Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study.

Science.gov (United States)

Malacco, Ettore; Omboni, Stefano; Volpe, Massimo; Auteri, Alberto; Zanchetti, Alberto

2010-11-01

To compare the efficacy and safety of the angiotensin II antagonist olmesartan medoxomil (O) and the ACE inhibitor ramipril (R) in elderly patients with essential arterial hypertension. After a 2-week placebo wash-out 1102 treated or untreated elderly hypertensive patients aged 65-89 years (office sitting diastolic blood pressure, DBP, 90-109 mmHg and/or office sitting systolic blood pressure, SBP, 140-179 mmHg) were randomized double-blind to 12-week treatment with O 10 mg or R 2.5 mg once-daily. After the first 2 and 6 weeks doses could be doubled in non-normalized [blood pressure (BP) < 140/90 mmHg for nondiabetic and < 130/80 mmHg for diabetic) individuals, up to 40 mg for O and 10 mg for R. Office BPs were assessed at randomization, after 2, 6 and 12 weeks of treatment, whereas 24-h ambulatory BP was recorded at randomization and after 12 weeks. In the intention-to-treat population (542 patients O and 539 R) after 12 weeks of treatment baseline-adjusted office SBP and DBP reductions were greater (P < 0.01) with O [17.8 (95% confidence interval: 16.8/18.9) and 9.2 (8.6/9.8) mmHg] than with R [15.7 (14.7/16.8) and 7.7 (7.1/8.3) mmHg]. BP normalization rate was also greater under O (52.6 vs. 46.0% R, P < 0.05). In the subgroup of patients with valid ambulatory BP recording (318 O and 312 R) the reduction in 24-h average BP was larger (P < 0.05) with O [SBP: 11.0 (12.2/9.9) and DBP: 6.5 (7.2/5.8) mmHg] than with R [9.0 (10.2/7.9) and 5.4 (6.1/4.7) mmHg]. The larger blood pressure reduction obtained with O was particularly evident in the last 6 h from the dosing interval; a better homogeneity of the 24-h BP control with O was confirmed by higher smoothness indices. The proportion of patients with drug-related adverse events was comparable in the two groups (3.6 O vs. 3.6% R), as well as the number of patients discontinuing study drug because of a side effect (14 O vs. 19 R). In elderly patients with essential arterial hypertension O provides an effective, prolonged

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

Directory of Open Access Journals (Sweden)

Julia K Ostermann

Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

Science.gov (United States)

Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

2015-01-01

Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; phomeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

39 CFR 3050.41 - Treatment of additional financial reports.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Treatment of additional financial reports. 3050.41... Treatment of additional financial reports. (a) For purposes of the reports required by § 3050.40(a)(2), the... § 3050.40(c) is fairly stated in all material respects, either in relation to the basic financial...

A treatment of expansive soil using different additives

Directory of Open Access Journals (Sweden)

Bestun J. Nareeman

2010-11-01

Full Text Available There are many factors that govern the expansion behavior of soil. The primary factors are a change in water contentand the amount and type of clay size particles in the soil. Other important factors affecting the expansion behavior include the typeof soil (natural or fill, condition of the soil in terms of dry density and moisture content, magnitude of the surcharge pressure,and amount of no expansive material such as gravel or cobble size particles.In this paper, a swelling soil from the site Hamamuk earth dam, which is located in Koya town north of Iraq, is treated by fourtypes of additives; cement, steel fibers, gasoline fuel and injection by cement grout.The treatment of the expansive soil with 5 % of cement or steel fibers or the injection with cement grout revealed a betterimprovement while 4 % of gasoline oil is sufficient to reveal the optimum treatment by this material. The angle of internal friction is notaffected by the treatment while the cohesion between particles is slightly affected by these additives due to a change in the adhesionbetween the additive and soil particles.

New Nomenclatures for Heat Treatments of Additively Manufactured Titanium Alloys

Science.gov (United States)

Baker, Andrew H.; Collins, Peter C.; Williams, James C.

2017-07-01

The heat-treatment designations and microstructure nomenclatures for many structural metallic alloys were established for traditional metals processing, such as casting, hot rolling or forging. These terms do not necessarily apply for additively manufactured (i.e., three-dimensionally printed or "3D printed") metallic structures. The heat-treatment terminology for titanium alloys generally implies the heat-treatment temperatures and their sequence relative to a thermomechanical processing step (e.g., forging, rolling). These designations include: β-processing, α + β-processing, β-annealing, duplex annealing and mill annealing. Owing to the absence of a thermomechanical processing step, these traditional designations can pose a problem when titanium alloys are first produced via additive manufacturing, and then heat-treated. This communication proposes new nomenclatures for heat treatments of additively manufactured titanium alloys, and uses the distinct microstructural features to provide a correlation between traditional nomenclature and the proposed nomenclature.

Triiodothyronine addition to paroxetine in the treatment of major depressive disorder

NARCIS (Netherlands)

Appelhof, Bente C.; Brouwer, Jantien P.; van Dyck, Richard; Fliers, Eric; Hoogendijk, Witte J. G.; Huyser, Jochanan; Schene, Aart H.; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

2004-01-01

There is evidence that thyroid hormone T-3 increases serotonergic neurotransmission. Therefore, T-3 addition to antidepressants may improve treatment response in major depression. In nonrefractory depression, T-3 addition to tricyclic antidepressants indeed accelerates treatment response. Current

Impact of Age, Gender, and Addition of Probiotics on Treatment Success for Helicobacter pylori in Children

Directory of Open Access Journals (Sweden)

Noam Weiner MD

2015-10-01

Full Text Available The primary objective of this study was to evaluate the effect of age, gender, and the use of probiotics with standard treatment regimen on Helicobacter pylori eradication. Based on endoscopic findings and clinical presentation, selected patients were treated with standard triple therapy (omeprazole, clarithromycin, and amoxicillin. Those who failed were offered a repeat treatment with omeprazole, metronidazole, and amoxicillin. After the publications of the possible advantages of probiotic treatment on H pylori eradication, the probiotic agent “Probiotica Forte” was routinely added to the treatment. Eradication was noted for 94/130 patients (72% and for 128/197 patients (65% with or without probiotic agent, respectively (P = .23. For second-line treatment eradication was noted in 33/46 (72% and in 9/20 (45% with or without probiotic agent, respectively (P = .053. The addition of probiotics may improve eradication success especially in addition to second-line treatment.

Time limited psychodynamic group therapy: Predictors of patients seeking additional treatment

DEFF Research Database (Denmark)

Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

2010-01-01

for psychological or psychiatric problems; the percentage was 41.6 when further treatment was defined as participating in more than 5 sessions. The majority (94.8 was treated within the public health services. Participation in additional treatment was predicted by improvement on the MCMI Antisocial personality...... disorder scale and a higher SCL-90-R Somatization end-state score. When additional treatment was defined as receiving more than 5 sessions, lack of paid work before treatment (odds ratio 8.0), lack of social network support (odds ratio 2.9), and the Antisocial pre-post difference score (odds ratio 1...

Family-based treatment of eating disorders in adolescents: current insights

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Rienecke RD

2017-06-01

Full Text Available Renee D Rienecke1–3 1Department of Pediatrics, 2Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, 3Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA Abstract: Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment. Keywords: eating disorders, adolescents, family-based therapy, anorexia nervosa, bulimia nervosa

Split double factorial with additional treatment and the post-harvest of Niagara grapes

Directory of Open Access Journals (Sweden)

Pórtya Piscitelli Cavalcanti

2015-09-01

Full Text Available ABSTRACTThis study aims to discuss and explain how to deal with the analysis of experiments conducted in completely randomized design (CRD and subdivided into double factorial with additional treatment in the plot. In addition it was illustrate the discussion by analyzing data from an experiment on post-harvest of Niagara grapes. The sums of squares for each source of variation are presented, while discussing how the additional treatment affects the whole variation. Niagara grapes were treated in the pre-harvest with three preservatives (calcium chloride, calcium nitrate and calcium lactate at 0%, 0.5%, 1% and 2% and stored for 0, 10, 20 and 30 days.All the preservatives evaluated at 0% represented the control (additional treatment.

Laser-based additive manufacturing of metals

CSIR Research Space (South Africa)

Kumar, S

2010-11-01

Full Text Available For making metallic products through Additive Manufacturing (AM) processes, laser-based systems play very significant roles. Laser-based processes such as Selective Laser Melting (SLM) and Laser Engineered Net Shaping (LENS) are dominating processes...

The effect of postproduction heat treatment on γ-TiAl alloys produced by the GTAW-based additive manufacturing process

Energy Technology Data Exchange (ETDEWEB)

Ma, Yan; Cuiuri, Dominic; Li, Huijun; Pan, Zengxi, E-mail: zengxi@uow.edu.au; Shen, Chen

2016-03-07

Postproduction heat treatments were carried out on additively manufactured γ-TiAl alloys that were produced by using the gas tungsten arc welding (GTAW) process. The microstructural evolution and mechanical properties of both as-fabricated and heat-treated specimens were investigated to assess the effect of different heat treatment conditions, by using optical microscopy (OM), scanning electron microscopy (SEM), X-ray diffraction (XRD), Neutron Diffraction and tensile tests. The results indicated that heat treatment promotes the formation of the γ phase in the majority region after heat treatment at 1200 °C for 24 h, while a fully lamellar structure was formed in the near-substrate zone. The response to heat treatment at 1060 °C/24 h was markedly different, producing a fine lamellar structure with differing sizes in the majority region and near-substrate zone. These various microstructural characteristics determined the mechanical properties of the heat-treated samples. The heat-treated samples at 1200 °C/24 h exhibited lower UTS and microhardness values but higher ductility than the as-fabricated samples without heat treatment, while the 1060 °C/24 h heat treatment resulted in higher UTS and microhardness values but lower ductility. Due to the homogenous microstructure in the majority region after each postproduction heat treatment, the tensile properties were similar for both the build direction (Z) and travel direction (Y), thereby minimising the anisotropy that is exhibited by the as-fabricated alloy prior to heat treatment.

Coffee Flower Honey (Coffea sp. Addition to Kefir Quality Based on Microbiology Characteristic

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Astri Wulandari

2017-11-01

Full Text Available The Objective of this research was to determine the best concentration of addition coffee flower honey to kefir based on total plate count, lactic acid bacteria, acidity, and pH value. The materials used in this research were honey kefir made from cow’s milk, kefir grains, and coffee flowers honey. The method used in this research was experimental with Completely Randomized Design by 4 treatments and 4 replications and continued by using Duncan’s Multiple Range Test. The result showed that the effect of addition coffee flowers honey was not significantly different (P>0.05 on total plate count, lactic acid bacteria, acidity, give highly significant different (P<0.01 on pH value. Addition 20% of  coffee flower honey was the best treatment with quality of total plate count 6.21 ± 0.60 log CFU/mL, total lactic acid bacteria 6.16 ± 0.14 log CFU/mL, acidity 0.76 ± 0.11 % and pH value 3.596 ± 0.021. Further study is needed to figure the storability of honey kefir.

Efficacy of an amlodipine/olmesartan treatment algorithm in patients with or without type 2 diabetes and hypertension (a secondary analysis of the BP-CRUSH study).

Science.gov (United States)

Nesbitt, S D; Shojaee, A; Maa, J-F; Weir, M R

2013-07-01

A prespecified subgroup analysis of an open-label, multicenter, single-arm, dose-titration study is presented. The efficacy and safety of 20-week treatment with an amlodipine (AML)/olmesartan medoxomil (OM)±hydrochlorothiazide (HCTZ) algorithm were assessed in patients with hypertension and type 2 diabetes mellitus (T2DM) who were uncontrolled by antihypertensive monotherapy. Eligible patients received AML/OM 5/20 mg for 4 weeks, followed by stepwise uptitration to AML/OM 5/40 mg, AML/OM 10/40 mg, AML/OM 10/40 mg+HCTZ 12.5 mg and AML/OM 10/40 mg+HCTZ 25 mg at 4-week intervals if blood pressure (BP) remained uncontrolled. The primary end point was the achievement of the seated cuff systolic BP (SeSBP) goal (hypertension and T2DM.

An improvement of the base bleed unit on base drag reduction and heat energy addition as well as mass addition

International Nuclear Information System (INIS)

Xue, Xiaochun; Yu, Yonggang

2016-01-01

Highlights: • A 2D axisymmetric Navier-Stokes equation for a multi-component reactive system is solved. • The coupling of the internal and wake flow field with secondary combustion is calculated. • Detailed data with combined effects of boattailing and post-combustion are obtained. • The mechanism of heat energy addition and thermodynamics performances is investigated. - Abstract: Numerical simulations are carried out to investigate the base drag and energy characteristics of a base-bleed projectile with and without containing the effect of a post-combustion process for a boattailed afterbody in a supersonic flow, and then to analyze the key factor of drag reduction and pressure decreasing of base bleed projectile. Detailed chemistry models for H_2−CO combustion have been incorporated into a Navier-Stokes computer code and applied to flow field simulation in the base region of a base-bleed projectile. Detailed numerical results for the flow patterns and heat energy addition as well as mass addition for different conditions are presented and compared with existing experimental data. The results shows that, the post-combustion contributes to energy addition and base drag reduction up to 78% on account of that the heat energy released from the post-combustion using fuel-rich reaction products as the fuel in the wake region is much higher than for the corresponding cold bleed and hot bleed cases. In addition, the temperature distribution regularities are changed under post-combustion effect, presenting that the peak appears in a couple of recirculation regions. The fuel-rich bleed gas flows into the shear layer along the crack between these two recirculation regions and then those can readily burn when mixing with the freestream, thus causing component changes of H_2 and CO in the base flowfield.

Clinical control and histopathologic outcome of asthma when using airway hyperresponsiveness as an additional guide to long-term treatment. The AMPUL Study Group

NARCIS (Netherlands)

Sont, J. K.; Willems, L. N.; Bel, E. H.; van Krieken, J. H.; Vandenbroucke, J. P.; Sterk, P. J.

1999-01-01

According to international guidelines, the level and adjustment of antiinflammatory treatment for asthma are based solely on symptoms and lung function. We investigated whether a treatment strategy aimed at reducing airway hyperresponsiveness (AHR strategy) in addition to the recommendations in the

Adsorption of molecular additive onto lead halide perovskite surfaces: A computational study on Lewis base thiophene additive passivation

Science.gov (United States)

Zhang, Lei; Yu, Fengxi; Chen, Lihong; Li, Jingfa

2018-06-01

Organic additives, such as the Lewis base thiophene, have been successfully applied to passivate halide perovskite surfaces, improving the stability and properties of perovskite devices based on CH3NH3PbI3. Yet, the detailed nanostructure of the perovskite surface passivated by additives and the mechanisms of such passivation are not well understood. This study presents a nanoscopic view on the interfacial structure of an additive/perovskite interface, consisting of a Lewis base thiophene molecular additive and a lead halide perovskite surface substrate, providing insights on the mechanisms that molecular additives can passivate the halide perovskite surfaces and enhance the perovskite-based device performance. Molecular dynamics study on the interactions between water molecules and the perovskite surfaces passivated by the investigated additive reveal the effectiveness of employing the molecular additives to improve the stability of the halide perovskite materials. The additive/perovskite surface system is further probed via molecular engineering the perovskite surfaces. This study reveals the nanoscopic structure-property relationships of the halide perovskite surface passivated by molecular additives, which helps the fundamental understanding of the surface/interface engineering strategies for the development of halide perovskite based devices.

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation.

Science.gov (United States)

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-06-01

This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care.

Additional Treatments for High-Risk Obstetric Antiphospholipid Syndrome: a Comprehensive Review.

Science.gov (United States)

Ruffatti, Amelia; Hoxha, Ariela; Favaro, Maria; Tonello, Marta; Colpo, Anna; Cucchini, Umberto; Banzato, Alessandra; Pengo, Vittorio

2017-08-01

Most investigators currently advocate prophylactic-dose heparin plus low-dose aspirin as the preferred treatment of otherwise healthy women with obstetric antiphospholipid syndrome, whilst women with a history of vascular thrombosis alone or associated with pregnancy morbidity are usually treated with therapeutic heparin doses in association with low-dose aspirin in an attempt to prevent both thrombosis and pregnancy morbidity. However, the protocols outlined above fail in about 20 % of pregnant women with antiphospholipid syndrome. Identifying risk factors associated with pregnancy failure when conventional therapies are utilized is an important step in establishing guidelines to manage these high-risk patients. Some clinical and laboratory risk factors have been found to be related to maternal-foetal complications in pregnant women on conventional therapy. However, the most efficacious treatments to administer to high-risk antiphospholipid syndrome women in addition to conventional therapy in order to avoid pregnancy complications are as yet unestablished. This is a comprehensive review on this topic and an invitation to participate in a multicentre study in order to identify the best additional treatments to be used in this subset of antiphospholipid syndrome patients.

Laser-Based Additive Manufacturing of Zirconium

Directory of Open Access Journals (Sweden)

Himanshu Sahasrabudhe

2018-03-01

Full Text Available Additive manufacturing of zirconium is attempted using commercial Laser Engineered Net Shaping (LENSTM technique. A LENSTM-based approach towards processing coatings and bulk parts of zirconium, a reactive metal, aims to minimize the inconvenience of traditional metallurgical practices of handling and processing zirconium-based parts that are particularly suited to small volumes and one-of-a-kind parts. This is a single-step manufacturing approach for obtaining near net shape fabrication of components. In the current research, Zr metal powder was processed in the form of coating on Ti6Al4V alloy substrate. Scanning electron microscopy (SEM and energy dispersive spectroscopy (EDS as well as phase analysis via X-ray diffraction (XRD were studied on these coatings. In addition to coatings, bulk parts were also fabricated using LENS™ from Zr metal powders, and measured part accuracy.

Promotion of Crystal Growth on Biomass-based Carbon using Phosphoric Acid Treatments

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Liwei Yu

2015-02-01

Full Text Available The effect of phosphoric acid treatments on graphitic microcrystal growth of biomass-based carbons was investigated using X-ray diffraction, infrared spectroscopy, and Raman spectroscopy. Although biomass-based carbons are believed to be hard to graphitize even after heat treatments well beyond 2000 °C, we found that graphitic microcrystals of biomass-based carbons were significantly promoted by phosphoric acid treatments above 800 °C. Moreover, twisted spindle-like whiskers were formed on the surface of the carbons. This suggests that phosphorus-containing groups turn graphitic microcrystalline domains into graphite during phosphoric acid treatments. In addition, the porous texture of the phosphoric acid-treated carbon has the advantage of micropore development.

Review on effect of chemical, thermal, additive treatment on mechanical properties of basalt fiber and their composites

Science.gov (United States)

Jain, Naman; Singh, Vinay Kumar; Chauhan, Sakshi

2017-12-01

Basalt fiber is emerging out the new reinforcing material for composites. To overcome some of the disadvantages of fibers such as poor bonding to polymers, low thermal stability and high moisture absorption fiber characteristics are modified with chemical, thermal and additive treatments. Chemical treatment corrosive resistance to alkali and acid were investigated which were used to clean and modify the surface of fiber for higher bonding with resins. To improve the thermal stability and reduce moisture uptake thermal treatment such as plasma and non thermal plasma were used which increased the surface roughness and change the chemical composition of surface of basalt fiber. Additive treatment is used to improve the mechanical properties of fibers, in basalt fiber additive treatment was done with SiO2 additive because of its chemical composition which contains major content of SiO2. In present investigation review on the effect of different treatment such as chemical, thermal and additive were studied. Effect of these treatment on chemical composition of the surface of basalt fiber and corrosion to acidic and alkali solution were studied with their effect on mechanical properties of basalt fiber and their composite.

Quality assurance of treatment for personality disorders - a web based solution

DEFF Research Database (Denmark)

Simonsen, Sebastian; Lau, Marianne Engelbrecht

We present data on approximately 200 patients treated for personality disorder at Stolpegaard Psychotherapeutic Centre in Denmark. The personality disorder clinic offers mentalization based treatment primarily delivered in groups. Patients have either been assigned to a standardized, time...... restricted treatment package or have been treated in the regional treatment program where duration is longer and individual psychotherapy is delivered in addition to group therapy. Data on symptom severity and interpersonal problems have been collected pre and post treatment. We discuss the implications...

The development of additive manufacturing technique for nickel-base alloys: A review

Science.gov (United States)

Zadi-Maad, Ahmad; Basuki, Arif

2018-04-01

Nickel-base alloys are an attractive alloy due to its excellent mechanical properties, a high resistance to creep deformation, corrosion, and oxidation. However, it is a hard task to control performance when casting or forging for this material. In recent years, additive manufacturing (AM) process has been implemented to replace the conventional directional solidification process for the production of nickel-base alloys. Due to its potentially lower cost and flexibility manufacturing process, AM is considered as a substitute technique for the existing. This paper provides a comprehensive review of the previous work related to the AM techniques for Ni-base alloys while highlighting current challenges and methods to solving them. The properties of conventionally manufactured Ni-base alloys are also compared with the AM fabricated alloys. The mechanical properties obtained from tension, hardness and fatigue test are included, along with discussions of the effect of post-treatment process. Recommendations for further work are also provided.

Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?

Directory of Open Access Journals (Sweden)

Hetrick SE

2011-08-01

controlled trials have investigated interventions for treatment resistant depression in young people, and results from these show modest benefit from antidepressants with no additional benefit over medication from CBT. Overall, there is a lack of evidence about effective interventions to treat young people who have failed to respond to evidence-based interventions for depression. Research in this area is urgently required.Keywords: depressive disorder, treatment-resistant, adolescence, cognitive behavioral therapy, systematic review, meta-analysis 

Additivity of Feature-based and Symmetry-based Grouping Effects in Multiple Object Tracking

Directory of Open Access Journals (Sweden)

Chundi eWang

2016-05-01

Full Text Available Multiple object tracking (MOT is an attentional process wherein people track several moving targets among several distractors. Symmetry, an important indicator of regularity, is a general spatial pattern observed in natural and artificial scenes. According to the laws of perceptual organization proposed by Gestalt psychologists, regularity is a principle of perceptual grouping, such as similarity and closure. A great deal of research reported that feature-based similarity grouping (e.g., grouping based on color, size, or shape among targets in MOT tasks can improve tracking performance. However, no additive feature-based grouping effects have been reported where the tracking objects had two or more features. Additive effect refers to a greater grouping effect produced by grouping based on multiple cues instead of one cue. Can spatial symmetry produce a similar grouping effect similar to that of feature similarity in MOT tasks? Are the grouping effects based on symmetry and feature similarity additive? This study includes four experiments to address these questions. The results of Experiments 1 and 2 demonstrated the automatic symmetry-based grouping effects. More importantly, an additive grouping effect of symmetry and feature similarity was observed in Experiments 3 and 4. Our findings indicate that symmetry can produce an enhanced grouping effect in MOT and facilitate the grouping effect based on color or shape similarity. The where and what pathways might have played an important role in the additive grouping effect.

Kinetics of pulp mill effluent treatment by ozone-based processes

International Nuclear Information System (INIS)

Ko, Chun-Han; Hsieh, Po-Hung; Chang, Meng-Wen; Chern, Jia-Ming; Chiang, Shih-Min; Tzeng, Chewn-Jeng

2009-01-01

The wastewaters generated from wood pulping and paper production processes are traditionally treated by biological and physicochemical processes. In order to reduce chemical oxygen demand (COD) and color to meet increasingly strict discharge standards, advanced oxidation processes (AOPs) are being adapted as polishing treatment units. Various ozone-based processes were used in this study to treat simulated wastewaters prepared from black liquor from a hardwood Kraft pulp mill in Taiwan. The experimental results showed that the COD and color were primarily removed by direct ozone oxidation and activated carbon adsorption. While the addition of activated carbon could enhance the COD and color removal during ozonation, the addition of hydrogen peroxide improved the color removal only. For the various ozone-based treatment processes, kinetic models were developed to satisfactorily predict the COD and color removal rates. According to the kinetic parameters obtained from the various ozone-based processes, the enhanced COD and color removal of ozonation in the presence of activated carbon was attributed to the regeneration of the activated carbon by ozonation. These kinetic models can be used for reactor design and process design to treat pulping wastewater using ozone-based processes.

Additive manufacturing of Co-Cr-Mo alloy: Influence of heat treatment on microstructure, tribological and electrochemical properties

Directory of Open Access Journals (Sweden)

Kedar Mallik Mantrala

2015-03-01

Full Text Available Co-Cr-Mo alloy samples, fabricated using Laser Engineered Net Shaping – a laser based additive manufacturing technology, have been subjected heat treatment to study its influence on microstructure, wear and corrosion properties. Following L9 Orthogonal array of Taguchi method, the samples were solutionized at 1200oC for 30, 45 and 60 min followed by water quenching. Ageing treatment was done at 815oC and 830oC for 2, 4 and 6 h. Heat treated samples were evaluated for their microstructure, hardness, wear resistance and corrosion resistance. The results revealed that highest hardness of 512 ± 58 Hv and wear rate of 0.90 ± 0.14 × 10-4 mm3/N.m can be achieved with appropriate post-fabrication heat treatment. ANOVA and grey relational analysis on the experimental data revealed that the samples subjected to solution treatment for 60 min, without ageing, exhibit best combination of hardness, wear and corrosion resistance.

Web-based tool for visualization of electric field distribution in deep-seated body structures and planning of electroporation-based treatments.

Science.gov (United States)

Marčan, Marija; Pavliha, Denis; Kos, Bor; Forjanič, Tadeja; Miklavčič, Damijan

2015-01-01

Treatments based on electroporation are a new and promising approach to treating tumors, especially non-resectable ones. The success of the treatment is, however, heavily dependent on coverage of the entire tumor volume with a sufficiently high electric field. Ensuring complete coverage in the case of deep-seated tumors is not trivial and can in best way be ensured by patient-specific treatment planning. The basis of the treatment planning process consists of two complex tasks: medical image segmentation, and numerical modeling and optimization. In addition to previously developed segmentation algorithms for several tissues (human liver, hepatic vessels, bone tissue and canine brain) and the algorithms for numerical modeling and optimization of treatment parameters, we developed a web-based tool to facilitate the translation of the algorithms and their application in the clinic. The developed web-based tool automatically builds a 3D model of the target tissue from the medical images uploaded by the user and then uses this 3D model to optimize treatment parameters. The tool enables the user to validate the results of the automatic segmentation and make corrections if necessary before delivering the final treatment plan. Evaluation of the tool was performed by five independent experts from four different institutions. During the evaluation, we gathered data concerning user experience and measured performance times for different components of the tool. Both user reports and performance times show significant reduction in treatment-planning complexity and time-consumption from 1-2 days to a few hours. The presented web-based tool is intended to facilitate the treatment planning process and reduce the time needed for it. It is crucial for facilitating expansion of electroporation-based treatments in the clinic and ensuring reliable treatment for the patients. The additional value of the tool is the possibility of easy upgrade and integration of modules with new

Cost–Utility of Angiotensin-Converting Enzyme Inhibitor-Based Treatment Compared With Thiazide Diuretic-Based Treatment for Hypertension in Elderly Australians Considering Diabetes as Comorbidity

Science.gov (United States)

Chowdhury, Enayet K.; Ademi, Zanfina; Moss, John R.; Wing, Lindon M.H.; Reid, Christopher M.

2015-01-01

, the probability of being below AUD 50,000 was 85%. Although the dispensed price of diuretic-based treatment of hypertension in the elderly is lower, upon considering the potential enhanced likelihood of the development of diabetes in addition to the costs of treating cardiovascular disease, ACEI-based treatment may be a more cost-effective strategy in this population. PMID:25738481

Effect of Cr and Mn addition and heat treatment on AlSi3Mg casting alloy

Energy Technology Data Exchange (ETDEWEB)

Tocci, Marialaura, E-mail: m.tocci@unibs.it [Department of Mechanical and Industrial Engineering, University of Brescia, Via Branze 38, 25123 Brescia (Italy); Donnini, Riccardo, E-mail: riccardo.donnini@cnr.it [National Research Council of Italy (CNR), Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), Via R. Cozzi 53, 20125 Milan (Italy); Angella, Giuliano, E-mail: giuliano.angella@cnr.it [National Research Council of Italy (CNR), Institute of Condensed Matter Chemistry and Technologies for Energy (ICMATE), Via R. Cozzi 53, 20125 Milan (Italy); Pola, Annalisa, E-mail: annalisa.pola@unibs.it [Department of Mechanical and Industrial Engineering, University of Brescia, Via Branze 38, 25123 Brescia (Italy)

2017-01-15

In the present paper the effect of heat treatment on an AlSi3Mg alloy with and without Cr and Mn addition was investigated. Beside the well-known modification of the morphology of Fe-containing intermetallics, it was found that Cr and Mn allowed the formation of dispersoids in the aluminium matrix after solution heat treatment at 545 °C, as shown by scanning transmission electron microscope observations. These particles were responsible of the enhanced Vickers microhardness of the aluminium matrix in comparison with the base alloy after solution treatment and quenching, according to dispersion hardening mechanism. The presence of these particles was not affected by ageing treatment, which instead allowed the precipitation of β-Mg{sub 2}Si, as shown by the elaboration of differential scanning calorimeter curves. The formation of dispersoids and the study of their effect on mechanical properties can represent an interesting development for applications at high temperatures of casting alloys due to their thermal stability compared to other strengthening phases as β-Mg{sub 2}Si. - Highlights: •Cr and Mn successfully modified the morphology of Fe-containing intermetallics. •Cr- and Mn-dispersoids formed in the aluminium matrix during solution treatment. •Dispersion hardening was detected after solution treatment for Cr-containing alloy. •The dispersion hardening effect was maintained after ageing treatment.

Additive free thermoplastic vulcanizates based on natural rubber

Energy Technology Data Exchange (ETDEWEB)

Mondal, Manas, E-mail: mondal@ipfdd.de [Leibniz-Institut für Polymerforschung Dresden e.V., Institut für Polymerwerkstoffe, Hohe Straße 6, 01069 Dresden (Germany); Technische Universität Dresden, Institut für Werkstoffwissenschaft, 01069 Dresden (Germany); Gohs, Uwe, E-mail: gohs@ipfdd.de [Leibniz-Institut für Polymerforschung Dresden e.V., Institut für Polymerwerkstoffe, Hohe Straße 6, 01069 Dresden (Germany); Wagenknecht, Udo [Leibniz-Institut für Polymerforschung Dresden e.V., Institut für Polymerwerkstoffe, Hohe Straße 6, 01069 Dresden (Germany); Heinrich, Gert [Leibniz-Institut für Polymerforschung Dresden e.V., Institut für Polymerwerkstoffe, Hohe Straße 6, 01069 Dresden (Germany); Technische Universität Dresden, Institut für Werkstoffwissenschaft, 01069 Dresden (Germany)

2013-12-16

Electron induced reactive processing (EIReP) is an eco-friendly and sustainable reactive processing method based on the use of high energy electrons. It was used to cross-link the elastomeric domain phase during melt mixing in order to prepare natural rubber (NR) and polypropylene (PP) based thermoplastic vulcanizates (TPVs). The electron treatment with various values of absorbed dose showed a prominent effect on mechanical, rheological, and morphological characteristics of the PP/NR TPVs. SEM and TEM studies confirmed that these TPVs can exists across the co-continuous or discrete phase morphology. The maximum set of mechanical properties (tensile strength of 15 MPa and elongation at break of more than 500%) were obtained at an absorbed dose of 100 kGy for a 50/50 blend ratio of NR and PP without addition of any compatibilizer or chemicals. At higher values of absorbed dose the degradation of polypropylene showed a negative impact on the properties of the TPVs. Depending on the morphology and the evaluation of mechanical properties a structure–property co-relationship is drawn on the basis of common phenomenological understanding of the TPVs. - Highlights: • Dynamic vulcanization of 50:50 PP/NR blend by high energy electron beam. • PP/NR TPVs show rubber like behavior with melt processability. • High tensile strength of 15 MPa and large extensibility beyond 500%. • Complete phase inversed morphology from NR to PP matrix. • Vulcanized natural rubber particle size of 1–3 μm.

Effects of additional team-based learning on students' clinical reasoning skills: a pilot study.

Science.gov (United States)

Jost, Meike; Brüstle, Peter; Giesler, Marianne; Rijntjes, Michel; Brich, Jochen

2017-07-14

In the field of Neurology good clinical reasoning skills are essential for successful diagnosing and treatment. Team-based learning (TBL), an active learning and small group instructional strategy, is a promising method for fostering these skills. The aim of this pilot study was to examine the effects of a supplementary TBL-class on students' clinical decision-making skills. Fourth- and fifth-year medical students participated in this pilot study (static-group comparison design). The non-treatment group (n = 15) did not receive any additional training beyond regular teaching in the neurology course. The treatment group (n = 11) took part in a supplementary TBL-class optimized for teaching clinical reasoning in addition to the regular teaching in the neurology course. Clinical decision making skills were assessed using a key-feature problem examination. Factual and conceptual knowledge was assessed by a multiple-choice question examination. The TBL-group performed significantly better than the non-TBL-group (p = 0.026) in the key-feature problem examination. No significant differences between the results of the multiple-choice question examination of both groups were found. In this pilot study participants of a supplementary TBL-class significantly improved clinical decision-making skills, indicating that TBL may be an appropriate method for teaching clinical decision making in neurology. Further research is needed for replication in larger groups and other clinical fields.

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants.

Science.gov (United States)

Cox, Sophie C; Jamshidi, Parastoo; Eisenstein, Neil M; Webber, Mark A; Hassanin, Hany; Attallah, Moataz M; Shepherd, Duncan E T; Addison, Owen; Grover, Liam M

2016-07-01

Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p=0.01) improved the compressive strength (5.8±0.7MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6hour period (additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. Copyright © 2016 Elsevier B.V. All rights reserved.

Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data.

Science.gov (United States)

Laxy, Michael; Wilson, Edward C F; Boothby, Clare E; Griffin, Simon J

2017-12-01

There is uncertainty about the cost effectiveness of early intensive treatment versus routine care in individuals with type 2 diabetes detected by screening. To derive a trial-informed estimate of the incremental costs of intensive treatment as delivered in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Europe (ADDITION) trial and to revisit the long-term cost-effectiveness analysis from the perspective of the UK National Health Service. We analyzed the electronic primary care records of a subsample of the ADDITION-Cambridge trial cohort (n = 173). Unit costs of used primary care services were taken from the published literature. Incremental annual costs of intensive treatment versus routine care in years 1 to 5 after diagnosis were calculated using multilevel generalized linear models. We revisited the long-term cost-utility analyses for the ADDITION-UK trial cohort and reported results for ADDITION-Cambridge using the UK Prospective Diabetes Study Outcomes Model and the trial-informed cost estimates according to a previously developed evaluation framework. Incremental annual costs of intensive treatment over years 1 to 5 averaged £29.10 (standard error = £33.00) for consultations with general practitioners and nurses and £54.60 (standard error = £28.50) for metabolic and cardioprotective medication. For ADDITION-UK, over the 10-, 20-, and 30-year time horizon, adjusted incremental quality-adjusted life-years (QALYs) were 0.014, 0.043, and 0.048, and adjusted incremental costs were £1,021, £1,217, and £1,311, resulting in incremental cost-effectiveness ratios of £71,232/QALY, £28,444/QALY, and £27,549/QALY, respectively. Respective incremental cost-effectiveness ratios for ADDITION-Cambridge were slightly higher. The incremental costs of intensive treatment as delivered in the ADDITION-Cambridge trial were lower than expected. Given UK willingness-to-pay thresholds in patients with screen

Interest in web-based treatments for postpartum anxiety: an exploratory survey.

Science.gov (United States)

Ashford, Miriam T; Ayers, Susan; Olander, Ellinor K

2017-09-01

This study aimed to explore women's interest in web-based treatments for postpartum anxiety and determine the feasibility of reaching women with postpartum anxiety online. Anxiety in the postpartum period is common and often untreated. One innovative approach of offering treatment during this period is through web-based self-help. Assessing women's interest in new treatments, such as a web-based self-help, is an important step prior to development efforts. A cross-sectional online survey was created and promoted for 4 months via unpaid social media posts (Facebook and Twitter). To be eligible, women had to be over the age of 18, live in England, fluent in English, be within 12 months postpartum and self-report at least mild levels of anxiety. A sample of 114 eligible women were recruited. The majority were Caucasian, well-educated, middle-class women. Seventy percent reported moderate or severe anxiety. Sixty-one percent of women expressed interest in web-based postpartum anxiety treatments. Women preferred treatment in a smartphone/tablet application format, presented in brief modules and supported by a therapist via email or chat/instant messaging. Based on the stated preferences of participating women it is recommended that postpartum anxiety web-based treatments include different forms of therapist support and use a flexibly accessible smartphone/tablet application format with content split into short sections. The findings also suggest that unpaid social media can be feasible in reaching women with postpartum anxiety, but additional efforts are needed to reach a more diverse population.

Effect of water treatment additives on lime softening residual trace chemical composition--implications for disposal and reuse.

Science.gov (United States)

Cheng, Weizhi; Roessler, Justin; Blaisi, Nawaf I; Townsend, Timothy G

2014-12-01

Drinking water treatment residues (WTR) offer potential benefits when recycled through land application. The current guidance in Florida, US allows for unrestricted land application of lime softening WTR; alum and ferric WTR require additional evaluation of total and leachable concentrations of select trace metals prior to land application. In some cases a mixed WTR is produced when lime softening is accompanied by the addition of a coagulant or other treatment chemical; applicability of the current guidance is unclear. The objective of this research was to characterize the total and leachable chemical content of WTR from Florida facilities that utilize multiple treatment chemicals. Lime and mixed lime WTR samples were collected from 18 water treatment facilities in Florida. Total and leachable concentrations of the WTR were measured. To assess the potential for disposal of mixed WTR as clean fill below the water table, leaching tests were conducted at multiple liquid to solid ratios and under reducing conditions. The results were compared to risk-based soil and groundwater contamination thresholds. Total metal concentrations of WTR were found to be below Florida soil contaminant thresholds with Fe found in the highest abundance at a concentration of 3600 mg/kg-dry. Aluminum was the only element that exceeded the Florida groundwater contaminant thresholds using SPLP (95% UCL = 0.23 mg/L; risk threshold = 0.2 mg/L). Tests under reducing conditions showed elevated concentrations of Fe and Mn, ranging from 1 to 3 orders of magnitude higher than SPLP leachates. Mixed lime WTR concentrations (total and leachable) were lower than the ferric and alum WTR concentrations, supporting that mixed WTR are appropriately represented as lime WTR. Testing of WTR under reducing conditions demonstrated the potential for release of certain trace metals (Fe, Al, Mn) above applicable regulatory thresholds; additional evaluation is needed to assess management options where

Additional calcium carbonate into concentrate diet for sheep fed ensiled king grass as a based-diet

Directory of Open Access Journals (Sweden)

I-W Mathius

1997-10-01

Full Text Available In order to ascertain the effect of additional calcium carbonate into concentrate diet, on the performance of sheep fed ensiled king grass as a basal diet, a trial was conducted using 28 growing sheep ( average body weight 17 _+ 1 .4 kg. Based on body weight, the animals were grouped and randomized into four dietary treatments in block randomized design . Dietary treatments were (i chopped king grass + 400 g of concentrate, (ii ensiled king grass + 400 g concentrate + 0 % of calcium carbonate, (iii ensiled king grass + 400 g concentrate + 5 % calcium carbonate and (iv ensiled king grass + 400 g concentrate + 10 % calcium carbonate . Results showed that offering 5 % of calcium carbonate into concentrate diet increased (P 0 .05 for all groups . No differences in the apparent digestibility of the nutrient components were observed, but crude protein decreased significantly (P < 0 .05 . A significant relationship ( P < 0 .01 was found between nitrogen intake (NI and nitrogen retention (NR, and the equation was NR = - 0.1848 + 0.3788 NI ( r = 0.9 . Based on data found that feeding only ensiled king grass as a single diet could not meet the maintenance requirement of energy and protein, therefore, additional energy and crude protein sources is needed .

Large-scale Manufacturing of Nanoparticulate-based Lubrication Additives for Improved Energy Efficiency and Reduced Emissions

Energy Technology Data Exchange (ETDEWEB)

Erdemir, Ali [Argonne National Laboratory

2013-09-26

surfaces. It is believed that the formation of such slick and highly durable boundary films is perhaps one of the fundamental reasons for their superior anti-friction, -wear, and -scuffing performance. Boron-based additives developed under this project have shown potential to reduce or replace the uses of environmentally unsafe sulfur- and phosphorus-bearing anti-wear and friction additives, such as zinc dialkyl dithiophosphate (ZDDP) and molybdenum dialkyl dithiocarbamate (MoDTC), in current lubricating oils. Because ZDDP and MoDTC were suspected of adversely impacting the performance of after-treatment catalysts in current engines, the Environmental Protection Agency (EPA) and other regulatory agencies are demanding that the concentrations of these catalysts in current oils be curtailed drastically. The boron-based nano-additives developed in this project may help reduce the use of ZDDP and MoDTC additives and, hence, help ease the poisoning effects on after-treatment catalysts. When used as lubricity additives, these boron additives can chemically interact with sliding or contacting surfaces and form a protective and slick boundary film, which can, in turn, help reduce friction and wear and increase resistance to scuffing. In the cases of traditional anti-friction and -wear additives mentioned, such protective boundary films result from phosphorus, sulfur, and other elements in the additive package, and again they have been under increased scrutiny in recent years, mainly because of their adverse effects on after-treatment devices. Overall, the boron-based nano-additive technology of this project was shown to hold promise for a broad range of industrial and transportation applications where lower friction and higher resistance to wear and scuffing are needed. Due to more stringent operating conditions of modern machinery, rolling, rotating, and sliding components have been failing to meet the projected lifetimes, mainly because of failures related to mechanical wear

Evidence-based evaluation of treatment strategy for multiple sclerosis

Directory of Open Access Journals (Sweden)

LI Meng-qiu

2012-04-01

Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

Additives for cement compositions based on modified peat

Energy Technology Data Exchange (ETDEWEB)

Kopanitsa, Natalya, E-mail: kopanitsa@mail.ru; Sarkisov, Yurij, E-mail: sarkisov@tsuab.ru; Gorshkova, Aleksandra, E-mail: kasatkina.alexandra@gmail.com; Demyanenko, Olga, E-mail: angel-n@sibmail.com [Tomsk State University of Architecture and Building, 2, Solyanaya sq., Tomsk, 634003 (Russian Federation)

2016-01-15

High quality competitive dry building mixes require modifying additives for various purposes to be included in their composition. There is insufficient amount of quality additives having stable properties for controlling the properties of cement compositions produced in Russia. Using of foreign modifying additives leads to significant increasing of the final cost of the product. The cost of imported modifiers in the composition of the dry building mixes can be up to 90% of the material cost, depending on the composition complexity. Thus, the problem of import substitution becomes relevant, especially in recent years, due to difficult economic situation. The article discusses the possibility of using local raw materials as a basis for obtaining dry building mixtures components. The properties of organo-mineral additives for cement compositions based on thermally modified peat raw materials are studied. Studies of the structure and composition of the additives are carried out by physicochemical research methods: electron microscopy and X-ray analysis. Results of experimental research showed that the peat additives contribute to improving of cement-sand mortar strength and hydrophysical properties.

Heightening in efficiency of biological treatment by additives. Tenkazai ni yoru seibutsu shori no koritsuka

Energy Technology Data Exchange (ETDEWEB)

Ishikawa, M. (Fukui Institute of Technology, Fukui (Japan))

1991-11-01

The activated sludge process and other biological treatments, though utilized for most sewerage and drainage water disposals, often necessitate the maintenance to be managed with a professional knowledge so that confrontation is oftem impossible with trouble in management. In the present report, different basic studies are to be introduced of microbial activation by an addition with saponin. Saponin'', etymologically identical with savon'' and soap'', has been being used as natural cleaner, emulsifier and foamer in South America and Europe since olden times, and is used also for the processed food and potable water in the USA. The present experiment concluded that, in case of using it as microbial activator, the activated sludge can be considerably increased in load quantity of disposal by the heightening in oxygen-supplying power, high concentration microbial maintenance, microbial activation, etc. In the future, there will remain many problems unsolved such as what is the optimized condition for the addition depending upon the condition of base material. 3 refs., 6 figs., 1 tab.

Additive Manufacturing of Silicon Carbide-Based Ceramic Matrix Composites: Technical Challenges and Opportunities

Science.gov (United States)

Singh, Mrityunjay; Halbig, Michael C.; Grady, Joseph E.

2016-01-01

Advanced SiC-based ceramic matrix composites offer significant contributions toward reducing fuel burn and emissions by enabling high overall pressure ratio (OPR) of gas turbine engines and reducing or eliminating cooling air in the hot-section components, such as shrouds, combustor liners, vanes, and blades. Additive manufacturing (AM), which allows high value, custom designed parts layer by layer, has been demonstrated for metals and polymer matrix composites. However, there has been limited activity on additive manufacturing of ceramic matrix composites (CMCs). In this presentation, laminated object manufacturing (LOM), binder jet process, and 3-D printing approaches for developing ceramic composite materials are presented. For the laminated object manufacturing (LOM), fiber prepreg laminates were cut into shape with a laser and stacked to form the desired part followed by high temperature heat treatments. For the binder jet, processing optimization was pursued through silicon carbide powder blending, infiltration with and without SiC nano powder loading, and integration of fibers into the powder bed. Scanning electron microscopy was conducted along with XRD, TGA, and mechanical testing. Various technical challenges and opportunities for additive manufacturing of ceramics and CMCs will be presented.

Cationic polyacrylamide enhancing cellulase treatment efficiency of hardwood kraft-based dissolving pulp.

Science.gov (United States)

Wang, Qiang; Liu, Shanshan; Yang, Guihua; Chen, Jiachuan; Ni, Yonghao

2015-05-01

Cellulase treatment for decreasing viscosity and increasing Fock reactivity of dissolving pulp is a promising approach to reduce the use of toxic chemicals, such as hypochlorite in the dissolving pulp manufacturing process in the industry. Improving the cellulase treatment efficiency during the process is of practical interest. In the present study, the concept of using cationic polyacrylamide (CPAM) to enhance the cellulase treatment efficiency was demonstrated. This was mainly attributed to the increased cellulase adsorption onto cellulose fibers based on the patching/bridging mechanism. Results showed that the cellulase adsorption was increased by about 20% with the addition of 250 ppm of CPAM under the same conditions as those of the control. It was found that the viscosity decrease and Fock reactivity increase for the cellulase treatment was enhanced from using CPAM. The CPAM-assisted cellulase treatment concept may provide a practical alternative to the present hypochlorite-based technology for viscosity control in the industry. Copyright © 2015 Elsevier Ltd. All rights reserved.

Behavior Therapy for Tic Disorders: An Evidenced-based Review and New Directions for Treatment Research

OpenAIRE

McGuire, Joseph F.; Ricketts, Emily J.; Piacentini, John; Murphy, Tanya K.; Storch, Eric A.; Lewin, Adam B.

2015-01-01

Behavior therapy is an evidenced-based intervention with moderate-to-large treatment effects in reducing tic symptom severity among individuals with Persistent Tic Disorders (PTDs) and Tourette’s Disorder (TD). This review describes the behavioral treatment model for tics, delineates components of evidence-based behavior therapy for tics, and reviews the empirical support among randomized controlled trials for individuals with PTDs or TD. Additionally, this review discusses several challenges...

Is addition of sodium fluoride to cyclical etidronate beneficial in the treatment of corticosteroid induced osteoporosis?

NARCIS (Netherlands)

Lems, W. F.; Jacobs, J. W.; Bijlsma, J. W.; van Veen, G. J.; Houben, H. H.; Haanen, H. C.; Gerrits, M. I.; van Rijn, H. J.

1997-01-01

To investigate whether administration of sodium fluoride (NaF) in addition to cyclical etidronate has a positive effect on bone mineral density (BMD) in patients with established osteoporosis during continued treatment with corticosteroids. 47 patients who were receiving treatment with

Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: a nationwide study.

Science.gov (United States)

Wu, Wen-Pyng; Lai, Ming-Nan; Lin, Ching-Heng; Li, Yu-Fen; Lin, Ching-Yuang; Wu, Ming-Ju

2014-01-01

Paraquat poisoning associates very high mortality rate. Early treatment with hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST) in combination with hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with hemoperfusion and the additional effects of IST combined with hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, Ppoisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age.

78 FR 14508 - Notice of Affirmation of Addition of a Treatment Schedule for Methyl Bromide Fumigation of...

Science.gov (United States)

2013-03-06

... contacting the Animal and Plant Health Inspection Service, Plant Protection and Quarantine, Manuals Unit, 92... the Plant Protection and Quarantine Treatment Manual a treatment schedule for methyl bromide..., 2013, we are affirming the addition to the Plant Protection and Quarantine Treatment Manual of the...

Electroporation-based treatment planning for deep-seated tumors based on automatic liver segmentation of MRI images.

Science.gov (United States)

Pavliha, Denis; Mušič, Maja M; Serša, Gregor; Miklavčič, Damijan

2013-01-01

Electroporation is the phenomenon that occurs when a cell is exposed to a high electric field, which causes transient cell membrane permeabilization. A paramount electroporation-based application is electrochemotherapy, which is performed by delivering high-voltage electric pulses that enable the chemotherapeutic drug to more effectively destroy the tumor cells. Electrochemotherapy can be used for treating deep-seated metastases (e.g. in the liver, bone, brain, soft tissue) using variable-geometry long-needle electrodes. To treat deep-seated tumors, patient-specific treatment planning of the electroporation-based treatment is required. Treatment planning is based on generating a 3D model of the organ and target tissue subject to electroporation (i.e. tumor nodules). The generation of the 3D model is done by segmentation algorithms. We implemented and evaluated three automatic liver segmentation algorithms: region growing, adaptive threshold, and active contours (snakes). The algorithms were optimized using a seven-case dataset manually segmented by the radiologist as a training set, and finally validated using an additional four-case dataset that was previously not included in the optimization dataset. The presented results demonstrate that patient's medical images that were not included in the training set can be successfully segmented using our three algorithms. Besides electroporation-based treatments, these algorithms can be used in applications where automatic liver segmentation is required.

Biocompatibility of hydroxyapatite scaffolds processed by lithography-based additive manufacturing.

Science.gov (United States)

Tesavibul, Passakorn; Chantaweroad, Surapol; Laohaprapanon, Apinya; Channasanon, Somruethai; Uppanan, Paweena; Tanodekaew, Siriporn; Chalermkarnnon, Prasert; Sitthiseripratip, Kriskrai

2015-01-01

The fabrication of hydroxyapatite scaffolds for bone tissue engineering applications by using lithography-based additive manufacturing techniques has been introduced due to the abilities to control porous structures with suitable resolutions. In this research, the use of hydroxyapatite cellular structures, which are processed by lithography-based additive manufacturing machine, as a bone tissue engineering scaffold was investigated. The utilization of digital light processing system for additive manufacturing machine in laboratory scale was performed in order to fabricate the hydroxyapatite scaffold, of which biocompatibilities were eventually evaluated by direct contact and cell-culturing tests. In addition, the density and compressive strength of the scaffolds were also characterized. The results show that the hydroxyapatite scaffold at 77% of porosity with 91% of theoretical density and 0.36 MPa of the compressive strength are able to be processed. In comparison with a conventionally sintered hydroxyapatite, the scaffold did not present any cytotoxic signs while the viability of cells at 95.1% was reported. After 14 days of cell-culturing tests, the scaffold was able to be attached by pre-osteoblasts (MC3T3-E1) leading to cell proliferation and differentiation. The hydroxyapatite scaffold for bone tissue engineering was able to be processed by the lithography-based additive manufacturing machine while the biocompatibilities were also confirmed.

Nanotechnology and nanocarrier-based approaches on treatment of degenerative diseases

Science.gov (United States)

Chowdhury, Anindita; Kunjiappan, Selvaraj; Panneerselvam, Theivendren; Somasundaram, Balasubramanian; Bhattacharjee, Chiranjib

2017-04-01

Degenerative diseases are results of deterioration of cells and tissues with aging either by unhealthy lifestyle or normal senescence. The degenerative disease likely affects central nervous system and cardiovascular system to a great extent. Certain medications and therapies have emerged for the treatment of degenerative diseases, but in most cases bearing with poor solubility, lower bioavailability, drug resistance, and incapability to cross the blood-brain barrier (BBB). Hence, it has to be overcome with conventional treatment system; in this connection, nanotechnology has gained a great deal of interest in recent years. Moreover, nanotechnology and nanocarrier-based approach drug delivery system could revolutionize the treatment of degenerative diseases by faster absorption of drug, targeted interaction at specific site, and its release in a controlled manner into human body with minimal side effects. The core objective of this review is to customize and formulate therapeutically active molecules with specific site of action and without affecting other organs and tissues to obtain effective result in the improvement of quality of health. In addition, the review provides a concise insight into the recent developments and applications of nanotech and nanocarrier-based drug delivery for the treatment of various degenerative diseases.

The influence of additives on crystallization of blends based on polylactid acid

Science.gov (United States)

Perd'ochová, D.; Tomanová, K.; Alexy, P.; Bočkaj, J.; Feranc, J.; Plavec, R.; Omaníková, L.; Jurkovič, P.; Prikřyl, R.

2017-11-01

The sustainable development consists of the effort of replacing commonly used polymer materials for the biodegradable ones. They do not have sufficient physical and mechanical properties, therefore they have to be modified by producing various ratio mixtures or with the additives. Improving their processability and properties is an important challenge to be afforded before using these materials on the market. One way to improve the properties of these materials is to prepare their blends [1]. The most common way of the preparation of packaging materials is the injection moulding, where the crystallization of material is very important. That is the reason the crystallization has become one of the most studied characteristics of biodegradable blends based on PLA / PHB. The work is a contribution to works that deal with the description of the structure of PLA / PHB blends, which have been modified by the addition of various types of additives, mainly nucleating agents and plasticizers [2]. The films of these blends keep approximately unchanged mechanical properties after two weeks of storage. The presence of plasticizer (ATBC) and nucleating agent (BN) has no significant impact on the processing stability of PLA/PHB blends. The results show that the combination of the plasticizer and nucleating agent greatly affects the process of crystallization of PLA/PHB blends as well as the ratio of polymers and the heat treatment process.

Economic and environmental sustainability of submerged anaerobic MBR-based (AnMBR-based) technology as compared to aerobic-based technologies for moderate-/high-loaded urban wastewater treatment.

Science.gov (United States)

Pretel, R; Robles, A; Ruano, M V; Seco, A; Ferrer, J

2016-01-15

The objective of this study was to assess the economic and environmental sustainability of submerged anaerobic membrane bioreactors (AnMBRs) in comparison with aerobic-based technologies for moderate-/high-loaded urban wastewater (UWW) treatment. To this aim, a combined approach of steady-state performance modelling, life cycle analysis (LCA) and life cycle costing (LCC) was used, in which AnMBR (coupled with an aerobic-based post-treatment) was compared to aerobic membrane bioreactor (AeMBR) and conventional activated sludge (CAS). AnMBR with CAS-based post-treatment for nutrient removal was identified as a sustainable option for moderate-/high-loaded UWW treatment: low energy consumption and reduced sludge production could be obtained at given operating conditions. In addition, significant reductions can be achieved in different aspects of environmental impact (global warming potential (GWP), abiotic depletion, acidification, etc.) and LCC over existing UWW treatment technologies. Copyright © 2015 Elsevier Ltd. All rights reserved.

The ADDITION-Cambridge trial protocol: a cluster – randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients

Directory of Open Access Journals (Sweden)

Kinmonth Ann

2009-05-01

Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. Methods and design The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i a stepwise screening strategy for type 2 diabetes; and (ii intensive multifactorial treatment for people with screen-detected diabetes in primary care. 63 practices in the East Anglia region participated. Three undertook the pilot study, 33 were allocated to three groups: no screening (control, screening followed by intensive treatment (IT and screening plus routine care (RC in an unbalanced (1:3:3 randomisation. The remaining 27 practices were randomly allocated to IT and RC. A risk score incorporating routine practice data was used to identify people aged 40–69 years at high-risk of undiagnosed diabetes. In the screening practices, high-risk individuals were invited to take part in a stepwise screening programme. In the IT group, diabetes treatment is optimised through guidelines, target-led multifactorial treatment, audit, feedback, and academic detailing for practice teams, alongside provision of educational materials for newly diagnosed participants. Primary endpoints are modelled cardiovascular risk at one year, and cardiovascular mortality and morbidity at five years after diagnosis of diabetes. Secondary endpoints include all-cause mortality, development of renal and visual impairment, peripheral neuropathy, health service costs, self-reported quality of life, functional status and health utility. Impact of the screening programme at the population level is also assessed through measures of mortality, cardiovascular morbidity, health status and health service use among high-risk individuals. Discussion ADDITION-Cambridge is conducted in a defined high-risk group

Acceleration of Intended Pozzolanic Reaction under Initial Thermal Treatment for Developing Cementless Fly Ash Based Mortar

Directory of Open Access Journals (Sweden)

Yang-Hee Kwon

2017-02-01

Full Text Available Without using strong alkaline solution or ordinary Portland cement, a new structural binder consisting of fly ash and hydrated lime was hardened through an intensified pozzolanic reaction. The main experimental variables are the addition of silica fume and initial thermal treatment (60 °C for 3 days. A series of experiments consisting of mechanical testing (compressive and flexural strength, modulus of elasticity, X-ray diffraction, and measurements of the heat of hydration, pore structure, and shrinkage were conducted. These tests show that this new fly ash-based mortar has a compressive strength of 15 MPa at 91 days without any silica fume addition or initial thermal treatment. The strength increased to over 50 MPa based on the acceleration of the intensified pozzolanic reaction from the silica fume addition and initial thermal treatment. This is explained by a significant synergistic effect induced by the silica fume. It intensifies the pozzolanic reaction under thermal treatment and provides a space filling effect. This improved material performance can open a new pathway to utilize the industrial by-product of fly ash in cementless construction materials.

Validation of a scale for network therapy: a technique for systematic use of peer and family support in addition treatment.

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Keller, D S; Galanter, M; Weinberg, S

1997-02-01

Substance abuse treatments are increasingly employing standardized formats. This is especially the case for approaches that utilize an individual psychotherapy format but less so for family-based approaches. Network therapy, an approach that involves family members and peers in the patient's relapse prevention efforts, is theoretically and clinically differentiated in this paper from family systems therapy for addiction. Based on these conceptual differences, a Network Therapy Rating Scale (NTRS) was developed to measure the integrity and differentiability of network therapy from other family-based approaches to addiction treatment. Seven addictions faculty and 10 third- and fourth-year psychiatry residents recently trained in the network approach used the NTRS to rate excerpts of network and family systems therapy sessions. Data revealed the NTRS had high internal consistency reliability when utilized by both groups of raters. In addition, network and nonnetwork subscales within the NTRS rated congruent therapy excerpts significantly higher than noncongruent therapy excerpts, indicating that the NTRS subscales measure what they are designed to measure. Implications for research and training are discussed.

Bayesian additive decision trees of biomarker by treatment interactions for predictive biomarker detection and subgroup identification.

Science.gov (United States)

Zhao, Yang; Zheng, Wei; Zhuo, Daisy Y; Lu, Yuefeng; Ma, Xiwen; Liu, Hengchang; Zeng, Zhen; Laird, Glen

2017-10-11

Personalized medicine, or tailored therapy, has been an active and important topic in recent medical research. Many methods have been proposed in the literature for predictive biomarker detection and subgroup identification. In this article, we propose a novel decision tree-based approach applicable in randomized clinical trials. We model the prognostic effects of the biomarkers using additive regression trees and the biomarker-by-treatment effect using a single regression tree. Bayesian approach is utilized to periodically revise the split variables and the split rules of the decision trees, which provides a better overall fitting. Gibbs sampler is implemented in the MCMC procedure, which updates the prognostic trees and the interaction tree separately. We use the posterior distribution of the interaction tree to construct the predictive scores of the biomarkers and to identify the subgroup where the treatment is superior to the control. Numerical simulations show that our proposed method performs well under various settings comparing to existing methods. We also demonstrate an application of our method in a real clinical trial.

Enhanced treatment of waste frying oil in an activated sludge system by addition of crude rhamnolipid solution.

Science.gov (United States)

Zhang, Hongzi; Xiang, Hai; Zhang, Guoliang; Cao, Xia; Meng, Qing

2009-08-15

The presence of high-strength oil and grease (O&G) in wastewater poses serious challenges for environment. Addition of surfactant into the activated sludge bioreactor is feasible in reducing high concentrations of O&G via enhancing its bioavailability. In this paper, an aqueous biosurfactant solution of rhamnolipid as a cell-free culture broth of Pseudomonas aeruginosa zju.um1 was added into a batch of aerobic activated sludge system for treatment of the waste frying oil. This treatment was conducted on both bench and pilot-scales, whereas the removal efficiency of frying oil was determined by analyzing the residue concentration of O&G and chemical oxygen demand (COD). In the presence of varying concentrations of rhamnolipid from 22.5 mg/L to 90 mg/L, aerobic treatment for 30 h was enough to remove over 93% of O&G while this biodegradability was only 10% in the control system with the absence of rhamnolipids. The equivalent biodegradability was similarly obtained on COD under addition of rhamnolipid. Compared with bench studies, a higher treatment efficiency with the presence of rhamnolipids was achieved on a pilot-scale of activated sludge system, in which a short time of 12h was required for removing approximately 95% of O&G while the control treatment attained a low efficiency of 17%. Finally, foaming and biodegradability of rhamnolipids in activated sludge system were further examined in the whole treatment process. It seems that the addition of rhamnolipid-containing culture broth showed great potential for treatment of oily wastewater by activated sludge.

Enhanced treatment of waste frying oil in an activated sludge system by addition of crude rhamnolipid solution

International Nuclear Information System (INIS)

Zhang Hongzi; Xiang Hai; Zhang Guoliang; Cao Xia; Meng Qing

2009-01-01

The presence of high-strength oil and grease (O and G) in wastewater poses serious challenges for environment. Addition of surfactant into the activated sludge bioreactor is feasible in reducing high concentrations of O and G via enhancing its bioavailability. In this paper, an aqueous biosurfactant solution of rhamnolipid as a cell-free culture broth of Pseudomonas aeruginosa zju.um1 was added into a batch of aerobic activated sludge system for treatment of the waste frying oil. This treatment was conducted on both bench and pilot-scales, whereas the removal efficiency of frying oil was determined by analyzing the residue concentration of O and G and chemical oxygen demand (COD). In the presence of varying concentrations of rhamnolipid from 22.5 mg/L to 90 mg/L, aerobic treatment for 30 h was enough to remove over 93% of O and G while this biodegradability was only 10% in the control system with the absence of rhamnolipids. The equivalent biodegradability was similarly obtained on COD under addition of rhamnolipid. Compared with bench studies, a higher treatment efficiency with the presence of rhamnolipids was achieved on a pilot-scale of activated sludge system, in which a short time of 12 h was required for removing approximately 95% of O and G while the control treatment attained a low efficiency of 17%. Finally, foaming and biodegradability of rhamnolipids in activated sludge system were further examined in the whole treatment process. It seems that the addition of rhamnolipid-containing culture broth showed great potential for treatment of oily wastewater by activated sludge.

Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Erkurt, E.; Tunali, C. [Cukurova University Medical Faculty, Dept. of Radiation Oncology, Balcali-Adana (Turkey); Erkisi, M. [Cukurova University Medical Faculty, Dept. of Medical Oncology (Turkey)

2000-12-01

The reversal of anorexia and weight loss especially in patients with advanced cancer suffering from radiation treatment (RT) -related complications and debilitated further during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with megestrol acetate (MA) in the weight-losing cancer patients increasingly experiencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT plus or minus chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. >From June 1997 to October 1998, 100 eligible patients were enrolled on a randomized, placebo-controlled clinical trial. Of the 100 patients, 46 received MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or change for each parameter of malnutrition, appetite, taste and smell developed by the researchers. At the end of the study a statistically significant weight gain was achieved in the patient group receiving MA compared to the placebo group (+ 3 to + 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen in performance status (p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compared to the placebo group. In the MA group there was no statistically significant difference related to the weight changes according to the grade of either the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the acute and late RT effects was detected on weight loss (p=0.008 and 0.007, respectively). It was observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects

Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

International Nuclear Information System (INIS)

Erkurt, E.; Tunali, C.; Erkisi, M.

2000-01-01

The reversal of anorexia and weight loss especially in patients with advanced cancer suffering from radiation treatment (RT) -related complications and debilitated further during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with megestrol acetate (MA) in the weight-losing cancer patients increasingly experiencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT plus or minus chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. From June 1997 to October 1998, 100 eligible patients were enrolled on a randomized, placebo-controlled clinical trial. Of the 100 patients, 46 received MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or change for each parameter of malnutrition, appetite, taste and smell developed by the researchers. At the end of the study a statistically significant weight gain was achieved in the patient group receiving MA compared to the placebo group (+ 3 to + 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen in performance status p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compared to the placebo group. In the MA group there was no statistically significant difference related to the weight changes according to the grade of either the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the acute and late RT effects was detected on weight loss (p=0.008 and 0.007, respectively). It was observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects, and

Full-scale effects of addition of sludge from water treatment stations into processes of sewage treatment by conventional activated sludge.

Science.gov (United States)

Luiz, Marguti André; Sidney Seckler, Ferreira Filho; Passos, Piveli Roque

2018-06-01

An emerging practice for water treatment plant (WTP) sludge is its disposal in wastewater treatment plants (WWTP), an alternative that does not require the installation of sludge treatment facilities in the WTP. This practice can cause both positive and negative impacts in the WWTP processes since the WTP sludge does not have the same characteristics as domestic wastewater. This issue gives plenty of information in laboratory and pilot scales, but lacks data from full-scale studies. The main purpose of this paper is to study the impact of disposing sludge from the Rio Grande conventional WTP into the ABC WWTP, an activated sludge process facility. Both plants are located in São Paulo, Brazil, and are full-scale facilities. The WTP volumetric flow rate (4.5 m³/s) is almost three times that of WWTP (1.6 m³/s). The data used in this study came from monitoring the processes at both plants. The WWTP liquid phase treatment analysis included the variables BOD, COD, TSS, VSS, ammonia, total nitrogen, phosphorus and iron, measured at the inlet, primary effluent, mixed liquor, and effluent. For the WWTP solids treatment, the parameters tested were total and volatile solids. The performance of the WWTP process was analyzed with and without sludge addition: 'without sludge' in years 2005 and 2006 and 'with sludge' from January 2007 to March 2008. During the second period, the WTP sludge addition increased the WWTP removal efficiencies for solids (93%-96%), organic matter (92%-94% for BOD) and phosphorus (52%-88%), when compared to the period 'without sludge'. These improvements can be explained by higher feed concentrations combined to same or lower effluent concentrations in the 'with sludge' period. No critical negative impacts occurred in the sludge treatment facilities, since the treatment units absorbed the extra solids load from the WTP sludge. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adaptation and implementation of family-based treatment enhanced with dialectical behavior therapy skills for anorexia nervosa in community-based specialist clinics.

Science.gov (United States)

Accurso, Erin C; Astrachan-Fletcher, Ellen; O'Brien, Setareh; McClanahan, Susan F; Le Grange, Daniel

2018-01-01

Although family-based therapy (FBT) is a well-established treatment for anorexia nervosa, its implementation and effectiveness in clinical settings has been neglected. A group of seven therapists at a community-based eating disorders clinic were trained in skills-enhanced FBT and provided treatment to 11 youth with anorexia nervosa. Family-based skills training, which borrowed heavily from dialectical behavior therapy, was introduced in four additional sessions and then integrated throughout the remainder of FBT. FBT was perceived as appropriate and acceptable by all participants. Therapists reported high treatment fidelity. There was a large improvement in weight and moderate improvement in caregiver-reported eating disorder psychopathology but no clinically significant change by youth report. This study provides preliminary data on the implementation and effectiveness of FBT in the community.

Enhanced performance of ultracapacitors using redox additive-based electrolytes

Science.gov (United States)

Jain, Dharmendra; Kanungo, Jitendra; Tripathi, S. K.

2018-05-01

Different concentrations of potassium iodide (KI) as redox additive had been added to 1 M sulfuric acid (H2SO4) electrolyte with an aim of enhancing the capacitance and energy density of ultracapacitors via redox reactions at the interfaces of electrode-electrolyte. Ultracapacitors were fabricated using chemically treated activated carbon as electrode with H2SO4 and H2SO4-KI as an electrolyte. The electrochemical performances of fabricated supercapacitors were investigated by impedance spectroscopy, cyclic voltammetry and charge-discharge techniques. The maximum capacitance ` C' was observed with redox additives-based electrolyte system comprising 1 M H2SO4-0.3 M KI (1072 F g- 1), which is very much higher than conventional 1 M H2SO4 (61.3 F g- 1) aqueous electrolyte-based ultracapacitors. It corresponds to an energy density of 20.49 Wh kg- 1 at 2.1 A g- 1 for redox additive-based electrolyte, which is six times higher as compared to that of pristine electrolyte (1 M H2SO4) having energy density of only 3.36 Wh kg- 1. The temperature dependence behavior of fabricated cell was also analyzed, which shows increasing pattern in its capacitance values in a temperature range of 5-70 °C. Under cyclic stability test, redox electrolyte-based system shows almost 100% capacitance retention up to 5000 cycles and even more. For comparison, ultracapacitors based on polymer gel electrolyte polyvinyl alcohol (PVA) (10 wt%)—{H2SO4 (1 M)-KI (0.3 M)} (90 wt%) have been fabricated and characterized with the same electrode materials.

Cost Per Additional Responder Associated With Ixekizumab and Etanercept in the Treatment of Moderate-to-Severe Psoriasis.

Science.gov (United States)

Feldman, Steven R; Foster, Shonda A; Zhu, Baojin; Burge, Russel; Al Sawah, Sarah; Goldblum, Orin M

2017-12-01

BACKGROUND: Newer psoriasis treatments can achieve greater levels of efficacy than older systemic therapies; however, current psoriasis costs are substantial. We sought to estimate costs per additional responder associated with ixekizumab and etanercept, versus placebo, using efficacy data from phase 3 clinical trials (UNCOVER-2 and UNCOVER-3). METHODS: In UNCOVER-2/UNCOVER-3, patients received subcutaneous placebo, etanercept 50 mg twice weekly (BIW), or ixekizumab one 80 mg injection every 2 weeks (Q2W) after a 160-mg starting dose. Twelve-week induction-phase Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100 response rates for ixekizumab, etanercept, and placebo were obtained from pooled data from the overall and United States (US) subgroup intention-to-treat (ITT) populations, and used to calculate numbers needed to treat (NNTs) to achieve one additional PASI 75, PASI 90, or PASI 100 response for ixekizumab Q2W and etanercept BIW versus placebo. Twelve-week drug costs per patient were calculated based on the UNCOVER-2/UNCOVER-3 dosing schedule and wholesale acquisition costs. Mean costs per additional responder for PASI 75, PASI 90, and PASI 100 for each treatment versus placebo were calculated for pooled UN-COVER-2/UNCOVER-3 overall and US subgroup ITT populations. RESULTS: Pooled overall ITT population: costs per additional PASI 75, PASI 90, or PASI 100 responder were US $37,540, US $46,299, or US $80,710 for ixekizumab Q2W and US $57,533, US $120,720, or US $404,695 for etanercept BIW, respectively. US subgroup ITT population: costs per additional PASI 75, PASI 90, or PASI 100 responder were US $38,165, US $49,740, or US $93,536 for ixekizumab Q2W and US $69,580, US $140,881, or US $631,875 for etanercept BIW, respectively. CONCLUSIONS: Twelve-week costs per additional responder were lower for ixekizumab Q2W than for etanercept BIW across all levels of clearance (PASI 75, PASI 90, and PASI 100) in the pooled UNCOVER-2/UNCOVER-3 overall and

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention.

Science.gov (United States)

Weidt, Steffi; Bruehl, Annette Beatrix; Delsignore, Aba; Zai, Gwyneth; Kuenburg, Alexa; Klaghofer, Richard; Rufer, Michael

2017-01-01

Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention. We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire. Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL) was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms ( P =0.002). Treatment history demonstrated no impact on the outcome of Internet-based interventions. Results demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders.

Predicting Social Anxiety Treatment Outcome Based on Therapeutic Email Conversations.

Science.gov (United States)

Hoogendoorn, Mark; Berger, Thomas; Schulz, Ava; Stolz, Timo; Szolovits, Peter

2017-09-01

Predicting therapeutic outcome in the mental health domain is of utmost importance to enable therapists to provide the most effective treatment to a patient. Using information from the writings of a patient can potentially be a valuable source of information, especially now that more and more treatments involve computer-based exercises or electronic conversations between patient and therapist. In this paper, we study predictive modeling using writings of patients under treatment for a social anxiety disorder. We extract a wealth of information from the text written by patients including their usage of words, the topics they talk about, the sentiment of the messages, and the style of writing. In addition, we study trends over time with respect to those measures. We then apply machine learning algorithms to generate the predictive models. Based on a dataset of 69 patients, we are able to show that we can predict therapy outcome with an area under the curve of 0.83 halfway through the therapy and with a precision of 0.78 when using the full data (i.e., the entire treatment period). Due to the limited number of participants, it is hard to generalize the results, but they do show great potential in this type of information.

Community-Based Psychosocial Treatment Has an Impact on Social Processing and Functional Outcome in Schizophrenia

Directory of Open Access Journals (Sweden)

Eszter Varga

2018-06-01

Full Text Available Schizophrenic patients have serious impairments in social cognition, which often persists after significant reduction in clinical symptoms. Community-based psychosocial treatments aim to recover social functioning for mentally ill individuals. Our aim was to examine prospective changes in social cognition and functional outcomes in two groups of schizophrenic patients involved in two forms of community-based psychosocial treatments namely case management (CM and community-based club (CC compared to a matched, treatment as usual (TAU group of patients. We hypothesized that CC and CM groups would exhibit better functional and social cognitive outcomes after a 6-month long psychosocial treatment period. Seventy-five patients participated either in CC, CM or TAU. Both CC and CM took part in community-based psychosocial treatment programs including trainings, such as communication and assertiveness trainings. In addition, CC provided group therapeutic treatments and a continuously available day care where patients had the possibility to participate in various social interactions. All participants were in remission, and on maintenance antipsychotic treatment. Participants were assessed on all study variables at two time points: baseline and after 6 months with a battery of questionnaires that examined affective face perception, affective prosody perception, pragmatic language comprehension and ToM. Our results showed that functional outcomes improved significantly in the CC as well as in the CM groups, in contrast to the TAU group. While analyzing summary scores of social cognition, it was found that only the CC group increased its performance in social cognition. In addition, a significant between-group difference in social cognitive function was found after 6 months between the three groups, with the CC group performing best. When investigating associations between changes in social cognition and changes in functional outcomes during a 6-month long

Morphea: Evidence-based recommendations for treatment

OpenAIRE

Nicole M Fett

2012-01-01

Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on ran...

Influence of additional coupling agent on the mechanical properties of polyester–agave cantala roxb based composites

Energy Technology Data Exchange (ETDEWEB)

Ubaidillah, E-mail: ubaidillah@uns.ac.id [Mechanical Engineering Department, Faculty of Engineering, Sebelas Maret University, Jl. Ir. Sutami 36A, Kentingan, Surakarta, 57126 (Indonesia); Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia, Jalan Sultan Yahya Petra, Kuala Lumpur (Malaysia); Raharjo, Wijang W.; Wibowo, A. [Mechanical Engineering Department, Faculty of Engineering, Sebelas Maret University, Jl. Ir. Sutami 36A, Kentingan, Surakarta, 57126 (Indonesia); Harjana [Iwany Acoustic Research Group, Sebelas Maret University, Jl. Ir. Sutami 36A, Kentingan, Surakarta, 57126 (Indonesia); Mazlan, S. A., E-mail: amri.kl@utm.my [Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia, Jalan Sultan Yahya Petra, Kuala Lumpur (Malaysia)

2016-03-29

The mechanical and morphological properties of the unsaturated polyester resins (UPRs)-agave cantala roxb based composite are investigated in this paper. The cantala fiber woven in 3D angle interlock was utilized as the composite reinforcement. Surface grafting of the cantala fiber through chemical treatment was performed by introducing silane coupling agent to improving the compatibility with the polymer matrix. The fabrication of the composite specimens was conducted using vacuum bagging technique. The effect of additional coupling agent to the morphological appearance of surface fracture was observed using scanning electron microscopy. Meanwhile, the influence of additional silane to the mechanical properties was examined using tensile, bending and impact test. The photograph of surface fracture on the treated specimens showed the residual matrix left on the fibers in which the phenomenon was not found in the untreated specimens. Based on mechanical tests, the treated specimens were successfully increased their mechanical properties by 55%, 9.67%, and 92.4% for tensile strength, flexural strength, and impact strength, respectively, at 1.5% silane coupling agent.

Specialized home treatment versus hospital-based outpatient treatment for first-episode psychosis: a randomized clinical trial.

Science.gov (United States)

Dewa, Carolyn S; Zipursky, Robert B; Chau, Nancy; Furimsky, Ivana; Collins, April; Agid, Ofer; Goering, Paula

2009-11-01

This pilot study compared the effectiveness of specialized care that was home based versus hospital based for individuals experiencing their first psychotic episode. A randomized controlled trial design was used. A total of 29 subjects were interviewed at baseline, 3 and 9 months. Repeated measures analysis of variance was employed to test for statistically significant changes over time within and between groups with regard to community psychosocial functioning and symptom severity. Our findings indicate that subjects in both the home-based and hospital-based programmes significantly improved with regard to symptoms and community functioning over time. However, the rates of change over time were not significantly different between the two programmes. There was a statistically significant difference between programmes with regard to the proportion of subjects with less than two visits (i.e. either did not attend their first assessment or attended follow-up visits after their assessment). This was a modest pilot study and the sample was too small to allow definitive conclusions to be drawn. However, the results raise questions about differences in initial treatment engagement. They suggest the need for additional research focusing on interventions that promote initial treatment seeking. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

Base Stabilization Guidance and Additive Selection for Pavement Design and Rehabilitation

Science.gov (United States)

2017-12-01

Significant improvements have been made in base stabilization practice that include design specifications and methodology, experience with the selection of stabilizing additives, and equipment for distribution and uniform blending of additives. For t...

Symptom burden and job absenteeism after treatment with additional catheter-directed thrombolysis for deep vein thrombosis

Directory of Open Access Journals (Sweden)

Enden T

2013-09-01

Full Text Available Tone Enden,1–3 Nils-Einar Kløw,2,3 Per Morten Sandset1,3 1Department of Hematology, Oslo University Hospital, Oslo, Norway; 2Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; 3Institute of Clinical Medicine, University of Oslo, Oslo, Norway Introduction: Additional catheter-directed thrombolysis (CDT for acute deep vein thrombosis (DVT reduces long-term postthrombotic syndrome and is likely to represent a cost-effective alternative treatment compared to the standard treatment of anticoagulation and elastic compression stockings. Accelerated thrombus resolution has also been suggested to improve symptoms and patient function in the acute phase. We aimed to investigate whether additional CDT led to fewer symptoms and job absenteeism during the first 6 months after initiation of DVT treatment compared to standard treatment alone. Methods: The Catheter-directed Venous Thrombolysis (CaVenT study was a multicenter open label, randomized controlled trial of patients ages 18 years to 75 years with a verified high proximal DVT,<21 days of symptoms, and no apparent bleeding risk. Patients were allocated to additional CDT or to standard treatment only. Symptoms were assessed at baseline and at 6 months using items from the generic and disease-specific quality of life questionnaires EQ-5D and VEINES-QOL/Sym, respectively. Individual data on sickness benefits related to venous thromboembolic disease were obtained from the national welfare service. Results: A total of 90 patients allocated additional CDT and 99 control patients completed long-term follow-up and were included in the analyses. Twenty-four in the CDT arm and 40 controls received sick leave (P = 0.046. When considering working patients only (54 in the CDT arm and 72 controls this difference was no longer statistically significant. Mean duration of job absenteeism was 86.4 days (95% confidence interval 59.4–113.5 in the CDT arm and 60.1 days (95% confidence

Effect of heat treatment on the microstructure of Co-Cr-W alloy fabricated by laser additive manufacturing

Science.gov (United States)

Ren, Bo; Chen, Changjun; Zhang, Min

2018-04-01

Stellite 6 cobalt-based alloy powder was used to produce Co-Cr-W alloy using laser additive manufacturing technology, and then different heat treatment strategies were carried out on the deposited sample. The characteristics of microstructure under different heat treatment conditions were investigated using scanning electron microscopy with energy dispersive spectroscopy, transmission electron microscope, and x-ray diffraction. The results show that the as-deposited sample has few cracks or pores, and the microstructure is typical dendritic structure, and lamellar eutectic carbides are rich in Cr in interdendritic. The matrix mainly consists of γ phases and a few ɛ phases. Some γ phases transform into ɛ phases after 900°C/6 h aging treatment and lamellar eutectic carbides transform into blocky carbides presenting as a network, most of the carbides are rich in Cr and a few are rich in W. When heat treated at 1200°C/1 h followed by water cooling and then treated at 900°C/6 h followed by furnace cooling, it can be found that some γ phases transform into ɛ phases. The carbides transform into elliptical M23C6 carbides that are rich in Cr with the size of 1 to 3 μm and a part of W-rich carbides.

Effect of homogenization heat treatments on the cast structure and tensile properties of nickel-base superalloy ATI 718Plus in the presence of boron and zirconium additions

Energy Technology Data Exchange (ETDEWEB)

Hosseini, Seyed Ali, E-mail: saliho3ini@gmail.com; Madar, Karim Zangeneh; Abbasi, Seyed Mehdi

2017-03-24

The effect of homogenization heat treatment on cast structure, hardness, and tensile properties of the nickel-based superalloy 718plus in the presence of boron and zirconium additives were investigated. For this purpose, five alloys with different contents of boron (0.00–0.016 wt%) and zirconium (0.0–0.1 wt%) were cast by double vacuum process VIM/VAR and then were homogenized at 1075–1175 °C for 5–25 h. Microstructural investigation by OM and SEM and phase analysis by XRD were done and then hardness and high temperature tensile tests were performed on the homogenized alloys. The results show that the amount of the Laves phase is reduced by increases in time and temperature of homogenization. It was also found that increases in duration of homogenization at 1075 °C results in improving strength and ductility, while duration increase at 1175 °C is accompanied with degradation of them, which caused the reduction of needle-like delta phase on grain boundaries. Boron and zirconium had negative effects on the strength and ductility of the alloy by increasing the amount of Laves in the cast structure. By increasing these elements in alloy composition, more time is needed in order to fully eliminate the Laves by homogenization treatment.

Optimization of heat treatment parameters for additive manufacturing and gravity casting AlSi10Mg alloy

Science.gov (United States)

Girelli, L.; Tocci, M.; Montesano, L.; Gelfi, M.; Pola, A.

2017-11-01

Additive manufacturing of metals is a production process developed in the last few years to realize net shape components with complex geometry and high performance. AlSi10Mg is one of the most widely used aluminium alloys, both in this field and in conventional foundry processes, for its significant mechanical properties combined with good corrosion resistance. In this paper the effect of heat treatment on AlSi10Mg alloy was investigated. Solution and ageing treatments were carried out with different temperatures and times on samples obtained by direct metal laser sintering and gravity casting in order to compare their performance. Microstructural analyses and hardness tests were performed to investigate the effectiveness of the heat treatment. The results were correlated to the sample microstructure and porosity, analysed by means of optical microscopy and density measurements. It was found that, in the additive manufactured samples, the heat treatment can reduce significantly the performance of the alloy also because of the increase of porosity due to entrapped gas during the deposition technique and that the higher the solution temperature the higher the increase of such defects. A so remarkable effect was not found in the conventional cast alloy.

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

Energy Technology Data Exchange (ETDEWEB)

Cox, Sophie C. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Jamshidi, Parastoo [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Eisenstein, Neil M. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston B15 2SQ (United Kingdom); Webber, Mark A. [School of Biosciences, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Hassanin, Hany [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); School of Mechanical and Automotive Engineering, Kingston University, London SW15 3DW (United Kingdom); Attallah, Moataz M. [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Shepherd, Duncan E.T. [Department of Mechanical Engineering, School of Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Addison, Owen [School of Dentistry, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Grover, Liam M. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom)

2016-07-01

Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p = 0.01) improved the compressive strength (5.8 ± 0.7 MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6 hour period (< 28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16 μg/mL) and Staphylococcus epidermidis (1 μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. - Highlights: • Titanium implants were additively manufactured with surface connected reservoirs. • Implants

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

International Nuclear Information System (INIS)

Cox, Sophie C.; Jamshidi, Parastoo; Eisenstein, Neil M.; Webber, Mark A.; Hassanin, Hany; Attallah, Moataz M.; Shepherd, Duncan E.T.; Addison, Owen; Grover, Liam M.

2016-01-01

Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p = 0.01) improved the compressive strength (5.8 ± 0.7 MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6 hour period (< 28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16 μg/mL) and Staphylococcus epidermidis (1 μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. - Highlights: • Titanium implants were additively manufactured with surface connected reservoirs. • Implants

Using a virtual reality in the inference based treatment of compulsive hoarding

Directory of Open Access Journals (Sweden)

Marie-Eve St-Pierre-Delorme

2016-07-01

Full Text Available The present study evaluated the efficacy of adding a virtual reality (VR component to the treatment of compulsive hoarding (CH following inference based therapy. Participants were randomly assigned to either an experimental or a control condition. Seven participants received the experimental and seven received the control condition. Five sessions of one hour were administered weekly. A significant difference indicated that the level of clutter in the bedroom tended to diminish more in the experimental group as compared to the control group F(2,24 = 2.28, p = .10. In addition, the results demonstrated that both groups were immersed and present in the environment. The results on post-treatment measures of CH (Saving Inventory revised, Saving Cognition Inventory and Clutter Image Rating scale demonstrate the efficacy of inference based therapy in terms of symptom reduction. Overall, these results suggest that the creation of a virtual environment may be effective in the treatment of CH by helping the compulsive hoarders take action over they're clutter.

Additively manufactured metallic porous biomaterials based on minimal surfaces

DEFF Research Database (Denmark)

Bobbert, F. S. L.; Lietaert, K.; Eftekhari, Ali Akbar

2017-01-01

Porous biomaterials that simultaneously mimic the topological, mechanical, and mass transport properties of bone are in great demand but are rarely found in the literature. In this study, we rationally designed and additively manufactured (AM) porous metallic biomaterials based on four different...... of bone properties is feasible, biomaterials that could simultaneously mimic all or most of the relevant bone properties are rare. We used rational design and additive manufacturing to develop porous metallic biomaterials that exhibit an interesting combination of topological, mechanical, and mass...

Morphea: Evidence-based recommendations for treatment

Directory of Open Access Journals (Sweden)

Nicole M Fett

2012-01-01

Full Text Available Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.

Inhalation of nanoparticle-based drug for lung cancer treatment: Advantages and challenges

Directory of Open Access Journals (Sweden)

Wing-Hin Lee

2015-12-01

Full Text Available Ever since the success of developing inhalable insulin, drug delivery via pulmonary administration has become an attractive route to treat chronic diseases. Pulmonary delivery system for nanotechnology is a relatively new concept especially when applicable to lung cancer therapy. Nano-based systems such as liposome, polymeric nanoparticles or micelles are strategically designed to enhance the therapeutic index of anti-cancer drugs through improvement of their bioavailability, stability and residency at targeted lung regions. Along with these benefits, nano-based systems also provide additional diagnostic advantages during lung cancer treatment, including imaging, screening and drug tracking. Nevertheless, delivery of nano-based drugs via pulmonary administration for lung cancer therapy is still in its infancy and numerous challenges are expected. Pharmacology, immunology, toxicology and large-scale manufacturing (stability and activity of drugs are some aspects in nanotechnology that should be taken into consideration for the development of inhalable nano-based chemotherapeutic drugs. This review will focus on the current inhalable nano-based drugs for lung cancer treatment.

Short communication: Effect of whey protein addition and transglutaminase treatment on the physical and sensory properties of reduced-fat ice cream.

Science.gov (United States)

Danesh, Erfan; Goudarzi, Mostafa; Jooyandeh, Hossein

2017-07-01

The effects of whey protein addition and transglutaminase treatment, alone and in combination, on the physical and sensory properties of reduced-fat ice cream were investigated. Adding whey protein with or without enzyme treatment decreased melting rate, overrun, and hardness of the reduced-fat ice cream; however, the enzyme-treated sample had a higher melting rate and overrun and softer texture. Whey protein-fortified samples showed higher melting resistance, but lower overrun and firmer texture compared with the enzyme-treated sample without added whey protein. Whey protein addition with or without transglutaminase treatment caused an increase in apparent viscosity and a decrease in flow index of the reduced-fat ice cream; nevertheless, the flow behavior of full-fat sample was most similar to the enzyme-treated reduced-fat sample with no added whey protein. Descriptive sensory analyses showed that neither whey protein addition nor transglutaminase treatment significantly influenced the flavor and odor of reduced-fat ice cream, but they both noticeably improved the color and texture of the final product. The results of this study suggest that whey protein addition with transglutaminase treatment improves the physical and sensory properties of reduced-fat ice cream more favorably than does whey protein addition or transglutaminase treatment alone. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Web-based depression treatment for type 1 and type 2 diabetic patients

DEFF Research Database (Denmark)

van Bastelaar, Kim M P; Pouwer, Francois; Cuijpers, Pim

2011-01-01

intervention on a large scale at relatively low costs. This study evaluated the effectiveness of Web-based CBT for depression treatment in adults with type 1 or type 2 diabetes, with minimal guidance. RESEARCH DESIGN AND METHODS: A randomized controlled trial was conducted in the Netherlands in 255 adult...... no beneficial effect on glycemic control (P > 0.05). CONCLUSIONS: Web-based CBT depression treatment is effective in reducing depressive symptoms in adults with type 1 and type 2 diabetes. In addition, the intervention reduces diabetes-specific emotional distress in depressed patients.......OBJECTIVE: Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT...

Dgroup: DG01495 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available n (USAN/INN) ... D00626 ... Candesartan cilexetil (JP17/USAN) ... D00627 ... Telmisartan (JP17/USAN/INN); Telmisartan tablet...N); Olmesartan medoxomil tablets (JP17) ... DG00351 ... Azilsartan ... D08864 ... Azilsarta

Colloidal-based additive manufacturing of bio-inspired composites

Science.gov (United States)

Studart, Andre R.

Composite materials in nature exhibit heterogeneous architectures that are tuned to fulfill the functional demands of the surrounding environment. Examples range from the cellulose-based organic structure of plants to highly mineralized collagen-based skeletal parts like bone and teeth. Because they are often utilized to combine opposing properties such as strength and low-density or stiffness and wear resistance, the heterogeneous architecture of natural materials can potentially address several of the technical limitations of artificial homogeneous composites. However, current man-made manufacturing technologies do not allow for the level of composition and fiber orientation control found in natural heterogeneous systems. In this talk, I will present two additive manufacturing technologies recently developed in our group to build composites with exquisite architectures only rivaled by structures made by living organisms in nature. Since the proposed techniques utilize colloidal suspensions as feedstock, understanding the physics underlying the stability, assembly and rheology of the printing inks is key to predict and control the architecture of manufactured parts. Our results will show that additive manufacturing routes offer a new exciting pathway for the fabrication of biologically-inspired composite materials with unprecedented architectures and functionalities.

Nanotechnology-Based Approach in Tuberculosis Treatment

Directory of Open Access Journals (Sweden)

Mohammad Nasiruddin

2017-01-01

Full Text Available Tuberculosis, commonly known as TB, is the second most fatal infectious disease after AIDS, caused by bacterium called Mycobacterium tuberculosis. Prolonged treatment, high pill burden, low compliance, and stiff administration schedules are factors that are responsible for emergence of MDR and XDR cases of tuberculosis. Till date, only BCG vaccine is available which is ineffective against adult pulmonary TB, which is the most common form of disease. Various unique antibodies have been developed to overcome drug resistance, reduce the treatment regimen, and elevate the compliance to treatment. Therefore, we need an effective and robust system to subdue technological drawbacks and improve the effectiveness of therapeutic drugs which still remains a major challenge for pharmaceutical technology. Nanoparticle-based ideology has shown convincing treatment and promising outcomes for chronic infectious diseases. Different types of nanocarriers have been evaluated as promising drug delivery systems for various administration routes. Controlled and sustained release of drugs is one of the advantages of nanoparticle-based antituberculosis drugs over free drug. It also reduces the dosage frequency and resolves the difficulty of low poor compliance. This paper reviews various nanotechnology-based therapies which can be used for the treatment of TB.

DNA-based catalytic enantioselective intermolecular oxa-Michael addition reactions

NARCIS (Netherlands)

Megens, Rik P.; Roelfes, Gerard

2012-01-01

Using the DNA-based catalysis concept, a novel Cu(II) catalyzed enantioselective oxa-Michael addition of alcohols to enones is reported. Enantioselectivities of up to 86% were obtained. The presence of water is important for the reactivity, possibly by reverting unwanted side reactions such as

Prevalence of Phosphorus-Based Additives in the Australian Food Supply: A Challenge for Dietary Education?

Science.gov (United States)

McCutcheon, Jemma; Campbell, Katrina; Ferguson, Maree; Day, Sarah; Rossi, Megan

2015-09-01

Phosphorus-based food additives may pose a significant risk in chronic kidney disease given the link between hyperphosphatemia and cardiovascular disease. The objective of the study was to determine the prevalence of phosphorus-based food additives in best-selling processed grocery products and to establish how they were reported on food labels. A data set of 3000 best-selling grocery items in Australia across 15 food and beverage categories was obtained for the 12 months ending December 2013 produced by the Nielsen Company's Homescan database. The nutrition labels of the products were reviewed in store for phosphorus additives. The type of additive, total number of additives, and method of reporting (written out in words or as an E number) were recorded. Presence of phosphorus-based food additives, number of phosphorus-based food additives per product, and the reporting method of additives on product ingredient lists. Phosphorus-based additives were identified in 44% of food and beverages reviewed. Additives were particularly common in the categories of small goods (96%), bakery goods (93%), frozen meals (75%), prepared foods (70%), and biscuits (65%). A total of 19 different phosphorus additives were identified across the reviewed products. From the items containing phosphorus additives, there was a median (minimum-maximum) of 2 (1-7) additives per product. Additives by E number (81%) was the most common method of reporting. Phosphorus-based food additives are common in the Australian food supply. This suggests that prioritizing phosphorus additive education may be an important strategy in the dietary management of hyperphosphatemia. Further research to establish a database of food items containing phosphorus-based additives is warranted. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Wastewater treatment using hybrid treatment schemes based on cavitation and Fenton chemistry: a review.

Science.gov (United States)

Bagal, Manisha V; Gogate, Parag R

2014-01-01

Advanced oxidation processes such as cavitation and Fenton chemistry have shown considerable promise for wastewater treatment applications due to the ease of operation and simple reactor design. In this review, hybrid methods based on cavitation coupled with Fenton process for the treatment of wastewater have been discussed. The basics of individual processes (Acoustic cavitation, Hydrodynamic cavitation, Fenton chemistry) have been discussed initially highlighting the need for combined processes. The different types of reactors used for the combined processes have been discussed with some recommendations for large scale operation. The effects of important operating parameters such as solution temperature, initial pH, initial pollutant concentration and Fenton's reagent dosage have been discussed with guidelines for selection of optimum parameters. The optimization of power density is necessary for ultrasonic processes (US) and combined processes (US/Fenton) whereas the inlet pressure needs to be optimized in the case of Hydrodynamic cavitation (HC) based processes. An overview of different pollutants degraded under optimized conditions using HC/Fenton and US/Fenton process with comparison with individual processes have been presented. It has been observed that the main mechanism for the synergy of the combined process depends on the generation of additional hydroxyl radicals and its proper utilization for the degradation of the pollutant, which is strongly dependent on the loading of hydrogen peroxide. Overall, efficient wastewater treatment with high degree of energy efficiency can be achieved using combined process operating under optimized conditions, as compared to the individual process. Copyright © 2013 Elsevier B.V. All rights reserved.

Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

Directory of Open Access Journals (Sweden)

Meredith Harrell

2014-01-01

Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

Comparative overview of primary sedimentation-based mechanical stage in some Romanian wastewater treatment systems

Science.gov (United States)

Zaharia, C.

2017-08-01

Nowadays, wastewater (WW) treatment facilities are considered significant exposure pathways for solid particles, and also significant concerns of any quality conscious manufacturer. Most solid particles have some forms of organic coating either used as active material or to suspend and/or stabilize different present solid materials, having increase in toxicity that must be reduced, or sometimes even totally eliminated, especially if effluent is either discharged directly to surface water, or distributed through industrial water supplies. Representatives providing innovative technologies, comprehensive supports and expertise in wastewater and sludge treatment field are known, each one using modern treatment technology and facilities. Mechanical treatment is indispensable in primary treatment steps of both municipal and industrial WW applications, its main goal being separation of floating, settling and suspended materials (especially into a primary sedimentation-based treatment step). The aim of this work is to present comparatively the performance in solids removal of conventional mechanical WW treatment stages, especially those based on primary sedimentation, or sedimentation-like operations applied for Romanian urban WW treatment plants (serving two towns with ca 18,000 inhabitants), industrial WW treatment plants (deserving industries of vegetal food processing and organic chemicals’ manufacturing) and additional information on valorisation of separated solid material and improvement possibilities.

Efficacy of peg-interferon based treatment in patients with hepatitis C refractory to previous conventional interferon-based treatment

International Nuclear Information System (INIS)

Shaikh, S.; Devrajani, B.R.; Kalhoro, M.

2012-01-01

Objective: To determine the efficacy of peg-interferon-based therapy in patients refractory to previous conventional interferon-based treatment and factors predicting sustained viral response (SVR). Study Design: Analytical study. Place and Duration of Study: Medical Unit IV, Liaquat University Hospital, Jamshoro, from July 2009 to June 2011. Methodology: This study included consecutive patients of hepatitis C who were previously treated with conventional interferon-based treatment for 6 months but were either non-responders, relapsed or had virologic breakthrough and stage = 2 with fibrosis on liver biopsy. All eligible patients were provided peg-interferon at the dosage of 180 mu g weekly with ribavirin thrice a day for 6 months. Sustained Viral Response (SVR) was defined as absence of HCV RNA at twenty four week after treatment. All data was processed on SPSS version 16. Results: Out of 450 patients enrolled in the study, 192 were excluded from the study on the basis of minimal fibrosis (stage 0 and 1). Two hundred and fifty eight patients fulfilled the inclusion criteria and 247 completed the course of peg-interferon treatment. One hundred and sixty one (62.4%) were males and 97 (37.6%) were females. The mean age was 39.9 +- 6.1 years, haemoglobin was 11.49 +- 2.45 g/dl, platelet count was 127.2 +- 50.6 10/sup 3/ /mm/sup 3/, ALT was 99 +- 65 IU/L. SVR was achieved in 84 (32.6%). The strong association was found between SVR and the pattern of response (p = 0. 001), degree of fibrosis and early viral response (p = 0.001). Conclusion: Peg-interferon based treatment is an effective and safe treatment option for patients refractory to conventional interferon-based treatment. (author)

Telemedicine of family-based treatment for adolescent anorexia nervosa: A protocol of a treatment development study.

Science.gov (United States)

Anderson, Kristen E; Byrne, Catherine; Goodyear, Alexandria; Reichel, Ryan; Le Grange, Daniel

2015-01-01

Family-based treatment is an efficacious treatment available for adolescents with anorexia nervosa. Yet the implementation of this treatment, at least in the United States, is challenging due to a limited number of trained family-based treatment therapists and the concentration of these therapists in a limited number of urban centers. The use of telemedicine in the delivery of family-based treatment can increase access to this therapy for this patient population. This two-year treatment development study (December 2013-November 2015) follows a two-wave iterative case series design. The study is ongoing and addresses the treatment needs of families in remote, rural, or underrepresented parts of the United States by delivering family-based treatment via telemedicine (video chat). The first six months of the study was dedicated to selecting a cloud-based secure telemedicine portal for use with participants. Recruitment for the first of two consecutive case series (N = 5) began during month seven. After these five patients completed treatment, a systematic review of treatment via feedback from participants and therapists related to the delivery of this model and use of technology was completed. A second wave of recruitment is underway (N = 5). At the end of both waves (N = 10), and after a second review of treatment, we should be able to establish the feasibility and acceptability of family-based treatment delivered via telemedicine for this patient population. This study is the first attempt to deliver family-based treatment for adolescents with anorexia nervosa via telemedicine. If delivering family-based treatment in this format is feasible, it will provide access to an evidence-based treatment for families heretofore unable to participate in specialist treatment for their child's eating disorder.

Enhanced performance of a submerged membrane bioreactor with powdered activated carbon addition for municipal secondary effluent treatment

Energy Technology Data Exchange (ETDEWEB)

Lin, Hongjun, E-mail: hjlin@zjnu.cn [College of Geography and Environmental Sciences, Zhejiang Normal University, 688 Yingbin Avenue, Jinhua, Zhejiang Province 321004 (China); Wang, Fangyuan; Ding, Linxian; Hong, Huachang [College of Geography and Environmental Sciences, Zhejiang Normal University, 688 Yingbin Avenue, Jinhua, Zhejiang Province 321004 (China); Chen, Jianrong, E-mail: cjr@zjnu.cn [College of Geography and Environmental Sciences, Zhejiang Normal University, 688 Yingbin Avenue, Jinhua, Zhejiang Province 321004 (China); Lu, Xiaofeng [Shanghai Institute of Applied Physics, Chinese Academy of Science, Shanghai 201800 (China)

2011-09-15

Highlights: {yields} The first study to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. {yields} The study revealed that most organics in the secondary effluent were low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by PAC-MBR process. {yields} The study suggested that the action of biomass and the PAC is mutual and synergistic. - Abstract: The aim of this study was to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. Two laboratory-scale submerged MBRs (SMBR) with and without PAC addition were continuously operated in parallel for secondary effluent treatment. Approximately 63%TOC, 95% NH{sub 4}{sup +}-N and 98% turbidity in secondary effluent were removed by the PAC-MBR process. Most organics in the secondary effluent were found to be low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by using PAC-MBR process. Parallel experiments showed that the addition of PAC significantly increased organic removal and responsible for the largest fraction of organic removal. Membrane fouling analysis showed the enhanced membrane performance in terms of sustainable operational time and filtration resistances by PAC addition. Based on these results, the PAC-MBR process was considered as an attractive option for the reduction of pollutants in secondary effluent.

Enhanced performance of a submerged membrane bioreactor with powdered activated carbon addition for municipal secondary effluent treatment

International Nuclear Information System (INIS)

Lin, Hongjun; Wang, Fangyuan; Ding, Linxian; Hong, Huachang; Chen, Jianrong; Lu, Xiaofeng

2011-01-01

Highlights: → The first study to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. → The study revealed that most organics in the secondary effluent were low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by PAC-MBR process. → The study suggested that the action of biomass and the PAC is mutual and synergistic. - Abstract: The aim of this study was to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. Two laboratory-scale submerged MBRs (SMBR) with and without PAC addition were continuously operated in parallel for secondary effluent treatment. Approximately 63%TOC, 95% NH 4 + -N and 98% turbidity in secondary effluent were removed by the PAC-MBR process. Most organics in the secondary effluent were found to be low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by using PAC-MBR process. Parallel experiments showed that the addition of PAC significantly increased organic removal and responsible for the largest fraction of organic removal. Membrane fouling analysis showed the enhanced membrane performance in terms of sustainable operational time and filtration resistances by PAC addition. Based on these results, the PAC-MBR process was considered as an attractive option for the reduction of pollutants in secondary effluent.

Elimination of N,O-bis(trimethylsilyl)trifluoroacetamide interference by base treatment in derivatization gas chromatography mass spectrometry determination of parts per billion of alcohols in a food additive.

Science.gov (United States)

Zhu, Koudi; Gu, Binghe; Kerry, Michael; Mintert, Markus; Luong, Jim; Pursch, Matthias

2017-03-24

A novel base treatment followed by liquid-liquid extraction was developed to remove the interference of excess derivatization reagent BSTFA [N,O-Bis(trimethylsilyl)trifluoroacetamide] and its byproducts for trace determination of 1-chloro-2-propanol and 2-chloro-1-propanol in a food additive. The corresponding trimethylsilyl derivatives were analyzed by gas chromatography mass spectrometry (GC/MS) detection in selective ion monitoring mode. Due to a large volume splitless injection needed for achieving the required sensitivity, excess BSTFA in the derivatization sample solution interfered with the trimethylsilyl derivatives of the analytes of interest, making their quantitation not attainable. Efforts were made to decompose BSTFA while keeping the trimethylsilyl derivatives intact. Water or aqueous sulfuric acid treatment converted BSTFA into mainly N-trimethylsilyltrifluoroacetamide, which partitions between aqueous and organic layers. In contrast, aqueous sodium hydroxide decomposed BSTFA into trifluoroacetic acid, which went entirely into the aqueous layer. No BSTFA or its byproduct N-trimethylsilyltrifluoroacetamide or trifluroacetamide was found in the organic layer where the derivatized alcohols existed, which in turn completely eliminated their interference, enabling accurate and precise determination of parts per billion of the short-chain alcohols in the food additive. Contrary to the conventional wisdom that a trimethylsilyl derivative is susceptible to hydrolysis, the derivatized short-chain alcohols were found stable even in the presence of 0.17N aqueous sodium hydroxide as the improved GC/MS method was validated successfully, with a satisfactory linearity response in the concentration range of 10-400ng/g (regression coefficient greater than 0.999), good method precision (<4%), good recovery (90-98%), and excellent limit of detection (3ng/g) and limit of quantitation (10ng/g). Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling uranium transport in acidic contaminated groundwater with base addition

Energy Technology Data Exchange (ETDEWEB)

Zhang, Fan [Institute of Tibetan Plateau Research, Chinese Academy of Sciences; Luo, Wensui [ORNL; Parker, Jack C. [University of Tennessee, Knoxville (UTK); Brooks, Scott C [ORNL; Watson, David B [ORNL; Jardine, Philip [University of Tennessee, Knoxville (UTK); Gu, Baohua [ORNL

2011-01-01

This study investigates reactive transport modeling in a column of uranium(VI)-contaminated sediments with base additions in the circulating influent. The groundwater and sediment exhibit oxic conditions with low pH, high concentrations of NO{sub 3}{sup -}, SO{sub 4}{sup 2-}, U and various metal cations. Preliminary batch experiments indicate that additions of strong base induce rapid immobilization of U for this material. In the column experiment that is the focus of the present study, effluent groundwater was titrated with NaOH solution in an inflow reservoir before reinjection to gradually increase the solution pH in the column. An equilibrium hydrolysis, precipitation and ion exchange reaction model developed through simulation of the preliminary batch titration experiments predicted faster reduction of aqueous Al than observed in the column experiment. The model was therefore modified to consider reaction kinetics for the precipitation and dissolution processes which are the major mechanism for Al immobilization. The combined kinetic and equilibrium reaction model adequately described variations in pH, aqueous concentrations of metal cations (Al, Ca, Mg, Sr, Mn, Ni, Co), sulfate and U(VI). The experimental and modeling results indicate that U(VI) can be effectively sequestered with controlled base addition due to sorption by slowly precipitated Al with pH-dependent surface charge. The model may prove useful to predict field-scale U(VI) sequestration and remediation effectiveness.

Modeling uranium transport in acidic contaminated groundwater with base addition

International Nuclear Information System (INIS)

Zhang Fan; Luo Wensui; Parker, Jack C.; Brooks, Scott C.; Watson, David B.; Jardine, Philip M.; Gu Baohua

2011-01-01

This study investigates reactive transport modeling in a column of uranium(VI)-contaminated sediments with base additions in the circulating influent. The groundwater and sediment exhibit oxic conditions with low pH, high concentrations of NO 3 - , SO 4 2- , U and various metal cations. Preliminary batch experiments indicate that additions of strong base induce rapid immobilization of U for this material. In the column experiment that is the focus of the present study, effluent groundwater was titrated with NaOH solution in an inflow reservoir before reinjection to gradually increase the solution pH in the column. An equilibrium hydrolysis, precipitation and ion exchange reaction model developed through simulation of the preliminary batch titration experiments predicted faster reduction of aqueous Al than observed in the column experiment. The model was therefore modified to consider reaction kinetics for the precipitation and dissolution processes which are the major mechanism for Al immobilization. The combined kinetic and equilibrium reaction model adequately described variations in pH, aqueous concentrations of metal cations (Al, Ca, Mg, Sr, Mn, Ni, Co), sulfate and U(VI). The experimental and modeling results indicate that U(VI) can be effectively sequestered with controlled base addition due to sorption by slowly precipitated Al with pH-dependent surface charge. The model may prove useful to predict field-scale U(VI) sequestration and remediation effectiveness.

Modeling uranium transport in acidic contaminated groundwater with base addition

Energy Technology Data Exchange (ETDEWEB)

Zhang Fan, E-mail: zhangfan@itpcas.ac.cn [Key Laboratory of Tibetan Environment Changes and Land Surface Processes, Institute of Tibetan Plateau Research, Chinese Academy of Sciences, P.O. Box 2871, Beijing, 100085 (China); Luo Wensui [Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021 (China); Parker, Jack C. [Institute for a Secure and Sustainable Environment, Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 (United States); Brooks, Scott C.; Watson, David B. [Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831 (United States); Jardine, Philip M. [Biosystems Engineering and Soil Science Department, University of Tennessee, Knoxville, TN 37996 (United States); Gu Baohua [Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831 (United States)

2011-06-15

This study investigates reactive transport modeling in a column of uranium(VI)-contaminated sediments with base additions in the circulating influent. The groundwater and sediment exhibit oxic conditions with low pH, high concentrations of NO{sub 3}{sup -}, SO{sub 4}{sup 2-}, U and various metal cations. Preliminary batch experiments indicate that additions of strong base induce rapid immobilization of U for this material. In the column experiment that is the focus of the present study, effluent groundwater was titrated with NaOH solution in an inflow reservoir before reinjection to gradually increase the solution pH in the column. An equilibrium hydrolysis, precipitation and ion exchange reaction model developed through simulation of the preliminary batch titration experiments predicted faster reduction of aqueous Al than observed in the column experiment. The model was therefore modified to consider reaction kinetics for the precipitation and dissolution processes which are the major mechanism for Al immobilization. The combined kinetic and equilibrium reaction model adequately described variations in pH, aqueous concentrations of metal cations (Al, Ca, Mg, Sr, Mn, Ni, Co), sulfate and U(VI). The experimental and modeling results indicate that U(VI) can be effectively sequestered with controlled base addition due to sorption by slowly precipitated Al with pH-dependent surface charge. The model may prove useful to predict field-scale U(VI) sequestration and remediation effectiveness.

Reduction of dioxin-like toxicity in effluents by additional wastewater treatment and related effects in fish.

Science.gov (United States)

Maier, Diana; Benisek, Martin; Blaha, Ludek; Dondero, Francesco; Giesy, John P; Köhler, Heinz-R; Richter, Doreen; Scheurer, Marco; Triebskorn, Rita

2016-10-01

Efficiency of advanced wastewater treatment technologies to reduce micropollutants which mediate dioxin-like toxicity was investigated. Technologies compared included ozonation, powdered activated carbon and granular activated carbon. In addition to chemical analyses in samples of effluents, surface waters, sediments, and fish, (1) dioxin-like potentials were measured in paired samples of effluents, surface waters, and sediments by use of an in vitro biotest (reporter gene assay) and (2) dioxin-like effects were investigated in exposed fish by use of in vivo activity of the mixed-function, monooxygenase enzyme, ethoxyresorufin O-deethylase (EROD) in liver. All advanced technologies studied, based on degradation or adsorption, significantly reduced dioxin-like potentials in samples and resulted in lesser EROD activity in livers of fish. Results of in vitro and in vivo biological responses were not clearly related to quantification of targeted analytes by use of instrumental analyses. Copyright © 2016 Elsevier Inc. All rights reserved.

The Maudsley Model of Family-Based Treatment for Anorexia Nervosa: A Qualitative Evaluation of Parent-to-Parent Consultation

Science.gov (United States)

Rhodes, Paul; Brown, Jac; Madden, Sloane

2009-01-01

This article describes the qualitative analysis of a randomized control trial that explores the use of parent-to-parent consultations as an augmentation to the Maudsley model of family-based treatment for anorexia. Twenty families were randomized into two groups, 10 receiving standard treatment and 10 receiving an additional parent-to-parent…

Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

Directory of Open Access Journals (Sweden)

Walter Kipp

Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a

Dgroup: DG01486 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available DG01486 DGroup Penem -penem DG01486.gif DG00594 ... Faropenem ... D01839 ... Faropenem sodi...um hydrate (JP17) ... D08919 ... Faropenem medoxomil (USAN) DG01213 ... Sulopenem ... D05969 ... Sulopenem (USAN/INN) ... D09672 ... Sulopene

Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

Energy Technology Data Exchange (ETDEWEB)

Marnitz, S.; Hinkelbein, W. [Dept. of Radiooncology, Charite Univ. Medicine, Berlin (Germany); Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H. [Eye Tumor Therapy, Hahn-Meitner Inst., Berlin (Germany); Bendl, R. [Dept. of Medical Physics, German Cancer Research Center (DKFZ), Heidelberg (Germany); Lemke, A.J. [Dept. of Diagnostic Radiology, Charite Univ. Medicine, Berlin (Germany); Bechrakis, N.E.; Foerster, M.H. [Dept. of Ophthalmology, Charite Univ. Medicine, Berlin (Germany)

2006-07-15

Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

International Nuclear Information System (INIS)

Marnitz, S.; Hinkelbein, W.; Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H.; Bendl, R.; Lemke, A.J.; Bechrakis, N.E.; Foerster, M.H.

2006-01-01

Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

Combined treatment of xenon and hypothermia in newborn rats--additive or synergistic effect?

Directory of Open Access Journals (Sweden)

Hemmen Sabir

Full Text Available Breathing the inert gas Xenon (Xe enhances hypothermic (HT neuroprotection after hypoxia-ischemia (HI in small and large newborn animal models. The underlying mechanism of the enhancement is not yet fully understood, but the combined effect of Xe and HT could either be synergistic (larger than the two effects added or simply additive. A previously published study, using unilateral carotid ligation followed by hypoxia in seven day old (P7 rats, showed that the combination of mild HT (35°C and low Xe concentration (20%, both not being neuroprotective alone, had a synergistic effect and was neuroprotective when both were started with a 4 h delay after a moderate HI insult. To examine whether another laboratory could confirm this finding, we repeated key aspects of the study.After the HI-insult 120 pups were exposed to different post-insult treatments: three temperatures (normothermia (NT NT37°C, HT35°C, HT32°C or Xe concentrations (0%, 20% or 50% starting either immediately or with a 4 h delay. To assess the synergistic potency of Xe-HT, a second set (n = 101 of P7 pups were exposed to either HT35°C+Xe0%, NT+Xe20% or a combination of HT35°C+Xe20% starting with a 4 h delay after the insult. Brain damage was analyzed using relative hemispheric (ligated side/unligated side brain tissue area loss after seven day survival.Immediate HT32°C (p = 0.042, but not HT35°C significantly reduced brain injury compared to NT37°C. As previously shown, adding immediate Xe50% to HT32°C increased protection. Neither 4 h-delayed Xe20%, nor Xe50% at 37°C significantly reduced brain injury (p>0.050. In addition, neither 4 h-delayed HT35°C alone, nor HT35°C+Xe20% reduced brain injury. We found no synergistic effect of the combined treatments in this experimental model.Combining two treatments that individually were ineffective (delayed HT35°C and delayed Xe20% did not exert neuroprotection when combined, and therefore did not show a synergistic

If additional shielding required for the linear accelerator room when modern treatment techniques are intensively used

International Nuclear Information System (INIS)

Miller, Albert V.; Atkocius, Vydmantas; Aleknavicius, Eduardas

2001-01-01

Full text: Introduction - When the new linear accelerator is to be installed in radiotherapy department the responsible personnel should perform necessary estimations and calculations of the protective barriers for the accelerator treatment room. These methods are described in details in literature. However, if modern treatment techniques are planned to be intensively used on this machine, additional concern rises regarding adequacy of these calculations. The new Saturne-43 linear accelerator with three photon energies of 8, 15 and 25 MV recently installed at our department was, planned to be used for conventional treatment techniques as well as for conformal and total body treatments. The method of conformal therapy generally employs more small fields per one treated patient than conventional techniques. It leads to the use of more linear accelerator monitor units for the average treatment. It was estimated that 'beam on' time of an accelerator to deliver the same dose to the tumor is up to 3 times more than for conventional methods. The total body technique contribute to the extra time on of an accelerator because of extended distance to the dose prescription point. Altogether intensive clinical use of these modern techniques will noticeably increase 'beam on' time of an accelerator and rise question regarding validity of the traditionally calculated shielding of the treatment room. Materials and methods - IAEA-TECDOC-1040 and NCRP Report No 49 suggest considering three main components incident on the protective barriers: direct radiation, scatter radiation and leakage radiation. The formulas for these components are similar and dose equivalent limits are proportional to the workload. For the conventional treatments workloads of direct, scattered and leakage radiation are equal and calculated by the division of total prescribed dose (for all treated per week patients) to the machine isocenter to average tissue maximum ratio. These workloads for conformal and TBI

Energy-Based Devices in Treatment of Acne Vulgaris.

Science.gov (United States)

Handler, Marc Z; Bloom, Bradley S; Goldberg, David J

2016-05-01

Acne vulgaris is a chronic dermatologic complaint with a multifactorial cause. Traditionally, antibiotics and retinoids have been used to manage the condition; patient compliance has been an ongoing issue. A variety of energy-based devices have been reported to be effective in the treatment of acne vulgaris. To review and summarize the current literature specific to treatment of acne vulgaris with energy-based devices. A review of the current literature of energy-based devices used for the treatment of acne vulgaris. Although limited randomized controlled trials for the treatment of acne have been performed, significant clinical improvement of acne vulgaris, especially of inflammatory lesions, has been demonstrated with a variety of energy-based devices. Newer approaches may lead to even better results.

The addition of medium-chain triglycerides to a purified fish oil-based diet alters inflammatory profiles in mice.

Science.gov (United States)

Carlson, Sarah J; Nandivada, Prathima; Chang, Melissa I; Mitchell, Paul D; O'Loughlin, Alison; Cowan, Eileen; Gura, Kathleen M; Nose, Vania; Bistrian, Bruce R; Puder, Mark

2015-02-01

Parenteral nutrition associated liver disease (PNALD) is a deadly complication of long term parenteral nutrition (PN) use in infants. Fish oil-based lipid emulsion has been shown in recent years to effectively treat PNALD. Alternative fat sources free of essential fatty acids have recently been investigated for health benefits related to decreased inflammatory response. We hypothesized that the addition of medium-chain triglycerides (MCT) to a purified fish oil-based diet would decrease the response to inflammatory challenge in mice, while allowing for sufficient growth and development. Six groups of ten adult male C57/Bl6 mice were pair-fed different dietary treatments for a period of twelve weeks, varying only in fat source (percent calories by weight): 10.84% soybean oil (SOY), 10% coconut oil (HCO), 10% medium-chain triglycerides (MCT), 3% purified fish oil (PFO), 3% purified fish oil with 3% medium-chain triglycerides (50:50 MCT:PFO) and 3% purified fish oil with 7.59% medium-chain triglycerides (70:30 MCT:PFO). An endotoxin challenge was administered to half of the animals in each group at the completion of dietary treatment. All groups demonstrated normal growth throughout the study period. Groups fed MCT and HCO diets demonstrated biochemical essential fatty acid deficiency and decreased IL-6 and TNF-α response to endotoxin challenge. Groups containing PFO had increased inflammatory response to endotoxin challenge, and the addition of MCT to PFO mitigated this inflammatory response. These results suggest that the addition of MCT to PFO formulations may decrease the host response to inflammatory challenge, which may pose potential for optimized PN formulations. Inclusion of MCT in lipid emulsions given with PN formulations may be of use in therapeutic interventions for disease states resulting from chronic inflammation. Copyright © 2015 Elsevier Inc. All rights reserved.

Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: a nationwide study.

Directory of Open Access Journals (Sweden)

Wen-Pyng Wu

Full Text Available Paraquat poisoning associates very high mortality rate. Early treatment with hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST in combination with hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with hemoperfusion and the additional effects of IST combined with hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, P<0.001. The combined IST with methylprednisolone, cyclophosphamide and dexamethasone associates with the highest survival rate (48%, P<0.001. Moreover, patients younger than 45 years of age in the IST group had the best survival (41.0% vs. 33.7%, p<0.001. Our results support the use of IST with hemoperfusion for paraquat-poisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age.

Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence.

Science.gov (United States)

Tomé-Carneiro, Joao; Visioli, Francesco

2016-10-15

In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of cardiovascular disease (CVD), even though most of them have been exclusively studied in vitro. We review the available evidence (focusing on when the amount of polyphenols' intake was measured) coming from randomized controlled trials (RCTs) of (poly)phenol-based supplements. We conclude that (poly)phenol-based nutraceuticals and functional foods might be indeed used as adjunct therapy of CVD, but additional long-term RCTs with adequate numerosity and with clinically relevant end points are needed to provide unequivocal evidence of their clinical usefulness. Copyright © 2015. Published by Elsevier GmbH.

Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

Science.gov (United States)

Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

2011-01-01

This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

Optimal chemotherapy for leukemia: a model-based strategy for individualized treatment.

Directory of Open Access Journals (Sweden)

Devaraj Jayachandran

Full Text Available Acute Lymphoblastic Leukemia, commonly known as ALL, is a predominant form of cancer during childhood. With the advent of modern healthcare support, the 5-year survival rate has been impressive in the recent past. However, long-term ALL survivors embattle several treatment-related medical and socio-economic complications due to excessive and inordinate chemotherapy doses received during treatment. In this work, we present a model-based approach to personalize 6-Mercaptopurine (6-MP treatment for childhood ALL with a provision for incorporating the pharmacogenomic variations among patients. Semi-mechanistic mathematical models were developed and validated for i 6-MP metabolism, ii red blood cell mean corpuscular volume (MCV dynamics, a surrogate marker for treatment efficacy, and iii leukopenia, a major side-effect. With the constraint of getting limited data from clinics, a global sensitivity analysis based model reduction technique was employed to reduce the parameter space arising from semi-mechanistic models. The reduced, sensitive parameters were used to individualize the average patient model to a specific patient so as to minimize the model uncertainty. Models fit the data well and mimic diverse behavior observed among patients with minimum parameters. The model was validated with real patient data obtained from literature and Riley Hospital for Children in Indianapolis. Patient models were used to optimize the dose for an individual patient through nonlinear model predictive control. The implementation of our approach in clinical practice is realizable with routinely measured complete blood counts (CBC and a few additional metabolite measurements. The proposed approach promises to achieve model-based individualized treatment to a specific patient, as opposed to a standard-dose-for-all, and to prescribe an optimal dose for a desired outcome with minimum side-effects.

Influence of metallic based fuel additives on performance and exhaust emissions of diesel engine

Energy Technology Data Exchange (ETDEWEB)

Keskin, Ali [Tarsus Technical Education Faculty, Mersin University, 33500 Mersin (Turkey); Guerue, Metin, E-mail: mguru@gazi.edu.t [Engineering and Architectural Faculty, Gazi University, 06570 Maltepe, Ankara (Turkey); Altiparmak, Duran [Technical Education Faculty, Gazi University, 06500 Ankara (Turkey)

2011-01-15

In this experimental study, influence of the metallic-based additives on fuel consumption and exhaust emissions of diesel engine were investigated. The metallic-based additives were produced by synthesizing of resin acid (abietic acid) with MnO{sub 2} or MgO. These additives were doped into diesel fuel at the rate of 8 {mu}mol/l and 16 {mu}mol/l for preparing test fuels. Both additives improved the properties of diesel fuel such as viscosity, flash point, cloud point and pour point. The fuels with and without additives were tested in a direct injection diesel engine at full load condition. Maximum reduction of specific fuel consumption was recorded as 4.16%. CO emission and smoke opacity decreased by 16.35% and by 29.82%, respectively. NO{sub x} emission was measured higher and CO{sub 2} emission was not changed considerably with the metallic-based additives.

Carbon dioxide test as an additional clinical measure of treatment response in panic disorder

Directory of Open Access Journals (Sweden)

Valença Alexandre M.

2002-01-01

Full Text Available OBJECTIVE: We aim to determine if a treatment with a dose of clonazepam - 2 mg/day, for 6 weeks, blocks spontaneous panic attacks and the ones induced by the inhalation of 35% carbon dioxide (CO2 in panic disorder (PD patients. The CO2 challenge-test may be a useful addition tool for measuring the pharmacological response during the initial phase (6 weeks in the treatment of PD. METHOD: Eighteen PD patients drug free for a week participated in a carbon dioxide challenge test. Fourteen had a panic attack and were openly treated for a 6-week period with clonazepam. At the end of the 6-week period they were submitted again to the CO2 challenge test. RESULTS: After 6 weeks of treatment with clonazepam, 12 of 14 PD patients (85.7% did not have a panic attack after the CO2 challenge test. Just 2 of 14 patients (14.3% had a panic attack after the CO2 challenge test. Ten of 14 (71.4% PD patients had panic free status after clonazepam treatment. The 2 patients who had a panic attack in the sixth week, after the CO2 test, did not have panic free status after the treatment with clonazepam. CONCLUSION: The CO2-test may be a valid tool for testing and predicting the drug response.

Characterization of Ti and Co based biomaterials processed via laser based additive manufacturing

Science.gov (United States)

Sahasrabudhe, Himanshu

Titanium and Cobalt based metallic materials are currently the most ideal materials for load-bearing metallic bio medical applications. However, the long term tribological degradation of these materials still remains a problem that needs a solution. To improve the tribological performance of these two metallic systems, three different research approaches were adapted, stemming out four different research projects. First, the simplicity of laser gas nitriding was utilized with a modern LENS(TM) technology to form an in situ nitride rich later in titanium substrate material. This nitride rich composite coating improved the hardness by as much as fifteen times and reduced the wear rate by more than a magnitude. The leaching of metallic ions during wear was also reduced by four times. In the second research project, a mixture of titanium and silicon were processed on a titanium substrate in a nitrogen rich environment. The results of this reactive, in situ additive manufacturing process were Ti-Si-Nitride coatings that were harder than the titanium substrate by more than twenty times. These coatings also reduced the wear rate by more than two magnitudes. In the third research approach, composites of CoCrMo alloy and Calcium phosphate (CaP) bio ceramic were processed using LENS(TM) based additive manufacturing. These composites were effective in reducing the wear in the CoCrMo alloy by more than three times as well as reduce the leaching of cobalt and chromium ions during wear. The novel composite materials were found to develop a tribofilm during wear. In the final project, a combination of hard nitride coating and addition of CaP bioceramic was investigated by processing a mixture of Ti6Al4V alloy and CaP in a nitrogen rich environment using the LENS(TM) technology. The resultant Ti64-CaP-Nitride coatings significantly reduced the wear damage on the substrate. There was also a drastic reduction in the metal ions leached during wear. The results indicate that the three

Septic tank additive impacts on microbial populations.

Science.gov (United States)

Pradhan, S; Hoover, M T; Clark, G H; Gumpertz, M; Wollum, A G; Cobb, C; Strock, J

2008-01-01

Environmental health specialists, other onsite wastewater professionals, scientists, and homeowners have questioned the effectiveness of septic tank additives. This paper describes an independent, third-party, field scale, research study of the effects of three liquid bacterial septic tank additives and a control (no additive) on septic tank microbial populations. Microbial populations were measured quarterly in a field study for 12 months in 48 full-size, functioning septic tanks. Bacterial populations in the 48 septic tanks were statistically analyzed with a mixed linear model. Additive effects were assessed for three septic tank maintenance levels (low, intermediate, and high). Dunnett's t-test for tank bacteria (alpha = .05) indicated that none of the treatments were significantly different, overall, from the control at the statistical level tested. In addition, the additives had no significant effects on septic tank bacterial populations at any of the septic tank maintenance levels. Additional controlled, field-based research iswarranted, however, to address additional additives and experimental conditions.

Dgroup: DG01925 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available amlodipine besilate mixt ... D07569 ... Candesartan cilexetil and anmlodipine besylate tablets (JP17) ... D10286 ... Amlodipine - valsartan... -hydrochlorothiazide mixt ... D10287 ... Aliskiren hemifumarate - valsartan... mixt D10288 ... Olmesartan medoxomil - amlodipine besylate - hydrochlorothiazide mixt ... D10226 ... Sacubitril valsartan

SU-F-BRA-13: Knowledge-Based Treatment Planning for Prostate LDR Brachytherapy Based On Principle Component Analysis

Energy Technology Data Exchange (ETDEWEB)

Roper, J; Bradshaw, B; Godette, K; Schreibmann, E [Winship Cancer Institute of Emory University, Atlanta, GA (United States); Chanyavanich, V [Rocky Mountain Cancer Centers, Denver, CO (United States)

2015-06-15

Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process and then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.

Boundary lubrication of stainless steel and CoCrMo alloy materials based on three ester-based additives

NARCIS (Netherlands)

Yan, J.; Zeng, Xiangqiong; Ren, T.; van der Heide, Emile

2014-01-01

Material selection and lubricant additive development are two important aspects for engineering applications. This work explores the possibilities of three different ester-based additives (DBOP, ODOC and DOB) to generate boundary films on two corrosion and wear resistant materials, stainless steel

Boundary lubrication of bearing steel in water-based lubricants with functional additives

NARCIS (Netherlands)

Wu, Y.

2017-01-01

This thesis focuses on the effect of additives on boundary lubrication of bearing steel for water-based lubrication systems. The oil-in-water (O/W) emulsion and the water-glycol based liquid were selected as the base fluids for research. Sulfur compounds, nitrogen heterocycles and graphene

Validation of an algorithm-based definition of treatment resistance in patients with schizophrenia.

Science.gov (United States)

Ajnakina, Olesya; Horsdal, Henriette Thisted; Lally, John; MacCabe, James H; Murray, Robin M; Gasse, Christiane; Wimberley, Theresa

2018-02-19

Large-scale pharmacoepidemiological research on treatment resistance relies on accurate identification of people with treatment-resistant schizophrenia (TRS) based on data that are retrievable from administrative registers. This is usually approached by operationalising clinical treatment guidelines by using prescription and hospital admission information. We examined the accuracy of an algorithm-based definition of TRS based on clozapine prescription and/or meeting algorithm-based eligibility criteria for clozapine against a gold standard definition using case notes. We additionally validated a definition entirely based on clozapine prescription. 139 schizophrenia patients aged 18-65years were followed for a mean of 5years after first presentation to psychiatric services in South-London, UK. The diagnostic accuracy of the algorithm-based measure against the gold standard was measured with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). A total of 45 (32.4%) schizophrenia patients met the criteria for the gold standard definition of TRS; applying the algorithm-based definition to the same cohort led to 44 (31.7%) patients fulfilling criteria for TRS with sensitivity, specificity, PPV and NPV of 62.2%, 83.0%, 63.6% and 82.1%, respectively. The definition based on lifetime clozapine prescription had sensitivity, specificity, PPV and NPV of 40.0%, 94.7%, 78.3% and 76.7%, respectively. Although a perfect definition of TRS cannot be derived from available prescription and hospital registers, these results indicate that researchers can confidently use registries to identify individuals with TRS for research and clinical practices. Copyright © 2018 Elsevier B.V. All rights reserved.

Naturalistic Outcome of Family-Based Inpatient Treatment for Adolescents with Anorexia Nervosa.

Science.gov (United States)

Halvorsen, Inger; Reas, Deborah Lynn; Nilsen, Jan-Vegard; Rø, Øyvind

2018-03-01

Outpatient family-based treatment (FBT) is the best-documented treatment for adolescent anorexia nervosa (AN), but research is scarce on FBT adapted to inpatient settings. The naturalistic outcome of inpatient FBT for adolescent AN was investigated. Thirty-seven (65%) of 57 patients who received inpatient FBT at a tertiary adolescent eating disorders (ED) unit participated in a follow-up interview (mean 4.5 ± 1.8, range 1-7 years) that assessed ED symptoms and general psychological functioning. A majority (65%) had achieved a normal body weight (body mass index ≥18.5). Thirty-six per cent (n = 12) were classified as fully recovered, as defined by body mass index ≥18.5, ED Examination Questionnaire global ≤2.5, and no binge eating/purging over past 3 months. Sixteen (43%) participants met criteria for one or more additional comorbid disorders. Inpatient family-based therapy for AN may be a promising therapeutic approach for adolescents that fail to respond to outpatient treatment and should be investigated further. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Addition of meloxicam to the treatment of clinical mastitis improves subsequent reproductive performance.

Science.gov (United States)

McDougall, S; Abbeloos, E; Piepers, S; Rao, A S; Astiz, S; van Werven, T; Statham, J; Pérez-Villalobos, N

2016-03-01

A blinded, negative controlled, randomized intervention study was undertaken to test the hypothesis that addition of meloxicam, a nonsteroidal anti-inflammatory drug, to antimicrobial treatment of mild to moderate clinical mastitis would improve fertility and reduce the risk of removal from the herd. Cows (n=509) from 61 herds in 8 regions (sites) in 6 European countries were enrolled. Following herd-owner diagnosis of mild to moderate clinical mastitis within the first 120 d of lactation in a single gland, the rectal temperature, milk appearance, and California Mastitis Test score were assessed. Cows were randomly assigned within each site to be treated either with meloxicam or a placebo (control). All cows were additionally treated with 1 to 4 intramammary infusions of cephalexin and kanamycin at 24-h intervals. Prior to treatment and at 14 and 21 d posttreatment, milk samples were collected for bacteriology and somatic cell count. Cows were bred by artificial insemination and pregnancy status was subsequently defined. General estimating equations were used to determine the effect of treatment (meloxicam versus control) on bacteriological cure, somatic cell count, the probability of being inseminated by 21 d after the voluntary waiting period, the probability of conception to first artificial insemination, the number of artificial insemination/conception, the probability of pregnancy by 120 or 200 d postcalving, and the risk of removal by 300 d after treatment. Cox's proportional hazards models were used to test the effect of treatment on the calving to first insemination and calving to conception intervals. Groups did not differ in terms of age, clot score, California Mastitis Test score, rectal temperature, number of antimicrobial treatments given or bacteria present at the time of enrollment, but cows treated with meloxicam had greater days in milk at enrollment. Cows treated with meloxicam had a higher bacteriological cure proportion than those treated with

Structural modification of swai-fish (Pangasius hypophthalmus)-based emulsions containing non-meat protein additives by ultra-high pressure and thermal treatments

Science.gov (United States)

Techarang, Jiranat; Apichartsrangkoon, Arunee; Phanchaisri, Boonrak; Pathomrungsiyoungkul, Pattavara; Sriwattana, Sujinda

2017-07-01

Swai-fish emulsions containing fermented soybeans (thua nao and rice-koji miso) were pressurized at 600 MPa for 20 min or heated at 72°C for 30 min. The fish batters were blended with soy protein isolate (SPI) or whey protein concentrate (WPC) to stabilize the emulsions. The processed fish emulsions were then subjected to physical, chemical and microbiological examinations. The results of gel strength and water-holding potential showed that SPI addition yielded higher impact on these properties than WPC addition, which was also confirmed by the interactions between SPI and native fish proteins depicted by electrophoregrams. The frequency profiles suggested that the heated gels had a greater storage and loss moduli than pressurized gels, while pressurized WPC set-gel displayed larger loss tangent (the predominance of viscous moiety) than those pressurized SPI set-gel. High bacteria and spore counts of B. subtilis (residual of the thua nao) were observed in both pressurized and heated fish-based emulsions.

[Analysis of constituents of ester-type gum bases used as natural food additives].

Science.gov (United States)

Tada, Atsuko; Masuda, Aino; Sugimoto, Naoki; Yamagata, Kazuo; Yamazaki, Takeshi; Tanamoto, Kenichi

2007-12-01

The differences in the constituents of ten ester-type gum bases used as natural food additives in Japan (urushi wax, carnauba wax, candelilla wax, rice bran wax, shellac wax, jojoba wax, bees wax, Japan wax, montan wax, and lanolin) were investigated. Several kinds of gum bases showed characteristic TLC patterns of lipids. In addition, compositions of fatty acid and alcohol moieties of esters in the gum bases were analyzed by GC/MS after methanolysis and hydrolysis, respectively. The results indicated that the varieties of fatty acids and alcohols and their compositions were characteristic for each gum base. These results will be useful for identification and discrimination of the ester-type gum bases.

Impact of Phosphorus-Based Food Additives on Bone and Mineral Metabolism.

Science.gov (United States)

Gutiérrez, Orlando M; Luzuriaga-McPherson, Alexandra; Lin, Yiming; Gilbert, Linda C; Ha, Shin-Woo; Beck, George R

2015-11-01

Phosphorus-based food additives can substantially increase total phosphorus intake per day, but the effect of these additives on endocrine factors regulating bone and mineral metabolism is unclear. This study aimed to examine the effect of phosphorus additives on markers of bone and mineral metabolism. Design and Setting, and Participants: This was a feeding study of 10 healthy individuals fed a diet providing ∼1000 mg of phosphorus/d using foods known to be free of phosphorus additives for 1 week (low-additive diet), immediately followed by a diet containing identical food items; however, the foods contained phosphorus additives (additive-enhanced diet). Parallel studies were conducted in animals fed low- (0.2%) and high- (1.8%) phosphorus diets for 5 or 15 weeks. The changes in markers of mineral metabolism after each diet period were measured. Participants were 32 ± 8 years old, 30% male, and 70% black. The measured phosphorus content of the additive-enhanced diet was 606 ± 125 mg higher than the low-additive diet (P additive diet, consuming the additive-enhanced diet for 1 week significantly increased circulating fibroblast growth factor 23 (FGF23), osteopontin, and osteocalcin concentrations by 23, 10, and 11%, respectively, and decreased mean sclerostin concentrations (P foods can disturb bone and mineral metabolism in humans. The results of the animal studies suggest that this may compromise bone health.

Additive protection by LDR and FGF21 treatment against diabetic nephropathy in type 2 diabetes model.

Science.gov (United States)

Shao, Minglong; Yu, Lechu; Zhang, Fangfang; Lu, Xuemian; Li, Xiaokun; Cheng, Peng; Lin, Xiufei; He, Luqing; Jin, Shunzi; Tan, Yi; Yang, Hong; Zhang, Chi; Cai, Lu

2015-07-01

The onset of diabetic nephropathy (DN) is associated with both systemic and renal changes. Fibroblast growth factor (FGF)-21 prevents diabetic complications mainly by improving systemic metabolism. In addition, low-dose radiation (LDR) protects mice from DN directly by preventing renal oxidative stress and inflammation. In the present study, we tried to define whether the combination of FGF21 and LDR could further prevent DN by blocking its systemic and renal pathogeneses. To this end, type 2 diabetes was induced by feeding a high-fat diet for 12 wk followed by a single dose injection of streptozotocin. Diabetic mice were exposed to 50 mGy LDR every other day for 4 wk with and without 1.5 mg/kg FGF21 daily for 8 wk. The changes in systemic parameters, including blood glucose levels, lipid profiles, and insulin resistance, as well as renal pathology, were examined. Diabetic mice exhibited renal dysfunction and pathological abnormalities, all of which were prevented significantly by LDR and/or FGF21; the best effects were observed in the group that received the combination treatment. Our studies revealed that the additive renal protection conferred by the combined treatment against diabetes-induced renal fibrosis, inflammation, and oxidative damage was associated with the systemic improvement of hyperglycemia, hyperlipidemia, and insulin resistance. These results suggest that the combination treatment with LDR and FGF21 prevented DN more efficiently than did either treatment alone. The mechanism behind these protective effects could be attributed to the suppression of both systemic and renal pathways. Copyright © 2015 the American Physiological Society.

Active home-based cancer treatment

Directory of Open Access Journals (Sweden)

Bordonaro S

2012-06-01

Full Text Available Sebastiano Bordonaro Fabio Raiti, Annamaria Di Mari, Calogera Lopiano, Fabrizio Romano, Vitalinda Pumo, Sebastiano Rametta Giuliano, Margherita Iacono, Eleonora Lanteri, Elena Puzzo, Sebastiano Spada, Paolo TralongoUOC Medical Oncology, RAO, ASP 8 Siracusa, ItalyBackground: Active home-based treatment represents a new model of health care. Chronic treatment requires continuous access to facilities that provide cancer care, with considerable effort, particularly economic, on the part of patients and caregivers. Oral chemotherapy could be limited as a consequence of poor compliance and adherence, especially by elderly patients.Methods: We selected 30 cancer patients referred to our department and treated with oral therapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate. This pilot study of oral therapy in the patient’s home was undertaken by a doctor and two nurses with experience in clinical oncology. The instruments used were clinical diaries recording home visits, hospital visits, need for caregiver support, and a questionnaire specially developed by the European Organization for Research and Treatment of Cancer (EORTC, known as the QLQ-C30 version 2.0, concerning the acceptability of oral treatment from the patient’s perspective.Results: This program decreased the need to access cancer facilities by 98.1%, promoted better quality of life for patients, as reflected in increased EORTC QLQ-C30 scores over time, allowing for greater adherence to oral treatment as a result of control of drug administration outside the hospital. This model has allowed treatment of patients with difficult access to care (elderly, disabled or otherwise needed caregivers that in the project represent the majority (78% of these.Conclusions: This model of active home care improves quality of life and adherence with oral therapy, reduces the need to visit the hospital, and consequently decreases the number of lost hours of work on

A new argon gas-based device for the treatment of keloid scars with the use of intralesional cryotherapy.

Science.gov (United States)

van Leeuwen, Michiel C E; Bulstra, Anne-Eva J; van Leeuwen, Paul A M; Niessen, Frank B

2014-12-01

Intralesional (IL) cryotherapy is a new promising technique for the treatment of keloid scars, in which the scar is frozen from inside. Multiple devices are available, mostly based on a simple liquid nitrogen Dewar system, which have a limited freezing capacity. Argon gas-based systems ensure accurate and highly controlled freezing and have shown to be effective within the field of oncologic surgery. However, this technique has never been used for the treatment of keloid scars. This prospective study evaluates an argon gas-based system for the treatment of keloids in a patient population including all Fitzpatrick skin types with a 1-year follow-up. Twenty-five patients with 30 keloid scars were included and treated with a device called Seednet (Galil Medical, Yokneam, Israel). Scar quality and possible scar recurrence were assessed before treatment and post treatment (6 and 12 months) with objective devices determining scar color, scar elasticity, scar volume, and patient's skin type. In addition, scars were evaluated using the Patient and Observer Scar Assessment Scale. After 12 months, a significant volume reduction of 62% was obtained, p = 0.05. Moreover, complaints of pain and itching were alleviated and scar quality had improved according to the Patient and Observer Scar Assessment Scale. Scar pigmentation recovered in 62% of all keloid scars within 12 months. Five out of 30 (17%) scars recurred within 12 months, three of which had previously been treated with liquid nitrogen-based IL cryotherapy. Both recurrent and persistent hypopigmentation were mainly seen in Afro-American patients. IL cryotherapy with the use of an argon gas-based system proves to be effective in the treatment of keloid scars, yielding volume reduction and low recurrence rates. Although hypopigmentation recovered in most cases, it is strongly related to non-Caucasian patients. Finally, additional treatment of keloid scars previously unresponsive to IL cryotherapy is predisposed to a high

The feasibility of utilizing pseudo CT-data for online MRI based treatment plan adaptation for a stereotactic radiotherapy treatment of spinal bone metastases

International Nuclear Information System (INIS)

Hoogcarspel, Stan J; Van der Velden, Joanne M; Lagendijk, Jan J W; Van Vulpen, Marco; Raaymakers, Bas W

2014-01-01

The purpose of this study was to investigate what pseudo-CT (pCT) strategy is sufficient for online MRI based treatment plan adaptation of a stereotactic treatment for spinal bone metastases. For this purpose, the dosimetric accuracy of five increasingly complex pCT strategies was evaluated using the planning CT data of 20 patients suffering from spinal metastases. For each pCT, a treatment plan was developed and simulated on both the pCT and the original CT data of the patient. The two resulting dose distributions were compared using gamma analysis of 2%/2 mm. In this paper, a Gamma Pass Rate (GPR) of ⩾95% within the Target Volume (TV) was considered clinically acceptable. We additionally demonstrated in this paper the automatic generation of each investigated pCT strategy with the use of dedicated MRI data complemented with pre-treatment CT data of a patient in treatment position. The dosimetric accuracy of a pCT increases when additional bulk densities are utilized for a pCT. However, the dosimetric accuracy of even the most complex ‘bulk density’ pCT strategy used in this study had an average GPR of only 78% within the TV. However, if information on the heterogeneous electron density distribution within the affected vertebral body was available, a clinically acceptable 99% mean GPR was observed. All pCTs could successfully be generated using the MRI data in combination with the CT data of a patient in treatment position. The results presented in this study show that a simple ‘bulk density’ pseudo-CT strategy is not feasible for online MRI based treatment plan adaptation for spinal bone metastases. However, a clinically acceptable result is generated if the information on the heterogeneous electron density (ED) distribution within the affected vertebral bone is available. Therefore, any pCT strategy for this tumor site should include a method which can estimate the heterogeneous ED of the affected vertebral bone. (paper)

[Proangiogenic cell-based therapy for treatment of ischemic diseases].

Science.gov (United States)

Silvestre, Jean-Sébastien

2009-11-01

The application of endothelial progenitor cells (EPC) cell-based therapy for regenerative medicine constitutes a promising therapeutic avenue for the treatment of cardiovascular diseases. Based on experimental studies demonstrating that bone marrow-, blood- or tissue-derived stem/progenitor cells improve the functional recovery after ischemia, clinical trials were initiated to address this new therapeutic concept. Although autolougous cell therapy was shown to improve perfusion and function of ischemic tissues, a number of issues remain to be adressed. The nature of the mobilizing, migratory and homing signals, and the mechanisms of action need to be identified and further defined. In addition, strategies to enhance homing, survival and therapeutic potential of EPC need to be developped to improve therapeutic effect and counteract EPC dysfunction in aged patients with cardiovascular risk factors. The present review article will discuss the mechanisms of action of different types of adult stem cells and several approaches to improve their therapeutic efficiency.

Effects of Rare Earth Metals addition and aging treatment on the corrosion resistance and mechanical properties of super duplex stainless steels

Science.gov (United States)

Park, Yong-Soo; Kim, Soon-Tae; Lee, In-Sung; Song, Chi-Bok

2002-05-01

Effects of rare earth metals addition and aging treatment on corrosion resistance and mechanical properties of super duplex stainless steels were investigated using optical/SEM/TEM metallographic examination, an X-ray diffraction test, a potentiodynamic anodic polarization test and a tensile test. The performance of the experimental alloy with 0.32% REM addition was compared with commercial super duplex stainless steel such as SAF 2507 when they were exposed to solution annealing heat treatment and aging treatment. The corrosion resistance in Cl- environments and mechanical properties of the experimental alloy were found superior to those of the commercial duplex stainless steel. The REM with larger atomic radii than those of Cr, Mo and W may fill vacancies inside the matrix and around the grain boundaries, retarding formation of harmful intermetallic σ and η phases. In addition, fine REM oxides/oxy-sulfides (1-3 μm) seemed to enhance the retardation effects. With REM additions, strength and ductility increased due to the phase and grain refinement caused by fine REM oxides and oxy-sulfides.

Clinical outcome comparison of immediate blanket treatment versus a delayed pathogen-based treatment protocol for clinical mastitis in a New York dairy herd.

Science.gov (United States)

Vasquez, A K; Nydam, D V; Capel, M B; Eicker, S; Virkler, P D

2017-04-01

The purpose was to compare immediate intramammary antimicrobial treatment of all cases of clinical mastitis with a selective treatment protocol based on 24-h culture results. The study was conducted at a 3,500-cow commercial farm in New York. Using a randomized design, mild to moderate clinical mastitis cases were assigned to either the blanket therapy or pathogen-based therapy group. Cows in the blanket therapy group received immediate on-label intramammary treatment with ceftiofur hydrochloride for 5 d. Upon receipt of 24 h culture results, cows in the pathogen-based group followed a protocol automatically assigned via Dairy Comp 305 (Valley Agricultural Software, Tulare, CA): Staphylococcus spp., Streptococcus spp., or Enterococcus spp. were administered on-label intramammary treatment with cephapirin sodium for 1 d. Others, including cows with no-growth or gram-negative results, received no treatment. A total of 725 cases of clinical mastitis were observed; 114 cows were not enrolled due to severity. An additional 122 cases did not meet inclusion criteria. Distribution of treatments for the 489 qualifying events was equal between groups (pathogen-based, n = 246; blanket, n = 243). The proportions of cases assigned to the blanket and pathogen-based groups that received intramammary therapy were 100 and 32%, respectively. No significant differences existed between blanket therapy and pathogen-based therapy in days to clinical cure; means were 4.8 and 4.5 d, respectively. The difference in post-event milk production between groups was not statistically significant (blanket therapy = 34.7 kg; pathogen-based = 35.4 kg). No differences were observed in test-day linear scores between groups; least squares means of linear scores was 4.3 for pathogen-based cows and 4.2 for blanket therapy cows. Odds of survival 30 d postenrollment was similar between groups (odds ratio of pathogen-based = 1.6; 95% confidence interval: 0.7-3.7) as was odds of survival to 60 d (odds ratio

Rapid production of hollow SS316 profiles by extrusion based additive manufacturing

Science.gov (United States)

Rane, Kedarnath; Cataldo, Salvatore; Parenti, Paolo; Sbaglia, Luca; Mussi, Valerio; Annoni, Massimiliano; Giberti, Hermes; Strano, Matteo

2018-05-01

Complex shaped stainless steel tubes are often required for special purpose biomedical equipment. Nevertheless, traditional manufacturing technologies, such as extrusion, lack the ability to compete in a market of customized complex components because of associated expenses towards tooling and extrusion presses. To rapid manufacture few of such components with low cost and high precision, a new Extrusion based Additive Manufacturing (EAM) process, is proposed in this paper, and as an example, short stainless steel 316L complex shaped and sectioned tubes were prepared by EAM. Several sample parts were produced using this process; the dimensional stability, surface roughness and chemical composition of sintered samples were investigated to prove process competence. The results indicate that feedstock with a 316L particle content of 92.5 wt. % can be prepared with a sigma blade mixing, whose rheological behavior is fit for EAM. The green samples have sufficient strength to handle them for subsequent treatments. The sintered samples considerably shrunk to designed dimensions and have a homogeneous microstructure to impart mechanical strength. Whereas, maintaining comparable dimensional accuracy and chemical composition which are required for biomedical equipment still need iterations, a kinematic correction and modification in debinding cycle was proposed.

European evidence-based recommendations for diagnosis and treatment of paediatric antiphospholipid syndrome: the SHARE initiative.

Science.gov (United States)

Groot, Noortje; de Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Dolezalova, Pavla; Feldman, Brian; Kenet, Gili; Koné-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza; Pilkington, Clarissa A; Ravelli, Angelo; van Royen-Kerkhof, Annet; Uziel, Yosef; Vastert, Sebastiaan J; Wulffraat, Nico M; Ozen, Seza; Brogan, Paul; Kamphuis, Sylvia; Beresford, Michael W

2017-10-01

Antiphospholipid syndrome (APS) is rare in children, and evidence-based guidelines are sparse. Consequently, management is mostly based on observational studies and physician's experience, and treatment regimens differ widely. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative was launched to develop diagnostic and management regimens for children and young adults with rheumatic diseases. Here, we developed evidence-based recommendations for diagnosis and treatment of paediatric APS. Evidence-based recommendations were developed using the European League Against Rheumatism standard operating procedure. Following a detailed systematic review of the literature, a committee of paediatric rheumatologists and representation of paediatric haematology with expertise in paediatric APS developed recommendations. The literature review yielded 1473 articles, of which 15 were valid and relevant. In total, four recommendations for diagnosis and eight for treatment of paediatric APS (including paediatric Catastrophic Antiphospholipid Syndrome) were accepted. Additionally, two recommendations for children born to mothers with APS were accepted. It was agreed that new classification criteria for paediatric APS are necessary, and APS in association with childhood-onset systemic lupus erythematosus should be identified by performing antiphospholipid antibody screening. Treatment recommendations included prevention of thrombotic events, and treatment recommendations for venous and/or arterial thrombotic events. Notably, due to the paucity of studies on paediatric APS, level of evidence and strength of the recommendations is relatively low. The SHARE initiative provides international, evidence-based recommendations for diagnosis and treatment for paediatric APS, facilitating improvement and uniformity of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

MINERVA: A multi-modality plug-in-based radiation therapy treatment planning system

International Nuclear Information System (INIS)

Wemple, C. A.; Wessol, D. E.; Nigg, D. W.; Cogliati, J. J.; Milvich, M.; Fredrickson, C. M.; Perkins, M.; Harkin, G. J.; Hartmann-Siantar, C. L.; Lehmann, J.; Flickinger, T.; Pletcher, D.; Yuan, A.; DeNardo, G. L.

2005-01-01

Researchers at the INEEL, MSU, LLNL and UCD have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system, which can be used for planning and analysing several radiotherapy modalities, either singly or combined, using common treatment planning tools. It employs an integrated, lightweight plug-in architecture to accommodate multi-modal treatment planning using standard interface components. The design also facilitates the future integration of improved planning technologies. The code is being developed with the Java programming language for inter-operability. The MINERVA design includes the image processing, model definition and data analysis modules with a central module to coordinate communication and data transfer. Dose calculation is performed by source and transport plug-in modules, which communicate either directly through the database or through MINERVA's openly published, extensible markup language (XML)-based application programmer's interface (API). All internal data are managed by a database management system and can be exported to other applications or new installations through the API data formats. A full computation path has been established for molecular-targeted radiotherapy treatment planning, with additional treatment modalities presently under development. (authors)

Effect of lime addition during sewage sludge treatment on characteristics of resulting SSA when it is used in cementitious materials.

Science.gov (United States)

Vouk, D; Nakic, D; Štirmer, N; Baricevic, A

2017-02-01

Final disposal of sewage sludge is important not only in terms of satisfying the regulations, but the aspect of choosing the optimal wastewater treatment technology, including the sludge treatment. In most EU countries, significant amounts of stabilized and dewatered sludge are incinerated, and sewage sludge ash (SSA) is generated as a by product. At the same time, lime is one of the commonly used additives in the sewage sludge treatment primarily to stabilize the sludge. In doing so, the question arose how desirable is such addition of lime if the sludge is subsequently incinerated, and the generated ash is further used in the production of cementitious materials. A series of mortars were prepared where 10-20% of the cement fraction was replaced by SSA. Since all three types of analyzed SSA (without lime, with lime added during sludge stabilization and with extra lime added during sludge incineration) yielded nearly same results, it can be concluded that if sludge incineration is accepted solution, lime addition during sludge treatment is unnecessary even from the standpoint of preserving the pozzolanic properties of the resulting SSA. Results of the research carried out on cement mortars point to the great possibilities of using SSA in concrete industry.

Investigation of effects of boron additives and heat treatment on carbides and phase transition of highly alloyed duplex cast iron

International Nuclear Information System (INIS)

Tasgin, Yahya; Kaplan, Mehmet; Yaz, Mehmet

2009-01-01

The effect of boron additives and heat treatment on the microstructural morphology of the transition zone in a duplex cast iron, which has an outer shell of white cast iron (with a high Cr-content and containing boron additives) and an inner side composed of normal gray cast iron, has been investigated. For this purpose, two experimental materials possessing different compositions of white-gray duplex cast iron were produced. Subsequently, metallographic investigations were carried out to study the effect of heat treatment applied to the experimental materials by using the scanning electron microscopy technique, along with optical microscopy and energy dispersive X-ray spectroscopy. Moreover, the formation of various phases and carbide composites in the samples and their effects on the hardness were also investigated using X-ray diffraction techniques. The results of investigations, and hardness showed that addition of the elements Cr and B to high-alloyed white cast iron affected carbide formation significantly, while simultaneously hardening the microstructure, and consequently the carbide present in the transition area of white-gray cast iron was spread out and became thinner. However, B additives and heat treatment did not cause any damage to the transition region of high Cr-content duplex cast iron.

Cell-based neurotrophin treatment supports long-term auditory neuron survival in the deaf guinea pig.

Science.gov (United States)

Gillespie, Lisa N; Zanin, Mark P; Shepherd, Robert K

2015-01-28

The cochlear implant provides auditory cues to profoundly deaf patients by electrically stimulating the primary auditory neurons (ANs) of the cochlea. However, ANs degenerate in deafness; the preservation of a robust AN target population, in combination with advances in cochlear implant technology, may provide improved hearing outcomes for cochlear implant patients. The exogenous delivery of neurotrophins such as brain-derived neurotrophic factor (BDNF) and neurotrophin-3 is well known to support AN survival in deafness, and cell-based therapies provide a potential clinically viable option for delivering neurotrophins into the deaf cochlea. This study utilized cells that were genetically modified to express BDNF and encapsulated in alginate microspheres, and investigated AN survival in the deaf guinea pig following (a) cell-based neurotrophin treatment in conjunction with chronic electrical stimulation from a cochlear implant, and (b) long-term cell-based neurotrophin delivery. In comparison to deafened controls, there was significantly greater AN survival following the cell-based neurotrophin treatment, and there were ongoing survival effects for at least six months. In addition, functional benefits were observed following cell-based neurotrophin treatment and chronic electrical stimulation, with a statistically significant decrease in electrically evoked auditory brainstem response thresholds observed during the experimental period. This study demonstrates that cell-based therapies, in conjunction with a cochlear implant, shows potential as a clinically transferable means of providing neurotrophin treatment to support AN survival in deafness. This technology also has the potential to deliver other therapeutic agents, and to be used in conjunction with other biomedical devices for the treatment of a variety of neurodegenerative conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

Soil solution and sugar maple response to NH(4)NO (3) additions in a base-poor northern hardwood forest of Québec, Canada.

Science.gov (United States)

Moore, Jean-David; Houle, Daniel

2009-08-01

Nitrogen additions (NH4NO3) at rates of three- and ten-fold ambient atmospheric deposition (8.5 kg ha(-1) year(-1)) were realised in an acid- and base-poor northern hardwood forest of Québec, Canada. Soil solution chemistry, foliar chemistry, crown dieback and basal area growth of sugar maple (Acer saccharum Marsh.) were measured. Except for a transitory increase of NO3 and NH4 concentrations, there was no persistent increase in their level in soil solution 3 years after N treatments, with the exception of one plot out of three, that received the highest N addition, beginning to show persistent and high NO3 concentrations after 2 years of N additions. Three years of N additions have significantly increased the N DRIS index of sugar maple but not N foliar concentration. Potassium, Ca and Mn foliar concentrations, as well as P and Ca DRIS indices, decreased in treated plots after 3 years. No treatment effect was observed for basal area growth and dieback rate. One unexpected result was the significant decrease in foliar Ca even in the treated plots that received low N rates, despite the absence of significant NO3-induced leaching of Ca. The mechanism responsible for the decrease in foliar Ca is not known. Our results, however, clearly demonstrate that increased N deposition at sites with low base saturation may affect Ca nutrition even when clear signs of N saturation are not observed.

Treatment of Type 2 diabetes mellitus based on glucagon-like peptide-1

DEFF Research Database (Denmark)

Holst, Jens Juul

1999-01-01

inhibition of gastrointestinal motility and secretion in the presence of nutrients in the lower small intestine). However, because of these same actions, the hormone can normalise the blood glucose of patients with Type 2 diabetes mellitus, and, in contradistinction to insulin and sulphonylurea, it does...... not cause hypoglycaemia. Therefore, treatment of Type 2 diabetes based on GLP-1 is currently being investigated. As a peptide, it must be administered parenterally, and, in addition, it is metabolised extremely rapidly. However, several methods to circumvent these problems have already been developed. A GLP......-1- based therapy of diabetes mellitus and perhaps also obesity is therefore likely to become a realistic alternative to current therapies of these disorders....

Randomized Controlled Trial of an Internet-Based Cognitive-Behavioral Treatment Program for Binge-Eating Disorder.

Science.gov (United States)

Wagner, Birgit; Nagl, Michaela; Dölemeyer, Ruth; Klinitzke, Grit; Steinig, Jana; Hilbert, Anja; Kersting, Anette

2016-07-01

Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n=69) or a wait-list condition (n=70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination-Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d=1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82≤d≤1.11). In the treatment group significant improvement was still observed for all measures 1year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED. Copyright © 2016. Published by Elsevier Ltd.

Wood lens design philosophy based on a binary additive manufacturing technique

Science.gov (United States)

Marasco, Peter L.; Bailey, Christopher

2016-04-01

Using additive manufacturing techniques in optical engineering to construct a gradient index (GRIN) optic may overcome a number of limitations of GRIN technology. Such techniques are maturing quickly, yielding additional design degrees of freedom for the engineer. How best to employ these degrees of freedom is not completely clear at this time. This paper describes a preliminary design philosophy, including assumptions, pertaining to a particular printing technique for GRIN optics. It includes an analysis based on simulation and initial component measurement.

Recommendations for Enhancing Implementation of Additional Protocol Declarations

International Nuclear Information System (INIS)

Niina, Toshiaki; Nidaira, Kazuo; Aono, Yosuke

2010-01-01

Japan signed the Additional Protocol (hereafter, AP) in December 1998. The domestic law and regulation had been revised to implement the initial and annual declarations for the Agency and the Additional Protocol came into force in December 1999. Since initial declaration in 2000, Japan has submitted the annual declaration in every May. Until 2010, Japan has made 10 annual declarations. This paper gives recommendations to enhance implementation of Additional Protocol declarations based on 10-year experience in Japan and addresses the following: Current status of additional protocol declaration in Japan; Outline of processing method; AP Information Management System; Recommendations for improving quality of declaration. Preparation of additional protocol declaration in NMCC has been conducted in the course of contract with Japan Safeguards Office (hereafter, JSGO) for safeguards information treatment. (author)

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention

Directory of Open Access Journals (Sweden)

Weidt S

2017-04-01

demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders. Keywords: trichotillomania, health-related quality of life, treatment experience, Internet, online, hairpulling

Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

Science.gov (United States)

Garner, Bryan R.; Hunter, Brooke D.; Modisette, Kathryn C.; Ihnes, Pamela C.; Godley, Susan H.

2011-01-01

High staff turnover has been described as a problem for the substance use disorder treatment field. This assertion is based primarily on the assumption that staff turnover adversely impacts treatment delivery and effectiveness. This assumption, however, has not been empirically tested. In this study, we computed annualized rates of turnover for treatment staff (n=249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. Additionally, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. PMID:22154040

Effect of solution treatment on precipitation behaviors and age hardening response of Al–Cu alloys with Sc addition

International Nuclear Information System (INIS)

Chen, B.A.; Pan, L.; Wang, R.H.; Liu, G.; Cheng, P.M.; Xiao, L.; Sun, J.

2011-01-01

Highlights: ► Effects of Sc addition on the precipitation and age hardening of Al–Cu alloy were investigated. ► The critical influence of solution treatment on the Sc effect was revealed. ► A significant enhancement in age hardening response was experimentally found and quantitatively assessed. - Abstract: Influences of solution treatment on precipitation behaviors and age hardening response of Al–2.5 wt% Cu–0.3 wt% Sc alloys were investigated, in comparison with Sc-free one. The Al 3 Sc dispersoids, formed during homogenization, were either survived or dissolved to become Sc solute atoms in solution treatment, depending on the solution temperature. When the temperature for solution treatment is 873 K, most of the Al 3 Sc dispersoids were dissolved and a significant enhancement in the uniform precipitation of finer θ′-Al 2 Cu particles was achieved in following aging treatment, causing a noticeable increase in peak-aging hardness by about 90% compared to Sc-free alloys. The enhanced age hardening effect was quantitatively related to the remarkable reduction in effective inter-particle spacing of the plate-shaped θ′-Al 2 Cu precipitates. When the temperature for solution treatment is 793 K, however, most of the Al 3 Sc dispersoids were survived after solution treatment and facilitated the heterogeneous precipitation of θ′-Al 2 Cu plates directly on the {1 0 0} facets of dispersoids in following aging treatment. Concomitantly, the uniform precipitation of θ′-Al 2 Cu plates was greatly suppressed, resulting in a reduced age hardening response. The age hardening responses were quantitatively assessed by using a modified strengthening model that is applicable to the plate-shaped precipitates. The calculations were in good agreement with experimental results. The present results show the importance of controlling solution treatments to achieve significant promotion effect of Sc addition on the precipitation hardening in heat-treatable aluminum

Cost-effectiveness of SQ® HDM SLIT-tablet in addition to pharmacotherapy for the treatment of house dust mite allergic rhinitis in Germany

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Green W

2017-02-01

Full Text Available William Green,1 Jörg Kleine-Tebbe,2 Ludger Klimek,3 Julie Hahn-Pedersen,4 Jakob Nørgaard Andreasen,4 Matthew Taylor1 1York Health Economics Consortium, University of York, York, UK; 2Allergy and Asthma Center, Westend, Berlin, 3Center for Rhinology and Allergology, Wiesbaden, Germany; 4ALK-Abelló, Hørsholm, Denmark Background: Allergic rhinitis is a global health problem that burdens society due to associated health care costs and its impact on health. Standardized quality (SQ® house dust mite (HDM sublingual immunotherapy (SLIT-tablet is a sublingually administered allergy immunotherapy tablet for patients with persistent moderate to severe HDM allergic rhinitis despite use of allergy pharmacotherapy.Objective: To assess the cost-effectiveness of SQ HDM SLIT-tablet in Germany for patients suffering from HDM allergic rhinitis.Methods: A pharmacoeconomic analysis, based on data collected in a double-blinded, phase III randomized placebo-controlled trial (n=992, was undertaken to compare SQ HDM SLIT-tablet in addition to allergy pharmacotherapy to placebo plus allergy pharmacotherapy. Quality-adjusted life year (QALY scores and health care resource use data recorded in the trial were applied to each treatment group and extrapolated over a nine-year time horizon. A series of scenarios were used to investigate the impact of changes on long-term patient health for both treatment groups, which was measured by annual changes in QALY scores. Deterministic and probabilistic sensitivity analyses were also performed. Results: In the base case analysis, compared with allergy pharmacotherapy, SQ HDM SLIT-tablet led to a QALY gain of 0.31 at an incremental cost of €2,276 over the nine-year time horizon, equating to an incremental cost-effectiveness ratio of €7,519. The treatment was cost-effective for all scenarios analyzed; however, results were sensitive to changes in individual parameter values during the deterministic sensitivity analysis

Cost-effectiveness of additional catheter-directed thrombolysis for deep vein thrombosis

Science.gov (United States)

ENDEN, T.; RESCH, S.; WHITE, C.; WIK, H. S.; KLØW, N. E.; SANDSET, P. M.

2013-01-01

Summary Background Additional treatment with catheter-directed thrombolysis (CDT) has recently been shown to reduce post-thrombotic syndrome (PTS). Objectives To estimate the cost effectiveness of additional CDT compared with standard treatment alone. Methods Using a Markov decision model, we compared the two treatment strategies in patients with a high proximal deep vein thrombosis (DVT) and a low risk of bleeding. The model captured the development of PTS, recurrent venous thromboembolism and treatment-related adverse events within a lifetime horizon and the perspective of a third-party payer. Uncertainty was assessed with one-way and probabilistic sensitivity analyzes. Model inputs from the CaVenT study included PTS development, major bleeding from CDT and utilities for post DVT states including PTS. The remaining clinical inputs were obtained from the literature. Costs obtained from the CaVenT study, hospital accounts and the literature are expressed in US dollars ($); effects in quality adjusted life years (QALY). Results In base case analyzes, additional CDT accumulated 32.31 QALYs compared with 31.68 QALYs after standard treatment alone. Direct medical costs were $64 709 for additional CDT and $51 866 for standard treatment. The incremental cost-effectiveness ratio (ICER) was $20 429/QALY gained. One-way sensitivity analysis showed model sensitivity to the clinical efficacy of both strategies, but the ICER remained < $55 000/QALY over the full range of all parameters. The probability that CDT is cost effective was 82% at a willingness to pay threshold of $50 000/QALY gained. Conclusions Additional CDT is likely to be a cost-effective alternative to the standard treatment for patients with a high proximal DVT and a low risk of bleeding. PMID:23452204

Remediation of textile effluents by membrane based treatment techniques: a state of the art review.

Science.gov (United States)

Dasgupta, Jhilly; Sikder, Jaya; Chakraborty, Sudip; Curcio, Stefano; Drioli, Enrico

2015-01-01

The textile industries hold an important position in the global industrial arena because of their undeniable contributions to basic human needs satisfaction and to the world economy. These industries are however major consumers of water, dyes and other toxic chemicals. The effluents generated from each processing step comprise substantial quantities of unutilized resources. The effluents if discharged without prior treatment become potential sources of pollution due to their several deleterious effects on the environment. The treatment of heterogeneous textile effluents therefore demands the application of environmentally benign technology with appreciable quality water reclamation potential. These features can be observed in various innovative membrane based techniques. The present review paper thus elucidates the contributions of membrane technology towards textile effluent treatment and unexhausted raw materials recovery. The reuse possibilities of water recovered through membrane based techniques, such as ultrafiltration and nanofiltration in primary dye houses or auxiliary rinse vats have also been explored. Advantages and bottlenecks, such as membrane fouling associated with each of these techniques have also been highlighted. Additionally, several pragmatic models simulating transport mechanism across membranes have been documented. Finally, various accounts dealing with techno-economic evaluation of these membrane based textile wastewater treatment processes have been provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

Silica scale prevention technology using organic additive, Geogard SX

Energy Technology Data Exchange (ETDEWEB)

Baltazar, Almario; Garcia, Serafin; Solis, Ramonito; Fragata, Jimmy; Ellseworth, Lucero; Llenarizas, Leonardo; Tabuena, Joseph Erwin (PNOC Energy Development Corporation, Makati City (Philippines))

1998-09-15

A field trial on the application of an organic additive, phosphino carboxylic acid copolymer, was conducted in a geothermal system to evaluate its effectiveness in preventing silica deposition from brine containing ultra high silica concentration (1000-1300 ppm). Low polymer concentration was applied for about five months, and treatment efficiency based on silica concentrations in various sampling points ranged from 64 to 98%. Treatment efficiency improved as a function of time. Massive silica scaling in the fluid collection and disposal system was minimized.

POLYMER RESIDUE BASED HYDROPHOBIC-FUNGICIDAL ADDITIVE AND PLASTER DRY MIX BASED ON IT

Directory of Open Access Journals (Sweden)

Chikichev Artur Andreevich

2017-07-01

Full Text Available Subject of study is the effect of additives on the structure formation of cement. Improvement of the re-sistance to aggressive media of materials for wet rooms. Objective is to develop a scientifically grounded composition of a plaster dry construction mix with increased water resistance and funginertness, with the use of locally available materials and man-made waste.The study was carried out by standard methods of research using XRF and DTA. The hydrophobic fungicidal additive based on the polymer residue of turpentine production and fly ash with the ratio by weight ZU: PO = 1.15: 1 was developed. It has been established that while adding the de-veloped additive in an amount of 2.5 % of the mass of cement, the rate of hydration of cement minerals and resistibility of the sand-cement mortar decrease in early strength with medium workability concrete mix. This creates conditions for the formation of a dense structure with increased resistance to aggressive envi-ronments.Using new hydrophobic fungicidal additive, a dry plaster mortar for wet rooms has been developed. It has increased water resistance values corresponding to the W8 grade and funginertness especially with respect to A. Niger, the pathogen and widespread decomposer.The additive is effective; it is developed on the basis of industrial wastes and recycled materials. Its use in the composition of materials with increased requirements for watertightness and biostability makes it pos-sible to reduce their cost and environmental stress, to increase the efficiency of the use of natural re-sources. The use of the developed plaster mixture will increase the resistance of walls of wet rooms to aggressive environments.

An optimized regulating method for composting phosphorus fractions transformation based on biochar addition and phosphate-solubilizing bacteria inoculation.

Science.gov (United States)

Wei, Yuquan; Zhao, Yue; Wang, Huan; Lu, Qian; Cao, Zhenyu; Cui, Hongyang; Zhu, Longji; Wei, Zimin

2016-12-01

The study was conducted to investigate the influence of biochar and/or phosphate-solubilizing bacteria (PSB) inoculants on microbial biomass, bacterial community composition and phosphorus (P) fractions during kitchen waste composting amended with rock phosphate (RP). There were distinct differences in the physic-chemical parameters, the proportion of P fractions and bacterial diversity in different treatments. The contribution of available P fractions increased during composting especially in the treatment with the addition of PSB and biochar. Redundancy analysis showed that bacterial compositions were significantly influenced by P content, inoculation and biochar. Variance partitioning further showed that synergy of inoculated PSB and indigenous bacterial communities and the joint effect between biochar and bacteria explained the largest two proportion of the variation in P fractions. Therefore, the combined application of PSB and biochar to improve the inoculation effect and an optimized regulating method were suggested based on the distribution of P fractions. Copyright © 2016 Elsevier Ltd. All rights reserved.

A new column-generation-based algorithm for VMAT treatment plan optimization

International Nuclear Information System (INIS)

Peng Fei; Epelman, Marina A; Romeijn, H Edwin; Jia Xun; Gu Xuejun; Jiang, Steve B

2012-01-01

We study the treatment plan optimization problem for volumetric modulated arc therapy (VMAT). We propose a new column-generation-based algorithm that takes into account bounds on the gantry speed and dose rate, as well as an upper bound on the rate of change of the gantry speed, in addition to MLC constraints. The algorithm iteratively adds one aperture at each control point along the treatment arc. In each iteration, a restricted problem optimizing intensities at previously selected apertures is solved, and its solution is used to formulate a pricing problem, which selects an aperture at another control point that is compatible with previously selected apertures and leads to the largest rate of improvement in the objective function value of the restricted problem. Once a complete set of apertures is obtained, their intensities are optimized and the gantry speeds and dose rates are adjusted to minimize treatment time while satisfying all machine restrictions. Comparisons of treatment plans obtained by our algorithm to idealized IMRT plans of 177 beams on five clinical prostate cancer cases demonstrate high quality with respect to clinical dose–volume criteria. For all cases, our algorithm yields treatment plans that can be delivered in around 2 min. Implementation on a graphic processing unit enables us to finish the optimization of a VMAT plan in 25–55 s. (paper)

Treatment of cellulite based on the hypothesis of a novel physiopathology

Directory of Open Access Journals (Sweden)

Pereira de Godoy JM

2011-05-01

Full Text Available José Maria Pereira de Godoy1, Maria de Fátima Guerreiro de Godoy21Department of Cardiology and Cardiovascular Surgery, 2Lymphovenous Rehabilitation, FAMERP, São José do Rio Preto, BrazilBackground: The aim of the current study is to report on a new form of treatment for cellulite based on a novel physiological hypothesis.Methods: A novel treatment for cellulite was evaluated in 14 patients aged 19–36 (mean 27.5 years. The only inclusion criterion was clinically diagnosed cellulite, and the exclusion criteria were history of edema, obesity, or any other disease diagnosed during the physical examination. Perimetry was performed at the gluteal fold, at 5 cm and 10 cm below the gluteal fold for both legs, and 5 cm and 10 cm below the navel. Additionally, standard photographs were taken and a questionnaire of satisfaction was applied. The patients were submitted to a treatment regimen of 1.5 hours per day adapted for the treatment of cellulite, consisting of manual and mechanical lymph drainage and cervical stimulation using the Godoy and Godoy technique. After 10 sessions over two weeks, the patients were evaluated again.Results: Reductions were identified at both points below the navel, the points on the thighs, and at the gluteal fold (P < 0.0001.Conclusion: This technique of lymphatic system stimulation is efficacious in the treatment of cellulite.Keywords: cellulite, treatment, physiopathology

Treatment of Unicameral Bone Cysts of the Proximal Femur With Internal Fixation Lessens the Risk of Additional Surgery.

Science.gov (United States)

Wilke, Benjamin; Houdek, Matthew; Rao, Rameshwar R; Caird, Michelle S; Larson, A Noelle; Milbrandt, Todd

2017-09-01

Little data exist to guide the treatment of unicameral bone cysts in the proximal femur. Methods of treatment include corticosteroid injections, curettage and bone grafting, and internal fixation. The authors completed a multi-institutional, retrospective review to evaluate their experience with proximal femoral unicameral bone cysts. They posed the following questions: (1) Does internal fixation reduce the risk of further procedures for the treatment of a unicameral bone cyst? (2) Is radiographic healing faster with internal fixation? Following institutional review board approval, the authors conducted a retrospective review of 36 patients treated for a unicameral bone cyst of the proximal femur at their institutions between 1974 and 2014. Medical records and radiographs were reviewed to identify patient demographics and treatment outcomes. Tumor locations included femoral neck (n=13), intertrochanteric (n=16), and subtrochanteric (n=7). Initial treatment included steroid injection (n=2), curettage and bone grafting (n=9), and internal fixation with curettage and bone grafting (n=25). Mean time was 9 months to radiographic healing and 15 months to return to full activity. The number of patients requiring additional surgeries was increased among those who did not undergo internal fixation. There was no difference in time to radiographic healing. However, time to return to normal activities was reduced if patients had received internal fixation. A significant reduction in additional procedures was observed when patients had been treated with internal fixation. Although this did not influence time to radiographic healing, patients did return to normal activities sooner. Internal fixation should be considered in the treatment of proximal femoral unicameral bone cysts. [Orthopedics. 2017; 40(5):e862-e867.]. Copyright 2017, SLACK Incorporated.

Polyethylene glycol intestinal lavage in addition to usual antibiotic treatment for severe Clostridium difficile colitis: a randomised controlled pilot study.

Science.gov (United States)

McCreery, Greig; Jones, Philip M; Kidane, Biniam; DeMelo, Vanessa; Mele, Tina

2017-07-31

Clostridium difficile infections (CDI) are common, costly and potentially life threatening. Most CDI will respond to antibiotic therapy, but 3%-10% of all patients with CDI will progress to a severe, life-threatening course. Complete removal of the large bowel is indicated for severe CDI. However, the 30-day mortality following surgical intervention for severe CDI ranges from 20% to 70%. A less invasive approach using surgical faecal diversion and direct colonic lavage with polyethylene glycol (PEG) and vancomycin has demonstrated a relative mortality reduction of approximately 50%. As an alternative to these operative approaches, we propose to treat patients with bedside intestinal lavage with PEG and vancomycin instillation via nasojejunal tube, in addition to usual antibiotic management. Preliminary data collected by our research group are encouraging. We will conduct a 1-year, single-centre, pilot randomised controlled trial to study this new treatment strategy for patients with severe CDI and additional risk factors for fulminant or complicated infection. After informed consent, patients with severe-complicated CDI without immediate indication for surgery will be randomised to either usual antibiotic treatment or usual antibiotic treatment with the addition of 8 L of PEG lavage via nasojejunal tube. This pilot trial will evaluate our eligibility and enrolment rate, protocol compliance and adverse event rates and provide further data to inform a more robust sample size calculation and protocol modifications for a definitive multicentre trial design. Based on historical data, we anticipate enrolling approximately 24 patients during the 1-year pilot study period.As a pilot study, data will be reported in aggregate. Between-group differences will be assessed in a blinded fashion for evidence of harm, and to further refine our sample size calculation. This study protocol has been reviewed and approved by our local institutional review board. Results of the pilot

7 CFR 985.153 - Issuance of additional allotment base to new and existing producers.

Science.gov (United States)

2010-01-01

... made available. (c) Issuance—(1) New producers—(i) Regions: For the purpose of issuing additional... quantities of that class of spearmint oil, shall be eligible to receive a share of the additional allotment... immediately notify each producer who is to receive additional allotment base by issuing that producer an...

Mindfulness based cognitive therapy versus treatment as usual in adults with attention deficit hyperactivity disorder (ADHD).

Science.gov (United States)

Janssen, Lotte; Kan, Cornelis C; Carpentier, Pieter J; Sizoo, Bram; Hepark, Sevket; Grutters, Janneke; Donders, Rogier; Buitelaar, Jan K; Speckens, Anne E M

2015-09-15

Adults with attention deficit hyperactivity disorder (ADHD) often present with a lifelong pattern of core symptoms that is associated with impairments of functioning in daily life. This has a substantial personal and economic impact. In clinical practice there is a high need for additional or alternative interventions for existing treatments, usually consisting of pharmacotherapy and/or psycho-education. Although previous studies show preliminary evidence for the effectiveness of mindfulness-based interventions in reducing ADHD symptoms and improving executive functioning, these studies have methodological limitations. This study will take account of these limitations and will examine the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) in further detail. A multi-centre, parallel-group, randomised controlled trial will be conducted in N = 120 adults with ADHD. Patients will be randomised to MBCT in addition to treatment as usual (TAU) or TAU alone. Assessments will take place at baseline and at three, six and nine months after baseline. Primary outcome measure will be severity of ADHD symptoms rated by a blinded clinician. Secondary outcome measures will be self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. In addition, a cost-effectiveness analysis will be conducted. This trial will offer valuable information about the clinical and cost-effectiveness of MBCT in addition to TAU compared to TAU alone in adults swith ADHD. ClinicalTrials.gov NCT02463396. Registered 8 June 2015.

Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

Science.gov (United States)

2013-01-01

Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF > 60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial

Recycling of drinking water treatment residue as an additional medium in columns for effective P removal from eutrophic surface water.

Science.gov (United States)

Wang, Changhui; Wu, Yu; Bai, Leilei; Zhao, Yaqian; Yan, Zaisheng; Jiang, Helong; Liu, Xin

2018-07-01

This study assesses the feasibility of recycling drinking water treatment residue (DWTR) to treat eutrophic surface water in a one-year continuous flow column test. Heat-treated DWTR was used as an additional medium (2%-4%) in columns in case excessive organic matter and N were released from the DWTR to surface water. The results indicated that with minimal undesirable effects on other water properties, DWTR addition substantially enhanced P removal, rendering P concentrations in treated water oligotrophic and treated water unsuitable for Microcystis aeruginosa breeding. Long-term stable P removal by DWTR-column treatment was mainly attributed to the relatively low P levels in raw water (cycles and multiple pollution control (e.g., Dechloromonas, Geobacter, Leucobacter, Nitrospira, Rhodoplanes, and Sulfuritalea); an apparent decrease in Mycobacterium with potential pathogenicity was observed in DWTR-columns. Regardless, limited denitrification of DWTR-columns was observed as a result of low bioavailability of C in surface water. This finding indicates that DWTR can be used with other methods to ensure denitrification for enhanced treatment effects. Overall, the use of DWTR as an additional medium in column systems can potentially treat eutrophic surface water. Copyright © 2018 Elsevier Ltd. All rights reserved.

Piloting the addition of contingency management to best practice counselling as an adjunct treatment for rural and remote disordered gamblers: study protocol.

Science.gov (United States)

Christensen, Darren R; Witcher, Chad S G; Leighton, Trent; Hudson-Breen, Rebecca; Ofori-Dei, Samuel

2018-04-03

Problematic gambling is a significant Canadian public health concern that causes harm to the gambler, their families, and society. However, a significant minority of gambling treatment seekers drop out prior to the issue being resolved; those with higher impulsivity scores have the highest drop-out rates. Consequently, retention is a major concern for treatment providers. The aim of this study is to investigate the efficacy of internet-delivered cognitive behavioural therapy (CBT) and internet-delivered CBT and contingency management (CM+) as treatments for gambling disorder in rural Albertan populations. Contingency management (CM) is a successful treatment approach for substance dependence that uses small incentives to reinforce abstinence. This approach may be suitable for the treatment of gambling disorder. Furthermore, internet-delivered CM may hold particular promise in rural contexts, as these communities typically struggle to access traditional clinic-based counselling opportunities. 54 adults with gambling disorder will be randomised into one of two conditions: CM and CBT (CM+) or CBT alone (CBT). Gambling will be assessed at intake, every treatment session, post-treatment, and follow-up. The primary outcome measures are treatment attendance, gambling abstinence, gambling, gambling symptomatology, and gambling urge. In addition, qualitative interviews assessing study experiences will be conducted with the supervising counsellor, graduate student counsellors, study affiliates, and a subset of treatment seekers. This is the first study to use CM as a treatment for gambling disorder in rural and remote populations. This study was approved by the University of Lethbridge's Human Subject Research Committee (#2016-080). The investigators plan to publish the results from this study in academic peer-reviewed journals. Summary information will be provided to the funder. NCT02953899; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in

Piloting the addition of contingency management to best practice counselling as an adjunct treatment for rural and remote disordered gamblers: study protocol

Science.gov (United States)

Christensen, Darren R; Witcher, Chad S G; Leighton, Trent; Hudson-Breen, Rebecca; Ofori-Dei, Samuel

2018-01-01

Introduction Problematic gambling is a significant Canadian public health concern that causes harm to the gambler, their families, and society. However, a significant minority of gambling treatment seekers drop out prior to the issue being resolved; those with higher impulsivity scores have the highest drop-out rates. Consequently, retention is a major concern for treatment providers. The aim of this study is to investigate the efficacy of internet-delivered cognitive behavioural therapy (CBT) and internet-delivered CBT and contingency management (CM+) as treatments for gambling disorder in rural Albertan populations. Contingency management (CM) is a successful treatment approach for substance dependence that uses small incentives to reinforce abstinence. This approach may be suitable for the treatment of gambling disorder. Furthermore, internet-delivered CM may hold particular promise in rural contexts, as these communities typically struggle to access traditional clinic-based counselling opportunities. Methods and analysis 54 adults with gambling disorder will be randomised into one of two conditions: CM and CBT (CM+) or CBT alone (CBT). Gambling will be assessed at intake, every treatment session, post-treatment, and follow-up. The primary outcome measures are treatment attendance, gambling abstinence, gambling, gambling symptomatology, and gambling urge. In addition, qualitative interviews assessing study experiences will be conducted with the supervising counsellor, graduate student counsellors, study affiliates, and a subset of treatment seekers. This is the first study to use CM as a treatment for gambling disorder in rural and remote populations. Ethics and dissemination This study was approved by the University of Lethbridge’s Human Subject Research Committee (#2016–080). The investigators plan to publish the results from this study in academic peer-reviewed journals. Summary information will be provided to the funder. Trial registration number NCT

Economic evaluation of Internet-based problem-solving guided self-help treatment in comparison with enhanced usual care for depressed outpatients waiting for face-to-face treatment: A randomized controlled trial.

Science.gov (United States)

Kolovos, Spyros; Kenter, Robin M F; Bosmans, Judith E; Beekman, Aartjan T F; Cuijpers, Pim; Kok, Robin N; van Straten, Annemieke

2016-08-01

Previous studies have demonstrated the effectiveness of Internet-based interventions for depression in comparison with usual care. However, evidence on the cost-effectiveness of these interventions when delivered in outpatient clinics is lacking. The aim of this study was to estimate the cost-effectiveness of an Internet-based problem-solving guided self-help intervention in comparison with enhanced usual care for outpatients on a waiting list for face-to-face treatment for major depression. After the waiting list period, participants from both groups received the same treatment at outpatient clinics. An economic evaluation was performed alongside a randomized controlled trial with 12 months follow-up. Outcomes were improvement in depressive symptom severity (measured by CES-D), response to treatment and Quality-Adjusted Life-Years (QALYs). Statistical uncertainty around cost differences and incremental cost-effectiveness ratios were estimated using bootstrapping. Mean societal costs for the intervention group were €1579 higher than in usual care, but this was not statistically significant (95% CI - 1395 to 4382). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.57 at a ceiling ratio of €15,000/additional point of improvement in CES-D, and 0.25 and 0.30 for an additional response to treatment and an extra QALY respectively, at a ceiling ratio of €30,000. Sensitivity analysis showed that from a mental healthcare provider perspective the probability of the intervention being cost-effective was 0.68 for a ceiling ratio of 0 €/additional unit of effect for the CES-D score, response to treatment and QALYs. As the ceiling ratio increased this probability decreased, because the mean costs in the intervention group were lower than the mean costs in the usual care group. The patients in the intervention group showed low adherence to the Internet-based treatment

Validation and implementation of model based control strategies at an industrial wastewater treatment plant.

Science.gov (United States)

Demey, D; Vanderhaegen, B; Vanhooren, H; Liessens, J; Van Eyck, L; Hopkins, L; Vanrolleghem, P A

2001-01-01

In this paper, the practical implementation and validation of advanced control strategies, designed using model based techniques, at an industrial wastewater treatment plant is demonstrated. The plant under study is treating the wastewater of a large pharmaceutical production facility. The process characteristics of the wastewater treatment were quantified by means of tracer tests, intensive measurement campaigns and the use of on-line sensors. In parallel, a dynamical model of the complete wastewater plant was developed according to the specific kinetic characteristics of the sludge and the highly varying composition of the industrial wastewater. Based on real-time data and dynamic models, control strategies for the equalisation system, the polymer dosing and phosphorus addition were established. The control strategies are being integrated in the existing SCADA system combining traditional PLC technology with robust PC based control calculations. The use of intelligent control in wastewater treatment offers a wide spectrum of possibilities to upgrade existing plants, to increase the capacity of the plant and to eliminate peaks. This can result in a more stable and secure overall performance and, finally, in cost savings. The use of on-line sensors has a potential not only for monitoring concentrations, but also for manipulating flows and concentrations. This way the performance of the plant can be secured.

Ethanol addition enhances acid treatment to eliminate Lactobacillus fermentum from the fermentation process for fuel ethanol production.

Science.gov (United States)

Costa, M A S; Cerri, B C; Ceccato-Antonini, S R

2018-01-01

Fermentation is one of the most critical steps of the fuel ethanol production and it is directly influenced by the fermentation system, selected yeast, and bacterial contamination, especially from the genus Lactobacillus. To control the contamination, the industry applies antibiotics and biocides; however, these substances can result in an increased cost and environmental problems. The use of the acid treatment of cells (water-diluted sulphuric acid, adjusted to pH 2·0-2·5) between the fermentation cycles is not always effective to combat the bacterial contamination. In this context, this study aimed to evaluate the effect of ethanol addition to the acid treatment to control the bacterial growth in a fed-batch system with cell recycling, using the industrial yeast strain Saccharomyces cerevisiae PE-2. When only the acid treatment was used, the population of Lactobacillus fermentum had a 3-log reduction at the end of the sixth fermentation cycle; however, when 5% of ethanol was added to the acid solution, the viability of the bacterium was completely lost even after the first round of cell treatment. The acid treatment +5% ethanol was able to kill L. fermentum cells without affecting the ethanol yield and with a low residual sugar concentration in the fermented must. In Brazilian ethanol-producing industry, water-diluted sulphuric acid is used to treat the cell mass at low pH (2·0) between the fermentative cycles. This procedure reduces the number of Lactobacillus fermentum from 10 7 to 10 4  CFU per ml. However, the addition of 5% ethanol to the acid treatment causes the complete loss of bacterial cell viability in fed-batch fermentation with six cell recycles. The ethanol yield and yeast cell viability are not affected. These data indicate the feasibility of adding ethanol to the acid solution replacing the antibiotic use, offering a low cost and a low amount of residue in the biomass. © 2017 The Society for Applied Microbiology.

Positioning SGLT2 Inhibitors/Incretin-Based Therapies in the Treatment Algorithm.

Science.gov (United States)

Wilding, John P H; Rajeev, Surya Panicker; DeFronzo, Ralph A

2016-08-01

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recent addition to the therapeutic options available for the treatment of type 2 diabetes and became available after the introduction of incretin-based therapies, dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs). These agents have potential advantages with regard to their weight loss-promoting effect, low risk of hypoglycemia, reduction in blood pressure, and reduction in cardiovascular events in high-risk patients (with empagliflozin). Apart from these clinically important outcomes, they may also correct core defects present in type 2 diabetes (i.e., improvement in β-cell function and insulin sensitivity). They do, however, have some adverse effects, notably, nausea with GLP-1 RAs and genital tract infections and potential for volume depletion with SGLT2i. Whether incretin-based therapies are associated with an increased risk of pancreatitis is unclear. Most recently, diabetic ketoacidosis has been reported with SGLT2i. Therefore, a key clinical question in relation to guidelines is whether these clinical advantages, in the context of the adverse effect profile, outweigh the additional cost compared with older, more established therapies. This article reviews the therapeutic rationale for the use of these newer drugs for diabetes treatment, considers their place in current guidelines, and discusses how this may change as new data emerge about their long-term efficacy and safety from ongoing outcome trials. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Microstructural discovery of Al addition on Sn–0.5Cu-based Pb-free solder design

International Nuclear Information System (INIS)

Koo, Jahyun; Lee, Changsoo; Hong, Sung Jea; Kim, Keun-Soo; Lee, Hyuck Mo

2015-01-01

It is important to develop Pb-free solder alloys suitable for automotive use instead of traditional Sn–Pb solder due to environmental regulations (e.g., Restriction of Hazardous Substances (RoHS)). Al addition has been spotlighted to enhance solder properties. In this study, we investigated the microstructural change of Sn–0.5Cu wt.% based Pb-free solder alloys with Al addition (0.01–0.05 wt.%). The small amount of Al addition caused a remarkable microstructural change. The Al was favored to form Cu–Al intermetallic compounds inside the solder matrix. We identified the Cu–Al intermetallic compound as Cu_3_3Al_1_7, which has a rhombohedral structure, using EPMA and TEM analyses. This resulted in refined Cu_6Sn_5 networks in the Sn–0.5Cu based solder alloy. In addition, we conducted thermal analysis to confirm its stability at a high temperature of approximately 230 °C, which is the necessary temperature range for automotive applications. The solidification results were substantiated thermodynamically using the Scheil solidification model. We can provide criteria for the minimum aluminum content to modify the microstructure of Pb-free solder alloys. - Graphical abstract: The minor Al additions refined eutectic Cu_6Sn_5 IMC networks on the Sn–0.5Cu based solder alloys. The microstructure was dramatically changed with the minor Al addition. - Highlights: • We observed dramatic microstructure-change with Al additions. • We defined Cu_3_3Al_1_7 IMC with Al additions using TEM analysis. • We investigated grain refinement with Al additions using EBSD. • We discussed the refinement based on Scheil solidification model.

Microstructural discovery of Al addition on Sn–0.5Cu-based Pb-free solder design

Energy Technology Data Exchange (ETDEWEB)

Koo, Jahyun; Lee, Changsoo [Department of Materials Science and Engineering, KAIST, Daejeon 305-701 (Korea, Republic of); Hong, Sung Jea [MK Electron Co., Ltd., Yongin Cheoin-gu 316-2 (Korea, Republic of); Kim, Keun-Soo, E-mail: keunsookim@hoseo.edu [Department of Display Engineering, Hoseo University, Asan 336-795 (Korea, Republic of); Lee, Hyuck Mo, E-mail: hmlee@kaist.ac.kr [Department of Materials Science and Engineering, KAIST, Daejeon 305-701 (Korea, Republic of)

2015-11-25

It is important to develop Pb-free solder alloys suitable for automotive use instead of traditional Sn–Pb solder due to environmental regulations (e.g., Restriction of Hazardous Substances (RoHS)). Al addition has been spotlighted to enhance solder properties. In this study, we investigated the microstructural change of Sn–0.5Cu wt.% based Pb-free solder alloys with Al addition (0.01–0.05 wt.%). The small amount of Al addition caused a remarkable microstructural change. The Al was favored to form Cu–Al intermetallic compounds inside the solder matrix. We identified the Cu–Al intermetallic compound as Cu{sub 33}Al{sub 17}, which has a rhombohedral structure, using EPMA and TEM analyses. This resulted in refined Cu{sub 6}Sn{sub 5} networks in the Sn–0.5Cu based solder alloy. In addition, we conducted thermal analysis to confirm its stability at a high temperature of approximately 230 °C, which is the necessary temperature range for automotive applications. The solidification results were substantiated thermodynamically using the Scheil solidification model. We can provide criteria for the minimum aluminum content to modify the microstructure of Pb-free solder alloys. - Graphical abstract: The minor Al additions refined eutectic Cu{sub 6}Sn{sub 5} IMC networks on the Sn–0.5Cu based solder alloys. The microstructure was dramatically changed with the minor Al addition. - Highlights: • We observed dramatic microstructure-change with Al additions. • We defined Cu{sub 33}Al{sub 17} IMC with Al additions using TEM analysis. • We investigated grain refinement with Al additions using EBSD. • We discussed the refinement based on Scheil solidification model.

Treating chronic tinnitus: comparison of cognitive-behavioural and habituation-based treatments.

Science.gov (United States)

Zachriat, Claudia; Kröner-Herwig, Birgit

2004-01-01

Using a randomized control group trial the long-term efficacy of a habituation-based treatment as conceived by Jastreboff, and a cognitive-behavioural tinnitus coping training were compared. An educational intervention was administered as a control condition. Both treatments were conducted in a group format (habituation-based treatment, 5 sessions; tinnitus coping training, 11 sessions). Educational intervention was delivered in a single group session. Patients were categorized according to their level of disability due to tinnitus (low, high), age and gender and then randomly allocated to the treatment conditions (habituation-based treatment, n = 30; tinnitus coping training, n = 27; educational intervention, n = 20). Data assessment included follow-ups of up to 21 months. Several outcome variables including disability due to tinnitus were assessed either by questionnaire or diary. Findings reveal highly significant improvements in both tinnitus coping training and habituation-based treatment in comparison with the control group. While tinnitus coping training and habituation-based treatment do not differ significantly in reduction of tinnitus disability, improvement in general well-being and adaptive behaviour is greater in tinnitus coping training than habituation-based treatment. The decrease in disability remains stable throughout the last follow-up in both treatment conditions.

Numerical simulation of residual stress in laser based additive manufacturing process

Science.gov (United States)

Kalyan Panda, Bibhu; Sahoo, Seshadev

2018-03-01

Minimizing the residual stress build-up in metal-based additive manufacturing plays a pivotal role in selecting a particular material and technique for making an industrial part. In beam-based additive manufacturing, although a great deal of effort has been made to minimize the residual stresses, it is still elusive how to do so by simply optimizing the processing parameters, such as beam size, beam power, and scan speed. Amid different types of additive manufacturing processes, Direct Metal Laser Sintering (DMLS) process uses a high-power laser to melt and sinter layers of metal powder. The rapid solidification and heat transfer on powder bed endows a high cooling rate which leads to the build-up of residual stresses, that will affect the mechanical properties of the build parts. In the present work, the authors develop a numerical thermo-mechanical model for the measurement of residual stress in the AlSi10Mg build samples by using finite element method. Transient temperature distribution in the powder bed was assessed using the coupled thermal to structural model. Subsequently, the residual stresses were estimated with varying laser power. From the simulation result, it found that the melt pool dimensions increase with increasing the laser power and the magnitude of residual stresses in the built part increases.

Process Evaluation in Corrections-Based Substance Abuse Treatment.

Science.gov (United States)

Wolk, James L.; Hartmann, David J.

1996-01-01

Argues that process evaluation is needed to validate prison-based substance abuse treatment effectiveness. Five groups--inmates, treatment staff, prison staff, prison administration, and the parole board--should be a part of this process evaluation. Discusses these five groups relative to three stages of development of substance abuse treatment in…

Adaptive brachytherapy of cervical cancer, comparison of conventional point A and CT based individual treatment planning

International Nuclear Information System (INIS)

Wanderaas, Anne D.; Langdal, Ingrid; Danielsen, Signe; Frykholm, Gunilla; Marthinsen, Anne B. L; Sundset, Marit

2012-01-01

Background. Locally advanced cervical cancer is commonly treated with external radiation therapy combined with local brachytherapy. The brachytherapy is traditionally given based on standard dose planning with prescription of dose to point A. Dosimetric aspects when changing from former standard treatment to individualized treatment plans based on computed tomography (CT) images are here investigated. Material and methods. Brachytherapy data from 19 patients with a total of 72 individual treatment fractions were retrospectively reviewed. Standard library plans were analyzed with respect to doses to organs at risk (OARs), and the result was compared to corresponding delivered individualized plans. The theoretical potential of further optimization based on prescription to target volumes was investigated. The treatments were performed with a Fletcher applicator. Results. For standard treatment planning, the tolerance dose limits were exceeded in the bladder, rectum and sigmoid in 26%, 4% and 15% of the plans, respectively. This was observed most often for the smallest target volumes. The individualized planning of the delivered treatment gave the possibility of controlling the dose to critical organs to below certain limits. The dose was still prescribed to point A. An increase in target dose coverage was achieved when additional individual optimization was performed, while still keeping the dose to the OARs below predefined limits. Relatively low average target coverage, especially for the largest volumes was however seen. Conclusion. The individualized delivered treatment plans ensured that doses to OARs were within acceptable limits. This was not the case in 42% of the corresponding standard plans. Further optimized treatment plans were found to give an overall better dose coverage. In lack of MR capacity, it may be favorable to use CT for planning due to possible protection of OARs. The CT based target volumes were, however, not equivalent to the volumes described

Novel treatments of mood disorders based on brain circuitry (ECT, MST, TMS, VNS, DBS).

Science.gov (United States)

George, Mark S; Nahas, Ziad; Li, Xiangbao; Kozel, F Andrew; Anderson, Berry; Yamanaka, Kaori; Chae, Jeong-Ho; Foust, Milton J

2002-10-01

Advances in understanding the functional and structural anatomy of depression outlined in this issue set the stage for attempting to manipulate implicated brain regions as potential antidepressant therapies. On the one hand, these circuit- and device-based approaches to treating depression are not new. Electroconvulsive therapy (ECT) dates back to the beginning of modern biologic psychiatry with the discovery and rapid increase of first chemical (around 1910), and then later ECT. On the other hand, this area represents an important paradigm shift with treatments that are radical and different. A dizzying array of diverse technologies now allows researchers to stimulate the brain in undreamed of ways. However, the approaches described in this article are still considered experimental and are not approved for use in the United States by the Food and Drug Administration (FDA), except ECT, which predates the FDA. These device-based approaches to brain stimulation offer promise as potential acute and even longterm treatments. Additionally, the research determining whether and how these devices work to influence mood promises to help unravel the neurophysiology of mood regulation. These novel treatments are thus the translational tools to bridge from advances in brain imaging, into new treatments for depressed patients. Copyright 2002, Elsevier Science (USA). All rights reserved.

Radiological, physical, and chemical characterization of additional alpha contaminated and mixed low-level waste for treatment at the advanced mixed waste treatment project

International Nuclear Information System (INIS)

Hutchinson, D.P.

1995-07-01

This document provides physical, chemical, and radiological descriptive information for a portion of mixed waste that is potentially available for private sector treatment. The format and contents are designed to provide treatment vendors with preliminary information on the characteristics and properties for additional candidate portions of the Idaho National Engineering Laboratory (INEL) and offsite mixed wastes not covered in the two previous characterization reports for the INEL-stored low-level alpha-contaminated and transuranic wastes. This report defines the waste, provides background information, briefly reviews the requirements of the Federal Facility Compliance Act (P.L. 102-386), and relates the Site Treatment Plans developed under the Federal Facility Compliance Act to the waste streams described herein. Each waste is summarized in a Waste Profile Sheet with text, charts, and tables of waste descriptive information for a particular waste stream. A discussion of the availability and uncertainty of data for these waste streams precedes the characterization descriptions

Radiological, physical, and chemical characterization of additional alpha contaminated and mixed low-level waste for treatment at the advanced mixed waste treatment project

Energy Technology Data Exchange (ETDEWEB)

Hutchinson, D.P.

1995-07-01

This document provides physical, chemical, and radiological descriptive information for a portion of mixed waste that is potentially available for private sector treatment. The format and contents are designed to provide treatment vendors with preliminary information on the characteristics and properties for additional candidate portions of the Idaho National Engineering Laboratory (INEL) and offsite mixed wastes not covered in the two previous characterization reports for the INEL-stored low-level alpha-contaminated and transuranic wastes. This report defines the waste, provides background information, briefly reviews the requirements of the Federal Facility Compliance Act (P.L. 102-386), and relates the Site Treatment Plans developed under the Federal Facility Compliance Act to the waste streams described herein. Each waste is summarized in a Waste Profile Sheet with text, charts, and tables of waste descriptive information for a particular waste stream. A discussion of the availability and uncertainty of data for these waste streams precedes the characterization descriptions.

Performance of cellulose acetate membrane with different additives for palm oil mill effluent (POME) liquid waste treatment

Science.gov (United States)

Aprilia, N. A. S.; Fauzi; Azmi, N.; Najwan, N.; Amin, A.

2018-03-01

Performance of cellulose acetate membrane for treatment of POME liquid has studied with different additives. Cellulose acetate membranes were prepared with different additive ie formamide and polyethylene glycol and used acetone as solvent. The function of formamide and polyethylene glycol (PEG) is to increase the porosity of the membrane surface. Performance of the membrane were included SEM, FT-IR and coefficient permeability. Membrane performance has been performed for percent rejection of total suspended solid (TSS) and turbidity of POME liquid waste. Cellulose acetate with formamide shows an increased percentage of rejection in removing TSS and turbidity than cellulose acetate with PEG.

The extension of a DNA double helix by an additional Watson-Crick base pair on the same backbone

DEFF Research Database (Denmark)

Kumar, P.; Sharma, P. K.; Madsen, Charlotte S.

2013-01-01

Additional base pair: The DNA duplex can be extended with an additional Watson-Crick base pair on the same backbone by the use of double-headed nucleotides. These also work as compressed dinucleotides and form two base pairs with cognate nucleobases on the opposite strand.......Additional base pair: The DNA duplex can be extended with an additional Watson-Crick base pair on the same backbone by the use of double-headed nucleotides. These also work as compressed dinucleotides and form two base pairs with cognate nucleobases on the opposite strand....

An Overview of Ni Base Additive Fabrication Technologies for Aerospace Applications (Preprint)

Science.gov (United States)

2011-03-01

fusion welding processes that have the ability to add filler material can be used as additive manufacturing processes . The majority of the work in the...Laser Additive Manufacturing (LAM) The LAM process uses a conventional laser welding heat source (CO2 or solid state laser) combined with a...wrought properties. The LAM process typically has a lower deposition rate (0.5 – 10 lbs/hr) compared to EB, PTA or TIG based processes , although as

Population-based cost-offset analyses for disorder-specific treatment of anorexia nervosa and bulimia nervosa in Germany.

Science.gov (United States)

Bode, Katharina; Götz von Olenhusen, Nina Maria; Wunsch, Eva-Maria; Kliem, Sören; Kröger, Christoph

2017-03-01

Previous research has shown that anorexia nervosa (AN) and bulimia nervosa (BN) are expensive illnesses to treat. To reduce their economic burden, adequate interventions need to be established. Our objective was to conduct cost-offset analyses for evidence-based treatment of eating disorders using outcome data from a psychotherapy trial involving cognitive behavioral therapy (CBT) and focal psychodynamic therapy (FPT) for AN and a trial involving CBT for BN. Assuming a currently running, ideal healthcare system using a 12-month, prevalence-based approach and varying the willingness to participate in treatment, we investigated whether the potential financial benefits of AN- and BN-related treatment outweigh the therapy costs at the population level. We elaborated on a formula that allows calculating cost-benefit relationships whereby the calculation of the parameters is based on estimates from data of health institutions within the German healthcare system. Additional intangible benefits were calculated with the aid of Quality-Adjusted Life Years. The annual costs of an untreated eating disorder were 2.38 billion EUR for AN and 617.69 million EUR for BN. Independent of the willingness to participate in treatment, the cost-benefit relationships for the treatment remained constant at 2.51 (CBT) and 2.33 (FPT) for AN and 4.05 (CBT) for BN. This consistency implies that for each EUR invested in the treatment, between 2.33 and 4.05 EUR could be saved each year. Our findings suggest that the implementation of evidence-based psychotherapy treatments for AN and BN may achieve substantial cost savings at the population level. © 2017 Wiley Periodicals, Inc.

Oil base fluids without tensoactive additives; Fluidos a base de oleo sem tensoativos

Energy Technology Data Exchange (ETDEWEB)

Machado, Jose Carlos V; Aragao, Atila Fernando L [PETROBRAS, XX (Brazil). Centro de Desenvolvimento de Recursos Humanos Norte e Nordeste

1990-12-31

The goal of this paper is to define an ideal oil base fluid composition without tensoactive additives, since these may cause damage to producing formation during drilling or well completion. We investigated the rheological, filtrating and phase separation properties of the systems composed of diesel oil, organophilic clay and a polar agent (water or ethyl alcohol). In order to to that, we used the 286 Baroid digital rotating viscometer, filtrating cells standardized according to the American Petroleum Institute (AP) for temperatures of 25 deg C to 149 deg C and pressures of 6,89 x 10{sup 5} Pa (100 psig) to 3,44 x 10{sup 6} (500 psig), and the setting method, according to the determinations of respectively rheological, filtrating and phase separation parameters. Results proved that the composition: diesel oil-94% v/v, Na Cl saturated solution - 6% v/v and bentone - 17,1 to 22,8 kg/m{sup 3} (6 to 8 lb/bbl), is ideal to meet the properties required for drilling and well completion operations for low densities, that is 0,84% to 1,02 (6,9 to 8,5 ib/gal). In order to obtain densities in the interval of 1,02 to 1,14 (8,5 to 9,5 ib/gal) the system should be condensed with calcite (Ca CO{sub 3}) and the base fluid composition should be : diesel oil-94 to 98% v/v, Na Cl saturated solution - 2 to 6% v/v and bentone 17,1 to 22,8 kg/m{sup 3} (6 to 8 ib/bbl). The average cost per barrel for the systems studied here is of the same order of conventional oil base fluids (with tensoactive additives). (author) 13 refs., 7 figs., 3 tabs.

Oil base fluids without tensoactive additives; Fluidos a base de oleo sem tensoativos

Energy Technology Data Exchange (ETDEWEB)

Machado, Jose Carlos V.; Aragao, Atila Fernando L. [PETROBRAS, XX (Brazil). Centro de Desenvolvimento de Recursos Humanos Norte e Nordeste

1989-12-31

The goal of this paper is to define an ideal oil base fluid composition without tensoactive additives, since these may cause damage to producing formation during drilling or well completion. We investigated the rheological, filtrating and phase separation properties of the systems composed of diesel oil, organophilic clay and a polar agent (water or ethyl alcohol). In order to to that, we used the 286 Baroid digital rotating viscometer, filtrating cells standardized according to the American Petroleum Institute (AP) for temperatures of 25 deg C to 149 deg C and pressures of 6,89 x 10{sup 5} Pa (100 psig) to 3,44 x 10{sup 6} (500 psig), and the setting method, according to the determinations of respectively rheological, filtrating and phase separation parameters. Results proved that the composition: diesel oil-94% v/v, Na Cl saturated solution - 6% v/v and bentone - 17,1 to 22,8 kg/m{sup 3} (6 to 8 lb/bbl), is ideal to meet the properties required for drilling and well completion operations for low densities, that is 0,84% to 1,02 (6,9 to 8,5 ib/gal). In order to obtain densities in the interval of 1,02 to 1,14 (8,5 to 9,5 ib/gal) the system should be condensed with calcite (Ca CO{sub 3}) and the base fluid composition should be : diesel oil-94 to 98% v/v, Na Cl saturated solution - 2 to 6% v/v and bentone 17,1 to 22,8 kg/m{sup 3} (6 to 8 ib/bbl). The average cost per barrel for the systems studied here is of the same order of conventional oil base fluids (with tensoactive additives). (author) 13 refs., 7 figs., 3 tabs.

Treatment plan modification using voxel-based weighting factors/dose prescription

International Nuclear Information System (INIS)

Wu Chuan; Olivera, Gustavo H; Jeraj, Robert; Keller, Harry; Mackie, Thomas R

2003-01-01

Under various clinical situations, it is desirable to modify the original treatment plan to better suit the clinical goals. In this work, a method to help physicians modify treatment plans based on their clinical preferences is proposed. The method uses a weighted quadratic dose objective function. The commonly used organ-/ROI-based weighting factors are expanded to a set of voxel-based weighting factors in order to obtain greater flexibility in treatment plan modification. Two different but equivalent modification schemes based on Rustem's quadratic programming algorithms -modification of a weighting matrix and modification of prescribed doses - are presented. Case studies demonstrated the effectiveness of the two methods with regard to their capability to fine-tune treatment plans

Enhancing CBT for Chronic Insomnia: A Randomised Clinical Trial of Additive Components of Mindfulness or Cognitive Therapy.

Science.gov (United States)

Wong, Mei Yin; Ree, Melissa J; Lee, Christopher W

2016-09-01

Although cognitive behavioural therapy (CBT) for insomnia has resulted in significant reductions in symptoms, most patients are not classified as good sleepers after treatment. The present study investigated whether additional sessions of cognitive therapy (CT) or mindfulness-based therapy (MBT) could enhance CBT in 64 participants with primary insomnia. All participants were given four sessions of standard CBT as previous research had identified this number of sessions as an optimal balance between therapist guidance and patient independence. Participants were then allocated to further active treatment (four sessions of CT or MBT) or a no further treatment control. The additional treatments resulted in significant improvements beyond CBT on self-report and objective measures of sleep and were well tolerated as evidenced by no dropouts from either treatment. The effect sizes for each of these additional treatments were large and clinically significant. The mean scores on the primary outcome measure, the Insomnia Severity Index, were 5.74 for CT and 6.69 for MBT, which are within the good-sleeper range. Treatment effects were maintained at follow-up. There were no significant differences between CT and MBT on any outcome measure. These results provide encouraging data on how to enhance CBT for treatment of insomnia. Copyright © 2015 John Wiley & Sons, Ltd. CBT treatments for insomnia can be enhanced using recent developments in cognitive therapy. CBT treatments for insomnia can be enhanced using mindfulness-based treatments. Both cognitive therapy and mindfulness produce additional clinically significant change. Copyright © 2015 John Wiley & Sons, Ltd.

Imidazolium-based ionic liquids used as additives in the nanolubrication of silicon surfaces

Directory of Open Access Journals (Sweden)

Patrícia M. Amorim

2017-09-01

Full Text Available In recent years, with the development of micro/nanoelectromechanical systems (MEMS/NEMS, the demand for efficient lubricants of silicon surfaces intensified. Although the use of ionic liquids (ILs as additives to base oils in the lubrication of steel/steel or other types of metal/ metal tribological pairs has been investigated, the number of studies involving Si is very low. In this work, we tested imidazolium-based ILs as additives to the base oil polyethylene glycol (PEG to lubricate Si surfaces. The friction coefficients were measured in a nanotribometer. The viscosity of the PEG + IL mixtures as well as their contact angles on the Si surface were measured. The topography and chemical composition of the substrates surfaces were determined with atomic force microscopy (AFM and X-ray photoelectron spectroscopy (XPS, respectively. Due to the hygroscopic properties of PEG, the first step was to assess the effect of the presence of water. Then, a series of ILs based on the cations 1-ethyl-3-methylimidazolium [EMIM], 1-butyl-3-methylimidazolium [BMIM], 1-ethyl-3-vinylimidazolium [EVIM], 1-(2-hydroxyethyl-3-methylimidazolium [C2OHMIM] and 1-allyl-3-methylimidazolium [AMIM] combined with the anions dicyanamide [DCA], trifluoromethanesulfonate [TfO], and ethylsulfate [EtSO4] were added to dry PEG. All additives (2 wt % led to a decrease in friction coefficient as well as an increase in viscosity (with the exception of [AMIM][TfO] and improved the Si wettability. The additives based on the anion [EtSO4] exhibited the most promising tribological behavior, which was attributed to the strong interaction with the Si surface ensuring the formation of a stable surface layer, which hinders the contact between the sliding surfaces.

Trial-Based Functional Analysis Informs Treatment for Vocal Scripting.

Science.gov (United States)

Rispoli, Mandy; Brodhead, Matthew; Wolfe, Katie; Gregori, Emily

2018-05-01

Research on trial-based functional analysis has primarily focused on socially maintained challenging behaviors. However, procedural modifications may be necessary to clarify ambiguous assessment results. The purposes of this study were to evaluate the utility of iterative modifications to trial-based functional analysis on the identification of putative reinforcement and subsequent treatment for vocal scripting. For all participants, modifications to the trial-based functional analysis identified a primary function of automatic reinforcement. The structure of the trial-based format led to identification of social attention as an abolishing operation for vocal scripting. A noncontingent attention treatment was evaluated using withdrawal designs for each participant. This noncontingent attention treatment resulted in near zero levels of vocal scripting for all participants. Implications for research and practice are presented.

Behavioral Activation Is an Evidence-Based Treatment for Depression

Science.gov (United States)

Sturmey, Peter

2009-01-01

Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier…

MO-FG-CAMPUS-TeP1-03: Pre-Treatment Surface Imaging Based Collision Detection

Energy Technology Data Exchange (ETDEWEB)

Wiant, D; Maurer, J; Liu, H; Hayes, T; Shang, Q; Sintay, B [Cone Health Cancer Center, Greensboro, NC (United States)

2016-06-15

Purpose: Modern radiotherapy increasingly employs large immobilization devices, gantry attachments, and couch rotations for treatments. All of which raise the risk of collisions between the patient and the gantry / couch. Collision detection is often achieved by manually checking each couch position in the treatment room and sometimes results in extraneous imaging if collisions are detected after image based setup has begun. In the interest of improving efficiency and avoiding extra imaging, we explore the use of a surface imaging based collision detection model. Methods: Surfaces acquired from AlignRT (VisionRT, London, UK) were transferred in wavefront format to a custom Matlab (Mathworks, Natick, MA) software package (CCHECK). Computed tomography (CT) scans acquired at the same time were sent to CCHECK in DICOM format. In CCHECK, binary maps of the surfaces were created and overlaid on the CT images based on the fixed relationship of the AlignRT and CT coordinate systems. Isocenters were added through a graphical user interface (GUI). CCHECK then compares the inputted surfaces to a model of the linear accelerator (linac) to check for collisions at defined gantry and couch positions. Note, CCHECK may be used with or without a CT. Results: The nominal surface image field of view is 650 mm × 900 mm, with variance based on patient position and size. The accuracy of collision detections is primarily based on the linac model and the surface mapping process. The current linac model and mapping process yield detection accuracies on the order of 5 mm, assuming no change in patient posture between surface acquisition and treatment. Conclusions: CCHECK provides a non-ionizing method to check for collisions without the patient in the treatment room. Collision detection accuracy may be improved with more robust linac modeling. Additional gantry attachments (e.g. conical collimators) can be easily added to the model.

Exploring the Utility of Web-Based Social Media Advertising to Recruit Adult Heavy-Drinking Smokers for Treatment.

Science.gov (United States)

Bold, Krysten W; Hanrahan, Tess H; O'Malley, Stephanie S; Fucito, Lisa M

2016-05-18

successful for reaching adult smokers interested in treatment. Additionally, recruiting for smokers reached those who also drink alcohol heavily, many of whom were interested in changing this behavior as well. However, additional social media strategies may be needed to engage individuals into treatment after completion of Web-based screening surveys.

Exploring the Utility of Web-Based Social Media Advertising to Recruit Adult Heavy-Drinking Smokers for Treatment

Science.gov (United States)

Hanrahan, Tess H; O'Malley, Stephanie S; Fucito, Lisa M

2016-01-01

were cost-effective and successful for reaching adult smokers interested in treatment. Additionally, recruiting for smokers reached those who also drink alcohol heavily, many of whom were interested in changing this behavior as well. However, additional social media strategies may be needed to engage individuals into treatment after completion of Web-based screening surveys. PMID:27194456

Microstructural evolution of 316L stainless steels with yttrium addition after mechanical milling and heat treatment

Energy Technology Data Exchange (ETDEWEB)

Kotan, Hasan, E-mail: hasankotan@gmail.com

2015-10-28

Nanocrystalline 316L stainless steels with yttrium addition were prepared by mechanical milling at cryogenic temperature and subjected to annealing treatments at various temperatures up to 1200 °C. The dependence of hardness on the microstructure was utilized to study the mechanical changes in the steels occurring during annealing. The microstructural evolution of the as-milled and annealed steels was characterized by means of X-ray diffraction (XRD), focused ion beam microscopy (FIB) and transmission electron microscopy (TEM) techniques. The results have revealed that austenite in as-received powder partially transformed to martensite phase during mechanical milling whereas the annealing induced reverse transformation of martensite-to-austenite. Furthermore, while the austenite-to-martensite phase ratio increased with increasing annealing temperature, the equilibrium structure was not achieved after three hours heat treatments up to 1200 °C resulting in a dual-phased steels with around 10% martensite. The grain size of 316L steel was 19 nm after mechanical milling and remained around 116 nm at 1100 °C with yttrium addition as opposed to micron size grains of plain 316L steel at the same annealing temperature. Such microstructural features facilitate the use of these materials at elevated temperatures, as well as the development of scalable processing routes into a dense nanocrystalline compact.

Use of dry sludge from waste water treatment plants as an additive in prefabricated concrete brick

OpenAIRE

Yagüe, A.; Valls, S.; Vázquez, E.; Kuchinow, V.

2002-01-01

Dry sludge from the Sabadell Water Treatment Plant was used to prepare prefabricated concrete bricks. After characterising the sludge and the manufacturing process used to make the bricks, we define the conditions of addition of the sludges in the manufacture. Reference samples not containing sludge and samples containing 2 % of dry sludge by cement weight were prepared. The variation in density, porosity, absorption coefficient and compressive strength of the bricks with the presence of...

49 CFR 40.303 - What happens if the SAP believes the employee needs additional treatment, aftercare, or support...

Science.gov (United States)

2010-10-01

... recommended services. You may also make use of SAP and employee assistance program (EAP) services in assisting... 49 Transportation 1 2010-10-01 2010-10-01 false What happens if the SAP believes the employee needs additional treatment, aftercare, or support group services even after the employee returns to...

MRI-based treatment planning for radiotherapy: Dosimetric verification for prostate IMRT

International Nuclear Information System (INIS)

Chen, Lili; Price, Robert A.; Wang Lu; Li Jinsheng; Qin Lihong; McNeeley, Shawn; Ma, C.-M. Charlie; Freedman, Gary M.; Pollack, Alan

2004-01-01

Purpose: Magnetic resonance (MR) and computed tomography (CT) image fusion with CT-based dose calculation is the gold standard for prostate treatment planning. MR and CT fusion with CT-based dose calculation has become a routine procedure for intensity-modulated radiation therapy (IMRT) treatment planning at Fox Chase Cancer Center. The use of MRI alone for treatment planning (or MRI simulation) will remove any errors associated with image fusion. Furthermore, it will reduce treatment cost by avoiding redundant CT scans and save patient, staff, and machine time. The purpose of this study is to investigate the dosimetric accuracy of MRI-based treatment planning for prostate IMRT. Methods and materials: A total of 30 IMRT plans for 15 patients were generated using both MRI and CT data. The MRI distortion was corrected using gradient distortion correction (GDC) software provided by the vendor (Philips Medical System, Cleveland, OH). The same internal contours were used for the paired plans. The external contours were drawn separately between CT-based and MR imaging-based plans to evaluate the effect of any residual distortions on dosimetric accuracy. The same energy, beam angles, dose constrains, and optimization parameters were used for dose calculations for each paired plans using a treatment optimization system. The resulting plans were compared in terms of isodose distributions and dose-volume histograms (DVHs). Hybrid phantom plans were generated for both the CT-based plans and the MR-based plans using the same leaf sequences and associated monitor units (MU). The physical phantom was then irradiated using the same leaf sequences to verify the dosimetry accuracy of the treatment plans. Results: Our results show that dose distributions between CT-based and MRI-based plans were equally acceptable based on our clinical criteria. The absolute dose agreement for the planning target volume was within 2% between CT-based and MR-based plans and 3% between measured dose

Additive effect of BPA and Gd-DTPA for application in accelerator-based neutron source

International Nuclear Information System (INIS)

Yoshida, F.; Yamamoto, T.; Nakai, K.; Zaboronok, A.; Matsumura, A.

2015-01-01

Because of its fast metabolism gadolinium as a commercial drug was not considered to be suitable for neutron capture therapy. We studied additive effect of gadolinium and boron co-administration using colony forming assay. As a result, the survival of tumor cells with additional 5 ppm of Gd-DTPA decreased to 1/10 compared to the cells with boron only. Using gadolinium to increase the effect of BNCT instead of additional X-ray irradiation might be beneficial, as such combination complies with the short-time irradiation regimen at the accelerator-based neutron source. - Highlights: • Gd-DTPA is widely clinically used as a contrast medium for MRI. • Shift to an accelerator-based neutron source is advantageous for gadolinium NCT. • Boron–gadolinium NCT effects on tumor cell lines were significant. • Additional administration of Gd-DTPA might enhance the effect of BPA–BNCT.

Improvement of lithium-ion battery performance at low temperature by adopting polydimethylsiloxane-based electrolyte additives

International Nuclear Information System (INIS)

Kim, Kwang Man; Ly, Nguyen Vu; Won, Jung Ha; Lee, Young-Gi; Cho, Won Il; Ko, Jang Myoun; Kaner, Richard B.

2014-01-01

Three kinds of polydimethylsiloxane (PDMS)-based grafted and ungrafted copolymers such as poly[dimethylsiloxane-co-(siloxane-g-acrylate)] (PDMS-A), poly(dimethylsiloxane-co-phenylsiloxane) (PDMS-P), and poly[dimethylsiloxane-co-(siloxane-g-ethylene oxide)] (PDMS-EO) are used as additives to standard liquid electrolyte solutions to enhance the lithium-ion battery performance at low temperatures. Liquid electrolyte solutions with PDMS-based additives are electrochemically stable under 5.0 V and have adequate ionic conductivities of 10 −4 S cm −1 at -20 °C. Particularly, liquid electrolytes with PDMS-P and PDMS-EO exhibit higher ionic conductivities of around 5 × 10 −4 S cm −1 at -20 °C, indicating a specific resisting property against the freezing of the liquid electrolyte components. As a result, the addition of PDMS-based additives to liquid electrolytes improves the capacity retention ratio and rate-capability of lithium-ion batteries at low temperatures

Personalized Clinical Diagnosis in Data Bases for Treatment Support in Phthisiology.

Science.gov (United States)

Lugovkina, T K; Skornyakov, S N; Golubev, D N; Egorov, E A; Medvinsky, I D

2016-01-01

The decision-making is a key event in the clinical practice. The program products with clinical decision support models in electronic data-base as well as with fixed decision moments of the real clinical practice and treatment results are very actual instruments for improving phthisiological practice and may be useful in the severe cases caused by the resistant strains of Mycobacterium tuberculosis. The methodology for gathering and structuring of useful information (critical clinical signals for decisions) is described. Additional coding of clinical diagnosis characteristics was implemented for numeric reflection of the personal situations. The created methodology for systematization and coding Clinical Events allowed to improve the clinical decision models for better clinical results.

The addition of a goal-based motivational interview to treatment as usual to enhance engagement and reduce dropouts in a personality disorder treatment service: results of a feasibility study for a randomized controlled trial.

Science.gov (United States)

McMurran, Mary; Cox, W Miles; Whitham, Diane; Hedges, Lucy

2013-02-17

There are high rates of treatment non-completion for personality disorder and those who do not complete treatment have poorer outcomes. A goal-based motivational interview may increase service users' readiness to engage with therapy and so enhance treatment retention. We conducted a feasibility study to inform the design of a randomized controlled trial. The aims were to test the feasibility of recruitment, randomization and follow-up, and to conduct a preliminary evaluation of the effectiveness of the motivational interview. Patients in an outpatient personality disorder service were randomized to receive the Personal Concerns Inventory plus treatment as usual or treatment as usual only. The main randomized controlled trial feasibility criteria were recruitment of 54% of referrals, and 80% of clients and therapists finding the intervention acceptable. Information was collected on treatment attendance, the clarity of therapy goals and treatment engagement. The recruitment rate was 29% (76 of 258). Of 12 interviewed at follow-up, eight (67%) were positive about the Personal Concerns Inventory. Pre-intervention interviews were conducted with 61% (23 out of 38) of the Personal Concerns Inventory group and 74% (28 out of 38) of the treatment as usual group. Participants' therapy goals were blind-rated for clarity on a scale of 0 to 10. The mean score for the Personal Concerns Inventory group was 6.64 (SD = 2.28) and for the treatment as usual group 2.94 (SD = 1.71). Over 12 weeks, the median percentage session attendance was 83.33% for the Personal Concerns Inventory group (N = 17) and 66.67% for the treatment as usual group (N = 24). Of 59 eligible participants at follow-up, the Treatment Engagement Rating scale was completed for 40 (68%). The mean Treatment Engagement Rating scale score for the Personal Concerns Inventory group was 6.64 (SD = 2.28) and for the treatment as usual group 2.94 (SD = 1.71). Of the 76 participants, 63 (83%) completed the Client Service

K-capture by Al-Si based Additives in an Entrained Flow Reactor

DEFF Research Database (Denmark)

Wang, Guoliang; Jensen, Peter Arendt; Wu, Hao

2016-01-01

A water slurry, consisting of KCl and Al-Si based additives (kaolin and coal fly ash) was fed into an entrained flow reactor (EFR) to study the K-capturing reaction of the additives at suspension-fired conditions. Solid products collected from the reactor were analysed with respect to total...... of KCl to K-aluminosilicate decreased. When reaction temperature increased from 1100 °C to 1450 °C, the conversion of KCl does not change significantly, which differs from the trend observed in fixed-bed reactor....

Acid base status in swamp buffaloes (Bubalus Bubalis fed rice straw and concentrate with addition of sodium

Directory of Open Access Journals (Sweden)

G Joseph

2001-12-01

Full Text Available An experiment was conducted to study the addition of NaHCO3 and Na2CO3 on acid-base status in swamp buffaloes, Three fistulated buffaloes were each introduced to dietary treatment control diett (50% rice straw + 50% concentrate, control + \\0% NaHCO3 and diet control + 10% Na2CO3 in two times Latin Square Design. The diets contained 9,7% crude protein and 53% TDN to achieve maintenance requirements of the animals. Parameters measured include (l Fed consumption, water consumption and urine volume. (2 pH in rumen fluid, saliva, bLood and urine, (3 natrium mineral content in rumen fluid, saliva, blood and urine. The results of the experiment showed higher pH in the rumen fluid, saliva, blood and urine of buffaloes due to supplementation of NaHCO3 and Na2CO3, Water consumption and urine volume was significanly increased as the effect of Na supplement. The acid-base status of buffaloes was apparently normal in all animals.

Validation of cold plasma treatment for protein inactivation: a surface plasmon resonance-based biosensor study

International Nuclear Information System (INIS)

Bernard, C; Leduc, A; Barbeau, J; Saoudi, B; Yahia, L'H; Crescenzo, G De

2006-01-01

Gas plasma is being proposed as an interesting and promising tool to achieve sterilization. The efficacy of gas plasma to destroy bacterial spores (the most resistant living microorganisms) has been demonstrated and documented over the last ten years. In addition to causing damage to deoxyribonucleic acid by UV radiation emitted by excited species originating from the plasma, gas plasma has been shown to promote erosion of the microorganism in addition to possible oxidation reactions within the microorganism. In this work, we used lysozyme as a protein model to assess the effect of gas plasma on protein inactivation. Lysozyme samples have been subjected to the flowing afterglow of a gas discharge achieved in a nitrogen-oxygen mixture. The efficiency of this plasma treatment on lysozyme has been tested by two different assays. These are an enzyme-linked immunosorbent assay (ELISA) and a surface plasmon resonance (SPR)-based biosensor assay. The two methods showed that exposure to gas plasma can abrogate lysozyme interactions with lysozyme-specific antibodies, more likely by destroying the epitopes responsible for the interaction. More specifically, two SPR-based assays were developed since our ELISA approach did not allow us to discriminate between background and low, but still intact, quantities of lysozyme epitope after plasma treatment. Our SPR results clearly demonstrated that significant protein destruction or desorption was achieved when amounts of lysozyme less than 12.5 ng had been deposited in polystyrene 96-well ELISA plates. At higher lysozyme amounts, traces of available lysozyme epitopes were detected by SPR through indirect measurements. Finally, we demonstrated that a direct SPR approach in which biosensor-immobilized lysozyme activity is directly measured prior and after plasma treatment is more sensitive, and thus, more appropriate to define plasma treatment efficacy with more certainty

Validation of cold plasma treatment for protein inactivation: a surface plasmon resonance-based biosensor study

Science.gov (United States)

Bernard, C.; Leduc, A.; Barbeau, J.; Saoudi, B.; Yahia, L'H.; DeCrescenzo, G.

2006-08-01

Gas plasma is being proposed as an interesting and promising tool to achieve sterilization. The efficacy of gas plasma to destroy bacterial spores (the most resistant living microorganisms) has been demonstrated and documented over the last ten years. In addition to causing damage to deoxyribonucleic acid by UV radiation emitted by excited species originating from the plasma, gas plasma has been shown to promote erosion of the microorganism in addition to possible oxidation reactions within the microorganism. In this work, we used lysozyme as a protein model to assess the effect of gas plasma on protein inactivation. Lysozyme samples have been subjected to the flowing afterglow of a gas discharge achieved in a nitrogen-oxygen mixture. The efficiency of this plasma treatment on lysozyme has been tested by two different assays. These are an enzyme-linked immunosorbent assay (ELISA) and a surface plasmon resonance (SPR)-based biosensor assay. The two methods showed that exposure to gas plasma can abrogate lysozyme interactions with lysozyme-specific antibodies, more likely by destroying the epitopes responsible for the interaction. More specifically, two SPR-based assays were developed since our ELISA approach did not allow us to discriminate between background and low, but still intact, quantities of lysozyme epitope after plasma treatment. Our SPR results clearly demonstrated that significant protein destruction or desorption was achieved when amounts of lysozyme less than 12.5 ng had been deposited in polystyrene 96-well ELISA plates. At higher lysozyme amounts, traces of available lysozyme epitopes were detected by SPR through indirect measurements. Finally, we demonstrated that a direct SPR approach in which biosensor-immobilized lysozyme activity is directly measured prior and after plasma treatment is more sensitive, and thus, more appropriate to define plasma treatment efficacy with more certainty.

A case series of family-based treatment for adolescents with atypical anorexia nervosa.

Science.gov (United States)

Hughes, Elizabeth K; Le Grange, Daniel; Court, Andrew; Sawyer, Susan M

2017-04-01

The aim of this case series was to examine engagement in and outcomes of family-based treatment (FBT) for adolescents with DSM-5 atypical AN, that is, adolescents who were not underweight at presentation. Consecutive referrals for FBT of adolescents with atypical AN to a specialist child and adolescent eating disorder program were examined. Engagement in treatment (i.e., dose of treatment, completion rate), and changes in psychological symptomatology (i.e., eating disorder symptoms, depressive symptoms, self-esteem, obsessive compulsiveness), weight, and menstrual function were examined. The need for additional interventions (i.e., hospitalization and medication), and estimated remission rates were also examined. The sample comprised 42 adolescents aged 12-18 years (88% female). Engagement in FBT was high, with 83% completing at least half the treatment dose. There were significant decreases in eating disorder and depressive symptoms during FBT (p adolescents who were not admitted to hospital prior to FBT gained some weight (M = 3.4 kg) while those who were admitted did not gain weight during FBT (M = 0.2 kg, p adolescents with atypical AN. However, more research is needed into systematic adaptations of FBT and other treatments that could improve overall remission rates. © 2017 Wiley Periodicals, Inc.

Skull base meningioma. Surgical and adjuvant treatment with clinical and PET evaluation

International Nuclear Information System (INIS)

Gudjonsson, O.

2001-01-01

The treatment strategy for skull base meningiomas remains a controversial issue. Because of the proximity of these tumours to critical neurovascular structures, the risk for vascular damage and new cranial neuropathies postoperatively is significant. To avoid unacceptable neurological deficits the surgical treatment strategy includes different surgical approaches and a subtotal removal of these tumours in some cases. However, because the rate of recurrence and progression is significant in these patients, a demand for adjuvant treatment and better prognostic methods is called for so that treatment and follow-up can be tailored to each patient. Accordingly, we have chosen to evaluate general outcome and facial nerve function after translabyrinthine and transcochlear approaches for cerebellopontine angle (CPA) meningiomas. Furthermore, we have evaluated two adjuvant treatments, namely, irradiation by high-energy proton beams and medical treatment with interferon-alpha as well as evaluation of the treatment effect with 11 C-L-methionine PET. In addition, we have evaluated a new PET tracer ( 76 Br-BrdU) for 'in vivo' determination of the growth potential of intracranial tumours. Conclusion: The translabyrinthine and transcochlear approaches are apparently safe surgical procedures in the treatment of CPA meningiomas. Proton beam therapy is technically feasible as suggested by the fact that only minimal side effects were observed. Moreover, none of the meningiomas treated have shown progression during a 36-month follow-up. Our results indicate that IFN-alpha can be an effective oncostatic treatment for certain patients with meningiomas. The 11 C-L-methionine PET method might be used as a complement to CT or MRI in the evaluation of the effect of proton beam and IFN-alpha treatment in meningiomas. The present attempt failed to demonstrate that the PET tracer 76 Br-BrdU could be used for the non-invasive characterisation of growth potential in brain, tumours

Skull base meningioma. Surgical and adjuvant treatment with clinical and PET evaluation

Energy Technology Data Exchange (ETDEWEB)

Gudjonsson, O

2001-05-01

The treatment strategy for skull base meningiomas remains a controversial issue. Because of the proximity of these tumours to critical neurovascular structures, the risk for vascular damage and new cranial neuropathies postoperatively is significant. To avoid unacceptable neurological deficits the surgical treatment strategy includes different surgical approaches and a subtotal removal of these tumours in some cases. However, because the rate of recurrence and progression is significant in these patients, a demand for adjuvant treatment and better prognostic methods is called for so that treatment and follow-up can be tailored to each patient. Accordingly, we have chosen to evaluate general outcome and facial nerve function after translabyrinthine and transcochlear approaches for cerebellopontine angle (CPA) meningiomas. Furthermore, we have evaluated two adjuvant treatments, namely, irradiation by high-energy proton beams and medical treatment with interferon-alpha as well as evaluation of the treatment effect with {sup 11}C-L-methionine PET. In addition, we have evaluated a new PET tracer ({sup 76}Br-BrdU) for 'in vivo' determination of the growth potential of intracranial tumours. Conclusion: The translabyrinthine and transcochlear approaches are apparently safe surgical procedures in the treatment of CPA meningiomas. Proton beam therapy is technically feasible as suggested by the fact that only minimal side effects were observed. Moreover, none of the meningiomas treated have shown progression during a 36-month follow-up. Our results indicate that IFN-alpha can be an effective oncostatic treatment for certain patients with meningiomas. The {sup 11}C-L-methionine PET method might be used as a complement to CT or MRI in the evaluation of the effect of proton beam and IFN-alpha treatment in meningiomas. The present attempt failed to demonstrate that the PET tracer {sup 76}Br-BrdU could be used for the non-invasive characterisation of growth potential in

Electrical and magnetic properties of Fe-based bulk metallic glass with minor Co and Ni addition

Energy Technology Data Exchange (ETDEWEB)

Jung, H.Y. [IFW Dresden, Institute for Complex Materials, D–01069 Dresden (Germany); Stoica, M. [IFW Dresden, Institute for Complex Materials, D–01069 Dresden (Germany); POLITEHNICA University of Timisoara, P-ta Victoriei 2, Timisoara (Romania); Yi, S. [Department of Materials Science and Metallurgical Engineering, Kyungpook National University, 702–701 Daegu (Korea, Republic of); Kim, D.H. [Center for Non-crystalline Materials, Department of Metallurgical Engineering, Yonsei University, 120–749 Seoul (Korea, Republic of); Eckert, J. [IFW Dresden, Institute for Complex Materials, D–01069 Dresden (Germany); University of Technology Dresden, Institute of Materials Science, D–01062 Dresden (Germany)

2014-09-01

The effect of minor Co and Ni alloying on soft magnetic properties and electrical resistivity of Fe{sub 75.5}C{sub 7.0}Si{sub 3.3}B{sub 5.5}P{sub 8.7} (at%) bulk metallic glass has been investigated. Within examined compositional range (Co and Ni up to 4 at%, respectively), the saturation magnetization and electrical resistivity of the alloys continuously decrease with increasing Co or Ni content, while the Curie temperature and initial permeability increase. Comparing the effect of Co and Ni additions, the alloys with Co addition have much higher Curie temperature and saturation magnetization than the alloy with Ni addition. Also, the Co-added alloys show smaller coercivity and larger permeability than the Ni-added alloys. The present results suggest that minor addition of Co can provide better effectiveness to enhance the magnetic softness of Fe-based BMGs than minor Ni addition. - Highlights: • Soft magnetic characteristics of CI-based BMGs can be enhanced with minor Co and Ni alloying. • Minor Co addition can provide better effectiveness to enhance the magnetic softness of CI-based BMG than Ni addition. • Optimum Co addition enlarges atomic packing density and randomness of amorphous structure.

Access to and Payment for Office-Based Buprenorphine Treatment in Ohio

Directory of Open Access Journals (Sweden)

Theodore V Parran

2017-06-01

Full Text Available Importance: Office-based opiate agonist therapy has dramatically expanded access to medication-assisted treatment over the past decade but has also led to increased buprenorphine diversion. Objective: Our study sought to characterize physicians who participate in office-based therapy (OBT to assess patient access to OBT in Ohio 10 years after its introduction. Design/Setting/Participants: Cross-sectional telephone survey of Drug Addiction Treatment Act–waivered physicians in Ohio listed by the Center for Substance Abuse Treatment (CSAT. Main Outcomes: This study sought to determine what proportion of eligible physicians are actively prescribing buprenorphine, whether they accept insurance for OBT, and whether they accept insurance for non-OBT services. In addition, we evaluated what physician characteristics predicted those primary outcomes. We hypothesized that a significant minority of eligible physicians are not active prescribers of buprenorphine. In addition, we expected that a significant minority of OBT prescribers do not accept insurance, further restricting patient access. We further hypothesized that a large subset of OBT prescribers accept insurance in their regular practices but do not take insurance for OBT. Results: Of the 466 listed physicians, 327 (70.2% practice representatives were reached for interview. Thirty-three physicians were excluded, with a true response rate of 75.5%. In total, 80.7% of providers reached were active OBT prescribers. Of these, 52.7% accepted insurance for OBT, 20.8% accepted insurance for non-OBT services but not for OBT, and 26.5% did not accept insurance for any services. Practices who did not accept insurance were more likely among dedicated addiction clinics located outside of Ohio’s 6 major cities. Practices who normally accepted insurance but did not for OBT services were more likely in urban locations and were not associated with dedicated addiction practices. Neither business practice was

Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

Science.gov (United States)

Key, Brenda L; Rowa, Karen; Bieling, Peter; McCabe, Randi; Pawluk, Elizabeth J

2017-09-01

A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from

Influence of attrition scrubbing, ultrasonic treatment, and oxidant additions on uranium removal from contaminated soils

International Nuclear Information System (INIS)

Timpson, M.E.; Elless, M.P.; Francis, C.W.

1994-01-01

As part of the Uranium in Soils Integrated Demonstration Project being conducted by the US Department of Energy, bench-scale investigations of selective leaching of uranium from soils at the Fernald Environmental Management Project site in Ohio were conducted at Oak Ridge National Laboratory. Two soils (storage pad soil and incinerator soil), representing the major contaminant sources at the site, were extracted using carbonate- and citric acid-based lixiviants. Physical and chemical processes were used in combination with the two extractants to increase the rate of uranium release from these soils. Attrition scrubbing and ultrasonic dispersion were the two physical processes utilized. Potassium permanganate was used as an oxidizing agent to transform tetravalent uranium to the hexavalent state. Hexavalent uranium is easily complexed in solution by the carbonate radical. Attrition scrubbing increased the rate of uranium release from both soils when compared with rotary shaking. At equivalent extraction times and solids loadings, however, attrition scrubbing proved effective only on the incinerator soil. Ultrasonic treatments on the incinerator soil removed 71% of the uranium contamination in a single extraction. Multiple extractions of the same sample removed up to 90% of the uranium. Additions of potassium permanganate to the carbonate extractant resulted in significant changes in the extractability of uranium from the incinerator soil but had no effect on the storage pad soil

Application of Finite Element, Phase-field, and CALPHAD-based Methods to Additive Manufacturing of Ni-based Superalloys.

Science.gov (United States)

Keller, Trevor; Lindwall, Greta; Ghosh, Supriyo; Ma, Li; Lane, Brandon M; Zhang, Fan; Kattner, Ursula R; Lass, Eric A; Heigel, Jarred C; Idell, Yaakov; Williams, Maureen E; Allen, Andrew J; Guyer, Jonathan E; Levine, Lyle E

2017-10-15

Numerical simulations are used in this work to investigate aspects of microstructure and microseg-regation during rapid solidification of a Ni-based superalloy in a laser powder bed fusion additive manufacturing process. Thermal modeling by finite element analysis simulates the laser melt pool, with surface temperatures in agreement with in situ thermographic measurements on Inconel 625. Geometric and thermal features of the simulated melt pools are extracted and used in subsequent mesoscale simulations. Solidification in the melt pool is simulated on two length scales. For the multicomponent alloy Inconel 625, microsegregation between dendrite arms is calculated using the Scheil-Gulliver solidification model and DICTRA software. Phase-field simulations, using Ni-Nb as a binary analogue to Inconel 625, produced microstructures with primary cellular/dendritic arm spacings in agreement with measured spacings in experimentally observed microstructures and a lesser extent of microsegregation than predicted by DICTRA simulations. The composition profiles are used to compare thermodynamic driving forces for nucleation against experimentally observed precipitates identified by electron and X-ray diffraction analyses. Our analysis lists the precipitates that may form from FCC phase of enriched interdendritic compositions and compares these against experimentally observed phases from 1 h heat treatments at two temperatures: stress relief at 1143 K (870 °C) or homogenization at 1423 K (1150 °C).

Vocational High School Students’ Creativity in Food Additives with Problem Based Learning Approach

Science.gov (United States)

Ratnasari, D.; Supriyanti, T.; Rosbiono, M.

2017-09-01

The aim of this study is to verify the creativity of vocational students through Problem Based Learning approach in the food additives. The method which used quasi-experiment with one group posttest design. The research subjects were 32 students in grade XII of a vocational high school students courses chemical analysis in Bandung city. Instrument of creativity were essay, Student Worksheet, and observation sheets. Creativity measured include creative thinking skills and creative act skills. The results showed creative thinking skills and creative act skills are good. Research showed that the problem based learning approach can be applied to develop creativity of vocational students in the food additives well, because the students are given the opportunity to determine their own experiment procedure that will be used. It is recommended to often implement Problem Based Learning approach in other chemical concepts so that students’ creativity is sustainable.

Effects of boron additions and solutionizing treatments on microstructures and ductility of forged Ti–6Al–4V alloys

International Nuclear Information System (INIS)

Luan, J.H.; Jiao, Z.B.; Chen, G.; Liu, C.T.

2015-01-01

Highlights: • Proper boron additions and heat-treatments improve the ductility of Ti64 alloys. • Coarse TiB precipitates embrittle the Ti64 alloys causing ductility loss. • Modified Ti64 forged alloys with high strength and high ductility are developed. - Abstract: The effects of boron additions on the microstructure and mechanical properties of forged Ti–6Al–4V alloys in different heat-treatment conditions have been characterized by both experimental studies and thermodynamic calculations. The results indicate a combination of proper post-forging treatments and B additions are helpful for control of the prior-β grain size and the volume fraction of α phase, thereby tuning the ductility of the forged Ti–6Al–4V alloys. However, the B-containing alloys exhibit a significant drop in ductility if the solutionizing temperature is too high, and this embrittlement is mainly due to the coarsening of brittle TiB borides. The mechanism in this case is due to the cleavage fracture of TiB rather than its debonding with the matrix, as indicated by the observation of the aligned TiB borides on the matching areas of both halves of the fracture surfaces. Thus, the TiB size and orientation, the prior-β grain size, and the volume fraction of the α phase all play important roles in controlling the mechanical properties of the forged Ti–6Al–4V alloys. The current findings shed light on the composition–microstructure–ductility relationship in the forged Ti–6Al–4V alloys

Effects of boron additions and solutionizing treatments on microstructures and ductility of forged Ti–6Al–4V alloys

Energy Technology Data Exchange (ETDEWEB)

Luan, J.H.; Jiao, Z.B. [Center for Advanced Structural Materials, Department of Mechanical and Biomedical Engineering, College of Science and Engineering, City University of Hong Kong, Hong Kong (China); Chen, G. [Engineering Research Center of Materials Behavior and Design, Ministry of Education, Nanjing University of Science and Technology, Nanjing 210094 (China); Liu, C.T., E-mail: chainliu@cityu.edu.hk [Center for Advanced Structural Materials, Department of Mechanical and Biomedical Engineering, College of Science and Engineering, City University of Hong Kong, Hong Kong (China)

2015-03-05

Highlights: • Proper boron additions and heat-treatments improve the ductility of Ti64 alloys. • Coarse TiB precipitates embrittle the Ti64 alloys causing ductility loss. • Modified Ti64 forged alloys with high strength and high ductility are developed. - Abstract: The effects of boron additions on the microstructure and mechanical properties of forged Ti–6Al–4V alloys in different heat-treatment conditions have been characterized by both experimental studies and thermodynamic calculations. The results indicate a combination of proper post-forging treatments and B additions are helpful for control of the prior-β grain size and the volume fraction of α phase, thereby tuning the ductility of the forged Ti–6Al–4V alloys. However, the B-containing alloys exhibit a significant drop in ductility if the solutionizing temperature is too high, and this embrittlement is mainly due to the coarsening of brittle TiB borides. The mechanism in this case is due to the cleavage fracture of TiB rather than its debonding with the matrix, as indicated by the observation of the aligned TiB borides on the matching areas of both halves of the fracture surfaces. Thus, the TiB size and orientation, the prior-β grain size, and the volume fraction of the α phase all play important roles in controlling the mechanical properties of the forged Ti–6Al–4V alloys. The current findings shed light on the composition–microstructure–ductility relationship in the forged Ti–6Al–4V alloys.

Remediation of metal polluted soils by phytorremediation combined with biochar addition

Science.gov (United States)

Méndez, Ana; Paz-Ferreiro, Jorge; Gómez-Limón, Dulce; César Arranz, Julio; Saa, Antonio; Gascó, Gabriel

2016-04-01

The main objective of this work is to optimize and quantify the treatment of metal polluted soils through phytoremediation techniques combined with the addition of biochar. Biochar is a carbon rich material obtained by thermal treatment of biomass in inert atmosphere. In recent years, it has been attracted considerable interest due to their positive effect after soil addition. The use of biochar also seems appropriate for the treatment of metal-contaminated soils decreasing their mobility. Biochar properties highly depend on the raw material composition and manufacturing conditions. This paper is based on the use of manure wastes, rich in nutrients and therefore interesting raw materials for biochar production, especially when combined with phytoremediation techniques since the biochar act as conditioner and slow release fertilizer. We are very grateful to Ministerio de Economia y Competitividad (Spain) for financial support under Project CGL2014-58322-R.

Composting system for waste treatment coca leaf with the addition of three biological activators in the Experimental Center Kallutaca

Directory of Open Access Journals (Sweden)

Apaza-Condori Emma Eva

2015-11-01

Full Text Available The objective of this study was to evaluate the composting process waste coca leaf with the addition of three biological activators (yogurt, whey and yeast. This work was carried out Kallutaca Experimental Center, Biofertilizers module Career Agricultural Engineering at the Public University of El Alto, La Paz municipality of Laja. Posed treatments were: T1 (+ Yogurt Coca wastes; T2 (Coca wastes + whey; T3 (Coca wastes + yeast and T4 (Control. The design was completely randomized with 4 treatments and 3 repetitions. The values in N are classified medium and high levels the quantities of P, K are classified as middle levels. The value obtained 7.9 pH, EC 12950 µS/cm and 61% organic matter belong to treatment T1. The decomposition time was a period of 105 days corresponds to treatment T3.

A computer-based anaglyphic system for the treatment of amblyopia

Directory of Open Access Journals (Sweden)

Rastegarpour A

2011-09-01

Full Text Available Ali Rastegarpour Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Purpose: Virtual reality (VR-based treatment has been introduced as a potential option for amblyopia management, presumably without involving the problems of occlusion and penalization, including variable and unsatisfactory outcomes, long duration of treatment, poor compliance, psychological impact, and complications. However, VR-based treatment is costly and not accessible for most children. This paper introduces a method that encompasses the advantages of VR-based treatment at a lower cost. Methods: The presented system consists of a pair of glasses with two color filters and software for use on a personal computer. The software is designed such that some active graphic components can only be seen by the amblyopic eye and are filtered out for the other eye. Some components would be seen by both to encourage fusion. The result is that the patient must use both eyes, and specifically the amblyopic eye, to play the games. Results: A prototype of the system, the ABG InSight, was found capable of successfully filtering out elements of a certain color and therefore, could prove to be a viable alternative to VR-based treatment for amblyopia. Conclusion: The anaglyphic system maintains most of the advantages of VR-based systems, but is less costly and highly accessible. It fulfills the means that VR-based systems are designed to achieve, and warrants further investigation. Keywords: amblyopia, computer-based, open source, virtual reality, color filters, 3-D

The prediction of food additives in the fruit juice based on electronic nose with chemometrics.

Science.gov (United States)

Qiu, Shanshan; Wang, Jun

2017-09-01

Food additives are added to products to enhance their taste, and preserve flavor or appearance. While their use should be restricted to achieve a technological benefit, the contents of food additives should be also strictly controlled. In this study, E-nose was applied as an alternative to traditional monitoring technologies for determining two food additives, namely benzoic acid and chitosan. For quantitative monitoring, support vector machine (SVM), random forest (RF), extreme learning machine (ELM) and partial least squares regression (PLSR) were applied to establish regression models between E-nose signals and the amount of food additives in fruit juices. The monitoring models based on ELM and RF reached higher correlation coefficients (R 2 s) and lower root mean square errors (RMSEs) than models based on PLSR and SVM. This work indicates that E-nose combined with RF or ELM can be a cost-effective, easy-to-build and rapid detection system for food additive monitoring. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of PAC addition on immersed ultrafiltration for the treatment of algal-rich water

Energy Technology Data Exchange (ETDEWEB)

Zhang Yan, E-mail: zhang.yan113@163.com [State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, 73 Huanghe Road, Nangang District, Harbin 150090 (China); Tian Jiayu; Nan Jun; Gao Shanshan; Liang Heng; Wang Meilian; Li Guibai [State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, 73 Huanghe Road, Nangang District, Harbin 150090 (China)

2011-02-28

The aim of this study was to evaluate the effect of powdered activated carbon (PAC) addition on the treatment of algal-rich water by immersed ultrafiltration (UF), in terms of permeate quality and membrane fouling. Experiments were performed with a hollow-fiber polyvinyl chloride ultrafiltration membrane at a laboratory scale, 20-25 deg, C and 10 L/(m{sup 2} h) constant permeate flux. UF could achieve an absolute removal of Microcystis aeruginosa cells, but a poor removal of algogenic organic matter (AOM) released into water, contaminants responsible for severe membrane fouling. The addition of 4 g/L PAC to the immersed UF reactor significantly alleviated the development of trans-membrane pressure and enhanced the removal of dissovled organic carbon (by 10.9 {+-} 1.7%), UV{sub 254} (by 27.1 {+-} 1.7%), and microcystins (expressed as MC-LR{sub eq}, by 40.8 {+-} 4.2%). However, PAC had little effect on the rejection of hydrophilic high molecular weight AOM such as carbohydrates and proteins. It was also identified that PAC reduced the concentrations of carbohydrates and proteins in the reactor due to decreased light intensity, as well as the MC-LR{sub eq} concentration by PAC adsorption.

[Evidence-based aspects of clinical mastitis treatment].

Science.gov (United States)

Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

2015-01-01

Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.   e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents.

Aluminium Alloy AA6060 surface treatment with high temperature steam containing chemical additives

DEFF Research Database (Denmark)

Din, Rameez Ud; Tabrizian, Naja; Jellesen, Morten S.

2015-01-01

The steam treatment process was employed to produce a conversion coating on aluminium alloy AA6060. The changes in microstructure and its effect on corrosion resistance properties were investigated. Various concentrations of KMnO4 containing Ce(NO3)3 was injected into the steam and its effect...... on the formation of steam-based conversion coating was evaluated. The use of Mn-Ce into the steam resulted in incorporation of these species into the conversion coating, which resulted in improved corrosion resistance of the alloy substrate....

Azilsartan Improves Glycemic Status and Reduces Kidney Damage in Zucker Diabetic Fatty Rats

Czech Academy of Sciences Publication Activity Database

Khan, M. A. H.; Neckář, Jan; Haines, J.; Imig, J. D.

2014-01-01

Roč. 27, č. 8 (2014), s. 1087-1095 ISSN 0895-7061 R&D Projects: GA ČR(CZ) GA13-10267S Institutional support: RVO:67985823 Keywords : azilsartan medoxomil * blood pressure * hypertension * inflammation * kidney injury * oxidative stress * type 2 diabetes Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 2.852, year: 2014

Additional BCAA-enriched nutrient mixture improves the nutritional condition in cirrhotic patients with hypoalbuminemia despite treatment with regular BCAA granules: A pilot study.

Science.gov (United States)

Fukui, Aiko; Kawabe, Naoto; Hashimoto, Senju; Murao, Michihito; Nakano, Takuji; Shimazaki, Hiroaki; Kan, Toshiki; Nakaoka, Kazunori; Ohki, Masashi; Takagawa, Yuka; Kamei, Hiroyuki; Yoshioka, Kentaro

2015-07-01

To elucidate the effect of adding branched-chain amino acid (BCAA)-enriched nutrient mixtures in cirrhotic patients with hypoalbuminemia despite the use of BCAA granules. A BCAA-enriched nutrient mixture containing 5.6 g of BCAA and 210 kcal was additionally administered in 40 cirrhotic patients with hypoalbuminemia despite their treatment with BCAA granules containing 12 g of BCAA. Laboratory data were assessed at 6 months before beginning additional therapy, at baseline, and at 6 months after baseline. Serum albumin levels significantly decreased from 6 months before baseline (3.14±0.47 g/dL) to baseline (2.83±0.46 g/dL), despite the treatment with BCAA granules (pBCAA-enriched nutrient mixtures increased serum albumin levels of the cirrhotic patients with hypoalbuminemia despite the treatment with BCAA granules and without hepatocellular carcinoma treatment, upper gastrointestinal tract bleeding, or albumin infusion.

Access and completion of a Web-based treatment in a population-based sample of tornado-affected adolescents.

Science.gov (United States)

Price, Matthew; Yuen, Erica K; Davidson, Tatiana M; Hubel, Grace; Ruggiero, Kenneth J

2015-08-01

Although Web-based treatments have significant potential to assess and treat difficult-to-reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a Web-based treatment for postdisaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a Web-based treatment. The modular treatment addressed symptoms of posttraumatic stress disorder, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of Web-based treatments to provide clinical services in a postdisaster context. (c) 2015 APA, all rights reserved).

Evaluation of some vanillin-modified polyoxyethylene surfactants as additives for water based mud

Directory of Open Access Journals (Sweden)

M.M.A. El-Sukkary

2014-03-01

Full Text Available Water-based drilling fluids are increasingly being used for oil and gas exploration and are generally considered to be more environmentally acceptable than oil-based or synthetic-based fluids. In this study, new types of vanillin-modified polyoxyethylene surfactants were evaluated as additives in water-based mud. Their rheological properties in water-based mud were investigated which included the apparent viscosity, the plastic viscosity, the yield point, the gel strength, the thixotropy as well as the filtration properties. Also, the effect of high temperature on the rheology of the formulated water based mud was studied. The tested ethoxylated non-ionic surfactants showed good results when utilized in the formulation of water-based mud.

The addition of a goal-based motivational interview to standardised treatment as usual to reduce dropouts in a service for patients with personality disorder: a feasibility study

Directory of Open Access Journals (Sweden)

Whitham Diane

2010-10-01

Full Text Available Abstract Background Rates of non-completion of treatments for personality disorder are high and there are indications that those who do not complete treatment have worse outcomes than those who do. Improving both cost-efficiency and client welfare require attention to engaging people with personality disorder in treatment. A motivational interview, based on the Personal Concerns Inventory, may have the ability to enhance engagement and retention in therapy. Here, we report the protocol for a feasibility study for a randomised controlled trial (RCT. Methods All referrals accepted to the psychological service of Nottinghamshire Healthcare NHS Trust's outpatient service for people with personality disorder are eligible for inclusion. Consenting participants are randomised to receive the Personal Concerns Inventory interview plus treatment as usual or treatment as usual only. We aim to recruit 100 participants over 11/2 years. A randomised controlled trial will be considered feasible if 1 the recruitment rate to the project is 54% of all referrals (95% CI 54-64, 2 80% of clients find the intervention acceptable in terms of its practicability and usefulness (95% CI 80-91, and 3 80% of therapists report finding the intervention helpful (95% CI 80-100. In a full-scale randomised controlled trial, the primary outcome measure will be completion of treatment i.e., entry into and completion of ≥ 75% of sessions offered. Therefore, information will be collected on recruitment rates, attendance at therapy sessions, and completion of treatment. The feasibility of examining the processes of engagement will be tested by assessing the value, coherence, and attainability of goals pre-treatment, and engagement in treatment. The costs associated with the intervention will be calculated, and the feasibility of calculating the cost-benefits of the intervention will be tested. The views of clients and therapists on the intervention, collected using semi

The addition of a goal-based motivational interview to standardised treatment as usual to reduce dropouts in a service for patients with personality disorder: a feasibility study.

Science.gov (United States)

McMurran, Mary; Cox, W Miles; Coupe, Stephen; Whitham, Diane; Hedges, Lucy

2010-10-14

Rates of non-completion of treatments for personality disorder are high and there are indications that those who do not complete treatment have worse outcomes than those who do. Improving both cost-efficiency and client welfare require attention to engaging people with personality disorder in treatment. A motivational interview, based on the Personal Concerns Inventory, may have the ability to enhance engagement and retention in therapy. Here, we report the protocol for a feasibility study for a randomised controlled trial (RCT). All referrals accepted to the psychological service of Nottinghamshire Healthcare NHS Trust's outpatient service for people with personality disorder are eligible for inclusion. Consenting participants are randomised to receive the Personal Concerns Inventory interview plus treatment as usual or treatment as usual only. We aim to recruit 100 participants over 11/2 years. A randomised controlled trial will be considered feasible if 1 the recruitment rate to the project is 54% of all referrals (95% CI 54-64), 2 80% of clients find the intervention acceptable in terms of its practicability and usefulness (95% CI 80-91), and 3 80% of therapists report finding the intervention helpful (95% CI 80-100). In a full-scale randomised controlled trial, the primary outcome measure will be completion of treatment i.e., entry into and completion of ≥ 75% of sessions offered. Therefore, information will be collected on recruitment rates, attendance at therapy sessions, and completion of treatment. The feasibility of examining the processes of engagement will be tested by assessing the value, coherence, and attainability of goals pre-treatment, and engagement in treatment. The costs associated with the intervention will be calculated, and the feasibility of calculating the cost-benefits of the intervention will be tested. The views of clients and therapists on the intervention, collected using semi-structured interviews, will be analysed using thematic

[Mentalization Based Treatment of an Adolescent Girl with Conduct Disorder].

Science.gov (United States)

Reiter, Melanie; Bock, Astrid; Althoff, Marie-Luise; Taubner, Svenja; Sevecke, Kathrin

2017-05-01

Mentalization Based Treatment of an Adolescent Girl with Conduct Disorder This paper will give a short overview on the theoretical concept of mentalization and its specific characteristics in adolescence. A previous study on Mentalization based treatment for adolescents (MBT-A) demonstrated the effectiveness of MBT-A for the treatment of adolescents with symptoms of deliberate self-harm (Rossouw u. Fonagy, 2012). Based on the results of this study Taubner, Gablonski, Sevecke, and Volkert (in preparation) developed a manual for mentalization based treatment for adolescents with conduct disorders (MBT-CD). This manual represents the foundation for a future study on the efficacy of the MBT-A for this specific disorder in young people. The present case report demonstrates the application of specific MBT interventions, as well as the therapeutic course over one year in a 16-year old girl who fulfilled all criteria of a conduct disorder. During the course of treatment, the de-escalating relationship-oriented therapeutic approach can be considered as a great strength of MBT-A, especially for patients with conduct disorders. The clinical picture, as well as the psychological assessment, showed a positive progress over the course of treatment. Despite frequent escalations, forced placements due to acute endangerment of self and others, and a precarious situation with the patient's place of residence towards the end of therapy, MBT-A treatment enabled the patient to continually use the evolved mentalizing capabilities as a resource.

Noise generator for tinnitus treatment based on look-up tables

Science.gov (United States)

Uriz, Alejandro J.; Agüero, Pablo; Tulli, Juan C.; Castiñeira Moreira, Jorge; González, Esteban; Hidalgo, Roberto; Casadei, Manuel

2016-04-01

Treatment of tinnitus by means of masking sounds allows to obtain a significant improve of the quality of life of the individual that suffer that condition. In view of that, it is possible to develop noise synthesizers based on random number generators in digital signal processors (DSP), which are used in almost any digital hearing aid devices. DSP architecture have limitations to implement a pseudo random number generator, due to it, the noise statistics can be not as good as expectations. In this paper, a technique to generate additive white gaussian noise (AWGN) or other types of filtered noise using coefficients stored in program memory of the DSP is proposed. Also, an implementation of the technique is carried out on a dsPIC from Microchip®. Objective experiments and experimental measurements are performed to analyze the proposed technique.

Addition of antimicrobial/antimold feature and antistatic treatment by electron beam

International Nuclear Information System (INIS)

Kinoshita, Shinobu

1996-01-01

A plastic which has a high insulation resistance and is apt to build up static causes an electrostatic problem during the process or other problem like an attraction of dust or small particle. Bacteria and fungus are suspended in the air by sticking to the dust/small particle/waterdrop or in the form of spore, and are apt to stick to the substance bearing the static electricity, which may lead to a microbial problem. In order to avoid these problems, an antistatic agent is mixed in a plastic so that the insulation resistance is decreased to prevent the static electricity. Also for the addition of antimicrobial/antimold feature to a plastic, a mixing-in of antimicrobial/antimold agent is adopted. However, problems still remain in the antistatic treatment, such as that an antistatic effect finally becomes invalid due to the loss of the antistatic agent after some time or the surface of the substance becomes viscous and consequently can not maintain the hardness. As to the antimicrobial/antimold treatment, a difficulty remains in selecting a suitable antimicrobial/antimold agent which must be resistant to high temperature during a mixing-in of the agent. In our test, an electron beam-induced technology (EB) by which a non-solvent resin can be hardened at room temperature and provided with a surface hardening is evaluated. An antimicrobial effect was tested by using Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. No live bacteria was observed in a bacteria solution which had been kept overnight in contact with the test film, and the result was proved to successful. As to the antimold effect, a drop of a suspension of 5 different spores including Aspergillus niger was applied to a culture medium, and it was kept in contact with the test film for culturing. On the untreated sample, a growth of the mold was observed approx. 2 weeks later, but on the test film, a growth of the mold was not observed, and the result was proved to be successful. (J.P.N.)

Prison-based rehabilitation: Predictors of offender treatment participation and treatment completion

NARCIS (Netherlands)

Bosma, A.; Kunst, M.; Dirkzwager, A.J.E.; Nieuwbeerta, Paul|info:eu-repo/dai/nl/138622973

2016-01-01

The purpose of the current study was to examine to what extent risk factors and treatment readiness were related to engagement (i.e., participation and completion) in prison-based rehabilitation programs. The sample consisted of the total 6-month inflow of male detainees in the Netherlands who were

Numerical modeling of the strand deposition flow in extrusion-based additive manufacturing

DEFF Research Database (Denmark)

Comminal, Raphaël; Serdeczny, Marcin P.; Pedersen, David B.

2018-01-01

-based additive manufacturing, as well as the surface roughness of the fabricated part. Under the assumptions of an isothermal Newtonian fluid and a creeping laminar flow, the deposition flow is controlled by two parameters: the gap distance between the extrusion nozzle and the substrate, and the velocity ratio...

The effects of radiation treatment on drugs and pharmaceutical additives. Pt. 5

International Nuclear Information System (INIS)

Schnell, R.; Boegl, W.

1982-01-01

The sterilization of medical instruments (e.g. catheters, one-way syringes) with ionizing radiation is successfully practiced in many countries. Simultaneously, the results of many experiments involving the sterilization of pharmaceuticals and aiding substances with radiation have been published during the past years. Experiences have shown that radiation treatment in many cases has brought about aberrations in the irradiated substances. In this bibliographic study (Part I-V), the results of 275 radiation tested pharmaceuticals are discussed and evaluated. The substances were treated with ionizing radiation in their pure form (solid substance or liquid), as aqueous or alcohol solution, as emulsion or in compound form, almost exclusively with gamma radiation from cobalt-60 sources. The radiation doses applied amounted from some krd to about 100 Mrd. The results of the original papers analyzed in this Part V are not summarized separately since the final Part VII of the study on the effects of irradiation of drugs and drug additives will contain a survey for all essential data discussed in Parts I to VI. (orig.) [de

Additive manufacturing of reflective optics: evaluating finishing methods

Science.gov (United States)

Leuteritz, G.; Lachmayer, R.

2018-02-01

Individually shaped light distributions become more and more important in lighting technologies and thus the importance of additively manufactured reflectors increases significantly. The vast field of applications ranges from automotive lighting to medical imaging and bolsters the statement. However, the surfaces of additively manufactured reflectors suffer from insufficient optical properties even when manufactured using optimized process parameters for the Selective Laser Melting (SLM) process. Therefore post-process treatments of reflectors are necessary in order to further enhance their optical quality. This work concentrates on the effectiveness of post-process procedures for reflective optics. Based on already optimized aluminum reflectors, which are manufactured with a SLM machine, the parts are differently machined after the SLM process. Selected finishing methods like laser polishing, sputtering or sand blasting are applied and their effects quantified and compared. The post-process procedures are investigated on their impact on surface roughness and reflectance as well as geometrical precision. For each finishing method a demonstrator will be created and compared to a fully milled sample and among themselves. Ultimately, guidelines are developed in order to figure out the optimal treatment of additively manufactured reflectors regarding their optical and geometrical properties. Simulations of the light distributions will be validated with the developed demonstrators.

Evidence-based treatment of metabolic myopathy

Directory of Open Access Journals (Sweden)

Yan LIN

2014-05-01

Full Text Available Objective To evaluate the current treatments and possible adverse reactions of metabolic myopathy, and to develop the best solution for evidence-based treatment.  Methods Taking metabolic myopathy, mitochondrial myopathy, lipid storage myopathy, glycogen storage diseases, endocrine myopathy, drug toxicity myopathy and treatment as search terms, retrieve in databases such as PubMed, Cochrane Library, ClinicalKey database, National Science and Technology Library (NSTL, in order to collect the relevant literature database including clinical guidelines, systematic reviews (SR, randomized controlled trials (RCT, controlled clinical trials, retrospective case analysis and case study. Jadad Scale was used to evaluate the quality of literature.  Results Twenty-eight related articles were selected, including 6 clinical guidelines, 5 systematic reviews, 10 randomized controlled trials and 7 clinical controlled trials. According to Jadad Scale, 23 articles were evaluated as high-quality literature (≥ 4, and the remaining 5 were evaluated as low-quality literature (< 4. Treatment principles of these clinical trials, efficacy of different therapies and drug safety evaluation suggest that: 1 Acid α-glycosidase (GAA enzyme replacement therapy (ERT is the main treatment for glycogen storage diseases, with taking a high-protein diet, exercising before taking a small amount of fructose orally and reducing the patient's physical activity gradually. 2 Carnitine supplementation is used in the treatment of lipid storage myopathy, with carbohydrate and low fat diet provided before exercise or sports. 3 Patients with mitochondrial myopathy can take coenzyme Q10, vitamin B, vitamin K, vitamin C, etc. Proper aerobic exercise combined with strength training is safe, and it can also enhance the exercise tolerance of patients effectively. 4 The first choice to treat the endocrine myopathy is treating primary affection. 5 Myopathies due to drugs and toxins should

Measures of motivation for psychiatric treatment based on self-determination theory: psychometric properties in Dutch psychiatric outpatients.

Science.gov (United States)

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

2014-08-01

Self-determination theory is potentially useful for understanding reasons why individuals with mental illness do or do not engage in psychiatric treatment. The current study examined the psychometric properties of three questionnaires based on self-determination theory-The Treatment Entry Questionnaire (TEQ), Health Care Climate Questionnaire (HCCQ), and the Short Motivation Feedback List (SMFL)-in a sample of 348 Dutch adult outpatients with primary diagnoses of mood, anxiety, psychotic, and personality disorders. Structural equation modeling showed that the empirical factor structures of the TEQ and SMFL were adequately represented by a model with three intercorrelated factors. These were interpreted as identified, introjected, and external motivation. The reliabilities of the Dutch TEQ, HCCQ, and SMFL were found to be acceptable but can be improved on; congeneric estimates ranged from 0.66 to 0.94 depending on the measure and patient subsample. Preliminary support for the construct validities of the questionnaires was found in the form of theoretically expected associations with other scales, including therapist-rated motivation and treatment engagement and with legally mandated treatment. Additionally, the study provides insights into the relations between measures of motivation based on self-determination theory, the transtheoretical model and the integral model of treatment motivation in psychiatric outpatients with severe mental illness. © The Author(s) 2013.

Innovative Additive for Bitumen Based on Processed Fats

Science.gov (United States)

Babiak, Michał; Kosno, Jacek; Ratajczak, Maria; Zieliński, Krzysztof

2017-10-01

Various additives, admixtures and modifiers are used to improve technical properties and strength characteristics of building materials. Manufacturers of waterproofing materials, concrete, ceramics and bitumen have to use innovative, increasingly complex and costly additives, admixtures or modifiers. As a result, simple and inexpensive substances have been replaced by complex, long chain polymers, multi component resins or plastics. For economic and ecological reasons waste materials are more frequently used as additives, admixtures and modifiers. Nowadays the most commonly used physical modifiers of bitumen belong to the group of polymers - large molecular organic compounds of natural origin or being the result of planned chemical synthesis. Polymers are substances that do not chemically react with bitumen, they act as fillers or create a spatial network within bitumen (the so called physical cross-linking). The development of organic chemistry has allowed the synthesis of a number of substances chemically modifying bitumen. The most promising are heterocyclic organic compounds belonging to the group of imidazolines. The aim of the study presented in this paper was to demonstrate the suitability of processed natural and post-refining fat waste (diamidoamine dehydrate) as bitumen modifier. This paper discusses the impact of adding technical imidazoline on selected bitumen characteristics. Samples of bitumen 160/220, which is most commonly used for the production of waterproofing products, were analysed. For base bitumen and bitumen modified with technical imidazoline the following measurements were taken: measurement of the softening point by Ball and Ring method, determination of the breaking point by Fraass method and needle penetration measurement at 25°C. Later the samples were aged using TFOT laboratory method and the basic characteristics were determined again. The results showed that a small amount of imidazoline improved bitumen thermoplastic parameters at

A comparison of arc-based and static mini-multileaf collimator-based radiosurgery treatment plans

International Nuclear Information System (INIS)

Kubo, Hideo Dale; Pappas, Conrad T.E.; Wilder, Richard B.

1997-01-01

Background: The purpose of this study is to compare arc-based and mini-multileaf collimator (mMLC)-based radiosurgery treatment plans using isodose distributions and dose-volume histograms. Methods: Of 11 patients who underwent conventional arc-based radiosurgery for intracranial malignancies, four were treated with one isocenter, four were treated with two isocenters and three were treated with three isocenters. The same cases were re-planned using a test version of mMLC-based radiosurgery software for multiple static non-coplanar fields. Results and conclusion: For non-spherical targets, treatment planning is relatively intuitive with mMLC-based radiosurgery, reducing the amount of time required for planning. Moreover, a lower dose of radiation is delivered to normal tissue with mMLC-based radiosurgery than with arc-based radiosurgery, which theoretically should lead to a reduced risk of complications

Competency Based Hospital Radiopharmacy Training. Additional Information

International Nuclear Information System (INIS)

2010-01-01

Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country

Early addition of topical corticosteroids in the treatment of bacterial keratitis.

Science.gov (United States)

Ray, Kathryn J; Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Glidden, David V; Oldenburg, Catherine E; Sun, Catherine Q; Zegans, Michael E; McLeod, Stephen D; Acharya, Nisha R; Lietman, Thomas M

2014-06-01

Scarring from bacterial keratitis remains a leading cause of visual loss. To determine whether topical corticosteroids are beneficial as an adjunctive therapy for bacterial keratitis if given early in the course of infection. The Steroids for Corneal Ulcers Trial (SCUT) was a randomized, double-masked, placebo-controlled trial that overall found no effect of adding topical corticosteroids to topical moxifloxacin hydrochloride in bacterial keratitis. Here, we assess the timing of administration of corticosteroids in a subgroup analysis of the SCUT. We define earlier administration of corticosteroids (vs placebo) as addition after 2 to 3 days of topical antibiotics and later as addition after 4 or more days of topical antibiotics. We assess the effect of topical corticosteroids (vs placebo) on 3-month best spectacle-corrected visual acuity in patients who received corticosteroids or placebo earlier vs later. Further analyses were performed for subgroups of patients with non-Nocardia keratitis and those with no topical antibiotic use before enrollment. Patients treated with topical corticosteroids as adjunctive therapy within 2 to 3 days of antibiotic therapy had approximately 1-line better visual acuity at 3 months than did those given placebo (-0.11 logMAR; 95% CI, -0.20 to -0.02 logMAR; P = .01). In patients who had 4 or more days of antibiotic therapy before corticosteroid treatment, the effect was not significant; patients given corticosteroids had 1-line worse visual acuity at 3 months compared with those in the placebo group (0.10 logMAR; 95% CI, -0.02 to 0.23 logMAR; P = .14). Patients with non-Nocardia keratitis and those having no topical antibiotic use before the SCUT enrollment showed significant improvement in best spectacle-corrected visual acuity at 3 months if corticosteroids were administered earlier rather than later. There may be a benefit with adjunctive topical corticosteroids if application occurs earlier in the course of bacterial

An overview on cellulose-based material in tailoring bio-hybrid nanostructured photocatalysts for water treatment and renewable energy applications.

Science.gov (United States)

Mohamed, Mohamad Azuwa; Abd Mutalib, Muhazri; Mohd Hir, Zul Adlan; M Zain, M F; Mohamad, Abu Bakar; Jeffery Minggu, Lorna; Awang, Nor Asikin; W Salleh, W N

2017-10-01

A combination between the nanostructured photocatalyst and cellulose-based materials promotes a new functionality of cellulose towards the development of new bio-hybrid materials for various applications especially in water treatment and renewable energy. The excellent compatibility and association between nanostructured photocatalyst and cellulose-based materials was induced by bio-combability and high hydrophilicity of the cellulose components. The electron rich hydroxyl group of celluloses helps to promote superior interaction with photocatalyst. The formation of bio-hybrid nanostructured are attaining huge interest nowadays due to the synergistic properties of individual cellulose-based material and photocatalyst nanoparticles. Therefore, in this review we introduce some cellulose-based material and discusses its compatibility with nanostructured photocatalyst in terms of physical and chemical properties. In addition, we gather information and evidence on the fabrication techniques of cellulose-based hybrid nanostructured photocatalyst and its recent application in the field of water treatment and renewable energy. Copyright © 2017 Elsevier B.V. All rights reserved.

Adding an Internet-delivered treatment to an efficacious treatment package for opioid dependence.

Science.gov (United States)

Christensen, Darren R; Landes, Reid D; Jackson, Lisa; Marsch, Lisa A; Mancino, Michael J; Chopra, Mohit P; Bickel, Warren K

2014-12-01

To examine the benefit of adding an Internet-delivered behavior therapy to a buprenorphine medication program and voucher-based motivational incentives. A block-randomized, unblinded, parallel, 12-week treatment trial was conducted with 170 opioid-dependent adult patients (mean age = 34.3 years; 54.1% male; 95.3% White). Participants received an Internet-based community reinforcement approach intervention plus contingency management (CRA+) and buprenorphine or contingency management alone (CM-alone) plus buprenorphine. The primary outcomes, measured over the course of treatment, were longest continuous abstinence, total abstinence, and days retained in treatment. Compared to those receiving CM-alone, CRA+ recipients exhibited, on average, 9.7 total days more of abstinence (95% confidence interval [CI = 2.3, 17.2]) and had a reduced hazard of dropping out of treatment (hazard ratio = 0.47; 95% CI [0.26, 0.85]). Prior treatment for opioid dependence significantly moderated the additional improvement of CRA+ for longest continuous days of abstinence. These results provide further evidence that an Internet-based CRA+ treatment is efficacious and adds clinical benefits to a contingency management/medication based program for opioid dependence.

Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial.

Science.gov (United States)

Kaale, Anett; Fagerland, Morten W; Martinsen, Egil W; Smith, Lars

2014-02-01

This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism. A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire. Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect. This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information--Joint Attention Intervention and Young Children With Autism; http://clinicaltrials.gov/; NCT00378157. Copyright © 2014 American Academy of Child and Adolescent Psychiatry

Effect of Sc addition and T6 aging treatment on the microstructure modification and mechanical properties of A356 alloy

Energy Technology Data Exchange (ETDEWEB)

Pramod, S.L. [Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai 600036 (India); Ravikirana [Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai 600036 (India); Department of Physics and Nanotechnology, SRM University, Chennai 603203 (India); Rao, A.K. Prasada [College of Engineering and Design, Alliance University, Bengaluru 562106 (India); Murty, B.S., E-mail: murty@iitm.ac.in [Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai 600036 (India); Bakshi, Srinivasa R., E-mail: sbakshi@iitm.ac.in [Department of Metallurgical and Materials Engineering, Indian Institute of Technology Madras, Chennai 600036 (India)

2016-09-30

Effect of Sc addition and T6 aging treatment on the secondary dendritic arm spacing (SDAS), modification of eutectic Si morphology, β-Al{sub 5}FeSiand π-Al{sub 8}Mg{sub 3}Si{sub 6}Fe{sub 1} phases and its effect on mechanical properties in A356 alloy has been investigated. Addition of 0.4 wt%Sc in A356 alloy resulted in a 50%reduction in the secondary dendritic arm spacing (SDAS). Sc addition changed the morphology of eutectic Si from plate like to fibrous and globular. The needle like morphology of β-Al{sub 5}FeSi phase in A356 alloy changed to Al{sub 5}Fe(Si,Sc) phase having smaller size and irregular morphology. Transmission electron microscopy (TEM) diffraction pattern and Energy dispersive spectroscopy (EDS) analysis revealed the presence of β-Al{sub 5}FeSiand π-Al{sub 8}Mg{sub 3}Si{sub 6}Fe{sub 1} phases in A356 alloy which changed to β-Al{sub 5}Fe(Si,Sc), π-Al{sub 8}Mg{sub 3}(Si,Sc){sub 6}Fe{sub 1} and additional V-AlSi{sub 2}Sc{sub 2}phase was observed in Sc containing alloys. Addition of 0.4 wt%Sc to A356 alloy improved its Vickers hardness, Ultimate tensile strength (UTS), Yield strength (YS) and ductility by 20%, 25%, 20% and 30% respectively. Artificial aging treatment resulted in significant improvement in the tensile properties for both A356 and Sc added A356 alloys.

Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada.

Science.gov (United States)

Joffres, Michel R; Campbell, Norm R C; Manns, Braden; Tu, Karen

2007-05-01

Hypertension is the leading risk factor for mortality worldwide. One-quarter of the adult Canadian population has hypertension, and more than 90% of the population is estimated to develop hypertension if they live an average lifespan. Reductions in dietary sodium additives significantly lower systolic and diastolic blood pressure, and population reductions in dietary sodium are recommended by major scientific and public health organizations. To estimate the reduction in hypertension prevalence and specific hypertension management cost savings associated with a population-wide reduction in dietary sodium additives. Based on data from clinical trials, reducing dietary sodium additives by 1840 mg/day would result in a decrease of 5.06 mmHg (systolic) and 2.7 mmHg (diastolic) blood pressures. Using Canadian Heart Health Survey data, the resulting reduction in hypertension was estimated. Costs of laboratory testing and physician visits were based on 2001 to 2003 Ontario Health Insurance Plan data, and the number of physician visits and costs of medications for patients with hypertension were taken from 2003 IMS Canada. To estimate the reduction in total physician visits and laboratory costs, current estimates of aware hypertensive patients in Canada were used from the Canadian Community Health Survey. Reducing dietary sodium additives may decrease hypertension prevalence by 30%, resulting in one million fewer hypertensive patients in Canada, and almost double the treatment and control rate. Direct cost savings related to fewer physician visits, laboratory tests and lower medication use are estimated to be approximately $430 million per year. Physician visits and laboratory costs would decrease by 6.5%, and 23% fewer treated hypertensive patients would require medications for control of blood pressure. Based on these estimates, lowering dietary sodium additives would lead to a large reduction in hypertension prevalence and result in health care cost savings in Canada.

78 FR 35115 - Listing of Color Additives Exempt From Certification; Mica-Based Pearlescent Pigments

Science.gov (United States)

2013-06-12

... (EDI) of the additive from all sources for both the mean and high- intake consumer to an acceptable daily intake (ADI) level established by toxicological data. The EDI is determined by projections based... the issuance of Sec. 73.350 we calculated a cumulative EDI (CEDI) for the use of mica-based...

The influence of Pb addition on the properties of fly ash-based geopolymers.

Science.gov (United States)

Nikolić, Violeta; Komljenović, Miroslav; Džunuzović, Nataša; Miladinović, Zoran

2018-05-15

Preventing or reducing negative effects on the environment from the waste landfilling is the main goal defined by the European Landfill Directive. Generally geopolymers can be considered as sustainable binders for immobilization of hazardous wastes containing different toxic elements. In this paper the influence of addition of high amount of lead on structure, strength, and leaching behavior (the effectiveness of Pb immobilization) of fly ash-based geopolymers depending on the geopolymer curing conditions was investigated. Lead was added during the synthesis of geopolymers in the form of highly soluble salt - lead-nitrate. Structural changes of geopolymers as a result of lead addition/immobilization were assessed by means of XRD, SEM/EDS, and 29 Si MAS NMR analysis. Investigated curing conditions significantly influenced structure, strength and leaching behavior of geopolymers. High addition of lead caused a sizeable decrease in compressive strength of geopolymers and promoted formation of aluminum-deficient aluminosilicate gel (depolymerization of aluminosilicate gel), regardless of the curing conditions investigated. According to the EUWAC limitations, 4% of lead was successfully immobilized by fly ash-based geopolymers cured for 28 days in a humid chamber at room temperature. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of La and Ce Addition on the Modification of Al-Si Based Alloys

Directory of Open Access Journals (Sweden)

Emad M. Elgallad

2016-01-01

Full Text Available This study focuses on the effects of the addition of rare earth metals (mainly lanthanum and cerium on the eutectic Si characteristics in Al-Si based alloys. Based on the solidification curves and microstructural examination of the corresponding alloys, it was found that addition of La or Ce increases the alloy melting temperature and the Al-Si eutectic temperature, with an Al-Si recalescence of 2-3°C, and the appearance of post-α-Al peaks attributed to precipitation of rare earth intermetallics. Addition of La or Ce to Al-(7–13% Si causes only partial modification of the eutectic Si particles. Lanthanum has a high affinity to react with Sr, which weakens the modification efficiency of the latter. Cerium, however, has a high affinity for Ti, forming a large amount of sludge. Due to the large difference in the length of the eutectic Si particles in the same sample, the normal use of standard deviation in this case is meaningless.

Evidence for phase-based psychotherapy as a treatment for dissociative identity disorder comorbid with major depressive disorder and alcohol dependence.

Science.gov (United States)

Pollock, Brianna E; Macfie, Jenny; Elledge, L Christian

2017-01-01

We report on the treatment and successful outcome of a 58-year-old Native American male with a history of complex trauma presenting with dissociative identity disorder (DID) and major depressive disorder. The treatment included a trauma-informed phase-based psychotherapy as recommended by the International Society for the Study of Trauma and Dissociation for treating DID. We assessed symptoms at baseline and at three additional time points over the course of 14 months. We utilized the Reliable Change Index to examine statistically significant change in symptoms over the course of treatment. Significant symptom improvements were realized posttreatment across all measured domains of functioning, including dissociative symptoms, alcohol abuse, depression, anxiety, and emotion regulation skills. Moreover, the client no longer met criteria for DID, major depressive disorder, or alcohol abuse. Results are discussed in terms of the effectiveness of trauma-focused, phase-based treatment for DID for cases of complex trauma with comorbid disorders.

Community-based MDR-TB care project improves treatment initiation in patients diagnosed with MDR-TB in Myanmar.

Science.gov (United States)

Wai, Pyae Phyo; Shewade, Hemant Deepak; Kyaw, Nang Thu Thu; Thein, Saw; Si Thu, Aung; Kyaw, Khine Wut Yee; Aye, Nyein Nyein; Phyo, Aye Mon; Maung, Htet Myet Win; Soe, Kyaw Thu; Aung, Si Thu

2018-01-01

The Union in collaboration with national TB programme (NTP) started the community-based MDR-TB care (CBMDR-TBC) project in 33 townships of upper Myanmar to improve treatment initiation and treatment adherence. Patients with MDR-TB diagnosed/registered under NTP received support through the project staff, in addition to the routine domiciliary care provided by NTP staff. Each township had a project nurse exclusively for MDR-TB and 30 USD per month (max. for 4 months) were provided to the patient as a pre-treatment support. To assess whether CBMDR-TBC project's support improved treatment initiation. In this cohort study (involving record review) of all diagnosed MDR-TB between January 2015 and June 2016 in project townships, CBMDR-TBC status was categorized as "receiving support" if date of project initiation in patient's township was before the date of diagnosis and "not receiving support", if otherwise. Cox proportional hazards regression (censored on 31 Dec 2016) was done to identify predictors of treatment initiation. Of 456 patients, 57% initiated treatment: 64% and 56% among patients "receiving support (n = 208)" and "not receiving support (n = 228)" respectively (CBMDR-TBC status was not known in 20 (4%) patients due to missing diagnosis dates). Among those initiated on treatment (n = 261), median (IQR) time to initiate treatment was 38 (20, 76) days: 31 (18, 50) among patients "receiving support" and 50 (26,101) among patients "not receiving support". After adjusting other potential confounders (age, sex, region, HIV, past history of TB treatment), patients "receiving support" had 80% higher chance of initiating treatment [aHR (0.95 CI): 1.8 (1.3, 2.3)] when compared to patients "not receiving support". In addition, age 15-54 years, previous history of TB and being HIV negative were independent predictors of treatment initiation. Receiving support under CBMDR-TBC project improved treatment initiation: it not only improved the proportion initiated but also

Use of Bio-Amp, a commercial bio-additive for the treatment of grease trap wastewater containing fat, oil, and grease.

Science.gov (United States)

Tang, Hao L; Xie, Yuefeng F; Chen, Yen-Chih

2012-11-01

This research investigated the application of Bio-Amp, a commercial bio-additive for the treatment of fat, oil, and grease (FOG) in a grease trap, and evaluated potential impacts of treated effluent on downstream collection system and treatment processes. Results show that after Bio-Amp treatment, FOG deposit formation was reduced by 40%, implicating a potential reduction of sewer line blockages. Chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP) and total fatty acids were reduced by 39%, 33%, 56%, and 59%, respectively, which represents an overall loading reduction of 9% COD, 5% TN and 40% TP received by the treatment plant from all the dining halls. On the other hand, readily biodegradable COD fractions significantly increased, which implies a potential improvement on Bio-P removal. Overall, the results showed that application of Bio-Amp in grease trap provides potential reduction of sewer line blockages, and can also alleviate downstream treatment burden. Copyright © 2012 Elsevier Ltd. All rights reserved.

Additive manufacturing of RF absorbers

Science.gov (United States)

Mills, Matthew S.

The ability of additive manufacturing techniques to fabricate integrated electromagnetic absorbers tuned for specific radio frequency bands within structural composites allows for unique combinations of mechanical and electromagnetic properties. These composites and films can be used for RF shielding of sensitive electromagnetic components through in-plane and out-of-plane RF absorption. Structural composites are a common building block of many commercial platforms. These platforms may be placed in situations in which there is a need for embedded RF absorbing properties along with structural properties. Instead of adding radar absorbing treatments to the external surface of existing structures, which adds increased size, weight and cost; it could prove to be advantageous to integrate the microwave absorbing properties directly into the composite during the fabrication process. In this thesis, a method based on additive manufacturing techniques of composites structures with prescribed electromagnetic loss, within the frequency range 1 to 26GHz, is presented. This method utilizes screen printing and nScrypt micro dispensing to pattern a carbon based ink onto low loss substrates. The materials chosen for this study will be presented, and the fabrication technique that these materials went through to create RF absorbing structures will be described. The calibration methods used, the modeling of the RF structures, and the applications in which this technology can be utilized will also be presented.

Future prospects of antiarrhythmic treatment based on experimental studies

NARCIS (Netherlands)

Janse, M. J.

1995-01-01

Based on recent experimental studies, a number of speculations about future developments are made regarding the treatment of atrial fibrillation, the problem of proarrhythmia in patients with heart failure, and the treatment of ventricular tachycardia developing during the first 6 weeks following

TREHALOSE-BASED ADDITIVE IMPROVED INTER-PRIMER BINDING SITE REACTIONS FOR DNA ISOLATED FROM RECALCITRANT PLANTS

Directory of Open Access Journals (Sweden)

Veronika Lancíková

2014-02-01

Full Text Available Trehalose-based (TBT-PAR additive was tested in order to optimize PCR amplification for DNA isolated from recalcitrant plants. Retrotransposon-based inter-primer binding site reactions were significantly improved with TBT-PAR solution using genomic DNA isolated from flax (Linum usitatissimum L., genotypes Kyivskyi, Bethune grown in radio-contaminated and non-radioactive remediated Chernobyl experimental fields. Additionally, similar improvements were observed using 19 recalcitrant genotypes of maize (Zea mays L. and three genotypes of yacon (Smallanthus sonchifolius, Poepp. et Endl., genotypes PER05, ECU45, BOL22 grown in standard field conditions.

Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability

Directory of Open Access Journals (Sweden)

Botella C

2015-10-01

Full Text Available Cristina Botella,1 Berenice Serrano,1 Rosa M Baños,2 Azucena Garcia-Palacios1 1Universitat Jaume I, Castellón de la Plana, Spain; 2Universitat de Valencia, Valencia, Spain Introduction: The essential feature of post-traumatic stress disorder (PTSD is the development of characteristic symptoms following exposure to one or more traumatic events. According to evidence-based intervention guidelines and empirical evidence, one of the most extensively researched and validated treatments for PTSD is prolonged exposure to traumatic events; however, exposure therapy can present some limitations. Virtual reality (VR can help to improve prolonged exposure because it creates fictitious, safe, and controllable situations that can enhance emotional engagement and acceptance. Objective: In addition to carrying out a review to evaluate the efficacy of VR exposure-based therapy (VR-EBT for the treatment of PTSD, the aim of this study was to contribute to analyzing the use of VR-EBT by: first, evaluating the adequacy of psychological treatment protocols that use VR-EBT to treat PTSD; and second, analyzing the acceptability of VR-EBT. Method: We performed a replica search with descriptors and databases used in two previous reviews and updated to April 2015. Next, we carried out an evaluation of the efficacy, adequacy, and acceptability of VR-EBT protocols. Results: Results showed that VR-EBT was effective in the treatment of PTSD. The findings related to adequacy showed that not all studies using VR-EBT reported having followed the clinical guidelines for evidence-based interventions in the treatment of PTSD. Regarding acceptability, few studies evaluated this subject. However, the findings are very promising, and patients reported high acceptability and satisfaction with the inclusion of VR in the treatment of PTSD. Conclusion: The main weaknesses identified in this review focus on the need for more controlled studies, the need to standardize treatment

Dose prescription and treatment planning based on FMISO-PET hypoxia

International Nuclear Information System (INIS)

Toma-Dasu, Iuliana; Antonovic, Laura; Uhrdin, Johan; Dasu, Alexandru; Nuyts, Sandra; Dirix, Piet; Haustermans, Karin; Brahme, Anders

2012-01-01

Purpose. The study presents the implementation of a novel method for incorporating hypoxia information from PET-CT imaging into treatment planning and estimates the efficiency of various optimization approaches. Its focuses on the feasibility of optimizing treatment plans based on the non-linear conversion of PET hypoxia images into radiosensitivity maps from the uptake properties of the tracers used. Material and methods. PET hypoxia images of seven head-and-neck cancer patients were used to determine optimal dose distributions needed to counteract the radiation resistance associated with tumor hypoxia assuming various scenarios regarding the evolution of the hypoxic compartment during the treatment. A research planning system for advanced studies has been used to optimize IMRT plans based on hypoxia information from patient PET images. These resulting plans were compared in terms of target coverage for the same fulfilled constraints regarding the organs at risk. Results. The results of a planning study indicated the clinical feasibility of the proposed method for treatment planning based on PET hypoxia. Antihypoxic strategies would lead to small improvements in all the patients, but higher effects are expected for the fraction of patients with hypoxic tumors. For these, individualization of the treatment based on hypoxia PET imaging could lead to improved treatment outcome while creating the premises for limiting the irradiation of the surrounding normal tissues. Conclusions. The proposed approach offers the possibility of improved treatment results as it takes into consideration the heterogeneity and the dynamics of the hypoxic regions. It also provides early identification of the clinical cases that might benefit from dose escalation as well as the cases that could benefit from other counter-hypoxic measures

Influence of 18F-fluorodeoxyglucose-positron emission tomography on computed tomography-based radiation treatment planning for oesophageal cancer

International Nuclear Information System (INIS)

Everitt, C.; Leong, T.

2006-01-01

The addition of positron emission tomography (PET) information to CT-based radiotherapy treatment planning has the potential to improve target volume definition through more accurate localization of the primary tumour and involved regional lymph nodes. This case report describes the first patient enrolled to a prospective study evaluating the effects of coregistered positron emission tomography/CT images on radiotherapy treatment planning for oesophageal cancer. The results show that if combined positron emission tomography/CT is used for radiotherapy treatment planning, there may be alterations to the delineation of tumour volumes when compared to CT alone. For this patient, a geographic miss of tumour would have occurred if CT data alone were used for radiotherapy planning Copyright (2006) Blackwell Publishing Asia Pty Ltd

Addition of meloxicam to the treatment of bovine clinical mastitis results in a net economic benefit to the dairy farmer.

Science.gov (United States)

van Soest, Felix J S; Abbeloos, Elke; McDougall, Scott; Hogeveen, Henk

2018-04-01

Recently, it has been shown that the addition of meloxicam to standard antimicrobial therapy for clinical mastitis (CM) improves the conception rate of dairy cows contracting CM in the first 120 d in milk. The objective of our study was to assess whether this improved reproduction through additional treatment with meloxicam would result in a positive net economic benefit for the farmer. We developed a stochastic bio-economic simulation model, in which a dairy cow with CM in the first 120 d in milk was simulated. Two scenarios were simulated in which CM cases were treated with meloxicam in conjunction with antimicrobial therapy or with antimicrobial therapy alone. The scenarios differed for conception rates (31% with meloxicam or 21% without meloxicam) and for the cost of CM treatment. Sensitivity analyses were undertaken for the biological and economic components of the model to assess the effects of a wide range of inputs on inferences about the cost effectiveness of meloxicam treatment. Model results showed an average net economic benefit of €42 per CM case per year in favor of the meloxicam scenario. Cows in the no-meloxicam treatment scenario had higher returns on milk production, lower costs upon calving, and reduced costs of treatment. However, these did not outweigh the savings associated with lower feed intake, reduced number of inseminations, and the reduced culling rate. The net economic benefit favoring meloxicam therapy was a consequence of the better reproductive performance in the meloxicam scenario in which cows had a shorter calving to conception interval (132 vs. 143 d), a shorter intercalving interval (405 vs. 416 d), and fewer inseminations per conception (2.9 vs. 3.7) compared with cows in the no-meloxicam treatment scenario. This resulted in a shorter lactation, hence a lower lactational milk production (8,441 vs. 8,517 kg per lactation) with lower feeding costs in the meloxicam group. A lower culling rate (12 vs. 25%) resulted in lower

Evaluation of fermentation quality of brewers' grains ensiled in combination with malt sprouts and chemical conservation additive

Directory of Open Access Journals (Sweden)

Ivo Vyskočil

2008-01-01

Full Text Available The aim of the work was to evaluate the effect of addition of humidity absorbent (malt sprouts and chemical conservation additive on fermentation process quality of brewer grains’ silage. Chemical conservation additive was based on formic acid, propionic acid, benzoic acid and ammonium formate content. In a model experiment the fresh brewer grains were used. A dry matter (DM content of brewer grains was 187.4 g / kg. Six treatments with three repetitions per treatment were prepared. The treatments A1, A2 and A3 were not supplied by humidity absorbent. Treatment A1 was a control treatment without any additive. The treatments A2 and A3 were supplied by chemical conservation additive in a dose of 3 L per tonne and 6 L per tonne, respectively. The treatments B1, B2 and B3 were supplied by malt sprouts to reach DM content of conserved matter on level 320–350 g / kg. Moreover the treatments B2 and B3 were supplied by chemical additive with its dose 3 and 6 L per tonne. Model silages were evaluated after 8 months of conservation at average laboratory temperature 26–28  °C, from each treatment were the final laboratory samples taken and analyzed. During conservation of treatments B1, B2 and B3 were no drain recognized. From A1 treatment drained 1300 ml of waste fluid that is 145 L per tonne of conserved matter. That was significant (P < 0.01 the malt sprouts addition support the lactic acid production and eliminate acetic acid production. There was no propionic acid or butyric acid detected in silages with malt sprouts event in these silages were analyzed higher (P < 0.01 concentration of ammoniac. Chemical additive supplementation improved (P < 0.01 the pH value and water leach acidity. The results show the malt sprout addition eliminates waste fluid drain and improves fermentation process. The higher concentration of chemical additive (6 l / t inhibited the fermentation process in our model experiment.

Effects of waste glass additions on quality of textile sludge-based bricks.

Science.gov (United States)

Rahman, Ari; Urabe, Takeo; Kishimoto, Naoyuki; Mizuhara, Shinji

2015-01-01

This research investigated the utilization of textile sludge as a substitute for clay in brick production. The addition of textile sludge to a brick specimen enhanced its pores, thus reducing the quality of the product. However, the addition of waste glass to brick production materials improved the quality of the brick in terms of both compressive strength and water absorption. Maximum compressive strength was observed with the following composition of waste materials: 30% textile sludge, 60% clay and 10% waste glass. The melting of waste glass clogged up pores on the brick, which improved water absorption performance and compressive strength. Moreover, a leaching test on a sludge-based brick to which 10% waste glass did not detect significant heavy metal compounds in leachates, with the product being in conformance with standard regulations. The recycling of textile sludge for brick production, when combined with waste glass additions, may thus be promising in terms of both product quality and environmental aspects.

Sofosbuvir based treatment of chronic hepatitis C genotype 3 infections

DEFF Research Database (Denmark)

Dalgard, Olav; Weiland, Ola; Noraberg, Geir

2017-01-01

BACKGROUND AND AIMS: Chronic hepatitis C virus (HCV) genotype 3 infection with advanced liver disease has emerged as the most challenging to treat. We retrospectively assessed the treatment outcome of sofosbuvir (SOF) based regimes for treatment of HCV genotype 3 infections in a real life setting...... in Scandinavia. METHODS: Consecutive patients with chronic HCV genotype 3 infection were enrolled at 16 treatment centers in Denmark, Sweden, Norway and Finland. Patients who had received a SOF containing regimen were included. The fibrosis stage was evaluated by liver biopsy or transient liver elastography...... was similar for all treatment regimens, but lower in men (p = 0.042), and in patients with decompensated liver disease (p = 0.004). CONCLUSION: We found that sofosbuvir based treatment in a real-life setting could offer SVR rates exceeding 90% in patients with HCV genotype 3 infection and advanced liver...

Improving precipitation hardening behavior of Mg−Zn based alloys with Ce−Ca microalloying additions

Energy Technology Data Exchange (ETDEWEB)

Langelier, B., E-mail: langelb@mcmaster.ca [Mechanical & Mechatronics Engineering, The University of Waterloo, N2L 3G1 (Canada); Canadian Centre for Electron Microscopy, McMaster University, L8S 4L8 (Canada); Korinek, A. [Canadian Centre for Electron Microscopy, McMaster University, L8S 4L8 (Canada); Donnadieu, P. [Univ. Grenoble Alpes, SIMAP, F-38000 Grenoble (France); CNRS, SIMAP, F-38000 Grenoble (France); Esmaeili, S. [Mechanical & Mechatronics Engineering, The University of Waterloo, N2L 3G1 (Canada)

2016-10-15

The precipitation hardening behavior of newly developed Mg−Zn−Ca−Ce alloys, with modified texture and improved ductility, is studied to delineate the microstructural characteristics that lead to effective hardening upon ageing treatments. Advanced electron microscopy and atom probe techniques are used to analyze the structural characteristics in relevance to the hardening potential. It has been found that the formation of a new basal precipitate phase, which evolves from a single atomic layer GP zone, and is finely distributed in both under-aged and peak-aged microstructures, has a significant impact in the improvement of the hardening response compared with the base Mg−Zn alloys. It has also been found that the β′{sub 1} rod precipitates, commonly formed during ageing treatments of Mg−Zn alloys, have their size and distribution significantly refined in the Ca−Ce containing alloys. The role of alloy chemistry in the formation of the fine basal plate GP zones and the refinement in β′{sub 1} precipitation and their relationships to the hardening behavior are discussed. It is proposed that Ca microalloying governs the formation of the GP zones and the enhancement of hardening, particularly in the under-aged conditions, but that this is aided by a beneficial effect from Ce. - Highlights: • Ce−Ca microalloying additions improve hardening in Mg−Zn, over Ce or Ca alone. • Improved hardening is due to refined β′{sub 1} rods, and fine basal plate precipitates. • Atom probe tomography identifies Ca in both β′{sub 1} and the fine basal plates. • The fine basal plates originate as ordered monolayer GP zones with 1:1 Zn:Ca (at.%). • With ageing GP zones become more Zn-rich and transform to the fine basal plates.

Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?

International Nuclear Information System (INIS)

Rades, D.; Huttenlocher, S.; Evers, J.N.; Bajrovic, A.; Karstens, J.H.; Rudat, V.; Schild, S.E.

2012-01-01

Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45). Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55). Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival. (orig.)

Nanotechnology-based water treatment strategies.

Science.gov (United States)

Kumar, Sandeep; Ahlawat, Wandit; Bhanjana, Gaurav; Heydarifard, Solmaz; Nazhad, Mousa M; Dilbaghi, Neeraj

2014-02-01

The most important component for living beings on the earth is access to clean and safe drinking water. Globally, water scarcity is pervasive even in water-rich areas as immense pressure has been created by the burgeoning human population, industrialization, civilization, environmental changes and agricultural activities. The problem of access to safe water is inevitable and requires tremendous research to devise new, cheaper technologies for purification of water, while taking into account energy requirements and environmental impact. This review highlights nanotechnology-based water treatment technologies being developed and used to improve desalination of sea and brackish water, safe reuse of wastewater, disinfection and decontamination of water, i.e., biosorption and nanoadsorption for contaminant removal, nanophotocatalysis for chemical degradation of contaminants, nanosensors for contaminant detection, different membrane technologies including reverse osmosis, nanofiltration, ultrafiltration, electro-dialysis etc. This review also deals with the fate and transport of engineered nanomaterials in water and wastewater treatment systems along with the risks associated with nanomaterials.

A clinical study of autogenic training-based behavioral treatment for panic disorder.

Science.gov (United States)

Sakai, M

1996-03-01

The present study investigated the effect of autogenic training-based behavioral treatment for panic disorder and identified the predictors of treatment outcome. Thirty-four patients meeting DSM-III-R criteria for panic disorder received autogenic training-based behavioral treatment from October 1981 to December 1994. They were treated individually by the author. The medical records of the patients were investigated for the purpose of this study. The results showed that this autogenic training-based behavioral treatment had successful results. Fifteen patients were cured, nine much improved, five improved, and five unchanged at the end of the treatment. Improvement trends were found as for the severity of panic attack and the severity of agoraphobic avoidance. No consistent findings about predictors emerged when such pretreatment variables as demographics and severity of symptoms were used to predict the outcome. Also, three treatment variables showed useful predictive power. First, practicing the second standard autogenic training exercise satisfactorily predicted better outcomes. Second, application of in vivo exposure was found to be positively associated with the treatment outcome in patients with agoraphobic avoidance. Third, longer treatment periods were associated with better outcomes. These findings suggested that the autogenic training-based behavioral treatment could provide relief to the majority of panic disorder patients.

The effect of Sn addition on phase stability and phase evolution during aging heat treatment in Ti–Mo alloys employed as biomaterials

Energy Technology Data Exchange (ETDEWEB)

Mello, Mariana G. de, E-mail: marianagm@fem.unicamp.br; Salvador, Camilo F., E-mail: csalvador@fem.unicamp.br; Cremasco, Alessandra, E-mail: alessandra@fem.unicamp.br; Caram, Rubens, E-mail: caram@fem.unicamp.br

2015-12-15

Increases in life expectancy and improvements in necessary healthcare attach great importance to the development of biomaterials. Ti alloys containing β stabilizing elements are often used as biomaterials due to their high specific strength, high corrosion resistance, unusual biocompatibility and low elastic moduli, which benefit bone tissues close to an implant. This study deals with phase stability in β Ti–Mo–Sn alloys processed under different conditions and was performed according to the following steps: a study of the effect of Sn content (a) on phase stability in Ti–Mo alloys, (b) on the suppression of α″ and ω phase precipitation; (c) on α-phase precipitation during aging heat treatments and (d) on mechanical properties, including the elastic modulus, as measured using tensile tests and acoustic techniques. The alloys were prepared by arc melting under a controlled atmosphere followed by homogenization heat treatment and hot rolling. Optical microscopy, scanning and transmission electron microscopy, X-ray diffraction and differential scanning calorimetry were employed for characterization purposes. Samples were also submitted to solution treatment above the β transus temperature and aging heat treatments under a controlled atmosphere. The results suggest that Sn suppresses the formation of the ω and α″ phases in Ti–Mo system. - Highlights: • Sn addition to Ti alloys decreases elastic modulus by suppressing ω phase precipitation. • Sn addition decreases the temperature of martensite decomposition. • Sn addition decreases the temperature of α phase precipitation and β transus. • Mechanical strength decreases with increasing Sn content.

The effect of Sn addition on phase stability and phase evolution during aging heat treatment in Ti–Mo alloys employed as biomaterials

International Nuclear Information System (INIS)

Mello, Mariana G. de; Salvador, Camilo F.; Cremasco, Alessandra; Caram, Rubens

2015-01-01

Increases in life expectancy and improvements in necessary healthcare attach great importance to the development of biomaterials. Ti alloys containing β stabilizing elements are often used as biomaterials due to their high specific strength, high corrosion resistance, unusual biocompatibility and low elastic moduli, which benefit bone tissues close to an implant. This study deals with phase stability in β Ti–Mo–Sn alloys processed under different conditions and was performed according to the following steps: a study of the effect of Sn content (a) on phase stability in Ti–Mo alloys, (b) on the suppression of α″ and ω phase precipitation; (c) on α-phase precipitation during aging heat treatments and (d) on mechanical properties, including the elastic modulus, as measured using tensile tests and acoustic techniques. The alloys were prepared by arc melting under a controlled atmosphere followed by homogenization heat treatment and hot rolling. Optical microscopy, scanning and transmission electron microscopy, X-ray diffraction and differential scanning calorimetry were employed for characterization purposes. Samples were also submitted to solution treatment above the β transus temperature and aging heat treatments under a controlled atmosphere. The results suggest that Sn suppresses the formation of the ω and α″ phases in Ti–Mo system. - Highlights: • Sn addition to Ti alloys decreases elastic modulus by suppressing ω phase precipitation. • Sn addition decreases the temperature of martensite decomposition. • Sn addition decreases the temperature of α phase precipitation and β transus. • Mechanical strength decreases with increasing Sn content.

Comprehensive Genomic Profiling of Esthesioneuroblastoma Reveals Additional Treatment Options.

Science.gov (United States)

Gay, Laurie M; Kim, Sungeun; Fedorchak, Kyle; Kundranda, Madappa; Odia, Yazmin; Nangia, Chaitali; Battiste, James; Colon-Otero, Gerardo; Powell, Steven; Russell, Jeffery; Elvin, Julia A; Vergilio, Jo-Anne; Suh, James; Ali, Siraj M; Stephens, Philip J; Miller, Vincent A; Ross, Jeffrey S

2017-07-01

Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant neoplasm of the olfactory mucosa. Despite surgical resection combined with radiotherapy and adjuvant chemotherapy, ENB often relapses with rapid progression. Current multimodality, nontargeted therapy for relapsed ENB is of limited clinical benefit. We queried whether comprehensive genomic profiling (CGP) of relapsed or refractory ENB can uncover genomic alterations (GA) that could identify potential targeted therapies for these patients. CGP was performed on formalin-fixed, paraffin-embedded sections from 41 consecutive clinical cases of ENBs using a hybrid-capture, adaptor ligation based next-generation sequencing assay to a mean coverage depth of 593X. The results were analyzed for base substitutions, insertions and deletions, select rearrangements, and copy number changes (amplifications and homozygous deletions). Clinically relevant GA (CRGA) were defined as GA linked to drugs on the market or under evaluation in clinical trials. A total of 28 ENBs harbored GA, with a mean of 1.5 GA per sample. Approximately half of the ENBs (21, 51%) featured at least one CRGA, with an average of 1 CRGA per sample. The most commonly altered gene was TP53 (17%), with GA in PIK3CA , NF1 , CDKN2A , and CDKN2C occurring in 7% of samples. We report comprehensive genomic profiles for 41 ENB tumors. CGP revealed potential new therapeutic targets, including targetable GA in the mTOR, CDK and growth factor signaling pathways, highlighting the clinical value of genomic profiling in ENB. Comprehensive genomic profiling of 41 relapsed or refractory ENBs reveals recurrent alterations or classes of mutation, including amplification of tyrosine kinases encoded on chromosome 5q and mutations affecting genes in the mTOR/PI3K pathway. Approximately half of the ENBs (21, 51%) featured at least one clinically relevant genomic alteration (CRGA), with an average of 1 CRGA per sample. The most commonly altered

Effect of B addition to hypereutectic Ti-based alloys

International Nuclear Information System (INIS)

Louzguina-Luzgina, Larissa V.; Louzguine-Luzgin, Dmitri V.; Inoue, Akihisa

2009-01-01

The structure and mechanical properties of Ti-Fe-B and Ti-Fe-Co-B alloys produced in the shape of the arc-melted ingots of about 25 mm diameter and 10 mm height are studied. The hypereutectic alloys showed excellent compressive mechanical properties. The structures of the high-strength and ductile hypereutectic alloys studied by X-ray diffractometry and scanning electron microscopy were found to consist of the primary cubic cP2 intermetallic compound (TiFe-phase or a solid solution on its base) and a dispersed eutectic consisting of this cP2 intermetallic compound + BCC cI2 β-Ti supersaturated solid solution phase. The addition of B increased mechanical strength. Si causes embrittlement owing to the formation of alternative intermetallic compounds. The structure and deformation behaviour were studied

Effect of conductive additives to gel electrolytes on activated carbon-based supercapacitors

Science.gov (United States)

Barzegar, Farshad; Dangbegnon, Julien K.; Bello, Abdulhakeem; Momodu, Damilola Y.; Johnson, A. T. Charlie; Manyala, Ncholu

2015-09-01

This article is focused on polymer based gel electrolyte due to the fact that polymers are cheap and can be used to achieve extended potential window for improved energy density of the supercapacitor devices when compared to aqueous electrolytes. Electrochemical characterization of a symmetric supercapacitor devices based on activated carbon in different polyvinyl alcohol (PVA) based gel electrolytes was carried out. The device exhibited a maximum energy density of 24 Wh kg-1 when carbon black was added to the gel electrolyte as conductive additive. The good energy density was correlated with the improved conductivity of the electrolyte medium which is favorable for fast ion transport in this relatively viscous environment. Most importantly, the device remained stable with no capacitance lost after 10,000 cycles.

Improvement of acid and base resistance of nickel phosphate pigment by the addition of lanthanum cation

International Nuclear Information System (INIS)

Onoda, Hiroaki; Matsui, Hironori; Tanaka, Isao

2007-01-01

Transition metal phosphates are used as inorganic pigments, however these materials had a weak point for acid and base resistance. Because lanthanum phosphate is insoluble in acidic and basic solution, the addition of lanthanum cation was tried for the improvement of the acid and base resistance of nickel phosphate pigment. The lanthanum-doped nickel phosphates were prepared from phosphoric acid, nickel nitrate, and lanthanum nitrate solution. The additional effects of lanthanum cation were studied on the chemical composition, particle shape and size distribution, specific surface area, color, acid and base resistance of the precipitations and their thermal products

The extension of a DNA double helix by an additional Watson-Crick base pair on the same backbone.

Science.gov (United States)

Kumar, Pawan; Sharma, Pawan K; Madsen, Charlotte S; Petersen, Michael; Nielsen, Poul

2013-06-17

Additional base pair: The DNA duplex can be extended with an additional Watson-Crick base pair on the same backbone by the use of double-headed nucleotides. These also work as compressed dinucleotides and form two base pairs with cognate nucleobases on the opposite strand. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Gating treatment delivery QA based on a surrogate motion analysis

International Nuclear Information System (INIS)

Chojnowski, J.; Simpson, E.

2011-01-01

Full text: To develop a methodology to estimate intrafractional target position error during a phase-based gated treatment. Westmead Cancer Care Centre is using respiratory correlated phase-based gated beam delivery in the treatment of lung cancer. The gating technique is managed by the Varian Real-time Position Management (RPM) system, version 1.7.5. A 6-dot block is placed on the abdomen of the patient and acts as a surrogate for the target motion. During a treatment session, the motion of the surrogate can be recorded by RPM application. Analysis of the surrogate motion file by in-house developed software allows the intrafractional error of the treatment session to be computed. To validate the computed error, a simple test that involves the introduction of deliberate errors is performed. Errors of up to 1.1 cm are introduced to a metal marker placed on a surrogate using the Varian Breathing Phantom. The moving marker was scanned in prospective mode using a GE Lightspeed 16 CT scanner. Using the CT images, a difference of the marker position with and without introduced errors is compared to the calculated errors based on the surrogate motion. The average and standard deviation of a difference between calculated target position errors and measured introduced artificial errors of the marker position is 0.02 cm and 0.07 cm respectively. Conclusion The calculated target positional error based on surrogate motion analysis provides a quantitative measure of intrafractional target positional errors during treatment. Routine QA for gated treatment using surrogate motion analysis is relatively quick and simple.

The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance.

Science.gov (United States)

Hess, Robert F; Babu, Raiju Jacob; Clavagnier, Simon; Black, Joanna; Bobier, William; Thompson, Benjamin

2014-09-01

Occlusion therapy for amblyopia is predicated on the idea that amblyopia is primarily a disorder of monocular vision; however, there is growing evidence that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression. Furthermore, we have found that a dichoptic treatment intervention designed to directly target suppression can result in clinically significant improvement in both binocular and monocular visual function in adult patients with amblyopia. The fact that monocular improvement occurs in the absence of any fellow eye occlusion suggests that amblyopia is, in part, due to chronic suppression. Previously the treatment has been administered as a psychophysical task and more recently as a video game that can be played on video goggles or an iPod device equipped with a lenticular screen. The aim of this case-series study of 14 amblyopes (six strabismics, six anisometropes and two mixed) ages 13 to 50 years was to investigate: 1. whether the portable video game treatment is suitable for at-home use and 2. whether an anaglyphic version of the iPod-based video game, which is more convenient for at-home use, has comparable effects to the lenticular version. The dichoptic video game treatment was conducted at home and visual functions assessed before and after treatment. We found that at-home use for 10 to 30 hours restored simultaneous binocular perception in 13 of 14 cases along with significant improvements in acuity (0.11 ± 0.08 logMAR) and stereopsis (0.6 ± 0.5 log units). Furthermore, the anaglyph and lenticular platforms were equally effective. In addition, the iPod devices were able to record a complete and accurate picture of treatment compliance. The home-based dichoptic iPod approach represents a viable treatment for adults with amblyopia. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

Uncertainties in model-based outcome predictions for treatment planning

International Nuclear Information System (INIS)

Deasy, Joseph O.; Chao, K.S. Clifford; Markman, Jerry

2001-01-01

Purpose: Model-based treatment-plan-specific outcome predictions (such as normal tissue complication probability [NTCP] or the relative reduction in salivary function) are typically presented without reference to underlying uncertainties. We provide a method to assess the reliability of treatment-plan-specific dose-volume outcome model predictions. Methods and Materials: A practical method is proposed for evaluating model prediction based on the original input data together with bootstrap-based estimates of parameter uncertainties. The general framework is applicable to continuous variable predictions (e.g., prediction of long-term salivary function) and dichotomous variable predictions (e.g., tumor control probability [TCP] or NTCP). Using bootstrap resampling, a histogram of the likelihood of alternative parameter values is generated. For a given patient and treatment plan we generate a histogram of alternative model results by computing the model predicted outcome for each parameter set in the bootstrap list. Residual uncertainty ('noise') is accounted for by adding a random component to the computed outcome values. The residual noise distribution is estimated from the original fit between model predictions and patient data. Results: The method is demonstrated using a continuous-endpoint model to predict long-term salivary function for head-and-neck cancer patients. Histograms represent the probabilities for the level of posttreatment salivary function based on the input clinical data, the salivary function model, and the three-dimensional dose distribution. For some patients there is significant uncertainty in the prediction of xerostomia, whereas for other patients the predictions are expected to be more reliable. In contrast, TCP and NTCP endpoints are dichotomous, and parameter uncertainties should be folded directly into the estimated probabilities, thereby improving the accuracy of the estimates. Using bootstrap parameter estimates, competing treatment

Effect of an organic acids based feed additive and enrofloxacin on the prevalence of antibiotic-resistant E. coli in cecum of broilers.

Science.gov (United States)

Roth, Nataliya; Mayrhofer, Sigrid; Gierus, Martin; Weingut, Christine; Schwarz, Christiane; Doupovec, Barbara; Berrios, Roger; Domig, Konrad J

2017-09-01

Increasing antibiotic resistance is a major public health concern. Fluoroquinolones are used to treat and prevent poultry diseases worldwide. Fluoroquinolone resistance rates are high in their countries of use. The aim of this study was to evaluate the effect of an acids-based feed additive, as well as fluoroquinolone antibiotics, on the prevalence of antibiotic-resistant E. coli. A total of 480 broiler chickens (Ross 308) were randomly assigned to 3 treatments: a control group receiving a basal diet; a group receiving a feed additive (FA) based on formic acid, acetic acid and propionic acid; and an antibiotic enrofloxacin (AB) group given the same diet, but supplemented with enrofloxacin in water. A pooled fecal sample of one-day-old chicks was collected upon arrival at the experimental farm. On d 17 and d 38 of the trial, cecal samples from each of the 8 pens were taken, and the count of E. coli and antibiotic-resistant E. coli was determined.The results of the present study show a high prevalence of antibiotic-resistant E. coli in one-day-old chicks. Supplementation of the diet with FA and treatment of broilers with AB did not have a significant influence on the total number of E. coli in the cecal content on d 17 and d 38 of the trial. Supplementation with FA contributed to better growth performance and to a significant decrease (P ≤ 0.05) in E. coli resistant to ampicillin and tetracycline compared to the control and AB groups, as well as to a decrease (P ≤ 0.05) in sulfamethoxazole and ciprofloxacin-resistant E. coli compared to the AB group. Treatment with AB increased (P ≤ 0.05) the average daily weight compared to the control group and increased (P ≤ 0.05) the number of E. coli resistant to ciprofloxacin, streptomycin, sulfamethoxazole and tetracycline; it also decreased (P ≤ 0.05) the number of E. coli resistant to cefotaxime and extended spectrum beta-lactamase- (ESBL-) producing E. coli in the ceca of broilers. © 2017 Poultry Science

Alternative prosthodontic-based treatment of a patient with hypocalcified type Amelogenesis Imperfecta.

Science.gov (United States)

Jivanescu, Anca; Miglionico, Antonio; Barua, Souman; Hategan, Simona Ioana

2017-07-01

The Amelogenesis Imperfecta is associated with malocclusion and usually requires an interdisciplinary treatment. Due to the patient's refusal of orthodontic treatment, prosthodontics-based treatments alternative was considered and planned. The patient was treated with zirconia-based fixed partial dentures, which resulted in improved occlusion, better oral health, and improved esthetic appearance.

Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

Directory of Open Access Journals (Sweden)

Samir El Alaoui

Full Text Available A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT.Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9 before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA was performed and the results presented as incremental net benefits (INB, cost-effectiveness acceptability curves (CEACs and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention.Taking into account the complete healthcare process (from referral to follow-up assessment, treatment costs decreased from $709 (SD = $130 per patient in 2013 to $659 (SD = $134 in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5 during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during

Additive Effects of Mechanical Marrow Ablation and PTH Treatment on de Novo Bone Formation in Mature Adult Rats

Directory of Open Access Journals (Sweden)

Jodi A. Carlson Scholz

2012-12-01

Full Text Available Mechanical ablation of bone marrow in young rats induces rapid but transient bone growth, which can be enhanced and maintained for three weeks by the administration of parathyroid hormone (PTH. Additionally, marrow ablation, followed by PTH treatment for three months leads to increased cortical thickness. In this study, we sought to determine whether PTH enhances bone formation after marrow ablation in aged rats. Aged rats underwent unilateral femoral marrow ablation and treatment with PTH or vehicle for four weeks. Both femurs from each rat were analyzed by X-ray and pQCT, then analyzed either by microCT, histology or biomechanical testing. Marrow ablation alone induced transient bone formation of low abundance that persisted over four weeks, while marrow ablation followed by PTH induced bone formation of high abundance that also persisted over four weeks. Our data confirms that the osteo-inducive effect of marrow ablation and the additive effect of marrow ablation, followed by PTH, occurs in aged rats. Our observations open new avenues of investigations in the field of tissue regeneration. Local marrow ablation, in conjunction with an anabolic agent, might provide a new platform for rapid site-directed bone growth in areas of high bone loss, such as in the hip and wrist, which are subject to fracture.

[Prevention and treatment of the complications of polycystic ovarian syndrome--the significance of evidence-based, interdisciplinary management].

Science.gov (United States)

Gődény, Sándor; Csenteri, Orsolya Karola

2015-12-13

Polycystic ovary syndrome is the most common hormonal and metabolic disorder likely to affect women. The syndrome is often associated with obesity, hyperinsulinemia and adversely affects endocrine, metabolic, and cardiovascular health. The complex feature of the syndrome requires an interdisciplinary approach to treatment, where cooperation of paediatrician, internist, gynaecologist, endocrinologist, dermatologist, psychologist and oncologist is essential. The prevention and the treatment should be based on the best available evidence. This should include physical examination, laboratory tests for hormones, serum insulin, glucose, lipids, in addition patient's preferences should be considered, too. To maximise health gain of polycystic ovarian syndrome, adequate, effective, efficient and safe treatment is necessary. This article summarises the highest available evidence provided by meta-analyses and systematic reviews of the prevention of metabolic and cardiovascular complications of the syndrome, and discusses the relevant evidence published in the literature.

Evidence-Based Practices in Outpatient Treatment for Eating Disorders

Science.gov (United States)

Schaffner, Angela D.; Buchanan, Linda Paulk

2010-01-01

This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

Anorexia Nervosa in Adolescence and Maudsley Family-Based Treatment

Science.gov (United States)

Hurst, Kim; Read, Shelly; Wallis, Andrew

2012-01-01

Anorexia nervosa is a serious psychiatric disorder that usually occurs in adolescence. The course of the illness can be protracted. Current empirical evidence suggests that the Maudsley Family-Based Treatment (MFBT) is efficacious for adolescents. MFBT empowers parents as a crucial treatment resource to assist in their child's recovery. The…

SU-F-J-94: Development of a Plug-in Based Image Analysis Tool for Integration Into Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Owen, D; Anderson, C; Mayo, C; El Naqa, I; Ten Haken, R; Cao, Y; Balter, J; Matuszak, M [University of Michigan, Ann Arbor, MI (United States)

2016-06-15

Purpose: To extend the functionality of a commercial treatment planning system (TPS) to support (i) direct use of quantitative image-based metrics within treatment plan optimization and (ii) evaluation of dose-functional volume relationships to assist in functional image adaptive radiotherapy. Methods: A script was written that interfaces with a commercial TPS via an Application Programming Interface (API). The script executes a program that performs dose-functional volume analyses. Written in C#, the script reads the dose grid and correlates it with image data on a voxel-by-voxel basis through API extensions that can access registration transforms. A user interface was designed through WinForms to input parameters and display results. To test the performance of this program, image- and dose-based metrics computed from perfusion SPECT images aligned to the treatment planning CT were generated, validated, and compared. Results: The integration of image analysis information was successfully implemented as a plug-in to a commercial TPS. Perfusion SPECT images were used to validate the calculation and display of image-based metrics as well as dose-intensity metrics and histograms for defined structures on the treatment planning CT. Various biological dose correction models, custom image-based metrics, dose-intensity computations, and dose-intensity histograms were applied to analyze the image-dose profile. Conclusion: It is possible to add image analysis features to commercial TPSs through custom scripting applications. A tool was developed to enable the evaluation of image-intensity-based metrics in the context of functional targeting and avoidance. In addition to providing dose-intensity metrics and histograms that can be easily extracted from a plan database and correlated with outcomes, the system can also be extended to a plug-in optimization system, which can directly use the computed metrics for optimization of post-treatment tumor or normal tissue response

Decomposition of Straw in Soil after Stepwise Repeated Additions

DEFF Research Database (Denmark)

Sørensen, Lasse Holst

1979-01-01

after the first repeated addition of labelled straw the soils were subjected to a number of “stress” treatments: addition of unlabelled glucose, air-drying, oven-drying, grinding and fumigation with vapour of chloroform, respectively. The CO2 that developed during the first 10 days after the treatments......, grinding the most. The effect of each treatment declined with an increasing number of successive additions of straw. The ratio between CO2 evolved after grinding and fumigation, respectively, revealed that grinding also exposed non-biomass material to accelerated decomposition. The effects of the stress...

Evaluation of a commercial biologically based IMRT treatment planning system

International Nuclear Information System (INIS)

Semenenko, Vladimir A.; Reitz, Bodo; Day, Ellen; Qi, X. Sharon; Miften, Moyed; Li, X. Allen

2008-01-01

A new inverse treatment planning system (TPS) for external beam radiation therapy with high energy photons is commercially available that utilizes both dose-volume-based cost functions and a selection of cost functions which are based on biological models. The purpose of this work is to evaluate quality of intensity-modulated radiation therapy (IMRT) plans resulting from the use of biological cost functions in comparison to plans designed using a traditional TPS employing dose-volume-based optimization. Treatment planning was performed independently at two institutions. For six cancer patients, including head and neck (one case from each institution), prostate, brain, liver, and rectal cases, segmental multileaf collimator IMRT plans were designed using biological cost functions and compared with clinically used dose-based plans for the same patients. Dose-volume histograms and dosimetric indices, such as minimum, maximum, and mean dose, were extracted and compared between the two types of treatment plans. Comparisons of the generalized equivalent uniform dose (EUD), a previously proposed plan quality index (fEUD), target conformity and heterogeneity indices, and the number of segments and monitor units were also performed. The most prominent feature of the biologically based plans was better sparing of organs at risk (OARs). When all plans from both institutions were combined, the biologically based plans resulted in smaller EUD values for 26 out of 33 OARs by an average of 5.6 Gy (range 0.24 to 15 Gy). Owing to more efficient beam segmentation and leaf sequencing tools implemented in the biologically based TPS compared to the dose-based TPS, an estimated treatment delivery time was shorter in most (five out of six) cases with some plans showing up to 50% reduction. The biologically based plans were generally characterized by a smaller conformity index, but greater heterogeneity index compared to the dose-based plans. Overall, compared to plans based on dose

Influence of titanium addition on the microstructure of the novel ferrous-based stainless steel

International Nuclear Information System (INIS)

Lin, Chia-Cheng; Lin, Li-Hsiang; Hung, Jing-Ming; Shih, Yung-Hsun; Wu, Ching-Zong; Ou, Keng-Liang; Chao, Chih-Yeh

2011-01-01

Highlights: → The microstructure of the as-quenched alloy is a mixture of γ, (α + B2 + DO 3 ), and TiC x phases. → The TiC x carbide had a face-center-cubic structure with a lattice parameter a = 0.432 nm.→ Formation of the TiC x carbide causing a γ → (α + γ) transition in the matrix of the alloy. → Addition of Ti promotes the formation of the α phase at high temperatures. - Abstract: The microstructural characteristics of the Fe-9Al-30Mn-1C-5Ti (wt.%) alloy were determined by scanning electron microscopy, transmission electron microscopy, and energy-dispersive X-ray spectrometry. The microstructure of the alloy was essentially a mixture of (γ + TiC x + (α + B2 + DO 3 )) phases during solution treatment between 950 deg. C and 1150 deg. C. The TiC x carbide had a face-center-cubic structure with a lattice parameter a of 0.432 nm. When the as-quenched alloy was subjected to aging treatment at temperatures of 450-850 deg. C, the following microstructural transformation occurred: (γ + TiC x + κ + (α + DO 3 )) → (γ + TiC x + κ + (α + B2 + DO 3 + TiC x )) → (γ + TiC x + κ + κ' + (α + B2 + DO 3 )) → (γ + TiC x + (α + B2 + DO 3 )). Addition of Ti promotes the formation of the α phase at high temperatures.

Effect of conductive additives to gel electrolytes on activated carbon-based supercapacitors

Directory of Open Access Journals (Sweden)

Farshad Barzegar

2015-09-01

Full Text Available This article is focused on polymer based gel electrolyte due to the fact that polymers are cheap and can be used to achieve extended potential window for improved energy density of the supercapacitor devices when compared to aqueous electrolytes. Electrochemical characterization of a symmetric supercapacitor devices based on activated carbon in different polyvinyl alcohol (PVA based gel electrolytes was carried out. The device exhibited a maximum energy density of 24 Wh kg−1 when carbon black was added to the gel electrolyte as conductive additive. The good energy density was correlated with the improved conductivity of the electrolyte medium which is favorable for fast ion transport in this relatively viscous environment. Most importantly, the device remained stable with no capacitance lost after 10,000 cycles.

Feature based Weld-Deposition for Additive Manufacturing of Complex Shapes

Science.gov (United States)

Panchagnula, Jayaprakash Sharma; Simhambhatla, Suryakumar

2018-06-01

Fabricating functional metal parts using Additive Manufacturing (AM) is a leading trend. However, realizing overhanging features has been a challenge due to the lack of support mechanism for metals. Powder-bed fusion techniques like, Selective Laser Sintering (SLS) employ easily-breakable-scaffolds made of the same material to realize the overhangs. However, the same approach is not extendible to deposition processes like laser or arc based direct energy deposition processes. Although it is possible to realize small overhangs by exploiting the inherent overhanging capability of the process or by blinding some small features like holes, the same cannot be extended for more complex geometries. The current work presents a novel approach for realizing complex overhanging features without the need of support structures. This is possible by using higher order kinematics and suitably aligning the overhang with the deposition direction. Feature based non-uniform slicing and non-uniform area-filling are some vital concepts required in realizing the same and are briefly discussed here. This method can be used to fabricate and/or repair fully dense and functional components for various engineering applications. Although this approach has been implemented for weld-deposition based system, the same can be extended to any other direct energy deposition processes also.

Effect of the AlCr20 Addition on the Microstructure of Secondary AlSi7Mg0.3 Alloy

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Bolibruchová D.

2014-06-01

Full Text Available This paper deals with influence of chrome addition and heat treatment on segregation of iron based phases in the secondary alloy AlSi7Mg0.3 microstructure by chrome and heat treatment. Iron is the most common and harmful impurity in aluminum casting alloys and has long been associated with an increase of casting defects. In generally, iron is associated with the formation of Fe-rich intermetallic phases. It is impossible to remove iron from melt by standard operations, but it is possible to eliminate its negative influence by addition some other elements that affect the segregation of intermetallics in less harmful type or by heat treatment. Realization of experiments and results of analysis show new view on solubility of iron based phases during melt preparation with higher iron content and influence of chrome as iron corrector of iron based phases.

Adolescent muscle dysmorphia and family-based treatment: a case report.

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Murray, Stuart B; Griffiths, Scott

2015-04-01

A growing body of evidence suggests that the prevalence of male body dissatisfaction and muscle dysmorphia is rising. To date, however, there is no published evidence on the efficacy of treatments for muscle dysmorphia. We present the case of a 15-year-old boy who met full diagnostic criteria for muscle dysmorphia, whose symptoms were treated into remission with eating disorder-focused, family-based treatment. The age of this patient fell within the time period in which symptoms of muscle dysmorphia are most likely to develop and this case represents the first published case report of family-based treatment for muscle dysmorphia in this age group. Thus, this case report has important implications for clinicians considering treatment options for presentations of muscle dysmorphia when first presenting in adolescence. Implications for the development of treatment guidelines for muscle dysmorphia and for the diagnostic debate surrounding muscle dysmorphia are also discussed. © The Author(s) 2014.

New approaches to addiction treatment based on learning and memory.

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Kiefer, Falk; Dinter, Christina

2013-01-01

Preclinical studies suggest that physiological learning processes are similar to changes observed in addicts at the molecular, neuronal, and structural levels. Based on the importance of classical and instrumental conditioning in the development and maintenance of addictive disorders, many have suggested cue-exposure-based extinction training of conditioned, drug-related responses as a potential new treatment of addiction. It may also be possible to facilitate this extinction training with pharmacological compounds that strengthen memory consolidation during cue exposure. Another potential therapeutic intervention would be based on the so-called reconsolidation theory. According to this hypothesis, already-consolidated memories return to a labile state when reactivated, allowing them to undergo another phase of consolidation-reconsolidation, which can be pharmacologically manipulated. These approaches suggest that the extinction of drug-related memories may represent a viable treatment strategy in the future treatment of addiction.

Virtual reality system for treatment of the fear of public speaking using image-based rendering and moving pictures.

Science.gov (United States)

Lee, Jae M; Ku, Jeong H; Jang, Dong P; Kim, Dong H; Choi, Young H; Kim, In Y; Kim, Sun I

2002-06-01

The fear of speaking is often cited as the world's most common social phobia. The rapid growth of computer technology enabled us to use virtual reality (VR) for the treatment of the fear of public speaking. There have been two techniques used to construct a virtual environment for the treatment of the fear of public speaking: model-based and movie-based. Virtual audiences and virtual environments made by model-based technique are unrealistic and unnatural. The movie-based technique has a disadvantage in that each virtual audience cannot be controlled respectively, because all virtual audiences are included in one moving picture file. To address this disadvantage, this paper presents a virtual environment made by using image-based rendering (IBR) and chroma keying simultaneously. IBR enables us to make the virtual environment realistic because the images are stitched panoramically with the photos taken from a digital camera. And the use of chroma keying allows a virtual audience to be controlled individually. In addition, a real-time capture technique was applied in constructing the virtual environment to give the subjects more interaction, in that they can talk with a therapist or another subject.

Recycling cellulase towards industrial application of enzyme treatment on hardwood kraft-based dissolving pulp.

Science.gov (United States)

Wang, Qiang; Liu, Shanshan; Yang, Guihua; Chen, Jiachuan; Ji, Xingxiang; Ni, Yonghao

2016-07-01

Cost-effectiveness is vital for enzymatic treatment of dissolving pulp towards industrial application. The strategy of cellulase recycling with fresh cellulase addition was demonstrated in this work to activate the dissolving pulp, i.e. decreasing viscosity and increasing Fock reactivity. Results showed that 48.8-35.1% of cellulase activity can be recovered from the filtered liquor in five recycle rounds, which can be reused for enzymatic treatment of dissolving pulp. As a result, the recycling cellulase with addition fresh cellulase of 1mg/g led to the pulp of viscosity 470mL/g and Fock reactivity 80%, which is comparable with cellulase charge of 2mg/g. Other pulp properties such as alpha-cellulose, alkaline solubility and molecular weight distribution were also determined. Additionally, a zero-release of recycling cellulase treatment was proposed to integrate into the dissolving pulp production process. Copyright © 2016 Elsevier Ltd. All rights reserved.

A patient-centred approach to treatment with incretin-based agents in patients with type 2 diabetes.

Science.gov (United States)

Cornell, Susan A

2013-06-01

The 2012 position statement from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommends a haemoglobin A1c level of <7% for most patients with type 2 diabetes (T2D). Initial therapy consists of lifestyle changes plus metformin, with an emphasis on a patient-centred approach to management. Addition of incretin-based therapy is recommended as an add-on after metformin failure, and later on in combination with basal insulin. Basal insulin is recommended from the onset in patients with A1c ≥10%. The possibility of incorporating incretin-based therapy in the patient-centred approach will be investigated both in the literature and clinical experience. Incretin-based therapy targets multiple dysfunctional organ systems in T2D and provides sustained glycaemic control, with extraglycaemic benefits and low risk of hypoglycaemia. To initiate an incretin-based therapy that best fits an individual patient's needs, the patient's A1c level, preference and comorbid conditions should be considered along with any drug safety and adherence-related issues. There is good evidence to support the patient-centred approach to T2D management. This approach allows patient treatment goals and personal preferences to be matched with the clinical profile(s) of one or more agents to formulate a treatment plan that can best achieve the goals. Incretin-based therapies are an important class of agents to consider after metformin monotherapy failure and later in combination with basal insulin. By matching patient needs with the clinical profiles of the various treatment options, pharmacists can actively engage in the practice of patient-centred care and management. © 2013 Blackwell Publishing Ltd.

Web-Based Aftercare for Women With Bulimia Nervosa Following Inpatient Treatment: Randomized Controlled Efficacy Trial.

Science.gov (United States)

Jacobi, Corinna; Beintner, Ina; Fittig, Eike; Trockel, Mickey; Braks, Karsten; Schade-Brittinger, Carmen; Dempfle, Astrid

2017-09-22

Relapse rates in bulimia nervosa (BN) are high even after successful treatment, but patients often hesitate to take up further treatment. An easily accessible program might help maintain treatment gains. Encouraged by the effects of Web-based eating disorder prevention programs, we developed a manualized, Web-based aftercare program (IN@) for women with BN following inpatient treatment. The objective of this study was to determine the efficacy of the web-based guided, 9-month, cognitive-behavioral aftercare program IN@ for women with BN following inpatient treatment. We conducted a randomized controlled efficacy trial in 253 women with DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) BN and compared the results of IN@ with treatment as usual (TAU). Assessments were carried out at hospital admission (T0), hospital discharge/baseline (T1), postintervention (T2; 9 months after baseline), 9-month follow-up (T3; 18 months after baseline). The primary outcome, abstinence from binge eating and compensatory behaviors during the 2 months preceding T2, was analyzed by intention to treat, using logistic regression analyses. Frequencies of binge eating and vomiting episodes, and episodes of all compensatory behaviors were analyzed using mixed effects models. At T2, data from 167 women were available. There were no significant differences in abstinence rates between the TAU group (n=24, 18.9%) and the IN@ group (n=27, 21.4%; odds ratio, OR=1.29; P=.44). The frequency of vomiting episodes in the IN@ group was significantly (46%) lower than in the TAU group (P=.003). Moderator analyses revealed that both at T2 and T3, women of the intervention group who still reported binge eating and compensatory behaviors after inpatient treatment benefited from IN@, whereas women who were already abstinent after the inpatient treatment did not (P=.004; P=.002). Additional treatment utilization was high in both groups between baseline and follow-up. Overall, data

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Science.gov (United States)

2010-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist for...

Effect of different oxidation treatments on the bonding strength of new dental alloys

International Nuclear Information System (INIS)

Lee, Sang-Bae; Lee, Ju-hye; Kim, Woong-Chul; Oh, Sae-Yoon; Kim, Kyoung-Nam; Kim, Ji-Hwan

2009-01-01

The influences of heat treatment and addition of a small amount of base metal (In, Sn, and Ir) for oxidation in Au-Pt-based alloy were investigated by electron spectroscopy and scanning electron microscopy. Au-Pt-based alloys were prepared by argon-arc melting furnace and then they are heat treated. Oxidation on alloy was significantly affected by addition of base metal (In and Sn) and heat treatment. The bond strength of the alloys was not dependent on the changing heat treatment. These results indicated that the Sn and In could be effective as oxidation elements for porcelain bonding to gold alloys.

Microstructure of rapidly solidified Nb-based pre-alloyed powders for additive manufacturing

Energy Technology Data Exchange (ETDEWEB)

Guo, Yueling; Jia, Lina, E-mail: jialina@buaa.edu.cn; Kong, Bin; Zhang, Shengnan; Zhang, Fengxiang; Zhang, Hu

2017-07-01

Highlights: • Sphere shaped Nb-37Ti-13Cr-2Al-1Si pre-alloyed powders were prepared by PREP. • An oxide layer with a thickness of 9.39 nm was generated on the powder surface. • The main phases of the pre-alloyed powders were Nbss and Cr{sub 2}Nb. • SDAS increased and microhardness decreased with the increase of powder size. • Microstructure of powders evolved into large grains from dendrite structures after HT. - Abstract: For powder-based additive manufacturing, sphere-shaped Nb-37Ti-13Cr-2Al-1Si pre-alloyed powders were prepared by plasma rotating electrode processing (PREP). The microstructure, surface oxidation and microhardness of the pre-alloyed powders were systematically investigated. Results showed that the main phases were Nb solid solution (Nbss) and Cr{sub 2}Nb. The Cr{sub 2}Nb phases were further determined using transmission electron microscopy (TEM). Fine dendrite structures were observed in the as-fabricated pre-alloyed powders, which transformed to large grains after heat treatment (HT) at 1450 °C for 3 h. With the increase of powder size, the secondary dendrite arm spacing (SDAS) increased and the microhardness (HV) decreased. A clean powder surface free of oxide particles was obtained by PREP and an oxide layer with 9.39 nm in thickness was generated on the powder surface. Compared with Cr- and Nb-oxides, more Ti-oxides were formed on outmost powder surface with a higher content of Ti (up to 47.86 at.%). The differences upon the microstructure and microhardness of the pre-alloyed powders with different sizes were discussed.

Effect of Rh-based additives on NO and CO formed during regeneration of spent FCC catalyst

Energy Technology Data Exchange (ETDEWEB)

Iliopoulou, E.F.; Efthimiadis, E.A.; Vasalos, I.A. [Aristotle University of Thessaloniki and Center for Research and Technology Hellas, Chemical Process Engineering Research Institute, Department of Chemical Engineering, P.O. Box 1517, 54006 University City, Thessaloniki (Greece); Barth, J.-O.; Lercher, J.A. [Institut fur Technische Chemie, Technische Universitat Munchen, Lichtenbergstrasse 4, D-85748 Garching (Germany)

2004-02-10

Regeneration studies of spent FCC catalyst were performed in a bench-scale unit under reaction conditions that sufficiently simulate those in the regenerator of the fluid catalytic cracking (FCC) unit. The effect of a conventional Pt-based CO promoter (CP-3) on the composition of flue gases was examined. As expected addition of CP-3 in the catalytic inventory decreased CO emissions by one order of magnitude, but tripled the NO emissions independently of the concentration of CO promoter used. Addition of a series of Rh-based catalysts modified the composition of flue gases emitted during regeneration. The parameters under study were the catalytic support, the Rh loading on the additive, and the amount of additive used during regeneration. Both a stoichiometric spinel MgO{center_dot}Al{sub 2}O{sub 3} of high crystallinity and a commercial alumina were competent supports. Promotion of the alumina support with Ce or performing regeneration introducing CO did not affect the additive performance significantly. A combined performance of CO oxidation and NO reduction was achieved minimizing both the Rh loading in the additive (0.1wt.%) and the concentration of additive used during regeneration (1wt.%). IR studies suggest that NO reduction by CO over Rh/alumina additives proceeds via the dissociative adsorption of NO, the formation of NCO species on Rh and their migration to the alumina support to finally yield N{sub 2} and CO{sub 2}.

Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing.

Science.gov (United States)

Bezuidenhout, Martin B; Dimitrov, Dimitar M; van Staden, Anton D; Oosthuizen, Gert A; Dicks, Leon M T

2015-01-01

Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.

Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing

Directory of Open Access Journals (Sweden)

Martin B. Bezuidenhout

2015-01-01

Full Text Available Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA, discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.

Web-based depression treatment : Associations of clients' word use with adherence and outcome

NARCIS (Netherlands)

Van der Zanden, Rianne; Curie, Keshia; van Londen - Barentsen, Monique|info:eu-repo/dai/nl/072312742; Kramer, Jeannet; Steen, Gerard; Cuijpers, Pim

Background: The growing number of web-based psychological treatments, based on textual communication, generates a wealth of data that can contribute to knowledge of online and face-to-face treatments. We investigated whether clients' language use predicted treatment outcomes and adherence in Master

Web-based depression treatment: Associations of clients word use with adherence and outocme

NARCIS (Netherlands)

Zanden, R. van der; Curie, K.; van Londen, M.; Kramer, J.; Steen, G.J.; Cuijpers, P.

2014-01-01

Background The growing number of web-based psychological treatments, based on textual communication, generates a wealth of data that can contribute to knowledge of online and face-to-face treatments. We investigated whether clients language use predicted treatment outcomes and adherence in Master

Robot-based additive manufacturing for flexible die-modelling in incremental sheet forming

Science.gov (United States)

Rieger, Michael; Störkle, Denis Daniel; Thyssen, Lars; Kuhlenkötter, Bernd

2017-10-01

The paper describes the application concept of additive manufactured dies to support the robot-based incremental sheet metal forming process (`Roboforming') for the production of sheet metal components in small batch sizes. Compared to the dieless kinematic-based generation of a shape by means of two cooperating industrial robots, the supporting robot models a die on the back of the metal sheet by using the robot-based fused layer manufacturing process (FLM). This tool chain is software-defined and preserves the high geometrical form flexibility of Roboforming while flexibly generating support structures adapted to the final part's geometry. Test series serve to confirm the feasibility of the concept by investigating the process challenges of the adhesion to the sheet surface and the general stability as well as the influence on the geometric accuracy compared to the well-known forming strategies.

Model-Based Individualized Treatment of Chemotherapeutics: Bayesian Population Modeling and Dose Optimization.

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Devaraj Jayachandran

Full Text Available 6-Mercaptopurine (6-MP is one of the key drugs in the treatment of many pediatric cancers, auto immune diseases and inflammatory bowel disease. 6-MP is a prodrug, converted to an active metabolite 6-thioguanine nucleotide (6-TGN through enzymatic reaction involving thiopurine methyltransferase (TPMT. Pharmacogenomic variation observed in the TPMT enzyme produces a significant variation in drug response among the patient population. Despite 6-MP's widespread use and observed variation in treatment response, efforts at quantitative optimization of dose regimens for individual patients are limited. In addition, research efforts devoted on pharmacogenomics to predict clinical responses are proving far from ideal. In this work, we present a Bayesian population modeling approach to develop a pharmacological model for 6-MP metabolism in humans. In the face of scarcity of data in clinical settings, a global sensitivity analysis based model reduction approach is used to minimize the parameter space. For accurate estimation of sensitive parameters, robust optimal experimental design based on D-optimality criteria was exploited. With the patient-specific model, a model predictive control algorithm is used to optimize the dose scheduling with the objective of maintaining the 6-TGN concentration within its therapeutic window. More importantly, for the first time, we show how the incorporation of information from different levels of biological chain-of response (i.e. gene expression-enzyme phenotype-drug phenotype plays a critical role in determining the uncertainty in predicting therapeutic target. The model and the control approach can be utilized in the clinical setting to individualize 6-MP dosing based on the patient's ability to metabolize the drug instead of the traditional standard-dose-for-all approach.

Model-Based Individualized Treatment of Chemotherapeutics: Bayesian Population Modeling and Dose Optimization

Science.gov (United States)

Jayachandran, Devaraj; Laínez-Aguirre, José; Rundell, Ann; Vik, Terry; Hannemann, Robert; Reklaitis, Gintaras; Ramkrishna, Doraiswami

2015-01-01

6-Mercaptopurine (6-MP) is one of the key drugs in the treatment of many pediatric cancers, auto immune diseases and inflammatory bowel disease. 6-MP is a prodrug, converted to an active metabolite 6-thioguanine nucleotide (6-TGN) through enzymatic reaction involving thiopurine methyltransferase (TPMT). Pharmacogenomic variation observed in the TPMT enzyme produces a significant variation in drug response among the patient population. Despite 6-MP’s widespread use and observed variation in treatment response, efforts at quantitative optimization of dose regimens for individual patients are limited. In addition, research efforts devoted on pharmacogenomics to predict clinical responses are proving far from ideal. In this work, we present a Bayesian population modeling approach to develop a pharmacological model for 6-MP metabolism in humans. In the face of scarcity of data in clinical settings, a global sensitivity analysis based model reduction approach is used to minimize the parameter space. For accurate estimation of sensitive parameters, robust optimal experimental design based on D-optimality criteria was exploited. With the patient-specific model, a model predictive control algorithm is used to optimize the dose scheduling with the objective of maintaining the 6-TGN concentration within its therapeutic window. More importantly, for the first time, we show how the incorporation of information from different levels of biological chain-of response (i.e. gene expression-enzyme phenotype-drug phenotype) plays a critical role in determining the uncertainty in predicting therapeutic target. The model and the control approach can be utilized in the clinical setting to individualize 6-MP dosing based on the patient’s ability to metabolize the drug instead of the traditional standard-dose-for-all approach. PMID:26226448

Drug treatment or alleviating the negative consequences of imprisonment? A critical view of prison-based drug treatment in Denmark.

Science.gov (United States)

Kolind, Torsten; Frank, Vibeke Asmussen; Dahl, Helle

2010-01-01

The availability of prison-based drug treatment has increased markedly throughout Europe over the last 15 years in terms of both volume and programme diversity. However, prison drug treatment faces problems and challenges because of the tension between ideologies of rehabilitation and punishment. This article reports on a study of four cannabis treatment programmes and four psychosocial drug treatment programmes in four Danish prisons during 2007. The data include the transcripts of 22 semi-structured qualitative interviews with counsellors and prison employees, prison statistics, and information about Danish laws and regulations. These treatment programmes reflect the 'treatment guarantee' in Danish prisons. However, they are simultaneously embedded in a new policy of zero tolerance and intensified disciplinary sanctions. This ambivalence is reflected in the experiences of treatment counsellors: reluctantly, they feel associated with the prison institution in the eyes of the prisoners; they experience severe opposition from prison officers; and the official goals of the programmes, such as making clients drug free and preparing them for a life without crime, are replaced by more pragmatic aims such as alleviating the pain of imprisonment felt by programme clients. The article concludes that at a time when prison-based drug treatment is growing, it is crucial that we thoroughly research and critically discuss its content and the restrictions facing such treatment programmes. One way of doing this is through research with counsellors involved in delivering drug treatment services. By so doing, the programmes can become more pragmatic and focused, and alternatives to prison-based drug treatment can be seriously considered.

Microcontroller based automatic liquid poison addition control system

International Nuclear Information System (INIS)

Kapatral, R.S.; Ananthakrishnan, T.S.; Pansare, M.G.

1989-01-01

Microcontrollers are finding increasing applications in instrumentation where complex digital circuits can be substituted by a compact and simple circuit, thus enhancing the reliability. In addition to this, intelligence and flexibility can be incorporated. For applications not requiring large amount of read/write memory (RAM), microcontrollers are ideally suited since they contain programmable memory (Eprom), parallel input/output lines, data memory, programmable timers and serial interface ports in one chip. This paper describes the design of automatic liquid poison addition control system (ALPAS) using intel's 8 bit microcontroller 8751, which is used to generate complex timing control sequence signals for liquid poison addition to the moderator in a nuclear reactor. ALPAS monitors digital inputs coming from protection system and regulating system of a nuclear reactor and provides control signals for liquid poison addition for long term safe shutdown of the reactor after reactor trip and helps the regulating system to reduce the power of the reactor during operation. Special hardware and software features have been incorporated to improve performance and fault detection. (author)

Synthesis and characterization of related substances of Azilsartan Kamedoxomil

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Maddi N. V. D. Harikiran

2017-03-01

Full Text Available Azilsartan Kamedoxomil is an AT1-subtype angiotensin II receptor blocker (ARB. During the laboratory synthesis of Azilsartan Kamedoxomil, four related substances of Azilsartan Kamedoxomil were observed and identified. These were 2-Ethoxy-3-[[4-[2- [4-[(5-methyl-2-oxo-1,3-dioxol-4-ylmethyl]-5-oxo-1,2,4-oxadiazol-3-yl]phenyl]phenyl] methyl] benzimidazole-4-carboxylic acid (azilsartan N-medoxomil, 9, (5-methyl-2-oxo- 1,3-dioxol-4-ylmethyl 2-ethoxy-3-[[4-[2-[4-[(5-methyl-2-oxo-1,3-dioxol-4-ylmethyl]-5- oxo-1,2,4-oxadiazol-3-yl]phenyl]phenyl] methyl] benzimidazole-4-carboxylate (azilsartan dimedoxomil, 10, (5-methyl-2-oxo-1,3-dioxo-4-ylmethyl 1-[2’-(4,5-dihydro-5-oxo-4H- 1,2,4-oxadiazol-3-ylbiphenyl-4-yl]methyl]-2-methoxy-1H-benzimidazole-7-carboxylate (methoxy analogue of azilsartan medoxomil, 11, Methyl 1-((2’-amidobiphenyl-4-yl methyl-2-ethoxy-1H-benzo[d]imidazole-7-carboxylate (amide methyl ester, 12. The present work describes the origin, synthesis and characterization of these related substances.

Dosimetry-based treatment planning for molecular radiotherapy: a summary of the 2017 report from the Internal Dosimetry Task Force

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Caroline Stokke

2017-11-01

Full Text Available Abstract Background The European directive on basic safety standards (Council directive 2013/59 Euratom mandates dosimetry-based treatment planning for radiopharmaceutical therapies. The directive comes into operation February 2018, and the aim of a report produced by the Internal Dosimetry Task Force of the European Association of Nuclear Medicine is to address this aspect of the directive. A summary of the report is presented. Results A brief review of five of the most common therapy procedures is included in the current text, focused on the potential to perform patient-specific dosimetry. In the full report, 11 different therapeutic procedures are included, allowing additional considerations of effectiveness, references to specific literature on quantitative imaging and dosimetry, and existing evidence for absorbed dose-effect correlations for each treatment. Individualized treatment planning with tracer diagnostics and verification of the absorbed doses delivered following therapy is found to be scientifically feasible for almost all procedures investigated, using quantitative imaging and/or external monitoring. Translation of this directive into clinical practice will have significant implications for resource requirements. Conclusions Molecular radiotherapy is undergoing a significant expansion, and the groundwork for dosimetry-based treatment planning is already in place. The mandated individualization is likely to improve the effectiveness of the treatments, although must be adequately resourced.

Consequences of additional use of PET information for target volume delineation and radiotherapy dose distribution for esophageal cancer

International Nuclear Information System (INIS)

Muijs, Christina T.; Schreurs, Liesbeth M.; Busz, Dianne M.; Beukema, Jannet C.; Borden, Arnout J. van der; Pruim, Jan; Van der Jagt, Eric J.; Plukker, John Th.; Langendijk, Johannes A.

2009-01-01

Background and purpose: To determine the consequences of target volume (TV) modifications, based on the additional use of PET information, on radiation planning, assuming PET/CT-imaging represents the true extent of the tumour. Materials and methods: For 21 patients with esophageal cancer, two separate TV's were retrospectively defined based on CT (CT-TV) and co-registered PET/CT images (PET/CT-TV). Two 3D-CRT plans (prescribed dose 50.4 Gy) were constructed to cover the corresponding TV's. Subsequently, these plans were compared for target coverage, normal tissue dose-volume histograms and the corresponding normal tissue complication probability (NTCP) values. Results: The addition of PET led to the modification of CT-TV with at least 10% in 12 of 21 patients (57%) (reduction in 9, enlargement in 3). PET/CT-TV was inadequately covered by the CT-based treatment plan in 8 patients (36%). Treatment plan modifications resulted in significant changes (p < 0.05) in dose distributions to heart and lungs. Corresponding changes in NTCP values ranged from -3% to +2% for radiation pneumonitis and from -0.2% to +1.2% for cardiac mortality. Conclusions: This study demonstrated that TV's based on CT might exclude PET-avid disease. Consequences are under dosing and thereby possibly ineffective treatment. Moreover, the addition of PET in radiation planning might result in clinical important changes in NTCP.

[Patient's Autonomy and Information in Psycho-Oncology: Computer Based Distress Screening for an Interactive Treatment Planning (ePOS-react)].

Science.gov (United States)

Schäffeler, Norbert; Sedelmaier, Jana; Möhrer, Hannah; Ziser, Katrin; Ringwald, Johanna; Wickert, Martin; Brucker, Sara; Junne, Florian; Zipfel, Stephan; Teufel, Martin

2017-07-01

To identify distressed patients in oncology using screening questionnaires is quite challenging in clinical routine. Up to now there is no evidence based recommendation which instrument is most suitable and how to put a screening to practice. Using computer based screening tools offers the possibility to automatically analyse patient's data, inform psycho-oncological and medical staff about the results, and use reactive questionnaires. Studies on how to empower patients in decision making in psycho-oncology are rare.Methods Women with breast and gynaecological cancer have been consecutively included in this study (n=103) at time of inpatient surgical treatment in a gynaecological clinic. They answered the computer based screening questionnaire (ePOS-react) for routine distress screening at time of admission. At the end of the tool an individual recommendation concerning psycho-oncological treatment is given ( i) psycho-oncological counselling, ii) brief psycho-oncological contact, iii) no treatment suggestion). The informed patients could choose autonomously either the recommended treatment or an individually more favoured alternative possibility. Additionally, a clinical interview (approx. 30 min) based on the "Psychoonkologische Basisdiagnostik (PO-Bado)" has been carried out for a third-party assessment of patients' need for treatment.Results 68.9% followed the treatment recommendation. 22.3% asked for a more "intense" (e. g. counselling instead of recommended brief contact) and 8,7% for a "less intense" intervention than recommended. The accordance of third-party assessment (clinical interview "PO-Bado") and treatment recommendation is about 72.8%. The accordance of third-party assessment and patient's choice (ePOS-react) is about 58.3%. The latter is smaller because 29.1% asked for a brief psycho-oncological contact for whom from the third-party assessment's perspective no indication for treatment has been existent.Discussion A direct response of the

Role of samarium additions on the shape memory behavior of iron based alloys

International Nuclear Information System (INIS)

Shakoor, R.A.; Khalid, F. Ahmad; Kang, Kisuk

2011-01-01

Research highlights: → The effect of samarium contents on shape memory behavior has been studied. → Addition of samarium increases the strength, c/a ratio and ε (hcp martensite). → Addition of samarium retards the nucleation of α (bcc martensite). → Improvement in shape memory effect with the increase in samarium contents. - Abstract: The effect of samarium contents on shape memory behavior of iron based shape memory alloys has been studied. It is found that the strength of the alloys increases with the increase in samarium contents. This effect can be attributed to the solid solution strengthening of austenite by samarium addition. It is also noticed that the shape memory effect increases with the increase in samarium contents. This improvement in shape memory effect presumably can be regarded as the effect of improvement in strength, increase in c/a ratio and obstruction of nucleation of α in the microstructure.

Effects of additives on microstructures of titanate based nanotubes prepared by the hydrothermal process

International Nuclear Information System (INIS)

Kubo, Takashi; Sugimoto, Keijiro; Onoki, Takamasa; Nakahira, Atsushi; Yamasaki, Yuki

2009-01-01

Silica-containing TiO 2 -derived titanate nanotubes were prepared by the addition of a small amount of tetraethyl orthosilicate (TEOS) to TiO 2 -derived titanate nanotubes prepared by the hydrothermal process and a subsequent heat-treatment at 473 K in air. The microstructure and thermal behavior of synthesized silica containing TiO 2 -derived titanate nanotubes were investigated by various methods such as X-ray diffraction (XRD), X-ray absorption fine structure (XAF), and X-ray photoelectron spectroscopy (XPS). As a result, the addition of a small amount of TEOS leaded to the improvement of the thermal stability for TiO 2 -derived titanate nanotubes. XPS results revealed that Si was combined onto the surface of TiO 2 -derived titanate nanotubes, forming partial Si-O-Ti chemical bonds. Therefore, it was inferred that the thermal stability could be modified by forming partial Si-O-Ti chemical bonds at interface of silica and TiO 2 -derived titanate nanotubes. (author)

Drag reduction by natural polymeric additives in PMDS microchannel: Effect of types of additives

OpenAIRE

Ling Fiona W.M.; Abdulbari Hayder A.

2017-01-01

Drag reduction technology was used in medical applications to enhance the blood flow in semiclogged blood streams which can be an alternative treatment for atherosclerosis. In this present study, natural polymeric drag reducing additives (DRA) was introduced to replace synthetic polymer which has the possibility of bringing side effects to human health. Three different sources, namely okra, aloe vera and hibiscus were utilized to extract the natural polymeric additives which were then tested ...

Regional MLEM reconstruction strategy for PET-based treatment verification in ion beam radiotherapy

International Nuclear Information System (INIS)

Gianoli, Chiara; Riboldi, Marco; Fattori, Giovanni; Baselli, Giuseppe; Baroni, Guido; Bauer, Julia; Debus, Jürgen; Parodi, Katia; De Bernardi, Elisabetta

2014-01-01

In ion beam radiotherapy, PET-based treatment verification provides a consistency check of the delivered treatment with respect to a simulation based on the treatment planning. In this work the region-based MLEM reconstruction algorithm is proposed as a new evaluation strategy in PET-based treatment verification. The comparative evaluation is based on reconstructed PET images in selected regions, which are automatically identified on the expected PET images according to homogeneity in activity values. The strategy was tested on numerical and physical phantoms, simulating mismatches between the planned and measured β + activity distributions. The region-based MLEM reconstruction was demonstrated to be robust against noise and the sensitivity of the strategy results were comparable to three voxel units, corresponding to 6 mm in numerical phantoms. The robustness of the region-based MLEM evaluation outperformed the voxel-based strategies. The potential of the proposed strategy was also retrospectively assessed on patient data and further clinical validation is envisioned. (paper)

Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial

DEFF Research Database (Denmark)

Johannsen, Maja; O Connor, Maja; OToole, Mia Skytte

2016-01-01

PURPOSE: To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer. METHODS: A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3...... pain rehabilitation strategy for women treated for breast cancer. In addition, the effect on neuropathic pain, a pain type reported by women treated for breast cancer, further suggests the potential of MBCT but should be considered preliminary....

26 CFR 54.9802-3T - Additional requirements prohibiting discrimination based on genetic information (temporary).

Science.gov (United States)

2010-04-01

... assembles the data requested by M and, although N reviews it to delete genetic information, the data from a... discrimination based on genetic information (temporary). 54.9802-3T Section 54.9802-3T Internal Revenue INTERNAL... EXCISE TAXES § 54.9802-3T Additional requirements prohibiting discrimination based on genetic information...

Improvement of stress-rupture property by Cr addition in Ni-based single crystal superalloys

International Nuclear Information System (INIS)

Chen, J.Y.; Feng, Q.; Cao, L.M.; Sun, Z.Q.

2011-01-01

Research highlights: → Cr improved the stress-rupture life of single crystal superalloys significantly. → Cr increased the Re partitioning ratio and resulted in more negative misfit. → Mechanism for improving the stress-rupture life by Cr addition is addressed here. - Abstract: The effects of Cr addition on the microstructure and stress-rupture property have been investigated in three experimental Ni-based single crystal superalloys containing various levels of Cr addition (0-5.7 wt.%). The Re partitioning ratio increased and the lattice misfit became more negative with increasing the Cr addition in both dendrite core and interdendritic region. The changes of elemental partitioning behaviors and the lattice misfit show good agreement with the change of γ' morphology. Cr addition increased the stress-rupture life at 1100 deg. C/140 MPa significantly due to higher γ' volume fraction, more negative lattice misfit and a well rafting structure as well as less width of γ channels. High Cr addition (5.7 wt.%) increased the degree of Re and Cr supersaturation in the γ phase and promoted the formation of topologically close-packed (TCP) phases significantly under thermal exposure and creep deformation at 1100 deg. C.

A randomized controlled study comparing community based with health facility based direct observation of treatment models on patients' satisfaction and TB treatment outcome in Nigeria.

Science.gov (United States)

Adewole, Olanisun O; Oladele, T; Osunkoya, Arinola H; Erhabor, Greg E; Adewole, Temitayo O; Adeola, Oluwaseun; Obembe, Olufemi; Ota, Martin O C

2015-12-01

Directly observed treatment short-course (DOTS) strategy is an effective mode of treating TB. We aimed to study the cost effectiveness and patients' satisfaction with home based direct observation of treatment (DOT), an innovative approach to community-based DOT (CBDOT) and hospital based DOT (HBDOT). A randomized controlled trial involving 150 newly diagnosed pulmonary TB patients in four TB clinics in Ile Ife , Nigeria, was done. They were randomly assigned to receive treatment with anti TB drugs for the intensive phase administered at home by a TB worker (CBDOT) or at the hospital (HBDOT). Outcome measures were treatment completion/default rates, cost effectiveness and patients' satisfaction with care using a 13 item patients satisfaction questionnaire (PS-13) at 2 months. This trial was registered with pactr.org: number PACTR 201503001058381. At the end of intensive phase, 15/75 (20%) and 2/75 (3%) of patients in the HBDOT and CBDOT, respectively had defaulted from treatment, p= 0.01. Of those with pretreatment positive sputum smear, 97% (68/70) on CBDOT and 54/67 (81%) on HBDOT were sputum negative for AFB at the end of 2 months of treatment, p=0.01. The CBDOT method was associated with a higher patient satisfaction score compared with HBDOT (OR 3.1; 95% CI 1.25-7.70), p=0.001.The total cost for patients was higher in HBDOT (US$159.38) compared with the CBDOT (US$89.52). The incremental cost effectiveness ratio was US$410 per patient who completed the intensive phase treatment with CBDOT. CBDOT is a cost effective approach associated with better compliance to treatment and better patient satisfaction compared to HBDOT. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of litter addition and warming on soil carbon, nutrient pools and microbial communities in a subarctic heath ecosystem

DEFF Research Database (Denmark)

Rinnan, Riikka; Michelsen, Anders; Jonasson, Sven Evert

2008-01-01

in the uppermost 5 cm soil, while decreasing the pool of total P per unit area of the organic profile and having no significant effects on N concentrations or pools. Microbial biomass C and N were unaffected by the treatments, while the microbial biomass P increased significantly with litter addition. Soil...... proportion of biomarkers for Gram-positive bacteria. The combined warming plus litter addition treatment decreased the soil water content in the uppermost 5 cm soil, which was a likely reason for many interactions between the effects of warming and litter addition. The soil organic matter quality...... of the combined treatment was also clearly different from the control based on a near-infrared reflectance (NIR) spectroscopic analysis, implying that the treatment altered the composition of soil organic matter. However, it appears that the biological processes and the microbial community composition responded...

Grain Structure Control of Additively Manufactured Metallic Materials

Directory of Open Access Journals (Sweden)

Fuyao Yan

2017-11-01

Full Text Available Grain structure control is challenging for metal additive manufacturing (AM. Grain structure optimization requires the control of grain morphology with grain size refinement, which can improve the mechanical properties of additive manufactured components. This work summarizes methods to promote fine equiaxed grains in both the additive manufacturing process and subsequent heat treatment. Influences of temperature gradient, solidification velocity and alloy composition on grain morphology are discussed. Equiaxed solidification is greatly promoted by introducing a high density of heterogeneous nucleation sites via powder rate control in the direct energy deposition (DED technique or powder surface treatment for powder-bed techniques. Grain growth/coarsening during post-processing heat treatment can be restricted by presence of nano-scale oxide particles formed in-situ during AM. Grain refinement of martensitic steels can also be achieved by cyclic austenitizing in post-processing heat treatment. Evidently, new alloy powder design is another sustainable method enhancing the capability of AM for high-performance components with desirable microstructures.

Novel approaches based on ultrasound for treatment of wastewater containing potassium ferrocyanide.

Science.gov (United States)

Jawale, Rajashree H; Tandale, Akash; Gogate, Parag R

2017-09-01

Industrial wastewaters containing biorefractory compounds like cyanide offer significant environmental problems attributed to the fact that the conventional methods have limited effectiveness and hence developing efficient treatment approaches is an important requirement. The present work investigates the use of novel treatment approach of ultrasound (US) combined with advanced oxidation techniques for the degradation of potassium ferrocyanide (KFC) for the first time. An ultrasonic bath equipped with longitudinal horn (1kW rated power and 25kHz frequency) has been used. The effect of initial pH (2-9) on the progress of degradation has been investigated initially and subsequently using the optimized pH, effect of addition of hydrogen peroxide (ratio of KFC:H 2 O 2 varied over the range of 1:0.5-1:5) and TiO 2 in the presence of H 2 O 2 (1:1 ratio by weight of TiO 2 ) as process intensifying approach has been studied. Combination of ultrasonic irradiation with ozone (O 3 ) (100-400mg/h) and ultraviolet irradiation (UV) has also been investigated. Use of combination of US with H 2 O 2, H 2 O 2 +TiO 2 and ozone resulted in extent of KFC degradation as 54.2%, 74.82% and 82.41% respectively. Combination of US with both UV and ozone was established to be the best approach yielding 92.47% degradation. The study also focused on establishing kinetic rate constants for all the treatment approaches which revealed that all the approaches followed first order kinetic mechanism with higher rate constants for the combination approaches. Overall, it has been conclusively established that ultrasound based combined treatment schemes are very effective for the treatment of KFC containing wastewaters. Copyright © 2017 Elsevier B.V. All rights reserved.

Diabetes and obesity treatment based on dual incretin receptor activation

DEFF Research Database (Denmark)

Skow, M A; Bergmann, N C; Knop, F K

2016-01-01

, whereas GIP seems to affect lipid metabolism. The introduction of selective GLP-1 receptor (GLP-1R) agonists for the treatment of type 2 diabetes and obesity has increased the scientific and clinical interest in incretins. Combining the body weight-lowering and glucose-lowering effects of GLP-1...... with a more potent improvement of β cell function through additional GIP action could potentially offer a more effective treatment of diabetes and obesity, with fewer adverse effects than selective GLP-1R agonists; therefore, new drugs designed to co-activate both the GIP receptor (GIPR) and the GLP-1R...

Cost-effectiveness analysis of additional bevacizumab to pemetrexed plus cisplatin for malignant pleural mesothelioma based on the MAPS trial.

Science.gov (United States)

Zhan, Mei; Zheng, Hanrui; Xu, Ting; Yang, Yu; Li, Qiu

2017-08-01

Malignant pleural mesothelioma (MPM) is a rare malignancy, and pemetrexed/cisplatin (PC) is the gold standard first-line regime. This study evaluated the cost-effectiveness of the addition of bevacizumab to PC (with maintenance bevacizumab) for unresectable MPM based on a phase III trial that showed a survival benefit compared with chemotherapy alone. To estimate the incremental cost-effectiveness ratio (ICER) of the incorporation of bevacizumab, a Markov model based on the MAPS trial, including the disease states of progression-free survival, progressive disease and death, was used. Total costs were calculated from a Chinese payer perspective, and health outcomes were converted into quality-adjusted life year (QALY). Model robustness was explored in sensitivity analyses. The addition of bevacizumab to PC was estimated to increase the cost by $81446.69, with a gain of 0.112 QALYs, resulting in an ICER of $727202.589 per QALY. In both one-way sensitivity and probabilistic sensitivity analyses, the ICER exceeded the commonly accepted willingness-to-pay threshold of 3 times the gross domestic product per capita of China ($23970.00 per QALY). The cost of bevacizumab had the most important impact on the ICER. The combination of bevacizumab with PC chemotherapy is not a cost-effective treatment option for MPM in China. Given its positive clinical value and extremely low incidence of MPM, an appropriate price discount, assistance programs and medical insurance should be considered to make bevacizumab more affordable for this rare patient population. Copyright © 2017 Elsevier B.V. All rights reserved.

Prescribed computer games in addition to occlusion versus standard occlusion treatment for childhood amblyopia: a pilot randomised controlled trial.

Science.gov (United States)

Tailor, Vijay K; Glaze, Selina; Khandelwal, Payal; Davis, Alison; Adams, Gillian G W; Xing, Wen; Bunce, Catey; Dahlmann-Noor, Annegret

2015-01-01

Amblyopia ("lazy eye") is the commonest vision deficit in children. If not fully corrected by glasses, amblyopia is treated by patching or blurring the better-seeing eye. Compliance with patching is often poor. Computer-based activities are increasingly topical, both as an adjunct to standard treatment and as a platform for novel treatments. Acceptability by families has not been explored, and feasibility of a randomised controlled trial (RCT) using computer games in terms of recruitment and treatment acceptability is uncertain. We carried out a pilot RCT to test whether computer-based activities are acceptable and accessible to families and to test trial methods such as recruitment and retention rates, randomisation, trial-specific data collection tools and analysis. The trial had three arms: standard near activity advice, Eye Five, a package developed for children with amblyopia, and an off-the-shelf handheld games console with pre-installed games. We enrolled 60 children age 3-8 years with moderate or severe amblyopia after completion of optical treatment. This trial was registered as UKCRN-ID 11074. Pre-screening of 3600 medical notes identified 189 potentially eligible children, of whom 60 remained eligible after optical treatment, and were enrolled between April 2012 and March 2013. One participant was randomised twice and withdrawn from the study. Of the 58 remaining, 37 were boys. The mean (SD) age was 4.6 (1.7) years. Thirty-seven had moderate and 21 severe amblyopia. Three participants were withdrawn at week 6, and in total, four were lost to follow-up at week 12. Most children and parents/carers found the study procedures, i.e. occlusion treatment, usage of the allocated near activity and completion of a study diary, easy. The prescribed cumulative dose of near activity was 84 h at 12 weeks. Reported near activity usage numbers were close to prescribed numbers in moderate amblyopes (94 % of prescribed) but markedly less in severe amblyopes (64

Preoperative analgesics for additional pain relief in children and adolescents having dental treatment.

Science.gov (United States)

Ashley, Paul F; Parekh, Susan; Moles, David R; Anand, Prabhleen; MacDonald, Laura C I

2016-08-08

Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort and intraoperative pain. We reviewed the available evidence to determine whether further research is warranted and to inform the development of prescribing guidelines. This is an update of a Cochrane review published in 2012. To assess the effects of preoperative analgesics for intraoperative or postoperative pain relief (or both) in children and adolescents undergoing dental treatment without general anaesthesia or sedation. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 5 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2015, Issue 12), MEDLINE via OVID (1946 to 5 January 2016), EMBASE via OVID (1980 to 5 January 2016), LILACS via BIREME (1982 to 5 January 2016) and the ISI Web of Science (1945 to 5 January 2016). We searched ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials to 5 January 2016. There were no restrictions regarding language or date of publication in the searches of the electronic databases. We handsearched several specialist journals dating from 2000 to 2011.We checked the reference lists of all eligible trials for additional studies. We contacted specialists in the field for any unpublished data. Randomised controlled clinical trials of analgesics given before dental treatment versus placebo or no analgesics in children and adolescents up to 17 years of age. We excluded children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia. Two review authors assessed titles and abstracts of the articles obtained from the searches for eligibility, undertook data extraction and assessed the risk of bias in the included studies. We assessed the quality of the

Evidence-Based Treatment of Delirium in Patients With Cancer

Science.gov (United States)

Breitbart, William; Alici, Yesne

2012-01-01

Delirium is the most common neuropsychiatric complication seen in patients with cancer, and it is associated with significant morbidity and mortality. Increased health care costs, prolonged hospital stays, and long-term cognitive decline are other well-recognized adverse outcomes of delirium. Improved recognition of delirium and early treatment are important in diminishing such morbidity. There has been an increasing number of studies published in the literature over the last 10 years regarding delirium treatment as well as prevention. Antipsychotics, cholinesterase inhibitors, and alpha-2 agonists are the three groups of medications that have been studied in randomized controlled trials in different patient populations. In patients with cancer, the evidence is most clearly supportive of short-term, low-dose use of antipsychotics for controlling the symptoms of delirium, with close monitoring for possible adverse effects, especially in older patients with multiple medical comorbidities. Nonpharmacologic interventions also appear to have a beneficial role in the treatment of patients with cancer who have or are at risk for delirium. This article presents evidence-based recommendations based on the results of pharmacologic and nonpharmacologic studies of the treatment and prevention of delirium. PMID:22412123

Effect of molybdenum and chromium additions on the mechanical properties of Fe3Al-based alloys

International Nuclear Information System (INIS)

Sun Yangshan; Xue Feng; Mei Jianping; Yu Xingquan; Zhang Lining

1995-01-01

Iron aluminides based on Fe 3 Al offer excellent oxidation and sulfidation resistance, with lower material cost and density than stainless steels. However, their potential use as structural material has been hindered by limited ductility and a sharp drop in strength above 600 C. Recent development efforts have indicated that adequate engineering ductility of 10--20% and tensile yield strength of as high as 500 MPa can be achieved through control of composition and microstructure. These improved tensile properties make Fe 3 Al-based alloys more competitive against conventional austenic and ferritic steels. The improvement of high temperature mechanical properties has been achieved mainly by alloying processes. Molybdenum has been found to be one of the most important alloying elements for strengthening Fe 3 Al-based alloys at high temperatures. However, the RT(room temperature) ductility decreases with the increase of a molybdenum addition. On the other hand, a chromium addition to Fe 3 Al-based alloys is very efficient for improving RT ductility but not beneficial to yield strength at temperatures to 800 C. The purpose of the present paper is to report the effects of combined additions of molybdenum and chromium on mechanical properties at ambient temperature and high temperature of 600 C

Predictors and Moderators of Outcome in Family-Based Treatment for Adolescent Bulimia Nervosa

Science.gov (United States)

Le Grange, Daniel; Crosby, Ross D.; Lock, James

2008-01-01

The predictors and moderators of treatment outcome for adolescents with bulimia nervosa (BN) are explored among those who participated in family based treatment or individual supportive psychotherapy. It is concluded that family-based treatment of BN may be most effective in those cases with low levels of eating disorder psychopathology.

Radiobiologically based treatment plan evaluation for prostate seed implants

Directory of Open Access Journals (Sweden)

Sotirios Stathakis

2011-07-01

Full Text Available Purpose: Accurate prostate low dose-rate brachytherapy treatment plan evaluation is important for future care decisions. Presently, an evaluation is based on dosimetric quantifiers for the tumor and organs at risk. However, these do not account for effects of varying dose-rate, tumor repopulation and other biological effects. In this work, incorporation of the biological response is used to obtain more clinically relevant treatment plan evaluation.Material and methods: Eleven patients were evaluated. Each patient received a 145 Gy implant. Iodine-125 seeds were used and the treatment plans were created on the Prowess system. Based on CT images the post-implant plan was created. In the post-plan, the tumor, urethra, bladder and rectum were contoured. The biologically effective dose was used to determine the tumor control probability and the normal tissue complication probabilities for the urethra, bladder, rectum and surrounding tissue. Results: The average tumor control probability and complication probabilities for the urethra, bladder, rectum and surrounding tissue were 99%, 29%, 0%, 12% and 6%, respectively. These measures provide a simpler means for evaluation and since they include radiobiological factors, they provide more reliable estimation of the treatment outcome. Conclusions: The goal of this work was to create more clinically relevant prostate seed-implant evaluation by incorporating radiobiological measures. This resulted in a simpler descriptor of treatment plan quality and was consistent with patient outcomes.

Randomized clinical trial assessing whether additional massage treatments for chronic neck pain improve 12- and 26-week outcomes.

Science.gov (United States)

Cook, Andrea J; Wellman, Robert D; Cherkin, Daniel C; Kahn, Janet R; Sherman, Karen J

2015-10-01

This is the first study to systematically evaluate the value of a longer treatment period for massage. We provide a framework of how to conceptualize an optimal dose in this challenging setting of nonpharmacologic treatments. The aim was to determine the optimal dose of massage for neck pain. Two-phase randomized trial for persons with chronic nonspecific neck pain. Primary randomization to one of five groups receiving 4 weeks of massage (30 minutes 2x/or 3x/wk or 60 minutes 1x, 2x, or 3x/wk). Booster randomization of participants to receive an additional six massages, 60 minutes 1x/wk, or no additional massage. A total of 179 participants from Group Health and the general population of Seattle, WA, USA recruited between June 2010 and August 2011 were included. Primary outcomes self-reported neck-related dysfunction (Neck Disability Index) and pain (0-10 scale) were assessed at baseline, 12, and 26 weeks. Clinically meaningful improvement was defined as greater than or equal to 5-point decrease in dysfunction and greater than or equal to 30% decrease in pain from baseline. Clinically meaningful improvement for each primary outcome with both follow-up times was analyzed using adjusted modified Poisson generalized estimating equations (GEEs). Secondary analyses for the continuous outcomes used linear GEEs. There were no observed differences by primary treatment group at 12 or 26 weeks. Those receiving booster dose had improvements in both dysfunction and pain at 12 weeks (dysfunction: relative risk [RR]=1.56 [1.08-2.25], p=.018; pain: RR=1.25 [0.98-1.61], p=.077), but those were nonsignificant at 26 weeks (dysfunction: RR=1.22 [0.85-1.74]; pain: RR=1.09 [0.82-1.43]). Subgroup analysis by primary and booster treatments found the booster dose only effective among those initially randomized to one of the 60-minute massage groups. "Booster" doses for those initially receiving 60 minutes of massage should be incorporated into future trials of massage for chronic neck pain

empiric treatment based on helicobacter pylori serology cannot ...

African Journals Online (AJOL)

EMPIRIC TREATMENT BASED ON. HELICOBACTER PYLORI SEROLOGY. CANNOT SUBSTITUTE FOR EARLY. ENDOSCOPY IN THE. MANAGEMENT OF DYSPEPTIC. RURAL BLACK AFRICANS. Stephen JD O'Keefe, B Salvador, J Nainkin, S Majikir H. Stevens, A Atherstone. Background_ Evidence that chronic gastric ...

Bromate Formation Characteristics of UV Irradiation, Hydrogen Peroxide Addition, Ozonation, and Their Combination Processes

Directory of Open Access Journals (Sweden)

Naoyuki Kishimoto

2012-01-01

Full Text Available Bromate formation characteristics of six-physicochemical oxidation processes, UV irradiation, single addition of hydrogen peroxide, ozonation, UV irradiation with hydrogen peroxide addition (UV/H2O2, ozonation with hydrogen peroxide addition (O3/H2O2, and ozonation with UV irradiation (O3/UV were investigated using 1.88 μM of potassium bromide solution with or without 6.4 μM of 4-chlorobenzoic acid. Bromate was not detected during UV irradiation, single addition of H2O2, and UV/H2O2, whereas ozone-based treatments produced . Hydroxyl radicals played more important role in bromate formation than molecular ozone. Acidification and addition of radical scavengers such as 4-chlorobenzoic acid were effective in inhibiting bromate formation during the ozone-based treatments because of inhibition of hydroxyl radical generation and consumption of hydroxyl radicals, respectively. The H2O2 addition was unable to decompose 4-chlorobenzoic acid, though O3/UV and O3/H2O2 showed the rapid degradation, and UV irradiation and UV/H2O2 showed the slow degradation. Consequently, if the concentration of organic contaminants is low, the UV irradiation and/or UV/H2O2 are applicable to organic contaminants removal without bromate formation. However, if the concentration of organic contaminants is high, O3/H2O2 and O3/UV should be discussed as advanced oxidation processes because of their high organic removal efficiency and low bromate formation potential at the optimum condition.

Alternative additives; Alternative additiver

Energy Technology Data Exchange (ETDEWEB)

2007-08-15

In this project a number of industrial and agricultural waste products have been characterised and evaluated in terms of alkali-getter performance. The intended use is for biomass-fired power stations aiming at reducing corrosion or slagging related problems. The following products have been obtained, characterised and evaluated: 1) Brewery draff 2) Danish de-gassed manure 3) Paper sludge 4) Moulding sand 5) Spent bleaching earth 6) Anorthosite 7) Sand 8) Clay-sludge. Most of the above alternative additive candidates are deemed unsuitable due to insufficient chemical effect and/or expensive requirements for pre-treatment (such as drying and transportation). 3 products were selected for full-scale testing: de-gassed manure, spent bleaching earth and clay slugde. The full scale tests were undertaken at the biomass-fired power stations in Koege, Slagelse and Ensted. Spent bleaching earth (SBE) and clay sludge were the only tested additive candidates that had a proven ability to react with KCl, to thereby reduce Cl-concentrations in deposits, and reduce the deposit flux to superheater tubes. Their performance was shown to nearly as good as commercial additives. De-gassed manure, however, did not evaluate positively due to inhibiting effects of Ca in the manure. Furthermore, de-gassed manure has a high concentration of heavy metals, which imposes a financial burden with regard to proper disposal of the ash by-products. Clay-sludge is a wet clay slurring, and drying and transportation of this product entails substantial costs. Spent bleaching does not require much pre-treatment and is therefore the most promising alternative additive. On the other hand, bleaching earth contains residual plant oil which means that a range of legislation relating to waste combustion comes into play. Not least a waste combustion fee of 330 DKK/tonne. For all alternative (and commercial) additives disposal costs of the increase ash by-products represents a significant cost. This is

Estimation of second primary cancers risk based on the treatment planning system

International Nuclear Information System (INIS)

Jin Chufeng; Sun Guangyao; Liu Hui; Zheng Huaqing; Cheng Mengyun; Li Gui; Wu Yican; FDS Team

2011-01-01

Estimates of second primary cancers risk after radiotherapy has become increasingly important for comparative treatment planning. A new method based on the treatment planning system to estimate the risk of second primary cancers was introduced in this paper. Using the Advanced/Accurate Radiotherapy Treatment System(ARTS), a treatment planning system developed by the FDS team,the risk of second primary cancer was estimated over two treatment plans for a patient with pancreatic cancer. Based on the second primary cancer risk, the two plans were compared. It was found that,kidney and gall-bladder had higher risk to develop second primary cancer. A better plan was chosen by the analysis of second primary cancer risk. The results showed that this risk estimation method we developed could be used to evaluate treatment plans. (authors)

Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

Science.gov (United States)

van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

2006-01-01

Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment.

Science.gov (United States)

Langkaas, Tomas Formo; Hoffart, Asle; Øktedalen, Tuva; Ulvenes, Pål G; Hembree, Elizabeth A; Smucker, Mervin

2017-10-01

Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents

Science.gov (United States)

Henggeler, Scott W.; Sheidow, Ashli J.

2012-01-01

Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief…

The Cruelest Cure? Ethical Issues in the Implementation of Exposure-Based Treatments

Science.gov (United States)

Olatunji, Bunmi O.; Deacon, Brett J.; Abramowitz, Jonathan S.

2009-01-01

Numerous studies have provided supportive evidence for the efficacy of exposure-based treatments for many psychological disorders. However, surprisingly few therapists use exposure therapy in the clinical setting. Although the limited use of exposure-based treatments may be partially attributable to a shortage of suitably trained therapists,…

Performance of Submerged Membrane Bioreactor Combined with Powdered Activated Carbon Addition for the Treatment of an Industrial Wastewater

Directory of Open Access Journals (Sweden)

Tri Widjaja

2010-02-01

Full Text Available Membrane technology is one of the alternative solutions to overcome industrial wastewater treatment developed nowadays. The addition of PAC (Powdered Activated Carbon in the activated sludge using Submerged Membrane Adsorption Hybrid Bioreactor (SMAHBR is expected to increase the organic material removal. The purpose of this study was to determine the performance of submerged membrane bioreactor and activated carbon adsorption capacity of organic materials in wastewater. This study used SIER (Surabaya Industrial Estate Rungkut – Surabaya, Indonesia waste as activated sludge operated at Mixed Liquor Suspended Solid (MLSS concentrations of 8000 and 15000 mg/l, and Chemical Oxygen Demand (COD concentrations of 1500, 2500 mg/l, Sludge Retention Time (SRT of 10;20; and 30 days and activated carbon variables of 0%; 2.5%; 5%; 7.5%; 10%. The results showed that the fouling potential occurred at high MLSS where the COD removal occurred at PAC addition of 10% reaching 91.86%. High Soluble Microbial Product (SMP accumulation (± 10 mg/l occurred in short SRT and high MLSS concentration. PAC addition resulted in decreased microorganisms in the reactor and better effluent of SMAHBR, as a result, the performance of the submerged membrane bioreactor would be restored.

Additive manufacturing of three-dimensional (3D) microfluidic-based microelectromechanical systems (MEMS) for acoustofluidic applications.

Science.gov (United States)

Cesewski, Ellen; Haring, Alexander P; Tong, Yuxin; Singh, Manjot; Thakur, Rajan; Laheri, Sahil; Read, Kaitlin A; Powell, Michael D; Oestreich, Kenneth J; Johnson, Blake N

2018-06-13

Three-dimensional (3D) printing now enables the fabrication of 3D structural electronics and microfluidics. Further, conventional subtractive manufacturing processes for microelectromechanical systems (MEMS) relatively limit device structure to two dimensions and require post-processing steps for interface with microfluidics. Thus, the objective of this work is to create an additive manufacturing approach for fabrication of 3D microfluidic-based MEMS devices that enables 3D configurations of electromechanical systems and simultaneous integration of microfluidics. Here, we demonstrate the ability to fabricate microfluidic-based acoustofluidic devices that contain orthogonal out-of-plane piezoelectric sensors and actuators using additive manufacturing. The devices were fabricated using a microextrusion 3D printing system that contained integrated pick-and-place functionality. Additively assembled materials and components included 3D printed epoxy, polydimethylsiloxane (PDMS), silver nanoparticles, and eutectic gallium-indium as well as robotically embedded piezoelectric chips (lead zirconate titanate (PZT)). Electrical impedance spectroscopy and finite element modeling studies showed the embedded PZT chips exhibited multiple resonant modes of varying mode shape over the 0-20 MHz frequency range. Flow visualization studies using neutrally buoyant particles (diameter = 0.8-70 μm) confirmed the 3D printed devices generated bulk acoustic waves (BAWs) capable of size-selective manipulation, trapping, and separation of suspended particles in droplets and microchannels. Flow visualization studies in a continuous flow format showed suspended particles could be moved toward or away from the walls of microfluidic channels based on selective actuation of in-plane or out-of-plane PZT chips. This work suggests additive manufacturing potentially provides new opportunities for the design and fabrication of acoustofluidic and microfluidic devices.

Microbiota-based Signature of Gingivitis Treatments: A Randomized Study.

Science.gov (United States)

Huang, Shi; Li, Zhen; He, Tao; Bo, Cunpei; Chang, Jinlan; Li, Lin; He, Yanyan; Liu, Jiquan; Charbonneau, Duane; Li, Rui; Xu, Jian

2016-04-20

Plaque-induced gingivitis can be alleviated by various treatment regimens. To probe the impacts of various anti-gingivitis treatments on plaque microflora, here a double blinded, randomized controlled trial of 91 adults with moderate gingivitis was designed with two anti-gingivitis regimens: the brush-alone treatment and the brush-plus-rinse treatment. In the later group, more reduction in both Plaque Index (TMQHI) and Gingival Index (mean MGI) at Day 3, Day 11 and Day 27 was evident, and more dramatic changes were found between baseline and other time points for both supragingival plaque microbiota structure and salivary metabonomic profiles. A comparison of plaque microbiota changes was also performed between these two treatments and a third dataset where 50 subjects received regimen of dental scaling. Only Actinobaculum, TM7 and Leptotrichia were consistently reduced by all the three treatments, whereas the different microbial signatures of the three treatments during gingivitis relieve indicate distinct mechanisms of action. Our study suggests that microbiota based signatures can serve as a valuable approach for understanding and potentially comparing the modes of action for clinical treatments and oral-care products in the future.

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury.

Science.gov (United States)

Cuthbert, Jeffrey P; Staniszewski, Kristi; Hays, Kaitlin; Gerber, Don; Natale, Audrey; O'Dell, Denise

2014-01-01

To evaluate the feasibility and safety of utilizing a commercially available virtual reality gaming system as a treatment intervention for balance training. A randomized controlled trial in which assessment and analysis were blinded. An inpatient rehabilitation facility. Interventions included balance-based physical therapy using a Nintendo Wii, as monitored by a physical therapist, and receipt of one-on-one balance-based physical therapy using standard physical therapy modalities available for use in the therapy gym. Participants in the standard physical therapy group were found to have slightly higher enjoyment at mid-intervention, while those receiving the virtual reality-based balance intervention were found to have higher enjoyment at study completion. Both groups demonstrated improved static and dynamic balance over the course of the study, with no significant differences between groups. Correlational analyses suggest a relationship exists between Wii balance board game scores and BBS scores for measures taken beyond the baseline assessment. This study provides a modest level of evidence to support using commercially available VR gaming systems for the treatment of balance deficits in patients with a primary diagnosis of TBI receiving inpatient rehabilitation. Additional research of these types of interventions for the treatment of balance deficits is warranted.

Energy-Based Facial Rejuvenation: Advances in Diagnosis and Treatment.

Science.gov (United States)

Britt, Christopher J; Marcus, Benjamin

2017-01-01

The market for nonsurgical, energy-based facial rejuvenation techniques has increased exponentially since lasers were first used for skin rejuvenation in 1983. Advances in this area have led to a wide range of products that require the modern facial plastic surgeon to have a large repertoire of knowledge. To serve as a guide for current trends in the development of technology, applications, and outcomes of laser and laser-related technology over the past 5 years. We performed a review of PubMed from January 1, 2011, to March 1, 2016, and focused on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines including case control, case studies and case reports when necessary, and included 14 articles we deemed landmark articles before 2011. Three broad categories of technology are leading non-energy-based rejuvenation technology: lasers, light therapy, and non-laser-based thermal tightening devices. Laser light therapy has continued to diversify with the use of ablative and nonablative resurfacing technologies, fractionated lasers, and their combined use. Light therapy has developed for use in combination with other technologies or stand alone. Finally, thermally based nonlaser skin-tightening devices, such as radiofrequency (RF) and intense focused ultrasonography (IFUS), are evolving technologies that have changed rapidly over the past 5 years. Improvements in safety and efficacy for energy-based treatment have expanded the patient base considering these therapies viable options. With a wide variety of options, the modern facial plastic surgeon can have a frank discussion with the patient regarding nonsurgical techniques that were never before available. Many of these patients can now derive benefit from treatments requiring significantly less downtime than before while the clinician can augment the treatment to maximize benefit to fit the patient's time schedule.

What Predicts Patients' Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship.

Science.gov (United States)

Roettl, Johanna; Bidmon, Sonja; Terlutter, Ralf

2016-02-04

Substantial research has focused on patients' health information-seeking behavior on the Internet, but little is known about the variables that may predict patients' willingness to undergo online treatment and willingness to pay additionally for online treatment. This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Exploratory factor analyses revealed that the disposition of patients' personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, Pcommunication with the GP (B=.198, Pmotive (B=.178, P=.002) were significant predictors. Age, gender, satisfaction with the GP, social motive, and trust in the GP had no significant impact on the willingness to pay additionally for online treatment, but it was predicted by health-related information-seeking personality (B=.127, P=.07), PU (B=-.098, P=.09), willingness to undergo online

Bulimia nervosa in adolescents: prevalence and treatment challenges

Directory of Open Access Journals (Sweden)

Hail L

2018-01-01

Full Text Available Lisa Hail, Daniel Le Grange Department of Psychiatry, University of California, San Francisco, CA, USA Abstract: Bulimia nervosa (BN is a serious psychiatric illness that typically develops during adolescence or young adulthood, rendering adolescents a target for early intervention. Despite the increasing research devoted to the treatment of youth with anorexia nervosa (AN and adults with BN, there remains a dearth of evidence for treating younger individuals with BN. To date, there have been four published randomized controlled trials comparing psychosocial treatments, leaving significant room to improve treatment outcomes. Family-based treatment is the leading treatment for youth with AN, while cognitive-behavioral therapy is the leading intervention for adults with BN. Involving caregivers in treatment shows promising results, however, additional research is needed to investigate ways in which this treatment can be adapted further to achieve higher rates of recovery. Keywords: eating disorders, youth, family-based treatment, cognitive behavioral therapy, psychodynamic therapy, psychopharmacological treatment, evidence based treatment

Cloud-Based Automated Design and Additive Manufacturing: A Usage Data-Enabled Paradigm Shift.

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Lehmhus, Dirk; Wuest, Thorsten; Wellsandt, Stefan; Bosse, Stefan; Kaihara, Toshiya; Thoben, Klaus-Dieter; Busse, Matthias

2015-12-19

Integration of sensors into various kinds of products and machines provides access to in-depth usage information as basis for product optimization. Presently, this large potential for more user-friendly and efficient products is not being realized because (a) sensor integration and thus usage information is not available on a large scale and (b) product optimization requires considerable efforts in terms of manpower and adaptation of production equipment. However, with the advent of cloud-based services and highly flexible additive manufacturing techniques, these obstacles are currently crumbling away at rapid pace. The present study explores the state of the art in gathering and evaluating product usage and life cycle data, additive manufacturing and sensor integration, automated design and cloud-based services in manufacturing. By joining and extrapolating development trends in these areas, it delimits the foundations of a manufacturing concept that will allow continuous and economically viable product optimization on a general, user group or individual user level. This projection is checked against three different application scenarios, each of which stresses different aspects of the underlying holistic concept. The following discussion identifies critical issues and research needs by adopting the relevant stakeholder perspectives.

Cloud-Based Automated Design and Additive Manufacturing: A Usage Data-Enabled Paradigm Shift

Science.gov (United States)

Lehmhus, Dirk; Wuest, Thorsten; Wellsandt, Stefan; Bosse, Stefan; Kaihara, Toshiya; Thoben, Klaus-Dieter; Busse, Matthias

2015-01-01

Integration of sensors into various kinds of products and machines provides access to in-depth usage information as basis for product optimization. Presently, this large potential for more user-friendly and efficient products is not being realized because (a) sensor integration and thus usage information is not available on a large scale and (b) product optimization requires considerable efforts in terms of manpower and adaptation of production equipment. However, with the advent of cloud-based services and highly flexible additive manufacturing techniques, these obstacles are currently crumbling away at rapid pace. The present study explores the state of the art in gathering and evaluating product usage and life cycle data, additive manufacturing and sensor integration, automated design and cloud-based services in manufacturing. By joining and extrapolating development trends in these areas, it delimits the foundations of a manufacturing concept that will allow continuous and economically viable product optimization on a general, user group or individual user level. This projection is checked against three different application scenarios, each of which stresses different aspects of the underlying holistic concept. The following discussion identifies critical issues and research needs by adopting the relevant stakeholder perspectives. PMID:26703606

Preparation and Tribological Properties of Dual-Coated TiO2 Nanoparticles as Water-Based Lubricant Additives

Directory of Open Access Journals (Sweden)

Yue Gu

2014-01-01

Full Text Available Titanium dioxide nanoparticles (TiO2 were synthesized and then dual-coated with silane coupling agent (KH-570 and OP-10 in sequence in order to be dispersed stably in water as lubricant additives. The tribological properties and the application performance in Q235 steel machining of the nanoparticles as water-based lubricant additives were investigated on an MSR-10D four-ball tribotester and on a bench drilling machine, respectively. Scanning electron microscope (SEM and atomic force microscope (AFM were used to analyze the worn surface. The results show that the surface-modified TiO2 nanoparticles can remarkably improve the load-carrying capacity, the friction reducing, and anti wear abilities of pure water. The wear scar diameter and the coefficient of friction of the water-based lubricating fluids with TiO2 nanoparticles decreased, and the thick deep furrows on the surface of wear scar also decreased obviously with the increase of TiO2 concentration. The power consumption in drilling process was lower and the cutting surface was smoother using the water-based lubricating fluids added TiO2 nanoparticles compared to the fluid without addition. The reason for nanoparticles improving tribological properties of water based lubricating fluid might be the formation of a dynamic deposition film during rubbing process according to analysis of the worn surface.

Selenium Adsorption To Aluminum-Based Water Treatment Residuals

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Aluminum-based water treatment residuals (WTR) can adsorb water-and soil-borne P, As(V), As(III), and perchlorate, and may be able to adsorb excess environmental selenium. WTR, clay minerals, and amorphous aluminum hydroxide were shaken for 24 hours in selenate or selenite solut...

Wire-based laser metal deposition for additive manufacturing of TiAl6V4: basic investigations of microstructure and mechanical properties from build up parts

Science.gov (United States)

Klocke, Fritz; Arntz, Kristian; Klingbeil, Nils; Schulz, Martin

2017-02-01

The wire-based laser metal deposition (LMD-W) is a new technology which enables to produce complex parts made of titanium for the aerospace and automotive industry. For establishing the LMD-W as a new production process it has to be proven that the properties are comparable or superior to conventional produced parts. The mechanical properties were investigated by analysis of microstructure and tensile test. Therefore, specimens were generated using a 4.5 kW diode laser cladding system integrated in a 5-Axis-machining center. The structural mechanical properties are mainly influence by crystal structure and thereby the thermal history of the work piece. Especially the high affinity to oxide, distortion and dual phase microstructure make titanium grade 5 (TiAl6V4) one of the most challenging material for additive manufacturing. By using a proper local multi-nozzle shielding gas concept the negative influence of oxide in the process could be eliminated. The distortion being marginal at a single bead, accumulated to a macroscopic effect on the work piece. The third critical point for additive processing of titanium, the bimodal microstructure, could not be cleared by the laser process alone. All metallurgical probes showed α-martensitic-structure. Therefore, a thermal treatment became a necessary production step in the additive production chain. After the thermal treatment the microstructure as well as the distortion was analyzed and compared with the status before. Although not all technical issues could be solved, the investigation show that LMD-W of titanium grade 5 is a promising alternative to other additive techniques as electronic beam melting or plasma deposition welding.

Soil carbon mineralization following biochar addition associated with external nitrogen

Directory of Open Access Journals (Sweden)

Rudong Zhao

2015-12-01

Full Text Available Biochar has been attracting increasing attention for its potentials of C sequestration and soil amendment. This study aimed to understand the effects of combining biochar with additional external N on soil C mineralization. A typical red soil (Plinthudults was treated with two biochars made from two types of plantation-tree trunks (soil-biochar treatments, and was also treated with external N (soil-biochar-N treatments. All treatments were incubated for 42 d. The CO2-C released from the treatments was detected periodically. After the incubation, soil properties such as pH, microbial biomass C (MBC, and microbial biomass N (MBN were measured. The addition of biochar with external N increased the soil pH (4.31-4.33 compared to the soil treated with external N only (4.21. This was not observed in the comparison of soil-biochar treatments (4.75-4.80 to soil only (4.74. Biochar additions (whether or not they were associated with external N increased soil MBC and MBN, but decreased CO2-C value per unit total C (added biochar C + soil C according to the model fitting. The total CO2-C released in soil-biochar treatments were enhanced compared to soil only (i.e., 3.15 vs. 2.57 mg and 3.23 vs. 2.45 mg, which was attributed to the labile C fractions in the biochars and through soil microorganism enhancement. However, there were few changes in soil C mineralization in soil-biochar-N treatments. Additionally, the potentially available C per unit total C in soil-biochar-N treatments was lower than that observed in the soil-biochar treatments. Therefore, we believe in the short term, that C mineralization in the soil can be enhanced by biochar addition, but not by adding external N concomitantly.

Inverting the diastereoselectivity of the mukaiyama-michael addition with graphite-based catalysts

KAUST Repository

Acocella, Maria Rosaria

2014-02-07

Here, we show that graphite-based catalysts, mainly graphite oxide (GO) and exfoliated GO, are effective recyclable catalysts for a relevant stereoselective Mukaiyama-Michael addition, outperforming currently available catalysts. Moreover, the graphite-based catalysts described here invert the diastereoselectivity relative to that observed with known catalysts, with the unprecedented large prevalence of the anti diastereoisomer. This inverted diastereoselectivity is increased when the catalyst concentration is reduced and after catalyst recycling. Density functional theory calculations suggest that the selectivity is determined by two types of supramolecular interactions operating between the catalyst and the substrates at the diastereoselectivity- determining transition state, specifically, the π-stacking of b-nitrostyrene with graphite and the van der Waals interaction between the SiMe3 group of the silyl ether and the graphite. © 2013 American Chemical Society.

The effectiveness and feasibility of videoconferencing technology to provide evidence-based treatment to rural domestic violence and sexual assault populations.

Science.gov (United States)

Hassija, Christina; Gray, Matt J

2011-05-01

Although evidence-based treatments for post-traumatic stress disorder (PTSD) have been available for some time, many treatment-seeking trauma survivors are unable to access such services. This is especially the case in remote and rural areas where access to specialists is an exception rather than a rule. Advances in videoconferencing-based technologies are improving rural residents' access to specialized psychological services. However, at present, little is known about the viability and efficacy of providing psychological interventions via distal technologies to individuals who present at rural domestic violence and rape crisis centers. The present study attempts to partially address this void by evaluating, in the context of an uncontrolled trial, the effectiveness and feasibility of providing evidence-based, trauma-focused treatment via videoconferencing to rural survivors of domestic violence and sexual assault. Participants in the present study were clients referred to the Wyoming Trauma Telehealth Treatment Clinic (WTTTC) for psychological services via videoconferencing from distal domestic violence and rape crisis centers located in the state of Wyoming. Fifteen female victims of assaultive violence who received at least four sessions of trauma-focused treatment via videoconferencing-based technology at distal rape and domestic violence crisis centers were included in the present study. Participants completed measures of PTSD and depression symptom severity and client satisfaction. Participants evidenced large reductions on measures of PTSD (d = 1.17) and depression (d = 1.24) symptom severity following treatment via videoconferencing. Additionally, participants reported a high degree of satisfaction with videoconferencing-administered services. Results provide evidence in support of videoconferencing as an effective means to provide psychological services to rural domestic violence and sexual assault populations. Clinical implications and avenues

Network Physics - the only company to provide physics-based network management - secures additional funding and new executives

CERN Multimedia

2003-01-01

"Network Physics, the only provider of physics-based network management products, today announced an additional venture round of $6 million in funding, as well as the addition of David Jones as president and CEO and Tom Dunn as vice president of sales and business development" (1 page).

Advances in the psychosocial treatment of addiction: the role of technology in the delivery of evidence-based psychosocial treatment.

Science.gov (United States)

Marsch, Lisa A; Dallery, Jesse

2012-06-01

The clinical community has a growing array of psychosocial interventions with a strong evidence base available for the treatment of SUDs. Considerable opportunity exists for leveraging technology in the delivery of evidence-based interventions to promote widespread reach and impact of evidence-based care. Data from this line of research to date are promising, and underscore the potential public health impact of technology-based therapeutic tools. To fully realize the potential of technology-delivered interventions, several areas of inquiry remain important. First, scientifically sound strategies should be explored to ensure technology-based interventions are optimally designed to produce maximal behavior change. Second, efficient and effective methods should be identified to integrate technology-based interventions into systems of care in a manner that is most responsive to the needs of individual users. Third, payment, privacy, and regulatory systems should be refined and extended to go beyond electronic medical records and telehealth/distance care models, and support the deployment of technology-based systems to enhance the quality, efficiency and cost-effectiveness of care. Fourth, the mechanisms underlying behavior change derived from technology-based treatments should be explicated, including new mechanisms that may be tapped via novel, technology-based tools. Such work will be critical in isolating mechanisms that are useful in predicting treatment response, and in ensuring that key ingredients are present in technology-based interventions as they are made widely available.

Use of medicinal plants as the additional therapy of viral hepatitis

Directory of Open Access Journals (Sweden)

I.B. Ershova

2017-04-01

Full Text Available Dear colleagues, continuing the rubric of the journal about the treatment of infectious diseases by medicinal plants, we want to present the methods of using medicinal plants as an additional therapy for treatment of viral hepatitis in addition to the main treatment according to the generally clinical standards of antiviral therapy. Viral hepatitis compiles a large group of human infectious diseases characterized by a predominant liver damage. “Currently, viral hepatitis is recognized as a major public health problem requiring urgent action”, said Dr Margaret Chan, WHO Director-General (WHO Global hepatitis report, 2017. Treatment of viral hepatitis is a complex task and involves the use of generally clinical recommendations or standards. There are criteria for determining the need for pharmacotherapy and the most rational scheme for antiviral treatment in every case of viral hepatitis. The purpose of antiviral therapy is to achieve a stable virologic response, to prevent the progression of the disease, the development of cirrhosis and hepatocellular carcinoma. However, at the present stage a stable virologic response in the general population of patients can be achieved in approximately 60 % of cases. In addition, standard antiviral drugs have side effects, are of high cost and are contraindicated in a number of clinical situations, for example, with a decrease in the number of blood elements (thrombocytopenia, leukopenia, anemia, at the stage of decompensated liver cirrhosis. Probably, all this induces to use alternative methods of therapy, which remain popular both among general practitioners and patients with this infection. The question of the treatment of viral hepatitis with medicinal herbs has been studied for a long time. According to some authors, there is no scientific evidence that hepatitis C can be cured by herbs. The only scientifically proven method of fighting the virus is antiviral therapy. However, there are other points

Exploration of the viscosity temperature dependences and microstructure of magnesium-based commercial alloy AZ91D with small additions of calcium

International Nuclear Information System (INIS)

Abaturov, I S; Popel, P S; Brodova, I G; Astafiev, V V; Li Peijie

2008-01-01

The technique of rotating oscillation damping of a crucible filled in with the melt under investigation was used for measurement of viscosity of the Mg-based AZ91D commercial alloy with various additions of calcium. The viscosity was measured in liquid state in temperature interval from 600 up to 840 deg. C. The comparative metallographic investigation of the structure of samples with calcium content of 0.0, 0.4, 0.6 and 0.8 wt.% which were crystallized just after re-melting at the temperature of 640 deg. C and after heating in liquid state up to 850 deg. C were made. It was shown that the thermal treatment of samples in liquid state is accompanied by considerable changes in the cast structure that forms after the crystallization of the samples

Molecular and Serological Assessment of Chronic HBV Carriers and Additional Burden of Applying Updated Guidelines in Pakistan

International Nuclear Information System (INIS)

Hussain, A. B.; Ghani, E.; Rathore, M. A.; Khan, F. A.; Ali, N.

2014-01-01

Objective: To assess the additional burden of the patients eligible for treatment, based on recommendations on viral load, in the light of 2009 version of AASLD guidelines, as compared to 2004 guidelines and to determine the frequency of HBeAg in chronic HBV carriers. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Virology Department, Armed Forces Institute of Pathology, Rawalpindi, from November 2010 to January 2012. Methodology: Persons with chronic HBV infection, reporting for HBV DNA PCR test, were included in the study and blood samples were collected. HBV DNA load was determined by Real Time PCR. HBsAg and HBeAg were tested by ELISA. Results: Out of the 801 subjects positive for HBsAg, 74 (9.24%) were positive for HBeAg. Out of them, 113 (14.1%) had HBV DNA load > 100,000 copies/ml and were eligible for treatment according to AASLD 2004 guidelines. Forty one (5.1%) had HBV load between 10,000 and 100,000 copies/ml, and were additionally eligible for treatment as per AASLD 2009 guidelines. The 5.1% of 4.5 million estimated HBV carries in Pakistan comes to 229500. Conclusion: There was a low HBeAg positivity and HBV DNA positivity in our chronic HBV infected persons. Moreover, there is an increase of 229500 potential candidates for HBV treatment in Pakistan based on viral load testing, according to the AASLD 2009 guidelines when compared with 2004 guidelines. The increase in the number of candidates for treatment may require an additional expenditure of tens of billions of rupees. (author)

Impacts of recessed gate and fluoride-based plasma treatment approaches toward normally-off AlGaN/GaN HEMT.

Science.gov (United States)

Heo, Jun-Woo; Kim, Young-Jin; Kim, Hyun-Seok

2014-12-01

We report two approaches to fabricating high performance normally-off AIGaN/GaN high-electron mobility transistors (HEMTs). The fabrication techniques employed were based on recessed-metal-insulator-semiconductor (MIS) gate and recessed fluoride-based plasma treatment. They were selectively applied to the area under the gate electrode to deplete the two-dimensional electron gas (2-DEG) density. We found that the recessed gate structure was effective in shifting the threshold voltage by controlling the etching depth of gate region to reduce the AIGaN layer thickness to less than 8 nm. Likewise, the CF4 plasma treatment effectively incorporated negatively charged fluorine ions into the thin AIGaN barrier so that the threshold voltage shifted to higher positive values. In addition to the increased threshold voltage, experimental results showed a maximum drain current and a maximum transconductance of 315 mA/mm and 100 mS/mm, respectively, for the recessed-MIS gate HEMT, and 340 mA/mm and 330 mS/mm, respectively, for the fluoride-based plasma treated HEMT.

The production of paper soaps from coconut oil and Virgin Coconut Oil (VCO) with the addition of glycerine as plasticizer

Science.gov (United States)

Widyasanti, Asri; Miracle Lenyta Ginting, Anastasia; Asyifani, Elgina; Nurjanah, Sarifah

2018-03-01

Hand washing with soap is important because it is proven to clean hands from germs and bacteria. The paper soapswere made from coconut oil and virgin coconut oil (VCO) with the addition of glycerin as a plasticizer. The aims of this research were to determine both formulation of paper soap using coconut oil and VCO based with addition of glycerin, and to determine the quality of the paper soapswhich is a disposable hand soap. This research used laboratory experimental method using descriptive analysis. The treatments of this research were treatment A (paper soap without the addition of glycerin), treatment B (paper soap with the addition of glycerin 10% (w/w)), treatment C (paper soap with the addition of glycerin 15% (w/w)), treatment D (paper soap with the addition of glycerin of 20% (w/w)). Parameters tested were moisture content, stability of foam, pH value, insoluble material in ethanol, free alkali content, unsaponified fat, antibacterial activity test, and organoleptic test. The result of physicochemical characteristics for bothcoconut oil-paper soap and VCO-paper soap revealed that treatment C (the addition of glycerin 15% (w/w) was the best soap formulation. Coconut Oil papersoap 15% w/w glicerin had water content 13.72%, the content of insoluble material in ethanol 3.93%, the content of free alkali 0.21%, and the content of unsaponified fat 4.06%, pH value 10.78, stability of foam 97.77%, and antibacterial activity against S. aureus 11.66 mm. Meanwhile, VCO paper soap 15% w/w glicerin had the value of water content of 18.47%, the value stability of foam of 96.7%, the pH value of 10.03, the value of insoluble material in ethanol of 3.49%, the value of free alkali content 0.17%, the value of unsaponified fat 4.91%, and the value of inhibition diameter on the antibacterial activity test 15.28 mm. Based on Mandatory Indonesian National Standard of solid soap SNI 3532:2016 showed that both of paper soap had not been accorded with SNI 3532:2016, unless the

Sewage sludge additive

Science.gov (United States)

Kalvinskas, J. J.; Mueller, W. A.; Ingham, J. D. (Inventor)

1980-01-01

The additive is for a raw sewage treatment process of the type where settling tanks are used for the purpose of permitting the suspended matter in the raw sewage to be settled as well as to permit adsorption of the dissolved contaminants in the water of the sewage. The sludge, which settles down to the bottom of the settling tank is extracted, pyrolyzed and activated to form activated carbon and ash which is mixed with the sewage prior to its introduction into the settling tank. The sludge does not provide all of the activated carbon and ash required for adequate treatment of the raw sewage. It is necessary to add carbon to the process and instead of expensive commercial carbon, coal is used to provide the carbon supplement.

Measurement of fracture toughness of metallic materials produced by additive manufacturing

Science.gov (United States)

Quénard, O.; Dorival, O.; Guy, Ph.; Votié, A.; Brethome, K.

2018-04-01

This study focuses on the microstructure and mechanical properties of metallic materials produced by additive layer manufacturing (ALM), especially the laser beam melting process. The influence of the specimen orientation during the ALM process and that of two post-build thermal treatments were investigated. The identified metal powder is Ti-6Al-4V (titanium base). Metallographic analysis shows their effects on the microstructure of the metals. Mechanical experiments involving tensile tests as well as toughness tests were performed according to ASTM (American Society for Testing and Materials) norms. The results show that the main influence is that of the thermal treatments; however the manufacturing stacking direction may lead to some anisotropy in the mechanical properties.

Microstructure and corrosion resistance of Ni-based alloy laser coatings with nanosize CeO2 addition

Science.gov (United States)

Zhang, Shi Hong; Li, Ming Xi; Yoon, Jae Hong; Cho, Tong Yul; Zhu He, Yi; Lee, Chan Gyu

2008-07-01

Micron-size Ni-base alloy (NBA) powders were mixed with both 1.5 wt.% (hereinafter %) micron-size CeO2 (m-CeO2) and also 1.5% and 3.0% nano-size CeO2 (n- CeO2) powders. These mixtures were coated on low-carbon steel (Q235) by 2.0 kW CO2 laser cladding. The effects on the microstructures, phases and electrochemical corrosion of the coatings upon the addition of m- and n- CeO2 powders to NBA (m- and n- CeO2 /NBA) have been investigated. The results showed that a smooth coating was prepared under suitable processing parameters (P= 2.0 kW, V= 180 mm min- 1) by adding 1.5% n- CeO2. In addition to the primary phases of γ-Ni, Cr23 C6 and Ni3 B in the Ni-base alloy coating, CeNi3 was formed in Ni-base alloy coatings with both n- CeO2 and m-CeO2 particles, and CeNi5 appeared in the coating upon decreasing the size of CeO2 particles. Well-developed dendrites were observed in the Ni-base alloy coating; directional dendrites grew at the interface in the coating upon the addition of m-CeO2, whereas fine and multioriented dendrites grew upon decreasing the size of CeO2 particles to the nanoscale. Actinomorphic dendrites and compact equiaxed dendrites grew from the interface to near the surface upon increasing the content of n- CeO2 from 1.5 to 3.0%. In strongly acidic HNO3 solution, the severe corrosion of dendrites occurred and there were many corrosion pits in the Ni-base alloy coating; intercrystalline corrosion also has a dominant role upon the addition of m-CeO2, whereas uniform corrosion occurs in the coating as the size of CeO2 particles is decreased to nanoscale.

Microstructure and corrosion resistance of Ni-based alloy laser coatings with nanosize CeO2 addition

Directory of Open Access Journals (Sweden)

Shi Hong Zhang et al

2008-01-01

Full Text Available Micron-size Ni-base alloy (NBA powders were mixed with both 1.5 wt.% (hereinafter % micron-size CeO2 (m-CeO2 and also 1.5% and 3.0% nano-size CeO2 (n- CeO2 powders. These mixtures were coated on low-carbon steel (Q235 by 2.0 kW CO2 laser cladding. The effects on the microstructures, phases and electrochemical corrosion of the coatings upon the addition of m- and n- CeO2 powders to NBA (m- and n- CeO2 /NBA have been investigated. The results showed that a smooth coating was prepared under suitable processing parameters (P= 2.0 kW, V= 180 mm min- 1 by adding 1.5% n- CeO2. In addition to the primary phases of γ-Ni, Cr23 C6 and Ni3 B in the Ni-base alloy coating, CeNi3 was formed in Ni-base alloy coatings with both n- CeO2 and m-CeO2 particles, and CeNi5 appeared in the coating upon decreasing the size of CeO2 particles. Well-developed dendrites were observed in the Ni-base alloy coating; directional dendrites grew at the interface in the coating upon the addition of m-CeO2, whereas fine and multioriented dendrites grew upon decreasing the size of CeO2 particles to the nanoscale. Actinomorphic dendrites and compact equiaxed dendrites grew from the interface to near the surface upon increasing the content of n- CeO2 from 1.5 to 3.0%. In strongly acidic HNO3 solution, the severe corrosion of dendrites occurred and there were many corrosion pits in the Ni-base alloy coating; intercrystalline corrosion also has a dominant role upon the addition of m-CeO2, whereas uniform corrosion occurs in the coating as the size of CeO2 particles is decreased to nanoscale.

PHI-base: a new interface and further additions for the multi-species pathogen–host interactions database

Science.gov (United States)

Urban, Martin; Cuzick, Alayne; Rutherford, Kim; Irvine, Alistair; Pedro, Helder; Pant, Rashmi; Sadanadan, Vidyendra; Khamari, Lokanath; Billal, Santoshkumar; Mohanty, Sagar; Hammond-Kosack, Kim E.

2017-01-01

The pathogen–host interactions database (PHI-base) is available at www.phi-base.org. PHI-base contains expertly curated molecular and biological information on genes proven to affect the outcome of pathogen–host interactions reported in peer reviewed research articles. In addition, literature that indicates specific gene alterations that did not affect the disease interaction phenotype are curated to provide complete datasets for comparative purposes. Viruses are not included. Here we describe a revised PHI-base Version 4 data platform with improved search, filtering and extended data display functions. A PHIB-BLAST search function is provided and a link to PHI-Canto, a tool for authors to directly curate their own published data into PHI-base. The new release of PHI-base Version 4.2 (October 2016) has an increased data content containing information from 2219 manually curated references. The data provide information on 4460 genes from 264 pathogens tested on 176 hosts in 8046 interactions. Prokaryotic and eukaryotic pathogens are represented in almost equal numbers. Host species belong ∼70% to plants and 30% to other species of medical and/or environmental importance. Additional data types included into PHI-base 4 are the direct targets of pathogen effector proteins in experimental and natural host organisms. The curation problems encountered and the future directions of the PHI-base project are briefly discussed. PMID:27915230

[Effects of superphosphate addition on NH3 and greenhouse gas emissions during vegetable waste composting].

Science.gov (United States)

Yang, Yan; Sun, Qin-ping; Li, Ni; Liu, Chun-sheng; Li, Ji-jin; Liu, Ben-sheng; Zou, Guo-yuan

2015-01-01

To study the effects of superphosphate (SP) on the NH, and greenhouse gas emissions, vegetable waste composting was performed for 27 days using 6 different treatments. In addition to the controls, five vegetable waste mixtures (0.77 m3 each) were treated with different amounts of the SP additive, namely, 5%, 10%, 15%, 20% and 25%. The ammonia volatilization loss and greenhouse gas emissions were measured during composting. Results indicated that the SP additive significantly decreased the ammonia volatilization and greenhouse gas emissions during vegetable waste composting. The additive reduced the total NH3 emission by 4.0% to 16.7%. The total greenhouse gas emissions (CO2-eq) of all treatments with SP additives were decreased by 10.2% to 20.8%, as compared with the controls. The NH3 emission during vegetable waste composting had the highest contribution to the greenhouse effect caused by the four different gases. The amount of NH3 (CO2-eq) from each treatment ranged from 59.90 kg . t-1 to 81.58 kg . t-1; NH3(CO2-eq) accounted for 69% to 77% of the total emissions from the four gases. Therefore, SP is a cost-effective phosphorus-based fertilizer that can be used as an additive during vegetable waste composting to reduce the NH3 and greenhouse gas emissions as well as to improve the value of compost as a fertilizer.

Manualized Family-Based Treatment for Anorexia Nervosa: A Case Series.

Science.gov (United States)

Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.

2005-01-01

Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…

Dendritic microstructure and hot cracking of laser additive manufactured Inconel 718 under improved base cooling

Energy Technology Data Exchange (ETDEWEB)

Chen, Yuan; Lu, Fenggui; Zhang, Ke; Nie, Pulin; Elmi Hosseini, Seyed Reza; Feng, Kai, E-mail: fengkai@sjtu.edu.cn; Li, Zhuguo, E-mail: lizg@sjtu.edu.cn

2016-06-15

The base cooling effect was improved by imposing the continuous water flow on the back of the substrate during the laser additive manufacturing of Inconel 718 (IN718). The dendritic microstructure, crystal orientation and hot cracking behavior were studied by using optical microscopy (OM), scanning electron microscopy (SEM) and electron backscatter diffraction (EBSD) techniques. The results showed that the crystal orientation was increased by increasing the base cooling effect during the deposition. Also, highly ordered columnar dendrites were established, and mono-crystalline texture was constructed in the final clad. It was fund that the effect of solidification cracking on the properties of final clad was negligible since it was only generated at the top region of the deposit, while liquation cracking was produced and remained in the heat affected zone (HAZ) and needed to be carefully controlled. The susceptibility to the liquation cracking showed a high dependence on the grain boundary misorientation, which was considered to be attributed to the stability of interdendritic liquation films, as well as the magnitude of local stress concentration in the last stage of solidification. - Highlights: • The base cooling effect was increased during laser additive manufacturing. • Highly ordered dendrites were established under improved base cooling. • The crystal orientation was increased by improving the base cooling effect. • Liquation cracking tendency was reduced due to the increase of base cooling. • Liquation cracking increased with the increase of grain boundary misorientation.

Dendritic microstructure and hot cracking of laser additive manufactured Inconel 718 under improved base cooling

International Nuclear Information System (INIS)

Chen, Yuan; Lu, Fenggui; Zhang, Ke; Nie, Pulin; Elmi Hosseini, Seyed Reza; Feng, Kai; Li, Zhuguo

2016-01-01

The base cooling effect was improved by imposing the continuous water flow on the back of the substrate during the laser additive manufacturing of Inconel 718 (IN718). The dendritic microstructure, crystal orientation and hot cracking behavior were studied by using optical microscopy (OM), scanning electron microscopy (SEM) and electron backscatter diffraction (EBSD) techniques. The results showed that the crystal orientation was increased by increasing the base cooling effect during the deposition. Also, highly ordered columnar dendrites were established, and mono-crystalline texture was constructed in the final clad. It was fund that the effect of solidification cracking on the properties of final clad was negligible since it was only generated at the top region of the deposit, while liquation cracking was produced and remained in the heat affected zone (HAZ) and needed to be carefully controlled. The susceptibility to the liquation cracking showed a high dependence on the grain boundary misorientation, which was considered to be attributed to the stability of interdendritic liquation films, as well as the magnitude of local stress concentration in the last stage of solidification. - Highlights: • The base cooling effect was increased during laser additive manufacturing. • Highly ordered dendrites were established under improved base cooling. • The crystal orientation was increased by improving the base cooling effect. • Liquation cracking tendency was reduced due to the increase of base cooling. • Liquation cracking increased with the increase of grain boundary misorientation.

Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

Directory of Open Access Journals (Sweden)

Alicia K. Matthews

2013-01-01

Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

Effectiveness of a Barge-Based Ballast Water Treatment System for Multi-Terminal Ports

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Lovro Maglić

2015-10-01

Full Text Available The paper presents outcomes of the discrete event simulation of the ballast water management in a multi-terminal port. The simulation includes ship’s manoeuvring, cargo and ballast operations and a barge-based ballast water treatment system operating within all terminal areas. The barge-based ballast water treatment system is used by ships unable to use their own equipment, not equipped with an appropriate ballast treatment system or non-compliant with the Ballast Water Management (BWM Convention 2004 for whatever reason. The main goal is to estimate the productivity and cost effectiveness of such systems as an option to support ships not able to comply with the BWM Convention, once it enters into force. The model was built and tested in Arena simulation software. Process parameters are based on real traffic data for the port of Rijeka. The results indicate that barge-based ballast treatment facility will be heavily underutilized, and that such systems are cost-effective only in ports where large volumes of ballast water need to be delivered to shore treatment systems.

Evaluation of Water Quality Renovation by Advanced Soil-Based Wastewater Treatment Systems

Science.gov (United States)

Cooper, J.; Loomis, G.; Kalen, D.; Boving, T.; Morales, I.; DeLuca, J.; Amador, J.

2013-12-01

25% of US households utilize onsite wastewater treatment systems (OWTS) for wastewater management. Advanced technologies were designed to overcome the inadequate wastewater treatment by conventional OWTS in critical shallow water table areas, such as coastal zones, in order to protect ground water quality. In addition to the septic tank and soil drainfield that comprise a conventional OWTS, advanced systems claim improved water renovation with the addition of sand filtration, timed dosing controls, and shallow placement of the infiltrative zone. We determined water quality renovation functions under current water table and temperature conditions, in anticipation of an experiment to measure OWTS response to a climate change scenario of 30-cm increase in water table elevation and 4C temperature increase. Replicate (n=3) intact soil mesocosms were used to evaluate the effectiveness of drainfields with a conventional wastewater delivery (pipe-and-stone) compared to two types of pressurized, shallow narrow drainfield. Results under steady state conditions indicate complete removal of fecal coliform bacteria, phosphorus and BOD by all soil-based systems. By contrast, removal of total nitrogen inputs was 16% in conventional and 11% for both advanced drainfields. Effluent waters maintained a steady state pH between 3.2 - 3.7 for all technologies. Average DO readings were 2.9mg/L for conventional drainfield effluent and 4.6mg/L for advanced, showing the expected oxygen uptake with shallow placement of the infiltrative zone. The conventional OWTS is outperforming the advanced with respect to nitrogen removal, but renovating wastewater equivalently for all other contaminants of concern. The results of this study are expected to facilitate development of future OWTS regulation and planning guidelines, particularly in coastal zones and in the face of a changing climate.

An additional simple denitrification bioreactor using packed gel envelopes applicable to industrial wastewater treatment.

Science.gov (United States)

Morita, Masahiko; Uemoto, Hiroaki; Watanabe, Atsushi

2007-08-15

A simple denitrification bioreactor for nitrate-containing wastewater without organic compounds was developed. This bioreactor consisted of packed gel envelopes in a single tank. Each envelope comprised two plates of gels containing Paracoccus denitrificans cells with an internal space between the plates. As an electron donor for denitrification, ethanol was injected into the internal space and not directly into the wastewater. P. denitrificans cells in the gel reduced nitrate to nitrogen gas by using the injected ethanol. Nitrate-containing desulfurization wastewater derived from a coal-fired thermal power plant was continuously treated with 20 packed gel envelopes (size, 1,000 x 900 x 12 mm; surface area, 1.44 m(2)) in a reactor tank (volume 1.5 m(3)). When the total nitrogen concentration in the inflow was around 150 mg-N x L(-1), the envelopes removed approximately 60-80% of the total nitrogen, and the maximum nitrogen removal rate was 5.0 g-N x day(-1) per square meter of the gel surface. This value corresponded to the volumetric nitrogen removal performance of 0.109 kg-N x m(-3) x day(-1). In each envelope, a high utilization efficiency of the electron donor was attained, although more than the double amount of the electron donor was empirically injected in the present activated sludge system to achieve denitrification when compared with the theoretical value. The bioreactor using the envelopes would be extremely effective as an additional denitrification system because these envelopes can be easily installed in the vacant spaces of preinstalled water treatment systems, without requiring additional facilities for removing surplus ethanol and sludge. (c) 2007 Wiley Periodicals, Inc.

Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer.

Directory of Open Access Journals (Sweden)

Malek B Hannouf

Full Text Available To assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC from the perspective of the Canadian public healthcare system.We developed a Markov state transition model to project the lifetime clinical and economic consequences of recurrent or metastatic HNSCC. Transition probabilities were derived from a phase III trial of cetuximab in patients with recurrent or metastatic HNSCC. Cost estimates were obtained from London Health Sciences Centre and the Ontario Case Costing Initiative, and expressed in 2011 CAD. A three year time horizon was used. Future costs and health benefits were discounted at 5%.In the base case, cetuximab plus platinum-based chemotherapy compared to platinum-based chemotherapy alone led to an increase of 0.093 QALY and an increase in cost of $36,000 per person, resulting in an incremental cost effectiveness ratio (ICER of $386,000 per QALY gained. The cost effectiveness ratio was most sensitive to the cost per mg of cetuximab and the absolute risk of progression among patients receiving cetuximab.The addition of cetuximab to standard platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic HNSCC has an ICER that exceeds $100,000 per QALY gained. Cetuximab can only be economically attractive in this patient population if the cost of cetuximab is substantially reduced or if future research can identify predictive markers to select patients most likely to benefit from the addition of cetuximab to chemotherapy.

A low molecular weight zinc2+-dipicolylamine-based probe detects apoptosis during tumour treatment better than an annexin V-based probe

International Nuclear Information System (INIS)

Palmowski, Karin; Rix, Anne; Lederle, Wiltrud; Kiessling, Fabian; Behrendt, Florian F.; Mottaghy, Felix M.; Gray, Brian D.; Pak, Koon Y.; Palmowski, Moritz

2014-01-01

Molecular imaging of apoptosis is frequently discussed for monitoring cancer therapies. Here, we compare the low molecular weight phosphatidylserine-targeting ligand zinc 2+ -dipicolylamine (Zn 2+ -DPA) with the established but reasonably larger protein annexin V. Molecular apoptosis imaging with the fluorescently labelled probes annexin V (750 nm, 36 kDa) and Zn 2+ -DPA (794 nm, 1.84 kDa) was performed in tumour-bearing mice (A431). Three animal groups were investigated: untreated controls and treated tumours after 1 or 4 days of anti-angiogenic therapy (SU11248). Additionally, μPET with 18 F-FDG was performed. Imaging data were displayed as tumour-to-muscle ratio (TMR) and validated by quantitative immunohistochemistry. Compared with untreated control tumours, TUNEL staining indicated significant apoptosis after 1 day (P 2+ -DPA uptake increased significantly after 1 day (P 2+ -DPA, 18 F-FDG tumour uptake decreased significantly at days 1 (P 2+ -DPA than with the annexin V-based probe. Additionally, significant treatment effects were detectable as early using Zn 2+ -DPA as with measurements of the glucose metabolism using 18 F-FDG. (orig.)

Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes : analysis of the ADDITION-UK cluster-randomized controlled trial

NARCIS (Netherlands)

Tao, L.; Wilson, E. C. F.; Wareham, N. J.; Sandbaek, A.; Rutten, G. E. H. M.; Lauritzen, T.; Khunti, K.; Davies, M. J.; Borch-Johnsen, K.; Griffin, S. J.; Simmons, R. K.

Aims To examine the short- and long-term cost-effectiveness of intensive multifactorial treatment compared with routine care among people with screen-detected Type 2 diabetes. Methods Cost-utility analysis in ADDITION-UK, a cluster-randomized controlled trial of early intensive treatment in people

Treatment Readiness as a Determinant of Treatment Participation in a Prison-Based Rehabilitation Program: An Exploratory Study.

Science.gov (United States)

Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul

2017-06-01

The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.