intradermal injection of 99mTc-labeled human serum albumin (HSA). Imaging...... was performed at 30-45 minute intervals for 5 hours. Time activity curves from each injection site and each arm region were recorded. The input into the arm region was obtained as the (minus) time derivative of the injection site activity curve. In the proposed model the arm activity curve was considered...

  19. Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2016-07-01

    Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

  20. Reference Values for Assessment of Unilateral Limb Lymphedema with Dual-Energy X-Ray Absorptiometry

    DEFF Research Database (Denmark)

    Gjorup, Caroline A; Hendel, Helle W; Klausen, Tobias W

    2018-01-01

    INTRODUCTION: The clinical assessment of unilateral limb lymphedema is commonly based on measurements of interlimb volume differences. Reference values for interlimb percentage differences of the volume, fat mass, and lean mass measured with dual-energy X-ray absorptiometry (DXA) scan are, however...... is calculated as follows: ("Limb-of-interest"-contralateral)/contralateral × 100. The interlimb percentage differences for the limb-of-interest were stratified to upper (according to handedness) and lower limbs and categorized as none/mild, moderate, or severe, respectively, based on whether the value is below...

  1. Development of an immunotherapeutic adenovirus targeting hormone-independent prostate cancer

    Directory of Open Access Journals (Sweden)

    Kim JS

    2013-11-01

    Full Text Available Jae Sik Kim,1 Sang Don Lee,2 Sang Jin Lee,3 Moon Kee Chung21Department of Urology, The Catholic University of Korea Incheon St Mary's Hospital, Incheon, 2Pusan National University Yangsan Hospital and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, 3Genitourinary Cancer Branch, National Cancer Center, Goyang, KoreaBackground: To develop a targeting therapy for hormone-independent prostate cancer, we constructed and characterized conditionally replicating oncolytic adenovirus (Ad equipped with mRFP(monomeric red fluorescence protein/ttk (modified herpes simplex virus thymidine kinase This construct was then further modified to express both mRFP/ttk and a soluble form of cytokine FLT3L (fms-related tyrosine kinase 3 ligand simultaneously.Methods: To construct the recombinant oncolytic adenovirus, E1a and E4 genes, which are necessary for adenovirus replication, were controlled by the prostate-specific enhancer sequence (PSES targeting prostate cancer cells expressing prostate-specific antigen (PSA and prostate-specific membrane antigen (PSMA. Simultaneously, it expressed the mRFP/ttk fusion protein in order to be able to elicit the cytotoxic effect.Results: The Ad5/35PSES.mRFP/ttk chimeric recombinant adenovirus was generated successfully. When replication of Ad5/35PSES.mRFP/ttk was evaluated in prostate cancer cell lines under fluorescence microscopy, red fluorescence intensity increased more in LNCaP cells, suggesting that the mRFP/ttk fusion protein was folded functionally. In addition, the replication assay including wild-type adenovirus as a positive control showed that PSES-positive cells (LNCaP and CWR22rv permitted virus replication but not PSES-negative cells (DU145 and PC3. Next, we evaluated the killing activity of this recombinant adenovirus. The Ad5/35PSES.mRFP/ttk killed LNCaP and CWR22rv more effectively. Unlike PSES-positive cells, DU145 and PC3 were resistant to killing by this recombinant

  2. Risk Factors Affecting Breast Cancer-related Lymphedema: Serial Body Weight Change During Neoadjuvant Anthracycline Plus Cyclophosphamide Followed by Taxane.

    Science.gov (United States)

    Park, Sungmin; Lee, Jeong Eon; Yu, Jonghan; Paik, Hyun-June; Ryu, Jai Min; Kim, Isaac; Bae, Soo Youn; Lee, Se Kyung; Kim, Seok Won; Nam, Seok Jin; Kim, Eun-Kyu; Kang, Eunyoung; Yang, Eun Joo

    2018-02-01

    The aim of our study was to analyze the risk of lymphedema (LE) according to the clinicopathologic factors and to investigate the serial change in body weight during neoadjuvant anthracycline plus cyclophosphamide followed by taxane and its correlation with the incidence of LE. We performed a retrospective 2-center study of 406 patients who had undergone neoadjuvant chemotherapy (NAC) followed by surgery from 2007 to 2014. The regimen included 4 cycles of anthracycline plus cyclophosphamide, followed by 4 cycles of taxane. We investigated the presence and degree of LE using a telephone questionnaire assessment. Weight changes were calculated at each cycle of NAC, and the baseline and preoperative body weights were used to calculate the rate of change to account for the change in weight before and after NAC. Of the 406 patients, 270 answered the questionnaires, of whom 97 (35.9%) experienced LE. The increase in body weight was significant during the 4 cycles of taxane, but the change in weight was not significant during the 4 cycles of anthracycline plus cyclophosphamide. The change in body weight was most significant just after the fourth cycle of taxane (P weight was not a significant factor for the incidence of LE. Because a BMI ≥ 25 kg/m 2 was an independent factor of LE occurrence on multivariate analysis, patients with a preoperative BMI ≥ 25 kg/m 2 should be closely monitored for LE given their increased risk, and monitoring and education should be initiated before surgery and continued throughout the course of NAC. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. IAEA Assistance in Helping Member States Develop Effectively Independent and Robust Regulators for Nuclear Installation Safety

    Energy Technology Data Exchange (ETDEWEB)

    Nicic, A., E-mail: A.Nicic@iaea.org [International Atomic Energy Agency (IAEA), Department of Nuclear Safety and Security, Wagramer Strasse 5, P.O. Box 100, 1400 Vienna (Austria)

    2014-10-15

    Full text: The International Conference on Topical Issues in Nuclear Installation Safety will be focused on the exchange of information on the latest thinking and advances in the implementation of the concept of Defence-in-Depth (DID) in nuclear installations, and the associated challenges. The focus will be on operating nuclear installations, including nuclear power plants, research reactors and fuel cycle facilities, and on how lessons learned from operating experience and recent events (e.g. the Fukushima Daiichi accident) are used to enhance safety. The implementation of DID covers a number of elements that are directly related to the different states and phases of a nuclear facility. This presentation will discuss the importance of the regulatory body in its oversight role as a cross-cutting element of DID in helping to assure the safety of nuclear installations. Taking note of the numerous challenges in developing an effectively independent and robust regulatory body, the presentation will describe how the IAEA assists Member States in their development of the appropriate regulatory infrastructure and necessary capacity to carry out their regulatory responsibilities – consistent with the IAEA Safety Standards. The presentation will describe the importance of the self-assessment process which serves as a starting point for helping Member States gain an understanding of what support they need and when the support should be provided as they develop into a competent regulatory authority. The presentation will discuss recent improvements in the self-assessment process and related IAEA services in this regard. Once regulatory bodies are established, it is essential that they seek continuous improvement. In this regard, the presentation will describe the IAEA’s assistance provided through the Integrated Regulatory Review Service (IRRS) and recent activities to improve the IRRS, consistent with the IAEA’s Action Plan on Nuclear Safety. (author)

  4. Direction-selective circuitry in rat retina develops independently of GABAergic, cholinergic and action potential activity.

    Directory of Open Access Journals (Sweden)

    Le Sun

    Full Text Available The ON-OFF direction selective ganglion cells (DSGCs in the mammalian retina code image motion by responding much more strongly to movement in one direction. They do so by receiving inhibitory inputs selectively from a particular sector of processes of the overlapping starburst amacrine cells, a type of retinal interneuron. The mechanisms of establishment and regulation of this selective connection are unknown. Here, we report that in the rat retina, the morphology, physiology of the ON-OFF DSGCs and the circuitry for coding motion directions develop normally with pharmacological blockade of GABAergic, cholinergic activity and/or action potentials for over two weeks from birth. With recent results demonstrating light independent formation of the retinal DS circuitry, our results strongly suggest the formation of the circuitry, i.e., the connections between the second and third order neurons in the visual system, can be genetically programmed, although emergence of direction selectivity in the visual cortex appears to require visual experience.

  5. Nanomolar bifenthrin alters synchronous Ca2+ oscillations and cortical neuron development independent of sodium channel activity.

    Science.gov (United States)

    Cao, Zhengyu; Cui, Yanjun; Nguyen, Hai M; Jenkins, David Paul; Wulff, Heike; Pessah, Isaac N

    2014-04-01

    Bifenthrin, a relatively stable type I pyrethroid that causes tremors and impairs motor activity in rodents, is broadly used. We investigated whether nanomolar bifenthrin alters synchronous Ca(2+) oscillations (SCOs) necessary for activity-dependent dendritic development. Primary mouse cortical neurons were cultured 8 or 9 days in vitro (DIV), loaded with the Ca(2+) indicator Fluo-4, and imaged using a Fluorescence Imaging Plate Reader Tetra. Acute exposure to bifenthrin rapidly increased the frequency of SCOs by 2.7-fold (EC50 = 58 nM) and decreased SCO amplitude by 36%. Changes in SCO properties were independent of modifications in voltage-gated sodium channels since 100 nM bifenthrin had no effect on the whole-cell Na(+) current, nor did it influence neuronal resting membrane potential. The L-type Ca(2+) channel blocker nifedipine failed to ameliorate bifenthrin-triggered SCO activity. By contrast, the metabotropic glutamate receptor (mGluR)5 antagonist MPEP [2-methyl-6-(phenylethynyl)pyridine] normalized bifenthrin-triggered increase in SCO frequency without altering baseline SCO activity, indicating that bifenthrin amplifies mGluR5 signaling independent of Na(+) channel modification. Competitive [AP-5; (-)-2-amino-5-phosphonopentanoic acid] and noncompetitive (dizocilpine, or MK-801 [(5S,10R)-(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine maleate]) N-methyl-d-aspartate antagonists partially decreased both basal and bifenthrin-triggered SCO frequency increase. Bifenthrin-modified SCO rapidly enhanced the phosphorylation of cAMP response element-binding protein (CREB). Subacute (48 hours) exposure to bifenthrin commencing 2 DIV-enhanced neurite outgrowth and persistently increased SCO frequency and reduced SCO amplitude. Bifenthrin-stimulated neurite outgrowth and CREB phosphorylation were dependent on mGluR5 activity since MPEP normalized both responses. Collectively these data identify a new mechanism by which bifenthrin potently alters Ca(2

  6. NETS - A NEURAL NETWORK DEVELOPMENT TOOL, VERSION 3.0 (MACHINE INDEPENDENT VERSION)

    Science.gov (United States)

    Baffes, P. T.

    1994-01-01

    NETS, A Tool for the Development and Evaluation of Neural Networks, provides a simulation of Neural Network algorithms plus an environment for developing such algorithms. Neural Networks are a class of systems modeled after the human brain. Artificial Neural Networks are formed from hundreds or thousands of simulated neurons, connected to each other in a manner similar to brain neurons. Problems which involve pattern matching readily fit the class of problems which NETS is designed to solve. NETS uses the back propagation learning method for all of the networks which it creates. The nodes of a network are usually grouped together into clumps called layers. Generally, a network will have an input layer through which the various environment stimuli are presented to the network, and an output layer for determining the network's response. The number of nodes in these two layers is usually tied to some features of the problem being solved. Other layers, which form intermediate stops between the input and output layers, are called hidden layers. NETS allows the user to customize the patterns of connections between layers of a network. NETS also provides features for saving the weight values of a network during the learning process, which allows for more precise control over the learning process. NETS is an interpreter. Its method of execution is the familiar "read-evaluate-print" loop found in interpreted languages such as BASIC and LISP. The user is presented with a prompt which is the simulator's way of asking for input. After a command is issued, NETS will attempt to evaluate the command, which may produce more prompts requesting specific information or an error if the command is not understood. The typical process involved when using NETS consists of translating the problem into a format which uses input/output pairs, designing a network configuration for the problem, and finally training the network with input/output pairs until an acceptable error is reached. NETS

  7. Low level laser therapy (photobiomodulation) for the management of breast cancer-related lymphedema: an update

    Science.gov (United States)

    Baxter, G. David; Liu, Lizhou; Chapple, Cathy; Petrich, Simone; Anders, Juanita J.; Tumilty, Steve

    2018-04-01

    Breast cancer related lymphedema (BCRL) is prevalent among breast cancer survivors, and may be painful and disfiguring with associated psychological impact. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy for managing BCRL, in countries including the United States and Australia. However, conclusions were limited by the paucity, heterogeneity, and poor quality of previous studies. LLLT (PBM) has been barely used in clinical practice in New Zealand, and no clinical studies on LLLT (PBM) for BCRL have been conducted in this country. In order to promote this potentially useful treatment modality for BCRL patients, the Laser Lymphedema Trial Team at the University of Otago conducted a program to assess the effectiveness of LLLT (PBM) in management of BCRL. The program comprises three phases including a systematic review (completed), a feasibility study (completed), and a full-scale randomized controlled trial (proposed). This current paper provides an update on the program. Based upon the systematic review, LLLT (PBM) is considered a potentially effective treatment approach for women with BCRL; the review also indicated the need for further research including exploration of the relevance of dosage and other LLLT (PBM) parameters. The feasibility study demonstrated that it is feasible to conduct a fully powered RCT to definitively test the effectiveness of the additional use of LLLT (PBM) in the management of BCRL, and 114 participants will be needed at baseline in the main study. Currently, the full-scale RCT is under preparation.

  8. Quality of life of women with lymphedema after surgery for breast cancer

    Directory of Open Access Journals (Sweden)

    Marislei Sanches Panobianco

    2014-06-01

    Full Text Available This study evaluated the quality of life of 20 women with post-mastectomy lymphedema due to breast cancer, using the Flanagan’s Adapted Quality of Life Scale (1 and the Visual Analogue Scale (2, with data collection from July to December 2009 in the countryside of the state of São Paulo. It was observed a lower quality of life concerning participation in recreational and work activities, and better quality of life was related to relationship with friends; listening to music, reading, watching TV and going to the movies. Cronbach's alpha of Scale 1 was 0.86 and the average of Scale 2 was 6.26. Overall, the scales showed satisfactory results of quality of life, but low values showed factors that must be worked out, such as participation in sports, work and learning activities. Thus, lymphedema interferes with the quality of life, indicating a need for early intervention in order to help women achieve better quality of life.

  9. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

    Directory of Open Access Journals (Sweden)

    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  10. Lower limb lymphedema in gynecological cancer survivors--effect on daily life functioning.

    Science.gov (United States)

    Dunberger, Gail; Lindquist, Helene; Waldenström, Ann-Charlotte; Nyberg, Tommy; Steineck, Gunnar; Åvall-Lundqvist, Elisabeth

    2013-11-01

    Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors. We identified a cohort of 789 eligible women, treated with pelvic radiotherapy alone or as part of combined treatment of gynecological cancer, from 1991 to 2003 at two departments of gynecological oncology in Sweden. As a preparatory study, we conducted in-depth interviews with gynecological cancer survivors and constructed a study-specific questionnaire which we validated face-to-face. The questionnaire covered physical symptoms originating in the pelvis, demographic, psychological, and quality of life factors. In relation to the lymph system, 19 questions were asked. Six hundred sixteen (78 %) gynecological cancer survivors answered the questionnaire and participated in the study. Thirty-six percent (218/606) of the cancer survivors reported LLL. Overall quality of life was significantly lower among cancer survivors with LLL. They were also less satisfied with their sleep, more worried about recurrence of cancer, and more likely to interpret symptoms from the body as recurrence. Cancer survivors reported that LLL kept them from physical activity (45 %) and house work (29 %) and affected their ability to partake in social activities (27 %) or to meet friends (20 %). Lower limb lymphedema has a negative impact on quality of life among gynecological cancer survivors, affecting sleep and daily life activities, yet only a few seek professional help.

  11. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

    International Nuclear Information System (INIS)

    Koul, Rashmi; Dufan, Tarek; Russell, Catherine; Guenther, Wanda; Nugent, Zoan; Sun Xuyan; Cooke, Andrew L.

    2007-01-01

    Objective: To evaluate the results of combined decongestive therapy and manual lymphatic drainage in patients with breast cancer-related lymphedema. Methods and Materials: The data from 250 patients were reviewed. The pre- and posttreatment volumetric measurements were compared, and the correlation with age, body mass index, and type of surgery, chemotherapy, and radiotherapy was determined. The Spearman correlation coefficients and Wilcoxon two-sample test were used for statistical analysis. Results: Of the 250 patients, 138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified on the basis of the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, manual lymphatic drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 mL (p < 0.0001). The type of surgery (p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of lymphedema. Conclusion: Combined decongestive therapy and manual lymphatic drainage with exercises were associated with a significant reduction in the lymphedema volume

  12. Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiae subspecies equisimilis in breast cancer-related lymphedema: a case report.

    Science.gov (United States)

    Sumazaki, Makoto; Saito, Fumi; Ogata, Hideaki; Yoshida, Miho; Kubota, Yorichika; Magoshi, Syunsuke; Kaneko, Hironori

    2017-07-14

    Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease.

  13. Technical advances in proteomics: new developments in data-independent acquisition [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Alex Hu

    2016-03-01

    Full Text Available The ultimate aim of proteomics is to fully identify and quantify the entire complement of proteins and post-translational modifications in biological samples of interest. For the last 15 years, liquid chromatography-tandem mass spectrometry (LC-MS/MS in data-dependent acquisition (DDA mode has been the standard for proteomics when sampling breadth and discovery were the main objectives; multiple reaction monitoring (MRM LC-MS/MS has been the standard for targeted proteomics when precise quantification, reproducibility, and validation were the main objectives. Recently, improvements in mass spectrometer design and bioinformatics algorithms have resulted in the rediscovery and development of another sampling method: data-independent acquisition (DIA. DIA comprehensively and repeatedly samples every peptide in a protein digest, producing a complex set of mass spectra that is difficult to interpret without external spectral libraries. Currently, DIA approaches the identification breadth of DDA while achieving the reproducible quantification characteristic of MRM or its newest version, parallel reaction monitoring (PRM. In comparative de novo identification and quantification studies in human cell lysates, DIA identified up to 89% of the proteins detected in a comparable DDA experiment while providing reproducible quantification of over 85% of them. DIA analysis aided by spectral libraries derived from prior DIA experiments or auxiliary DDA data produces identification and quantification as reproducible and precise as that achieved by MRM/PRM, except on low‑abundance peptides that are obscured by stronger signals. DIA is still a work in progress toward the goal of sensitive, reproducible, and precise quantification without external spectral libraries. New software tools applied to DIA analysis have to deal with deconvolution of complex spectra as well as proper filtering of false positives and false negatives. However, the future outlook is

  14. Exome sequencing of bilateral testicular germ cell tumors suggests independent development lineages.

    Science.gov (United States)

    Brabrand, Sigmund; Johannessen, Bjarne; Axcrona, Ulrika; Kraggerud, Sigrid M; Berg, Kaja G; Bakken, Anne C; Bruun, Jarle; Fosså, Sophie D; Lothe, Ragnhild A; Lehne, Gustav; Skotheim, Rolf I

    2015-02-01

    Intratubular germ cell neoplasia, the precursor of testicular germ cell tumors (TGCTs), is hypothesized to arise during embryogenesis from developmentally arrested primordial germ cells (PGCs) or gonocytes. In early embryonal life, the PGCs migrate from the yolk sac to the dorsal body wall where the cell population separates before colonizing the genital ridges. However, whether the malignant transformation takes place before or after this separation is controversial. We have explored the somatic exome-wide mutational spectra of bilateral TGCT to provide novel insight into the in utero critical time frame of malignant transformation and TGCT pathogenesis. Exome sequencing was performed in five patients with bilateral TGCT (eight tumors), of these three patients in whom both tumors were available (six tumors) and two patients each with only one available tumor (two tumors). Selected loci were explored by Sanger sequencing in 71 patients with bilateral TGCT. From the exome-wide mutational spectra, no identical mutations in any of the three bilateral tumor pairs were identified. Exome sequencing of all eight tumors revealed 87 somatic non-synonymous mutations (median 10 per tumor; range 5-21), some in already known cancer genes such as CIITA, NEB, platelet-derived growth factor receptor α (PDGFRA), and WHSC1. SUPT6H was found recurrently mutated in two tumors. We suggest independent development lineages of bilateral TGCT. Thus, malignant transformation into intratubular germ cell neoplasia is likely to occur after the migration of PGCs. We reveal possible drivers of TGCT pathogenesis, such as mutated PDGFRA, potentially with therapeutic implications for TGCT patients. Copyright © 2014 Neoplasia Press, Inc. Published by Elsevier Inc. All rights reserved.

  15. Exome Sequencing of Bilateral Testicular Germ Cell Tumors Suggests Independent Development Lineages

    Directory of Open Access Journals (Sweden)

    Sigmund Brabrand

    2015-02-01

    Full Text Available Intratubular germ cell neoplasia, the precursor of testicular germ cell tumors (TGCTs, is hypothesized to arise during embryogenesis from developmentally arrested primordial germ cells (PGCs or gonocytes. In early embryonal life, the PGCs migrate from the yolk sac to the dorsal body wall where the cell population separates before colonizing the genital ridges. However, whether the malignant transformation takes place before or after this separation is controversial. We have explored the somatic exome-wide mutational spectra of bilateral TGCT to provide novel insight into the in utero critical time frame of malignant transformation and TGCT pathogenesis. Exome sequencing was performed in five patients with bilateral TGCT (eight tumors, of these three patients in whom both tumors were available (six tumors and two patients each with only one available tumor (two tumors. Selected loci were explored by Sanger sequencing in 71 patients with bilateral TGCT. From the exome-wide mutational spectra, no identical mutations in any of the three bilateral tumor pairs were identified. Exome sequencing of all eight tumors revealed 87 somatic non-synonymous mutations (median 10 per tumor; range 5-21, some in already known cancer genes such as CIITA, NEB, platelet-derived growth factor receptor α (PDGFRA, and WHSC1. SUPT6H was found recurrently mutated in two tumors. We suggest independent development lineages of bilateral TGCT. Thus, malignant transformation into intratubular germ cell neoplasia is likely to occur after the migration of PGCs. We reveal possible drivers of TGCT pathogenesis, such as mutated PDGFRA, potentially with therapeutic implications for TGCT patients.

  16. An integrated development framework for rapid development of platform-independent and reusable satellite on-board software

    Science.gov (United States)

    Ziemke, Claas; Kuwahara, Toshinori; Kossev, Ivan

    2011-09-01

    Even in the field of small satellites, the on-board data handling subsystem has become complex and powerful. With the introduction of powerful CPUs and the availability of considerable amounts of memory on-board a small satellite it has become possible to utilize the flexibility and power of contemporary platform-independent real-time operating systems. Especially the non-commercial sector such like university institutes and community projects such as AMSAT or SSETI are characterized by the inherent lack of financial as well as manpower resources. The opportunity to utilize such real-time operating systems will contribute significantly to achieve a successful mission. Nevertheless the on-board software of a satellite is much more than just an operating system. It has to fulfill a multitude of functional requirements such as: Telecommand interpretation and execution, execution of control loops, generation of telemetry data and frames, failure detection isolation and recovery, the communication with peripherals and so on. Most of the aforementioned tasks are of generic nature and have to be conducted on any satellite with only minor modifications. A general set of functional requirements as well as a protocol for communication is defined in the SA ECSS-E-70-41A standard "Telemetry and telecommand packet utilization". This standard not only defines the communication protocol of the satellite-ground link but also defines a set of so called services which have to be available on-board of every compliant satellite and which are of generic nature. In this paper, a platform-independent and reusable framework is described which is implementing not only the ECSS-E-70-41A standard but also functionalities for interprocess communication, scheduling and a multitude of tasks commonly performed on-board of a satellite. By making use of the capabilities of the high-level programming language C/C++, the powerful open source library BOOST, the real-time operating system RTEMS and

  17. Increasing compliance with mass drug administration programs for lymphatic filariasis in India through education and lymphedema management programs.

    Directory of Open Access Journals (Sweden)

    Paul T Cantey

    2010-06-01

    Full Text Available Nearly 45% of people living at risk for lymphatic filariasis (LF worldwide live in India. India has faced challenges obtaining the needed levels of compliance with its mass drug administration (MDA program to interrupt LF transmission, which utilizes diethylcarbamazine (DEC or DEC plus albendazole. Previously identified predictors of and barriers to compliance with the MDA program were used to refine a pre-MDA educational campaign. The objectives of this study were to assess the impact of these refinements and of a lymphedema morbidity management program on MDA compliance.A randomized, 30-cluster survey was performed in each of 3 areas: the community-based pre-MDA education plus community-based lymphedema management education (Com-MDA+LM area, the community-based pre-MDA education (Com-MDA area, and the Indian standard pre-MDA education (MDA-only area. Compliance with the MDA program was 90.2% in Com-MDA+LM, 75.0% in Com-MDA, and 52.9% in the MDA-only areas (p<0.0001. Identified barriers to adherence included: 1 fear of side effects and 2 lack of recognition of one's personal benefit from adherence. Multivariable predictors of adherence amenable to educational intervention were: 1 knowing about the MDA in advance of its occurrence, 2 knowing everyone is at risk for LF, 3 knowing that the MDA was for LF, and 4 knowing at least one component of the lymphedema management techniques taught in the lymphedema management program.This study confirmed previously identified predictors of and barriers to compliance with India's MDA program for LF. More importantly, it showed that targeting these predictors and barriers in a timely and clear pre-MDA educational campaign can increase compliance with MDA programs, and it demonstrated, for the first time, that lymphedema management programs may also increase compliance with MDA programs.

  18. Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

    International Nuclear Information System (INIS)

    Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae

    2005-01-01

    We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients

  19. Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients.

  20. Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

    Science.gov (United States)

    Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

    2004-01-01

    The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

  1. SUGGESTIONS FOR DEVELOPING INDEPENDENT WORD ATTACK IN READING, FOR USE IN BASIC INSTITUTE MEETINGS, GRADES THREE AND FOUR.

    Science.gov (United States)

    REECE, THOMAS E.; AND OTHERS

    A GUIDE FOR PLANNING SPECIFIC INSTRUCTION FOR DEVELOPING INDEPENDENT WORD ATTACK PRESENTS THE SKILLS NECESSARY FOR MASTERING SIGHT VOCABULARY, WORD RECOGNITION, AND THE USE OF THE DICTIONARY. SPECIFIC DEFINITIONS OF TERMS AND EXAMPLES OF TEACHING TECHNIQUES WITH THE SEQUENCE OF INSTRUCTION FOR THE DEVELOPMENT OF PHONETIC AND STRUCTURAL ANALYSIS…

  2. Developing Independence in a Capstone Course: Helping Students Ask and Answer Their Own Questions

    Science.gov (United States)

    Camenga, Kristin A.

    2013-01-01

    We discuss a mathematics capstone course designed to help students grow in mathematical independence. We describe how the course is structured to support this goal and the major assignments: a course wiki, a group expository project, and an individual problem to solve and extend. Students learn to ask and answer their own questions, helping them…

  3. Development of a prototype interactive learning system using multi-media technology for mission independent training program

    Science.gov (United States)

    Matson, Jack E.

    1992-01-01

    The Spacelab Mission Independent Training Program provides an overview of payload operations. Most of the training material is currently presented in workbook form with some lecture sessions to supplement selected topics. The goal of this project was to develop a prototype interactive learning system for one of the Mission Independent Training topics to demonstrate how the learning process can be improved by incorporating multi-media technology into an interactive system. This report documents the development process and some of the problems encountered during the analysis, design, and production phases of this system.

  4. Independent Planning System and Public Administration in Metropolitan Development: Agglomeration Strategies of Greater Chaoshan in Southern China

    Directory of Open Access Journals (Sweden)

    Tian Guang

    2017-04-01

    Full Text Available This paper examines independent planning system as a means of public administration in regional economic development. It proposes a new strategy based on the theories of public administrative resources, to agglomerate and unify the cities of Shantou, Jieyang, and Chaozhou into a new administrative entity as a metropolis with the status of independent planning and the preferred policies of a Special Economic Region to lead regional development. The optimal allocation of public administrative resources has played a key role in the fundamental economic development in China in recent years. The new administrative system of large cities (metropolises with independent planning has become an innovative format to utilize the renewable soft resources of administration, which in fact is a new attempt to reform the economic system by the Chinese government. The greater Chaoshan area needs to be agglomerated and unified to further develop the regional economy with the implementation of independent planning system. The current research conducted from a practical and political point of view is of significant value to the overall planning and strategic layout of the economic and social development of the whole eastern Guangdong region.

  5. Development of methodological principles for organization of students’ independent work in the e-learning system

    Directory of Open Access Journals (Sweden)

    Олександр Іванович Пушкар

    2016-10-01

    Full Text Available The concept of organization of professional competence formation of students’ independent work in e-learning is proposed in the article. Implementation of the proposed model of competence formation in e-learning is done on the example of multimedia complex for discipline "Processes of publishing and printing". Selection of the most important components for each competence is made on the basis of Saaty method

  6. A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report.

    Science.gov (United States)

    Crane, Patricia; Feinberg, Lauren; Morris, John

    2015-02-01

    There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted.

  7. Patterns of Feedback on the Bridge to Independence: A Qualitative Thematic Analysis of NIH Mentored Career Development Award Application Critiques.

    Science.gov (United States)

    Kaatz, Anna; Dattalo, Melissa; Regner, Caitlin; Filut, Amarette; Carnes, Molly

    2016-01-01

    NIH Mentored Career Development (K) Awards bridge investigators from mentored to independent research. A smaller proportion of women than men succeed in this transition. The aim of this qualitative study was to analyze reviewers' narrative critiques of K award applications and explore thematic content of feedback provided to male and female applicants. We collected 88 critiques, 34 from 9 unfunded and 54 from 18 funded applications, from 70% (n = 26) of investigators at the University of Wisconsin-Madison with K awards funded between 2005 and 2009 on the first submission or after revision. We qualitatively analyzed text in the 5 critique sections: candidate, career development plan, research plan, mentors, and environment and institutional commitment. We explored thematic content within these sections for male and female applicants and for applicants who had received a subsequent independent research award by 2014. Themes revealed consistent areas of criticism for unfunded applications and praise for funded applications. Subtle variations in thematic content appeared for male and female applicants: For male applicants criticism was often followed by advice but for female applicants it was followed by questions about ability; praise recurrently characterized male but not female applicants' research as highly significant with optimism for future independence. Female K awardees that obtained subsequent independent awards stood out as having track records described as "outstanding." This exploratory study suggests that K award reviewer feedback, particularly for female applicants, should be investigated as a potential contributor to research persistence and success in crossing the bridge to independence.

  8. Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study.

    Science.gov (United States)

    Kuroda, Kenji; Yamamoto, Yasuhiro; Yanagisawa, Manami; Kawata, Akira; Akiba, Naoya; Suzuki, Kensuke; Naritaka, Kazutoshi

    2017-07-25

    Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence. Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk. The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m 2 (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030-2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126-4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148-5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120-2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3-6) and low-risk (scores 0-2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440-3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9-62.1%] for the high-risk group and 28.9% [95% CI, 21.1-38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0

  9. How Much Professional Development Is Enough? Meeting the Needs of Independent Music Teachers Learning to Use a Digital Tool

    Science.gov (United States)

    Upitis, Rena; Brook, Julia

    2017-01-01

    Even though there are demonstrated benefits of using online tools to support student musicians, there is a persistent challenge of providing sufficient and effective professional development for independent music teachers to use such tools successfully. This paper describes several methods for helping teachers use an online tool called iSCORE,…

  10. Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

    International Nuclear Information System (INIS)

    Dalia, Roberta Maria; Martins, Glaucia Ribeiro P.; Barbosa, Rodolfo; Lima, Carla Flavia de; Siqueira, Cristiano Ferrari

    2005-01-01

    The purpose of this study was to prove the efficiency of qualitative and quantitative lymphoscintigraphy in the diagnosis of the lower extremity lymphedema. Seventy-seven patients had been studied, most of then (85.7%) were female. Patients' ages ranged from 18 to 82 years. All patients underwent a bilateral lymphoscintigraphy. Images were recorded with a dual-detector instrument in the whole-body scanning mode. Feet and inguinal static views were acquired within 15 minutes and three hours after radiopharmaceutical injection. Two nuclear doctors evaluated the lymphoscintigrams qualitatively. Quantitative studies of the radiopharmaceutical absorption and the lymph node chain uptake were also obtained. Of the 154 evaluated members, 21.44% (n = 33) were classified as normal, 61.68% (n = 95) as mildly altered and 16.88% (n = 26) much altered. Quantitation of lymphatic chain uptake may be a more sensitive approach to the diagnosis of lymphatic impairment than the qualitative analysis. (author)

  11. Immune proteins and other biochemical constituents of peripheral lymph in patients with malignancy and postirradiation lymphedema

    International Nuclear Information System (INIS)

    Olszewski, W.L.; Norske Radiumhospital, Oslo. Lab. of Hematology and Lymphology); Loe, K.; Engeset, A.

    1978-01-01

    Concentrations of immunoglobulins and complement proteins were studied in a group of 33 patients with localized tumors and lymphoproliferative disorders. Generally, low levels have been found, in many cases below the lowest limit of the control group. The reductions in concentration were more pronounced in patients with lympho-proliferative disorders than with solid tumors. The most reduced were lgM, Clg and total complement hemolytic activity. In a group of 8 patients with lymphedema of lower extremity complicating therapy for uterine cancer an increase of IgM and IgA and decrease in hemolytic activity were found. This indicates the existence of a chronic inflammatory process typical for tissues deprived in lymphatic outflow. (orig.) [de

  12. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  13. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  14. Ultrasonographic, quantitative comparison of lower extremity lymphedema versus normal control. Technical note with case reports

    Directory of Open Access Journals (Sweden)

    Vanessa Lôbo de Carvalho

    2018-01-01

    Full Text Available Characterization of tissue by ultrasonography (CATUS is a modern-day research endeavor intended to improve visual perception and image quantification. Visual perception increases with color. Quantification focuses on pixel echo brightnesses. A previously presented case report demonstrated reappearance of lymphatic channels a few days after manual drainage. Ultrasonographic images (US of lymphatic leg and foot were quantitated and compared to a normal extremity based on proportions of pixels in specific brightness intervals. Anatomy evaluated included control- subcutaneous and lymphatic compartments. US with 256 brightness levels were obtained at the proximal, mid and distal leg and foot. Control and lymphatic Gray Scale Medians (GSM and histograms were compared using t-test and Chi-square statistics. Average GSM was 97±9 (SD (82-114, n=12 images for control, greater than 51±15 (24-69, n=12 for lymphedematous leg/foot (P99% of pixels with brightness in the muscle-fiber range (41-196, in contrast to 62% for the lymphatic extremity (P<0.001. Lymphedema averaged 7%, 3%, 15% and 14% of pixels in blood, blood/fat, fat and fat/muscle-like regions (0-4, 5-7, 8-26, 27- 40 brightness intervals. Such regions were visually interpreted as lymphatic channels or lakes. Visual perception by colorization is subjective, but most people perceives details better, for example, during the day than at night. Furthermore, US images have 16 times more shades of gray, 256, than that perceived by the human visual system, 16 on average. Colorization improved perception of lymphatic channels and lakes by transforming blood echoes into red and lymphatic liquid with echoes similar to fat into yellow. Pixel proportions in low brightness intervals were higher in the lymphatic than in the normal extremity. Lymphedema severity was quantified. The CATUS technique may be used to monitor treatment effects or disease evolution.

  15. [Does the public sector have an independent research role in the development of drugs?].

    Science.gov (United States)

    Poulsen, Henrik Enghusen; Grønlykke, Thor Buch

    2003-04-14

    Exclusively private companies do drug development. The State contributes with education of academics and basic research constituting the basis of half of the drugs developed by the private companies. The Danish private drug research amounts to six billion DKK per year, corresponding to the estimated price of the development of one new drug. The development shows a negative tendency. There are doubts about the scientific credibility, the number of new drugs is declining, drug development costs are rising, and the competitiveness in Europe is declining compared with the one of The United States. Continued improvement of Danish drug development can be achieved by stimulation of the public research related to drug development.

  16. Product Development Categorized as Independent Strategic and Innovative Practice: Case from Indian Manufacturing

    Directory of Open Access Journals (Sweden)

    Himanshu Dutt

    2008-06-01

    Full Text Available In recent time, Indian manufacturing has seen technologically intensive and resource optimization based initiatives to satisfy competitive urge and to build or sustain market position. This they do by developing products either strategically or innovatively, but that is hardly distinguished or seen as a separate approach to product development. Strategically, product development is resource optimization based while innovatively, it is product differentiation focused. This paper outlines the strategic and innovative approach to product development and analyzes sector specific role of each in product development. The study is undertaken with nine product development team-leaders and resource-heads, three of each from automobile, steel and textile. It is concluded that textile is strategically skewed toward product development whereas automobile is inclined towards innovative orientation. The biggest limitation of this study is smaller sample-size because respondents are reluctant to disclose new technical initiatives and composition of product development.

  17. Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood.

    Science.gov (United States)

    Sadauskaite-Kuehne, Vaiva; Ludvigsson, Johnny; Padaiga, Zilvinas; Jasinskiene, Edita; Samuelsson, Ulf

    2004-01-01

    Early weaning diet, early introduction of breast milk substitution and cow's milk have been shown to increase the risk of type 1 diabetes later in life. It is also shown that older maternal age, maternal education, preeclampsia, prematurity, neonatal illness and neonatal icterus caused by blood group incompatibility, infections and stress might be risk factors for type 1 diabetes. We aimed to determine whether early nutrition is an independent risk factor for diabetes despite other life events. Data from 517 children (268 boys and 249 girls) in south-east of Sweden and 286 children (133 boys and 153 girls) in Lithuania in the age group of 0 to 15 years with newly diagnosed type 1 diabetes mellitus were included into analysis. Three age- and sex-matched healthy controls were randomly selected. Response rate in control families in Sweden was 72.9% and in Lithuania 94.8%. Information was collected via questionnaires. Exclusive breastfeeding longer than five months (odds ratio 0.54, 95% confidence interval 0.36-0.81) and total breastfeeding longer than 7 (0.56, 0.38-0.84) or 9 months (0.61, 0.38-0.84), breastfeeding substitution that started later than the third month (0.57, 0.33-0.98) among Swedish children 5 to 9 years old and later than the seventh month (0.24, 0.07-0.84) among all Swedish children is protective against diabetes when adjusted for all other above-listed risk factors. In Lithuania, exclusive breastfeeding longer than two months in the age group of 5 to 9 years is protective (0.58, 0.34-0.99) when adjusted for other factors. Longer exclusive and total breastfeeding appears as an independent protective factor against type 1 diabetes. Copyright 2004 John Wiley & Sons, Ltd.

  18. Regional Distribution of Epifascial Swelling and Epifascial Lymph Drainage Rate Constants in Breast Cancer-Related Lymphedema

    OpenAIRE

    MODI, STEPHANIE; STANTON, ANTHONY W. B.; MELLOR, RUSSELL H.; MICHAEL PETERS, A.; RODNEY LEVICK, J.; MORTIMER, PETER S.

    2005-01-01

    Background: The view that breast cancer-related lymphedema (BCRL) is a simple, direct mechanical result of axillary lymphatic obstruction (‘stopcock’ mechanism) appears incomplete, because parts of the swollen limb (e.g., hand) can remain nonswollen. The lymph drainage rate constant (k) falls in the swollen forearm but not in the spared hand, indicating regional differences in lymphatic function. Here the generality of the hypothesis that regional epifascial lymphatic failure underlies region...

  19. [The application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities].

    Science.gov (United States)

    Kulchitskaya, D B; Gerasimenko, M Yu; Aphanova, T V; Konchugova, T V

    The principal objective of the present work was to evaluate the influence of impulse magnetic therapy on the state of the microcirculatory system in the patients presenting with lymphedema of the lower extremities. The study included 59 patients with stage of 1 and 2 lymphedema who were divided into two groups. Those comprising the first group had impulse magnetic therapy applied to their lower extremities while the patients making up the second group served as controls. All the patients were examined with the use of the laser Doppler flowmetry (LDF) that revealed the initially present pathological changes in the microcirculatory system of their lower extremities. The study has demonstrated that the application of impulse magnetic therapy produced a positive effect on all the constituent components of the microcirculatory blood stream of the patients suffering from lymphedema of the lower extremities. Specifically, the initially increased arteriolar tonus was decreased, the blood flow in the capillary vessels was improved, and congestive phenomena in the venular segments of the microcirculation blood stream were markedly reduced. The results of the LDF examination in the control group gave no evidence of significant changes in the patients' microcirculatory system. The results of the LDF examination of the patients of the control group suggested the absence of any appreciable changes in the microcirculatory system. The present study has demonstrated the advisability of the application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities as a minimally invasive technique for the evaluation of the condition of the microcirculatory system and the objective assessment of the effectiveness of the outcomes of physiotherapy in the patients with vascular pathology.

  20. 48 CFR 31.205-18 - Independent research and development and bid and proposal costs.

    Science.gov (United States)

    2010-10-01

    ... determine and exploit the potential of scientific discoveries or improvements in technology, materials... systematic use, under whatever name, of scientific and technical knowledge in the design, development, test...

  1. Hydrops fetalis and pulmonary lymphangiectasia due to FOXC2 mutation: an autosomal dominant hereditary lymphedema syndrome with variable expression.

    Science.gov (United States)

    de Bruyn, Gwendolyn; Casaer, Alexandra; Devolder, Katrien; Van Acker, Geert; Logghe, Hilde; Devriendt, Koen; Cornette, Luc

    2012-03-01

    Non-immune hydrops fetalis may find its origin within genetically determined lymphedema syndromes, caused by mutations in FOXC2 and SOX-18. We describe a newborn girl, diagnosed with non-immune hydrops fetalis at a gestational age of 30 weeks. Family history revealed the presence of an autosomal dominant late-onset form of lymphedema of the lower limbs in her father, associated with an aberrant implantation of the eyelashes in some individuals. The newborn, hydropic girl suffered from severe pulmonary lymphangiectasia, resulting in terminal respiratory failure at the age of 3 months. Genetic analysis in both the father and the newborn girl demonstrated a heterozygous FOXC2 mutation, i.e., c.939C>A, p.Tyr313X. Her two older sisters are currently asymptomatic and the parents decided not to test them for the FOXC2 mutation. Patients with a mutation in the FOXC2 transcription factor usually show lower limb lymphedema with onset at or after puberty, together with distichiasis. However, the eye manifestations can be very mild and easily overlooked. The association between FOXC2 mutation and neonatal hydrops resulting in terminal respiratory failure is not reported so far. Therefore, in sporadic patients diagnosed with non-immune hydrops fetalis, lymphangiogenic genes should be systematically screened for mutations. In addition, all cases of fetal edema must prompt a thorough analysis of the familial pedigree, in order to detect familial patterns and to facilitate adequate antenatal counseling.

  2. Administration of rocuronium based on real body weight versus fat-free mass in patients with lymphedema.

    Science.gov (United States)

    Jing, Zhang; Muheremu, Aikeremujiang; Liu, Pengfei; Hu, Xiaoyun; Binjiang, Zhao

    2017-12-01

    Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion. Intubation was attempted when the onset time (T1) (time from end of bolus injection to 100% twitch depression) reached maximal inhibition, and respiratory support with mechanical ventilation was then applied. The T1, clinical duration (time from end of bolus injection to recovery of twitch tension to 25% of control), recovery index (time from 25% to 75% of recovery of T1), and dosage were recorded. Results Complete data were recorded for 59 patients, and there were no significant differences in the general condition, intubation condition, or median duration of action of rocuronium between the two groups. However, the median T1, recovery index, and dosage of rocuronium were significantly different. Conclusion Good intubation conditions and a shortened clinical duration can be obtained for patients with lymphedema when induction with rocuronium is based on the fat-free mass.

  3. Usability of advanced pneumatic compression to treat cancer-related head and neck lymphedema: A feasibility study.

    Science.gov (United States)

    Mayrovitz, Harvey N; Ryan, Shelly; Hartman, James M

    2018-01-01

    This functional usability study assessed ease of use, fit, comfort, and potential clinical benefits of advanced pneumatic compression treatment of cancer-related head and neck lymphedema. Patient-reported comfort and other treatment aspects were evaluated and multiple face and neck measurements were obtained on 44 patients with head and neck lymphedema before and after 1 treatment session to assess usability and treatment-related lymphedema changes. A majority of the patients (82%) reported the treatment was comfortable; most patients (61%) reported feeling better after treatment, and 93% reported that they would be likely to use this therapy at home. One treatment produced overall small but highly statistically significant reductions in composite metrics (mean ± SD) of the face (82.5 ± 4.3 cm vs 80.9 ± 4.1 cm; P < .001) and neck (120.4 ± 12.2 cm vs 119.2 ± 12.1 cm; P < .001) with no adverse events. Results found the treatment to be safe, easy to use, and well tolerated while demonstrating edema reduction after a single initial treatment. © 2017 The Authors Head & Neck Published by Wiley Periodicals, Inc.

  4. The development of cognitive independence of students of the University through networking cooperation

    Directory of Open Access Journals (Sweden)

    Eliseev Vladimir N.

    2016-01-01

    Full Text Available The paper describes the aspects of the augmented reality application development on the base of ARToolkit for Android. The steps consistently used for the augmented reality application development have been considered. The simplest Java-based examples of augmented reality have been discussed.

  5. 76 FR 7186 - TGP Development Company, LLC v. California Independent System Operator Corporation; Notice of...

    Science.gov (United States)

    2011-02-09

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-17-000] TGP Development.... Take notice that on January 28, 2011, TGP Development Company, LLC (TGP or Complainants), pursuant to...), concerning the requirement that TGP post its second financial security for transmission upgrades identified...

  6. Catalytic-independent roles of UTX-1 in C. elegans development

    DEFF Research Database (Denmark)

    Vandamme, Julien; Salcini, Anna Elisabetta

    2013-01-01

    We recently analyzed the functional roles of UTX-1 during development. utx-1 is an essential gene required for the correct embryonic and post-embryonic development of C. elegans, and it displays an H3K27me3 demethylase activity. Rescue experiments demonstrated that the enzymatic activity of UTX-1...

  7. Development of a model-independent evaluation of photon-deuteron reactions for the SAPHIR detector

    International Nuclear Information System (INIS)

    Wolf, A.

    1993-01-01

    The SAPHIR detector measures photon induced reactions with many particles in the final state. Thus a detailed investigation of those processes at photon energies between 0.4 and 3.3 GeV is possible. The interpretation of the distribution of the sample of events, which SAPHIR is able to reconstruct, has to be done after a correction of influences induced by the detector acceptance. In this work a model independent method of correcting and analysing the data is discussed. The implementation of the basic tools of this analysis is described and first tests with simulated and real events are performed. SAPHIR uses a time-of-flight system for the identification of particles. This work describes the structure of a program library, which supports an easy way of decoding the digitizations of this system (including calibration of the hardware) and obtaining the flight time for a particle in a event. The necessary step for calibrating the system are outlined, too. (orig.)

  8. [Development of the soft independent modelling of class analogies model to discrimination Vibrio parahemolyticus by Smartongue].

    Science.gov (United States)

    Huang, Jianfeng; Zhao, Guangying; Dou, Wenchao

    2011-04-01

    To explore a new rapid detection method for detecting of Food pathogens. We used the Smartongue, to determine the composition informations of the liquid culture samples and combined with soft independent modelling of class analogies (SIMCA) to analyze their respective species, then set up a Smartongue -SIMCA model to discriminate the V. parahaemolyticus. The Smartongue has 6 working electrodes and three frequency segments, we can built 18 discrimination models in one detection. After comparing all the 18 discrimination models, the optimal working electrodes and frequency segments were selected out, they were: palladium electrode in 1 Hz frequency segment, tungsten electrode in 100 Hz and silver electrode in 100 Hz. Then 10 species of pathogenic Vibrio were discriminated by the 3 models. The V. damsela, V. metschnikovii, V. alginalyticus, V. cincinnatiensis, V. metschnikovii and V. cholerae O serogroup samples could be discriminated by the SIMCA model of V. parahaemolyticus with palladium electrode 1 Hz frequency segment; V. mimicus and V. vulnincus samples could be discriminated by the SIMCA model of V. parahaemolyticus with tungsten electrode 100 Hz frequency segment; V. carcariae and V. cholerae non-O serogroup samples could be discriminated with the SIMCA model of V. parahaemolyticus in silver electrode 100 Hz frequency segment. The accurate discrimination of ten species of Vibrio samples is 100%. The Smartongue combined with SIMCA can discriminate V. parahaemolyticus with other pathogenic Vibrio effectively. It has a promising future as a new rapid detection method for V. parahaemolyticus.

  9. Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

    International Nuclear Information System (INIS)

    McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

    2016-01-01

    Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

  10. Twisting Tourniquet© Technique: introducing Schnogh, a novel device and its effectiveness in treating primary and secondary lymphedema of extremities

    International Nuclear Information System (INIS)

    Chanwimalueang, Narumon; Ekataksin, Wichai; Piyaman, Parkpoom; Pattanapen, Gedsuda; Hanboon, Borimas K

    2015-01-01

    Twisting Tourniquet © or in Thai “Schnogh” is a new invention for compression therapy of lymphedema. Twisting Tourniquet © Technique (TTT) is totally noninvasive for lymphedema management. After the amazing successful evidence in the first series of 28 patients, we have conducted preliminary studies in lymphedema clinics. It was found that the combination of gradually increasing constriction force by Schnogh until desired pressure was reached and maintained for 15 min, followed by a 5-min release, doing repeatedly this compression-decompression for at least 10 sessions a day, can generate acceptable results. The aim of the study was to evaluate the scientific effectiveness and establish a treatment protocol of TTT proposed as a therapeutic approach for clinical management of lymphedema. During 2006–2013, from over 3500 patients, 647 with primary/secondary lymphedema passed inclusion criteria, 307 for upper, and 340 for lower extremity. In the 5-day course of TTT, each day patients underwent 10 sessions of a 15-min compression followed by a 5-min decompression. Vegan diet was encouraged as an adjuvant therapy. Among lymphedema patients whose spectrum of edema severity ranged from mild to gigantic, TTT yielded an average volume reduction rate (VR) at 50.2% and 55.6%, making the average edema reduction volume attained at 463 and 1856 mL for upper and lower limb, respectively. The uniformed practice by Schnogh which supports a continual compression–decompression maneuver over 3.5 h daily for five consecutive days could induce an average VR at above half of the swelling in extremities of 647 patients. Schnogh is therefore effective in clinical management of lymphedema under TTT treatment of fibroblastic interstitium

  11. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

    Science.gov (United States)

    Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

    2014-03-01

    Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

  12. McDonnell Douglas Helicopter Company independent research and development: Preparing for the future

    Science.gov (United States)

    Haggerty, Allen C.

    1988-01-01

    During the 1970's and 80's, research has produced the technology that is seen in aircraft such as the LHX and future models. The technology is discussed that is reaching maturity and moving into the application stage of future programs. Technology is discussed in six major areas: advanced concepts, analysis techniques, structures, systems, simulation, and research and development facilities. The partnership of McDonnell Douglas Helicopter Co. and the government in developing these technologies is illustrated in several programs.

  13. Report of the Defense Science Board Task Group on Independent Research and Development

    Science.gov (United States)

    1967-02-01

    guidance and navigation market running well over a half billion dollars per year, the laser gyro opportunities are many and varied. The early contract...e.~F.Sa-Lr- R. E. Samuelson Director of Researc ~ and Development S-Band Solid-State Telemetry Transmitters Standard RF Circuit Development...such as QDRI and SMEDO, from market research, and from service R&D RFP’s. While the present system of !R&D allowance in defense industries leads to

  14. Creb1 regulates late stage mammalian lung development via respiratory epithelial and mesenchymal-independent mechanisms

    Science.gov (United States)

    Antony, N.; McDougall, A. R.; Mantamadiotis, T.; Cole, T. J.; Bird, A. D.

    2016-01-01

    During mammalian lung development, the morphological transition from respiratory tree branching morphogenesis to a predominantly saccular architecture, capable of air-breathing at birth, is dependent on physical forces as well as molecular signaling by a range of transcription factors including the cAMP response element binding protein 1 (Creb1). Creb1−/− mutant mice exhibit complete neonatal lethality consistent with a lack of lung maturation beyond the branching phase. To further define its role in the developing mouse lung, we deleted Creb1 separately in the respiratory epithelium and mesenchyme. Surprisingly, we found no evidence of a morphological lung defect nor compromised neonatal survival in either conditional Creb1 mutant. Interestingly however, loss of mesenchymal Creb1 on a genetic background lacking the related Crem protein showed normal lung development but poor neonatal survival. To investigate the underlying requirement for Creb1 for normal lung development, Creb1−/− mice were re-examined for defects in both respiratory muscles and glucocorticoid hormone signaling, which are also required for late stage lung maturation. However, these systems appeared normal in Creb1−/− mice. Together our results suggest that the requirement of Creb1 for normal mammalian lung morphogenesis is not dependent upon its expression in lung epithelium or mesenchyme, nor its role in musculoskeletal development. PMID:27150575

  15. Economical assumption for formation of independent energy policy in developing countries

    International Nuclear Information System (INIS)

    Tamonis, M.; Kveselis, V; Klevas

    1996-01-01

    This study concerning the power production and consumption problems in developing countries analyses the following aspects: energy efficiency, fuel prices, technological advances, management of energy demand and environment policy. To obtain background data for state support power programs economical, legal and socio-psychological conditions are considered. (author). 1 fig., 1 tab

  16. The Role of Multi Purpose Cooperative in Developing Economic Independence or SME’s

    Directory of Open Access Journals (Sweden)

    Partono Thomas

    2017-03-01

    Full Text Available Cooperatives are seen as one of the important instrument to improve economic and social conditions of societies, to arouse the spirit of initiative and improving the general knowledge and technical skills of the society. On the present cooperatives members are business people of small medium scale enterprises (SMEs which need a guidance or development. The purpose of this study is to describe the role of cooperatives in small medium scale enterprises (SMEs development. The method used is descriptive qualitative. Data collection techniques used are observation, documentation and interview.The results of research showed that KSU Padurenan Jaya is a multi-purpose cooperatives that has five business units i.e. save loan, store, embroidery service, marketing, research and development. KSU Padurenan Jaya was instrumental in developing the small medium scale enterprises (SMEs embroidery and convection consists of (1 aspects of the market, by following the events of the exhibition or expo, online marketing, providing material needs in the cooperative store, and create innovative products according to consumer taste. (2 the aspect of technology, by socialization and demonstration of the use technology of embroidery machines, embroidery design with computer programs, internet information technology for promoting and marketing product, And to optimize the use of the machine by provide services embroidery using advanced machine in cooperation so that can improve the productivity and efficiency of the business. (3 the aspect of the capital, by providing save loan service with simple procedures, mentoring to access other sources of financing.

  17. Organization Development of the Dutch Judiciary, between Accountability and Judicial Independence

    NARCIS (Netherlands)

    Langbroek, Philip

    2010-01-01

    The Netherlands are a country on the European Continent with a French inspired legal system as far as civil and criminal law is concerned. Administrative law has followed a different development and reflects the middle position of the Netherlands between the French, English and German administrative

  18. Development of fusimotor innervation correlates with group Ia afferents but is independent of neurotrophin-3

    NARCIS (Netherlands)

    Ringstedt, T; Copray, S; Walro, J; Kucera, J

    1998-01-01

    Fusimotor neurons, group Ia afferents and muscle spindles are absent in mutant mice lacking the gene for neurotrophin-3 (NT3). To partition the effect of Ia afferent or spindle absence from that of NT3 deprivation on fusimotor neuron development, we examined the fusimotor system in a mutant mouse

  19. Developing Independent Listening Skills for English as an Additional Language Students

    Science.gov (United States)

    Picard, Michelle; Velautham, Lalitha

    2016-01-01

    This paper describes an action research project to develop online, self-access listening resources mirroring the authentic academic contexts experienced by graduate university students. Current listening materials for English as an Additional Language (EAL) students mainly use Standard American English or Standard British pronunciation, and far…

  20. Dendritic development of Drosophila high order visual system neurons is independent of sensory experience

    Directory of Open Access Journals (Sweden)

    Reuter John E

    2003-06-01

    Full Text Available Abstract Background The complex and characteristic structures of dendrites are a crucial part of the neuronal architecture that underlies brain function, and as such, their development has been a focal point of recent research. It is generally believed that dendritic development is controlled by a combination of endogenous genetic mechanisms and activity-dependent mechanisms. Therefore, it is of interest to test the relative contributions of these two types of mechanisms towards the construction of specific dendritic trees. In this study, we make use of the highly complex Vertical System (VS of motion sensing neurons in the lobula plate of the Drosophila visual system to gauge the importance of visual input and synaptic activity to dendritic development. Results We find that the dendrites of VS1 neurons are unchanged in dark-reared flies as compared to control flies raised on a 12 hour light, 12 hour dark cycle. The dendrites of these flies show no differences from control in dendrite complexity, spine number, spine density, or axon complexity. Flies with genetically ablated eyes show a slight but significant reduction in the complexity and overall length of VS1 dendrites, although this effect may be due to a reduction in the overall size of the dendritic field in these flies. Conclusions Overall, our results indicate no role for visual experience in the development of VS dendrites, while spontaneous activity from photoreceptors may play at most a subtle role in the formation of fully complex dendrites in these high-order visual processing neurons.

  1. Mapping the geographical distribution of podoconiosis in Cameroon using parasitological, serological, and clinical evidence to exclude other causes of lymphedema.

    Directory of Open Access Journals (Sweden)

    Kebede Deribe

    2018-01-01

    Full Text Available Podoconiosis is a non-filarial elephantiasis, which causes massive swelling of the lower legs. It was identified as a neglected tropical disease by WHO in 2011. Understanding of the geographical distribution of the disease is incomplete. As part of a global mapping of podoconiosis, this study was conducted in Cameroon to map the distribution of the disease. This mapping work will help to generate data on the geographical distribution of podoconiosis in Cameroon and contribute to the global atlas of podoconiosis.We used a multi-stage sampling design with stratification of the country by environmental risk of podoconiosis. We sampled 76 villages from 40 health districts from the ten Regions of Cameroon. All individuals of 15-years old or older in the village were surveyed house-to-house and screened for lymphedema. A clinical algorithm was used to reliably diagnose podoconiosis, excluding filarial-associated lymphedema. Individuals with lymphoedema were tested for circulating Wuchereria bancrofti antigen and specific IgG4 using the Alere Filariasis Test Strips (FTS test and the Standard Diagnostics (SD BIOLINE lymphatic filariasis IgG4 test (Wb123 respectively, in addition to thick blood films. Presence of DNA specific to W. bancrofti was checked on night blood using a qPCR technique.Overall, 10,178 individuals from 4,603 households participated in the study. In total, 83 individuals with lymphedema were identified. Of the 83 individuals with lymphedema, two were found to be FTS positive and all were negative using the Wb123 test. No microfilaria of W. bancrofti were found in the night blood of any individual with clinical lymphedema. None were found to be positive for W. bancrofti using qPCR. Of the two FTS positive cases, one was positive for Mansonella perstans DNA, while the other harbored Loa loa microfilaria. Overall, 52 people with podoconiosis were identified after applying the clinical algorithm. The overall prevalence of podoconiosis was

  2. Development of the Human Placenta and Fetal Heart: Synergic or Independent?

    Directory of Open Access Journals (Sweden)

    Graham J. Burton

    2018-04-01

    Full Text Available The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c. give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12–14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces

  3. Occipital foramina development involves localised regulation of mesenchyme proliferation and is independent of apoptosis

    Science.gov (United States)

    Akbareian, Sophia E; Pitsillides, Andrew A; Macharia, Raymond G; McGonnell, Imelda M

    2015-01-01

    Cranial foramina are holes within the skull, formed during development, allowing entry and exit of blood vessels and nerves. Once formed they must remain open, due to the vital structures they contain, i.e. optic nerves, jugular vein, carotid artery, and other cranial nerves and blood vessels. Understanding cranial foramina development is essential as cranial malformations lead to the stenosis or complete closure of these structures, resulting in blindness, deafness, facial paralysis, raised intracranial pressure and lethality. Here we focus on describing early events in the formation of the jugular, carotid and hypoglossal cranial foramina that form in the mesoderm-derived, endochondral occipital bones at the base of the embryonic chick skull. Whole-mount skeletal staining of skulls indicates the appearance of these foramina from HH32/D7.5 onwards. Haematoxylin & eosin staining of sections shows that the intimately associated mesenchyme, neighbouring the contents of these cranial foramina, is initially very dense and gradually becomes sparser as development proceeds. Histological examination also revealed that these foramina initially contain relatively large-diameter nerves, which later become refined, and are closely associated with the blood vessel, which they also innervate within the confines of the foramina. Interestingly cranial foramina in the base of the skull contain blood vessels lacking smooth muscle actin, which suggests these blood vessels belong to glomus body structures within the foramina. The blood vessel shape also appears to dictate the overall shape of the resulting foramina. We initially hypothesised that cranial foramina development could involve targeted proliferation and local apoptosis to cause ‘mesenchymal clearing’ and the creation of cavities in a mechanism similar to joint cavitation. We find that this is not the case, and propose that a mechanism reliant upon local nerve/blood vessel-derived restriction of ossification may

  4. Development of behavioural profile in the Northern common boa (Boa imperator): Repeatable independent traits or personality?

    Science.gov (United States)

    Šimková, Olga; Frýdlová, Petra; Žampachová, Barbora; Frynta, Daniel; Landová, Eva

    2017-01-01

    Recent studies of animal personality have focused on its proximate causation and ecological and evolutionary significance in particular, but the question of its development was largely overlooked. The attributes of personality are defined as between-individual differences in behaviour, which are consistent over time (differential consistency) and contexts (contextual generality) and both can be affected by development. We assessed several candidates for personality variables measured in various tests with different contexts over several life-stages (juveniles, older juveniles, subadults and adults) in the Northern common boa. Variables describing foraging/feeding decision and some of the defensive behaviours expressed as individual average values are highly repeatable and consistent. We found two main personality axes—one associated with foraging/feeding and the speed of decision, the other reflecting agonistic behaviour. Intensity of behaviour in the feeding context changes during development, but the level of agonistic behaviour remains the same. The juveniles and adults have a similar personality structure, but there is a period of structural change of behaviour during the second year of life (subadults). These results require a new theoretical model to explain the selection pressures resulting in this developmental pattern of personality. We also studied the proximate factors and their relationship to behavioural characteristics. Physiological parameters (heart and breath rate stress response) measured in adults clustered with variables concerning the agonistic behavioural profile, while no relationship between the juvenile/adult body size and personality concerning feeding/foraging and the agonistic behavioural profile was found. Our study suggests that it is important for studies of personality development to focus on both the structural and differential consistency, because even though behaviour is differentially consistent, the structure can change. PMID

  5. Nanomolar Bifenthrin Alters Synchronous Ca2+ Oscillations and Cortical Neuron Development Independent of Sodium Channel Activity

    OpenAIRE

    Cao, Zhengyu; Cui, Yanjun; Nguyen, Hai M.; Jenkins, David Paul; Wulff, Heike; Pessah, Isaac N.

    2014-01-01

    Bifenthrin, a relatively stable type I pyrethroid that causes tremors and impairs motor activity in rodents, is broadly used. We investigated whether nanomolar bifenthrin alters synchronous Ca 2+ oscillations (SCOs) necessary for activity-dependent dendritic development. Primary mouse cortical neurons were cultured 8 or 9 days in vitro (DIV), loaded with the Ca2+ indicator Fluo-4, and imaged using a Fluorescence Imaging Plate Reader Tetra. Acute exposure to bifenthrin rapidly increased the fr...

  6. Development of behavioural profile in the Northern common boa (Boa imperator: Repeatable independent traits or personality?

    Directory of Open Access Journals (Sweden)

    Olga Šimková

    Full Text Available Recent studies of animal personality have focused on its proximate causation and ecological and evolutionary significance in particular, but the question of its development was largely overlooked. The attributes of personality are defined as between-individual differences in behaviour, which are consistent over time (differential consistency and contexts (contextual generality and both can be affected by development. We assessed several candidates for personality variables measured in various tests with different contexts over several life-stages (juveniles, older juveniles, subadults and adults in the Northern common boa. Variables describing foraging/feeding decision and some of the defensive behaviours expressed as individual average values are highly repeatable and consistent. We found two main personality axes-one associated with foraging/feeding and the speed of decision, the other reflecting agonistic behaviour. Intensity of behaviour in the feeding context changes during development, but the level of agonistic behaviour remains the same. The juveniles and adults have a similar personality structure, but there is a period of structural change of behaviour during the second year of life (subadults. These results require a new theoretical model to explain the selection pressures resulting in this developmental pattern of personality. We also studied the proximate factors and their relationship to behavioural characteristics. Physiological parameters (heart and breath rate stress response measured in adults clustered with variables concerning the agonistic behavioural profile, while no relationship between the juvenile/adult body size and personality concerning feeding/foraging and the agonistic behavioural profile was found. Our study suggests that it is important for studies of personality development to focus on both the structural and differential consistency, because even though behaviour is differentially consistent, the structure can

  7. Development of behavioural profile in the Northern common boa (Boa imperator): Repeatable independent traits or personality?

    Science.gov (United States)

    Šimková, Olga; Frýdlová, Petra; Žampachová, Barbora; Frynta, Daniel; Landová, Eva

    2017-01-01

    Recent studies of animal personality have focused on its proximate causation and ecological and evolutionary significance in particular, but the question of its development was largely overlooked. The attributes of personality are defined as between-individual differences in behaviour, which are consistent over time (differential consistency) and contexts (contextual generality) and both can be affected by development. We assessed several candidates for personality variables measured in various tests with different contexts over several life-stages (juveniles, older juveniles, subadults and adults) in the Northern common boa. Variables describing foraging/feeding decision and some of the defensive behaviours expressed as individual average values are highly repeatable and consistent. We found two main personality axes-one associated with foraging/feeding and the speed of decision, the other reflecting agonistic behaviour. Intensity of behaviour in the feeding context changes during development, but the level of agonistic behaviour remains the same. The juveniles and adults have a similar personality structure, but there is a period of structural change of behaviour during the second year of life (subadults). These results require a new theoretical model to explain the selection pressures resulting in this developmental pattern of personality. We also studied the proximate factors and their relationship to behavioural characteristics. Physiological parameters (heart and breath rate stress response) measured in adults clustered with variables concerning the agonistic behavioural profile, while no relationship between the juvenile/adult body size and personality concerning feeding/foraging and the agonistic behavioural profile was found. Our study suggests that it is important for studies of personality development to focus on both the structural and differential consistency, because even though behaviour is differentially consistent, the structure can change.

  8. Arabidopsis CPR5 independently regulates seed germination and postgermination arrest of development through LOX pathway and ABA signaling.

    Directory of Open Access Journals (Sweden)

    Guilan Gao

    Full Text Available The phytohormone abscisic acid (ABA and the lipoxygenases (LOXs pathway play important roles in seed germination and seedling growth and development. Here, we reported on the functional characterization of Arabidopsis CPR5 in the ABA signaling and LOX pathways. The cpr5 mutant was hypersensitive to ABA in the seed germination, cotyledon greening and root growth, whereas transgenic plants overexpressing CPR5 were insensitive. Genetic analysis demonstrated that CPR5 gene may be located downstream of the ABI1 in the ABA signaling pathway. However, the cpr5 mutant showed an ABA independent drought-resistant phenotype. It was also found that the cpr5 mutant was hypersensitive to NDGA and NDGA treatment aggravated the ABA-induced delay in the seed germination and cotyledon greening. Taken together, these results suggest that the CPR5 plays a regulatory role in the regulation of seed germination and early seedling growth through ABA and LOX pathways independently.

  9. Development of electronics and data acquisition system for independent calibration of electron cyclotron emission radiometer

    Energy Technology Data Exchange (ETDEWEB)

    Kumari, Praveena, E-mail: praveena@ipr.res.in; Raulji, Vismaysinh; Mandaliya, Hitesh; Patel, Jignesh; Siju, Varsha; Pathak, S.K.; Rajpal, Rachana; Jha, R.

    2016-11-15

    Highlights: • Indigenous development of an electronics and data acquisition system to digitize signals for a desired time and automatization of calibration process. • 16 bit DAQ board with form factor of 90 × 89 mm. • VHDL Codes written for generating control signals for PC104 Bus, ADC and RAM. • Averaging process is done in two ways single point averaging and additive averaging. - Abstract: Signal conditioning units (SCU) along with Multichannel Data acquisition system (DAS) are developed and installed for automatization and frequent requirement of absolute calibration of ECE radiometer system. The DAS is an indigenously developed economical system which is based on Single Board Computer (SBC). The onboard RAM memory of 64 K for each channel enables the DAS for simultaneous and continuous acquisition. A Labview based graphical user interface provides commands locally or remotely to acquire, process, plot and finally save the data in binary format. The microscopic signals received from radiometer are strengthened, filtered by SCU and acquired through DAS for the set time and at set sampling frequency. Stored data are processed and analyzed offline with Labview utility. The calibration process has been performed for two hours continuously at different sampling frequency (100 Hz to 1 KHz) at two set of temperature like hot body and the room temperature. The detailed hardware and software design and testing results are explained in the paper.

  10. Infant Gut Microbiota Development Is Driven by Transition to Family Foods Independent of Maternal Obesity.

    Science.gov (United States)

    Laursen, Martin Frederik; Andersen, Louise B B; Michaelsen, Kim F; Mølgaard, Christian; Trolle, Ellen; Bahl, Martin Iain; Licht, Tine Rask

    2016-01-01

    The first years of life are paramount in establishing our endogenous gut microbiota, which is strongly affected by diet and has repeatedly been linked with obesity. However, very few studies have addressed the influence of maternal obesity on infant gut microbiota, which may occur either through vertically transmitted microbes or through the dietary habits of the family. Additionally, very little is known about the effect of diet during the complementary feeding period, which is potentially important for gut microbiota development. Here, the gut microbiotas of two different cohorts of infants, born either of a random sample of healthy mothers (n = 114), or of obese mothers (n = 113), were profiled by 16S rRNA amplicon sequencing. Gut microbiota data were compared to breastfeeding patterns and detailed individual dietary recordings to assess effects of the complementary diet. We found that maternal obesity did not influence microbial diversity or specific taxon abundances during the complementary feeding period. Across cohorts, breastfeeding duration and composition of the complementary diet were found to be the major determinants of gut microbiota development. In both cohorts, gut microbial composition and alpha diversity were thus strongly affected by introduction of family foods with high protein and fiber contents. Specifically, intake of meats, cheeses, and Danish rye bread, rich in protein and fiber, were associated with increased alpha diversity. Our results reveal that the transition from early infant feeding to family foods is a major determinant for gut microbiota development. IMPORTANCE The potential influence of maternal obesity on infant gut microbiota may occur either through vertically transmitted microbes or through the dietary habits of the family. Recent studies have suggested that the heritability of obesity may partly be caused by the transmission of "obesogenic" gut microbes. However, the findings presented here suggest that maternal obesity per

  11. Division of Labour and Coordination between independent Participants in Research and Development

    DEFF Research Database (Denmark)

    Pedersen, Jørgen Lindgaard; Edwards, Kasper; Pedersen, Søren Marcus

    2004-01-01

    accumulation, diminishing uncertainty, applying the modularisation concept in division of labour and all that covering with sphere of globalisation and faster, cheaper and more reliable and accurate information flow are making R&D processes object for outsourcing. We are looking at three empirical cases: 1......Not only relatively simple work routines can today be outsourced to home countries or sent abroad. Also R&D is today object for such a development. In this paper we consider the issue through the prisms of history, uncertainty, and modularity. We look at the temporal dimension of knowledge...

  12. Development of Conformation Independent Computational Models for the Early Recognition of Breast Cancer Resistance Protein Substrates

    Directory of Open Access Journals (Sweden)

    Melisa Edith Gantner

    2013-01-01

    Full Text Available ABC efflux transporters are polyspecific members of the ABC superfamily that, acting as drug and metabolite carriers, provide a biochemical barrier against drug penetration and contribute to detoxification. Their overexpression is linked to multidrug resistance issues in a diversity of diseases. Breast cancer resistance protein (BCRP is the most expressed ABC efflux transporter throughout the intestine and the blood-brain barrier, limiting oral absorption and brain bioavailability of its substrates. Early recognition of BCRP substrates is thus essential to optimize oral drug absorption, design of novel therapeutics for central nervous system conditions, and overcome BCRP-mediated cross-resistance issues. We present the development of an ensemble of ligand-based machine learning algorithms for the early recognition of BCRP substrates, from a database of 262 substrates and nonsubstrates compiled from the literature. Such dataset was rationally partitioned into training and test sets by application of a 2-step clustering procedure. The models were developed through application of linear discriminant analysis to random subsamples of Dragon molecular descriptors. Simple data fusion and statistical comparison of partial areas under the curve of ROC curves were applied to obtain the best 2-model combination, which presented 82% and 74.5% of overall accuracy in the training and test set, respectively.

  13. Development of a novel hydroxyl ammonium nitrate based liquid propellant for air-independent propulsion

    Science.gov (United States)

    Fontaine, Joseph Henry

    The focus of this dissertation is the development of an Unmanned Undersea Vehicle (UUV) liquid propellant employing Hydroxyl Ammonium Nitrate (HAN) as the oxidizer. Hydroxyl Ammonium Nitrate is a highly acidic aqueous based liquid oxidizer. Therefore, in order to achieve efficient combustion of a propellant using this oxidizer, the fuel must be highly water soluble and compatible with the oxidizer to prevent a premature ignition prior to being heated within the combustion chamber. An extensive search of the fuel to be used with this oxidizer was conducted. Propylene glycol was chosen as the fuel for this propellant, and the propellant given the name RF-402. The propellant development process will first evaluate the propellants thermal stability and kinetic parameters using a Differential Scanning Calorimeter (DSC). The purpose of the thermal stability analysis is to determine the temperature at which the propellant decomposition begins for the future safe handling of the propellant and the optimization of the combustion chamber. Additionally, the thermogram results will provide information regarding any undesirable endotherms prior to the decomposition and whether or not the decomposition process is a multi-step process. The Arrhenius type kinetic parameters will be determined using the ASTM method for thermally unstable materials. The activation energy and pre-exponential factor of the propellant will be determined by evaluating the decomposition peak temperature over a temperature scan rate ranging from 1°C per minute to 10°C per minute. The kinetic parameters of the propellant will be compared to those of 81 wt% HAN to determine if the HAN decomposition is controlling the overall decomposition of the propellant RF-402. The lifetime of individual droplets will be analyzed using both experimental and theoretical techniques. The theoretical technique will involve modeling the lifetime of an individual droplet in a combustion chamber like operating environment

  14. Development of heart failure is independent of K+ channel-interacting protein 2 expression

    Science.gov (United States)

    Speerschneider, Tobias; Grubb, Søren; Metoska, Artina; Olesen, Søren-Peter; Calloe, Kirstine; Thomsen, Morten B

    2013-01-01

    Abnormal ventricular repolarization in ion channelopathies and heart disease is a major cause of ventricular arrhythmias and sudden cardiac death. K+ channel-interacting protein 2 (KChIP2) expression is significantly reduced in human heart failure (HF), contributing to a loss of the transient outward K+ current (Ito). We aim to investigate the possible significance of a changed KChIP2 expression on the development of HF and proarrhythmia. Transverse aortic constrictions (TAC) and sham operations were performed in wild-type (WT) and KChIP2−/− mice. Echocardiography was performed before and every 2 weeks after the operation. Ten weeks post-surgery, surface ECG was recorded and we paced the heart in vivo to induce arrhythmias. Afterwards, tissue from the left ventricle was used for immunoblotting. Time courses of HF development were comparable in TAC-operated WT and KChIP2−/− mice. Ventricular protein expression of KChIP2 was reduced by 70% after 10 weeks TAC in WT mice. The amplitudes of the J and T waves were enlarged in KChIP2−/− control mice. Ventricular effective refractory period, RR, QRS and QT intervals were longer in mice with HF compared to sham-operated mice of either genotype. Pacing-induced ventricular tachycardia (VT) was observed in 5/10 sham-operated WT mice compared with 2/10 HF WT mice with HF. Interestingly, and contrary to previously published data, sham-operated KChIP2−/− mice were resistant to pacing-induced VT resulting in only 1/10 inducible mice. KChIP2−/− with HF mice had similar low vulnerability to inducible VT (1/9). Our results suggest that although KChIP2 is downregulated in HF, it is not orchestrating the development of HF. Moreover, KChIP2 affects ventricular repolarization and lowers arrhythmia susceptibility. Hence, downregulation of KChIP2 expression in HF may be antiarrhythmic in mice via reduction of the fast transient outward K+ current. PMID:24099801

  15. CENTRAL BANK INDEPENDENCY ON THE DEVELOPMENT OF THE FINANCIAL SECTOR. A CASE OF RESERVE BANK OF ZIMBABWE (1998-2008

    Directory of Open Access Journals (Sweden)

    KOSMAS NJANIKE

    2010-01-01

    Full Text Available The study looks deeper in the relationship between central bank independence and Gross Domestic product growth and other economic variables which are indicative of improved performance with specific reference to a developing economy. It seeks to find out how the central bank policies affected the state of development of the financial sector and the extent to which the banking sector influenced economic development in the economy. The research also aims to find out how the government affected or influenced the state of development of the financial sector in the country. It was found that the government was sorely dependent on central bank financing as a matter of survival due to limited sources of finance as GDP decline meant a reduction tax revenue base. Rising inflation and contracting real incomes put pressure on the fiscal budget. Questionnaires, interviews and document review were used to obtain information for the study. It was concluded that the cohesion between fiscal and monetary policy is of paramount importance; and there was need for a high degree of formal instrument independence.

  16. Xenopus laevis Retinal Ganglion Cell Dendritic Arbors Develop Independently of Visual Stimulation

    Directory of Open Access Journals (Sweden)

    Barbara Lom

    2004-01-01

    Full Text Available Newly formed neurons must locate their appropriate target cells and then form synaptic connections with these targets in order to establish a functional nervous system. In the vertebrate retina, retinal ganglion cell (RGC dendrites extend from the cell body and form synapses with nearby amacrine and bipolar cells. RGC axons, however, exit the retina and synapse with the dendrites of midbrain neurons in the optic tectum. We examined how visual stimulation influenced Xenopus RGC dendritic arborization. Neuronal activity is known to be an important factor in shaping dendritic and axonal arborization. Thus, we reared tadpoles in dark and light environments then used rhodamine dextran retrograde labeling to identify RGCs in the retina. When we compared RGC dendritic arbors from tadpoles reared in dark and light environments, we found no morphological differences, suggesting that physiological visual activity did not contribute to the morphological development of Xenopus RGC dendritic arbors.

  17. Development of an Owner Engineer's independent capability in NPP safety and licensing

    International Nuclear Information System (INIS)

    Auglaire, M.; Bayart, D.; D'Eer, A.; Polet, F.; Vanhoenacker, L.; Zhang, J.

    2002-01-01

    As Owner's Engineer to Electrabel, the Belgian utility which owns and operates the 7 NPPs in Belgium, Tractebel Energy Engineering has gained considerable experience in the field of ten-yearly safety overhauls of NPPs since 1983. It has developed a methodology leading to proposing corrective actions by means of a global and integrated approach in which safety improvement costs are optimized. Safety issues addressed during those projects encompass the writing of Probabilistic Safety Assessment studies, post-TMI recommendations implementation, the installation of autocatalytic recombiners, accident studies, protection against pressurized thermal shock, impact of flooding of internal or external origin, implementation of severe accident management guidelines, re-evaluation of the environment, verification of extreme climate conditions, updating of the Safety Analysis Reports, operation review. (author)

  18. Acute exposure to lead increases myocardial contractility independent of hypertension development

    International Nuclear Information System (INIS)

    Fioresi, M.; Furieri, L.B.; Simões, M.R.; Ribeiro, R.F. Junior; Meira, E.F.; Fernandes, A.A.; Stefanon, I.; Vassallo, D.V.

    2013-01-01

    We studied the effects of the acute administration of small doses of lead over time on hemodynamic parameters in anesthetized rats to determine if myocardial contractility changes are dependent or not on the development of hypertension. Male Wistar rats received 320 µg/kg lead acetate iv once, and their hemodynamic parameters were measured for 2 h. Cardiac contractility was evaluated in vitro using left ventricular papillary muscles as were Na + ,K + -ATPase and myosin Ca 2+ -ATPase activities. Lead increased left- (control: 112 ± 3.7 vs lead: 129 ± 3.2 mmHg) and right-ventricular systolic pressures (control: 28 ± 1.2 vs lead: 34 ± 1.2 mmHg) significantly without modifying heart rate. Papillary muscles were exposed to 8 µM lead acetate and evaluated 60 min later. Isometric contractions increased (control: 0.546 ± 0.07 vs lead: 0.608 ± 0.06 g/mg) and time to peak tension decreased (control: 268 ± 13 vs lead: 227 ± 5.58 ms), but relaxation time was unchanged. Post-pause potentiation was similar between groups (n = 6 per group), suggesting no change in sarcoplasmic reticulum activity, evaluated indirectly by this protocol. After 1-h exposure to lead acetate, the papillary muscles became hyperactive in response to a β-adrenergic agonist (10 µM isoproterenol). In addition, post-rest contractions decreased, suggesting a reduction in sarcolemmal calcium influx. The heart samples treated with 8 µM lead acetate presented increased Na + ,K + -ATPase (approximately 140%, P < 0.05 for control vs lead) and myosin ATPase (approximately 30%, P < 0.05 for control vs lead) activity. Our results indicated that acute exposure to low lead concentrations produces direct positive inotropic and lusitropic effects on myocardial contractility and increases the right and left ventricular systolic pressure, thus potentially contributing to the early development of hypertension

  19. Acute exposure to lead increases myocardial contractility independent of hypertension development

    Energy Technology Data Exchange (ETDEWEB)

    Fioresi, M. [Programa de Pós-Graduação em Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Furieri, L.B.; Simões, M.R.; Ribeiro, R.F. Junior; Meira, E.F.; Fernandes, A.A.; Stefanon, I. [Programa de Pós-Graduação em Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Vassallo, D.V. [Programa de Pós-Graduação em Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Centro de Ciências da Saúde de Vitória, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Vitória, ES (Brazil)

    2013-02-01

    We studied the effects of the acute administration of small doses of lead over time on hemodynamic parameters in anesthetized rats to determine if myocardial contractility changes are dependent or not on the development of hypertension. Male Wistar rats received 320 µg/kg lead acetate iv once, and their hemodynamic parameters were measured for 2 h. Cardiac contractility was evaluated in vitro using left ventricular papillary muscles as were Na{sup +},K{sup +}-ATPase and myosin Ca{sup 2+}-ATPase activities. Lead increased left- (control: 112 ± 3.7 vs lead: 129 ± 3.2 mmHg) and right-ventricular systolic pressures (control: 28 ± 1.2 vs lead: 34 ± 1.2 mmHg) significantly without modifying heart rate. Papillary muscles were exposed to 8 µM lead acetate and evaluated 60 min later. Isometric contractions increased (control: 0.546 ± 0.07 vs lead: 0.608 ± 0.06 g/mg) and time to peak tension decreased (control: 268 ± 13 vs lead: 227 ± 5.58 ms), but relaxation time was unchanged. Post-pause potentiation was similar between groups (n = 6 per group), suggesting no change in sarcoplasmic reticulum activity, evaluated indirectly by this protocol. After 1-h exposure to lead acetate, the papillary muscles became hyperactive in response to a β-adrenergic agonist (10 µM isoproterenol). In addition, post-rest contractions decreased, suggesting a reduction in sarcolemmal calcium influx. The heart samples treated with 8 µM lead acetate presented increased Na{sup +},K{sup +}-ATPase (approximately 140%, P < 0.05 for control vs lead) and myosin ATPase (approximately 30%, P < 0.05 for control vs lead) activity. Our results indicated that acute exposure to low lead concentrations produces direct positive inotropic and lusitropic effects on myocardial contractility and increases the right and left ventricular systolic pressure, thus potentially contributing to the early development of hypertension.

  20. Development of heart failure is independent of K+ channel-interacting protein 2 expression

    DEFF Research Database (Denmark)

    Speerschneider, Tobias; Grubb, Søren; Metoska, Artina

    2013-01-01

    of the transient outward K(+) current (Ito). We aim to investigate the possible significance of a changed KChIP2 expression on the development of HF and proarrhythmia. Transverse aortic constrictions (TAC) and sham operations were performed in wild-type (WT) and KChIP2(-/-) mice. Echocardiography was performed......(-/-) mice. Ventricular protein expression of KChIP2 was reduced by 70% after 10 weeks TAC in WT mice. The amplitudes of the J and T waves were enlarged in KChIP2(-/-) control mice. Ventricular effective refractory period, RR, QRS and QT intervals were longer in mice with HF compared to sham-operated mice...... of either genotype. Pacing-induced ventricular tachycardia (VT) was observed in 5/10 sham-operated WT mice compared with 2/10 HF WT mice with HF. Interestingly, and contrary to previously published data, sham-operated KChIP2(-/-) mice were resistant to pacing-induced VT resulting in only 1/10 inducible mice...

  1. Growth hormone mediates pubertal skeletal development independent of hepatic IGF-1 production.

    Science.gov (United States)

    Courtland, Hayden-William; Sun, Hui; Beth-On, Mordechay; Wu, Yingjie; Elis, Sebastien; Rosen, Clifford J; Yakar, Shoshana

    2011-04-01

    Deficiencies in either growth hormone (GH) or insulin-like growth factor 1 (IGF-1) are associated with reductions in bone size during growth in humans and animal models. Liver-specific IGF-1-deficient (LID) mice, which have 75% reductions in serum IGF-1, were created previously to separate the effects of endocrine (serum) IGF-1 from autocrine/paracrine IGF-1. However, LID mice also have two- to threefold increases in GH, and this may contribute to the observed pubertal skeletal phenotype. To clarify the role of GH in skeletal development under conditions of significantly reduced serum IGF-1 levels (but normal tissue IGF-1 levels), we studied the skeletal response of male LID and control mice to GH inhibition by pegvisomant from 4 to 8 weeks of age. Treatment of LID mice with pegvisomant resulted in significant reductions in body weight, femur length (Le), and femur total area (Tt.Ar), as well as further reductions in serum IGF-1 levels by 8 weeks of age, compared with the mean values of vehicle-treated LID mice. Reductions in both Tt.Ar and Le were proportional after treatment with pegvisomant. On the other hand, the relative amount of cortical tissue formed (RCA) in LID mice treated with pegvisomant was significantly less than that in both vehicle-treated LID and control mice, indicating that antagonizing GH action, either directly (through GH receptor signaling inhibition) or indirectly (through further reductions in serum/tissue IGF-1 levels), results in disproportionate reductions in the amount of cortical bone formed. This resulted in bones with significantly reduced mechanical properties (femoral whole-bone stiffness and work to failure were markedly decreased), suggesting that compensatory increases of GH in states of IGF-1 deficiency (LID mice) act to protect against a severe inhibition of bone modeling during growth, which otherwise would result in bones that are too weak for normal and/or extreme loading conditions. Copyright © 2011 American Society for

  2. Methylcholanthrene-Induced Sarcomas Develop Independently from NOX2-Derived ROS.

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    Maarten A Ligtenberg

    Full Text Available Reactive oxygen species (ROS produced by the inducible NADPH oxidase type 2 (NOX2 complex are essential for clearing certain infectious organisms but may also have a role in regulating inflammation and immune response. For example, ROS is involved in myeloid derived suppressor cell (MDSC- and regulatory T cell (T(reg mediated T- and NK-cell suppression. However, abundant ROS produced within the tumor microenvironment, or by the tumor itself may also yield oxidative stress, which can blunt anti-tumor immune responses as well as eventually leading to tumor toxicity. In this study we aimed to decipher the role of NOX2-derived ROS in a chemically (by methylcholanthrene (MCA induced sarcoma model. Superoxide production by NOX2 requires the p47(phox (NCF1 subunit to organize the formation of the NOX2 complex on the cell membrane. Homozygous mutant mice (NCF1*/* have a functional loss of their super oxide burst while heterozygous mice (NCF1*/+ retain this key function. Mice harboring either a homo- or a heterozygous mutation were injected intramuscularly with MCA to induce sarcoma formation. We found that NOX2 functionality does not determine tumor incidence in the tested MCA model. Comprehensive immune monitoring in tumor bearing mice showed that infiltrating immune cells experienced an increase in their oxidative state regardless of the NOX2 functionality. While MCA-induced sarcomas where characterized by a T(reg and MDSC accumulation, no significant differences could be found between NCF1*/* and NCF1*/+ mice. Furthermore, infiltrating T cells showed an increase in effector-memory cell phenotype markers in both NCF1*/* and NCF1*/+ mice. Tumors established from both NCF1*/* and NCF1*/+ mice were tested for their in vitro proliferative capacity as well as their resistance to cisplatin and radiation therapy, with no differences being recorded. Overall our findings indicate that NOX2 activity does not play a key role in tumor development or immune cell

  3. Development and degeneration of cone bipolar cells are independent of cone photoreceptors in a mouse model of retinitis pigmentosa.

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    Miao Chen

    Full Text Available Retinal photoreceptors die during retinal synaptogenesis in a portion of retinal degeneration. Whether cone bipolar cells establish regular retinal mosaics and mature morphologies, and resist degeneration are not completely understood. To explore these issues, we backcrossed a transgenic mouse expressing enhanced green fluorescent protein (EGFP in one subset of cone bipolar cells (type 7 into rd1 mice, a classic mouse model of retinal degeneration, to examine the development and survival of cone bipolar cells in a background of retinal degeneration. Our data revealed that both the development and degeneration of cone bipolar cells are independent of the normal activity of cone photoreceptors. We found that type 7 cone bipolar cells achieved a uniform tiling of the retinal surface and developed normal dendritic and axonal arbors without the influence of cone photoreceptor innervation. On the other hand, degeneration of type 7 cone bipolar cells, contrary to our belief of central-to-peripheral progression, was spatially uniform across the retina independent of the spatiotemporal pattern of cone degeneration. The results have important implications for the design of more effective therapies to restore vision in retinal degeneration.

  4. Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.

    Science.gov (United States)

    Kwan, Marilyn L; Yao, Song; Lee, Valerie S; Roh, Janise M; Zhu, Qianqian; Ergas, Isaac J; Liu, Qian; Zhang, Yali; Kutner, Susan E; Quesenberry, Charles P; Ambrosone, Christine B; Kushi, Lawrence H

    2016-08-01

    Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p ancestry data, with a potential ancestry-obesity interaction.

  5. Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

    Science.gov (United States)

    Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

    2014-07-01

    Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery. © 2014 International Society for Hemodialysis.

  6. The effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Park, Jin-Hyuck

    2017-07-01

    This study was to investigate the effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema. 69 women participated in this study and then they were randomly allocated to complex exercise group (n = 35) or the conventional decongestive therapy group (n = 34). All subjects received 8 sessions for 4 weeks. To identify the effects on shoulder range of motion and pain, goniometer and visual analog scale were used, respectively. The outcome measurements were performed before and after the 4 week intervention. After 4 weeks, complex exercise group had greater improvements in shoulder range of motion and pain compared with the conventional decongestive therapy group (p women with breast cancer-related lymphedema. Complex exercise would be useful to improve shoulder range of motion and pain of the women with breast cancer-related lymphedema.

  7. Developing wood construction in France in order to enhance energy independence, reduce greenhouse gas emissions and develop employment

    International Nuclear Information System (INIS)

    2015-05-01

    In France, forests represent a third of the surface of the whole country, whereas the national commercial balance on transformed wood shows a large deficit. A well designed development of wood production and transformation for the construction sector could induce many beneficial effects: diminution of greenhouse gas (CO_2) emissions related to the production of construction materials (cement, steel); substitution of a part of space heating fuels by wood collection and transformation by-products and wastes; and decrease of imports of hydrocarbons (through fuel substitution) and transformed woods (through a better transformation in France of timbers grown in French forests). Some recommendations concerning the development of the wood construction sector are given

  8. Independent walking as a major skill for the development of anticipatory postural control: evidence from adjustments to predictable perturbations.

    Directory of Open Access Journals (Sweden)

    Fabien Cignetti

    Full Text Available Although there is suggestive evidence that a link exists between independent walking and the ability to establish anticipatory strategy to stabilize posture, the extent to which this skill facilitates the development of anticipatory postural control remains largely unknown. Here, we examined the role of independent walking on the infants' ability to anticipate predictable external perturbations. Non-walking infants, walking infants and adults were sitting on a platform that produced continuous rotation in the frontal plane. Surface electromyography (EMG of neck and lower back muscles and the positions of markers located on the platform, the upper body and the head were recorded. Results from cross-correlation analysis between rectified and filtered EMGs and platform movement indicated that although muscle activation already occurred before platform movement in non-walking infants, only walking infants demonstrated an adult-like ability for anticipation. Moreover, results from further cross-correlation analysis between segmental angular displacement and platform movement together with measures of balance control at the end-points of rotation of the platform evidenced two sorts of behaviour. The adults behaved as a non-rigid non-inverted pendulum, rather stabilizing head in space, while both the walking and non-walking infants followed the platform, behaving as a rigid inverted pendulum. These results suggest that the acquisition of independent walking plays a role in the development of anticipatory postural control, likely improving the internal model for the sensorimotor control of posture. However, despite such improvement, integrating the dynamics of an external object, here the platform, within the model to maintain balance still remains challenging in infants.

  9. Development of independent MU/treatment time verification algorithm for non-IMRT treatment planning: A clinical experience

    Science.gov (United States)

    Tatli, Hamza; Yucel, Derya; Yilmaz, Sercan; Fayda, Merdan

    2018-02-01

    The aim of this study is to develop an algorithm for independent MU/treatment time (TT) verification for non-IMRT treatment plans, as a part of QA program to ensure treatment delivery accuracy. Two radiotherapy delivery units and their treatment planning systems (TPS) were commissioned in Liv Hospital Radiation Medicine Center, Tbilisi, Georgia. Beam data were collected according to vendors' collection guidelines, and AAPM reports recommendations, and processed by Microsoft Excel during in-house algorithm development. The algorithm is designed and optimized for calculating SSD and SAD treatment plans, based on AAPM TG114 dose calculation recommendations, coded and embedded in MS Excel spreadsheet, as a preliminary verification algorithm (VA). Treatment verification plans were created by TPSs based on IAEA TRS 430 recommendations, also calculated by VA, and point measurements were collected by solid water phantom, and compared. Study showed that, in-house VA can be used for non-IMRT plans MU/TT verifications.

  10. ["Scores of Independence for Neurologic and Geriatric Rehabilitation (SINGER)" - development and validation of a new assessment instrument].

    Science.gov (United States)

    Gerdes, N; Funke, U-N; Schüwer, U; Themann, P; Pfeiffer, G; Meffert, C

    2012-10-01

    In the context of developing and testing a procedure for "Outcome-oriented payment for rehabilitation after stroke", we found that the instruments commonly used to measure the outcomes of rehabilitation after stroke (e. g., Barthel-Index or FIM) were not meeting the special requirements of the new payment system. Therefore the "Scores of Independence for Neurologic and Geriatric Rehabilitation" (SINGER) was developed as a new assessment instrument. This instrument is based on the ICF and measures 20 aspects of "independence in activities of daily living". The characteristic feature of the SINGER is, above all, the way all items are graded in 6 steps: the gradation does not refer to the degree of disability but to the kind and amount of help required for the respective activity, i. e.: 0 = totally dependent on professional help; 1 = professional contact help needed; 2 = contact help by (instructed) lay persons sufficient; 3 = preparation or supervision by lay persons still needed; 4 = independent with assistive device or still slow; 5 = independent without assistive device. For experienced personnel in neurologic rehabilitation, these gradations are "intuitively plausible". A manual moreover describes each grade in detail for each item so that the instrument can be used in rehabilitation facilities without extensive training. The SINGER has been tested and validated in a pilot study (n = 100) and in 2 subsequent studies with large case numbers in neurologic rehabilitation (n = 1058 and n = 700 patients after stroke in all categories of severity). Factor analyses showed that the instrument contains 2 dimensions which can be interpreted as "physical activities" and "activities of communication and cognition". Each of these 2 dimensions can be split into 2 sub-dimensions that can be assigned to the tasks of therapeutical professions in care/Occupational Therapy, physiotherapy, logopedics, and neuro- psychology. The test criteria of reliability, sensitivity, convergent

  11. Functional analysis of the zebrafish ortholog of HMGCS1 reveals independent functions for cholesterol and isoprenoids in craniofacial development.

    Directory of Open Access Journals (Sweden)

    Anita M Quintana

    Full Text Available There are 8 different human syndromes caused by mutations in the cholesterol synthesis pathway. A subset of these disorders such as Smith-Lemli-Opitz disorder, are associated with facial dysmorphia. However, the molecular and cellular mechanisms underlying such facial deficits are not fully understood, primarily because of the diverse functions associated with the cholesterol synthesis pathway. Recent evidence has demonstrated that mutation of the zebrafish ortholog of HMGCR results in orofacial clefts. Here we sought to expand upon these data, by deciphering the cholesterol dependent functions of the cholesterol synthesis pathway from the cholesterol independent functions. Moreover, we utilized loss of function analysis and pharmacological inhibition to determine the extent of sonic hedgehog (Shh signaling in animals with aberrant cholesterol and/or isoprenoid synthesis. Our analysis confirmed that mutation of hmgcs1, which encodes the first enzyme in the cholesterol synthesis pathway, results in craniofacial abnormalities via defects in cranial neural crest cell differentiation. Furthermore targeted pharmacological inhibition of the cholesterol synthesis pathway revealed a novel function for isoprenoid synthesis during vertebrate craniofacial development. Mutation of hmgcs1 had no effect on Shh signaling at 2 and 3 days post fertilization (dpf, but did result in a decrease in the expression of gli1, a known Shh target gene, at 4 dpf, after morphological deficits in craniofacial development and chondrocyte differentiation were observed in hmgcs1 mutants. These data raise the possibility that deficiencies in cholesterol modulate chondrocyte differentiation by a combination of Shh independent and Shh dependent mechanisms. Moreover, our results describe a novel function for isoprenoids in facial development and collectively suggest that cholesterol regulates craniofacial development through versatile mechanisms.

  12. Thin chest wall is an independent risk factor for the development of pneumothorax after chest tube removal.

    Science.gov (United States)

    Anand, Rahul J; Whelan, James F; Ferrada, Paula; Duane, Therese M; Malhotra, Ajai K; Aboutanos, Michel B; Ivatury, Rao R

    2012-04-01

    The factors contributing to the development of pneumothorax after removal of chest tube thoracostomy are not fully understood. We hypothesized that development of post pull pneumothorax (PPP) after chest tube removal would be significantly lower in those patients with thicker chest walls, due to the "protective" layer of adipose tissue. All patients on our trauma service who underwent chest tube thoracostomy from July 2010 to February 2011 were retrospectively reviewed. Patient age, mechanism of trauma, and chest Abbreviated Injury Scale score were analyzed. Thoracic CTs were reviewed to ascertain chest wall thickness (CW). Thickness was measured at the level of the nipple at the midaxillary line, as perpendicular distance between skin and pleural cavity. Chest X-ray reports from immediately prior and after chest tube removal were reviewed for interval development of PPP. Data are presented as average ± standard deviation. Ninety-one chest tubes were inserted into 81 patients. Patients who died before chest tube removal (n = 11), or those without thoracic CT scans (n = 13) were excluded. PPP occurred in 29.9 per cent of chest tube removals (20/67). When PPP was encountered, repeat chest tube was necessary in 20 per cent of cases (4/20). After univariate analysis, younger age, penetrating mechanism, and thin chest wall were found to be significant risk factors for development of PPP. Chest Abbreviated Injury Scale score was similar in both groups. Logistic regression showed only chest wall thickness to be an independent risk factor for development of PPP.

  13. Development of a data independent acquisition mass spectrometry workflow to enable glycopeptide analysis without predefined glycan compositional knowledge.

    Science.gov (United States)

    Lin, Chi-Hung; Krisp, Christoph; Packer, Nicolle H; Molloy, Mark P

    2018-02-10

    Glycoproteomics investigates glycan moieties in a site specific manner to reveal the functional roles of protein glycosylation. Identification of glycopeptides from data-dependent acquisition (DDA) relies on high quality MS/MS spectra of glycopeptide precursors and often requires manual validation to ensure confident assignments. In this study, we investigated pseudo-MRM (MRM-HR) and data-independent acquisition (DIA) as alternative acquisition strategies for glycopeptide analysis. These approaches allow data acquisition over the full MS/MS scan range allowing data re-analysis post-acquisition, without data re-acquisition. The advantage of MRM-HR over DDA for N-glycopeptide detection was demonstrated from targeted analysis of bovine fetuin where all three N-glycosylation sites were detected, which was not the case with DDA. To overcome the duty cycle limitation of MRM-HR acquisition needed for analysis of complex samples such as plasma we trialed DIA. This allowed development of a targeted DIA method to identify N-glycopeptides without pre-defined knowledge of the glycan composition, thus providing the potential to identify N-glycopeptides with unexpected structures. This workflow was demonstrated by detection of 59 N-glycosylation sites from 41 glycoproteins from a HILIC enriched human plasma tryptic digest. 21 glycoforms of IgG1 glycopeptides were identified including two truncated structures that are rarely reported. We developed a data-independent mass spectrometry workflow to identify specific glycopeptides from complex biological mixtures. The novelty is that this approach does not require glycan composition to be pre-defined, thereby allowing glycopeptides carrying unexpected glycans to be identified. This is demonstrated through the analysis of immunoglobulins in human plasma where we detected two IgG1 glycoforms that are rarely observed. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Feasibility study of axillary reverse mapping lymphoscintigraphy in carcinoma breast: A concept toward preventing lymphedema

    International Nuclear Information System (INIS)

    Gandhi, Sunny J.; Satish, C.; Sundaram, Palaniswamy Shanmuga; Subramanyam, Padma; Vijaykumar, D. K.

    2016-01-01

    In the surgery of breast cancer, axillary reverse mapping (ARM) is the identification and preservation of arm draining lymph node (ARM node) during an axillary dissection. The assumption is that the ARM node is different from node draining breast and is unlikely to be involved even in the patients with axillary nodal metastases. If we can identify and preserve ARM node using lymphoscintigraphy; morbidity of lymphedema, as seen with axillary dissection, may be avoided. Pathologically proven 50 breast cancer patients undergoing initial surgery (cTx-4, cN0-2, and Mx-0) were included in this study. Less than 37 MBq, 0.5 ml in equally divided doses of filtered 99mTc sulfur colloid was injected intradermally into the second and third web spaces. ARM nodes in the axilla were identified with the help of Gamma Probe intraoperatively; however, their location was noted with the reference to specific anatomical landmarks and sent for histopathological examination after excision. The ARM node was successfully identified in 47/50 cases (sensitivity - 94%). In 40 out of 47 cases (85%), the location of the ARM node was found to lateral to the subscapular pedicle, above the second intercostobrachial nerve and just below the axillary vein. Of the 47 patients in whom ARM node/s were identified, metastasis was noted in 5 of them (10%). Four out of these 5 patients had the pN3 disease. ARM node exists, and it is feasible to identify ARM node using radio isotope technique with an excellent sensitivity. ARM node seems to have a fairly constant location in more than 80% cases. It is involved with metastasis (10% cases) only when there are multiple lymph nodal metastases in the axilla

  15. Development Of Entrepreneur Learning Model Based On Problem Based Learning To Increase Competency Independence And Creativity Students Of Industrial Engineering

    Directory of Open Access Journals (Sweden)

    Leola Dewiyani

    2017-10-01

    Full Text Available Currently it is undeniable that the competition to get a job is very tight and of course universities have an important role in printing human resources that can compete globally not least with the Department of Industrial Engineering Faculty of Engineering Muhammadiyah University of Jakarta FT UMJ. Problems that occur is based on the analysis obtained from the track record of graduates researchers found that 60 percent of students of Industrial Engineering FT UMJ work not in accordance with the level of education owned so financially their income is still below the standard. This study aims to improve the competence of students of Industrial Engineering Department FT UMJ in entrepreneurship courses especially through the development of Problem Based Learning based learning model. Specific targets of this research were conducted with the aim to identify and analyze the need to implement learning model based on Problem Based Learning Entrepreneurship and to design and develop the model of entrepreneurship based on Problem Based Learning to improve the competence independence and creativity of Industrial Engineering students of FT UMJ in Entrepreneurship course. To achieve the above objectives this research uses research and development R amp D method. The product produced in this research is the detail of learning model of entrepreneurial model based on Problem Based Learning entrepreneurship model based on Problem Based Learning and international journals

  16. Retinoic acid-independent expression of Meis2 during autopod patterning in the developing bat and mouse limb.

    Science.gov (United States)

    Mason, Mandy K; Hockman, Dorit; Curry, Lyle; Cunningham, Thomas J; Duester, Gregg; Logan, Malcolm; Jacobs, David S; Illing, Nicola

    2015-01-01

    The bat has strikingly divergent forelimbs (long digits supporting wing membranes) and hindlimbs (short, typically free digits) due to the distinct requirements of both aerial and terrestrial locomotion. During embryonic development, the morphology of the bat forelimb deviates dramatically from the mouse and chick, offering an alternative paradigm for identifying genes that play an important role in limb patterning. Using transcriptome analysis of developing Natal long-fingered bat (Miniopterus natalensis) fore- and hindlimbs, we demonstrate that the transcription factor Meis2 has a significantly higher expression in bat forelimb autopods compared to hindlimbs. Validation by reverse transcriptase and quantitative polymerase chain reaction (RT-qPCR) and whole mount in situ hybridisation shows that Meis2, conventionally known as a marker of the early proximal limb bud, is upregulated in the bat forelimb autopod from CS16. Meis2 expression is localised to the expanding interdigital webbing and the membranes linking the wing to the hindlimb and tail. In mice, Meis2 is also expressed in the interdigital region prior to tissue regression. This interdigital Meis2 expression is not activated by retinoic acid (RA) signalling as it is present in the retained interdigital tissue of Rdh10 (trex/trex) mice, which lack RA. Additionally, genes encoding RA-synthesising enzymes, Rdh10 and Aldh1a2, and the RA nuclear receptor Rarβ are robustly expressed in bat fore- and hindlimb interdigital tissues indicating that the mechanism that retains interdigital tissue in bats also occurs independently of RA signalling. Mammalian interdigital Meis2 expression, and upregulation in the interdigital webbing of bat wings, suggests an important role for Meis2 in autopod development. Interdigital Meis2 expression is RA-independent, and retention of interdigital webbing in bat wings is not due to the suppression of RA-induced cell death. Rather, RA signalling may play a role in the thinning

  17. The effect of relaxation techniques on edema, anxiety and depression in post-mastectomy lymphedema patients undergoing comprehensive decongestive therapy: A clinical trial.

    Science.gov (United States)

    Abbasi, Bahareh; Mirzakhany, Navid; Angooti Oshnari, Leila; Irani, Ashkan; Hosseinzadeh, Samaneh; Tabatabaei, Seyed Mehdi; Haghighat, Shahpar

    2018-01-01

    Lymphedema is sometimes accompanied by high degrees of anxiety and depression. This study aimed to assess the effects of relaxation techniques on the level of edema, anxiety and depression in women undergoing Comprehensive Decongestive Therapy (CDT). This clinical trial compared two treatment methods in 31 women with post-mastectomy lymphedema, including 15 cases who received CDT and 16 who received RCDT (Relaxation plus CDT). The edema volume, anxiety and depression scores were compared at the first and last sessions of the first phase of the treatment and six weeks afterwards. The edema, anxiety and depression scores were 63.6%, 54.1% and 65.5% in the RCDT group and 60.7%, 31.4% and 35.2% in the CDT group. There were significant differences between the two groups in terms of the reduction in depression (p = 0.024) and anxiety (p = 0.011) scores throughout the study. This significant relationship was due to the differences in the depression score in the 3rd and 9th weeks of the study between the two groups. Similarly, anxiety levels differed significantly between the two groups at the 9th week of the study (P = 0.013). Relaxation techniques reduced the anxiety and depression scores and the volume of edema in the patients with lymphedema. The addition of this intervention to the therapeutic package for lymphedema patients requires further studies in terms of cost-effectiveness.

  18. Tissue dielectric constant and circumference measurement in the follow-up of treatment-related changes in lower-limb lymphedema.

    Science.gov (United States)

    Tugral, Alper; Viren, Tuomas; Bakar, Yesim

    2018-02-01

    Lymphedema of lower limbs is a chronic condition that requires life-long management. Therapeutic effect of complex decongestive physiotherapy (CDP) is most often followed by circumference measurements (CM). However, the CM measurements are not specific to interstitial tissue fluid and have problems in sensitivity and objectivity. The aim of present study was to evaluate the therapeutic effect of CDP with a new tissue water specific measurement technique, in patients with lower limb lymphedema (LLL). A total of 17 patients with unilateral LLL (11 primary, 6 secondary lymphedema) were recruited in this study. CDP was applied for 5 days a week for 4 weeks. CM measurement of both limbs was performed at nine sites along limb by tape measure. Percentage skin water content (PWC) of thigh, calf and ankle was measured in affected lymphedema limb and contralateral limb with MoistureMeterD Compact (MMDC) device. Inter-limb PWC ratio was calculated by dividing affected side's PWC value with PWC of contralateral limb. Patients were asked to fullfill the Lymph Quality of Life Questionnaire. Significant reduction of circumference after CDP was detected at all nine measurement sites along lower limb (Pwater at thigh, calf and ankle measurement sites after CDP (Plimb PWC ratios demonstrated significant reduction of edema between affected and contraletral limbs post-treatment (Plimb PWC ratios were meaningful tools to follow the effect of therapautic intervention. Compared with CM measurements the TDC technique offered easier, quicker, objective and more practical measurements for routine assessments of LLL.

  19. Elephantiasis, elastin, and chronic wound healing: 19th century and contemporary viewpoints relevant to hypotheses concerning lymphedema, leprosy, erysipelas, and psoriasis--review and reflections.

    Science.gov (United States)

    Ryan, T J

    2009-03-01

    Both wound healing and lymphedema have fibrosis of the skin in common. They also share destruction of elastin by elastases from neutrophils as a significant feature. These are not new observations, and the writings of Unna and Kaposi are recalled. The contemporary observations on elastin by Gerli and his team are discussed in the light of these much earlier opinions.

  20. Ecdysone-dependent and ecdysone-independent programmed cell death in the developing optic lobe of Drosophila.

    Science.gov (United States)

    Hara, Yusuke; Hirai, Keiichiro; Togane, Yu; Akagawa, Hiromi; Iwabuchi, Kikuo; Tsujimura, Hidenobu

    2013-02-01

    The adult optic lobe of Drosophila develops from the primordium during metamorphosis from mid-3rd larval stage to adult. Many cells die during development of the optic lobe with a peak of the number of dying cells at 24 h after puparium formation (h APF). Dying cells were observed in spatio-temporal specific clusters. Here, we analyzed the function of a component of the insect steroid hormone receptor, EcR, in this cell death. We examined expression patterns of two EcR isoforms, EcR-A and EcR-B1, in the optic lobe. Expression of each isoform altered during development in isoform-specific manner. EcR-B1 was not expressed in optic lobe neurons from 0 to 6h APF, but was expressed between 9 and 48 h APF and then disappeared by 60 h APF. In each cortex, its expression was stronger in older glia-ensheathed neurons than in younger ones. EcR-B1 was also expressed in some types of glia. EcR-A was expressed in optic lobe neurons and many types of glia from 0 to 60 h APF in a different pattern from EcR-B1. Then, we genetically analyzed EcR function in the optic lobe cell death. At 0 h APF, the optic lobe cell death was independent of any EcR isoforms. In contrast, EcR-B1 was required for most optic lobe cell death after 24 h APF. It was suggested that cell death cell-autonomously required EcR-B1 expressed after puparium formation. βFTZ-F1 was also involved in cell death in many dying-cell clusters, but not in some of them at 24 h APF. Altogether, the optic lobe cell death occurred in ecdysone-independent manner at prepupal stage and ecdysone-dependent manner after 24 h APF. The acquisition of ecdysone-dependence was not directly correlated with the initiation or increase of EcR-B1 expression. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

    Directory of Open Access Journals (Sweden)

    Miguel Modolin

    2006-08-01

    Full Text Available PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS: Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.INTRODUÇÃO: O linfedema peno-escrotal, independentemente da etiologia, é determinado pela redução do fluxo linfático com conseqüente aumento do volume do escroto e pênis. A evolução clínica da doença é caracterizada com extremo desconforto ao paciente, limitando a higiene local, a deambulação, o intercurso sexual e a micção em posição ortostática. OBJETIVO: Apresentar a experiência e resultados no tratamento da patologia com

  2. Increase in serum albumin concentration is associated with prediabetes development and progression to overt diabetes independently of metabolic syndrome.

    Science.gov (United States)

    Jun, Ji Eun; Lee, Seung-Eun; Lee, You-Bin; Jee, Jae Hwan; Bae, Ji Cheol; Jin, Sang-Man; Hur, Kyu Yeon; Lee, Moon-Kyu; Kim, Jae Hyeon

    2017-01-01

    Serum albumin concentration is associated with both type 2 diabetes and metabolic syndrome (MetS). We sought to investigate whether baseline serum albumin and change in serum albumin could be independent risk factors for prediabetes in subjects without MetS. We further examined the effect of serum albumin on progression to overt diabetes in subjects who developed prediabetes. Among 10,792 participants without diabetes and MetS who consecutively underwent yearly health check-ups over six years, 9,807 subjects without incident MetS were enrolled in this longitudinal retrospective study. The risk of developing prediabetes (impared fasting glucose or hemoglobin A1c) was analyzed according to baseline and percent change in serum albumin concentration using Cox regression analysis. Serial changes in serum albumin concentration were measured from baseline to one year before prediabetes diagnosis, and then from the time of prediabetes diagnosis to progression to overt diabetes or final follow-up. A total of 4,398 incident cases of prediabetes developed during 35,807 person-years (median 3.8 years). The hazard ratio for incident prediabetes decreased as percent change in serum albumin concentration (quartiles and per 1%) increased in a crude and fully adjusted model. However, baseline serum albumin concentration itself was not associated with prediabetic risk. Serum albumin levels kept increasing until the end of follow-up in prediabetic subjects who returned to normal glycemic status, whereas these measures did not change in prediabetic subjects who developed type 2 diabetes. Serum albumin concentration measured at the end of follow-up was the highest in the regression group, compared to the stationary (p = 0.014) or progression groups (p = 0.009). Increase in serum albumin concentration might protect against early glycemic deterioration and progression to type 2 diabetes even in subjects without MetS.

  3. Family nurture intervention in preterm infants increases early development of cortical activity and independence of regional power trajectories.

    Science.gov (United States)

    Welch, Martha G; Stark, Raymond I; Grieve, Philip G; Ludwig, Robert J; Isler, Joseph R; Barone, Joseph L; Myers, Michael M

    2017-12-01

    Premature delivery and maternal separation during hospitalisation increase infant neurodevelopmental risk. Previously, a randomised controlled trial of Family Nurture Intervention (FNI) in the neonatal intensive care unit demonstrated improvement across multiple mother and infant domains including increased electroencephalographic (EEG) power in the frontal polar region at term age. New aims were to quantify developmental changes in EEG power in all brain regions and frequencies and correlate developmental changes in EEG power among regions. EEG (128 electrodes) was obtained at 34-44 weeks postmenstrual age from preterm infants born 26-34 weeks. Forty-four infants were treated with Standard Care and 53 with FNI. EEG power was computed in 10 frequency bands (1-48 Hz) in 10 brain regions and in active and quiet sleep. Percent change/week in EEG power was increased in FNI in 132/200 tests (p regional independence in those developmental rates of change. This study strengthens the conclusion that FNI promotes cerebral cortical development of preterm infants. The findings indicate that developmental changes in EEG may provide biomarkers for risk in preterm infants as well as proximal markers of effects of FNI. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Complementary, alternative, and other noncomplete decongestive therapy treatment methods in the management of lymphedema: a systematic search and review.

    Science.gov (United States)

    Rodrick, Julia R; Poage, Ellen; Wanchai, Ausanee; Stewart, Bob R; Cormier, Janice N; Armer, Jane M

    2014-03-01

    (1) To provide a critical analysis of the contemporary published research that pertains to complementary, alternative, and other noncomplete decongestive therapies for treatment of lymphedema (LE), and (2) to provide practical applications of that evidence to improve care of patients with or at risk for LE. TYPE: This study meets the defining criteria as a systematic search and review because it includes varied study types. All studies that met the inclusion criteria were evaluated for weight of evidence and value. The systematic search and review includes articles published in the contemporary literature (2004-2012). Publications published from 2004-2011 were retrieved from 11 major medical indices by using search terms for LE and management approaches. Literature archives were examined through 2012. Data extraction included study design, objectives pertaining to LE, number and characteristics of participants, interventions, and outcomes. Study strengths and weaknesses were summarized. Study evidence was categorized according to the Oncology Nursing Society Putting Evidence into Practice level-of-evidence guidelines after achieving consensus among the authors. No authors participated in development of nor benefitted from the review of these modality methods or devices. Extracted data from 85 studies were reviewed in 4 subcategories: botanical, pharmaceutical, physical agent modality, and modalities of contemporary value. After review, 47 articles were excluded, which left 16 articles on botanicals and pharmaceuticals and 22 articles for physical agent modality and/or modalities of contemporary value. Pharmaceuticals were later excluded. The authors concluded that botanicals had generated sufficient studies to support a second, more specific systematic review; thus, botanicals are reported elsewhere. It was found that limited high-level evidence was available for all categories. Well-constructed randomized controlled trials related specifically to LE were limited

  5. Environmental implications of offshore oil and gas development in Australia. The finding of an independent scientific review

    International Nuclear Information System (INIS)

    Swan, J.M.; Neff, J.M.; Young, P.C.

    1994-01-01

    It is widely recognised that uncontrolled discharge of petroleum products or other materials from offshore oil and gas exploration and production wells, and from associated industrial operations including treatment and service facilities that are required to be on or near the coast, can have direct and sometimes deleterious impacts on the marine environment. In mid-1992, the Australian Petroleum Exploration Association (APEA) commissioned five scientific reviews to examine the environmental implications of offshore petroleum developments in Australia. The reviews, carried out by an Independent Scientific Review Committee on behalf of the Australian Petroleum Exploration Association (APEA) and the Energy Research and Development Corporation (ERDC) deal with: (1) the preliminary geophysical exploration of the sea bed and underlying strata using seismic surveys, and especially the effects of bursts of underwater sound energy on biological communities; (2) the drilling of offshore wells, especially the disposal of drilling fluids and drill cuttings; (3) the production of oil and gas from proven wells, especially the disposal of large quantities of produced formation water (fossil water); (4) the construction and operation of coastal support facilities and associated activities which might have consequences for marine habitats; (5) oil spills associated with any of the above operations and especially the likely short- and long-term effects of an accidental oil spill on marine biota and on the aesthetic and commercial values of an impacted coastline. Comments on the findings are preceded by a brief summary of background information, relevant technologies and the main implications for the marine environment. Some suggestions are provided for possible future research, monitoring and environmental management. refs., figs., tabs

  6. Independent preferences

    DEFF Research Database (Denmark)

    Vind, Karl

    1991-01-01

    A simple mathematical result characterizing a subset of a product set is proved and used to obtain additive representations of preferences. The additivity consequences of independence assumptions are obtained for preferences which are not total or transitive. This means that most of the economic ...... theory based on additive preferences - expected utility, discounted utility - has been generalized to preferences which are not total or transitive. Other economic applications of the theorem are given...

  7. Institutional contexts contribute to the low priority given to developing self-care independence in a rehabilitation ward: a qualitative study.

    Science.gov (United States)

    Chang, Ling-Hui; Wang, Jye

    2013-06-01

    To examine the institutional contexts that contribute to the low priority given to the development of self-care independence in a rehabilitation ward. Research was guided by ethnographic principles of Martyn Hammersley and Paul Atkinson (2007). Individual in-depth interviews were completed. Participant observation was done daily during the rehabilitation stay of the patients. Six men and three women with neurological impairments and their caregivers. Patients' daily routines on a rehabilitation ward in Taiwan are described. Four prominent themes emerged from the data: (1) the attitudes of patients, caregivers, and staff facilitated extended rehabilitation stays within the first year after disability, (2) attending therapy sessions was the most important activity, (3) pragmatic considerations, such as 'faster and easier', outweighed the value of developing self-care independence, and (4) strategic organization of daily routines to keep therapy the priority was critical for daily activity. Multiple institutional factors jeopardize the development of self-care independence in a rehabilitation ward. The factors include the primacy of biomedical-oriented rehabilitation ideology, insurance reimbursement policies, and cultural values associated with family caregiving. They legitimize the low priority given to developing self-care independence. Therapists need to include a critical review of daily routines (what and how activities are carried out inside and outside of therapy clinics) as part of therapy regime to identify opportunities and institutional constraints to the development of self-care independence.

  8. Independent Directors

    DEFF Research Database (Denmark)

    Ringe, Wolf-Georg

    2013-01-01

    This paper re-evaluates the corporate governance concept of ‘board independence’ against the disappointing experiences during the 2007-08 financial crisis. Independent or outside directors had long been seen as an essential tool to improve the monitoring role of the board. Yet the crisis revealed...... that they did not prevent firms' excessive risk taking; further, these directors sometimes showed serious deficits in understanding the business they were supposed to control, and remained passive in addressing structural problems. A closer look reveals that under the surface of seemingly unanimous consensus...

  9. Developing a complex independent component analysis technique to extract non-stationary patterns from geophysical time-series

    Science.gov (United States)

    Forootan, Ehsan; Kusche, Jürgen

    2016-04-01

    Geodetic/geophysical observations, such as the time series of global terrestrial water storage change or sea level and temperature change, represent samples of physical processes and therefore contain information about complex physical interactionswith many inherent time scales. Extracting relevant information from these samples, for example quantifying the seasonality of a physical process or its variability due to large-scale ocean-atmosphere interactions, is not possible by rendering simple time series approaches. In the last decades, decomposition techniques have found increasing interest for extracting patterns from geophysical observations. Traditionally, principal component analysis (PCA) and more recently independent component analysis (ICA) are common techniques to extract statistical orthogonal (uncorrelated) and independent modes that represent the maximum variance of observations, respectively. PCA and ICA can be classified as stationary signal decomposition techniques since they are based on decomposing the auto-covariance matrix or diagonalizing higher (than two)-order statistical tensors from centered time series. However, the stationary assumption is obviously not justifiable for many geophysical and climate variables even after removing cyclic components e.g., the seasonal cycles. In this paper, we present a new decomposition method, the complex independent component analysis (CICA, Forootan, PhD-2014), which can be applied to extract to non-stationary (changing in space and time) patterns from geophysical time series. Here, CICA is derived as an extension of real-valued ICA (Forootan and Kusche, JoG-2012), where we (i) define a new complex data set using a Hilbert transformation. The complex time series contain the observed values in their real part, and the temporal rate of variability in their imaginary part. (ii) An ICA algorithm based on diagonalization of fourth-order cumulants is then applied to decompose the new complex data set in (i

  10. Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial.

    Science.gov (United States)

    Brown, Justin C; Troxel, Andrea B; Schmitz, Kathryn H

    2012-01-01

    It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs.

  11. [Development and reliability evaluation of an instrument to measure health-related quality of life in independent elderly].

    Science.gov (United States)

    Lima, Maria José Barbosa de; Portela, Margareth Crisóstomo

    2010-08-01

    This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.

  12. Development and application of two independent real-time PCR assays to detect clinically relevant Mucorales species.

    Science.gov (United States)

    Springer, Jan; Goldenberger, Daniel; Schmidt, Friderike; Weisser, Maja; Wehrle-Wieland, Elisabeth; Einsele, Hermann; Frei, Reno; Löffler, Jürgen

    2016-03-01

    PCR-based detection of Mucorales species could improve diagnosis of suspected invasive fungal infection, leading to a better patient outcome. This study describes two independent probe-based real-time PCR tests for detection of clinically relevant Mucorales, targeting specific fragments of the 18S and the 28S rRNA genes. Both assays have a short turnaround time, allow fast, specific and very sensitive detection of clinically relevant Mucorales and have the potential to be used as quantitative tests. They were validated on various clinical samples (fresh and formalin-fixed paraffin-embedded specimens, mainly biopsies, n = 17). The assays should be used as add-on tools to complement standard techniques; a combined approach of both real-time PCR assays has 100 % sensitivity. Genus identification by subsequent sequencing is possible for amplicons of the 18S PCR assay. In conclusion, combination of the two independent Mucorales assays described in this study, 18S and 28S, detected all clinical samples associated with proven Mucorales infection (n = 10). Reliable and specific identification of Mucorales is a prerequisite for successful antifungal therapy as these fungi show intrinsic resistance to voriconazole and caspofungin.

  13. Microsurgery guided by sequential preoperative lymphography using {sup 68}Ga-NEB PET and MRI in patients with lower-limb lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Long, Xiao; Gao, Chao; Yang, Elan [Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Plastic Surgery, Beijing (China); Zhang, Jingjing [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China); National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhang, Daming; Xue, Huadan [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, Beijing (China); Chi, Chongwei [Institute of Automation Chinese Academy of Sciences Beijing, Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Beijing (China); Lang, Lixin; Niu, Gang; Chen, Xiaoyuan [National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhu, Zhaohui; Li, Fang [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China)

    2017-08-15

    The popularity of contemporary microsurgical techniques in treatment of lower-limb lymphedema calls for better visualization of the lymphatic system, both preoperatively and intra-operatively. The aim of this prospective study was to investigate the feasibility of a novel combination of {sup 68}Ga-NEB positron emission tomography (PET) with magnetic resonance lymphography (MRL) in evaluating lymphedema and guiding surgical intervention. A total of 11 patients (F 9, M 2, age range 29-69 y) with lower-limb lymphedema classified into stage I to III were recruited. PET acquisition was performed at 30, 60 and 90 min after subcutaneous injection of the albumin-binding radiotracer {sup 68}Ga-NEB into the bilateral first web spaces of the feet. All the patients were also subjected to {sup 99m}Tc-sulfur colloid (SC) lymphoscintigraphy for comparison. Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed using sequences specialized for lymphatic vessel scans. All the patients underwent surgical interventions within a week. The surgical approach includes the use of a linear marker for edema localization and indocyanine green (ICG) lymphography with a near-infrared surgical navigation system intra-operatively. Lymph transport in lymphatic channels was clearly observed by visualization of {sup 68}Ga-NEB activity in the lymphatic vessels and within lymph nodes for all 11 patients as well as the visualization of the edema section plane with dermal backflow (DB), abnormally increased and disconnected uptake along the lymphatic channels. Preoperative {sup 68}Ga-NEB PET combined with MRL provides advantageous three-dimensional images, higher temporal resolution, significantly shorter time lapse before image acquisition after tracer injection and more accurate pathological lymphatic vessel distribution than {sup 99m}Tc-SC lymphoscintigraphy combined with MRI. This study documented an effective imaging pattern to combine {sup 68}Ga-NEB PET and MRL in patients with lower

  14. Cell therapy for the treatment of lower limb lymphedema. Case report Terapia celular en el tratamiento de linfedema de miembros inferiores. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Pedro Goicoechea-Díaz

    2010-12-01

    Full Text Available Although lymphedema is a common disabling disease causing significant morbidity for affected patients, treatment for this condition remains limited and largely ineffective. Some reported data suggest that some bone-marrow derived cells may play a role in lymphangiogenesis. It appears that blood vessels and lymphatic vessels might use the same population of cells for vasculogenesis and lymphangiogenesis. Therefore, adult stem cell therapy could be a new useful strategy for the treatment of lymphedema. We report a resolution of a severe lower limb bilateral lymphedema after implantation of autologous adult stem cells derived from bone marrow. As far as we know, this is the first reported case with chronic lower limb lymphedema treated successfully with autologous cell therapy. This procedure is a low-cost, relatively simple and easy to perform option that opens new ways for the treatment of lymphedema.Aunque el linfedema es una enfermedad crónica inhabilitante común que causa morbilidad significativa en los pacientes afectados, el tratamiento para esta enfermedad se mantiene muy limitada y en la mayor parte de los casos resulta ineficaz. Algunos datos reportados sugieren que algunas de las células madre derivadas de la medula ósea pueden intervenir en la linfangiogénesis. Al parecer, los vasos sanguíneos y los vasos linfáticos podrían usar la misma población celular para la vasculogénesis y la linfangiogénesis. Por consiguiente, la terapia con células madre adultas podría ser una nueva estrategia útil para el tratamiento de linfedema. En el presente trabajo se informa la resolución de un linfedema bilateral severo de miembros inferiores después de la implantación de células madre autólogas derivadas de la médula ósea. Hasta donde sabemos, este es el primer caso de linfedema crónico de los miembros inferiores tratado exitosamente con células madre autólogas. Este método de tratamiento es económico, relativamente simple, f

  15. Overview and Categorization of Robots Supporting Independent Living of Elderly People: What Activities Do They Support and How Far Have They Developed.

    Science.gov (United States)

    Bedaf, Sandra; Gelderblom, Gert Jan; De Witte, Luc

    2015-01-01

    Over the past decades, many robots for the elderly have been developed, supporting different activities of elderly people. A systematic review in four scientific literature databases and a search in article references and European projects was performed in order to create an overview of robots supporting independent living of elderly people. The robots found were categorized based on their development stage, the activity domains they claim to support, and the type of support provided (i.e., physical, non-physical, and/or non-specified). In total, 107 robots for the elderly were identified. Six robots were still in a concept phase, 95 in a development phase, and six of these robots were commercially available. These robots claimed to provide support related to four activity domains: mobility, self-care, interpersonal interaction & relationships, and other activities. Of the many robots developed, only a small percentage is commercially available. Technical ambitions seem to be guiding robot development. To prolong independent living, the step towards physical support is inevitable and needs to be taken. However, it will be a long time before a robot will be capable of supporting multiple activities in a physical manner in the home of an elderly person in order to enhance their independent living.

  16. Fatores associados ao linfedema em pacientes com câncer de mama Associated factors of lymphedema in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Daniella Marta Ferreira de Paiva

    2011-02-01

    Full Text Available OBJETIVO: determinar a prevalência e os fatores associados ao linfedema em pacientes com câncer de mama. MÉTODOS: este estudo de corte transversal incluiu 250 mulheres com mais de seis meses de tratamento para o câncer de mama, que compareceram ao Ambulatório de Mastologia e Oncologia para consulta de seguimento em um Centro de Referência em Oncologia, em Juiz de Fora, Minas Gerais. Elas foram entrevistadas e submetidas à avaliação física. Foram colhidos dados de prontuário relacionados ao tratamento da neoplasia, à intervenção axilar e ao tumor. Diagnosticou-se linfedema quando a diferença entre os membros superiores foi maior ou igual a 2 cm pela perimetria. Os grupos de mulheres com e sem linfedema foram comparados em relação aos possíveis fatores de risco, e as medidas de tendência central, dispersão e prevalência foram obtidas admitindo o nível de significância de 95%. RESULTADOS: Cento e doze mulheres (44,8% apresentaram linfedema. Foi encontrada diferença significativa entre os grupos de mulheres com e sem linfedema em relação à mediana de linfonodos retirados (p=0,02; apresentação de trombose linfática superficial no braço homolateral à cirurgia (pPURPOSE: to determine the prevalence of lymphedema and its associated factors in breast cancer patients. METHODS: Two hundred and fifty women that had undergone more than six months of breast cancer treatment and were being treated at an oncology reference hospital in Juiz de Fora, Minas Gerais, Brazil. They were interviewed and submitted to physical evaluation. Data from the patients' medical records regarding the treatment of breast cancer, the extent of axillary intervention and the tumor were analyzed. Lymphedema was diagnosed when the difference between both upper limbs was 2 cm or more by perimetry. The groups of women with and without lymphedema were compared regarding the possible risk factors, and central tendency, dispersion, and prevalence were

  17. LONG-TERM STRATEGY IMPLEMENTATION FOR STUDENTS’ INDEPENDENT WORK IN A FOREIGN LANGUAGE AS AN EFFECTIVE MEANS OF FUTURE SPECIALIST’S PROFESSIONAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Elena Mikhaylovna Galishnikova

    2017-03-01

    Full Text Available This article deals with the development and implementation of a long-term strategy of the organization of independent work of undergraduate and graduate students by means of a foreign language, which allows designing a vector for further professional and personal development of the future specialist. The proposed strategy is based on a four-step approach, providing for the integration of communication means of training and information technology, streamlining effective means and forms of implementation of the independent work and the control, strengthening the relationships between a student and a teacher, the principle of continuity and consistency. The methods of theoretical and empirical studies were used; there were described the stages of the approach, that is the basis of the strategy itself. Based on the stages, the sequence of the controlled independent work systematic elements was defined; its forms and types were grouped and specified. The mastery performance criteria for competence in the discipline “Foreign language” were defined and refined. The authors cite data of the experimental studies proving the positive impact of the implementation of the long-term strategy of the organization of independent work of students on formation of professional foreign language competence.

  18. Development of quantification methods for the myocardial blood flow using ensemble independent component analysis for dynamic H215O PET

    International Nuclear Information System (INIS)

    Lee, Byeong Il; Lee, Jae Sung; Lee, Dong Soo; Kang, Won Jun; Lee, Jong Jin; Kim, Soo Jin; Chung, June Key; Lee, Myung Chul; Choi, Seung Jin

    2004-01-01

    Factor analysis and independent component analysis (lCA) has been used for handling dynamic image sequences. Theoretical advantages of a newly suggested ICA method, ensemble ICA, leaded us to consider applying this method to the analysis of dynamic myocardial H 2 15 O PET data. In this study, we quantified patients, blood flow using the ensemble ICA method. Twenty subjects underwent H 2 15 O PET scans using ECAT EXACT 47 scanner and myocardial perfusion SPECT using Vertex scanner. After transmission scanning, dynamic emission scans were initiated simultaneously with the injection of 555∼740 MBq H 2 15 O. Hidden independent components can be extracted from the observed mixed data (PET image) by means of ICA algorithms. Ensemble learning is a variational Bayesian method that provides an analytical approximation to the parameter posterior using a tractable distribution. Variational approximation forms a lower bound on the ensemble likelihood and the maximization of the lower bound is achieved through minimizing the Kullback-Leibler divergence between the true posterior and the variational posterior. In this study, posterior pdf was approximated by a rectified Gaussian distribution to incorporate non-negativity constraint, which is suitable to dynamic images in nuclear medicine. Blood flow was measured in 9 regions - apex, four areas in mid wall, and four areas in base wall. Myocardial perfusion SPECT score and angiography results were compared with the regional blood flow. Major cardiac components were separated successfully by the ensemble ICA method and blood flow could be estimated in 15 among 20 patients. Mean myocardial blood flow was 1.2±0.40 ml/min/g in rest, 1.85±1.12 ml/min/g in stress state. Blood flow values obtained by an operator in two different occasion were highly correlated (r=0.99). In myocardium component image, the image contrast between left ventricle and myocardium was 1:2.7 in average. Perfusion reserve was significantly different between

  19. Auditor Independence: Beyond the Dilemma of Combining Auditing and Advisory Activities for the Development of Quality Assurance Systems in Agriculture

    Science.gov (United States)

    Maxime, Francoise; Maze, Armelle

    2006-01-01

    This article aims to study the design and the organization of auditing systems to develop environmental or quality assurance schemes at the farm level and the role that extension services could play in these processes. It starts by discussing the issue of combining auditing and advisory activities and developing auditing competences. Empirical…

  20. Process Demonstration For Lunar In Situ Resource Utilization-Molten Oxide Electrolysis (MSFC Independent Research and Development Project No. 5-81)

    Science.gov (United States)

    Curreri, P. A.; Ethridge, E. C.; Hudson, S. B.; Miller, T. Y.; Grugel, R. N.; Sen, S.; Sadoway, D. R.

    2006-01-01

    The purpose of this Focus Area Independent Research and Development project was to conduct, at Marshall Space Flight Center, an experimental demonstration of the processing of simulated lunar resources by the molten oxide electrolysis process to produce oxygen and metal. In essence, the vision was to develop two key technologies, the first to produce materials (oxygen, metals, and silicon) from lunar resources and the second to produce energy by photocell production on the Moon using these materials. Together, these two technologies have the potential to greatly reduce the costs and risks of NASA s human exploration program. Further, it is believed that these technologies are the key first step toward harvesting abundant materials and energy independent of Earth s resources.

  1. Independent technical review, handbook

    International Nuclear Information System (INIS)

    1994-02-01

    Purpose Provide an independent engineering review of the major projects being funded by the Department of Energy, Office of Environmental Restoration and Waste Management. The independent engineering review will address questions of whether the engineering practice is sufficiently developed to a point where a major project can be executed without significant technical problems. The independent review will focus on questions related to: (1) Adequacy of development of the technical base of understanding; (2) Status of development and availability of technology among the various alternatives; (3) Status and availability of the industrial infrastructure to support project design, equipment fabrication, facility construction, and process and program/project operation; (4) Adequacy of the design effort to provide a sound foundation to support execution of project; (5) Ability of the organization to fully integrate the system, and direct, manage, and control the execution of a complex major project

  2. Independent technical review, handbook

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    Purpose Provide an independent engineering review of the major projects being funded by the Department of Energy, Office of Environmental Restoration and Waste Management. The independent engineering review will address questions of whether the engineering practice is sufficiently developed to a point where a major project can be executed without significant technical problems. The independent review will focus on questions related to: (1) Adequacy of development of the technical base of understanding; (2) Status of development and availability of technology among the various alternatives; (3) Status and availability of the industrial infrastructure to support project design, equipment fabrication, facility construction, and process and program/project operation; (4) Adequacy of the design effort to provide a sound foundation to support execution of project; (5) Ability of the organization to fully integrate the system, and direct, manage, and control the execution of a complex major project.

  3. The role of biofilms in persistent infections and factors involved in ica-independent biofilm development and gene regulation in Staphylococcus aureus.

    Science.gov (United States)

    Figueiredo, Agnes Marie Sá; Ferreira, Fabienne Antunes; Beltrame, Cristiana Ossaille; Côrtes, Marina Farrel

    2017-09-01

    Staphylococcus aureus biofilms represent a unique micro-environment that directly contribute to the bacterial fitness within hospital settings. The accumulation of this structure on implanted medical devices has frequently caused the development of persistent and chronic S. aureus-associated infections, which represent an important social and economic burden worldwide. ica-independent biofilms are composed of an assortment of bacterial products and modulated by a multifaceted and overlapping regulatory network; therefore, biofilm composition can vary among S. aureus strains. In the microniches formed by biofilms-produced by a number of bacterial species and composed by different structural components-drug refractory cell subpopulations with distinct physiological characteristics can emerge and result in therapeutic failures in patients with recalcitrant bacterial infections. In this review, we highlight the importance of biofilms in the development of persistence and chronicity in some S. aureus diseases, the main molecules associated with ica-independent biofilm development and the regulatory mechanisms that modulate ica-independent biofilm production, accumulation, and dispersion.

  4. Multi-Axis Independent Electromechanical Load Control for Docking System Actuation Development and Verification Using dSPACE

    Science.gov (United States)

    Oesch, Christopher; Dick, Brandon; Rupp, Timothy

    2015-01-01

    The development of highly complex and advanced actuation systems to meet customer demands has accelerated as the use of real-time testing technology expands into multiple markets at Moog. Systems developed for the autonomous docking of human rated spacecraft to the International Space Station (ISS), envelope multi-operational characteristics which place unique constraints on an actuation system. Real-time testing hardware has been used as a platform for incremental testing and development for the linear actuation system which controls initial capture and docking for vehicles visiting the ISS. This presentation will outline the role of dSPACE hardware as a platform for rapid control-algorithm prototyping as well as an Electromechanical Actuator (EMA) system dynamic loading simulator, both conducted at Moog to develop the safety critical Linear Actuator System (LAS) of the NASA Docking System (NDS).

  5. Oil and gas development in the United States in the early 1990`s: An expanded role for independent producers

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    Since 1991, the major petroleum companies` foreign exploration and development expenditures have exceeded their US exploration and development expenditures. The increasing dependence of US oil and gas development on the typically much smaller nonmajor companies raises a number of issues. Did those companies gain increased prominence largely through the reduced commitments of the majors or have they been significantly adding to the US reserve base? What are the characteristics of surviving and growing producers compared with companies exiting the US oil and gas business? Differences between majors` development strategies and those of other US oil and gas producers appear considerable. As the mix of exploration and development strategies in US oil and gas increasingly reflects the decisions of smaller, typically more specialized producers, what consequences can be seen regarding the costs of adding to US reserves? How are capital markets accessed? Are US oil and gas investments by the nonmajors likely to be undertaken only with higher costs of capital? This report analyzes these issues. 20 figs., 6 tabs.

  6. The C. elegans H3K27 Demethylase UTX-1 Is Essential for Normal Development, Independent of Its Enzymatic Activity

    DEFF Research Database (Denmark)

    Vandamme, Julien; Buchhorn, Gaëlle Lettier; Sidoli, Simone

    2012-01-01

    specific for H3K27me2/3. We demonstrate that utx-1 is an essential gene that is required for correct embryonic and postembryonic development. Consistent with its homology to UTX, UTX-1 regulates global levels of H3K27me2/3 in C. elegans. Surprisingly, we found that the catalytic activity is not required......Epigenetic modifications influence gene expression and provide a unique mechanism for fine-tuning cellular differentiation and development in multicellular organisms. Here we report on the biological functions of UTX-1, the Caenorhabditis elegans homologue of mammalian UTX, a histone demethylase...

  7. Experiences of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers.

    Directory of Open Access Journals (Sweden)

    Tali Cassidy

    2016-02-01

    Full Text Available Globally 68 million people are infected with lymphatic filariasis (LF, 17 million of whom have lymphedema. This study explores the effects of a lymphedema management program in Odisha State, India on morbidity and psychosocial effects associated with lymphedema.Focus groups were held with patients (eight groups, separated by gender, their family members (eight groups, community members (four groups and program volunteers (four groups who had participated in a lymphedema management program for the past three years. Significant social, physical, and economic difficulties were described by patients and family members, including marriageability, social stigma, and lost workdays. However, the positive impact of the lymphedema management program was also emphasized, and many family and community members indicated that community members were accepting of patients and had some improved understanding of the etiology of the disease. Program volunteers and community members stressed the role that the program had played in educating people, though interestingly, local explanations and treatments appear to coexist with knowledge of biomedical treatments and the mosquito vector.Local and biomedical understandings of disease can co-exist and do not preclude individuals from participating in biomedical interventions, specifically lymphedema management for those with lymphatic filariasis. There is a continued need for gender-specific psychosocial support groups to address issues particular to men and women as well as a continued need for improved economic opportunities for LF-affected patients. There is an urgent need to scale up LF-related morbidity management programs to reduce the suffering of people affected by LF.

  8. Dopamine Attenuates Ketamine-Induced Neuronal Apoptosis in the Developing Rat Retina Independent of Early Synchronized Spontaneous Network Activity.

    Science.gov (United States)

    Dong, Jing; Gao, Lingqi; Han, Junde; Zhang, Junjie; Zheng, Jijian

    2017-07-01

    Deprivation of spontaneous rhythmic electrical activity in early development by anesthesia administration, among other interventions, induces neuronal apoptosis. However, it is unclear whether enhancement of neuronal electrical activity attenuates neuronal apoptosis in either normal development or after anesthesia exposure. The present study investigated the effects of dopamine, an enhancer of spontaneous rhythmic electrical activity, on ketamine-induced neuronal apoptosis in the developing rat retina. TUNEL and immunohistochemical assays indicated that ketamine time- and dose-dependently aggravated physiological and ketamine-induced apoptosis and inhibited early-synchronized spontaneous network activity. Dopamine administration reversed ketamine-induced neuronal apoptosis, but did not reverse the inhibitory effects of ketamine on early synchronized spontaneous network activity despite enhancing it in controls. Blockade of D1, D2, and A2A receptors and inhibition of cAMP/PKA signaling partially antagonized the protective effect of dopamine against ketamine-induced apoptosis. Together, these data indicate that dopamine attenuates ketamine-induced neuronal apoptosis in the developing rat retina by activating the D1, D2, and A2A receptors, and upregulating cAMP/PKA signaling, rather than through modulation of early synchronized spontaneous network activity.

  9. Dissection of SAP-dependent and SAP-independent SLAM family signaling in NKT cell development and humoral immunity

    Science.gov (United States)

    Cai, Chenxu; Liu, Guangao; Wang, Yuande; Du, Juan; Lin, Xin; Yang, Meixiang

    2017-01-01

    Signaling lymphocytic activation molecule (SLAM)–associated protein (SAP) mutations in X-linked lymphoproliferative disease (XLP) lead to defective NKT cell development and impaired humoral immunity. Because of the redundancy of SLAM family receptors (SFRs) and the complexity of SAP actions, how SFRs and SAP mediate these processes remains elusive. Here, we examined NKT cell development and humoral immunity in mice completely deficient in SFR. We found that SFR deficiency severely impaired NKT cell development. In contrast to SAP deficiency, SFR deficiency caused no apparent defect in follicular helper T (TFH) cell differentiation. Intriguingly, the deletion of SFRs completely rescued the severe defect in TFH cell generation caused by SAP deficiency, whereas SFR deletion had a minimal effect on the defective NKT cell development in SAP-deficient mice. These findings suggest that SAP-dependent activating SFR signaling is essential for NKT cell selection; however, SFR signaling is inhibitory in SAP-deficient TFH cells. Thus, our current study revises our understanding of the mechanisms underlying T cell defects in patients with XLP. PMID:28049627

  10. Using TQM/CQI Processes To Guide Development of Independent and Collaborative Learning in Two Levels of Baccalaureate Nursing Students.

    Science.gov (United States)

    Grant, LaVerne F.; Kelley, Jane H.; Northington, LaDonna; Barlow, Delores

    2002-01-01

    Junior and senior nursing students participated in collaborative learning projects developed using total quality management/continuous quality improvement processes. Seniors mentored and evaluated juniors. Feedback from 37 seniors and 53 juniors was predominantly positive; dissatisfaction centered on time issues and misunderstanding of project…

  11. Dissection of SAP-dependent and SAP-independent SLAM family signaling in NKT cell development and humoral immunity.

    Science.gov (United States)

    Chen, Shasha; Cai, Chenxu; Li, Zehua; Liu, Guangao; Wang, Yuande; Blonska, Marzenna; Li, Dan; Du, Juan; Lin, Xin; Yang, Meixiang; Dong, Zhongjun

    2017-02-01

    Signaling lymphocytic activation molecule (SLAM)-associated protein (SAP) mutations in X-linked lymphoproliferative disease (XLP) lead to defective NKT cell development and impaired humoral immunity. Because of the redundancy of SLAM family receptors (SFRs) and the complexity of SAP actions, how SFRs and SAP mediate these processes remains elusive. Here, we examined NKT cell development and humoral immunity in mice completely deficient in SFR. We found that SFR deficiency severely impaired NKT cell development. In contrast to SAP deficiency, SFR deficiency caused no apparent defect in follicular helper T (T FH ) cell differentiation. Intriguingly, the deletion of SFRs completely rescued the severe defect in T FH cell generation caused by SAP deficiency, whereas SFR deletion had a minimal effect on the defective NKT cell development in SAP-deficient mice. These findings suggest that SAP-dependent activating SFR signaling is essential for NKT cell selection; however, SFR signaling is inhibitory in SAP-deficient T FH cells. Thus, our current study revises our understanding of the mechanisms underlying T cell defects in patients with XLP. © 2017 Chen et al.

  12. Children's Intuitive Sense of Number Develops Independently of Their Perception of Area, Density, Length, and Time

    Science.gov (United States)

    Odic, Darko

    2018-01-01

    Young children can quickly and intuitively represent the number of objects in a visual scene through the Approximate Number System (ANS). The precision of the ANS--indexed as the most difficult ratio of two numbers that children can reliably discriminate--is well known to improve with development: whereas infants require relatively large ratios to…

  13. Cultivation independent analysis of the development of the Lactobacillus spp. Community in the intestinal tract of newborn piglets

    NARCIS (Netherlands)

    Yao, W.; Zhu, W.Y.; Smidt, H.; Verstegen, M.W.A.

    2011-01-01

    Molecular diversity and development of the Lactobacillus community in the intestinal tract, as influenced by age and intestinal compartment, were studied in one litter of 12 conventionally raised piglets. Piglets were euthanized at each week (3 animals per time). Digesta and tissue samples from

  14. The Defense Department’s Support of Industry’s Independent Research and Development (IR&D). Analyses and Evaluation

    Science.gov (United States)

    1989-04-01

    Hill and Susan Bodilly were incorporated into this report. Todd Porter, a RAND Summer Intern, contributed to the data development, statistical...5Bailey and Lawrence , 1987, pp. 19-20. The R&D tax credit allowed a 25 percent credit for R&D expenditures in excess of the average amount spent...See J. A. Hausman , ’Specificaticn Tests in Econometrics,"Econormetrica, Vol, 46, No. 6, November 1978. 61 (7) and (8) report the results of this

  15. DeSyGNER: A Building Block Architecture Fostering Independent Cooperative Development of Multimedia Knowledge Management Applications

    OpenAIRE

    Deibel, Stephan R.A.; Greenes, Robert A.; Snydr-Michal, Jan T.

    1990-01-01

    Multimedia knowledge management requires generalized sharing, composition and inter-relation of disparate data and knowledge elements. Since traditional computer operating systems treat programs as bodies of isolated functionality, inter-program connections can be made only by considerable effort on the part of each program author. We have been developing a multimedia kernel called DeSyGNER (the Decision Systems Group Nucleus of Extensible Resources) that provides basic multimedia knowledge m...

  16. Identification of new members of Fertilisation Independent Seed Polycomb Group pathway involved in the control of seed development in Arabidopsis thaliana.

    Science.gov (United States)

    Guitton, Anne-Elisabeth; Page, Damian R; Chambrier, Pierre; Lionnet, Claire; Faure, Jean-Emmanuel; Grossniklaus, Ueli; Berger, Frédéric

    2004-06-01

    In higher plants, double fertilisation initiates seed development. One sperm cell fuses with the egg cell and gives rise to the embryo, the second sperm cell fuses with the central cell and gives rise to the endosperm. The endosperm develops as a syncytium with the gradual organisation of domains along an anteroposterior axis defined by the position of the embryo at the anterior pole and by the attachment to the placenta at the posterior pole. We report that ontogenesis of the posterior pole in Arabidopsis thaliana involves oriented migration of nuclei in the syncytium. We show that this migration is impaired in mutants of the three founding members of the FERTILIZATION INDEPENDENT SEED (FIS) class, MEDEA (MEA), FIS2 and FERTILIZATION INDEPENDENT ENDOSPERM (FIE). A screen based on a green fluorescent protein (GFP) reporter line allowed us to identify two new loci in the FIS pathway, medicis and borgia. We have cloned the MEDICIS gene and show that it encodes the Arabidopsis homologue of the yeast WD40 domain protein MULTICOPY SUPRESSOR OF IRA (MSI1). The mutations at the new fis loci cause the same cellular defects in endosperm development as other fis mutations, including parthenogenetic development, absence of cellularisation, ectopic development of posterior structures and overexpression of the GFP marker.

  17. Development of computer program ENMASK for prediction of residual environmental masking-noise spectra, from any three independent environmental parameters

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Y.-S.; Liebich, R. E.; Chun, K. C.

    2000-03-31

    Residual environmental sound can mask intrusive4 (unwanted) sound. It is a factor that can affect noise impacts and must be considered both in noise-impact studies and in noise-mitigation designs. Models for quantitative prediction of sensation level (audibility) and psychological effects of intrusive noise require an input with 1/3 octave-band spectral resolution of environmental masking noise. However, the majority of published residual environmental masking-noise data are given with either octave-band frequency resolution or only single A-weighted decibel values. A model has been developed that enables estimation of 1/3 octave-band residual environmental masking-noise spectra and relates certain environmental parameters to A-weighted sound level. This model provides a correlation among three environmental conditions: measured residual A-weighted sound-pressure level, proximity to a major roadway, and population density. Cited field-study data were used to compute the most probable 1/3 octave-band sound-pressure spectrum corresponding to any selected one of these three inputs. In turn, such spectra can be used as an input to models for prediction of noise impacts. This paper discusses specific algorithms included in the newly developed computer program ENMASK. In addition, the relative audibility of the environmental masking-noise spectra at different A-weighted sound levels is discussed, which is determined by using the methodology of program ENAUDIBL.

  18. Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial

    Science.gov (United States)

    Brown, Justin C.; Troxel, Andrea B.

    2012-01-01

    Introduction. It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Methods. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. Results. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Conclusion. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs. PMID:22752068

  19. Dynamic analysis of muscular lymphokinetic activities in the treatment of lymphedema of the upper limbs - doi:10.5020/18061230.2007.p233

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Guerreiro Godoy

    2012-01-01

    Full Text Available The aim of the present study was to evaluate the resting and working pressures associated to a restrain mechanism, in patients suffering from lymphedema of the upper limbs, postbreast cancer treatment, whilst performing occupational and day-to-day self-care activities. Six female patients under treatment of lymphedema due to surgical, radiotherapeutic and chemotherapeutic treatment of breast cancer, in the age group between 32 and 76 years (mean 54 years old, ± 31.11 were selected. A compression sleeve of “gorgurão” (cotton-polyester material was applied as a restrain mechanism. The occupational and daily personal care activities evaluated were those common to all participants. These activities included washingup, cooking in a small pan, sweeping the floor using the affected arm, brushing the teeth, brushing the hair, washing small items of clothes, ironing clothes and making the bed. For statistical analysis, mean and standard deviation between resting pressures and minimum and maximum working pressures were determined. The two-tailed student t-test and variance analysis were used for repeated measurements. The Bonferroni limit was used in the analysis of the variables to calculate the alpha error, with a value of 5%, considered statistically significant. All of the analyzed activities associated to the “gorgurão” compression sleeve generated both resting and working pressures (p <0.005. In conclusion, the occupational daily life tasks used in the present study generate resting and working pressures and can be used as a form of treatment of the lymphedema.

  20. SU-E-T-110: Development of An Independent, Monte Carlo, Dose Calculation, Quality Assurance Tool for Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Faught, A [UT MD Anderson Cancer Center, Houston, TX (United States); University of Texas Health Science Center Houston, Graduate School of Biomedical Sciences, Houston, TX (United States); Davidson, S [University of Texas Medical Branch of Galveston, Galveston, TX (United States); Kry, S; Ibbott, G; Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States); Fontenot, J [Mary Bird Perkins Cancer Center, Baton Rouge, LA (United States); Etzel, C [Consortium of Rheumatology Researchers of North America (CORRONA), Inc., Southborough, MA (United States)

    2014-06-01

    Purpose: To develop a comprehensive end-to-end test for Varian's TrueBeam linear accelerator for head and neck IMRT using a custom phantom designed to utilize multiple dosimetry devices. Purpose: To commission a multiple-source Monte Carlo model of Elekta linear accelerator beams of nominal energies 6MV and 10MV. Methods: A three source, Monte Carlo model of Elekta 6 and 10MV therapeutic x-ray beams was developed. Energy spectra of two photon sources corresponding to primary photons created in the target and scattered photons originating in the linear accelerator head were determined by an optimization process that fit the relative fluence of 0.25 MeV energy bins to the product of Fatigue-Life and Fermi functions to match calculated percent depth dose (PDD) data with that measured in a water tank for a 10x10cm2 field. Off-axis effects were modeled by a 3rd degree polynomial used to describe the off-axis half-value layer as a function of off-axis angle and fitting the off-axis fluence to a piecewise linear function to match calculated dose profiles with measured dose profiles for a 40×40cm2 field. The model was validated by comparing calculated PDDs and dose profiles for field sizes ranging from 3×3cm2 to 30×30cm2 to those obtained from measurements. A benchmarking study compared calculated data to measurements for IMRT plans delivered to anthropomorphic phantoms. Results: Along the central axis of the beam 99.6% and 99.7% of all data passed the 2%/2mm gamma criterion for 6 and 10MV models, respectively. Dose profiles at depths of dmax, through 25cm agreed with measured data for 99.4% and 99.6% of data tested for 6 and 10MV models, respectively. A comparison of calculated dose to film measurement in a head and neck phantom showed an average of 85.3% and 90.5% of pixels passing a 3%/2mm gamma criterion for 6 and 10MV models respectively. Conclusion: A Monte Carlo multiple-source model for Elekta 6 and 10MV therapeutic x-ray beams has been developed as a

  1. Response to the independent technical review of the UMTRA Project procedures and practices for well drilling and development

    International Nuclear Information System (INIS)

    1994-07-01

    This report is a response to the findings and recommendations contained in the ITR report. The text of this document summarizes each ITR finding and recommendation, presents the TAC response, and concludes that implementation of many of the recommendations would benefit the UMTRA Project. Implementation of the recommendations represents ongoing improvement to the TAC well installation and development procedures and will result, in lower overall project costs. Appendix B is an implementation plan that groups similar or complementary action items, provides a schedule for implementation, identifies the group or people responsible for the changes, and estimates hours to implement the changes. The four major action items are as follows: (1) ITR Reevaluation, (2) Well Installation SOP Review and Revision, (3) Well Installation Contract Review and Revision, and (4) TAC and DOE Communications Improvement. The hours listed to implement the improvements are intended to be estimates for budgeting and planning purposes for the remainder of this fiscal year and the upcoming fiscal year

  2. Response to the independent technical review of the UMTRA Project procedures and practices for well drilling and development

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    This report is a response to the findings and recommendations contained in the ITR report. The text of this document summarizes each ITR finding and recommendation, presents the TAC response, and concludes that implementation of many of the recommendations would benefit the UMTRA Project. Implementation of the recommendations represents ongoing improvement to the TAC well installation and development procedures and will result, in lower overall project costs. Appendix B is an implementation plan that groups similar or complementary action items, provides a schedule for implementation, identifies the group or people responsible for the changes, and estimates hours to implement the changes. The four major action items are as follows: (1) ITR Reevaluation, (2) Well Installation SOP Review and Revision, (3) Well Installation Contract Review and Revision, and (4) TAC and DOE Communications Improvement. The hours listed to implement the improvements are intended to be estimates for budgeting and planning purposes for the remainder of this fiscal year and the upcoming fiscal year.

  3. An Independent Review and Accountability Mechanism for the Sustainable Development Goals: The Possibilities of a Framework Convention on Global Health.

    Science.gov (United States)

    Friedman, Eric A

    2016-06-01

    The Framework Convention on Global Health (FCGH), a proposed global treaty to be rooted in the right to health and aimed at health equity, could establish a nuanced, layered, and multi-faceted regime of compliance with, and accountability to, the right to health. In so doing, it would significantly strengthen accountability for the health-related Sustainable Development Goals (SDGs), which it would encompass. Legally binding, the FCGH could facilitate accountability through the courts and catalyze comprehensive domestic accountability regimes, requiring national strategies that include transparency, community and national mechanisms for accountability and participation and an enabling environment for social empowerment. A "Right to Health Capacity Fund" could ensure resources to implement these strategies. Inclusive national processes could establish targets, benchmarks, and indicators consistent with FCGH guidance, with regular reporting to a treaty body, which could also hear individual cases. State reports could be required to include plans to overcome implementation gaps, subjecting poorly complying states to penalties and targeted capacity building measures. Regional special rapporteurs could facilitate compliance through regular country visits, while also responding to serious violations. And reaching beyond government compliance, from capacity building to the courts and contractual obligations, the FCGH could establish nationally enforceable right to health obligations on the private sector.

  4. Altered T cell memory and effector cell development in chronic lymphatic filarial infection that is independent of persistent parasite antigen.

    Directory of Open Access Journals (Sweden)

    Cathy Steel

    2011-04-01

    Full Text Available Chronic lymphatic filarial (LF infection is associated with suppression of parasite-specific T cell responses that persist even following elimination of infection. While several mechanisms have been implicated in mediating this T cell specific downregulation, a role for alterations in the homeostasis of T effector and memory cell populations has not been explored. Using multiparameter flow cytometry, we investigated the role of persistent filarial infection on the maintenance of T cell memory in patients from the filarial-endemic Cook Islands. Compared to filarial-uninfected endemic normals (EN, microfilaria (mf positive infected patients (Inf had a reduced CD4 central memory (T(CM compartment. In addition, Inf patients tended to have more effector memory cells (T(EM and fewer effector cells (T(EFF than did ENs giving significantly smaller T(EFF:T(EM ratios. These contracted T(CM and T(EFF populations were still evident in patients previously mf+ who had cleared their infection (CLInf. Moreover, the density of IL-7Rα, necessary for T memory cell maintenance (but decreased in T effector cells, was significantly higher on memory cells of Inf and CLInf patients, although there was no evidence for decreased IL-7 or increased soluble IL7-Rα, both possible mechanisms for signaling defects in memory cells. However, effector cells that were present in Inf and CLInf patients had lower percentages of HLA-DR suggesting impaired function. These changes in T cell populations appear to reflect chronicity of infection, as filarial-infected children, despite the presence of active infection, did not show alterations in the frequencies of these T cell phenotypes. These data indicate that filarial-infected patients have contracted T(CM compartments and a defect in effector cell development, defects that persist even following clearance of infection. The fact that these global changes in memory and effector cell compartments do not yet occur in infected children

  5. Development of the mouse dermal adipose layer occurs independently of subcutaneous adipose tissue and is marked by restricted early expression of FABP4.

    Directory of Open Access Journals (Sweden)

    Kamila Wojciechowicz

    Full Text Available The laboratory mouse is a key animal model for studies of adipose biology, metabolism and disease, yet the developmental changes that occur in tissues and cells that become the adipose layer in mouse skin have received little attention. Moreover, the terminology around this adipose body is often confusing, as frequently no distinction is made between adipose tissue within the skin, and so called subcutaneous fat. Here adipocyte development in mouse dorsal skin was investigated from before birth to the end of the first hair follicle growth cycle. Using Oil Red O staining, immunohistochemistry, quantitative RT-PCR and TUNEL staining we confirmed previous observations of a close spatio-temporal link between hair follicle development and the process of adipogenesis. However, unlike previous studies, we observed that the skin adipose layer was created from cells within the lower dermis. By day 16 of embryonic development (e16 the lower dermis was demarcated from the upper dermal layer, and commitment to adipogenesis in the lower dermis was signalled by expression of FABP4, a marker of adipocyte differentiation. In mature mice the skin adipose layer is separated from underlying subcutaneous adipose tissue by the panniculus carnosus. We observed that the skin adipose tissue did not combine or intermix with subcutaneous adipose tissue at any developmental time point. By transplanting skin isolated from e14.5 mice (prior to the start of adipogenesis, under the kidney capsule of adult mice, we showed that skin adipose tissue develops independently and without influence from subcutaneous depots. This study has reinforced the developmental link between hair follicles and skin adipocyte biology. We argue that because skin adipocytes develop from cells within the dermis and independently from subcutaneous adipose tissue, that it is accurately termed dermal adipose tissue and that, in laboratory mice at least, it represents a separate adipose depot.

  6. Lessons from Iowa : development of a 270 megawatt compressed air energy storage project in midwest Independent System Operator : a study for the DOE Energy Storage Systems Program.

    Energy Technology Data Exchange (ETDEWEB)

    Holst, Kent (Iowa Stored Energy Plant Agency, Traer, IA); Huff, Georgianne; Schulte, Robert H. (Schulte Associates LLC, Northfield, MN); Critelli, Nicholas (Critelli Law Office PC, Des Moines, IA)

    2012-01-01

    The Iowa Stored Energy Park was an innovative, 270 Megawatt, $400 million compressed air energy storage (CAES) project proposed for in-service near Des Moines, Iowa, in 2015. After eight years in development the project was terminated because of site geological limitations. However, much was learned in the development process regarding what it takes to do a utility-scale, bulk energy storage facility and coordinate it with regional renewable wind energy resources in an Independent System Operator (ISO) marketplace. Lessons include the costs and long-term economics of a CAES facility compared to conventional natural gas-fired generation alternatives; market, legislative, and contract issues related to enabling energy storage in an ISO market; the importance of due diligence in project management; and community relations and marketing for siting of large energy projects. Although many of the lessons relate to CAES applications in particular, most of the lessons learned are independent of site location or geology, or even the particular energy storage technology involved.

  7. No evidence of benefit from class-II compression stockings in the prevention of lower-limb lymphedema after inguinal lymph node dissection: results of a randomized controlled trial.

    Science.gov (United States)

    Stuiver, M M; de Rooij, J D; Lucas, C; Nieweg, O E; Horenblas, S; van Geel, A N; van Beurden, M; Aaronson, N K

    2013-09-01

    Graduated compression stockings have been advocated for prevention of lymphedema after inguinal lymph node dissection (ILND) although scientific evidence of their efficacy in preventing lymphedema is lacking. The primary objective of this study was to assess the efficacy of class II compression stockings for the prevention of lymphedema in cancer patients following ILND. Secondary objectives were to investigate the influence of stockings on the occurrence of wound complications and genital edema, health-related quality of life (HRQoL) and body image. Eighty patients (45 with melanoma, 35 with urogenital tumors) who underwent ILND at two specialized cancer centers were randomly allocated to class II compression stocking use for six months or to a usual care control group. Lymphedema of the leg and genital area, wound complications, HRQoL, and body image were assessed at regular intervals prior to and up to 12 months after ILND. No significant differences were observed between groups in the incidence of edema, median time to the occurrence of edema, incidence of genital edema, frequency of complications, HRQoL, or body image. Based on the results of the current study, routine prescription of class II graduated compression stockings after ILND should be questioned and alternative prevention strategies should be considered.

  8. Deciding How to Stay Independent at Home in Later Years: Development and Acceptability Testing of an Informative Web-Based Module.

    Science.gov (United States)

    Garvelink, Mirjam Marjolein; Jones, C Allyson; Archambault, Patrick M; Roy, Noémie; Blair, Louisa; Légaré, France

    2017-12-14

    Seniors with loss of autonomy may face decisions about whether they should stay at home or move elsewhere. Most seniors would prefer to stay home and be independent for as long as possible, but most are unaware of options that would make this possible. The study aimed to develop and test the acceptability of an interactive website for seniors, their caregivers, and health professionals with short interlinked videos presenting information about options for staying independent at home. The approach for design and data collection varied, involving a multipronged, user-centered design of the development process, qualitative interviews, and end-user feedback to determine content (ie, needs assessment) in phase I; module development (in English and French) in phase II; and survey to test usability and acceptability with end users in phase III. Phase I participants were a convenience sample of end users, that is, seniors, caregivers, and professionals with expertise in modifiable factors (eg, day centers, home redesign, equipment, community activities, and finances), enabling seniors to stay independent at home for longer in Quebec and Alberta, Canada. Phase II participants were bilingual actors; phase III participants included phase I participants and new participants recruited through snowballing. Qualitative interviews were thematically analyzed in phase II to determine relevant topics for the video-scripts, which were user-checked by interview participants. In phase III, the results of a usability questionnaire were analyzed using descriptive statistics. In phase I, interviews with 29 stakeholders, including 4 seniors, 3 caregivers, and 22 professionals, showed a need for a one-stop information resource about options for staying independent at home. They raised issues relating to 6 categories: cognitive autonomy, psychological or mental well-being, functional autonomy, social autonomy, financial autonomy, and people involved. A script was developed and evaluated by

  9. Development of innovative problem based learning model with PMRI-scientific approach using ICT to increase mathematics literacy and independence-character of junior high school students

    Science.gov (United States)

    Wardono; Waluya, B.; Kartono; Mulyono; Mariani, S.

    2018-03-01

    This research is very urgent in relation to the national issue of human development and the nation's competitiveness because of the ability of Indonesian Junior High School students' mathematics literacy results of the Programme for International Student Assessment (PISA) by OECD field of Mathematics is still very low compared to other countries. Curriculum 2013 launched one of them reflect the results of PISA which is still far from the expectations of the Indonesian nation and to produce a better quality of education, PISA ratings that reflect the nation's better competitiveness need to be developed innovative, interactive learning models such as innovative interactive learning Problem Based Learning (PBL) based on the approach of Indonesian Realistic Mathematics Education (PMRI) and the Scientific approach using Information and Communication Technology (ICT).The research was designed using Research and Development (R&D), research that followed up the development and dissemination of a product/model. The result of the research shows the innovative interactive learning PBL model based on PMRI-Scientific using ICT that developed valid, practical and effective and can improve the ability of mathematics literacy and independence-character of junior high school students. While the quality of innovative interactive learning PBL model based on PMRI-Scientific using ICT meet the good category.

  10. Development of language, Mathematics and self-independence abilities of a five-year-old with speech delay using educational toys

    Directory of Open Access Journals (Sweden)

    Geertruida Maya

    2017-12-01

    Full Text Available The objective of this research was to identify the development of language and Mathematics abilities as well as self-independence of a five years old child with speech disorder. The study was conducted in eight weeks period in which playing with educational toys had been the main activity. This is a descriptive qualitative research in which the data were collected using direct interviews, checklist instruments and observations. Based on intensive observations using the four point Likert scale, there were medium increases in the observed variables. For the language ability the average score increased from 1.5 to 2.9 with the N-gain of 0,56, for the Mathematics ability the average score increased from 1.7 to 3.0 with the N-gain of 0,57 and for the self-independence the average score increased from 2.1 to 3.0 with N-gain of 0,47. A longitudinal study on the child for one or two years is needed to arrive at more meaningful and conclusive findings.

  11. Independent component analysis: recent advances

    OpenAIRE

    Hyv?rinen, Aapo

    2013-01-01

    Independent component analysis is a probabilistic method for learning a linear transform of a random vector. The goal is to find components that are maximally independent and non-Gaussian (non-normal). Its fundamental difference to classical multi-variate statistical methods is in the assumption of non-Gaussianity, which enables the identification of original, underlying components, in contrast to classical methods. The basic theory of independent component analysis was mainly developed in th...

  12. Independent random sampling methods

    CERN Document Server

    Martino, Luca; Míguez, Joaquín

    2018-01-01

    This book systematically addresses the design and analysis of efficient techniques for independent random sampling. Both general-purpose approaches, which can be used to generate samples from arbitrary probability distributions, and tailored techniques, designed to efficiently address common real-world practical problems, are introduced and discussed in detail. In turn, the monograph presents fundamental results and methodologies in the field, elaborating and developing them into the latest techniques. The theory and methods are illustrated with a varied collection of examples, which are discussed in detail in the text and supplemented with ready-to-run computer code. The main problem addressed in the book is how to generate independent random samples from an arbitrary probability distribution with the weakest possible constraints or assumptions in a form suitable for practical implementation. The authors review the fundamental results and methods in the field, address the latest methods, and emphasize the li...

  13. Is Administration of Trastuzumab an Independent Risk Factor for Developing Osteonecrosis of the Jaw Among Metastatic Breast Cancer Patients Under Zoledronic Acid Treatment?

    Science.gov (United States)

    Pilanci, Kezban Nur; Alco, Gul; Ordu, Cetin; Sarsenov, Dauren; Celebi, Filiz; Erdogan, Zeynep; Agacayak, Filiz; Ilgun, Serkan; Tecimer, Coskun; Demir, Gokhan; Eralp, Yesim; Okkan, Sait; Ozmen, Vahit

    2015-01-01

    Abstract One of the most important adverse effects of zoledronic acid (ZA) is osteonecrosis of the jaw (ONJ). In previous literature, several risk factors have been identified in the development of ONJ. In this study, we aimed to determine the role of trastuzumab, an antiangiogenic agent, as an independent risk factor for the development of this serious side effect. Our study included 97 patients (mean age: 54 ± 10 years) with breast cancer, recorded in the archives of the Istanbul Florence Nightingale Breast Study Group, who received ZA therapy due to bone metastases between March 2006 and December 2013. We recorded the patients’ ages, weights, duration of treatment with ZA, number of ZA infusions, dental procedures, anticancer treatments (chemotherapy, aromatase inhibitor, trastuzumab), the presence of diabetes mellitus or renal dysfunction, and smoking habits. Thirteen patients (13.40%) had developed ONJ. Among the patients with ONJ, the mean time of exposure to ZA was 41 months (range: 13–82) and the mean number of ZA infusions was 38 (range: 15–56). The duration of treatment with ZA and the use of trastuzumab were observed to be 2 factors that influenced the development of ONJ (P = 0.049 and P = 0.028, respectively). The development of ONJ under ZA treatment may be associated solely with the duration of ZA treatment and the concurrent administration of trastuzumab. These findings show that patients who are administered trastuzumab for metastatic breast cancer while undergoing ZA treatment are prone to developing ONJ. Therefore, we recommend intense clinical observation to avoid this particular condition in patients receiving ZA and trastuzumab. PMID:25950681

  14. Ptpn11 Deletion in CD4+ Cells Does Not Affect T Cell Development and Functions but Causes Cartilage Tumors in a T Cell-Independent Manner.

    Science.gov (United States)

    Miah, S M Shahjahan; Jayasuriya, Chathuraka T; Salter, Alexander I; Reilly, Emma C; Fugere, Céline; Yang, Wentian; Chen, Qian; Brossay, Laurent

    2017-01-01

    The ubiquitously expressed tyrosine phosphatase Src homology region 2 domain-containing phosphatase-2 (SHP-2, encoded by Ptpn11 ) is required for constitutive cellular processes including proliferation, differentiation, and the regulation of immune responses. During development and maturation, subsets of T cells express a variety of inhibitory receptors known to associate with phosphatases, which in turn, dephosphorylate key players of activating receptor signaling pathways. We hypothesized that SHP-2 deletion would have major effects on T cell development by altering the thresholds for activation, as well as positive and negative selection. Surprisingly, using mice conditionally deficient for SHP-2 in the T cell lineage, we show that the development of these lymphocytes is globally intact. In addition, our data demonstrate that SHP-2 absence does not compromise T cell effector functions, suggesting that SHP-2 is dispensable in these cells. Unexpectedly, in aging mice, Ptpn11 gene deletion driven by CD4 Cre recombinase leads to cartilage tumors in wrist bones in a T cell-independent manner. These tumors resemble miniature cartilaginous growth plates and contain CD4-lineage positive chondrocyte-like cells. Altogether these results indicate that SHP-2 is a cartilage tumor suppressor during aging.

  15. Ptpn11 Deletion in CD4+ Cells Does Not Affect T Cell Development and Functions but Causes Cartilage Tumors in a T Cell-Independent Manner

    Directory of Open Access Journals (Sweden)

    S. M. Shahjahan Miah

    2017-10-01

    Full Text Available The ubiquitously expressed tyrosine phosphatase Src homology region 2 domain-containing phosphatase-2 (SHP-2, encoded by Ptpn11 is required for constitutive cellular processes including proliferation, differentiation, and the regulation of immune responses. During development and maturation, subsets of T cells express a variety of inhibitory receptors known to associate with phosphatases, which in turn, dephosphorylate key players of activating receptor signaling pathways. We hypothesized that SHP-2 deletion would have major effects on T cell development by altering the thresholds for activation, as well as positive and negative selection. Surprisingly, using mice conditionally deficient for SHP-2 in the T cell lineage, we show that the development of these lymphocytes is globally intact. In addition, our data demonstrate that SHP-2 absence does not compromise T cell effector functions, suggesting that SHP-2 is dispensable in these cells. Unexpectedly, in aging mice, Ptpn11 gene deletion driven by CD4 Cre recombinase leads to cartilage tumors in wrist bones in a T cell-independent manner. These tumors resemble miniature cartilaginous growth plates and contain CD4-lineage positive chondrocyte-like cells. Altogether these results indicate that SHP-2 is a cartilage tumor suppressor during aging.

  16. Development of a flattening filter free multiple source model for use as an independent, Monte Carlo, dose calculation, quality assurance tool for clinical trials.

    Science.gov (United States)

    Faught, Austin M; Davidson, Scott E; Popple, Richard; Kry, Stephen F; Etzel, Carol; Ibbott, Geoffrey S; Followill, David S

    2017-09-01

    The Imaging and Radiation Oncology Core-Houston (IROC-H) Quality Assurance Center (formerly the Radiological Physics Center) has reported varying levels of compliance from their anthropomorphic phantom auditing program. IROC-H studies have suggested that one source of disagreement between institution submitted calculated doses and measurement is the accuracy of the institution's treatment planning system dose calculations and heterogeneity corrections used. In order to audit this step of the radiation therapy treatment process, an independent dose calculation tool is needed. Monte Carlo multiple source models for Varian flattening filter free (FFF) 6 MV and FFF 10 MV therapeutic x-ray beams were commissioned based on central axis depth dose data from a 10 × 10 cm 2 field size and dose profiles for a 40 × 40 cm 2 field size. The models were validated against open-field measurements in a water tank for field sizes ranging from 3 × 3 cm 2 to 40 × 40 cm 2 . The models were then benchmarked against IROC-H's anthropomorphic head and neck phantom and lung phantom measurements. Validation results, assessed with a ±2%/2 mm gamma criterion, showed average agreement of 99.9% and 99.0% for central axis depth dose data for FFF 6 MV and FFF 10 MV models, respectively. Dose profile agreement using the same evaluation technique averaged 97.8% and 97.9% for the respective models. Phantom benchmarking comparisons were evaluated with a ±3%/2 mm gamma criterion, and agreement averaged 90.1% and 90.8% for the respective models. Multiple source models for Varian FFF 6 MV and FFF 10 MV beams have been developed, validated, and benchmarked for inclusion in an independent dose calculation quality assurance tool for use in clinical trial audits. © 2017 American Association of Physicists in Medicine.

  17. Agent independent task planning

    Science.gov (United States)

    Davis, William S.

    1990-01-01

    Agent-Independent Planning is a technique that allows the construction of activity plans without regard to the agent that will perform them. Once generated, a plan is then validated and translated into instructions for a particular agent, whether a robot, crewmember, or software-based control system. Because Space Station Freedom (SSF) is planned for orbital operations for approximately thirty years, it will almost certainly experience numerous enhancements and upgrades, including upgrades in robotic manipulators. Agent-Independent Planning provides the capability to construct plans for SSF operations, independent of specific robotic systems, by combining techniques of object oriented modeling, nonlinear planning and temporal logic. Since a plan is validated using the physical and functional models of a particular agent, new robotic systems can be developed and integrated with existing operations in a robust manner. This technique also provides the capability to generate plans for crewmembers with varying skill levels, and later apply these same plans to more sophisticated robotic manipulators made available by evolutions in technology.

  18. Development of radiation pneumopathy and generalised radiological changes after radiotherapy are independent negative prognostic factors for survival in non-small cell lung cancer patients

    International Nuclear Information System (INIS)

    Farr, Katherina P.; Khalil, Azza A.; Knap, Marianne M.; Møller, Ditte S.; Grau, Cai

    2013-01-01

    Background and purpose: To investigate the risk factors for radiation pneumopathy (RP) and survival rate of non-small cell lung cancer patients with RP and generalised interstitial lung changes (gen-ILC). Material and methods: A total of 147 consecutive patients receiving curative radiotherapy were analysed. RP was graded according to Common Terminology Criteria for Adverse Events v. 3. Computed tomography images were assessed for the presence of gen-ILC after radiotherapy. Univariate and multivariate analyses were performed to identify significant factors. Results: Median follow-up was 16.2 months (range 1.4–58.6). Radiological changes after radiotherapy were confined to high dose irradiation volume in 111 patients, while 31 patients developed gen-ILC. Dosimetric parameters and level of C-reactive protein before radiotherapy were significantly associated with severe RP. Development of gen-ILC (p = 0.008), as well as severe RP (p = 0.03) had significant negative impact on patients’ survival. These two factors remained significant in the multivariate analysis. Conclusions: Severe radiation pneumopathy and generalised radiographic changes were significant independent prognostic factors for survival. More studies on pathophysiology of radiation induced damage are necessary to fully understand the mechanisms behind it

  19. Lead nitrate-induced development of hypercholesterolemia in rats: sterol-independent gene regulation of hepatic enzymes responsible for cholesterol homeostasis.

    Science.gov (United States)

    Kojima, Misaki; Masui, Toshimitsu; Nemoto, Kiyomitsu; Degawa, Masakuni

    2004-12-01

    Changes in the gene expressions of hepatic enzymes responsible for cholesterol homeostasis were examined during the process of lead nitrate (LN)-induced development of hypercholesterolemia in male rats. Total cholesterol levels in the liver and serum were significantly increased at 3-72 h and 12-72 h, respectively, after LN-treatment (100 micromol/kg, i.v.). Despite the development of hypercholesterolemia, the genes for hepatic 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) and other enzymes (FPPS, farnesyl diphosphate synthase; SQS, squalene synthase; CYP51, lanosterol 14alpha-demethylase) responsible for cholesterol biosynthesis were activated at 3-24 h and 12-18 h, respectively. On the other hand, the gene expression of cholesterol 7alpha-hydroxylase (CYP7A1), a catabolic enzyme of cholesterol, was remarkably suppressed at 3-72 h. The gene expression levels of cytokines interleukin-1beta (IL-1beta) and TNF-alpha, which activate the HMGR gene and suppress the CYP7A1 gene, were significantly increased at 1-3 h and 3-24 h, respectively. Furthermore, gene activation of SREBP-2, a gene activator of several cholesterogenic enzymes, occurred before the gene activations of FPPS, SQS and CYP51. This is the first report demonstrating sterol-independent gene regulation of hepatic enzymes responsible for cholesterol homeostasis in LN-treated male rats. The mechanisms for the altered-gene expressions of hepatic enzymes in LN-treated rats are discussed.

  20. The Elderly’s Independent Living in Smart Homes: A Characterization of Activities and Sensing Infrastructure Survey to Facilitate Services Development

    Science.gov (United States)

    Ni, Qin; García Hernando, Ana Belén; de la Cruz, Iván Pau

    2015-01-01

    Human activity detection within smart homes is one of the basis of unobtrusive wellness monitoring of a rapidly aging population in developed countries. Most works in this area use the concept of “activity” as the building block with which to construct applications such as healthcare monitoring or ambient assisted living. The process of identifying a specific activity encompasses the selection of the appropriate set of sensors, the correct preprocessing of their provided raw data and the learning/reasoning using this information. If the selection of the sensors and the data processing methods are wrongly performed, the whole activity detection process may fail, leading to the consequent failure of the whole application. Related to this, the main contributions of this review are the following: first, we propose a classification of the main activities considered in smart home scenarios which are targeted to older people’s independent living, as well as their characterization and formalized context representation; second, we perform a classification of sensors and data processing methods that are suitable for the detection of the aforementioned activities. Our aim is to help researchers and developers in these lower-level technical aspects that are nevertheless fundamental for the success of the complete application. PMID:26007717

  1. The Elderly’s Independent Living in Smart Homes: A Characterization of Activities and Sensing Infrastructure Survey to Facilitate Services Development

    Directory of Open Access Journals (Sweden)

    Qin Ni

    2015-05-01

    Full Text Available Human activity detection within smart homes is one of the basis of unobtrusive wellness monitoring of a rapidly aging population in developed countries. Most works in this area use the concept of “activity” as the building block with which to construct applications such as healthcare monitoring or ambient assisted living. The process of identifying a specific activity encompasses the selection of the appropriate set of sensors, the correct preprocessing of their provided raw data and the learning/reasoning using this information. If the selection of the sensors and the data processing methods are wrongly performed, the whole activity detection process may fail, leading to the consequent failure of the whole application. Related to this, the main contributions of this review are the following: first, we propose a classification of the main activities considered in smart home scenarios which are targeted to older people’s independent living, as well as their characterization and formalized context representation; second, we perform a classification of sensors and data processing methods that are suitable for the detection of the aforementioned activities. Our aim is to help researchers and developers in these lower-level technical aspects that are nevertheless fundamental for the success of the complete application.

  2. Independent and joint effects of prenatal maternal smoking and maternal exposure to second-hand smoke on the development of adolescent obesity: a longitudinal study.

    Science.gov (United States)

    Wang, Liang; Mamudu, Hadii M; Alamian, Arsham; Anderson, James L; Brooks, Billy

    2014-11-01

    To examine associations of prenatal maternal smoking and second-hand smoke (SHS) exposure with the development of adolescent obesity. Longitudinal data (1991-2007) from National Institute of Child Health and Human Development Study of Early Child Care and Youth Development involving mothers that smoked and or exposed to SHS during the year before birth were analysed. Adolescent obesity in ages 12.0-15.9 years was defined as a BMI ≥ 95th percentile. Generalised estimating equations (GEE) were used for the analyses. Obesity was more prevalent among adolescents whose mothers smoked or had SHS exposure than those that did not smoke or exposed to SHS. After adjusting for maternal and child factors, GEE models showed that odds of adolescent obesity increased with prenatal maternal smoking (OR = 1.57, 95% CI = 1.03-2.39) and SHS exposure (OR = 1.53, 95% CI = 1.04-2.27). The odds for obesity increased more than two times among adolescents exposed to both maternal smoking and SHS (OR = 2.10, 95% CI = 1.24, 3.56) compared with those without exposure. Additionally, not breastfeeding, maternal obesity, and longer screen viewing hours per day were associated with increased odds of obesity. There is possibly a long-term joint effect of prenatal maternal smoke (smoking and SHS) exposure on obesity among adolescent offspring, and the effect is independent of birthweight. These findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programmes for families during the year before birth. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  3. Independence and Product Systems

    OpenAIRE

    Skeide, Michael

    2003-01-01

    Starting from elementary considerations about independence and Markov processes in classical probability we arrive at the new concept of conditional monotone independence (or operator-valued monotone independence). With the help of product systems of Hilbert modules we show that monotone conditional independence arises naturally in dilation theory.

  4. Yearbook of International Co-operation on Environment and Development 2002/2003; an independent publication from the Fridtjof Nansen Institute, Norway

    Energy Technology Data Exchange (ETDEWEB)

    Stokke, Olav Schram; Thommessen, Oeystein B.

    2002-07-01

    The Yearbook of International Cooperation on Environment and Development aims to demonstrate the status of collaboration, the main obstacles to effective international solutions, and how to overcome them. The Yearbook assesses the achievements and the shortcomings of international co-operation, and helps the reader to distinguish between rhetoric and reality. The combination of independent, high-quality analysis and updated reference material makes this Yearbook an indispensable guide for decision-makers in government, international organizations, NGOs, and industry, as well as an essential source book for academic institutions, students, and libraries serving the concerned public. Current Issues and Key Themes in this edition focus on: (1) how effective environmental mega-conferences are in global environmental governance; (2) how the climate change regime can achieve its objective by addressing the very real concerns about climate-change impacts on human beings as much as on healthy ecosystems; (3) how the South Pacific Regional Environment Programme has been an effective regional agent for environmental protection and how it should cope with the challenges ahead; (4) how the Environmental Protocol to the Antarctic Treaty has contributed to strengthening international cooperation within the Treaty, but nevertheless is hampered by the vagueness of some core requirements and by the unresolved issues of jurisdiction, control, and enforcement in the Antarctic; (5) how the Ramsar Convention on Wetlands-neither rigorous nor extensive in its obligations-has acted as a vehicle for the development of a reasonably detailed policy framework for wetland conservation; (6) how Friends of the Earth International-among the world's largest, most diverse, and most influential environmental NGOs-has such internal diversity, in addition to its geographic spread and lack of agreed political ideology, that it risks its external profile becoming blurred and its internal

  5. Cofactor Independent Phosphoglycerate Mutase of Brugia malayi Induces a Mixed Th1/Th2 Type Immune Response and Inhibits Larval Development in the Host

    Directory of Open Access Journals (Sweden)

    Prashant K. Singh

    2014-01-01

    Full Text Available Lymphatic filariasis is a major debilitating disease, endemic in 72 countries putting more than 1.39 billion people at risk and 120 million are already infected. Despite the significant progress in chemotherapeutic advancements, there is still need for other measures like development of an effective vaccine or discovery of novel drug targets. In this study, structural and immunological characterization of independent phosphoglycerate mutase of filarial parasite Brugia malayi was carried out. Protein was found to be expressed in all major parasite life stages and as an excretory secretory product of adult parasites. Bm-iPGM also reacted to all the categories of human bancroftian patient’s sera including endemic normals. In vivo immunological behaviour of protein was determined in immunized BALB/c mice followed by prophylactic analysis in BALB/c mice and Mastomys coucha. Immunization with Bm-iPGM led to generation of a mixed Th1/Th2 type immune response offering 58.2% protection against larval challenge in BALB/c and 65–68% protection in M. coucha. In vitro studies confirmed participation of anti-Bm-iPGM antibodies in killing of B. malayi infective larvae and microfilariae through ADCC mechanism. The present findings reveal potential immunoprotective nature of Bm-iPGM advocating its worth as an antifilarial vaccine candidate.

  6. Elucidating the mechanisms of fear extinction in developing animals: a special case of NMDA receptor-independent extinction in adolescent rats.

    Science.gov (United States)

    Bisby, Madelyne A; Baker, Kathryn D; Richardson, Rick

    2018-04-01

    NMDA receptors (NMDARs) are considered critical for the consolidation of extinction but recent work challenges this assumption. Namely, NMDARs are not required for extinction retention in infant rats as well as when extinction training occurs for a second time (i.e., reextinction) in adult rats. In this study, a possible third instance of NMDAR-independent extinction was tested. Although adolescents typically exhibit impaired extinction retention, rats that are conditioned as juveniles and then given extinction training as adolescents (JuvCond-AdolesExt) have good extinction retention. Unexpectedly, this good extinction retention is not associated with an up-regulation of a synaptic plasticity marker in the medial prefrontal cortex, a region implicated in extinction consolidation. In the current study, rats received either the noncompetitive NMDAR antagonist MK801 (0.1 mg/kg, s.c.) or saline before extinction training. In several experiments, rats conditioned and extinguished as juveniles, adolescents, or adults exhibited impaired extinction retention after MK801 compared to saline, but this effect was not observed in JuvCond-AdolesExt rats. Further experiments ruled out several alternative explanations for why NMDAR antagonism did not affect extinction retention in adolescents extinguishing fear learned as a juvenile. These results illustrate yet another circumstance in which NMDARs are not required for successful extinction retention and highlight the complexity of fear inhibition across development. © 2018 Bisby et al.; Published by Cold Spring Harbor Laboratory Press.

  7. Defining and Selecting Independent Directors

    Directory of Open Access Journals (Sweden)

    Eric Pichet

    2017-10-01

    Full Text Available Drawing from the Enlightened Shareholder Theory that the author first developed in 2011, this theoretical paper with practical and normative ambitions achieves a better definition of independent director, while improving the understanding of the roles he fulfils on boards of directors. The first part defines constructs like firms, Governance system and Corporate governance, offering a clear distinction between the latter two concepts before explaining the four main missions of a board. The second part defines the ideal independent director by outlining the objective qualities that are necessary and adding those subjective aspects that have turned this into a veritable profession. The third part defines the ideal process for selecting independent directors, based on nominating committees that should themselves be independent. It also includes ways of assessing directors who are currently in function, as well as modalities for renewing their mandates. The paper’s conclusion presents the Paradox of the Independent Director.

  8. Linfedema primário congênito em bovinos Red Angus Primary congenital lymphedema in Red Angus cattle

    Directory of Open Access Journals (Sweden)

    Juliana Targino S.A. Macêdo

    2009-09-01

    Full Text Available Casos de linfedema congênito foram observados acometendo 12 terneiros cruza Red Angus na região Central do Rio Grande do Sul. Os terneiros afetados apresentavam graus variáveis de edema subcutâneo ao nascimento, envolvendo principalmente os membros pélvicos, mas também outras regiões do corpo. A injeção de solução a 5% de azul de metileno no espaço interdigital dos membros pélvicos de três terneiros afetados e um controle, indicaram uma interrupção no fluxo da linfa, sugerindo uma falha dos linfáticos periféricos distais em contactar os troncos centrais. Na necropsia de três terneiros afetados, edema subcutâneo foi observado de modo variável nos membros pélvicos, prepúcio e abdômen ventral. Não foi observado edema nas cavidades orgânicas. Em dois casos, observou-se hipoplasia dos linfonodos poplíteos associadas à dilatação dos vasos linfáticos. Testes de DNA demonstraram que todos os terneiros afetados nasceram de vacas inseminadas pelo mesmo touro, sugerindo uma base genética para a doença. Levando em consideração que uma pequena porcentagem de terneiros nasceram de vacas inseminadas pelo touro suspeito, é provável que um modo autossômico recessivo esteja envolvido na hereditariedade da doença.Cases of congenital lymphedema were observed affecting 12 cross Red Angus calves from the central region of the state of Rio Grande do Sul, Brazil. Affected calves presented variable degrees of subcutaneous edema at birth, involving mainly the hind limbs but also other body regions. The injection of methylene blue dye in 5% solution into the interdigital space of the hind limbs of three affected calves and one normal control indicated an interruption of the lymph flow in the affected calves; this suggests a failure of the distal peripheral lymphatics to connect with the central trunks. At necropsy of three affected calves subcutaneous edema was variably observed in the hind limbs, prepuce and ventral abdomen. Edema

  9. Are Independent Fiscal Institutions Really Independent?

    Directory of Open Access Journals (Sweden)

    Slawomir Franek

    2015-08-01

    Full Text Available In the last decade the number of independent fiscal institutions (known also as fiscal councils has tripled. They play an important oversight role over fiscal policy-making in democratic societies, especially as they seek to restore public finance stability in the wake of the recent financial crisis. Although common functions of such institutions include a role in analysis of fiscal policy, forecasting, monitoring compliance with fiscal rules or costing of spending proposals, their roles, resources and structures vary considerably across countries. The aim of the article is to determine the degree of independence of such institutions based on the analysis of the independence index of independent fiscal institutions. The analysis of this index values may be useful to determine the relations between the degree of independence of fiscal councils and fiscal performance of particular countries. The data used to calculate the index values will be derived from European Commission and IMF, which collect sets of information about characteristics of activity of fiscal councils.

  10. Guide to Understanding Lymphedema

    Science.gov (United States)

    ... ACTH CAF CMF FAC TAC TC TCH TH THP Radiation Therapy Whole Breast Radiation Partial Breast Radiation ... Basics Treatments and Your Bone Health Bone Health Tests Improving Bone Health Medicines To Protect Bones Diet, ...

  11. National Lymphedema Network

    Science.gov (United States)

    ... Insurance Issues G-Codes and LE Sample Insurance Appeal Letter New Medicare Limits Inspirational Patients Lymph e- ... their physician/therapist regarding their own medical situation. Advertising | Privacy Policy | Terms of Use Find Treatment About ...

  12. Flexitouch® Home Maintenance Therapy or Standard Home Maintenance Therapy in Treating Patients With Lower-Extremity Lymphedema Caused by Treatment for Cervical Cancer, Vulvar Cancer, or Endometrial Cancer

    Science.gov (United States)

    2014-12-29

    Lymphedema; Stage 0 Cervical Cancer; Stage 0 Uterine Corpus Cancer; Stage 0 Vulvar Cancer; Stage I Uterine Corpus Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Vulvar Cancer; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer; Stage IVB Vulvar Cancer

  13. Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first six months

    Directory of Open Access Journals (Sweden)

    Brittany L Thomas

    2015-01-01

    Full Text Available The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first six months of life and subjects the movements to analyses of body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal including the hips, legs, and feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged contacts included palmar and eventually grasp and manipulatory contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. In contrast, developmental increases in self grasping emerged a few weeks after the increases observed in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows for the coordination of the Reach and the Grasp prior to their use under visual

  14. Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months.

    Science.gov (United States)

    Thomas, Brittany L; Karl, Jenni M; Whishaw, Ian Q

    2014-01-01

    The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first 6 months of life and subjected the Reach movements to an analysis in relation to body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal and included the hips, then legs, and eventually the feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged, contacts included palmar contacts and eventually grasp and manipulation contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. Developmental increases in self-grasping contacts occurred a few weeks after the increase in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows the coordination of the Reach and the Grasp prior to and

  15. The effectiveness of a clinical and home-based physical activity program and simple lymphatic drainage in the prevention of breast cancer-related lymphedema: A prospective randomized controlled study.

    Science.gov (United States)

    Dönmez, Ayşe Arıkan; Kapucu, Sevgisun

    2017-12-01

    To investigate the effectiveness of a clinical and home-based, nurse-led physical activity program (PAP) and simple lymphatic drainage (SLD) in the prevention of breast cancer-related lymphedema. A total of 52 breast cancer patients were randomized to either a PAP and SLD program (n = 25) or a control group (n = 27). Patients in both groups were also provided training for lymphedema. The PAP and SLD were administered through home visits by the investigators, twice a week for six weeks, in the intervention group. The control group did not undergo intervention. The circumference of the upper extremity, symptom severity, and physical function were measured in both groups. The upper extremity circumference increased by about two times from the baseline, in the control group, especially in the sixth week (p breast cancer surgery, starting from before surgery and continuing until after, to prevent breast cancer-related lymphedema. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Central Bank independence

    Directory of Open Access Journals (Sweden)

    Vasile DEDU

    2012-08-01

    Full Text Available In this paper we present the key aspects regarding central bank’s independence. Most economists consider that the factor which positively influences the efficiency of monetary policy measures is the high independence of the central bank. We determined that the National Bank of Romania (NBR has a high degree of independence. NBR has both goal and instrument independence. We also consider that the hike of NBR’s independence played an important role in the significant disinflation process, as headline inflation dropped inside the targeted band of 3% ± 1 percentage point recently.

  17. Organizing Independent Student Work

    Directory of Open Access Journals (Sweden)

    Zhadyra T. Zhumasheva

    2015-03-01

    Full Text Available This article addresses issues in organizing independent student work. The author defines the term “independence”, discusses the concepts of independent learner work and independent learner work under the guidance of an instructor, proposes a classification of assignments to be done independently, and provides methodological recommendations as to the organization of independent student work. The article discusses the need for turning the student from a passive consumer of knowledge into an active creator of it, capable of formulating a problem, analyzing the ways of solving it, coming up with an optimum outcome, and proving its correctness. The preparation of highly qualified human resources is the primary condition for boosting Kazakhstan’s competitiveness. Independent student work is a means of fostering the professional competence of future specialists. The primary form of self-education is independent work.

  18. Fatores de risco para linfedema após câncer de mama: uma revisão da literatura Risk factors of arm lymphedema after breast cancer: a literature review

    Directory of Open Access Journals (Sweden)

    Anke Bergmann

    2008-01-01

    Full Text Available O linfedema representa uma das principais seqüelas do câncer de mama. Esta revisão da literatura visou discutir os principais fatores associados ao linfedema após o tratamento do câncer de mama. Foram selecionados 26 artigos publicados entre janeiro de 2000 e março de 2008 nas bases Medline e Lilacs, utilizando os descritores breast neoplasms, lymphedema, upper extremity, arm e risk factors. Sua revisão permitiu discutir os fatores relacionados ao linfedema, quanto a: clínica e paciente (tabagismo, escolaridade, etnia, comorbidades, hipertensão arterial, diabetes melito, menopausa, idade, peso corporal, índice de massa corporal, atividade física, membro dominante, restrição articular, infecção, seroma e trauma no membro superior; tratamento do câncer de mama (cirurgia, reconstrução mamária, número de linfonodos retirados, nível da linfadenectomia axilar, radioterapia, quimioterapia, hormonioterapia e tempo transcorrido após o tratamento; tumor (tamanho, grau, localização, comprometimento dos linfonodos axilares e estadiamento. A revisão feita indica que a linfadenectomia axilar, a radioterapia em cadeias de drenagem e a obesidade são fatores preponderantes do risco para desenvolvimento do linfedema.Arm lymphedema is one of the most frequent sequelae of breast cancer treatment. The purpose of this literature review was to discuss main risk factors of lymphedema after breast cancer treatment. The search in Medline and Lilacs databases, by means of key words breast neoplasms, lymphedema, upper extremity, arm, and risk factors, allowed selecting 26 studies published between January, 2000, and March, 2008. This review discusses factors linked to: clinic and the patient (smoking, education level, race/ethnicity, comorbidity, hypertension, diabetes, menopause, age, weight, body mass index, physical activity, handedness, impaired range of motion, infection, seroma and arm injuries; breast cancer treatment (type of surgery

  19. Sensor monitoring to measure and support daily functioning for independently living older people: A systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, M.C.; Poerbodipoero, S.; Robben, S.; Daams, J.; van Hartingsveldt, M.; de Vos, R.; de Rooij, S.E.; Kröse, B.; Buurman, B.M.

    2013-01-01

    Objectives To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently

  20. Sensor monitoring to measure and support daily functioning for independently living older people: a systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, Margriet C.; Poerbodipoero, Soemitro; Robben, Saskia; Daams, Joost; van Hartingsveldt, Margo; de Vos, Rien; de Rooij, Sophia E.; Kröse, Ben; Buurman, Bianca M.

    2013-01-01

    To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently at home.

  1. The Membrane-anchored Serine Protease Prostasin (CAP1/PRSS8) Supports Epidermal Development and Postnatal Homeostasis Independent of Its Enzymatic Activity

    DEFF Research Database (Denmark)

    Peters, Diane E; Szabo, Roman; Friis, Stine

    2014-01-01

    The membrane-anchored serine protease prostasin (CAP1/PRSS8) is part of a cell surface proteolytic cascade that is essential for epithelial barrier formation and homeostasis. Here, we report the surprising finding that prostasin executes these functions independent of its own enzymatic activity. ...

  2. Deciding How to Stay Independent at Home in Later Years: Development and Acceptability Testing of an Informative Web-Based Module

    NARCIS (Netherlands)

    Garvelink, M.M.; Jones, C.A.; Archambault, P.M.; Roy, N. van; Blair, L.; Legare, F.

    2017-01-01

    BACKGROUND: Seniors with loss of autonomy may face decisions about whether they should stay at home or move elsewhere. Most seniors would prefer to stay home and be independent for as long as possible, but most are unaware of options that would make this possible. OBJECTIVE: The study aimed to

  3. Experiência de mulheres com linfedema pós-mastectomia: significado do sofrimento vivido Experiencia de mujeres con linfedema post-mastectomía: significado del sufrimiento vivido Experience of women with post-mastectomy lymphedema: the meaning of experienced suffering

    Directory of Open Access Journals (Sweden)

    Marislei Sanches Panobianco

    2008-12-01

    cotidiano y en el trabajo, alteraciones emocionales, cambios de hábitos, caracterizándose como un problema estigmatizante. Identificaron instituciones: ciencia, trabajo, servicios de salud y sociedad, que promovieron cuestionamientos, perjuicio, aislamiento, constreñimiento. La familia y el servicio de apoyo que frecuentaban fueron instituciones que posibilitaron aproximación social.Arm lymphedema affects approximately 40% of mastectomized women with axillary hollowness, increasing limb weight and volume, with subsequent professional, domestic, sexual and psychosocial problems. Current study analyzes the experience of women with post-mastectomy lymphedema and aims at understanding the meaning that foregrounds their experienced suffering. Analysis was based on an anthropological and interpretative approach, whereas data were submitted to thematic content analysis. Fourteen women, attending a rehabilitation unit for mastectomized women, where authors of current paper work, participated in the study, were selected. From the participants' point of view, characterizing a stigmatizing problem, lymphedema brings about concern with treatment and its maintenance, difficulty in daily life and work, emotional alterations, habits changes. The subjects identified institutions, such as science, place of work, health services and society, which develop negative conditions by their questioning, bias, isolation and embarrassment. The family and the support service they attended were institutions that favored social approximation.

  4. Current development of Green IPPs: experiences, challenges, and strategies. Workshop of the EC-ASEAN Green Independent Power Producers Network, 15th of Sept., 2005 in Karlsruhe

    OpenAIRE

    Rentz, Otto; Möst, Dominik; Eßer, Anke [Hrsg.

    2005-01-01

    Due to growing environmental issues, a strong political will to increase the use of renewable energy sources exists in many countries of the world. Mainly in the EU, measures to promote renewable energies have been taken. In Asia, the use of renewable energy is being promoted, too. However, policies as well as markets are still rather in the fledging stages. Therefore, a network on Green Independent Power Producers (GrIPPs) was set up, to exchange experiences between Europe and Southeast Asia...

  5. Accounting for Independent Schools.

    Science.gov (United States)

    Sonenstein, Burton

    The diversity of independent schools in size, function, and mode of operation has resulted in a considerable variety of accounting principles and practices. This lack of uniformity has tended to make understanding, evaluation, and comparison of independent schools' financial statements a difficult and sometimes impossible task. This manual has…

  6. Lessons from independence

    International Nuclear Information System (INIS)

    Hauptfuhrer, R.R.

    1990-01-01

    The recent history of Oryx provides invaluable lessons for those who plan future energy strategies, relates the author of this paper. When Oryx became an independent oil and gas company, its reserves were declining, its stock was selling below asset values, and the price of oil seemed stuck below $15 per barrel. The message from Oryx management to Oryx employees was: We are in charge of our own destiny. We are about to create our own future. Oryx had developed a new, positive corporate culture and the corporate credit required for growth. This paper points to two basic principles that have guided the metamorphosis in Oryx's performance. The first objective was to improve operational efficiency and to identify the right performance indicators to measure this improvement. It states that the most critical performance indicator for an exploration and production company must be replacement and expansion of reserves at a competitive replacement cost. Oryx has cut its finding costs from $12 to $5 per barrel, while the BP acquisition provided proven reserves at a cost of only $4 per barrel. Another performance indicator measures Oryx's standing in the financial markets

  7. Development of a Grid-Independent Geos-Chem Chemical Transport Model (v9-02) as an Atmospheric Chemistry Module for Earth System Models

    Science.gov (United States)

    Long, M. S.; Yantosca, R.; Nielsen, J. E; Keller, C. A.; Da Silva, A.; Sulprizio, M. P.; Pawson, S.; Jacob, D. J.

    2015-01-01

    The GEOS-Chem global chemical transport model (CTM), used by a large atmospheric chemistry research community, has been re-engineered to also serve as an atmospheric chemistry module for Earth system models (ESMs). This was done using an Earth System Modeling Framework (ESMF) interface that operates independently of the GEOSChem scientific code, permitting the exact same GEOSChem code to be used as an ESM module or as a standalone CTM. In this manner, the continual stream of updates contributed by the CTM user community is automatically passed on to the ESM module, which remains state of science and referenced to the latest version of the standard GEOS-Chem CTM. A major step in this re-engineering was to make GEOS-Chem grid independent, i.e., capable of using any geophysical grid specified at run time. GEOS-Chem data sockets were also created for communication between modules and with external ESM code. The grid-independent, ESMF-compatible GEOS-Chem is now the standard version of the GEOS-Chem CTM. It has been implemented as an atmospheric chemistry module into the NASA GEOS- 5 ESM. The coupled GEOS-5-GEOS-Chem system was tested for scalability and performance with a tropospheric oxidant-aerosol simulation (120 coupled species, 66 transported tracers) using 48-240 cores and message-passing interface (MPI) distributed-memory parallelization. Numerical experiments demonstrate that the GEOS-Chem chemistry module scales efficiently for the number of cores tested, with no degradation as the number of cores increases. Although inclusion of atmospheric chemistry in ESMs is computationally expensive, the excellent scalability of the chemistry module means that the relative cost goes down with increasing number of cores in a massively parallel environment.

  8. A New Method for Treatment of Lymphedema of Limbs: Standardized Manual Massage with a New Device Linforoll in Conservative and Surgical Therapy Protocols.

    Science.gov (United States)

    Olszewski, Waldemar L; Zaleska, Marzanna; Michelin, Sandro

    2016-12-01

    Edema fluid in lymphedematous limbs should be evacuated to sites where it can be absorbed. It should be moved either to the hypogastrium or arm/scapular regions along tissue channels or implanted silicon channels or through lymphovenous anastomoses. For that purpose, the manual lymphatic drainage of limb is an effective method. Standardization of manual massage applied force and timing becomes necessary. A device with known pressing area and continuously showing the applied force while moving it toward the root of the limb is needed. Moreover, force could be adjusted to the stiffness of the massaged tissues that varies at different levels of the limb. Results from such a device would be repeatable and reproducible by others. In this study we present data on tissue fluid hydromechanics obtained from 20 patients with obstructive limb lymphedema during massage with a massaging roller called Linforoll. Linforoll is composed of a hand piece with roller and pressure sensor connected wireless to the computer displaying the pressure curve of the applied force. Electron microscopy studies for checking eventual tissue changes were done. Linforoll provides the possibilities of: 1) regulating the applied force according to the hydromechanic conditions of the massaged tissues; 2) standardization of massage repeatable in the same patient; 3) decrease of limb volume; 4) evident increase in tissue elasticity; 5) application as a driving force for fluid flow along the surgically implanted tubing and vessels running to the lymphovenous shunts.

  9. Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema

    Directory of Open Access Journals (Sweden)

    Lorraine T. Dean

    2016-01-01

    Full Text Available Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD. Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI 6 months from treatment in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (−0.26, p=0.89 nor BMI (0.22, p=0.10 was associated with ILD. Attending college (−4.89, p=0.03 was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p=0.01, >25% BCRL care adherence (4.10, p=0.01, and years since treatment (0.55, p<0.001. Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

  10. Probabilistic conditional independence structures

    CERN Document Server

    Studeny, Milan

    2005-01-01

    Probabilistic Conditional Independence Structures provides the mathematical description of probabilistic conditional independence structures; the author uses non-graphical methods of their description, and takes an algebraic approach.The monograph presents the methods of structural imsets and supermodular functions, and deals with independence implication and equivalence of structural imsets.Motivation, mathematical foundations and areas of application are included, and a rough overview of graphical methods is also given.In particular, the author has been careful to use suitable terminology, and presents the work so that it will be understood by both statisticians, and by researchers in artificial intelligence.The necessary elementary mathematical notions are recalled in an appendix.

  11. Disease: H00535 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00535 Lymphedemas, including: Lymphedema, hereditary I; Lymphedema-distichiasis s...yndrome; Hypotrichosis-lymphedema-telangiectasia syndrome (HLTS); Hennekam syndrome Lymphoedemas are develop... The dilated lymphatic channels that are not connected to the lymphatic vessels cause these edema...s. LD patients develop extra eyelashes, Hypotrichosis-lymphedema-telangiectasia syndrome (HL...TS) is associated with sparse hair and cutaneous telangiectasias, and Hennekam lymphangiectasia-lymphedema s

  12. Model-Independent Diffs

    DEFF Research Database (Denmark)

    Könemann, Patrick

    just contain a list of strings, one for each line, whereas the structure of models is defined by their meta models. There are tools available which are able to compute the diff between two models, e.g. RSA or EMF Compare. However, their diff is not model-independent, i.e. it refers to the models...

  13. All Those Independent Variables.

    Science.gov (United States)

    Meacham, Merle L.

    This paper presents a case study of a sixth grade remedial math class which illustrates the thesis that only the "experimental attitude," not the "experimental method," is appropriate in the classroom. The thesis is based on the fact that too many independent variables exist in a classroom situation to allow precise measurement. The case study…

  14. Bayesian Independent Component Analysis

    DEFF Research Database (Denmark)

    Winther, Ole; Petersen, Kaare Brandt

    2007-01-01

    In this paper we present an empirical Bayesian framework for independent component analysis. The framework provides estimates of the sources, the mixing matrix and the noise parameters, and is flexible with respect to choice of source prior and the number of sources and sensors. Inside the engine...

  15. Independent safety organization

    International Nuclear Information System (INIS)

    Kato, W.Y.; Weinstock, E.V.; Carew, J.F.; Cerbone, R.J.; Guppy, J.G.; Hall, R.E.; Taylor, J.H.

    1985-01-01

    Brookhaven National Laboratory has conducted a study on the need and feasibility of an independent organization to investigate significant safety events for the Office for Analysis and Evaluation of Operational Data, USNRC. The study consists of three parts: the need for an independent organization to investigate significant safety events, alternative organizations to conduct investigations, and legislative requirements. The determination of need was investigated by reviewing current NRC investigation practices, comparing aviation and nuclear industry practices, and interviewing a spectrum of representatives from the nuclear industry, the regulatory agency, and the public sector. The advantages and disadvantages of alternative independent organizations were studied, namely, an Office of Nuclear Safety headed by a director reporting to the Executive Director for Operations (EDO) of NRC; an Office of Nuclear Safety headed by a director reporting to the NRC Commissioners; a multi-member NTSB-type Nuclear Safety Board independent of the NRC. The costs associated with operating a Nuclear Safety Board were also included in the study. The legislative requirements, both new authority and changes to the existing NRC legislative authority, were studied. 134 references

  16. The Regulatory Independence of FANR

    International Nuclear Information System (INIS)

    ALNuaimi, Fatema; Choi, Kwang Shik

    2012-01-01

    Regulatory independence is meant to provide a conservative system of policy making in order to comply with the problems that are forecasted upon the basis of assumptions. The Federal Authorization of Nuclear Regulation (FANR) is a regulatory commission that was formed to be regulatory body that governs the generation of nuclear power in United Arab Emirates. It was established under the UAE nuclear law (9/2009) as an independent regulatory body that was tasked with the regulation of all nuclear activities in the United Arab Emirates. As an independent body, FANR was tasked with ensuring that the regulation of the nuclear sector is done in effective and transparent manner to ensure its accountability to the people. Being independent, the regulatory body develops national nuclear regulations based on laid down safety standards by the International Atomic Energy Agency, ensuring that they are based on scientific and proven technologies The role of FANR is to ensure that the all corporations that undertake nuclear activities follow the laid down procedures and objectives and ensure safety measures are taken keenly to ensure the safety of the workers and the general public while at the same time ensuring the environment is free from nuclear radiations

  17. The Regulatory Independence of FANR

    Energy Technology Data Exchange (ETDEWEB)

    ALNuaimi, Fatema; Choi, Kwang Shik [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Regulatory independence is meant to provide a conservative system of policy making in order to comply with the problems that are forecasted upon the basis of assumptions. The Federal Authorization of Nuclear Regulation (FANR) is a regulatory commission that was formed to be regulatory body that governs the generation of nuclear power in United Arab Emirates. It was established under the UAE nuclear law (9/2009) as an independent regulatory body that was tasked with the regulation of all nuclear activities in the United Arab Emirates. As an independent body, FANR was tasked with ensuring that the regulation of the nuclear sector is done in effective and transparent manner to ensure its accountability to the people. Being independent, the regulatory body develops national nuclear regulations based on laid down safety standards by the International Atomic Energy Agency, ensuring that they are based on scientific and proven technologies The role of FANR is to ensure that the all corporations that undertake nuclear activities follow the laid down procedures and objectives and ensure safety measures are taken keenly to ensure the safety of the workers and the general public while at the same time ensuring the environment is free from nuclear radiations

  18. The Effect of Yoga on Arm Volume, Strength, and Range of Motion in Women at Risk for Breast Cancer-Related Lymphedema.

    Science.gov (United States)

    Mazor, Melissa; Lee, Jeannette Q; Peled, Anne; Zerzan, Sarah; Irwin, Chetan; Chesney, Margaret A; Serrurier, Katherine; Sbitany, Hani; Dhruva, Anand; Sacks, Devorah; Smoot, Betty

    2018-02-01

    To assess the feasibility, safety, and initial estimates of efficacy of a yoga program in postoperative care for women at high risk for breast cancer-related lymphedema (BCRL). Single-group pretest-post-test design. Patients were recruited from the University of California, San Francisco Carol Franc Buck Breast Care Center. Twenty-one women were enrolled in the study. Women were >18 years of age, had undergone surgical treatment for breast cancer, and were at high risk for BCRL. The women participated in an Ashtanga yoga intervention for 8 weeks. Sessions consisted of once/week instructor-led practice and once/week home practice. Particular attention was given to poses that emphasized upper body strength and flexibility, while avoiding significant time with the upper extremity (UE) in a dependent position. UE volume was assessed through circumferential forearm measurement, which was converted to volume using the formula for a truncated cone. Range of motion (ROM) was assessed for the shoulders, elbows, and wrists, using a standard goniometer. UE strength was assessed for shoulder abduction, elbow flexion, wrist flexion, and grip using a dynamometer. Twenty women completed the yoga intervention, with 17 returning for final assessment. Mean age was 52 (±9.1) years and body mass index was 24.8 (±5.1) kg/m 2 . Postintervention, mean volume in the at-risk UE was slightly reduced (p = 0.397). ROM for shoulder flexion (p yoga is feasible and safe for women who are at risk for BCRL and may result in small improvements in shoulder ROM and UE strength.

  19. CD5−NK1.1+ γδ T Cells that Develop in a Bcl11b-Independent Manner Participate in Early Protection against Infection

    Directory of Open Access Journals (Sweden)

    Shinya Hatano

    2017-10-01

    Full Text Available Summary: We recently found that a unique subset of innate-like γδ T cells develops from the DN2a stage of the fetal thymus independently of the zinc-finger transcription factor B cell leukemia/lymphoma 11b (Bcl11b. Herein, we characterize these Bcl11b-independent γδ T cells in the periphery as CD5−NK1.1+ and Granzyme B+, and we show that they are capable of producing interferon (IFN-γ upon T cell receptor stimulation without Ca2+ influx. In wild-type mice, these cells were sparse in lymphoid tissues but abundant in non-lymphoid tissues, such as the liver. Bcl11b-independent CD5−NK1.1+ γδ T cells appeared and contributed to early protection before Bcl11b-dependent CD5+NK1.1− γδ T cells following Listeria monocytogenes infection, resembling their sequential appearance during development in the thymus. : Bcl11b is essential for transition from the DN2a to the DN2b stage in the thymus. Hatano et al. find that CD5−NK1.1+ γδ T cells develop from the DN2a stage in a Bcl11b-independent manner and participate in host defense at an early stage after bacterial infection in periphery. Keywords: innate immunity, γδ T cell, Bcl11b, DN2a, IFN-γ, Granzyme, IL-17A, host defense, bacteria, Listeria monocytogenes

  20. Calibration and Propagation of Uncertainty for Independence

    Energy Technology Data Exchange (ETDEWEB)

    Holland, Troy Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Kress, Joel David [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bhat, Kabekode Ghanasham [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-30

    This document reports on progress and methods for the calibration and uncertainty quantification of the Independence model developed at UT Austin. The Independence model is an advanced thermodynamic and process model framework for piperazine solutions as a high-performance CO2 capture solvent. Progress is presented in the framework of the CCSI standard basic data model inference framework. Recent work has largely focused on the thermodynamic submodels of Independence.

  1. Limitations in social anticipation are independent of imaginative and Theory of Mind abilities in children with autism but not in typically developing children.

    Science.gov (United States)

    Angus, Douglas Jozef; de Rosnay, Marc; Lunenburg, Patty; Meerum Terwogt, Mark; Begeer, Sander

    2015-07-01

    Anticipating future interactions is characteristic of our everyday social experiences, yet has received limited empirical attention. Little is known about how children with autism spectrum disorder, known for their limitations in social interactive skills, engage in social anticipation. We asked children with autism spectrum disorder and their typically developing counterparts to consider an interaction with another person in the near future. Our results suggest that children with autism spectrum disorder and typically developing children performed similarly when anticipating the age, gender, and possible questions of another person, but children with autism spectrum disorder struggled more to anticipate what they would say in response to an anticipated interaction. Furthermore, such responses were robustly associated with imaginative capacities in typically developing children but not children with autism spectrum disorder. Our findings suggest that the cognitive mechanisms of social anticipation may differ between these groups. © The Author(s) 2014.

  2. Plasmodium berghei Δp52&p36 parasites develop independent of a parasitophorous vacuole membrane in Huh-7 liver cells.

    Science.gov (United States)

    Ploemen, Ivo H J; Croes, Huib J; van Gemert, Geert-Jan J; Wijers-Rouw, Mietske; Hermsen, Cornelus C; Sauerwein, Robert W

    2012-01-01

    The proteins P52 and P36 are expressed in the sporozoite stage of the murine malaria parasite Plasmodium berghei. Δp52&p36 sporozoites lacking expression of both proteins are severely compromised in their capability to develop into liver stage parasites and abort development soon after invasion; presumably due to the absence of a parasitophorous vacuole membrane (PVM). However, a small proportion of P. berghei Δp52&p36 parasites is capable to fully mature in hepatocytes causing breakthrough blood stage infections. We have studied the maturation of replicating Δp52&p36 parasites in cultured Huh-7 hepatocytes. Approximately 50% of Δp52&p36 parasites developed inside the nucleus of the hepatocyte but did not complete maturation and failed to produce merosomes. In contrast cytosolic Δp52&p36 parasites were able to fully mature and produced infectious merozoites. These Δp52&p36 parasites developed into mature schizonts in the absence of an apparent parasitophorous vacuole membrane as shown by immunofluorescence and electron microscopy. Merozoites derived from these maturing Δp52&p36 liver stages were infectious for C57BL/6 mice.

  3. The Role of Independent Activities in Development of Strategic Learning Competences and Increase of School Performance Level, within the Study of High School Pedagogy

    Science.gov (United States)

    Anca, Monica-Iuliana; Bocos, Musata

    2017-01-01

    The experimental research performed by us with the purpose of exploring the possibilities of development of strategic learning competences and improvement of school performance of 11th grade students, pedagogical profile, specialisation in primary school-kindergarten teacher, falls in the category of researches aiming to make efficient certain…

  4. Quantum independent increment processes

    CERN Document Server

    Franz, Uwe

    2005-01-01

    This volume is the first of two volumes containing the revised and completed notes lectures given at the school "Quantum Independent Increment Processes: Structure and Applications to Physics". This school was held at the Alfried-Krupp-Wissenschaftskolleg in Greifswald during the period March 9 – 22, 2003, and supported by the Volkswagen Foundation. The school gave an introduction to current research on quantum independent increment processes aimed at graduate students and non-specialists working in classical and quantum probability, operator algebras, and mathematical physics. The present first volume contains the following lectures: "Lévy Processes in Euclidean Spaces and Groups" by David Applebaum, "Locally Compact Quantum Groups" by Johan Kustermans, "Quantum Stochastic Analysis" by J. Martin Lindsay, and "Dilations, Cocycles and Product Systems" by B.V. Rajarama Bhat.

  5. Quantum independent increment processes

    CERN Document Server

    Franz, Uwe

    2006-01-01

    This is the second of two volumes containing the revised and completed notes of lectures given at the school "Quantum Independent Increment Processes: Structure and Applications to Physics". This school was held at the Alfried-Krupp-Wissenschaftskolleg in Greifswald in March, 2003, and supported by the Volkswagen Foundation. The school gave an introduction to current research on quantum independent increment processes aimed at graduate students and non-specialists working in classical and quantum probability, operator algebras, and mathematical physics. The present second volume contains the following lectures: "Random Walks on Finite Quantum Groups" by Uwe Franz and Rolf Gohm, "Quantum Markov Processes and Applications in Physics" by Burkhard Kümmerer, Classical and Free Infinite Divisibility and Lévy Processes" by Ole E. Barndorff-Nielsen, Steen Thorbjornsen, and "Lévy Processes on Quantum Groups and Dual Groups" by Uwe Franz.

  6. Canada's resources and the national interest. A summary of a report by an independent task force on the crisis in the development of Canada's mining and petroleum resources

    Energy Technology Data Exchange (ETDEWEB)

    Brown, R D; Chapman, E P; Gander, J E; Manning, E C; Pallister, A E; Peters, D D; Thorssen, L A [Canada West Foundation

    1977-01-01

    This report summarizes almost two years of research and discussion concerning the fundamental problems facing Canada with respect to the development of its resource industries. The report expresses the concern of the members of the Task Force that, unless action is taken now, Canada will fail to secure the benefits that it should from the use of its national heritage of mineral and petroleum resources. The main report of the Task Force is accompanied by four major research studies, published as appendices to the main report and covering the broad subjects of the taxation of non-renewable resources, a survey of Canada's oil and gas resources, a survey of its other mineral resources, and a possible plan for the development of its oil and gas reserves in the coming decade. This booklet represents only a summary of the Report's main discussion and conclusions.

  7. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1991-01-01

    Recent industry trends indicate that the smaller US independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. It is usually accepted that foreign finding costs per barrel are substantially lower than domestic because of the large reserve potential of international plays. To get involved overseas requires, however, an adaptation to different cultural, financial, legal, operational, and political conditions. Generally foreign exploration proceeds at a slower pace than domestic because concessions are granted by the government, or are explored in partnership with the national oil company. First, a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company, must be prepared; it must be followed by an ongoing evaluation of quality prospects in various sedimentary basins, and a careful planning and conduct of the operations. To successfully explore overseas also requires the presence on the team of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work, having had a considerable amount of onsite experience in various geographical and climatic environments. Independents that are best suited for foreign expansion are those that have been financially successful domestically, and have a good discovery track record. When properly approached foreign exploration is well within the reach of smaller US independents and presents essentially no greater risk than domestic exploration; the reward, however, can be much larger and can catapult the company into the big leagues

  8. International exploration by independent

    International Nuclear Information System (INIS)

    Bertragne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. Foreign finding costs per barrel usually are accepted to be substantially lower than domestic costs because of the large reserve potential of international plays. To get involved in overseas exploration, however, requires the explorationist to adapt to different cultural, financial, legal, operational, and political conditions. Generally, foreign exploration proceeds at a slower pace than domestic exploration because concessions are granted by a country's government, or are explored in partnership with a national oil company. First, the explorationist must prepare a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company; next, is an ongoing evaluation of quality prospects in various sedimentary basins, and careful planning and conduct of the operations. To successfully explore overseas also requires the presence of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work. Ideally, these team members will have had a considerable amount of on-site experience in various countries and climates. Independents best suited for foreign expansion are those who have been financially successful in domestic exploration. When properly approached, foreign exploration is well within the reach of smaller U.S. independents, and presents essentially no greater risk than domestic exploration; however, the reward can be much larger and can catapult the company into the 'big leagues.'

  9. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. The problems of communications and logistics caused by different cultures and by geographic distances must be carefully evaluated. A mid-term to long-term strategy tailored to the goals and the financial capabilities of the company should be prepared and followed by a careful planning of the operations. This paper addresses some aspects of foreign exploration that should be considered before an independent venture into the foreign field. It also provides some guidelines for conducting successful overseas operations. When properly assessed, foreign exploration is well within the reach of smaller U.S. independents and presents no greater risk than domestic exploration; the rewards, however, can be much larger. Furthermore, the Oil and Gas Journal surveys of the 300 largest U.S. petroleum companies show that companies with a consistent foreign exploration policy have fared better financially during difficult times

  10. A definition of background independence

    International Nuclear Information System (INIS)

    Gryb, Sean

    2010-01-01

    We propose a definition for background (in)/dependence in dynamical theories of the evolution of configurations that have a continuous symmetry and test this definition on particle models and on gravity. Our definition draws from Barbour's best matching framework developed for the purpose of implementing spatial and temporal relationalism. Among other interesting theories, general relativity can be derived within this framework in novel ways. We study the detailed canonical structure of a wide range of best matching theories and show that their actions must have a local gauge symmetry. When gauge theory is derived in this way, we obtain at the same time a conceptual framework for distinguishing between background-dependent and -independent theories. Gauge invariant observables satisfying Kuchar's criterion are identified and, in simple cases, explicitly computed. We propose a procedure for inserting a global background time into temporally relational theories. Interestingly, using this procedure in general relativity leads to unimodular gravity.

  11. [Accreditation of Independent Ethics Committees].

    Science.gov (United States)

    Ramiro Avilés, Miguel A

    According to Law 14/2007 and Royal Decree 1090/2015, biomedical research must be assessed by an Research Ethics Committee (REC), which must be accredited as an Research ethics committee for clinical trials involving medicinal products (RECm) if the opinion is issued for a clinical trial involving medicinal products or clinical research with medical devices. The aim of this study is to ascertain how IEC and IECm accreditation is regulated. National and regional legislation governing biomedical research was analysed. No clearly-defined IEC or IECm accreditation procedures exist in the national or regional legislation. Independent Ethics Committees are vital for the development of basic or clinical biomedical research, and they must be accredited by an external body in order to safeguard their independence, multidisciplinary composition and review procedures. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Rates of oxygen uptake increase independently of changes in heart rate in late stages of development and at hatching in the green iguana, Iguana iguana.

    Science.gov (United States)

    Sartori, Marina R; Abe, Augusto S; Crossley, Dane A; Taylor, Edwin W

    2017-03-01

    Oxygen consumption (VO 2 ), heart rate (f H ), heart mass (M h ) and body mass (M b ) were measured during embryonic incubation and in hatchlings of green iguana (Iguana iguana). Mean f H and VO 2 were unvarying in early stage embryos. VO 2 increased exponentially during the later stages of embryonic development, doubling by the end of incubation, while f H was constant, resulting in a 2.7-fold increase in oxygen pulse. Compared to late stage embryos, the mean inactive level of VO 2 in hatchlings was 1.7 fold higher, while f H was reduced by half resulting in a further 3.6 fold increase in oxygen pulse. There was an overall negative correlation between mean f H and VO 2 when data from hatchlings was included. Thus, predicting metabolic rate as VO 2 from measurements of f H is not possible in embryonic reptiles. Convective transport of oxygen to supply metabolism during embryonic incubation was more reliably indicated as an index of cardiac output (CO i ) derived from the product of f H and M h . However, a thorough analysis of factors determining rates of oxygen supply during development and eclosion in reptiles will require cannulation of blood vessels that proved impossible in the present study, to determine oxygen carrying capacity by the blood and arteriovenous oxygen content difference (A-V diff), plus patterns of blood flow. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The C5a/C5aR1 axis controls the development of experimental allergic asthma independent of LysM-expressing pulmonary immune cells.

    Directory of Open Access Journals (Sweden)

    Anna V Wiese

    Full Text Available C5a regulates the development of maladaptive immune responses in allergic asthma mainly through the activation of C5a receptor 1 (C5aR1. Yet, the cell types and the mechanisms underlying this regulation are ill-defined. Recently, we described increased C5aR1 expression in lung tissue eosinophils but decreased expression in airway and pulmonary macrophages as well as in pulmonary CD11b+ conventional dendritic cells (cDCs and monocyte-derived DCs (moDCs during the allergic effector phase using a floxed green fluorescent protein (GFP-C5aR1 knock-in mouse. Here, we determined the role of C5aR1 signaling in neutrophils, moDCs and macrophages for the pulmonary recruitment of such cells and the importance of C5aR1-mediated activation of LysM-expressing cells for the development of allergic asthma. We used LysM-C5aR1 KO mice with a specific deletion of C5aR1 in LysMCre-expressing cells and confirmed the specific deletion of C5aR1 in neutrophils, macrophages and moDCs in the airways and/or the lung tissue. We found that alveolar macrophage numbers were significantly increased in LysM-C5aR1 KO mice. Induction of ovalbumin (OVA-driven experimental allergic asthma in GFP-C5aR1fl/fl and LysM-C5aR1 KO mice resulted in strong but similar airway resistance, mucus production and Th2/Th17 cytokine production. In contrast, the number of airway but not of pulmonary neutrophils was lower in LysM-C5aR1 KO as compared with GFP-C5aR1fl/fl mice. The recruitment of macrophages, cDCs, moDCs, T cells and type 2 innate lymphoid cells was not altered in LysM-C5aR1 KO mice. Our findings demonstrate that C5aR1 is critical for steady state control of alveolar macrophage numbers and the transition of neutrophils from the lung into the airways in OVA-driven allergic asthma. However, C5aR1 activation of LysM-expressing cells plays a surprisingly minor role in the recruitment and activation of such cells and the development of the allergic phenotype in OVA-driven experimental

  14. Development of a Micro-SPM (Scanning Probe Microscope by Post-Assembly of a MEMS-Stage and an Independent Cantilever

    Directory of Open Access Journals (Sweden)

    Zhi Li

    2007-08-01

    Full Text Available The development of miniature scanning probe microscopes (SPM on the basis of the MEMS technique has gained more and more interest. Here a novel approach is presented to realize a micro-SPM, in which by means of post-assembly a conventional cantilever is mounted onto a MEMS positioning stage and used to detect the topography variation of the surface under test. Compared with other integrated micro-SPMs, the proposed micro-SPM can maintain the lateral resolution by simply renewing its cantilever in use, and therefore features low cost, practicability and longer lifetime. Preliminary experimental results are reported, which demonstrate that the proposed microSPM can be realized.

  15. Independence in appearance

    DEFF Research Database (Denmark)

    Warming-Rasmussen, Bent; Quick, Reiner; Liempd, Dennis van

    2011-01-01

    In the wake of the financial crisis, the EU Commission has published a Green Paper on the future role of the audit function in Europe. The Green Paper lists a number of proposals for tighter rules for audits and auditors in order to contribute to stabilizing the financial system. The present...... article presents research contributions to the question whether the auditor is to continue to provide both audit and non-audit services (NAS) to an audit client. Research results show that this double function for the same audit client is a problem for stakeholders' confidence in auditor independence...

  16. How many Enrons? Mark-ups in the stated capital cost of independent power producers' (IPPs') power projects in developing countries

    International Nuclear Information System (INIS)

    Phadke, Amol

    2009-01-01

    I analyze the determinants of the stated capital cost of IPPs' power projects which significantly influences their price of power. I show that IPPs face a strong incentive to overstate their capital cost and argue that effective competition or regulatory scrutiny will limit the extent of the same. I analyze the stated capital costs of combined cycle gas turbine (CCGT) IPP projects in eight developing countries which became operational during 1990-2006 and find that the stated capital cost of projects selected without competitive bidding is 44-56% higher than those selected with competitive bidding, even after controlling for the effect of cost differences among projects. The extent to which the stated capital costs of projects selected without competitive bidding are higher compared those selected with competitive bidding, is a lower bound on the extent to which they are overstated. My results indicate the drawbacks associated with a policy of promoting private sector participation without an adequate focus on improving competition or regulation. (author)

  17. Physiotherapy treatments for breast cancer-related lymphedema: a literature review Tratamientos fisioterapéuticos para el linfedema después de la cirugía de cáncer de seno: una revisión de literatura Tratamentos fisioterapêuticos para o linfedema pós-câncer de mama: uma revisão de literatura

    Directory of Open Access Journals (Sweden)

    Nara Fernanda Braz da Silva Leal

    2009-10-01

    Full Text Available Breast cancer is the second most frequent cancer among women. Surgery is part of the therapeutic process to prevent metastases, but it can also cause some complications, including lymphedema. Physiotherapy contributes to its treatment, using different techniques that have been developed over the years. This systematic literature review aims to present physiotherapy modalities applied for lymphedema therapy. The literature review was conducted using textbooks and Lilacs, Pubmed and Scielo databases, from 1951 to 2009. Physiotherapy resources used for lymphedema treatment include complex decongestive therapy (CDT, pneumatic compression (PC, high voltage electrical stimulation (HVES and laser therapy. The analyzed literature shows that better results are obtained with combined techniques. CDT is the most used protocol, and its association with PC has demonstrated efficacy. The new techniques HVES and laser present satisfactory results.El cáncer de seno es el segundo tipo de cáncer más común entre las mujeres. La cirugía es parte del proceso terapéutico en la prevención de la diseminación de la enfermedad, sin embargo, puede ser causa de algunas complicaciones como el linfedema. La fisioterapia contribuye para su tratamiento con diferentes técnicas que vienen siendo desarrolladas a lo largo de los años. El objetivo de esta revisión sistemática de la literatura es presentar las modalidades fisioterapéuticas aplicadas en el tratamiento del linfedema. La revisión bibliográfica fue efectuada en libros textos y en las bases de datos LILACS, PubMed y SciELO, en el período de 1951 a 2009. Entre los recursos fisioterapéuticos utilizados en el tratamiento del linfedema están la terapia compleja descongestiva (TCD, compresión neumática (CN, estimulación eléctrica de alto voltaje (EVA y láserterapia. Los trabajos analizados muestran que los resultados son mejores con las técnicas combinadas. La TCD es el protocolo más utilizado, y su

  18. Development and characterization of a novel C-terminal inhibitor of Hsp90 in androgen dependent and independent prostate cancer cells

    International Nuclear Information System (INIS)

    Eskew, Jeffery D; Rajewski, Roger A; Blagg, Brian SJ; Manjarrez, Jacob R; Matts, Robert L; Holzbeierlein, Jeffrey M; Vielhauer, George A; Sadikot, Takrima; Morales, Pedro; Duren, Alicia; Dunwiddie, Irene; Swink, Megan; Zhang, Xiaoying; Hembruff, Stacey; Donnelly, Alison

    2011-01-01

    The molecular chaperone, heat shock protein 90 (Hsp90) has been shown to be overexpressed in a number of cancers, including prostate cancer, making it an important target for drug discovery. Unfortunately, results with N-terminal inhibitors from initial clinical trials have been disappointing, as toxicity and resistance resulting from induction of the heat shock response (HSR) has led to both scheduling and administration concerns. Therefore, Hsp90 inhibitors that do not induce the heat shock response represent a promising new direction for the treatment of prostate cancer. Herein, the development of a C-terminal Hsp90 inhibitor, KU174, is described, which demonstrates anti-cancer activity in prostate cancer cells in the absence of a HSR and describe a novel approach to characterize Hsp90 inhibition in cancer cells. PC3-MM2 and LNCaP-LN3 cells were used in both direct and indirect in vitro Hsp90 inhibition assays (DARTS, Surface Plasmon Resonance, co-immunoprecipitation, luciferase, Western blot, anti-proliferative, cytotoxicity and size exclusion chromatography) to characterize the effects of KU174 in prostate cancer cells. Pilot in vivo efficacy studies were also conducted with KU174 in PC3-MM2 xenograft studies. KU174 exhibits robust anti-proliferative and cytotoxic activity along with client protein degradation and disruption of Hsp90 native complexes without induction of a HSR. Furthermore, KU174 demonstrates direct binding to the Hsp90 protein and Hsp90 complexes in cancer cells. In addition, in pilot in-vivo proof-of-concept studies KU174 demonstrates efficacy at 75 mg/kg in a PC3-MM2 rat tumor model. Overall, these findings suggest C-terminal Hsp90 inhibitors have potential as therapeutic agents for the treatment of prostate cancer

  19. Development and characterization of a novel C-terminal inhibitor of Hsp90 in androgen dependent and independent prostate cancer cells

    Directory of Open Access Journals (Sweden)

    Eskew Jeffery D

    2011-10-01

    Full Text Available Abstract Background The molecular chaperone, heat shock protein 90 (Hsp90 has been shown to be overexpressed in a number of cancers, including prostate cancer, making it an important target for drug discovery. Unfortunately, results with N-terminal inhibitors from initial clinical trials have been disappointing, as toxicity and resistance resulting from induction of the heat shock response (HSR has led to both scheduling and administration concerns. Therefore, Hsp90 inhibitors that do not induce the heat shock response represent a promising new direction for the treatment of prostate cancer. Herein, the development of a C-terminal Hsp90 inhibitor, KU174, is described, which demonstrates anti-cancer activity in prostate cancer cells in the absence of a HSR and describe a novel approach to characterize Hsp90 inhibition in cancer cells. Methods PC3-MM2 and LNCaP-LN3 cells were used in both direct and indirect in vitro Hsp90 inhibition assays (DARTS, Surface Plasmon Resonance, co-immunoprecipitation, luciferase, Western blot, anti-proliferative, cytotoxicity and size exclusion chromatography to characterize the effects of KU174 in prostate cancer cells. Pilot in vivo efficacy studies were also conducted with KU174 in PC3-MM2 xenograft studies. Results KU174 exhibits robust anti-proliferative and cytotoxic activity along with client protein degradation and disruption of Hsp90 native complexes without induction of a HSR. Furthermore, KU174 demonstrates direct binding to the Hsp90 protein and Hsp90 complexes in cancer cells. In addition, in pilot in-vivo proof-of-concept studies KU174 demonstrates efficacy at 75 mg/kg in a PC3-MM2 rat tumor model. Conclusions Overall, these findings suggest C-terminal Hsp90 inhibitors have potential as therapeutic agents for the treatment of prostate cancer.

  20. Pengembangan Program Pemberdayaan Peningkatan Kemandirian Ibu Rumah Tangga Pengidap HIV (Studi Kasus pada Komunitas Women Empowerment (WE Surabaya Developing Empowerment Program to Enhancing Independency of Housewives with HIV (Case Study on Women Empow

    Directory of Open Access Journals (Sweden)

    Dewi Lestari

    2014-04-01

    Full Text Available Background: Empowerment program aims at improving the independency in social economic sector or psychology. Theresearch aims at formulating the development of empowerment program to improve the independency of the housewiveswith HIV. Method: The research is a qualitative and its design is an exploration research. The subjects of the researchare ten housewives with HIV, the members of Women Empowerment Community/WE Surabaya. Data collection uses indepth interview and Focus Group Discussion (FGD. Results: Research result shows that the subject character has noinfl uence on the kind of the desired empowerment program. The majority of problem lies on the aspect of social economyand the need for economic improvement. Innovation character which infl uences the adoption of empowerment programwhich is now WE developing is the relative advantage while social systems which effect is the friends who even prove tobe the agent of change. WE empowerment program has actually met the concept of empowerment program; it providesmembers with human resources, opportunity, knowledge as well as skill but it still unable to provide the result according tothe program goal. Recommendations: Government and NGO are expected to develop program according to the problem,need and the ability of the housewives with HIV in such a way that empowerment program improve their independencyparticularly in the sector of social economy.

  1. What is Happening with Independent System Operators?

    Energy Technology Data Exchange (ETDEWEB)

    Porter, K. L.

    1999-02-01

    Emerging independent system operators (ISOs) appear to have many advantages for the wind power industry. This paper compares some past research on wind and transmission issues with some of the developments in ISO design and implementation.

  2. RIPE [robot independent programming environment]: A robot independent programming environment

    International Nuclear Information System (INIS)

    Miller, D.J.; Lennox, R.C.

    1990-01-01

    Remote manual operations in radiation environments are typically performed very slowly. Sensor-based computer-controlled robots hold great promise for increasing the speed and safety of remote operations; however, the programming of robotic systems has proven to be expensive and difficult. Generalized approaches to robot programming that reuse available software modules and employ programming languages which are independent of the specific robotic and sensory devices being used are needed to speed software development and increase overall system reliability. This paper discusses the robot independent programming environment (RIPE) developed at Sandia National Laboratories (SNL). The RIPE is an object-oriented approach to robot system architectures; it is a software environment that facilitates rapid design and implementation of complex robot systems for diverse applications. An architecture based on hierarchies of distributed multiprocessors provides the computing platform for a layered programming structure that models applications using software objects. These objects are designed to support model-based automated programming of robotic and machining devices, real-time sensor-based control, error handling, and robust communication

  3. The importance of board independence

    NARCIS (Netherlands)

    Zijl, N.J.M.

    2012-01-01

    Although the attributed importance of board independence is high, a clear definition of independence does not exist. Furthermore, the aim and consequences of independence are the subject of discussion and empirical evidence about the impact of independence is weak and disputable. Despite this lack

  4. Autonomy, Independence, Inclusion

    Directory of Open Access Journals (Sweden)

    Filippo Angelucci

    2015-04-01

    Full Text Available The living environment must not only meet the primary needs of living, but also the expectations of improvement of life and social relations and people’s work. The need for a living environment that responds to the needs of users with their different abilities, outside of standardizations, is increasingly felt as autonomy, independence and well-being are the result of real usability and adaptability of the spaces. The project to improve the inclusivity of living space and to promote the rehabilitation of fragile users need to be characterized as an interdisciplinary process in which the integration of specialized contributions leads to adaptive customization of space solutions and technological that evolve with the changing needs, functional capacities and abilities of individuals.

  5. Independents' group posts loss

    International Nuclear Information System (INIS)

    Sanders, V.; Price, R.B.

    1992-01-01

    Low oil gas prices and special charges caused the group of 50 U.S. independent producers Oil and Gas Journal tracks to post a combined loss in first half 1992. The group logged a net loss of $53 million in the first half compared with net earnings of $354 million in first half 1991, when higher oil prices during the Persian Gulf crisis buoyed earnings in spite of crude oil and natural gas production declines. The combined loss in the first half follows a 45% drop in the group's earnings in 1991 and compares with the OGJ group of integrated oil companies whose first half 1992 income fell 47% from the prior year. Special charges, generally related to asset writedowns, accounted for most of the almost $560 million in losses posted by about the third of the group. Nerco Oil and Gas Inc., Vancouver, Wash., alone accounted for almost half that total with charges related to an asset writedown of $238 million in the first quarter. Despite the poor first half performance, the outlook is bright for sharply improved group earnings in the second half, assuming reasonably healthy oil and gas prices and increased production resulting from acquisitions and in response to those prices

  6. PPARγ-Independent Mechanism

    Directory of Open Access Journals (Sweden)

    Christopher M. Hogan

    2011-01-01

    Full Text Available Acute and chronic lung inflammation is associated with numerous important disease pathologies including asthma, chronic obstructive pulmonary disease and silicosis. Lung fibroblasts are a novel and important target of anti-inflammatory therapy, as they orchestrate, respond to, and amplify inflammatory cascades and are the key cell in the pathogenesis of lung fibrosis. Peroxisome proliferator-activated receptor gamma (PPARγ ligands are small molecules that induce anti-inflammatory responses in a variety of tissues. Here, we report for the first time that PPARγ ligands have potent anti-inflammatory effects on human lung fibroblasts. 2-cyano-3, 12-dioxoolean-1, 9-dien-28-oic acid (CDDO and 15-deoxy-Δ12,14-prostaglandin J2 (15d-PGJ2 inhibit production of the inflammatory mediators interleukin-6 (IL-6, monocyte chemoattractant protein-1 (MCP-1, COX-2, and prostaglandin (PGE2 in primary human lung fibroblasts stimulated with either IL-1β or silica. The anti-inflammatory properties of these molecules are not blocked by the PPARγ antagonist GW9662 and thus are largely PPARγ independent. However, they are dependent on the presence of an electrophilic carbon. CDDO and 15d-PGJ2, but not rosiglitazone, inhibited NF-κB activity. These results demonstrate that CDDO and 15d-PGJ2 are potent attenuators of proinflammatory responses in lung fibroblasts and suggest that these molecules should be explored as the basis for novel, targeted anti-inflammatory therapies in the lung and other organs.

  7. Commonwealth of (Independent States

    Directory of Open Access Journals (Sweden)

    Vrućinić Dušan

    2013-01-01

    Full Text Available Following the stages from the establishment itself to the present day of the functioning of such a specific regional organization as the Commonwealth of Independent States (CIS, the article seeks to further explain the meaning of its existence, efficiency and functioning. The CIS was created in order to make the dissolution of a major world super-power, which throughout the 20th century together with the USA defined the bipolar world, as painless as possible, especially for the new countries and its nationally and ethnically diverse population. During the early years after the dissolution of the USSR, the CIS played a major role in a more flexible and less severe dissolution of the Soviet empire, alleviating the consequences for its people. A more efficient functioning among the republics in all fields was also one of the tasks of the Commonwealth, to which it was devoted to the extent which was permitted by the then, not too favourable circumstances. Difficult years of economic crisis did not allow the CIS to mutually integrate its members as much as possible on the economy level. Thanks to the economic recovery of the post-Soviet states in the early 21st century, the Commonwealth has also been transformed, reformed, and renewed, and all this in order to achieve better and more fruitful cooperation between the members. The CIS may serve as a proper example of how the former Soviet Union states are inextricably linked by social, security-political, economic, cultural, communication-transport, and other ties, thanks to the centuries-long existence of the peoples of these states in this area, despite both internal and external factors which occasionally, but temporarily halt the post-Soviet integration. Mathematically expressed, the CIS members are naturally predisposed, to be reciprocally depended on each other, just as they also have the capacity for successful cooperation in the future times and epochs brought on by the modern world.

  8. Media independence and dividend policy

    DEFF Research Database (Denmark)

    Farooq, Omar; Dandoune, Salma

    2012-01-01

    independence and dividend policies in emerging markets. Using a dataset from twenty three emerging markets, we show a significantly negative relationship between dividend policies (payout ratio and decision to pay dividend) and media independence. We argue that independent media reduces information asymmetries...... for stock market participants. Consequently, stock market participants in emerging markets with more independent media do not demand as high and as much dividends as their counterparts in emerging markets with less independent media. We also show that press independence is more important in defining......Can media pressurize managers to disgorge excess cash to shareholders? Do firms in countries with more independent media follow different dividend policies than firms with less independent media? This paper seeks to answer these questions and aims to document the relationship between media...

  9. A randomized cross-over trial to detect differences in arm volume after low- and heavy-load resistance exercise among patients receiving adjuvant chemotherapy for breast cancer at risk for arm lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Hayes, Sandi; Adamsen, Lis

    2016-01-01

    changes after resistance exercise with heavy loads in this population. The purpose of this study is to determine acute changes in arm volume after a session of low- and heavy-load resistance exercise among women undergoing adjuvant chemotherapy for breast cancer at risk for arm lymphedema. METHODS....../DESIGN: This is a randomized cross-over trial. PARTICIPANTS: Women receiving adjuvant chemotherapy for breast cancer who have undergone axillary lymph node dissection will be recruited from rehabilitation centers in the Copenhagen area. INTERVENTION: Participants will be randomly assigned to engage in a low- (two sets of 15...... was calculated based on changes in L-Dex scores between baseline and 72-hours post exercise sessions. DISCUSSION: Findings from this study are relevant for exercise prescription guidelines, as well as recommendations regarding participating in activities of daily living for women following surgery for breast...

  10. Ergodic theory independence and dichotomies

    CERN Document Server

    Kerr, David

    2016-01-01

    This book provides an introduction to the ergodic theory and topological dynamics of actions of countable groups. It is organized around the theme of probabilistic and combinatorial independence, and highlights the complementary roles of the asymptotic and the perturbative in its comprehensive treatment of the core concepts of weak mixing, compactness, entropy, and amenability. The more advanced material includes Popa's cocycle superrigidity, the Furstenberg-Zimmer structure theorem, and sofic entropy. The structure of the book is designed to be flexible enough to serve a variety of readers. The discussion of dynamics is developed from scratch assuming some rudimentary functional analysis, measure theory, and topology, and parts of the text can be used as an introductory course. Researchers in ergodic theory and related areas will also find the book valuable as a reference.

  11. Hardware independence checkout software

    Science.gov (United States)

    Cameron, Barry W.; Helbig, H. R.

    1990-01-01

    ACSI has developed a program utilizing CLIPS to assess compliance with various programming standards. Essentially the program parses C code to extract the names of all function calls. These are asserted as CLIPS facts which also include information about line numbers, source file names, and called functions. Rules have been devised to establish functions called that have not been defined in any of the source parsed. These are compared against lists of standards (represented as facts) using rules that check intersections and/or unions of these. By piping the output into other processes the source is appropriately commented by generating and executing parsed scripts.

  12. CONTAIN independent peer review

    International Nuclear Information System (INIS)

    Boyack, B.E.; Corradini, M.L.; Khatib-Rahbar, M.; Loyalka, S.K.; Smith, P.N.

    1995-01-01

    The CONTAIN code was developed by Sandia National Laboratories under the sponsorship of the US Nuclear Regulatory Commission (NRC) to provide integrated analyses of containment phenomena. It is used to predict nuclear reactor containment loads, radiological source terms, and associated physical phenomena for a range of accident conditions encompassing both design-basis and severe accidents. The code's targeted applications include support for containment-related experimental programs, light water and advanced light water reactor plant analysis, and analytical support for resolution of specific technical issues such as direct containment heating. The NRC decided that a broad technical review of the code should be performed by technical experts to determine its overall technical adequacy. For this purpose, a six-member CONTAIN Peer Review Committee was organized and a peer review as conducted. While the review was in progress, the NRC issued a draft ''Revised Severe Accident Code Strategy'' that incorporated revised design objectives and targeted applications for the CONTAIN code. The committee continued its effort to develop findings relative to the original NRC statement of design objectives and targeted applications. However, the revised CONTAIN design objectives and targeted applications. However, the revised CONTAIN design objectives and targeted applications were considered by the Committee in assigning priorities to the Committee's recommendations. The Committee determined some improvements are warranted and provided recommendations in five code-related areas: (1) documentation, (2) user guidance, (3) modeling capability, (4) code assessment, and (5) technical assessment

  13. CONTAIN independent peer review

    Energy Technology Data Exchange (ETDEWEB)

    Boyack, B.E. [Los Alamos National Lab., NM (United States); Corradini, M.L. [Univ. of Wisconsin, Madison, WI (United States). Nuclear Engineering Dept.; Denning, R.S. [Battelle Memorial Inst., Columbus, OH (United States); Khatib-Rahbar, M. [Energy Research Inc., Rockville, MD (United States); Loyalka, S.K. [Univ. of Missouri, Columbia, MO (United States); Smith, P.N. [AEA Technology, Dorchester (United Kingdom). Winfrith Technology Center

    1995-01-01

    The CONTAIN code was developed by Sandia National Laboratories under the sponsorship of the US Nuclear Regulatory Commission (NRC) to provide integrated analyses of containment phenomena. It is used to predict nuclear reactor containment loads, radiological source terms, and associated physical phenomena for a range of accident conditions encompassing both design-basis and severe accidents. The code`s targeted applications include support for containment-related experimental programs, light water and advanced light water reactor plant analysis, and analytical support for resolution of specific technical issues such as direct containment heating. The NRC decided that a broad technical review of the code should be performed by technical experts to determine its overall technical adequacy. For this purpose, a six-member CONTAIN Peer Review Committee was organized and a peer review as conducted. While the review was in progress, the NRC issued a draft ``Revised Severe Accident Code Strategy`` that incorporated revised design objectives and targeted applications for the CONTAIN code. The committee continued its effort to develop findings relative to the original NRC statement of design objectives and targeted applications. However, the revised CONTAIN design objectives and targeted applications. However, the revised CONTAIN design objectives and targeted applications were considered by the Committee in assigning priorities to the Committee`s recommendations. The Committee determined some improvements are warranted and provided recommendations in five code-related areas: (1) documentation, (2) user guidance, (3) modeling capability, (4) code assessment, and (5) technical assessment.

  14. Between regulation and independence

    International Nuclear Information System (INIS)

    Ladoucette, Ph. de

    2007-01-01

    This article stresses, first, on the differences between electricity and gas in terms of storability and place of production before introducing the gas sector and its reorganization and re-structuration in the framework of energy markets deregulation. Then, it presents the actions carried out by the commission of energy regulation (CRE) intended to improve the operation of the gas market: improvement of transparency, incitation to invest in transportation infrastructures, organisation of the downstream market and development of regional gas markets. Since July 1, 2007, the opening of gas market is juridically and technically complete. The role of CRE is also to inform the consumers and to warrant a non-discriminatory access to infrastructures in a context of sound competition. On this point, the new situation is satisfactory but improvements are needed to increase the offer. The future objectives of CRE is to maintain a climate favorable to investments, to implement stable and efficient conditions of access to infrastructures and, finally, to regularly work at the European scale for the building up of a domestic gas market synonymous of security of supplies, sustainable development and competitiveness. (J.S.)

  15. Electric power statistics from independence to establishment

    International Nuclear Information System (INIS)

    1997-02-01

    This paper reports power statistics from independence to establishment pf KEPIC. It has the lists of electricity industry, electric equipment on the whole country power equipment at the independence and development of power facility, power generation about merit of power plants, demand according to types and use, power loss, charge for electric power distribution, power generation and generating cost, financial lists on income measurement and financing, meteorological phenomena and amount of rainfall electric power development, international statistics on major countries power generation and compare power rates with general price.

  16. Boards: Independent and Committed Directors?

    OpenAIRE

    Christophe Volonté

    2011-01-01

    Regulators, proxy advisors and shareholders are regularly calling for independent directors. However, at the same time, independent directors commonly engage in numerous outside activities potentially reducing their time and commitment with the particular firm. Using Tobin's Q as an approximation of market valuation and controlling for endogeneity, our empirical analysis reveals that neither is independence positively related to firm performance nor are outside activities negatively related t...

  17. Fuzzy AHP Analysis on Enterprises’ Independent Innovation Capability Evaluation

    Science.gov (United States)

    Zhu, Yu; Lei, Huai-ying

    Independent innovation has become a key factor in the rapid and healthy development of the enterprises. Therefore, an effective and reasonable comprehensive evaluation on the independent innovation capability of the businesses is especially important. This paper applies fuzzy AHP in the evaluation of the independent innovation capability of the businesses, and validates the rationality and feasibility of the evaluation methods and the indicators.

  18. Risk management for independent power projects

    International Nuclear Information System (INIS)

    Owen, J.L.

    1993-01-01

    Independent Power, where electric utilities or other bulk electric power users contract with individual electric power generation facilities to meet their projected long term power needs, has grown dramatically over the past ten years or more. This concept, to contract with Independent Power Producers (IPP), is not a new concept and in fact goes back to the early formation of the electric power industry in this country and worldwide. Successful Risk Management is the foundation for ultimate project completion and operation in fulfilling the expectations of all parties. The primary risks associated with the development of Independent Power projects include: predicting long term fuel availability and cost; predicting long term price for the deliverable of electricity; site selection, site characteristics and permitting; innovative or evolving technology; project execution (design and construction), and; lifetime O ampersand M costs and plant reliability. This paper focuses on the risks inherent in the development of IPPs and addresses the management of these risks

  19. A novel early risk assessment tool for detecting clinical outcomes in patients with heat-related illness (J-ERATO score: Development and validation in independent cohorts in Japan.

    Directory of Open Access Journals (Sweden)

    Kei Hayashida

    Full Text Available We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness.Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system.A total of 3,001 eligible patients were analyzed. There was no difference in variables between development and validation cohorts. Based on the result of a logistic regression model in the development phase (n = 1,805, the J-ERATO score was defined as the sum of the six binary components in the prehospital setting (respiratory rate≥22 /min, Glasgow coma scale0.2 by Hosmer-Lemeshow test. The observed proportion of hospital admission increased with increasing J-ERATO score (score = 0, 5.0%; score = 1, 15.0%; score = 2, 24.6%; score = 3, 38.6%; score = 4, 68.0%; score = 5, 85.2%; score = 6, 96.4%. Multivariate analyses showed that the J-ERATO score was an independent positive predictor of hospital admission (adjusted OR, 2.43; 95% CI, 2.06-2.87; P<0.001, intensive care unit (ICU admission (3.73; 2.95-4.72; P<0.001 and in-hospital mortality (1.65; 1.18-2.32; P = 0.004.The J-ERATO score is simply assessed and can facilitate the identification of patients with higher risk of heat-related hospitalization. This scoring system is also significantly associated with the higher likelihood of ICU admission and in-hospital mortality after heat-related hospitalization.

  20. On independence in risk communication

    International Nuclear Information System (INIS)

    Lacronique, J. F.

    2006-01-01

    The term 'independence' is a common key word used by almost all stake holders in the field of nuclear safety regulation. The intention is to persuade the public that it can have more confidence and trust in the persons in charge, if their competence and judgment cannot be altered by any kind of political issue or personal interest. However, it is possible to discuss the reality of this claimed quality: how is it possible to verify that the organization that claim 'independence' really respect it? National expertise Institutions can show that they are independent from the industry, but can they claim total independence from the government? NGO have build a large part of their constituency on 'independence' from industry and governments, but are they independent from the ideological forces -sometimes very powerful - that support them? How can we achieve to make this noble word really meaningful? We will show through different examples, that 'independence' is by definition a fragile and versatile challenge, rather than a durable label. It has to be refreshed regularly and thoroughly. Risk communication, in that context, must respect principles which will build independence as a solid asset, and keep a certain distance with mere marketing purposes or candid wishful thinking

  1. Problems Identifying Independent and Dependent Variables

    Science.gov (United States)

    Leatham, Keith R.

    2012-01-01

    This paper discusses one step from the scientific method--that of identifying independent and dependent variables--from both scientific and mathematical perspectives. It begins by analyzing an episode from a middle school mathematics classroom that illustrates the need for students and teachers alike to develop a robust understanding of…

  2. Comment on atomic independent-particle models

    International Nuclear Information System (INIS)

    Doda, D.D.; Gravey, R.H.; Green, A.E.S.

    1975-01-01

    The Hartree-Fock-Slater (HFS) independent-particle model in the form developed by Hermann and Skillman (HS) and the Green, Sellin, and Zachor (GSZ) analytic independent-particle model are being used for many types of applications of atomic theory to avoid cumbersome, albeit more rigorous, many-body calculations. The single-electron eigenvalues obtained with these models are examined and it is found that the GSZ model is capable of yielding energy eigenvalues for valence electrons which are substantially closer to experimental values than are the results of HS-HFS calculations. With the aid of an analytic representation of the equivalent HS-HFS screening function, the difficulty with this model is identified as a weakness of the potential in the neighborhood of the valence shell. Accurate representations of valence states are important in most atomic applications of the independent-particle model

  3. Logical independence and quantum randomness

    International Nuclear Information System (INIS)

    Paterek, T; Kofler, J; Aspelmeyer, M; Zeilinger, A; Brukner, C; Prevedel, R; Klimek, P

    2010-01-01

    We propose a link between logical independence and quantum physics. We demonstrate that quantum systems in the eigenstates of Pauli group operators are capable of encoding mathematical axioms and show that Pauli group quantum measurements are capable of revealing whether or not a given proposition is logically dependent on the axiomatic system. Whenever a mathematical proposition is logically independent of the axioms encoded in the measured state, the measurement associated with the proposition gives random outcomes. This allows for an experimental test of logical independence. Conversely, it also allows for an explanation of the probabilities of random outcomes observed in Pauli group measurements from logical independence without invoking quantum theory. The axiomatic systems we study can be completed and are therefore not subject to Goedel's incompleteness theorem.

  4. Logical independence and quantum randomness

    Energy Technology Data Exchange (ETDEWEB)

    Paterek, T; Kofler, J; Aspelmeyer, M; Zeilinger, A; Brukner, C [Institute for Quantum Optics and Quantum Information, Austrian Academy of Sciences, Boltzmanngasse 3, A-1090 Vienna (Austria); Prevedel, R; Klimek, P [Faculty of Physics, University of Vienna, Boltzmanngasse 5, A-1090 Vienna (Austria)], E-mail: tomasz.paterek@univie.ac.at

    2010-01-15

    We propose a link between logical independence and quantum physics. We demonstrate that quantum systems in the eigenstates of Pauli group operators are capable of encoding mathematical axioms and show that Pauli group quantum measurements are capable of revealing whether or not a given proposition is logically dependent on the axiomatic system. Whenever a mathematical proposition is logically independent of the axioms encoded in the measured state, the measurement associated with the proposition gives random outcomes. This allows for an experimental test of logical independence. Conversely, it also allows for an explanation of the probabilities of random outcomes observed in Pauli group measurements from logical independence without invoking quantum theory. The axiomatic systems we study can be completed and are therefore not subject to Goedel's incompleteness theorem.

  5. Algae: America's Pathway to Independence

    National Research Council Canada - National Science Library

    Custer, James

    2007-01-01

    .... Oil dependency is an unacceptable risk to U.S. national strategy. This paper advocates independence from foreign oil by converting the national transportation fleet to biodiesel derived from algae...

  6. Independent production and Poisson distribution

    International Nuclear Information System (INIS)

    Golokhvastov, A.I.

    1994-01-01

    The well-known statement of factorization of inclusive cross-sections in case of independent production of particles (or clusters, jets etc.) and the conclusion of Poisson distribution over their multiplicity arising from it do not follow from the probability theory in any way. Using accurately the theorem of the product of independent probabilities, quite different equations are obtained and no consequences relative to multiplicity distributions are obtained. 11 refs

  7. Designing platform independent mobile apps and services

    CERN Document Server

    Heckman, Rocky

    2016-01-01

    This book explains how to help create an innovative and future proof architecture for mobile apps by introducing practical approaches to increase the value and flexibility of their service layers and reduce their delivery time. Designing Platform Independent Mobile Apps and Services begins by describing the mobile computing landscape and previous attempts at cross platform development. Platform independent mobile technologies and development strategies are described in chapter two and three. Communication protocols, details of a recommended five layer architecture, service layers, and the data abstraction layer are also introduced in these chapters. Cross platform languages and multi-client development tools for the User Interface (UI) layer, as well as message processing patterns and message routing of the Service Int rface (SI) layer are explained in chapter four and five. Ways to design the service layer for mobile computing, using Command Query Responsibility Segregation (CQRS) and the Data Abstraction La...

  8. Innovative high-performance liquid chromatography method development for the screening of 19 antimalarial drugs based on a generic approach, using design of experiments, independent component analysis and design space.

    Science.gov (United States)

    Debrus, B; Lebrun, P; Kindenge, J Mbinze; Lecomte, F; Ceccato, A; Caliaro, G; Mbay, J Mavar Tayey; Boulanger, B; Marini, R D; Rozet, E; Hubert, Ph

    2011-08-05

    An innovative methodology based on design of experiments (DoE), independent component analysis (ICA) and design space (DS) was developed in previous works and was tested out with a mixture of 19 antimalarial drugs. This global LC method development methodology (i.e. DoE-ICA-DS) was used to optimize the separation of 19 antimalarial drugs to obtain a screening method. DoE-ICA-DS methodology is fully compliant with the current trend of quality by design. DoE was used to define the set of experiments to model the retention times at the beginning, the apex and the end of each peak. Furthermore, ICA was used to numerically separate coeluting peaks and estimate their unbiased retention times. Gradient time, temperature and pH were selected as the factors of a full factorial design. These retention times were modelled by stepwise multiple linear regressions. A recently introduced critical quality attribute, namely the separation criterion (S), was also used to assess the quality of separations rather than using the resolution. Furthermore, the resulting mathematical models were also studied from a chromatographic point of view to understand and investigate the chromatographic behaviour of each compound. Good adequacies were found between the mathematical models and the expected chromatographic behaviours predicted by chromatographic theory. Finally, focusing at quality risk management, the DS was computed as the multidimensional subspace where the probability for the separation criterion to lie in acceptance limits was higher than a defined quality level. The DS was computed propagating the prediction error from the modelled responses to the quality criterion using Monte Carlo simulations. DoE-ICA-DS allowed encountering optimal operating conditions to obtain a robust screening method for the 19 considered antimalarial drugs in the framework of the fight against counterfeit medicines. Moreover and only on the basis of the same data set, a dedicated method for the

  9. Food Independence of the Region

    Directory of Open Access Journals (Sweden)

    Vasiliy Vladimirovich Tyutyunik

    2016-06-01

    Full Text Available The article deals with such basic definitions as food security, food independence and food self- sufficiency of the region. The author shows the ambiguity problem of interpretations of these terms in the Russian legislation, which is especially evident in the transition from the national to the regional level. Using the example of legislative acts of some of the Russian Federation’s subjects the study demonstrates the incorrect use of mentioned terms. In author’s opinion, regional authorities in the Russian Federation must introduce amendments to the legislative documents concerning food security. To be more concrete, the regional authorities should either deny the goal of food independence for a particular region, or specify that the goal of reaching food independence for the region does not mean food self-sufficiency, but just import substitution on the regional level

  10. Independent technical review of the Pinellas Plant

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    This report documents an Independent Technical Review (ITR) of facilities, organizations, plans, activities and various other elements required to successfully transition the Pinellas Plant from Defense Program (DP) funded operation to either community developed reuse or safe deactivation leading to decontamination and decommissioning (D&D). The review was conducted at the request of the Department of Energy (DOE) Deputy Assistant Secretary for Facility Transition and Management (EM-60) and is a consensus of the nine member ITR Team.

  11. Bibliographic information interchange with data independence

    International Nuclear Information System (INIS)

    Macedo, L.F.P. de

    1980-01-01

    A technique for bibliographic information processing, at the standardized interchange format ISO 2709 or ANSI Z39.2, which allows to obtain programs with data independence is developed. A format definition language and manipulation commands which enable data storage and retrieval at the logical level are specified. With this technique it is possible to implement programs which can accept data from any information system, reducing, therefore, the requirements of a common bibliographic information interchange format. (Author) [pt

  12. Supplying safety and energy independence

    International Nuclear Information System (INIS)

    Maillard, D.

    2001-03-01

    The french Observatory of the Energy wonders about the energy independence notion. Many risks are possible: physical, economical, geo-political, social and ecological risks. Because those risks are numerous, the answers for a supplying safety are also numerous. In this context the energy policy is a difficult art which the public opinion needs to be more and more aware. (A.L.B.)

  13. Independent Study Project, Topic: Topology.

    Science.gov (United States)

    Notre Dame High School, Easton, PA.

    Using this guide and the four popular books noted in it, a student, working independently, will learn about some of the classical ideas and problems of topology: the Meobius strip and Klein bottle, the four color problem, genus of a surface, networks, Euler's formula, and the Jordan Curve Theorem. The unit culminates in a project of the students'…

  14. Charge independence and charge symmetry

    Energy Technology Data Exchange (ETDEWEB)

    Miller, G A [Washington Univ., Seattle, WA (United States). Dept. of Physics; van Oers, W T.H. [Manitoba Univ., Winnipeg, MB (Canada). Dept. of Physics; [TRIUMF, Vancouver, BC (Canada)

    1994-09-01

    Charge independence and charge symmetry are approximate symmetries of nature, violated by the perturbing effects of the mass difference between up and down quarks and by electromagnetic interactions. The observations of the symmetry breaking effects in nuclear and particle physics and the implications of those effects are reviewed. (author). 145 refs., 3 tabs., 11 figs.

  15. Charge independence and charge symmetry

    International Nuclear Information System (INIS)

    Miller, G.A.

    1994-09-01

    Charge independence and charge symmetry are approximate symmetries of nature, violated by the perturbing effects of the mass difference between up and down quarks and by electromagnetic interactions. The observations of the symmetry breaking effects in nuclear and particle physics and the implications of those effects are reviewed. (author). 145 refs., 3 tabs., 11 figs

  16. Characteristics of Independent Music Teachers

    Science.gov (United States)

    Upitis, Rena; Abrami, Philip C.; Brook, Julia; Boese, Karen; King, Matthew

    2017-01-01

    The purpose of the present study was to learn about the characteristics of independent music teachers, their beliefs about music teaching, and their studio practices. A self-report survey included questions about the teachers' (a) background experiences, (b) pedagogical approaches, (c) use of digital technologies, and (d) professional development…

  17. Central bank independence and conservatism under uncertainty: Substitutes or complements?

    OpenAIRE

    Hefeker, Carsten; Zimmer, Blandine

    2010-01-01

    The paper examines the optimal combination of central bank independence and conservatism in the presence of uncertain central bank preferences. We develop a model of endogenous monetary policy delegation in which government chooses the central bank's degree of inde-pendence and conservatism so as to minimise society's loss function. We find that the optimal combination between independence and conservatism is not necessarily characterised by substitutability. When uncertainty about the centra...

  18. Curriculum Development for Promoting Students' Life Management Skills related to their Independence at Social and Vocational Aspects in Special Support Classes of Lower Secondary School : Practice study of "the food processing" in the carrier management

    OpenAIRE

    Fujii, Tomoko; Wakamatsu, Akihiko

    2015-01-01

    I reconsidered the work learning to bring up life management skills aimed at the social and vocational independence of the students with the mental disabilities in special support class and newly conducted with educational practice based on the subject "carrier management". In this study, we took up the practice of "food processing" and analyzed the students' behavior and description by adapting an evaluation standard, which involved the point of view of the evaluation and basic, transferable...

  19. Management Technology of Students’ Independent Work

    Directory of Open Access Journals (Sweden)

    Melis K. Asanaliev

    2012-09-01

    Full Text Available The researchers are convinced that for an intensification of educational process in higher education institution it is necessary development of essentially new approaches, forms and the methods of social and pedagogical interaction adequate to new requirements, new pedagogical thinking. Among them we can choose the methods of social and psychological training (SPT which received their development in experimental psychology by synthesis of wide practical experience educational, creative, administrative, and other types of interrelation between people. These methods conditionally divide on: debatable (group discussion, analysis of a situation of a moral choice, game methods (didactic, creative, role-playing games, sensitive training (training of interpersonal sensitivity which are formations of independent informative activity of students on the basis of modern technologies, as the mechanism of improvement of independent work. Researches are expressed in search and finding enough effective forms and means of activation of educational and informative process of preparation of young teachers of vocational training, theoretically and practically prepared in the field of the independent informative activity, use the modern technology of training and its further realization in work with students of technical secondary. It is offered the model of the organization and application in educational process of the complex of these methods in contents complex of training programs of systems of tasks as one of ways of formation of social and psychological culture of future teacher.

  20. Recent experiences with independent power projects

    International Nuclear Information System (INIS)

    Kline, R.H.; Fitzowitch, J.R.; Dalla-Longa, L.

    1999-01-01

    New opportunities are making it possible to develop independent power projects involving partnerships with the electric power industry, and the petroleum and natural gas industry . This paper described those opportunities, the impediments and the risks involved. Mercury Electric Corp. has been involved in power projects at remote gas field and oil field sites where they use of a turbogenerator which runs on flare gas to generate electricity. TransCanada Power's involvement in independent power projects includes the supply and transport of gas and their ability to provide gas fired combined cycle technology. They are involved in a project at Hermiston, Oregon and also in a cogeneration project in Medicine Hat, Alberta. The CanCarb City of Medicine Hat project makes use of waste heat at an industrial facility. 11 figs

  1. Online Crowdfunding Campaign for an Independent Video Game

    OpenAIRE

    Kivikangas, Inessa

    2014-01-01

    Over the past several years online reward-model crowdfunding platforms have become a popular tool for raising funds among independent game developers. Big success of several brilliant indie titles brought to the online crowdfunding platforms Kickstarter and Indiegogo hundreds of hopeful independent developers. However, apart from creating an excellent game indie developers have to be able to reach out to their audience and capture attention of potential supporters and gaming media. Time and e...

  2. Independent regulatory authorities - a comparative study of European energy regulators

    International Nuclear Information System (INIS)

    Sander Johansen, K.; Holm Pedersen, L.; Moll Soerensen, E.

    2004-04-01

    Independent regulatory authorities are widely recommended as part of the institutional design of liberalised energy markets - not least by the European Commission. This report describes and compares the regulatory authorities for energy in the EU. Arguments for regulatory independence are presented and discussed, and an index is developed to measure the degree of conformance to theories of regulatory independence. It is established that the main pattern of variation is that countries, which formerly had strong state-owned companies, have chosen to create regulatory authorities at state level with many institutional safeguards for independence. (au)

  3. Financial Independence of Central Bank through the Balance Sheet Prism

    Directory of Open Access Journals (Sweden)

    Ivanović Valentina

    2014-05-01

    Full Text Available The main reason for central bank independence lies in the fact that it is necessary to clearly distinguish spending money from the ability of making money. Independence of central banks is now a characteristic of almost all developed and highly industrialized countries. In this respect, it represents an essential part of the overall economic reality of these countries. Over the past decade or somewhat earlier, the issue of importance of central bank independence has been raised in developing countries, making the institutional, functional, personal and financial independence of central banks current topics for consideration. The key reason for the growing attention to financial independence of central banks is due to the effects of the global financial crisis on their balance sheets and therefore the challenges related to achieving the basic goals of the functioning of central banks - financial stability and price stability.

  4. Independent EEG sources are dipolar.

    Directory of Open Access Journals (Sweden)

    Arnaud Delorme

    Full Text Available Independent component analysis (ICA and blind source separation (BSS methods are increasingly used to separate individual brain and non-brain source signals mixed by volume conduction in electroencephalographic (EEG and other electrophysiological recordings. We compared results of decomposing thirteen 71-channel human scalp EEG datasets by 22 ICA and BSS algorithms, assessing the pairwise mutual information (PMI in scalp channel pairs, the remaining PMI in component pairs, the overall mutual information reduction (MIR effected by each decomposition, and decomposition 'dipolarity' defined as the number of component scalp maps matching the projection of a single equivalent dipole with less than a given residual variance. The least well-performing algorithm was principal component analysis (PCA; best performing were AMICA and other likelihood/mutual information based ICA methods. Though these and other commonly-used decomposition methods returned many similar components, across 18 ICA/BSS algorithms mean dipolarity varied linearly with both MIR and with PMI remaining between the resulting component time courses, a result compatible with an interpretation of many maximally independent EEG components as being volume-conducted projections of partially-synchronous local cortical field activity within single compact cortical domains. To encourage further method comparisons, the data and software used to prepare the results have been made available (http://sccn.ucsd.edu/wiki/BSSComparison.

  5. Independent accident investigation: a modern safety tool

    International Nuclear Information System (INIS)

    Stoop, John A.

    2004-01-01

    Historically, safety has been subjected to a fragmented approach. In the past, every department has had its own responsibility towards safety, focusing either on working conditions, internal safety, external safety, rescue and emergency, public order or security. They each issued policy documents, which in their time were leading statements for elaboration and regulation. They also addressed safety issues with tools of various nature, often specifically developed within their domain. Due to a series of major accidents and disasters, the focus of attention is shifting from complying with quantitative risk standards towards intervention in primary operational processes, coping with systemic deficiencies and a more integrated assessment of safety in its societal context. In The Netherlands recognition of the importance of independent investigations has led to an expansion of this philosophy from the transport sector to other sectors. The philosophy now covers transport, industry, defense, natural disaster, environment and health and other major occurrences such as explosions, fires, and collapse of buildings or structures. In 2003 a multi-sector covering law will establish an independent safety board in The Netherlands. At a European level, mandatory investigation agencies are recognized as indispensable safety instruments for aviation, railways and the maritime sector, for which EU Directives are in place or being progressed [Transport accident and incident investigation in the European Union, European Transport Safety Council, ISBN 90-76024-10-3, Brussel, 2001]. Due to a series of major events, attention has been drawn to the consequences of disasters, highlighting the involvement of rescue and emergency services. They also have become subjected to investigative efforts, which in return, puts demands on investigation methodology. This paper comments on an evolutionary development in safety thinking and of safety boards, highlighting some consequences for strategic

  6. Enacting Risk in Independent Technological Innovation

    DEFF Research Database (Denmark)

    Berglund, Henrik; Hellström, Tomas

    2002-01-01

    The present study aims at investigating the role of risk in the activity of independent technological venturing. Altogether, 12 deep-interviews were conducted with technological entrepreneurs, who had taken part in the inventive, developmental and the commercialisation phases of a technology......-based innovation process. The interviews revealed a number of enactment approaches through which these innovators encountered and affected (dealt with or transformed) risk within the innovation process. Factors thus developed from the empirical material included human capital, pace and priority, the world moves...... for the benefit of innovation management....

  7. The Faroe Islands: Options for Independence

    Directory of Open Access Journals (Sweden)

    Maria Ackren

    2006-11-01

    Full Text Available The Faroe Islands are currently at a crossroads in their constitutional status. Discussions concerning changes in the current constitutional status are ongoing and several analyses about possible trajectories of future development are being proposed. Argued in a context of Faroese nationalism, this article tries to assess these trajectories in the future jurisdictional and political development of the Faroe Islands in terms of three possible scenarios: independence or full sovereignty (as is Iceland; a freely associated statehood (as are Niue and the Cook Islands in relation to New Zealand; or a confederation, probably involving changes at both the central level of the Danish state and the European Union level. This article argues that the most likely future development is that of a state in free association with Denmark. Meanwhile, island politics can change very quickly and the traditional cleavages in Faroese politics are liable to changing degrees of public support.

  8. On Judicial and Quasi-Judicial Independence

    NARCIS (Netherlands)

    Comtois, Suzanne; de Graaf, K.J.

    2013-01-01

    'Principles of judicial and quasi-judicial independence are fundamental to all democracies and yet, the notion of independence is still elusive. What is judicial and quasi-judicial independence and why is it important? From whom and what are the judiciary and other adjudicators to be independent? Is

  9. Worker flag. Independent Electrical Policy

    International Nuclear Information System (INIS)

    Bahen, D.

    2000-01-01

    This work analyses the initiative of privatization of the Mexican Electric Industry and also it is showed the incoherence of this mistaken proposal. Along the same line is analysed tthe situation of the National Electric Sector and the working process for the distinct types of electric generation just as the syndical and labor situations. In consequence it is proposed an Independent Electrical Policy, which includes the integration of the Nationalized Electric Industry, the syndical union and the Unique Collective Contract. The purpose of this work is to contribute to the success of the electrical and nuclear struggle always maintaining in rising position the red flag of the proletariat. The author considers that the privatization means mercantilization of the human necessities. The privatization is not inevitable at condition of to exercise consequently the political actions necessary through alternatives includes: the worker control of production, research, and the National Electric strike. (Author)

  10. Independent technical review of the Mound Plant

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    This report documents an Independent Technical Review (ITR) of the facilities, organizations, plans, and activities required to transition particular elements of the Mound Plant from Defense Program (DP) funded operation as appropriate either to community developed reuse or safe deactivation leading to decontamination and decommissioning (D&D). The review was conducted at the request of the Dr. Willis Bixby, Deputy Assistant Secretary, U.S. Department of Energy EM-60, Office of Facility Transition and Management and is a consensus of the nine member ITR Team. Information for the review was drawn from documents provided to the ITR Team by the Miamisburg Area Office (MB) of the DOE, EG&G, the City of Miamisburg, and others; and from presentations, discussions, interviews, and facility inspections at the Mound Plant during the weeks of March 14 and March 28, 1994. During the week of April 25, 1994, the ITR Team met at Los Alamos, New Mexico to develop consensus recommendations. A presentation of the core recommendations was made at the Mound Plant on May 5, 1994. This is an independent assessment of information available to, and used by, the Mound Plant personnel. Repetition of the information is not meant to imply discovery by the ITR Team. Team members, however, acting as independent reviewers, frequently assess the information from a perspective that differs significantly from that of the Mound Plant personnel. The report is based on information obtained and conditions observed during the March 1994 review interval. The ITR process and normal site work often initiate rapid, beneficial changes in understanding and organization immediately following the review. These changes frequently alter conditions observed during the review, but the report does not address changes subsequent to the review interval.

  11. Influência da fisioterapia complexa descongestiva associada à ingestão de triglicerídeos de cadeia média no tratamento do linfedema de membro superior Influence of complex descongestive physical therapy associated with intake of medium-chain triglycerides for treating upper-limb lymphedema

    Directory of Open Access Journals (Sweden)

    J Oliveira

    2008-02-01

    Full Text Available OBJETIVO: Verificar a influência da utilização da fisioterapia complexa descongestiva associada à dietoterapia com triglicerídeos de cadeia média (TCM como forma de intervenção no linfedema de membro superior (MS. MÉTODOS: Para a avaliação do linfedema, foram utilizadas cirtometria, volumetria, pregas cutâneas e quantidade de água corporal total. A Escala Visual Análoga (EVA foi utilizada para avaliar as sensações de desconforto, peso e dor no MS. Participaram deste estudo dez mulheres mastectomizadas com linfedema de MS homolateral à cirurgia, com idade média de 65,9 ± 10,4 anos e índice de massa corpórea (IMC de 26,8 ± 3,0kg/m² que, após avaliação nutricional, foram divididas aleatoriamente em dois grupos: Grupo Controle (n= 5, submetido ao tratamento fisioterapêutico constando da terapia complexa descongestiva (massagem clássica, drenagem linfática manual, bandagem compressiva e cuidados com a pele três vezes na semana, durante quatro semanas; Grupo TCM (n= 5, submetido ao mesmo protocolo fisioterapêutico somado ao tratamento dietético diário com ingestão de TCM, por quatro semanas. RESULTADOS: Ao final da intervenção, a análise da cirtometria e da volumetria mostraram diferenças significativas entre os grupos (OBJECTIVE: To investigate the influence of complex decongestive physical therapy (CDP in association with diet therapy using medium-chain triglycerides (MCT, as an intervention in cases of upper-limb lymphedema. METHODS: The lymphedema was evaluated by measuring circumferences, volumes, skin folds and whole-body water content. Feelings of discomfort, pain and heaviness in the arms were evaluated using a visual analog scale. Ten women who had undergone mastectomy and presented upper-limb lymphedema homolateral to the surgery participated in this study. Their mean age was 65.9 ± 10.4 years and their mean body mass index (BMI was 26.8 ± 3.0kg/m². After nutritional evaluation, they were randomly

  12. Dimension-independent likelihood-informed MCMC

    KAUST Repository

    Cui, Tiangang

    2015-10-08

    Many Bayesian inference problems require exploring the posterior distribution of high-dimensional parameters that represent the discretization of an underlying function. This work introduces a family of Markov chain Monte Carlo (MCMC) samplers that can adapt to the particular structure of a posterior distribution over functions. Two distinct lines of research intersect in the methods developed here. First, we introduce a general class of operator-weighted proposal distributions that are well defined on function space, such that the performance of the resulting MCMC samplers is independent of the discretization of the function. Second, by exploiting local Hessian information and any associated low-dimensional structure in the change from prior to posterior distributions, we develop an inhomogeneous discretization scheme for the Langevin stochastic differential equation that yields operator-weighted proposals adapted to the non-Gaussian structure of the posterior. The resulting dimension-independent and likelihood-informed (DILI) MCMC samplers may be useful for a large class of high-dimensional problems where the target probability measure has a density with respect to a Gaussian reference measure. Two nonlinear inverse problems are used to demonstrate the efficiency of these DILI samplers: an elliptic PDE coefficient inverse problem and path reconstruction in a conditioned diffusion.

  13. Dimension-independent likelihood-informed MCMC

    KAUST Repository

    Cui, Tiangang; Law, Kody; Marzouk, Youssef M.

    2015-01-01

    Many Bayesian inference problems require exploring the posterior distribution of high-dimensional parameters that represent the discretization of an underlying function. This work introduces a family of Markov chain Monte Carlo (MCMC) samplers that can adapt to the particular structure of a posterior distribution over functions. Two distinct lines of research intersect in the methods developed here. First, we introduce a general class of operator-weighted proposal distributions that are well defined on function space, such that the performance of the resulting MCMC samplers is independent of the discretization of the function. Second, by exploiting local Hessian information and any associated low-dimensional structure in the change from prior to posterior distributions, we develop an inhomogeneous discretization scheme for the Langevin stochastic differential equation that yields operator-weighted proposals adapted to the non-Gaussian structure of the posterior. The resulting dimension-independent and likelihood-informed (DILI) MCMC samplers may be useful for a large class of high-dimensional problems where the target probability measure has a density with respect to a Gaussian reference measure. Two nonlinear inverse problems are used to demonstrate the efficiency of these DILI samplers: an elliptic PDE coefficient inverse problem and path reconstruction in a conditioned diffusion.

  14. Baylor University and Midway Independent School District: An Exemplary Partnership

    Science.gov (United States)

    McCall, Madelon; Howell, Leanne; Rogers, Rachelle; Osborne, Lisa; Goree, Krystal; Merritt, Brent; Cox, Herb; Fischer, Jay; Gardner, Paula; Gasaway, Jeff

    2017-01-01

    The National Association of Professional Development Schools recognized the partnership between Baylor University and Midway Independent School District as one of three partnerships to receive the 2017 Award for Exemplary Professional Development School Achievement. This Professional Development School partnership began in 2009 and places the…

  15. Development of a selective and pH-independent method for the analysis of ultra trace amounts of nitrite in environmental water samples after dispersive magnetic solid phase extraction by spectrofluorimetry.

    Science.gov (United States)

    Daneshvar Tarigh, Ghazale; Shemirani, Farzaneh

    2014-10-01

    This paper describes an innovative and rapidly dispersive magnetic solid phase extraction spectrofluorimetry (DMSPE-FL) method for the analysis of trace amounts of nitrite in some environmental water samples. The method includes derivatization of aqueous nitrite with 2, 3-diaminonaphthalene (DAN), analysis of highly fluorescent 2, 3-naphthotriazole (NAT) derivative using spectrofluorimetry after DSPME. The novelty of our method is based on forming NAT that was independent with the pH-responsive and was adsorbed on MMWCNT by hydrophobic attractions in both acidic and basic media. The extraction efficiency of the sorbent was investigated by extraction of nitrite. The optimum extraction conditions for NO2(-) were obtained as of extraction time, 1.5 min; 10mg sorbent from 160 mL of the sample solution, and elution with 1 mL of acetone/KOH. Under the optimal conditions, the calibration curves were obtained in the range of 0.1-80 µg L(-1) (R(2)=0.999) and LOD (S/N=3) was obtained in 34 ng L(-1). Relative standard deviations (RSD) were 0.6 % (five replicates at 5 μg L(-1)). In addition, the feasibility of the method was demonstrated with extraction and determination of nitrite from some real samples containing tap, mineral, sea, rain, snow and ground waters, with the recovery in standard addition to real matrix of 94-102 % and RSDs of 1.8-10.6%. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Chandra Independently Determines Hubble Constant

    Science.gov (United States)

    2006-08-01

    A critically important number that specifies the expansion rate of the Universe, the so-called Hubble constant, has been independently determined using NASA's Chandra X-ray Observatory. This new value matches recent measurements using other methods and extends their validity to greater distances, thus allowing astronomers to probe earlier epochs in the evolution of the Universe. "The reason this result is so significant is that we need the Hubble constant to tell us the size of the Universe, its age, and how much matter it contains," said Max Bonamente from the University of Alabama in Huntsville and NASA's Marshall Space Flight Center (MSFC) in Huntsville, Ala., lead author on the paper describing the results. "Astronomers absolutely need to trust this number because we use it for countless calculations." Illustration of Sunyaev-Zeldovich Effect Illustration of Sunyaev-Zeldovich Effect The Hubble constant is calculated by measuring the speed at which objects are moving away from us and dividing by their distance. Most of the previous attempts to determine the Hubble constant have involved using a multi-step, or distance ladder, approach in which the distance to nearby galaxies is used as the basis for determining greater distances. The most common approach has been to use a well-studied type of pulsating star known as a Cepheid variable, in conjunction with more distant supernovae to trace distances across the Universe. Scientists using this method and observations from the Hubble Space Telescope were able to measure the Hubble constant to within 10%. However, only independent checks would give them the confidence they desired, considering that much of our understanding of the Universe hangs in the balance. Chandra X-ray Image of MACS J1149.5+223 Chandra X-ray Image of MACS J1149.5+223 By combining X-ray data from Chandra with radio observations of galaxy clusters, the team determined the distances to 38 galaxy clusters ranging from 1.4 billion to 9.3 billion

  17. Independent companies in the North Sea - exploration and operations opportunities

    International Nuclear Information System (INIS)

    Greentree, C.

    1992-01-01

    The North Sea was the launching pad for many independent oil companies, particularly through exploration success in the UK and the Netherlands. Norway has an excellent history of oil exploration but, for the independents, the onerous tax regime, long lead times, and terms of trade are simply not conducive to the higher rate of return demanded by shareholders of independent E and P companies in exchange for shouldering the heavy burden of risk. The UK in particular has pursued imaginative licensing, tax and legislative policies which have allowed the independents an opportunity to participate and grow. The attraction of the UK is clearly reflected by the constant arrival of new entrants, even at this stage of maturity. This was demonstrated in the recent round of license awards. Such has been the success of the independents in the UK that, beginning with virtually nothing, they now hold a net 28% of the UK North Sea acreage, and a net 25% of its oil reserves. Equally, the independents play an important role in ensuring the comprehensive exploration of the offshore areas. Because of size and significance, a prime objective of the independents will remain the early evaluation, through drilling, and development of offshore interests to generate a financial return. This paper addresses the question of how independent companies can expand in the North Sea when the size and quality of new range acreage available through new license awards is reducing. (author)

  18. The role of independent inspection in verification activities

    International Nuclear Information System (INIS)

    Fuerste, W.

    1982-01-01

    Independent inspection has its origin in the early Middle Ages, when kings prescribed to textile manufacturers a quality control by authorized inspectors. Independent inspection became more important with respect to the safety of workers in the industrial era begi