Sample records for monthly long-term discharges

  1. Long-term multipactor discharge in multicarrier systems

    International Nuclear Information System (INIS)

    Anza, S.; Vicente, C.; Gimeno, B.; Boria, V. E.; Armendariz, J.


    A new mechanism of long-term multipactor in multicarrier systems is studied employing both analytical and numerical methods. In particular, the investigation is focused on the impact that a realistic secondary emission yield at low energies produces on the development of long term multipactor. A novel analytical model for this interperiod charge accumulation is presented using the traditional multipactor theory for parallel plates, and approximating the multicarrier signal as a single-carrier signal modulated by a pulsed signal envelope. The analytical predictions are verified by numerical simulations for a typical rectangular waveguide. The analytical and numerical results demonstrate that the susceptibility of the system to develop a long-term multipactor discharge increases with higher values of low-energy secondary emission yield

  2. Autonomous long-term gamma-spectrometric monitoring of submarine groundwater discharge trends in Hawaii

    International Nuclear Information System (INIS)

    Dulai, Henrietta; Waters, Ch.A.; Kennedy, Joseph; Kamenik, Jan; Academy of Sciences of the Czech Republic, Rez; Babinec, James; Jolly, James; Williamson, Mario


    We developed a fully autonomous underwater gamma-spectrometer for long-term coastal submarine groundwater discharge (SGD) monitoring. The instrument represents a significant improvement over previous submarine gamma-spectrometers in that it is very robust, has high sensitivity allowing high temporal resolution, and is completely autonomous. Here we describe the technical parameters of the new instrument as well as data collected over its 9-month deployment in Kiholo Bay, HI, USA. We also present methods to convert the measured activities to SGD rates. In Kiholo Bay, the derived SGD matched previous estimates but in addition it revealed previously undocumented short- and long-term patterns in SGD. (author)

  3. Long-term memory for pitch in six-month-old infants. (United States)

    Plantinga, Judy; Trainor, Laurel J


    We examined 6-month-old infants' long-term memory representations for the pitch of familiar melodies. Infants remembered the relative pitch of the melodies, but the absolute pitch was either not remembered or not a particularly salient attribute.

  4. The long-term effect of listening to Mozart K.448 decreases epileptiform discharges in children with epilepsy. (United States)

    Lin, Lung-Chang; Lee, Wei-Te; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Mok, Hin-Kiu; Weng, Chia-Fen; Lee, Mei-wen; Yang, Rei-Cheng


    Mozart's Sonata for Two Pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart Effect. Our previous work revealed that epileptiform discharges in children with epilepsy decrease during and right after listening to Mozart K.448. However, the duration of the effect was not studied. In the study described here, we evaluated the long-term effect of Mozart K.448 on epileptiform discharges in children with epilepsy. Eighteen children with epilepsy whose seizures were clinically well controlled with antiepileptic drugs were included. For each child, EEGs had revealed persistent epileptiform discharges for at least 6 months. These patients listened to Mozart K.448 for 8 minutes once a day before bedtime for 6 months. Epileptiform discharges were recorded and compared before and after 1, 2, and 6 months of listening to Mozart K.448. All of the children remained on the same antiepileptic drug over the 6 months. Relationships between number of epileptiform discharges and foci of discharges, intelligence, epilepsy etiology, age, and gender were analyzed. Epileptiform discharges significantly decreased by 53.2±47.4, 64.4±47.1, and 71.6±45.8%, respectively, after listening to Mozart K.448 for 1, 2, and 6 months. All patients except those with occipital discharges showed a significant decrease in epileptiform discharges. Patients with normal intelligence and idiopathic epilepsy had greater decreases than those with mental retardation and symptomatic epilepsy. Age and gender did not affect the results. We conclude that long-term listening to Mozart K.448 may be effective in decreasing epileptiform discharges in children with epilepsy in a chronologically progressive manner. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Long-Term Memory for an Emotional Interpersonal Interaction Occurring at 5 Months of Age (United States)

    Bornstein, Marc H.; Arterberry, Martha E.; Mash, Clay


    We examined infants' long-term retention of a single unique emotional experience into early childhood. Twenty-month-olds who had participated in a still-face procedure at 5 months (experience group) fixated the face of the person who had instigated the still face significantly less than the faces of 2 other novel persons. Control 20-month-olds…

  6. Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Metaanalysis. (United States)

    Burton, Jennifer K; Ferguson, Eilidh E C; Barugh, Amanda J; Walesby, Katherine E; MacLullich, Alasdair M J; Shenkin, Susan D; Quinn, Terry J


    Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed. Acute and rehabilitation hospitals. Adults hospitalized for stroke who were newly admitted directly to long-term institutional care at the time of hospital discharge. Factors associated with new institutionalization. From 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long-term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long-term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long-term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long-term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined. Age and stroke severity are important predictors of institutional long-term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long-term care setting.

  7. Autonomous long-term gamma-spectrometric monitoring of submarine groundwater discharge trends in Hawaii

    Czech Academy of Sciences Publication Activity Database

    Dulai, H.; Kameník, Jan; Waters, C. A.; Kennedy, J.; Babinec, J.; Jolly, J.; Williamson, M.


    Roč. 307, č. 3 (2016), s. 1865-1870 ISSN 0236-5731. [10th International Conference on Methods and Applications of Radioanalytical Chemistry (MARC). Kailua Kona, 12.04.2015-17.04.2015] Institutional support: RVO:61389005 Keywords : submarine groundwater discharge * long-term SGD monitoring * underwater gammaspectrometry Subject RIV: CB - Analytical Chemistry, Separation Impact factor: 1.282, year: 2016

  8. Long-Term Memory for Context-Specific Category Information at Six Months. (United States)

    Shields, Pamela J.; Rovee-Collier, Carolyn


    The ability of six-month-old infants to remember a functional category acquired in a specific context was assessed in three experiments. Findings revealed that at six months, information about the place where categories are constructed is prerequisite for retrieval of a category concept from long-term memory. (GLR)

  9. Conditioning and Long-Term Memory in Three-Month-Old Infants with Down Syndrome. (United States)

    Ohr, Phyllis, S.; Fagen, Jeffrey W.


    This study of 20 3-month-old infants with Down's syndrome and 20 nondisabled infants found that both groups were successfully trained to produce movement in an overhead crib mobile by kicking, and displayed long-term retention a week later. Conditioning and retention-test performance of the two groups did not differ. (Author/JDD)

  10. Long-term memory, forgetting, and deferred imitation in 12-month-old infants


    Klein, Pamela J.; Meltzoff, Andrew N.


    Long-term recall memory, as indexed by deferred imitation, was assessed in 12-month-old infants. Independent groups of infants were tested after retention intervals of 3 min, 1 week and 4 weeks. Deferred imitation was assessed using the ‘observation-only’ procedure in which infants were not allowed motor practice on the tasks before the delay was imposed. Thus, the memory could not have been based on re-accessing a motor habit, because none was formed in the first place. After the delay, memo...

  11. Biological effects of long term fine limestone tailings discharge in a fjord ecosystem. (United States)

    Brooks, Lucy; Melsom, Fredrik; Glette, Tormod


    Benthic infaunal data collected from 1993 to 2010 were analysed to examine the effect of long term discharge of fine limestone tailings on macrofaunal species assemblages in a fjord. Relative distance from the outfall and proportion of fine tailings in the sediment were correlated with benthic community structure. Diversity decreased with increasing proportion of fine tailings. Biological Traits Analysis (BTA) was used to explore the temporal and spatial effects of the tailings gradient on macrofaunal functional attributes. BTA revealed that all stations along a pressure gradient of fine limestone tailings were dominated by free-living species. As the proportion of fine tailings in the sediment increased, there was an increase in fauna that were smaller, highly mobile, living on or nearer the surface sediment, with shorter lifespans. There was a decrease in permanent tube dwellers, those fauna with low or no mobility, that live deeper in the sediment and have longer lifespans (>5 yrs). Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    Directory of Open Access Journals (Sweden)

    Marika Pane

    Full Text Available The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3% lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14% and 11 between 24 and 36 months (12%. The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3 m at 12 months, of -58.9 (SD 125.7 m at 24 months and -104.22 (SD 146.2 m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m (p<0.001. The changes were also significantly different according to steroid treatment (p = 0.01. Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  13. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes. (United States)

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Sormani, Maria Pia; Messina, Sonia; D'Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P; Bertini, Enrico; Mercuri, Eugenio


    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  14. Long-term benefits of education by emergency care nurses at discharge of patients with atrial fibrillation. (United States)

    Fuenzalida, Carolina; Hernández, Gritzel; Ferro, Inés; Siches, Carme; Ambrós, Àngels; Coll-Vinent, Blanca


    Health education improves the prognosis of many diseases. A previous study in patients with atrial fibrillation (AF) showed that an educational intervention by nurses at discharge from the emergency room (ER) decreased AF-related complications at 3-month follow-up. Our objective was to determine whether this intervention had a long-term effect. A prospective study assessed the outcomes of an intervention carried out upon discharge from the ER. Patients with a diagnosis of AF were randomized into two groups: the intervention group and the control group. The intervention consisted of a basic explanation about the arrhythmia and its treatment, precautions and warning signs, a training to take their pulse, and an individualized informational leaflet. At one year of follow-up, the clinical records for all participants were reviewed. The primary variable was the combined endpoint of AF-related or treatment-related complications and death. The study included 240 patients (116 intervention and 124 control), mean age 76.1±10.9years. The primary variable was significantly lower in the intervention group (31.9% vs 48.4%; p=0.005). Education by ER nurses at patient discharge helped to decrease AF-related complications at one year of follow-up. Copyright © 2017. Published by Elsevier Ltd.

  15. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial. (United States)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E


    Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been studied. The objective of this randomized controlled study was to examine the effect of a post-discharge individualized nutritional intervention on survival in malnourished older patients. Malnourished older patients, aged ≥ 60 years, were randomized during hospitalization to a three-months post-discharge nutritional intervention group (protein and energy enriched diet, oral nutritional supplements, vitamin D3/calcium supplement and telephone counseling by a dietitian) or to a usual care regimen (control group). Survival data were collected 4 years after enrollment. Survival analyses were performed using intention-to-treat analysis by Log-rank tests and Cox regression adjusted for confounders. The study population consisted of 94 men (45%) and 116 women with a mean age of 74.5 (SD 9.5) years. There were no statistically significant differences in baseline characteristics. Survival data was available in 208 out of 210 patients. After 1 and 4 years of follow-up, survival rates were respectively 66% and 29% in the intervention group (n=104) and 73% and 30% in the control group (n=104). There were no statistically significant differences in survival between the two groups 1 year (HR= 0.933, 95% CI=0.675-1.289) and 4 years after enrollment (HR=0.928, 95% CI=0.671-1.283). The current study failed to show an effect of a three-months post-discharge multi-component nutritional intervention in malnourished older patients on long-term survival, despite the positive effects on short-term outcome such as functional limitations and falls.

  16. Short- and long-term plasma phenomena in a HiPIMS discharge

    International Nuclear Information System (INIS)

    Poolcharuansin, P; Bradley, J W


    Using a time-resolved Langmuir probe the temporal evolution of the bulk plasma parameters in a high-power impulse magnetron sputtering (HiPIMS) discharge was investigated for a number of different discharge conditions. The magnetron was operated in argon between 0.5 and 1.6 Pa with a titanium target and with peak target power densities up to 1000 W cm -2 . The pulse width and repetition rate were held constant at 100 μs and 100 Hz, respectively. Using an OML analysis as well as a Druyvesteyn formulation, the electron densities, effective temperatures and energy distribution functions were obtained throughout the pulse period (0-9 ms), including a detailed study of the first 10 μs, which was achieved with a temporal resolution better than 0.5 μs. In the initial phase of the voltage pulse (t ∼ 1-4 μs), three distinct groups of electrons (indistinguishable from Maxwellian electrons) were observed, namely 'super-thermal', 'hot' and 'cold' populations with effective temperatures of 70-100 eV, 5-7 eV and 0.8-1 eV, respectively. After 4 μs these groups become energetically indistinguishable from each other to form a single distribution with an electron temperature that decays from about 5 to 3 eV during the rest of the pulse on-time. The presence of the 'super-thermal' electron group pushes the probe floating potential to a very negative value (significantly deeper than -95 V) during the initial period of the pulse. In the off-time, the electron density decays with two-fold characteristic times, revealing initially short-term (30-40 μs) and ultimately long-term (3-4 ms) decay rates. These long decay times lead to a relative high density remnant plasma (2 x 10 9 cm -3 ) at the end of the off-time, which serves to seed the next voltage pulse. The electron temperature and plasma potential also exhibit two-fold decay in the off-time, but with typically somewhat faster decays, particularly for the long-term decay (100-500 μs) up to the end of the off-time. The time

  17. Four-month-old infants' long-term memory for a stressful social event.

    Directory of Open Access Journals (Sweden)

    Rosario Montirosso

    Full Text Available Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants' memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to social stress two times (experimental condition; the first time when they were 4 months of age and second exposure after a 2 week interval. Infants in the control condition (N = 37 were exposed to social stress just one time, at the age corresponding to the second exposure for infants in the experimental condition (4 months plus 2 weeks. Given individual differences in infants' reactivity to social stress events, we categorized infants as increasers or decreasers based on their cortisol reactivity after their initial exposure to the stress of the maternal still-face. Infants in the experimental condition, both increasers and decreasers, showed a significant change in cortisol response after the second exposure to the maternal still-face, though change was different for each reactivity group. In contrast, age-matched infants with no prior exposure to the maternal still-face showed similar post-stress cortisol reactivity to the reactivity of the experimental infants at their first exposure. There were no behavioral differences between increasers and decreasers during the Still-Face paradigm and exposures to the social stress. Thus differences between the experimental and control groups' post-stress cortisol reactivity was associated with the experimental group having previous experience with the social stress. These findings indicate long-term memory for social stress in infants as young as 4 months of age.

  18. Four-month-old infants' long-term memory for a stressful social event. (United States)

    Montirosso, Rosario; Tronick, Ed; Morandi, Francesco; Ciceri, Francesca; Borgatti, Renato


    Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants' memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm) after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to social stress two times (experimental condition); the first time when they were 4 months of age and second exposure after a 2 week interval. Infants in the control condition (N = 37) were exposed to social stress just one time, at the age corresponding to the second exposure for infants in the experimental condition (4 months plus 2 weeks). Given individual differences in infants' reactivity to social stress events, we categorized infants as increasers or decreasers based on their cortisol reactivity after their initial exposure to the stress of the maternal still-face. Infants in the experimental condition, both increasers and decreasers, showed a significant change in cortisol response after the second exposure to the maternal still-face, though change was different for each reactivity group. In contrast, age-matched infants with no prior exposure to the maternal still-face showed similar post-stress cortisol reactivity to the reactivity of the experimental infants at their first exposure. There were no behavioral differences between increasers and decreasers during the Still-Face paradigm and exposures to the social stress. Thus differences between the experimental and control groups' post-stress cortisol reactivity was associated with the experimental group having previous experience with the social stress. These findings indicate long-term memory for social stress in infants as young as 4 months of age.

  19. Four-Month-Old Infants’ Long-Term Memory for a Stressful Social Event (United States)

    Montirosso, Rosario; Tronick, Ed; Morandi, Francesco; Ciceri, Francesca; Borgatti, Renato


    Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants’ memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm) after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to social stress two times (experimental condition); the first time when they were 4 months of age and second exposure after a 2 week interval. Infants in the control condition (N = 37) were exposed to social stress just one time, at the age corresponding to the second exposure for infants in the experimental condition (4 months plus 2 weeks). Given individual differences in infants’ reactivity to social stress events, we categorized infants as increasers or decreasers based on their cortisol reactivity after their initial exposure to the stress of the maternal still-face. Infants in the experimental condition, both increasers and decreasers, showed a significant change in cortisol response after the second exposure to the maternal still-face, though change was different for each reactivity group. In contrast, age-matched infants with no prior exposure to the maternal still-face showed similar post-stress cortisol reactivity to the reactivity of the experimental infants at their first exposure. There were no behavioral differences between increasers and decreasers during the Still-Face paradigm and exposures to the social stress. Thus differences between the experimental and control groups’ post-stress cortisol reactivity was associated with the experimental group having previous experience with the social stress. These findings indicate long-term memory for social stress in infants as young as 4 months of age. PMID:24349244

  20. The global historical climatology network: Long-term monthly temperature, precipitation, and pressure data

    International Nuclear Information System (INIS)

    Vose, R.S.; Schmoyer, R.L.; Peterson, T.C.; Steurer, P.M.; Heim, R.R. Jr.; Karl, T.R.; Eischeid, J.K.


    Interest in global climate change has risen dramatically during the past several decades. In a similar fashion, the number of data sets available to study global change has also increased. Unfortunately, many different organizations and researchers have compiled these data sets, making it confusing and time consuming for individuals to acquire the most comprehensive data. In response to this rapid growth in the number of global data sets, DOE's Carbon Dioxide Information Analysis Center (CDIAC) and NOAA's National Climatic Data Center (NCDC) established the Global Historical Climatology Network (GHCN) project. The purpose of this project is to compile an improved data set of long-term monthly mean temperature, precipitation, sea level pressure, and station pressure for as dense a network of global stations as possible. Specifically, the GHCN project seeks to consolidate the numerous preexisting national-, regional-, and global-scale data sets into a single global data base; to subject the data to rigorous quality control; and to update, enhance, and distribute the data set at regular intervals. The purpose of this paper is to describe the compilation and contents of the GHCN data base (i.e., GHCN Version 1.0)

  1. Long-Term Charge/Discharge Cycling Stability of MnO2 Aqueous Supercapacitor under Positive Polarization

    KAUST Repository

    Ataherian, Fatemeh; Wu, Nae-Lih


    The long-term charge/discharge cycling stability of MnO 2 electrode under positive polarization in aqueous KCl electrolyte has been studied over different potential windows spanning from the open circuit potential to varied higher-end potential

  2. Focused breastfeeding counselling improves short- and long-term success in an early-discharge setting

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M S; Strandberg-Larsen, Katrine; Knight, Christopher H


    Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self...... in the intervention compared to the reference group (adjusted OR 0.55, 95% CI 0.37, −0.81), and 6 months following birth, more infants were exclusively breastfed in the intervention group (adjusted OR 1.36, 95% CI 1.02, −1.81). Moreover, mothers in the intervention compared to the reference group were breastfeeding...

  3. Long-term generation scheduling of Xiluodu and Xiangjiaba cascade hydro plants considering monthly streamflow forecasting error

    International Nuclear Information System (INIS)

    Xie, Mengfei; Zhou, Jianzhong; Li, Chunlong; Zhu, Shuang


    Highlights: • Monthly streamflow forecasting error is considered. • An improved parallel progressive optimality algorithm is proposed. • Forecasting dispatching chart is manufactured accompanying with a set of rules. • Applications in Xiluodu and Xiangjiaba cascade hydro plants. - Abstract: Reliable streamflow forecasts are very significant for reservoir operation and hydropower generation. But for monthly streamflow forecasting, the forecasting result is unreliable and it is hard to be utilized, although it has a certain reference value for long-term hydro generation scheduling. Current researches mainly focus on deterministic scheduling, and few of them consider the uncertainties. So this paper considers the forecasting error which exists in monthly streamflow forecasting and proposes a new long-term hydro generation scheduling method called forecasting dispatching chart for Xiluodu and Xiangjiaba cascade hydro plants. First, in order to consider the uncertainties of inflow, Monte Carlo simulation is employed to generate streamflow data according to the forecasting value and error distribution curves. Then the large amount of data obtained by Monte Carlo simulation is used as inputs for long-term hydro generation scheduling model. Because of the large amount of streamflow data, the computation speed of conventional algorithm cannot meet the demand. So an improved parallel progressive optimality algorithm is proposed to solve the long-term hydro generation scheduling problem and a series of solutions are obtained. These solutions constitute an interval set, unlike the unique solution in the traditional deterministic long-term hydro generation scheduling. At last, the confidence intervals of the solutions are calculated and forecasting dispatching chart is proposed as a new method for long-term hydro generation scheduling. A set of rules are proposed corresponding to forecasting dispatching chart. The chart is tested for practical operations and achieves

  4. Hip protector compliance: a 13-month study on factors and cost in a long-term care facility. (United States)

    Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen


    To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

  5. An assessment method of long-term radiation impacts to environment and public individual from tritium discharged by inland NPP

    International Nuclear Information System (INIS)

    Shangguan Zhihong; Huang Yanjun; Tao Yunliang


    In this paper, an assessment method of environmental impacts from long-term releases of tritium of inland nuclear power plant is proposed; the tritium concentrations in different environmental materials, including the two main chemical form HTO and OBT. and the radiation dose to public individuals including drinking water, food, inhalation. skin adsorption, are estimated based on the method and environmental parameters from typical inland NPP. The two discharge pathways, gaseous and liquid, are considered with particular concerns to drinking and irrigation ascribed to liquid discharge. This study would contribute to the assessment techniques of environmental impacts and safety of inland NPP. (authors)

  6. Long-term outcome of 6-month maintenance chemotherapy for acute lymphoblastic leukemia in children. (United States)

    Kato, M; Ishimaru, S; Seki, M; Yoshida, K; Shiraishi, Y; Chiba, K; Kakiuchi, N; Sato, Y; Ueno, H; Tanaka, H; Inukai, T; Tomizawa, D; Hasegawa, D; Osumi, T; Arakawa, Y; Aoki, T; Okuya, M; Kaizu, K; Kato, K; Taneyama, Y; Goto, H; Taki, T; Takagi, M; Sanada, M; Koh, K; Takita, J; Miyano, S; Ogawa, S; Ohara, A; Tsuchida, M; Manabe, A


    In the treatment of childhood acute lymphoblastic leukemia (ALL), excess shortening of maintenance therapy resulted in high relapse rate, as shown by our previous trial, TCCSG L92-13, in which maintenance therapy was terminated at 1 year from initiation of treatment. In this study, we aimed to confirm the long-term outcome of L92-13, and to identify who can or cannot be cured by shorter duration of maintenance therapy. To obtain sentinel cytogenetics information that had been missed before, we performed genetic analysis with genomic microarray and target intron-capture sequencing from diagnostic bone marrow smear. Disease-free survival (DFS) at 10 years from the end of therapy was 66.0±2.8%. Females (n=138) had better DFS (74.6±3.7%) than males (n=142, 57.5±4.2%, P=0.002). Patients with TCF3-PBX1 (n=11) and ETV6-RUNX1 (n=16) had excellent DFS (90.9±8.7% and 93.8±6.1%, respectively), whereas high hyperdiploidy (n=23) was the most unfavorable subgroup, with 56.6±10.3% of DFS. Short duration of therapy can cure more than half of pediatric ALL, especially females, TCF3-PBX1 and ETV6-RUNX1. Our retrospective observations suggest a gender/karyotype inhomogeneity on the impact of brief therapy.

  7. Thirteen- and Sixteen-Month-Olds' Long-Term Recall of Event Sequences. (United States)

    Hertsgaard, L.; Bauer, P. J.

    In two experiments, the ability of children younger than 20 months to engage in delayed ordered recall was investigated. In the first experiment, 13- and 16-month-old children were presented with 2-step event sequences and tested for recall, first, immediately following the event and second, after a one-week delay. Sequences were novel-causal,…

  8. Severity of acidosis affects long-term survival in COPD patients with hypoxemia after intensive care unit discharge. (United States)

    Gungor, Sinem; Kargin, Feyza; Irmak, Ilim; Ciyiltepe, Fulya; Acartürk Tunçay, Eylem; Atagun Guney, Pinar; Aksoy, Emine; Ocakli, Birsen; Adiguzel, Nalan; Karakurt, Zuhal


    Patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) due to COPD have high mortality and morbidity. Acidosis has several harmful effects on hemodynamics and metabolism, and the current knowledge regarding the relationship between respiratory acidosis severity on the short- and long-term survival of COPD patients is limited. We hypothesized that COPD patients with severe acidosis would have a poorer short- and long-term prognosis compared with COPD patients with mild-to-moderate acidosis. This retrospective observational cohort study was conducted in a level III respiratory ICU of a tertiary teaching hospital for chest diseases between December 1, 2013, and December 30, 2014. Subject characteristics, comorbidities, ICU parameters, duration of mechanical ventilation, length of ICU stay, ICU mortality, use of domiciliary noninvasive mechanical ventilation (NIMV) and long-term oxygen therapy (LTOT), and short- and long-term mortality were recorded. Patients were grouped according to their arterial blood gas (ABG) values during ICU admission: severe acidotic (pH≤7.20) and mild-to-moderate acidotic (pH 7.21-7.35). These groups were compared with the recorded data. The mortality predictors were analyzed by logistic regression test in the ICU and the Cox regression test for long-term mortality predictors. During the study period, a total of 312 COPD patients admitted to the ICU with ARF, 69 (72.5% male) in the severe acidosis group and 243 (79% male) in the mild-to-moderate acidosis group, were enrolled. Group demographics, comorbidities, duration of mechanical ventilation, and length of ICU stay were similar in the two groups. The severe acidosis group had a significantly higher rate of NIMV failure (60.7% vs 40%) in the ICU. Mild-to-moderate acidotic COPD patients using LTOT had longer survival after ICU discharge than those without LTOT. On the other hand, severely acidotic COPD patients without LTOT showed shorter survival than

  9. Long-term study of an estuarine mudflat subjected to petro-chemical discharges

    International Nuclear Information System (INIS)

    McLusky, D.A.; Martins, T.


    The Kinneil intertidal area, situated in the middle reaches of the Forth estuary, eastern Scotland, has been subject to the effects of industrial discharges, principally from petro-chemical industries (oil refinery and chemical works) since the 1920s. The intertidal fauna has been studied annually since 1976 using consistent methodology. The study continues, now providing over 20 yrs of data. During the study period the discharges from the industrial sources have been reduced substantially through a combination of plant closure and modernization and the installation of effluent treatment works. Furthermore, the River Avon which flows across the area has experienced substantial improvements in water quality, attributed to improvements in waste treatment works at localities upstream from the estuarine site. Overall, however, the clearest trends have been increases in diversity, expressed either as mean number of species per station, or as diversity indices. These increases in diversity are shown to be a clear community response to the improvements made to the petro-chemical wastes discharged to the area. (author)

  10. Long-term effects of OBM cutting discharges at 12 locations on the Dutch continental shelf

    International Nuclear Information System (INIS)

    Daan, R.; Mulder, M.


    A sampling programme was carried out in 1994 and 1995 covering 12 well sites where OBM cuttings had been discharged 7 to 13 years ago. The locations were selected in areas with different sediment types. In terms of amounts of base oil discharged the discharge loads ranged from 13 to 298 tonnes. The locations included actual production platforms but also abandoned well sites. At each location compendious surveys were carried out, during which 4 stations were sampled at distances between 100 and 2000m from the discharge site. Sediment samples for chemical analysis were collected at all stations and numbers of the OBM-sensitive species Echinocardium cordatum were counted in all samples. Additional macrofauna analyses were performed for 5 locations. The chemical analyses revealed elevated oil concentrations at 5 of the 12 locations, but traces of oil were visually observed in a few samples at another 2 locations. Maximum concentrations, measured over the upper 10 cm layer, were generally in the order of 10-50 mg/kg dry sediment, but at one location a concentration of 200 mg/kg was found, which is comparable to the values found at formerly investigated locations L4-a and P6-b, but considerably lower than at K12-a. This indicates that concentration levels at most locations are generally not as high as found at the locations formerly investigated. Except for one location where oil was found up to 250m from the platform, elevated oil concentrations in surface sediments only occurred at 100m stations. Significant effects on the population densities of E. cordatum were found at 7 of the 12 locations. Further, at 2 locations the abundance pattern of the species was indicative of an effect but there was no statistical significance. Population densities of E. cordaturn appeared to be depressed in the vicinity of two locations where no oil was detected. This indicates that the absence of oil in samples does not necessarily mean that sediment conditions have completely recovered

  11. Simulated long-term changes in river discharge and soil moisture due to global warming (United States)

    Manabe, S.; Milly, P.C.D.; Wetherald, R.


    By use of a coupled ocean atmosphere-land model, this study explores the changes of water availability, as measured by river discharge and soil moisture, that could occur by the middle of the 21st century in response to combined increases of greenhouse gases and sulphate aerosols based upon the "IS92a" scenario. In addition, it presents the simulated change in water availability that might be realized in a few centuries in response to a quadrupling of CO2 concentration in the atmosphere. Averaging the results over extended periods, the radiatively forced changes, which are very similar between the two sets of experiments, were successfully extracted. The analysis indicates that the discharges from Arctic rivers such as the Mackenzie and Ob' increase by up to 20% (of the pre-Industrial Period level) by the middle of the 21st century and by up to 40% or more in a few centuries. In the tropics, the discharges from the Amazonas and Ganga-Brahmaputra rivers increase substantially. However, the percentage changes in runoff from other tropical and many mid-latitude rivers are smaller, with both positive and negative signs. For soil moisture, the results of this study indicate reductions during much of the year in many semiarid regions of the world, such as the southwestern region of North America, the northeastern region of China, the Mediterranean coast of Europe, and the grasslands of Australia and Africa. As a percentage, the reduction is particularly large during the dry season. From middle to high latitudes of the Northern Hemisphere, soil moisture decreases in summer but increases in winter.

  12. Superiority of Serum Cystatin C Over Creatinine in Prediction of Long-Term Prognosis at Discharge From ICU. (United States)

    Ravn, Bo; Prowle, John R; Mårtensson, Johan; Martling, Claes-Roland; Bell, Max


    Renal outcomes after critical illness are seldom assessed despite strong correlation between chronic kidney disease and survival. Outside hospital, renal dysfunction is more strongly associated with mortality when assessed by serum cystatin C than by creatinine. The relationship between creatinine and longer term mortality might be particularly weak in survivors of critical illness. Retrospective observational cohort study. In 3,077 adult ICU survivors, we compared ICU discharge cystatin C and creatinine and their association with 1-year mortality. Exclusions were death within 72 hours of ICU discharge, ICU stay less than 24 hours, and end-stage renal disease. None. During ICU admission, serum cystatin C and creatinine diverged, so that by ICU discharge, almost twice as many patients had glomerular filtration rate less than 60 mL/min/1.73 m when estimated from cystatin C compared with glomerular filtration rate estimated from creatinine, 44% versus 26%. In 743 patients without acute kidney injury, where ICU discharge renal function should reflect ongoing baseline, discharge glomerular filtration rate estimated from creatinine consistently overestimated follow-up glomerular filtration rate estimated from creatinine, whereas ICU discharge glomerular filtration rate estimated from cystatin C well matched follow-up chronic kidney disease status. By 1 year, 535 (17.4%) had died. In survival analysis adjusted for age, sex, and comorbidity, cystatin C was near-linearly associated with increased mortality, hazard ratio equals to 1.78 (95% CI, 1.46-2.18), 75th versus 25th centile. Conversely, creatinine demonstrated a J-shaped relationship with mortality, so that in the majority of patients, there was no significant association with survival, hazard ratio equals to 1.03 (0.87-1.2), 75th versus 25th centile. After adjustment for both creatinine and cystatin C levels, higher discharge creatinine was then associated with lower long-term mortality. In contrast to creatinine

  13. Effects of Long-Term Storage Time and Original Sampling Month on Biobank Plasma Protein Concentrations

    Directory of Open Access Journals (Sweden)

    Stefan Enroth


    Full Text Available The quality of clinical biobank samples is crucial to their value for life sciences research. A number of factors related to the collection and storage of samples may affect the biomolecular composition. We have studied the effect of long-time freezer storage, chronological age at sampling, season and month of the year and on the abundance levels of 108 proteins in 380 plasma samples collected from 106 Swedish women. Storage time affected 18 proteins and explained 4.8–34.9% of the observed variance. Chronological age at sample collection after adjustment for storage-time affected 70 proteins and explained 1.1–33.5% of the variance. Seasonal variation had an effect on 15 proteins and month (number of sun hours affected 36 proteins and explained up to 4.5% of the variance after adjustment for storage-time and age. The results show that freezer storage time and collection date (month and season exerted similar effect sizes as age on the protein abundance levels. This implies that information on the sample handling history, in particular storage time, should be regarded as equally prominent covariates as age or gender and need to be included in epidemiological studies involving protein levels.

  14. Assessment of long-term effects of radionuclides discharged from a phosphate ore processing plant to the environment

    International Nuclear Information System (INIS)

    Degetti, S.; Mazzoti, D.; Dall'Ara, S.; DeJoanna, C.


    The Northern Adriatic Sea was interested by continuous direct discharge of phosphogypsum from a local phosphate fertilizer industry up to 1985 following a productive activity of about twenty years.As it is known, due to the remarkable amounts of natural radioactivity connected with the productive cycle of fertilizers from phosphate ores, the release to the environment of huge amounts of potentially hazardous wastes might be in principle of major radioecological concern.In this respect Ra-226 and its decay products are expected to be the main responsible of radioactivity background enhancement.Taking into account that discharge at sea (depth 30-35 m) was interrupted over ten years ago, following the closing of the plant, the main scope of this investigation was to assess the long-term effect of the disposal of phosphogypsum in the marine environment and in particular the possible enrichment of the radioactive fraction after solubilization of the gypsum carrier. In order to assess the actual radioecological influence of discharged slurries on the marine environment a preliminary sampling was carried out.Radioactivity data obtained from sediment cores clearly indicate anomalies in respect to typical 'background' values obtained from homologous samples collected in an unaffected area in proximity of the disposal site.As an example, Ra-226 activities in sediment were found to be one hundred fold higher than natural background.Radioactivity data from sediments cores collected in sites interested by bottom sea currents coming from discharge area will be also reported and discussed.(authors)

  15. Bed-side inferior vena cava diameter and mean arterial pressure predict long-term mortality in hospitalized patients with heart failure: 36 months of follow-up. (United States)

    Torres, Daniele; Cuttitta, Francesco; Paterna, Salvatore; Garofano, Alessandro; Conti, Giosafat; Pinto, Antonio; Parrinello, Gaspare


    In discharged patients with heart failure (HF), diverse conditions can intervene to worsen outcome. We would investigate whether such factors present on hospital admission can affect long-term mortality in subjects hospitalized for acute HF. One hundred twenty-three consecutive patients hospitalized for acute HF (mean age 74.8 years; 57% female) were recruited and followed for 36 months after hospitalization. At multivariate Cox model, only inferior vena cava (IVC) diameter and mean arterial pressure (MAP) registered bed-side on admission, resulted, after correction for all confounders factors, the sole factors significantly associated with a higher risk of all-cause mortality in long-term (HR 1.06, p=0.0057; HR 0.97, p=0.0218; respectively). Study population was subdivided according to median values of IVC diameter (23 mm) and MAP (93.3 mm Hg). The Kaplan–Meier curve showed that HF patients with both IVC ≥ 23 mm and MAP b93.3 mm Hg on admission had reduced probability of survival free from all-cause death (log rank p = 0.0070 and log rank p = 0.0028, respectively). In patients hospitalized for acute HF, IVC diameter, measured by hand-carried ultrasound (HCU), and MAP detected on admission are strong predictors of long-term all-cause mortality. The data suggest the need for a careful clinical-therapeutic surveillance on these patients during the post-discharge period. IVC diameter and MAP can be utilized as parameters to stratify prognosis on admission and to be supervised during follow-up. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy.

    Directory of Open Access Journals (Sweden)

    Anna Buchheim

    Full Text Available Neuroimaging studies of depression have demonstrated treatment-specific changes involving the limbic system and regulatory regions in the prefrontal cortex. While these studies have examined the effect of short-term, interpersonal or cognitive-behavioural psychotherapy, the effect of long-term, psychodynamic intervention has never been assessed. Here, we investigated recurrently depressed (DSM-IV unmedicated outpatients (N = 16 and control participants matched for sex, age, and education (N = 17 before and after 15 months of psychodynamic psychotherapy. Participants were scanned at two time points, during which presentations of attachment-related scenes with neutral descriptions alternated with descriptions containing personal core sentences previously extracted from an attachment interview. Outcome measure was the interaction of the signal difference between personal and neutral presentations with group and time, and its association with symptom improvement during therapy. Signal associated with processing personalized attachment material varied in patients from baseline to endpoint, but not in healthy controls. Patients showed a higher activation in the left anterior hippocampus/amygdala, subgenual cingulate, and medial prefrontal cortex before treatment and a reduction in these areas after 15 months. This reduction was associated with improvement in depressiveness specifically, and in the medial prefrontal cortex with symptom improvement more generally. This is the first study documenting neurobiological changes in circuits implicated in emotional reactivity and control after long-term psychodynamic psychotherapy.

  17. Changes in Prefrontal-Limbic Function in Major Depression after 15 Months of Long-Term Psychotherapy (United States)

    Buchheim, Anna; Viviani, Roberto; Kessler, Henrik; Kächele, Horst; Cierpka, Manfred; Roth, Gerhard; George, Carol; Kernberg, Otto F.; Bruns, Georg; Taubner, Svenja


    Neuroimaging studies of depression have demonstrated treatment-specific changes involving the limbic system and regulatory regions in the prefrontal cortex. While these studies have examined the effect of short-term, interpersonal or cognitive-behavioural psychotherapy, the effect of long-term, psychodynamic intervention has never been assessed. Here, we investigated recurrently depressed (DSM-IV) unmedicated outpatients (N = 16) and control participants matched for sex, age, and education (N = 17) before and after 15 months of psychodynamic psychotherapy. Participants were scanned at two time points, during which presentations of attachment-related scenes with neutral descriptions alternated with descriptions containing personal core sentences previously extracted from an attachment interview. Outcome measure was the interaction of the signal difference between personal and neutral presentations with group and time, and its association with symptom improvement during therapy. Signal associated with processing personalized attachment material varied in patients from baseline to endpoint, but not in healthy controls. Patients showed a higher activation in the left anterior hippocampus/amygdala, subgenual cingulate, and medial prefrontal cortex before treatment and a reduction in these areas after 15 months. This reduction was associated with improvement in depressiveness specifically, and in the medial prefrontal cortex with symptom improvement more generally. This is the first study documenting neurobiological changes in circuits implicated in emotional reactivity and control after long-term psychodynamic psychotherapy. PMID:22470470

  18. Six-month outcomes of co-occurring delirium, depression, and dementia in long-term care. (United States)

    McCusker, Jane; Cole, Martin G; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Belzile, Eric


    To describe the 6-month outcomes of co-occurring delirium (full syndrome and subsyndromal symptoms), depression, and dementia in a long-term care (LTC) population. Observational, prospective cohort study with 6-month follow-up conducted from 2005 to 2009. Seven LTC facilities in the province of Quebec, Canada. Newly admitted and long-term residents recruited consecutively from lists of residents aged 65 and older admitted for LTC, with stratification into groups with and without severe cognitive impairment. The study sample comprised 274 residents with complete data at baseline on delirium, dementia, and depression. Outcomes were 6-month mortality, functional decline (10-point decline from baseline on 100-point Barthel scale), and cognitive decline (3-point decline on 30-point Mini-Mental State Examination). Predictors included delirium (full syndrome or subsyndromal symptoms, using the Confusion Assessment Method), depression (Cornell Scale for Depression in Dementia), and dementia (chart diagnosis). The baseline prevalences of delirium, subsyndromal symptoms of delirium (SSD), depression, and dementia were 11%, 44%, 19%, and 66%, respectively. By 6 months, 10% of 274 had died, 19% of 233 had experienced functional decline, and 17% of 246 had experienced cognitive decline. An analysis using multivariable generalized linear models found the following significant interaction effects (P delirium and depression for functional decline, and between SSD and dementia for cognitive decline. Co-occurrence of delirium, SSD, depression, and dementia in LTC residents appears to affect some 6-month outcomes. Because of limited statistical power, it was not possible to draw conclusions about the effects of the co-occurrence of some syndromes on poorer outcomes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  19. Long-Term Charge/Discharge Cycling Stability of MnO2 Aqueous Supercapacitor under Positive Polarization

    KAUST Repository

    Ataherian, Fatemeh


    The long-term charge/discharge cycling stability of MnO 2 electrode under positive polarization in aqueous KCl electrolyte has been studied over different potential windows spanning from the open circuit potential to varied higher-end potential limited by O 2 evolution. Cycling up to 1.2 V (vs Ag/AgCl (aq)) causes partial (35) capacitance fading to a plateau value within the initial cycles, accompanied by morphological reconstruction, reduction of surface Mn ions and oxygen evolution. The surface Mn-ion reduction has been attributed to a two-step oxidation-reduction mechanism involving OH oxidation in electrolyte, based on electrochemical analysis. When cycling potential extends to 1.4 V, extensive oxygen evolution takes place. The combination of surface passivation of current collector and extensive gas bubbling, which deteriorates electrical contact among the constituent particles within the electrode, results in further monotonic capacitance reduction. © 2011 The Electrochemical Society.

  20. Bilateral extensive ductitis obliterans manifested by bloody nipple discharge in a patient with long-term diabetes mellitus. (United States)

    Wang, Zhiqin; Leonard, Morton H; Khamapirad, Tuenchit; Castro, Claudia Y


    Ductitis obliterans or mastitis obliterans is a rare late manifestation of mammary ductal ectasia. We describe a long-term diabetic patient who presented with bilateral bloody nipple discharge and poorly defined nodularities around the nipple of both breasts. The ductography showed multiple segments of irregular ductal narrowing and intraluminal filling defects in both breasts. The bilateral resection of the sub-areolar portion of the breast showed exuberant fibrous obliteration of the large- and medium-sized ducts by granulation tissue associated with few histiocytes. Ductal dilatation and intraductal accumulation of histiocytes was also present. This represents a late and florid form of mammary ductal ectasia. Differential diagnostic considerations including fibrocystic changes, diabetic sclerosing lymphocytic lobulitis, idiopathic granulomatous lobular mastitis, and periductal mastitis (Zuska disease) are discussed. Accurate diagnosis can help avoid or limit radical surgeries in this group of patients.

  1. [Effectiveness of dialectical behavior therapy for patients with borderline personality disorder in the long-term course--a 30-month-follow-up after inpatient treatment]. (United States)

    Fassbinder, Eva; Rudolf, Sebastian; Bussiek, Anke; Kröger, Christoph; Arnold, Rüdiger; Greggersen, Wiebke; Hüppe, Michael; Sipos, Valerija; Schweiger, Ulrich


    The beneficial effects of Dialectical Behavior Therapy (DBT) for patients with borderline personality disorder (BPD) are well established. However, it is not well known whether this type of treatment relieves symptoms and signs of BPD in the long-term course thereafter and whether the results of DBT are transferable for patients with high comorbidity. We conducted a follow-up examination of 50 consecutive inpatients with BPD as defined by DSM-IV. The patients were examined at admission, at discharge and 15 and 30 months after discharge. For the clinical diagnosis and to survey psychopathology we used the Structured Clinical Interview for DSM-IV (SCID), the Global Assessment of Functioning (GAF) and several self-rating-instruments. Compared to admission 30 months after discharge we observed the following results: A significant number of patients did not meet the DSM-IV criteria for BPD anymore, comorbidity (particularly mood disorders, drug or alcohol abuse/dependence and eating disorders) was reduced, psychosocial functioning was improved and general and BPD-typical symptoms were relieved. Our findings support the efficacy of DBT in an inpatient setting and show that the achieved success of therapy is stable for a prolonged period of time. Patients with high comorbidity seem to profit from DBT as well.

  2. Effects of Joint Attention on Long-Term Memory in 9-Month-Old Infants: An Event-Related Potentials Study (United States)

    Kopp, Franziska; Lindenberger, Ulman


    Joint attention develops during the first year of life but little is known about its effects on long-term memory. We investigated whether joint attention modulates long-term memory in 9-month-old infants. Infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high…

  3. Riverine discharges to Chesapeake Bay: Analysis of long-term (1927–2014) records and implications for future flows in the Chesapeake Bay basin (United States)

    Rice, Karen; Moyer, Douglas; Mills, Aaron L.


    The Chesapeake Bay (CB) basin is under a total maximum daily load (TMDL) mandate to reduce nitrogen, phosphorus, and sediment loads to the bay. Identifying shifts in the hydro-climatic regime may help explain observed trends in water quality. To identify potential shifts, hydrologic data (1927–2014) for 27 watersheds in the CB basin were analyzed to determine the relationships among long-term precipitation and stream discharge trends. The amount, frequency, and intensity of precipitation increased from 1910 to 1996 in the eastern U.S., with the observed increases greater in the northeastern U.S. than the southeastern U.S. The CB watershed spans the north-to-south gradient in precipitation increases, and hydrologic differences have been observed in watersheds north relative to watersheds south of the Pennsylvania—Maryland (PA-MD) border. Time series of monthly mean precipitation data specific to each of 27 watersheds were derived from the Precipitation-elevation Regression on Independent Slopes Model (PRISM) dataset, and monthly mean stream-discharge data were obtained from U.S. Geological Survey streamgage records. All annual precipitation trend slopes in the 18 watersheds north of the PA-MD border were greater than or equal to those of the nine south of that border. The magnitude of the trend slopes for 1927–2014 in both precipitation and discharge decreased in a north-to-south pattern. Distributions of the monthly precipitation and discharge datasets were assembled into percentiles for each year for each watershed. Multivariate correlation of precipitation and discharge within percentiles among the groups of northern and southern watersheds indicated only weak associations. Regional-scale average behaviors of trends in the distribution of precipitation and discharge annual percentiles differed between the northern and southern watersheds. In general, the linkage between precipitation and discharge was weak, with the linkage weaker in the northern watersheds

  4. Does early change predict long-term (6 months) improvements in subjects who receive manual therapy for low back pain? (United States)

    Cook, Chad; Petersen, Shannon; Donaldson, Megan; Wilhelm, Mark; Learman, Ken


    Early change is commonly assessed for manual therapy interventions and has been used to determine treatment appropriateness. However, current studies have only explored the relationship of between or within-session changes and short-/medium-term outcomes. The goal of this study was to determine whether pain changes after two weeks of pragmatic manual therapy could predict those participants with chronic low back pain who demonstrate continued improvements at 6-month follow-up. This study was a retrospective observational design. Univariate logistic regression analyses were performed using a 33% and a 50% pain change to predict improvement. Those who experienced a ≥33% pain reduction by 2 weeks had 6.98 (95% CI = 1.29, 37.53) times higher odds of 50% improvement on the GRoC and 4.74 (95% CI = 1.31, 17.17) times higher odds of 50% improvement on the ODI (at 6 months). Subjects who reported a ≥50% pain reduction at 2 weeks had 5.98 (95% CI = 1.56, 22.88) times higher odds of a 50% improvement in the GRoC and 3.99 (95% CI = 1.23, 12.88) times higher odds of a 50% improvement in the ODI (at 6 months). Future studies may investigate whether a change in plan of care is beneficial for patients who are not showing early improvement predictive of a good long-term outcome.

  5. Better off in the community? A 5-year follow up study of long-term psychiatric patients discharged into the community.

    LENUS (Irish Health Repository)

    McInerney, Shane J


    The quality of life of long-term psychiatric inpatients relocated to the community was investigated in this study. The aim was to investigate what changes, if any occurred, on standardised quality of life related instruments between discharge from hospital and at 1 year after discharge into the community. We were also interested to see if these changes continued 5 years after discharge into the community.

  6. Long-term biomonitoring of a produced water discharge from the Cedar Cove degasification field, Alabama. January 1991

    Energy Technology Data Exchange (ETDEWEB)

    O' Neil, P.E.; Harris, S.C.; Mettee, M.F.; McGregor, S.W.; Shepard, T.E.


    Development of coalbed methane has become a major industry for the state of Alabama. In excess of 1,300 wells were producing methane by the end of July 1990. A byproduct of methane production is produced water containing elevated concentrations of chloride, sodium, iron and bicarbonate. These waters are currently permitted for discharge into streams or as a land application. The purpose of the study was to examine the long-term impacts of produced waters to streams relative to water-quality changes and aquatic biological effects. Distinct water-quality changes in the receiving stream were documented and consisted primarily of increased dissolved solids, changes in the pH regime and changes in the carbonate buffering system. In contrast, no significant or consistent detrimental change in the structure or function of the stream biological community could be detected. Subtle changes in biological community structure and composition were noted and most likely due to effects associated with algal productivity in settling lagoons. These changes, however, were within the boundaries of variation typically observed for the communities. Based on the results of this and earlier studies, it was concluded that the national water-quality criterion for chloride was protective of stream life as examined in the study.

  7. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial. (United States)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren


    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, pacute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. © 2013.

  8. Long-term collections

    CERN Multimedia

    Collectes à long terme


    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  9. Infective endocarditis: long-term reversibility of kidney function impairment. A 1-y post-discharge follow-up study

    DEFF Research Database (Denmark)

    Buchholtz, Kristine; Larsen, Carsten T; Hassager, Christian


    The aim of this study was to quantify the long-term reversibility of kidney function decrease occurring during hospitalization and treatment for infective endocarditis (IE). A prospective observational cohort study was performed at a tertiary university hospital in Copenhagen from October 2002...

  10. Short- and long-term effectiveness of a three-month individualized need-supportive physical activity counseling intervention at the workplace

    Directory of Open Access Journals (Sweden)

    Anass Arrogi


    Full Text Available Abstract Background The objective of the present study was to evaluate the short- and long-term intervention and mediation effects of a 3-month individualized need-supportive physical activity (PA counseling intervention on employees’ PA and sedentary behavior. Methods Insufficiently active employees (n = 300; mean age 42 ± 9 years; 78% female were recruited from a large pharmaceutical company in Flanders, Belgium. A quasi-experimental design was used in which the intervention group (N = 246 was recruited separately from the reference group (N = 54. Intervention group participants received a 3-month behavioral support intervention, which consisted of two one-hour face-to-face counseling sessions and three follow-up counseling contacts by e-mail or telephone at weeks three, six and nine. PA counseling, delivered by qualified PA counselors, aimed to satisfy participants’ basic psychological needs for autonomy, competence, and relatedness. Reference group participants did not receive individualized PA counseling. Outcome measures included objectively assessed and self-reported PA and sedentary time and psychological need satisfaction. Assessments were held at baseline, immediately after the intervention (short-term and 6 months post-intervention (long-term. Mixed model analyses and bootstrapping analyses were used to determine intervention and mediation effects, respectively. Results The intervention group increased weekday daily steps both in the short- and long-term, while the reference group showed reductions in daily step count (ES = .65 and ES = .48 in the short- and long-term, respectively. In the short-term, weekday moderate-to-vigorous PA increased more pronouncedly in the intervention group compared to the reference group (ES = .34. Moreover, the intervention group demonstrated reductions in self-reported sitting time during weekends both in the short- and long-term, whereas the reference group reported

  11. High levels of comorbidity and disability cancel out the dementia effect in predictions of long-term mortality after discharge in the very old. (United States)

    Zekry, Dina; Herrmann, François R; Graf, Christophe E; Giannelli, Sandra; Michel, Jean-Pierre; Gold, Gabriel; Krause, Karl-Heinz


    The relative weight of various etiologies of dementia as predictors of long-term mortality after other risk factors have been taken into account remains unclear. We investigated the 5-year mortality risk associated with dementia in elderly people after discharge from acute care, taking into account comorbid conditions and functionality. A prospective cohort study of 444 patients (mean age: 85 years; 74% female) discharged from the acute geriatric unit of Geneva University Hospitals. On admission, each subject underwent a standardized diagnostic evaluation: demographic variables, cognitive, comorbid medical conditions and functional assessment. Patients were followed yearly by the same team. Predictors of survival at 5 years were evaluated by Cox proportional hazards models. The univariate model showed that being older and male, and having vascular and severe dementia, comorbidity and functional disability, were predictive of shorter survival. However, in the full multivariate model adjusted for age and sex, the effect of dementia type or severity completely disappeared when all the variables were added. In multivariate analysis, the best predictor was higher comorbidity score, followed by functional status (R(2) = 23%). The identification of comorbidity and functional impairment effects as predictive factors for long-term mortality independent of cognitive status may increase the accuracy of long-term discharge planning. Copyright © 2011 S. Karger AG, Basel.

  12. Bloody nipple discharge in a 7-month-old boy.

    LENUS (Irish Health Repository)

    Zaid, Ahmed


    Isolated bloody nipple discharge is rare in infancy and is usually idiopathic. Discharge commonly resolves spontaneously, and ultrasonography is a useful diagnostic technique to detect the cause of discharge. The authors report a 7-month-old boy who presented with unilateral spontaneous bloody nipple discharge for 1 month without signs of infection or mass.

  13. Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge

    NARCIS (Netherlands)

    Bulthuis, Y.; Drossaers-Bakker, K.W.; Drossaers-Bakker, K.W.; Taal, Erik; Rasker, Johannes J.; Oostveen, J.; van 't Pad Bosch, P.; Oosterveld, F.; van de Laar, Mart A F J


    Objective: To examine the efficacy of short-term intensive exercise training (IET) directly following hospital discharge. - Methods: In the Disabled Arthritis Patients Post-hospitalization Intensive Exercise Rehabilitation (DAPPER) study, patients with rheumatoid arthritis or osteoarthritis were

  14. Long-Term Temporal Variability of the Freshwater Discharge and Water Levels at Patos Lagoon, Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    G. P. Barros


    Full Text Available The aim of this study is to investigate the importance of freshwater discharge as a physical forcing in Patos Lagoon at timescales longer than one year, as well as identify the temporal variability of the dominant processes in freshwater discharge and water levels along the Patos Lagoon. Due to its proximity to the mouth, the water level at the estuary is influenced by the remote effects associated with the adjacent ocean circulation and wave climatology, reducing the observed correlation. At the lagoonar region a high correlation is expected because interannual data is being used, reducing the influence of the wind. Cross wavelet technique is applied to examine the coherence and phase between interannual time-series (South Oscillation Index, freshwater discharge and water levels. The freshwater discharge of the main tributaries and water levels in Patos Lagoon are influenced by ENSO on interannual scales (cycles between 3.8 and 6 years. Therefore, El Niño events are associated with high mean values of freshwater discharge and water levels above the mean. On the other hand, La Niña events are associated with low mean values of freshwater discharge and water levels below the mean.

  15. Development of an autonomous device for long-term monitoring of radon in water as a tracer for submarine groundwater discharge

    International Nuclear Information System (INIS)

    Kamenik, Jan; Dulaiova, Henrieta; Babinec, James; Jolly, James; Williamson, Mario


    An autonomous SGD Sniffer was developed for long-term submarine groundwater discharge (SGD) monitoring. The device is equipped with a scintillation detector NaI(Tl) with a multichannel analyzer. The measurement is controlled by an embedded PC. The device is powered by batteries charged from photovoltaic panels and can be used in a remote area without any additional power source. The device detects gamma-lines from 214 Bi, a grand-grand daughter of 222 Rn. The gamma spectra are saved as text files and contain also basic diagnostic parameters for the analyzer and batteries. A script for batch processing of the spectra was developed for peak area determination. (author)

  16. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E


    BACKGROUND: Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been

  17. Effects of joint attention on long-term memory in 9-month-old infants: an event-related potentials study. (United States)

    Kopp, Franziska; Lindenberger, Ulman


    Joint attention develops during the first year of life but little is known about its effects on long-term memory. We investigated whether joint attention modulates long-term memory in 9-month-old infants. Infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high versus low). EEG indicators in response to old and novel objects were probed directly after the familiarization phase (immediate recognition), and following a 1-week delay (delayed recognition). In immediate recognition, the amplitude of positive slow-wave activity was modulated by joint attention. In the delayed recognition, the amplitude of the Pb component differentiated between high and low joint attention. In addition, the positive slow-wave amplitude during immediate and delayed recognition correlated with the frequency of infants' looks to the experimenter during familiarization. Under both high- and low-joint-attention conditions, the processing of unfamiliar objects was associated with an enhanced Nc component. Our results show that the degree of joint attention modulates EEG during immediate and delayed recognition. We conclude that joint attention affects long-term memory processing in 9-month-old infants by enhancing the relevance of attended items. © 2010 Blackwell Publishing Ltd.

  18. Long-term success and failure with SG is predictable by 3 months: a multivariate model using simple office markers. (United States)

    Cottam, Austin; Billing, Josiah; Cottam, Daniel; Billing, Peter; Cottam, Samuel; Zaveri, Hinali; Surve, Amit


    Despite being the most common surgery in the United States, little is known about predicting weight loss success and failure with sleeve gastrectomy (SG). Papers that have been published are inconclusive. We decided to use multivariate analysis from 2 practices to design a model to predict weight loss outcomes using data widely available to any surgical practice at 3 months to determine weight loss outcomes at 1 year. Two private practices in the United States. A retrospective review of 613 patients from 2 bariatric institutions were included in this study. Co-morbidities and other preoperative characteristics were gathered, and %EWL was calculated for 1, 3, and 12 months. Excess weight loss (%EWL)failure. Multiple variate analysis was used to find factors that affect %EWL at 12 months. Preoperative sleep apnea, preoperative diabetes, %EWL at 1 month, and %EWL at 3 months all affect %EWL at 1 year. The positive predictive value and negative predictive value of our model was 72% and 91%, respectively. Sensitivity and specificity were 71% and 91%, respectively. One-year results of the SG can be predicted by diabetes, sleep apnea, and weight loss velocity at 3 months postoperatively. This can help surgeons direct surgical or medical interventions for patients at 3 months rather than at 1 year or beyond. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Efficacy and safety of nimesulide long term administration in patients with osteoarthritis: results of 12-months open controlled study DINAMO (long term administration of nimesulide in osteoarthritis multifactor assessment

    Directory of Open Access Journals (Sweden)

    L I Alexeeva


    Full Text Available Objective. To compare efficacy and safety of nimesulide and paracetamol in treatment of patients with osteoarthritis (OA during 12 months. Material and methods. 40 women (mean age 66,8±5,1 years with knee osteoarthritis (II-III stage according to Kellgren-Lawrence having intensive pain (>40 mm on VAS were included. Group 1 pts (n=20 received nimesulide 200-100 mg/day. Group 2 pts were treated with paracetamol till 3 g/day. WOMAC was used as efficacy measure. Safety was assessed with endoscopic examination of upper gastrointestinal tract, ECG, blood pressure and ECG Holter monitoring, clinical and biochemical blood parameters. Statistical significance of differences was assessed with Student’s t-test, χ2 and Fisher exact test Results. WOMAC index decreased during treatment from 1182,7±345,9 to 698,4±351,1 for nimesulide and from 1136,4±313,8 to 1031,6±21 for paracetamol (p<0,05. There were 6 cases of gastrointestinal complications and 4 cases of hypertension development or deterioration in each group. Coronary heart disease developed or deteriorated in 4 patients receiving nimesulide but not in control group. Liver function tests did not deteriorated during treatment with nimesulide. Conclusion. Nimesulide was more effective than paracetamol in treatment of OA. But risk of cardiovascular complications development during treatment with NSAIDs requires serious attention. Nimesulide did not induced liver damage during long term treatment.

  20. The Ebb and Flow of Infant Attentional Preferences: Evidence for Long-Term Recognition Memory in 3-Month-Olds. (United States)

    Courage, Mary L.; Howe, Mark L.


    Two experiments used paired-comparisons to investigate 3-month olds' recognition of dynamic visual events after various retention intervals. Results indicated a changing pattern of attentional preferences over time consistent with models of infant recognition memory in which novelty, familiarity, and null preferences are considered conjointly and…

  1. Long-Term Retention in 3.5-Month-Olds: Familiarization Time and Individual Differences in Attentional Style. (United States)

    Courage, Mary L.; Howe, Mark L.


    Examined effect of familiarization on 3.5-month-olds' retention of visual stimuli with varying delay times. Found support for retention models in which direction of attentional preferences (novel, familiar, or null) depends on memory accessibility. Short lookers showed better retention over time than long lookers, indicating that much of the…

  2. Vagal tone as a biomarker of long-term memory for a stressful social event at 4 months. (United States)

    Montirosso, Rosario; Provenzi, Livio; Tronick, Ed; Morandi, Francesco; Reni, Gianluigi; Borgatti, Renato


    This study investigates infants' memory for social stress after a 15-day retention interval using behavior and respiratory sinus arrhythmia (RSA). Experimental group infants were exposed to face-to-face still-face paradigm (FFSF) two times; the first time at 4 months and after a 2-week interval. Control group infants were exposed to FFSF only once at 4 months plus 2 weeks. Infants were categorized as suppressors or non-suppressors based on the direction of RSA change at first FFSF exposure. No behavioral differences were found among groups and exposure conditions. In the experimental group suppressors changed and showed no suppression when re-exposed 2 weeks later to FFSF. Non-suppressors showed no change in RSA from the first to the second exposure to FFSF. Control infants showed similar RSA changes to experimental infants at their first exposure. Findings indicate that 4-month-old infants have memory for social stress related to individual differences in autonomic reactivity. © 2014 Wiley Periodicals, Inc.

  3. Mid- and long-term effects of family constellation seminars in a general population sample: 8- and 12-month follow-up. (United States)

    Hunger, Christina; Weinhold, Jan; Bornhäuser, Annette; Link, Leoni; Schweitzer, Jochen


    In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals' experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8-month follow-up, p = .000; d = 0.40 at 12-month follow-up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants' experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed. © 2014 Family Process Institute.

  4. Discharge-planning for long-term care needs: the values and priorities of older people, their younger relatives and health professionals. (United States)

    Denson, Linley A; Winefield, Helen R; Beilby, Justin J


    Discharge-planning decisions about long-term care (LTC) can be difficult and distressing for older people, families and discharge-planning health professionals. Retrospective research suggests that despite good intentions and a shared focus on the best interests of the older person, stakeholders may hold very different values about good outcomes and how to decide them. We aimed to compare the opinions and values of frail elders living at home, younger relatives and health professionals experienced in discharge-planning, prospectively: before, not after, a LTC decision. We interviewed three types of stakeholders (10 older people, 8 relatives and 18 health professionals) using a hypothetical vignette about a frail elder leaving hospital. In a mixed methods design, we quantitatively compared the discharge plans and decision-makers that stakeholders suggested, and qualitatively analysed the 36 interview transcripts for participants' articulation of underlying values during these discussions. Older participants often suggested safe restrictive options (residential care, proxy decision-making) for the hypothetical frail elder, while advocating autonomy for themselves. Younger people generally endorsed autonomous decision-making and less restrictive discharge options especially if the elder was mentally competent, but reported difficult ethical tensions between safety and autonomy. Individual personality and preferences, mental capacity, and the importance of personal care in supporting autonomy were central themes consistent with the Ecological Theory of Aging. Accordingly, discharge planners can usefully articulate the balance of safety and autonomy, conceptualizing home care as maintaining independence rather than accepting dependence. Ethical training should incorporate sophisticated models of practice specifying both psychological and physical safety as components of beneficence. Few elders adopt a consumer approach to LTC: health professionals can encourage mid

  5. Long-Term Outcomes in Patients with Neovascular Age-Related Macular Degeneration Who Maintain Dry Macula after Three Monthly Ranibizumab Injections. (United States)

    Kim, Kyung Min; Kim, Jae Hui; Chang, Young Suk; Kim, Jong Woo; Kim, Chul Gu


    To evaluate long-term changes in visual acuity and retinal microstructure in patients with neovascular age-related macular degeneration (AMD) who had maintained dry macula after initial treatment. This retrospective observational study included 55 eyes that were diagnosed with neovascular AMD, were treated with three monthly ranibizumab injections, and maintained dry macula during a two-year follow-up. Best-corrected visual acuity (BCVA) at three months and at the final follow-up were compared, and the degree of visual improvement was compared between eyes with and without improvement of the ellipsoid zone. In addition, the incidence of improvement of the ellipsoid zone was compared between eyes with different extents of disruption. The mean follow-up period was 30.3 ± 4.1 months. BCVA at three months and at the final follow-up was 0.51 ± 0.46 and 0.45 ± 0.49 (P200 μm of disruption of the ellipsoid zone, 15 (42.9%) showed improvement of the ellipsoid zone, and the improvement in BCVA was greater in these eyes than that in the remaining 20 eyes (P=0.021). A higher incidence of improvement of the ellipsoid zone was noted in eyes with 200 to 800 μm of disruption than in eyes with >800 μm of disruption (P<0.001). Long-term improvement in visual acuity was noted in eyes that had maintained dry macula after three ranibizumab injections. The status of the ellipsoid zone at three months was closely associated with visual improvement.

  6. The impact of reforestation on discharge and sediment fluxes in drylands: long-term evidences from the Western Rift Valley Escarpment (Northern Ethiopia) (United States)

    Asfaha, Tesfaalem; Frankl, Amaury; Zenebe, Amanuel; Haile, Mitiku; Nyssen, Jan


    Deforestation and land degradation have been common problems in the Northern Ethiopian highlands, including for the Western Rift Valley Escarpment. In particular, the rapid deforestation of the steep catchments (average slope gradient of 44% ± 10%) in the second half of 20th century, together with rainfall variability and over-cultivation, resulted in the development of dense gully and scar networks. Subsequently, huge amounts sediment were taken to the densely populated graben bottoms. In response, extensive reforestation interventions were carried out as of the 1980s, resulting in improvements of vegetation cover in many catchments. This study analyses the spatio-temporal changes in vegetation cover and rainfall variability and their impact on discharge and sediment transport in escarpment catchments. Degree of rehabilitation was examined in 20 adjacent catchments by correlating the density of scar networks incised down to the bed rock with Normalize Difference Vegetation Index (NDVI) and slope gradient. Based on these results, 11 contrasting catchments were selected for detailed investigation. To study the current spatio-temporal variability in rainfall and its relation with daily peak discharge, 7 rain gauges were installed at different locations and altitudes. Trendlines of decadal rainfall variability since 1996 will be established based on the analysis of NOAA's rainfall estimates, and long-term rainfall variability will be explored by correlating the field data to long-term rainfall measurements in nearby synoptic stations. The changes in land use and cover will be detected from aerial photos of the 1935, 1965 and 1986. Peak discharges were monitored using 11 crest stage gauges. Fixed boulders were painted in stream reaches to quantify the transport of bedload. This was done by photographing the stream reaches and by measuring the displacement of painted boulders after flood events. In a multiple regression analysis, scar density was negatively related

  7. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ding, William, E-mail: [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Lee, John [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Chamberlain, David [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States); Cunningham, James [Carson Urology, Carson City, Nevada (United States); Yang Lixi [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Tay, Jonathan [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States)


    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naieve patients with localized adenocarcinoma of the prostate treated at St. Mary's Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of {<=}1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic

  8. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    International Nuclear Information System (INIS)

    Ding, William; Lee, John; Chamberlain, David; Cunningham, James; Yang Lixi; Tay, Jonathan


    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naïve patients with localized adenocarcinoma of the prostate treated at St. Mary’s Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of ≤1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic variables for

  9. Long-term stability of contour augmentation in the esthetic zone: histologic and histomorphometric evaluation of 12 human biopsies 14 to 80 months after augmentation. (United States)

    Jensen, Simon S; Bosshardt, Dieter D; Gruber, Reinhard; Buser, Daniel


    Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure. Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis. The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed. The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

  10. Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists. (United States)

    Hamilton-West, Kate; Hotham, Sarah; Yang, Wei; Hedayioglu, Julie; Brigden, Charlotte


    Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a 'safety net' they could fall back on in case of difficulties, whereas staff used the analogy of a 'bridge' to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient's care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.

  11. Effectiveness of long-term (twelve months) nonsurgical weight loss interventions for obese women with polycystic ovary syndrome: a systematic review. (United States)

    Nicholson, Fiona; Rolland, Catherine; Broom, John; Love, John


    Polycystic ovary syndrome (PCOS) affects 2%-26% of women of reproductive age and is often accompanied by obesity. Modest weight loss reduces health risks and ameliorates effects of the syndrome. Weight loss interventions are mainly of short duration and have limited success. A systematic review of the literature was carried out to assess the efficacy of long-term (12 months), nonsurgical weight loss interventions for women with PCOS. Fifteen databases were searched, resulting in eight papers that met the search criteria. Comparison of results and meta-analysis was difficult due to heterogeneity of studies. Behavioral components of interventions were poorly described, and compliance was difficult to ascertain. The results suggested that the inclusion of a lifestyle component improves outcomes, but protocols must be clearly described to maintain study validity and to identify successful behavioral strategies.

  12. Long-term remineralizing effect of MI Paste Plus on regression of early caries after orthodontic fixed appliance treatment: a 12-month follow-up randomized controlled trial. (United States)

    Beerens, Moniek W; Ten Cate, Jacob M; Buijs, Mark J; van der Veen, Monique H


    Casein-phosphopeptide-amorphous-calcium-fluoride-phosphate (CPP-ACFP) can remineralize subsurface lesions. It is the active ingredient of MI-Paste-Plus® (MPP). The long-term remineralization efficacy is unknown. To evaluate the long-term effect of MPP versus a placebo paste on remineralization of enamel after fixed orthodontic treatment over a 12-month period. This trial was designed as a prospective, double-blinded, placebo-controlled RCT. Patients with subsurface lesions scheduled for removal of the appliance were included. They applied either MPP or control paste once a day at bedtime for 12 months, complementary to normal oral hygiene. Changes in enamel lesions (primary outcome) were fluorescence loss and lesion area determined by quantitative light-induced fluorescence (QLF). Secondary outcomes were Microbial composition, by conventional plating, and acidogenicity of plaque, by capillary ion analysis (CIA), and lesion changes scored visually on clinical photographs. Participants [age = 15.5 years (SD = 1.6)] were randomly assigned to either the MPP or the control group, as determined by a computer-randomization scheme, created and locked before the start of the study. Participants received neutral-coloured concealed toothpaste tubes marked A or B. The patients and the observers were blinded with respect to the content of tube A or B. A total of 51 patients were analysed; MPP (n = 25) versus control group (n = 26); data loss (n = 14). There was no significant difference between the groups over time for all the used outcome measures. There was a significant improvement in enamel lesions (fluorescence loss) over time in both groups (P orthodontic fixed appliance treatment did not improve these lesions during the 1 year following debonding. This trial is registered at the medical ethical committee of the VU Medical Centre in Amsterdam (NL.199226.029.07). © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society

  13. Long-term omega-3 supplementation modulates behavior, hippocampal fatty acid concentration, neuronal progenitor proliferation and central TNF-α expression in 7 month old unchallenged mice (United States)

    Grundy, Trent; Toben, Catherine; Jaehne, Emily J.; Corrigan, Frances; Baune, Bernhard T.


    Dietary polyunsaturated fatty acid (PUFA) manipulation is being investigated as a potential therapeutic supplement to reduce the risk of developing age-related cognitive decline (ARCD). Animal studies suggest that high omega (Ω)-3 and low Ω-6 dietary content reduces cognitive decline by decreasing central nervous system (CNS) inflammation and modifying neuroimmune activity. However, no previous studies have investigated the long term effects of Ω-3 and Ω-6 dietary levels in healthy aging mice leaving the important question about the preventive effects of Ω-3 and Ω-6 on behavior and underlying molecular pathways unaddressed. We aimed to investigate the efficacy of long-term Ω-3 and Ω-6 PUFA dietary supplementation in mature adult C57BL/6 mice. We measured the effect of low, medium, and high Ω-3:Ω-6 dietary ratio, given from the age of 3–7 months, on anxiety and cognition-like behavior, hippocampal tissue expression of TNF-α, markers of neuronal progenitor proliferation and gliogenesis and serum cytokine concentration. Our results show that a higher Ω-3:Ω-6 PUFA diet ratio increased hippocampal PUFA, increased anxiety, improved hippocampal dependent spatial memory and reduced hippocampal TNF-α levels compared to a low Ω-3:Ω-6 diet. Furthermore, serum TNF-α concentration was reduced in the higher Ω-3:Ω-6 PUFA ratio supplementation group while expression of the neuronal progenitor proliferation markers KI67 and doublecortin (DCX) was increased in the dentate gyrus as opposed to the low Ω-3:Ω-6 group. Conversely, Ω-3:Ω-6 dietary PUFA ratio had no significant effect on astrocyte or microglia number or cell death in the dentate gyrus. These results suggest that supplementation of PUFAs may delay aging effects on cognitive function in unchallenged mature adult C57BL/6 mice. This effect is possibly induced by increasing neuronal progenitor proliferation and reducing TNF-α. PMID:25484856

  14. Effectiveness of long-term (twelve months nonsurgical weight loss interventions for obese women with polycystic ovary syndrome: a systematic review

    Directory of Open Access Journals (Sweden)

    Fiona Nicholson


    Full Text Available Fiona Nicholson1, Catherine Rolland1, John Broom1, John Love21Centre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen, Scotland; 2School of Applied Social Studies, Faculty of Health and Social Care, The Robert Gordon University, Aberdeen, ScotlandAbstract: Polycystic ovary syndrome (PCOS affects 2%–26% of women of reproductive age and is often accompanied by obesity. Modest weight loss reduces health risks and ameliorates effects of the syndrome. Weight loss interventions are mainly of short duration and have limited success. A systematic review of the literature was carried out to assess the efficacy of long-term (12 months, nonsurgical weight loss interventions for women with PCOS. Fifteen databases were searched, resulting in eight papers that met the search criteria. Comparison of results and meta-analysis was difficult due to heterogeneity of studies. Behavioral components of interventions were poorly described, and compliance was difficult to ascertain. The results suggested that the inclusion of a lifestyle component improves outcomes, but protocols must be clearly described to maintain study validity and to identify successful behavioral strategies.Keywords: obesity, polycystic ovary syndrome, weight loss 

  15. Long Term Effects on Risk Factors for Cardiovascular Disease after 12-Months of Aerobic Exercise Intervention - A Worksite RCT among Cleaners.

    Directory of Open Access Journals (Sweden)

    Mette Korshøj

    Full Text Available Occupational groups exposed to high occupational physical activity have an increased risk for cardiovascular disease (CVD. This may be explained by the high relative aerobic workload. Enhanced cardiorespiratory fitness reduces the relative aerobic workload. Thus, the aim was to evaluate the 12-months effects of worksite aerobic exercise on risk factors for CVD among cleaners.One hundred and sixteen cleaners aged 18-65 years were randomized to a group performing aerobic exercise and a reference group receiving lectures. Outcomes were collected at baseline and after 12-months. A repeated measures 2×2 multi-adjusted mixed-model design was applied to compare the between-group differences using intention-to-treat analysis.Between-group differences (p<0.05 were found favouring the aerobic exercise group: cardiorespiratory fitness 2.15 (SE 1.03 mlO2/min/kg, aerobic workload -2.15 (SE 1.06 %HRR, resting HR -5.31 (SE 1.61 beats/min, high sensitive C-reactive protein -0.65 (SE 0.24 μg/ml. The blood pressure was unaltered. Stratified analyses on relative aerobic workload at baseline revealed that those with relative aerobic workloads ≥30% of HRR seems to impose a notable adverse effect on resting and ambulatory blood pressure.This long-term worksite aerobic exercise intervention among cleaners led to several beneficial effects, but also potential adverse effects among those with high relative aerobic ISRCTN86682076.

  16. Service use and costs for people with long-term neurological conditions in the first year following discharge from in-patient neuro-rehabilitation: a longitudinal cohort study.

    Directory of Open Access Journals (Sweden)

    Diana Jackson

    Full Text Available BACKGROUND: Knowledge of the configuration and costs of community rehabilitation and support for people with long-term neurological conditions (LTNCs is needed to inform future service development and resource allocation. In a multicentre prospective cohort study evaluating community service delivery during the year post-discharge from in-patient neuro-rehabilitation, a key objective was to determine service use, costs, and predictors of these costs. METHODS: Patients consecutively admitted over one year to all nine London specialised (Level 1 in-patient neuro-rehabilitation units were recruited on discharge. They or their carers completed postal/web-based questionnaires at discharge and six and twelve months later, providing demographic data and measures of impairment, disability, service needs and provision. This paper describes health and social care service use, informal care and associated costs. Regression models using non-parametric boot-strapping identified predictors of costs over time. RESULTS: Overall, 152 patients provided consistent data. Mean formal service costs fell significantly from £13,290 (sd £19,369 during the first six months to £9,335 (sd £19,036 from six-twelve months, (t = 2.35, P<0.05, mainly due to declining health service use. At six months, informal care was received on average for 8.2 hours/day, mean cost £14,615 (sd 23,305, comprising 52% of overall care costs. By twelve months, it had increased to 8.8 hours per day, mean cost £15,468 (sd £25,534, accounting for 62% of overall care costs. Being younger and more disabled predicted higher formal care costs, explaining 32% and 30% of the variation in costs respectively at six and twelve months. CONCLUSION: Community services for people with LTNCs carry substantial costs that shift from health to social care over time, increasing the burden on families. Prioritising rehabilitation services towards those in greatest need could limit access to others needing on

  17. Estimating the monthly discharge of a photovoltaic water pumping system: Model verification

    International Nuclear Information System (INIS)

    Amer, E.H.; Younes, M.A.


    A simple algorithm has been adopted for estimating the long term performance of a photovoltaic water pumping system without battery storage. The method uses the standard solar utilizability correlation equation to calculate the flow rate of the system, knowing an insolation threshold value. The method uses the monthly average solar radiation as the only input. The nonlinear relation between flow rate and solar insolation has been obtained experimentally in a first step and then used for performance prediction. The meteorological data collected instantaneously at the site of the pumping system has been used to obtain the monthly average values for solar radiation that are needed by the method. The method has been validated by predicting the performance of two PV pumping systems. The average output of the systems predicted by the method has been compared with experimental measurements. The estimated discharge differs by about 5% from the experimental measurements

  18. Long-term changes in the surface conditions of PLT

    International Nuclear Information System (INIS)

    Cohen, S.A.; Dylla, H.F.; Rossnagel, S.M.; Picraux, S.T.; Borders, J.A.; Magee, C.W.


    Long-term changes in the surface conditions of the PLT vacuum vessel wall have been monitored by the periodic analysis of a variety of sample substrates (stainless steel, alumina, silicon), exposed to PLT discharges for periods of up to several months and subsequently removed for analysis by Auger electron spectroscopy (AES), photoelectron spectroscopy, ion backscattering, nuclear reaction analysis, secondary ion mass spectroscopy, and scanning electron microscopy

  19. Long-term effects of discharges of produced water the marine environment from petroleum-related activities at Sonda de Campeche, Gulf of México. (United States)

    Schifter, I; González-Macías, C; Salazar-Coria, L; Sánchez-Reyna, G; González-Lozano, C


    Produced water from offshore oil platforms is a major source of oil and related chemicals into the sea. The large volume and high salinity of produced water could pose severe environmental impacts upon inadequate disposal. This study is based on direct field sampling of effluents released into the ocean in the years 2003 and 2013 at the Sonda de Campeche located in the southern part of the Gulf of Mexico. Metals and hydrocarbons were characterized in water, sediments, and fish tissues at the discharge site and compared with those obtained at two reference sites. Chemicals that exceeded risk-based concentrations in the discharge included the metals As, Pb, Cd, and Cr, and a variety of compounds polycyclic aromatic hydrocarbon (PAHs), including naphthalene, fluorenes, and low molecular weight PAHs. The values of low to high molecular weight polycyclic aromatic hydrocarbon (PAHs), and carbon preference index indicate that hydrocarbons in sediments of the discharge zone are originated from the produced water and combustion sources. Fish tissues at the discharge zone and reference site are contaminated with PAHs, dominated by 2- and 3-rings; 4-ring accounted for less than 1% of total PAHs (TPAHs) in 2003, but increased to 7% in 2013. Results suggest that, from 2003 to 2013, discharges of produced water have had a non-negligible impact on ecosystems at a regional level, so the possibility of subtle, cumulative effects from operational discharges should not be ignored.

  20. Increasing Steps in Recall of Events: Factors Facilitating Immediate and Long-Term Memory in 13.5- and 16.5-Month-Old Children. (United States)

    Bauer, Patricia J.; Hertsgaard, Louise A.


    Results of 3 experiments indicated that 13.5- and 16.5-month-old children recalled multiple sequences after a 1-week delay. Without cues, the recall of 16.5-month olds was facilitated by familiarity and by enabling relations; only enabling relations aided the 13.5-month olds' recall. With verbal cues, the recall of 13.5- and 16.5-month olds was…

  1. Assessment of capacity loss in low-rate lithium/bromine chloride in thionyl chloride cells by microcalorimetry and long-term discharge (United States)

    Takeuchi, E. S.; Meyer, S. M.; Holmes, C. F.


    Real-time discharge is one of the few reliable methods available for determining capacities of low-rate cells. The utilization of high energy density lithium batteries in low-rate implantable applications has increased the need for more time-efficient methods of predicting cell longevity since cells have been shown to last in excess of eight years. The relationship between heat dissipation and self-discharge of low-rate lithium/BCX (bromine chloride in thionyl chloride) cells was studied and allows prediction of cell life prior to the availability of real-time data. The method was verified by real-time cell discharge data and provided estimates of delivered capacity within 6 percent of the actual values.

  2. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme


    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  3. Long-term tolerability of tolterodine extended release in children 5-11 years of age: results from a 12-month, open-label study

    DEFF Research Database (Denmark)

    Nijman, Rien J M; Borgstein, Niels G; Ellsworth, Pamela


    OBJECTIVE: To evaluate the long-term tolerability of tolterodine extended release (ER) in children (aged 5-11 yr) with urgency urinary incontinence (UUI). METHODS: This was a multicenter, open-label extension of a 12-wk, double-blind, placebo-controlled study of tolterodine ER. Patients had UUI...... suggestive of detrusor overactivity (>/=1 diurnal incontinence episode per 24h for >/=5 of 7 d) and >/=6 voids per 24h at baseline and had completed the 12-wk double-blind study. Patients received tolterodine ER (2mg once daily) for 12 mo. The primary end points were the incidence and severity of adverse......-blind tolterodine ER, n=221; placebo, n=97). The majority of patients were white (90%), mean+/-SD age was 7.6+/-1.5 yr, and 54% were boys. Forty-nine percent of patients reported >/=1 AE during the study, similar to that observed in the preceding 12-wk study (42%). The most frequent AEs were urinary tract infection...

  4. Number Size Distribution of Ambient Particles in a Typical Urban Site: The First Polish Assessment Based on Long-Term (9 Months Measurements

    Directory of Open Access Journals (Sweden)

    Krzysztof Klejnowski


    Full Text Available This work presents results from the long-term measurements of particle number carried out at an urban background station in Zabrze, Poland. Ambient particles with aerodynamic diameters of between 28 nm and 10 μm were investigated by means of a DEKATI thirteen-stage electrical low pressure impactor (ELPI. The particle number-size distribution was bimodal, whilst its density function had the local maxima in the aerodynamic diameter intervals 0.056–0.095 μm and 0.157–0.263 μm. The average particle number in winter was nearly twice as high as in summer. The greatest number concentrations in winter were those of the particles with diameters of between 0.617 and 2.41 μm, that is, the anthropogenic particles from fossil fuel combustion. Approximately 99% of the particles observed in Zabrze had aerodynamic diameters ≤1 μm—they may have originated from the combustion of biomass, liquid, and gaseous fuels in domestic stoves or in car engines. The daily variation of particle number was similar for both seasons—the highest values were observed in the morning (traffic rush hour and in the afternoon/late evening (traffic and house heating emissions. An additional maximum (0.028–0.056 μm observed in the early afternoon in summer was due to the intensive formation of new PM particles from gas precursors.

  5. Vitamin A supplementation and risk of atopy: long-term follow-up of a randomized trial of vitamin A supplementation at six and nine months of age. (United States)

    Kiraly, Nicholas; Balde, Aliu; Lisse, Ida Marie; Eriksen, Helle Brander; Aaby, Peter; Benn, Christine Stabell


    The World Health Organization recommends high-dose vitamin A supplementation (VAS) for children above six months of age in low-income countries. VAS has been associated with up-regulation of the Th2 response. We aimed to determine if VAS is associated with atopy in childhood. Infants in Guinea-Bissau were randomly allocated VAS or placebo, either at six and nine months of age, or only at nine months of age. At six months of age, children were furthermore randomized to measles vaccine or inactivated polio vaccine. At nine months of age all children received measles vaccine. Children were revisited seven years later and skin prick testing was performed. Atopy was defined as a skin prick reaction ≥ 3 mm. 40 of 263 children (15%) were atopic. Overall VAS had no significant effect on the risk of atopy (Prevalence Ratio 1.23; 95% CI 0.69-2.18). The Prevalence Ratio was 1.60 (0.66-3.90) for males and 1.00 (0.46-2.15) for females. There was no significant effect of VAS in infancy on atopy later in childhood. The role of infant VAS in the development of atopy is still unclear.

  6. Long-term (12-month) improvement in meibomian gland function and reduced dry eye symptoms with a single thermal pulsation treatment. (United States)

    Greiner, Jack V


    To determine the 1-year post-treatment dry eye status of subjects with meibomian gland dysfunction and dry eye symptoms after receiving a single LipiFlow Thermal Pulsation System treatment. Single-centre, prospective, observational, open-label, 1-month-registered clinical trial with a 1-year follow-up examination. Patients with evaporative dry eye disease with meibomian gland dysfunction and dry eye symptoms who had participated in the registered 1-month clinical trial. Eighteen of 30 subjects initially enrolled were able to return for a 1-year follow-up. Both eyes of all patients were treated with a single 12-min treatment using the LipiFlow Thermal Pulsation System. Meibomian gland function, tear break-up time and dry eye symptoms were measured. Data are presented for pretreatment (baseline), and 1-month and 1-year post-treatment. Meibomian gland secretion scores, and tear break-up time and dry eye symptoms. Significant improvement in meibomian gland secretion scores from baseline measurements (4.0 ± 3.4) to 1-month post-treatment (11.3 ± 4.7; P treatment (6.0 ± 4.4). The significant improvement in symptom scores on Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires observed at 1-month (P Eye Dryness [P treatment with the Lipi Flow Thermal Pulsation System offers an effective treatment for evaporative dry eye and meibomian gland dysfunction resulting in significant and sustained improvement in signs and symptoms for up to 1 year. © 2012 The Author. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  7. Long-term cognitive outcome of very low birth-weight Saudi preterm infants at the corrected age of 24-36 months. (United States)

    Sobaih, Badr H


    To assess infants' cognitive function at the corrected age of 24-36 months, and to identify factors associated with adverse outcome and examine the correlation between Bayley Infants Neurodevelopmental Screener (BINS) score and Gesell Schedule of Child Development (GSCD). Methods: This retrospective study was performed on Saudi very low birth-weight (VLBW)  infants born   in King Khalid University Hospital, Riyadh, Saudi Arabia between 1997 and 2014 by the use of BINS as screening test and GSCD as definitive test. Results: Of 561 enrolled infants, 367 (65.4%) continued to follow-up. Three-hundred and fifteen infants (85.6%) had a normal cognitive function. In addition to lower birth weight (beta = -0.003) (p less than 0.001), male gender (OR =3.9) (p=0.001)and cerebral palsy (OR =33.9) (p less than 0.001) were the strongest factors associated with poor cognitive outcome. Approximately 75.4% of infants with normal BINS score had normal cognitive function and 7.6% of total infants had sever cognitive impairment. Conclusion: The majority of VLBW infants in our center have  normal cognitive function at the corrected age of 24-36 months. Male gender, lower birth weight, and cerebral palsy are major predictors of poor outcome. The BINS scores were correlated with GSCD as a valid predictor for future developmental outcome.

  8. Long-Term Collections

    CERN Multimedia

    Staff Association


    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  9. Long-Term Collection

    CERN Multimedia

    Staff Association


    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  10. Collectes à long terme

    CERN Multimedia

    Collectes à long terme


    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  11. A comparison of performance of several artificial intelligence methods for forecasting monthly discharge time series (United States)

    Wang, Wen-Chuan; Chau, Kwok-Wing; Cheng, Chun-Tian; Qiu, Lin


    SummaryDeveloping a hydrological forecasting model based on past records is crucial to effective hydropower reservoir management and scheduling. Traditionally, time series analysis and modeling is used for building mathematical models to generate hydrologic records in hydrology and water resources. Artificial intelligence (AI), as a branch of computer science, is capable of analyzing long-series and large-scale hydrological data. In recent years, it is one of front issues to apply AI technology to the hydrological forecasting modeling. In this paper, autoregressive moving-average (ARMA) models, artificial neural networks (ANNs) approaches, adaptive neural-based fuzzy inference system (ANFIS) techniques, genetic programming (GP) models and support vector machine (SVM) method are examined using the long-term observations of monthly river flow discharges. The four quantitative standard statistical performance evaluation measures, the coefficient of correlation ( R), Nash-Sutcliffe efficiency coefficient ( E), root mean squared error (RMSE), mean absolute percentage error (MAPE), are employed to evaluate the performances of various models developed. Two case study river sites are also provided to illustrate their respective performances. The results indicate that the best performance can be obtained by ANFIS, GP and SVM, in terms of different evaluation criteria during the training and validation phases.

  12. The long-term course of temporal lobe epilepsy: From unilateral to bilateral interictal epileptiform discharges in repeated video-EEG monitorings. (United States)

    Gollwitzer, Stephanie; Scott, Catherine A; Farrell, Fiona; Bell, Gail S; de Tisi, Jane; Walker, Matthew C; Wehner, Tim; Sander, Josemir W; Hamer, Hajo M; Diehl, Beate


    Bilateral interictal epileptiform discharges (IED) and ictal patterns are common in temporal lobe epilepsy (TLE) and have been associated with decreased chances of seizure freedom after epilepsy surgery. It is unclear whether secondary epileptogenesis, although demonstrated in experimental models, exists in humans and may account for progression of epilepsy. We reviewed consecutive video-EEG recordings from 1992 to 2014 repeated at least two years apart (mean interval 6.14years) in 100 people diagnosed with TLE. Ictal EEG patterns and IED remained restricted to one hemisphere in 36 people (group 1), 46 exhibited bilateral abnormalities from the first recording (group 2), 18 progressed from unilateral to bilateral EEG pathology over time (group 3). No significant differences between the three groups were seen with respect to age at epilepsy onset, duration, or underlying pathology. Extra-temporal IED during the first EEG recording were associated with an increased risk of developing bilateral epileptiform changes over time (hazard ratio 3.67; 95% CI 1.4, 9.4). Our findings provide some support of progression in TLE and raise the possibility of secondary epileptogenesis in humans. The development of an independent contra-lateral epileptogenic focus is known to be associated with a less favorable surgical outcome. We defined reliable EEG markers for an increased risk of progression to more widespread or independent bitemporal epileptogenicity at an early stage, thus allowing for individualized pre-surgical counselling. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The effects of long-term oral benfotiamine supplementation on peripheral nerve function and inflammatory markers in patients with type 1 diabetes: a 24-month, double-blind, randomized, placebo-controlled trial. (United States)

    Fraser, David A; Diep, Lien M; Hovden, Inger Anette; Nilsen, Kristian B; Sveen, Kari Anne; Seljeflot, Ingebjørg; Hanssen, Kristian F


    To study the effects of long-term oral benfotiamine supplementation on peripheral nerve function and soluble inflammatory markers in patients with type 1 diabetes. The study randomly assigned 67 patients with type 1 diabetes to receive 24-month benfotiamine (300 mg/day) or placebo supplementation. Peripheral nerve function and levels of soluble inflammatory variables were assessed at baseline and at 24 months. Fifty-nine patients completed the study. Marked increases in whole-blood concentrations of thiamine and thiamine diphosphate were found in the benfotiamine group (both P benfotiamine (300 mg/day) supplementation over 24 months has no significant effects upon peripheral nerve function or soluble markers of inflammation in patients with type 1 diabetes.

  14. Stability of Zircon and Its Isotopic Ratios in High-Temperature Fluids: Long-Term (4 months Isotope Exchange Experiment at 850°C and 50 MPa

    Directory of Open Access Journals (Sweden)

    Ilya N. Bindeman


    Full Text Available Stability of zircon in hydrothermal fluids and vanishingly slow rates of diffusion identify zircon as a reliable recorder of its formation conditions in recent and ancient rocks. Debate, however, persists on how rapidly oxygen and key trace elements (e.g., Li, B, Pb diffuse when zircon is exposed to silicate melt or hot aqueous fluids. Here, we report results of a nano- to micrometer-scale investigation of isotopic exchange using natural zircon from Mesa Falls Tuff (Yellowstone treated with quartz-saturated, isotopically (18O, D, 7Li, and 11B labeled water with a nominal δ18O value of +450%0 over 4 months at 850°C and 50 MPa. Frontside (crystal rim inwards δ18O depth profiling of zircon by magnetic sector SIMS shows initially high but decreasing 18O/16O over a ~130 nm non-Fickian profile, with a decay length comparable to the signal from surficial Au coating deposited onto zircon. In contrast, backside (crystal interior outwards depth profiling on a 2-3 μm thick wafer cut and thinned from treated zircon by focused ion beam (FIB milling lacks any significant increase in 18O/16O during penetration of the original surface layer. Near-surface time-of-flight (TOF-SIMS frontside profiles of uncoated zircon from 4-month and 1-day-long experiments as well as untreated zircons display similar enrichments of 18O over a distance of ~20 nm. All frontside 18O profiles are here interpreted as transient surface signals from nm-thick surface enrichment or contamination unrelated to diffusion. Likewise, frontside depth profiling of H, Li, and B isotopes are similar for long- and short-duration experiments. Additionally, surface U-Pb dating of zircon from the 4-month experiment returned U-Pb ages by depth profiling with ~1 μm penetration that were identical to untreated samples. Frontside and backside depth-profiling thus demonstrate that diffusive 18O enrichment in the presence of H2O is much slower than predicted from experiments in Watson and Cherniak

  15. Long-term performance of grid-connected photovoltaic plant - Appendix 2: normalised monthly statistics; Langzeitverhalten von netzgekoppelten Photovoltaikanlagen 2 (LZPV2). Anhang 2: Normierte Monatsstatistiken

    Energy Technology Data Exchange (ETDEWEB)

    Renken, C.; Haeberlin, H.


    This is the third part of a four-part final report for the Swiss Federal Office of Energy (SFOE) made by the University of Applied Sciences in Burgdorf, Switzerland. This report presents the findings of a project begun in 1992 that monitored the performance of around 40 photovoltaic (PV) installations in Switzerland. This extensive second appendix to the report describes the eight installations that were monitored in detail, including - amongst others - the demonstration installations on Mont Soleil in the Jura mountains and on the Jungfraujoch in the Alps as well as three test installations using modern thin-film technologies in Burgdorf. The normalised monthly specific performance of these installations was monitored. The report presents the various performance figures in graphical form.

  16. Magnifying Endoscopic Findings Can Predict Clinical Outcome during Long-Term Follow-Up of More Than 12 Months in Patients with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Hajime Isomoto


    Full Text Available Background and Aims. To explore the association of magnifying endoscopic (ME findings with histopathology and relapse in ulcerative colitis (UC. Methods. Forty-six patients with UC underwent ME with narrow band imaging (NBI and crystal violet staining and were followed for more than 12 months. ME findings with vital staining were classified into ME-A, regular arrangement of round to oval pits; ME-B, irregular arrangement with/without enlarged spaces between even pits; ME-C, irregular pits in size and shape with more irregular arrangement of pits; and ME-D, disrupted or disappeared pits. NBI-guided ME features of microvascular pattern (MVP were divided into the MVP-regular and MVP-irregular type. Results. There were 5, 24, 10, and 7 cases of ME-A, ME-B, ME-C, and ME-D grade, respectively, while there were 21 and 25 of MVP-regular and MVP-irregular type, respectively. ME classifications were significantly associated with Matts endoscopic grade. ME classifications and MVP types were significantly associated with each pathognomonic microscopic feature of severe mucosal inflammation, crypt abscess, and goblet cell depletion. There were significant differences in the percentages of remission among ME classifications and between MVP types. Conclusion. ME findings can be predictive of relapse in UC and reliable for in vivo histopathological assessment.

  17. Introduction: Long term prediction

    International Nuclear Information System (INIS)

    Beranger, G.


    Making a decision upon the right choice of a material appropriate to a given application should be based on taking into account several parameters as follows: cost, standards, regulations, safety, recycling, chemical properties, supplying, transformation, forming, assembly, mechanical and physical properties as well as the behaviour in practical conditions. Data taken from a private communication (J.H.Davidson) are reproduced presenting the life time range of materials from a couple of minutes to half a million hours corresponding to applications from missile technology up to high-temperature nuclear reactors or steam turbines. In the case of deep storage of nuclear waste the time required is completely different from these values since we have to ensure the integrity of the storage system for several thousand years. The vitrified nuclear wastes should be stored in metallic canisters made of iron and carbon steels, stainless steels, copper and copper alloys, nickel alloys or titanium alloys. Some of these materials are passivating metals, i.e. they develop a thin protective film, 2 or 3 nm thick - the so-called passive films. These films prevent general corrosion of the metal in a large range of chemical condition of the environment. In some specific condition, localized corrosion such as the phenomenon of pitting, occurs. Consequently, it is absolutely necessary to determine these chemical condition and their stability in time to understand the behavior of a given material. In other words the corrosion system is constituted by the complex material/surface/medium. For high level nuclear wastes the main features for resolving problem are concerned with: geological disposal; deep storage in clay; waste metallic canister; backfill mixture (clay-gypsum) or concrete; long term behavior; data needed for modelling and for predicting; choice of appropriate solution among several metallic candidates. The analysis of the complex material/surface/medium is of great importance

  18. Long-Term Symbolic Learning

    National Research Council Canada - National Science Library

    Kennedy, William G; Trafton, J. G


    What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks...


    CERN Multimedia



    ACKNOWLEDGMENTS The Long-Term Collections (CLT) committee would like to warmly thank its faithful donors who, year after year, support our actions all over the world. Without you, all this would not be possible. We would like to thank, in particular, the CERN Firemen’s Association who donated 5000 CHF in the spring thanks to the sale of their traditional calendar, and the generosity of the CERN community. A huge thank you to the firemen for their devotion to our cause. And thank you to all those who have opened their door, their heart, and their purses! Similarly, we warmly thank the CERN Yoga Club once again for its wonderful donation of 2000 CHF we recently received. We would also like to tell you that all our projects are running well. Just to remind you, we are currently supporting the activities of the «Réflexe-Partage» Association in Mali; the training centre of «Education et Développement» in Abomey, Benin; and the orphanage and ...

  20. Evaluating long term forecasts

    Energy Technology Data Exchange (ETDEWEB)

    Lady, George M. [Department of Economics, College of Liberal Arts, Temple University, Philadelphia, PA 19122 (United States)


    The U.S. Department of Energy's Energy Information Administration (EIA), and its predecessor organizations, has published projections of U.S. energy production, consumption, distribution and prices annually for over 30 years. A natural issue to raise in evaluating the projections is an assessment of their accuracy compared to eventual outcomes. A related issue is the determination of the sources of 'error' in the projections that are due to differences between the actual versus realized values of the associated assumptions. One way to do this would be to run the computer-based model from which the projections are derived at the time the projected values are realized, using actual rather than assumed values for model assumptions; and, compare these results to the original projections. For long term forecasts, this approach would require that the model's software and hardware configuration be archived and available for many years, possibly decades, into the future. Such archival creates many practical problems; and, in general, it is not being done. This paper reports on an alternative approach for evaluating the projections. In the alternative approach, the model is run many times for cases in which important assumptions are changed individually and in combinations. A database is assembled from the solutions and a regression analysis is conducted for each important projected variable with the associated assumptions chosen as exogenous variables. When actual data are eventually available, the regression results are then used to estimate the sources of the differences in the projections of the endogenous variables compared to their eventual outcomes. The results presented here are for residential and commercial sector natural gas and electricity consumption. (author)

  1. TBI Patient, Injury, Therapy, and Ancillary Treatments Associated with Outcomes at Discharge and 9 Months Post-discharge (United States)

    Horn, Susan D.; Corrigan, John D.; Beaulieu, Cynthia L.; Bogner, Jennifer; Barrett, Ryan S.; Giuffrida, Clare G.; Ryser, David K.; Cooper, Kelli; Carroll, Deborah M.; Deutscher, Daniel


    Objective To examine associations of patient and injury characteristics, inpatient rehabilitation therapy activities, and neurotropic medications with outcomes at discharge and 9 months post-discharge for patients with traumatic brain injury (TBI) Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Consecutive patients (n=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Rehabilitation length of stay, discharge to home, and Functional Independence Measure (FIM) at discharge and 9 months post-discharge Results The admission FIM Cognitive score was used to create 5 relatively homogeneous subgroups for subsequent analysis of treatment outcomes. Within each subgroup, significant associations were found between outcomes and patient and injury characteristics, time spent in therapy activities, and medications used. Patient and injury characteristics explained on average 35.7% of the variation in discharge outcomes and 22.3% in 9-month outcomes. Adding time spent and level of effort in therapy activities, as well as percent of stay using specific medications, explained approximately 20.0% more variation for discharge outcomes and 12.9% for 9-month outcomes. After patient, injury, and treatment characteristics were used to predict outcomes, center differences added only approximately 1.9% additional variance explained. Conclusions At discharge, greater effort during therapy sessions, time spent in more complex therapy activities, and use of specific medications were associated with better outcomes for patients in all admission FIM Cognitive subgroups. At 9 months post-discharge, similar but less pervasive associations were observed for therapy activities, but not classes of medications. Further research is warranted to examine more specific combinations of therapy activities and medications that

  2. Long-term (60-month) results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration (United States)

    Boyer, David; Freund, K Bailey; Regillo, Carl; Levy, Marc H; Garg, Sumit


    Background The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT) in patients with bilateral, end-stage, age-related macular degeneration (AMD). Methods A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years) with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800) resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to 30 days after surgery (7/70; 10%) and persistent corneal edema (3/70; 4.3%); and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%), corneal edema >30 days after surgery (9/127; 7.1%), and persistent corneal edema (6/127; 4.7%). Significant adverse events included four corneal transplants, comprising two (2.9%) in group 1 and two (1.6%) in group 2. At 60 months, one patient in group 1 (3.2%) and three patients in group 2 (9.4%) had lost ≥2 lines of vision. The IMT was removed in one (1.4%) and ten (7.9%) patients in group 1 and group 2, respectively. Mean ECD loss was 20% at 3 months. Chronic loss was 3% per year. ECD loss was less in group 1 than in group 2 (35% versus 40%, respectively) at 60 months. Conclusion Long-term results show substantial retention of improvement in BDCVA. Chronic ECD loss was consistent with that reported for conventional intraocular lenses. The IMT performed as well in group 1 (the younger group) as it did in group 2 through month 60. Younger patients retained more vision than their older counterparts and had fewer adverse events. Although not a specified outcome for this study, patients younger than 65 years also fared better than those in group 2 and retained more vision with fewer adverse events through month 60. PMID:26124633

  3. Long Term Financing of Infrastructure


    Sinha, Sidharth


    Infrastructure projects, given their long life, require long term financing. The main sources of long term financings are insurance and pension funds who seek long term investments with low credit risk. However, in India household financial savings are mainly invested in bank deposits. Insurance and pension funds account for only a small percentage of household financial savings. In addition most infrastructure projects do not qualify for investment by insurance and pension funds because of t...

  4. Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework. (United States)

    Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A


    Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of

  5. A long-term randomised trial on tenoxicam and piroxicam in osteoarthritis of the hip or knee: a 24-month interim report focusing on the 12-24 month interval

    DEFF Research Database (Denmark)

    Lund, B; Andersen, R B; Fossgreen, J


    The long-acting antiphlogistics tenoxicam (Ro 12-0068, Tilcotil) and piroxicam in single daily oral doses of 20 mg are compared in a double-blind, group-comparative, randomised trial planned to last for five years. Results of 12 months' treatment of 108 patients with osteoarthritis of the hip...... or knee have been reported. This interim analysis focuses mainly on the 12 to 24 month interval. The clinical improvements obtained within the first 12 months persisted during the second year in the 55 patients remaining on treatment. After 24 months, 53 patients had been withdrawn prematurely, three......-quarters because of inefficacy or intolerance. Only six patients were withdrawn between 12 and 24 months, three for lack of efficacy, two for side-effects and one for reasons unrelated to therapy. There was no difference between the treatment groups with regard to incidence, time or reason for withdrawal, and only...

  6. Long-term (60-month results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Boyer D


    Full Text Available David Boyer,1 K Bailey Freund,2 Carl Regillo,3 Marc H Levy,4 Sumit Garg5 1Retina-Vitreous Associates Medical Group, Beverly Hills, CA, 2Vitreous-Retina-Macula Consultants of New York, New York, NY; 3Wills Eye Institute, Philadelphia, PA, 4Sarasota Retina Institute, Sarasota, FL, 5The Gavin Herbert Eye Institute (University of California, Irvine Irvine, CA, USA Background: The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT in patients with bilateral, end-stage, age-related macular degeneration (AMD.Methods: A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800 resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to <75 years [group 1; n=70] and patient age ≥75 years [group 2; n=127], with a comparative evaluation of change in best-corrected distance visual acuity (BCDVA, quality of life, ocular complications from surgery, adverse events, and endothelial cell density (ECD. Follow-up in an extension study was 60 months.Results: Data were available for 22, 38, and 31 patients in group 1 and 42, 46, and 32 patients in group 2 at 36, 48, and 60 months, respectively. Mean BCDVA improvement from baseline to 60 months was 2.41±2.69 lines in all patients (n=76, with 2.64±2.55 lines in group 1 and 2.09±2.88 lines in group 2. Quality of life scores were significantly higher in group 1. The most common significant surgery-related ocular complications in group 1 were iritis >30 days after surgery (7/70; 10% and persistent corneal edema (3/70; 4.3%; and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%, corneal edema >30 days after surgery (9/127; 7.1%, and persistent corneal edema (6/127; 4.7%. Significant

  7. Bloody nipple discharge (BND) in an 8 months old girl and a 9 months old male--rational diagnostic approach. (United States)

    Harmsen, S; Mayatepek, E; Klee, D; Meissner, T


    Bloody nipple discharge in adults is, in men as well as in women, often a symptom of an underlying malignant disease. In respect of this, multiple invasive and mutilating diagnostic procedures have been performed in infants and older children. Apart from individual cases in older and pubertal children, in childhood benign conditions are most common and can be diagnosed by non-invasive diagnostic procedures. Here we discuss a rational diagnostic approach on the basis of 2 patients with bloody nipple discharge at the age of 8 and 9 months which resolved spontaneously without treatment after 3 and 6 months, respectively. (c) Georg Thieme Verlag KG Stuttgart-New York.

  8. Long-term urethral catheterisation. (United States)

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  9. Reconstruction of peak water levels, peak discharges and long-term occurrence of extreme- as well as smaller pre-instrumental flood events of river Aare, Limmat, Reuss, Rhine and Saane in Switzerland. Part I (United States)

    Wetter, Oliver; Tuttenuj, Daniel


    systematically analysed the period from 1446-1542 and could prove a large number of pre-instrumental flood events of river Rhine, Birs, Birsig and Wiese in Basel. All in all the weekly led account books contained 54 Rhine flood events, whereas chroniclers and annalists only recorded seven floods during the same period. This is a ratio of almost eight to one. This large difference points to the significantly sharper "observation skills" of the account books towards smaller floods, which may be explained by the fact that bridges can be endangered by relatively small floods because of driftwood, whereas it is known that chroniclers or annalists were predominantly focussing on spectacular (extreme) flood events. We [Oliver Wetter and Daniel Tuttenuj] are now able to present first preliminary results of reconstructed peak water levels and peak discharges of pre instrumental river Aare-, Emme-, Limmat-, Reuss-, Rhine- and Saane floods. These first results clearly show the strengths as well as the limits of the data and method used, depending mainly on the river types. Of the above mentioned rivers only the floods of river Emme could not be reconstructed whereas the long-term development of peak water levels and peak discharges of the other rivers clearly correlate with major local and supra-regional Swiss flood corrections over time. PhD student Daniel Tuttenuj is going to present the results for river Emme and Saane (see Abstract Daniel Tuttenuj), whereas Dr Oliver Wetter is going to present the results for the other rivers and gives a first insight on long-term recurring periods of smaller river Birs-, Birsig-, Rhine- and Wiese flood events based on the analysis of the weekly led account books "Wochenausgabenbücher der Stadt Basel" (see also Abstract of Daniel Tuttenuj).

  10. Reconstruction of peak water levels, peak discharges and long-term occurrence of extreme- as well as smaller pre-instrumental flood events of river Aare, Limmat, Reuss, Rhine and Saane in Switzerland. Part II. (United States)

    Tuttenuj, Daniel; Wetter, Oliver


    contained 54 Rhine flood events, whereas chroniclers and annalists only recorded seven floods during the same period. This is a ratio of almost eight to one. This large difference points to the significantly sharper "observation skills" of the account books towards smaller floods, which may be explained by the fact that bridges can be endangered by relatively small floods because of driftwood, whereas it is known that chroniclers or annalists were predominantly focussing on spectacular (extreme) flood events. We [Oliver Wetter and Daniel Tuttenuj] are now able to present first preliminary results of reconstructed peak water levels and peak discharges of pre instrumental river Aare-, Emme-, Limmat-, Reuss-, Rhine- and Saane floods. These first results clearly show the strengths as well as the limits of the data and method used, depending mainly on the river types. Of the above mentioned rivers only the floods of river Emme could not be reconstructed whereas the long-term development of peak water levels and peak discharges of the other rivers clearly correlate with major local and supra-regional Swiss flood corrections over time. PhD student Daniel Tuttenuj is going to present the results of river Emme and Saane, whereas Dr Oliver Wetter is going to present the results for the other rivers and gives a first insight on long-term recurring periods of smaller river Birs, Birsig, Rhine and Wiese flood events based on the analysis of the weekly led account books "Wochenausgabenbücher der Stadt Basel" (see Abstract Oliver Wetter).

  11. Long-term competence restoration. (United States)

    Morris, Douglas R; DeYoung, Nathaniel J


    While the United States Supreme Court's Jackson v. Indiana decision and most state statutes mandate determinations of incompetent defendants' restoration probabilities, courts and forensic clinicians continue to lack empirical evidence to guide these determinations and do not yet have a consensus regarding whether and under what circumstances incompetent defendants are restorable. The evidence base concerning the restoration likelihood of those defendants who fail initial restoration efforts is even further diminished and has largely gone unstudied. In this study, we examined the disposition of a cohort of defendants who underwent long-term competence restoration efforts (greater than six months) and identified factors related to whether these defendants were able to attain restoration and adjudicative success. Approximately two-thirds (n = 52) of the 81 individuals undergoing extended restoration efforts were eventually deemed restored to competence. Lengths of hospitalization until successful restoration are presented with implications for the reasonable length of time that restoration efforts should persist. Older individuals were less likely to be restored and successfully adjudicated, and individuals with more severe charges and greater factual legal understanding were more likely to be restored and adjudicated. The significance of these findings for courts and forensic clinicians is discussed.

  12. Forecasting monthly inflow discharge of the Iffezheim reservoir using data-driven models (United States)

    Zhang, Qing; Aljoumani, Basem; Hillebrand, Gudrun; Hoffmann, Thomas; Hinkelmann, Reinhard


    River stream flow is an essential element in hydrology study fields, especially for reservoir management, since it defines input into reservoirs. Forecasting this stream flow plays an important role in short or long-term planning and management in the reservoir, e.g. optimized reservoir and hydroelectric operation or agricultural irrigation. Highly accurate flow forecasting can significantly reduce economic losses and is always pursued by reservoir operators. Therefore, hydrologic time series forecasting has received tremendous attention of researchers. Many models have been proposed to improve the hydrological forecasting. Due to the fact that most natural phenomena occurring in environmental systems appear to behave in random or probabilistic ways, different cases may need a different methods to forecast the inflow and even a unique treatment to improve the forecast accuracy. The purpose of this study is to determine an appropriate model for forecasting monthly inflow to the Iffezheim reservoir in Germany, which is the last of the barrages in the Upper Rhine. Monthly time series of discharges, measured from 1946 to 2001 at the Plittersdorf station, which is located 6 km downstream of the Iffezheim reservoir, were applied. The accuracies of the used stochastic models - Fiering model and Auto-Regressive Integrated Moving Average models (ARIMA) are compared with Artificial Intelligence (AI) models - single Artificial Neural Network (ANN) and Wavelet ANN models (WANN). The Fiering model is a linear stochastic model and used for generating synthetic monthly data. The basic idea in modeling time series using ARIMA is to identify a simple model with as few model parameters as possible in order to provide a good statistical fit to the data. To identify and fit the ARIMA models, four phase approaches were used: identification, parameter estimation, diagnostic checking, and forecasting. An automatic selection criterion, such as the Akaike information criterion, is utilized

  13. Long term complications of diabetes (United States)

    ... Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  14. Monthly sediment discharge changes and estimates in a typical karst catchment of southwest China (United States)

    Li, Zhenwei; Xu, Xianli; Xu, Chaohao; Liu, Meixian; Wang, Kelin; Yi, Ruzhou


    As one of the largest karst regions in the world, southwest China is experiencing severe soil erosion due to its special geological conditions, inappropriate land use, and lower soil loss tolerance. Knowledge and accurate estimations of changes in sediment discharge rates is important for finding potential measures to effectively control sediment delivery. This study investigated temporal variation in monthly sediment discharge (SD), and developed sediment rating curves and state-space model to estimate SD. Monthly water discharge, SD, precipitation, potential evapotranspiration, and normalized differential vegetation index during 2003-2015 collected from a typical karst catchment of Yujiang River were analyzed in present study. A Mann-Kendal test and Morlet wavelet analysis were employed to detect the changes in SD. Results indicated that a decreasing trend was observed in sediment discharge at monthly and annual scale. The water and sediment discharge both had a significant 1-year period, implying that water discharge has substantial influence on SD. The best state-space model using water discharge was a simple but effective model, accounting for 99% of the variation in SD. The sediment rating curves, however, represented only 78% of the variation in SD. This study provides an insight into the possibility of accurate estimation of SD only using water discharge with state-space model approach. State-space model is recommended as an effective approach for quantifying the temporal relationships between SD and its driving factors in karst regions of southwest China.

  15. [Long-term psychiatric hospitalizations]. (United States)

    Plancke, L; Amariei, A


    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  16. Intergranular Cracking as a Major Cause of Long-Term Capacity Fading of Layered Cathodes. (United States)

    Liu, Hao; Wolf, Mark; Karki, Khim; Yu, Young-Sang; Stach, Eric A; Cabana, Jordi; Chapman, Karena W; Chupas, Peter J


    Capacity fading has limited commercial layered Li-ion battery electrodes to NCA) electrode change after capacity fade following months of slow charge-discharge. The changes in the reactions that underpin energy storage after long-term cycling directly correlate to the capacity loss; heterogeneous reaction kinetics observed during extended cycles quantitatively account for the capacity loss. This reaction heterogeneity is ultimately attributed to intergranular fracturing that degrades the connectivity of subsurface grains within the polycrystalline NCA aggregate.

  17. Long term economic relationships from cointegration maps (United States)

    Vicente, Renato; Pereira, Carlos de B.; Leite, Vitor B. P.; Caticha, Nestor


    We employ the Bayesian framework to define a cointegration measure aimed to represent long term relationships between time series. For visualization of these relationships we introduce a dissimilarity matrix and a map based on the sorting points into neighborhoods (SPIN) technique, which has been previously used to analyze large data sets from DNA arrays. We exemplify the technique in three data sets: US interest rates (USIR), monthly inflation rates and gross domestic product (GDP) growth rates.

  18. A six-month intervention with two different types of micronutrient-fortified complementary foods had distinct short- and long-term effects on linear and ponderal growth of vietnamese infants

    DEFF Research Database (Denmark)

    Phu, Pham V.; Hoan, Nguyen V.; Salvignol, Bertrand


    -scores in the C group intermediate and not significantly different from the others. This study shows that regular provision of locally produced CF fortified with micronutrients partly stopped growth faltering in Vietnamese infants, with differential effects on long-term length and ponderal growth. Providing only...

  19. Long-Term Patency of Lymphovenous Anastomoses: A Systematic Review. (United States)

    Tourani, Saam S; Taylor, G Ian; Ashton, Mark W


    With advancements in technology and microsurgical techniques, lymphovenous anastomosis has become a popular reconstructive procedure in the treatment of chronic lymphedema. However, the long-term patency of these anastomoses is not clear in the literature. A systematic review of the MEDLINE and EMBASE databases was performed to assess the reported long-term patency of lymphovenous anastomoses. A total of eight studies satisfied the inclusion criteria. Pooled data from four similar experiments in normal dogs showed an average long-term (≥5 months) patency of 52 percent. The only experiment in dogs with chronic lymphedema failed to show any long-term patency. The creation of peripheral lymphovenous anastomoses with a moderate long-term patency rate has become technically possible. However, the long-term results in chronic lymphedema are limited.

  20. Specific job anxiety in comparison to general psychosomatic symptoms at admission, discharge and six months after psychosomatic inpatient treatment. (United States)

    Muschalla, Beate; Linden, Michael


    Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge. A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment. 15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up. General psychosomatic symptom load and job anxiety show a

  1. Prediction of mean monthly river discharges in Colombia through Empirical Mode Decomposition

    Directory of Open Access Journals (Sweden)

    A. M. Carmona


    Full Text Available The hydro-climatology of Colombia exhibits strong natural variability at a broad range of time scales including: inter-decadal, decadal, inter-annual, annual, intra-annual, intra-seasonal, and diurnal. Diverse applied sectors rely on quantitative predictions of river discharges for operational purposes including hydropower generation, agriculture, human health, fluvial navigation, territorial planning and management, risk preparedness and mitigation, among others. Various methodologies have been used to predict monthly mean river discharges that are based on "Predictive Analytics", an area of statistical analysis that studies the extraction of information from historical data to infer future trends and patterns. Our study couples the Empirical Mode Decomposition (EMD with traditional methods, e.g. Autoregressive Model of Order 1 (AR1 and Neural Networks (NN, to predict mean monthly river discharges in Colombia, South America. The EMD allows us to decompose the historical time series of river discharges into a finite number of intrinsic mode functions (IMF that capture the different oscillatory modes of different frequencies associated with the inherent time scales coexisting simultaneously in the signal (Huang et al. 1998, Huang and Wu 2008, Rao and Hsu, 2008. Our predictive method states that it is easier and simpler to predict each IMF at a time and then add them up together to obtain the predicted river discharge for a certain month, than predicting the full signal. This method is applied to 10 series of monthly mean river discharges in Colombia, using calibration periods of more than 25 years, and validation periods of about 12 years. Predictions are performed for time horizons spanning from 1 to 12 months. Our results show that predictions obtained through the traditional methods improve when the EMD is used as a previous step, since errors decrease by up to 13% when the AR1 model is used, and by up to 18% when using Neural Networks is

  2. Nuclear Energy, Long Term Requirements

    International Nuclear Information System (INIS)

    Knapp, V.


    There are serious warnings about depletion of oil and gas and even more serious warnings about dangers of climate change caused by emission of carbon dioxide. Should developed countries be called to replace CO2 emitting energy sources as soon as possible, and the time available may not be longer then few decades, can nuclear energy answer the call and what are the requirements? Assuming optimistic contribution of renewable energy sources, can nuclear energy expand to several times present level in order to replace large part of fossil fuels use? Paper considers intermediate and long-term requirements. Future of nuclear power depends on satisfactory answers on several questions. First group of questions are those important for near and intermediate future. They deal with economics and safety of nuclear power stations in the first place. On the same time scale a generally accepted concept for radioactive waste disposal is also required. All these issues are in the focus of present research and development. Safer and more economical reactors are targets of international efforts in Generation IV and INPRO projects, but aiming further ahead these innovative projects are also addressing issues such as waste reduction and proliferation resistance. However, even assuming successful technical development of these projects, and there is no reason to doubt it, long term and large-scale nuclear power use is thereby not yet secured. If nuclear power is to play an essential role in the long-term future energy production and in reduction of CO2 emission, than several additional questions must be replied. These questions will deal with long-term nuclear fuel sufficiency, with necessary contribution of nuclear power in sectors of transport and industrial processes and with nuclear proliferation safety. This last issue is more political then technical, thus sometimes neglected by nuclear engineers, yet it will have essential role for the long-term prospects of nuclear power. The

  3. Analysing long term discursive processes

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    which extend beyond the single interaction, for instance negotiations or planning processes, seems to have played a less important role, with studies such as Iedema 2001 and Wodak 2000 as exceptions. These long term processes, however, are central to the constitution and workings of organizations......What do timescales - the notion that processes take place or can be viewed within a shorter or longer temporal range (Lemke 2005) - mean for the analysis of discourse? What are the methodological consequences of analyzing discourse at different timescales? It may be argued that discourse analysis...... in general has favored either the analysis of short term processes such as interviews, discussions, and lessons, or the analysis of non-processual entities such as (multimodal) texts, arguments, discursive repertoires, and discourses (in a Foucaultian sense). In contrast, analysis of long term processes...

  4. Comparing long term energy scenarios

    International Nuclear Information System (INIS)

    Cumo, M.; Simbolotti, G.


    Major projection studies by international organizations and senior analysts have been compared with reference to individual key parameters (population, energy demand/supply, resources, technology, emissions and global warming) to understand trends and implications of the different scenarios. Then, looking at the long term (i.e., 2050 and beyond), parameters and trends have been compared together to understand and quantify whether and when possible crisis or market turbulence might occur due to shortage of resources or environmental problems [it

  5. Long term radioactive waste management

    International Nuclear Information System (INIS)

    Lavie, J.M.


    In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

  6. Murine model of long term obstructive jaundice (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki


    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  7. Long-term biodosimetry Redux

    International Nuclear Information System (INIS)

    Simon, Steven L.; Bouville, Andre


    This paper revisits and reiterates the needs, purposes and requirements of bio-dosimetric assays for long-term dose and health risk assessments. While the most crucial need for bio-dosimetric assays is to guide medical response for radiation accidents, the value of such techniques for improving our understanding of radiation health risk by supporting epidemiological (long-term health risk) studies is significant. As new cohorts of exposed persons are identified and new health risk studies are undertaken with the hopes that studying the exposed will result in a deeper understanding of radiation risk, the value of reliable dose reconstruction is underscored. The ultimate application of biodosimetry in long-term health risk studies would be to completely replace model-based dose reconstruction-a complex suite of methods for retrospectively estimating dose that is commonly fraught with large uncertainties due to the absence of important exposure-related information, as well as imperfect models. While biodosimetry could potentially supplant model-based doses, there are numerous limitations of presently available techniques that constrain their widespread application in health risk research, including limited ability to assess doses received far in the past, high cost, great inter-individual variability, invasiveness, higher than preferred detection limits and the inability to assess internal dose (for the most part). These limitations prevent the extensive application of biodosimetry to large cohorts and should be considered a challenge to researchers to develop new and more flexible techniques that meet the demands of long-term health risk research. Events in recent years, e.g. the Fukushima reactor accident and the increased threat of nuclear terrorism, underscore that any event that results in significant radiation exposures of a group of people will also produce a much larger population, exposed at lower levels, but that likewise needs (or demands) an exposure

  8. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P; Gao, B [Powertech Labs. Inc., Surrey, BC (Canada)


    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  9. Hospital discharge bags and breastfeeding at 6 months: data from the infant feeding practices study II. (United States)

    Sadacharan, Radha; Grossman, Xena; Matlak, Stephanie; Merewood, Anne


    Distribution of industry-sponsored formula sample packs to new mothers undermines breastfeeding. Using data from the Infant Feeding Practices Study II (IFPS II), we aimed to determine whether receipt of 4 different types of bags was associated with exclusive breastfeeding during the first 6 months of life. We extracted data from IFPS II questionnaires. Type of discharge bag received was categorized as "formula bag," "coupon bag," "breastfeeding supplies bag," or "no bag". We examined exclusive breastfeeding status at 10 weeks (post hoc) and at 6 months using univariate descriptive analyses and multivariate logistic regression models, controlling for sociodemographic and attitudinal variables. Overall, 1868 (81.4%) of women received formula bags, 96 (4.2%) received coupon bags, 46 (2.0%) received breastfeeding supplies bags, and 284 (12.4%) received no bag. By 10 weeks, recipients of breastfeeding supplies bags or no bag were significantly more likely to be exclusively breastfeeding than formula bag recipients. In the adjusted model, compared to formula bag/coupon bag recipients, recipients of breastfeeding supplies bag/no bag were significantly more likely to breastfeed exclusively for 6 months (odds ratio = 1.58; 95% confidence interval, 1.06-2.36). The vast majority of new mothers received formula sample packs at discharge, and this was associated with reduced exclusive breastfeeding at 10 weeks and 6 months. Bags containing breastfeeding supplies or no bag at all were positively associated with exclusive breastfeeding at 10 weeks and 6 months.

  10. Navigating Long-Term Care

    Directory of Open Access Journals (Sweden)

    James D. Holt MD


    Full Text Available Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly to possibly 20% in 2030 (70 million elderly. In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC, 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.

  11. Short-and long-term effects of discharged OBM cuttings, with and without previous washing, tested in field and laboratory studies on the Dutch continental shelf, 1985-1990

    International Nuclear Information System (INIS)

    De Jong, A.; Zevenboom, W.; Van Het Groenewoud, H.; Daan, R.


    This paper reports on a Dutch programme that was carried out to study the distribution of discharged washed and unwashed oil-containing cuttings in the sediment and waterphase and their effects on selected test species in the Dutch part of the North Sea. The distribution of OBM cuttings in sediment around drilling locations was related to the total amount of oil discharged in the watercolumn. Increased oil contents were found over a range of 1000 to 5000 m in residual current direction. Total oil contents remained high at locations where unwashed OBM cuttings were discharged. At one location oil was found in high concentrations up to 6 years after discharge of OBM cuttings, especially due to the persistence of the oil fractions Other peaks and UCM. Washing of OBM cuttings resulted in lower amounts of oil discharged, lower concentrations in the sediment in the vicinity of the platform (up to 100 m), equal concentrations at 250 m but higher concentrations up to at more than 500 m off the platform when compared with unwashed cuttings and the respective amount of oil discharged. However, within one year, degradation of oil seems to have taken place at one of the washed sites at 5000 m. During discharge in the watercolumn, oil was taken up by Mytilus edulis from washed cuttings as well as from unwashed cuttings. Leaching of oil from the sediment into the waterphase was measurable in the field for only a limited period to time, less than a year after discharge. Several sediment-inhabiting species were tested on their response to oil contamination. Four species tested in experimental boxcosm set-ups, Echinocardium cordatum, Amphiura filiformis, Lagis koreni and Nucula turgida responded to elevated contamination levels by increased mortality

  12. Preclinical rodent toxicity studies for long term use of ceftriaxone

    Directory of Open Access Journals (Sweden)

    Elena Ratti


    Ceftriaxone showed rapid absorption with half-life values ranging between 1 and 1.5 h. Additionally, there was no evidence of accumulation and a virtually complete elimination by 16 h after the last dose. Overall there were no toxicologically meaningful drug-related animal findings associated with the long-term administration (6 months of ceftriaxone. These results support safety of long-term use of ceftriaxone in human clinical trials.

  13. Long-term stability of sodium caseinate-stabilized nanoemulsions. (United States)

    Yerramilli, Manispuritha; Ghosh, Supratim


    Oil-in-water (5 wt%) nanoemulsions were prepared with different concentration (2.5-10 wt%) of sodium caseinate as a sole emulsifier and their long-term storage stability was investigated for 6 months. Previous studies associated with sodium caseinate looked only into nanoemulsion formation; hence the challenges with long-term stability were not addressed. All nanoemulsions displayed an average droplet size sodium caseinate-stabilized nanoemulsions.

  14. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city. (United States)

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk


    One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.

  15. Former foster youth's perspectives on independent living preparation six months after discharge. (United States)

    Jones, Loring P


    Research findings have developed a troubling narrative of youth leaving foster care. Congress attempted to address the post-discharge difficulties of foster youth by passing the Independent Living Initiative in 1986, which mandated that the states develop services that would prepare youth for life after foster care. However, it is unclear what effect these programs have on post-foster care trajectories. This largely qualitative study examined the perceptions of a sample of discharged foster six months after leaving care. Most youth felt prepared for life and foster care. They were also for the most part were satisfied with their independent living program, but had significant dissatisfactions with elements of the program. These satisfactions and dissatisfactions are reported along with suggestions for improvement. The policy and practice implications of these suggestions are considered.

  16. Long term study of mechanical

    Directory of Open Access Journals (Sweden)

    Ahmed M. Diab


    Full Text Available In this study, properties of limestone cement concrete containing different replacement levels of limestone powder were examined. It includes 0%, 5%, 10%, 15%, 20% and 25% of limestone powder as a partial replacement of cement. Silica fume was added incorporated with limestone powder in some mixes to enhance the concrete properties. Compressive strength, splitting tensile strength and modulus of elasticity were determined. Also, durability of limestone cement concrete with different C3A contents was examined. The weight loss, length change and cube compressive strength loss were measured for concrete attacked by 5% sodium sulfate using an accelerated test up to 525 days age. The corrosion resistance was measured through accelerated corrosion test using first crack time, cracking width and steel reinforcement weight loss. Consequently, for short and long term, the use of limestone up to 10% had not a significant reduction in concrete properties. It is not recommended to use blended limestone cement in case of sulfate attack. The use of limestone cement containing up to 25% limestone has insignificant effect on corrosion resistance before cracking.

  17. Uranium ... long-term confidence

    International Nuclear Information System (INIS)



    Half way through 1983 the outlook for the world's uranium producers was far from bright if one takes a short term view. The readily accessible facts present a gloomy picture. The spot prices of uranium over the past few years decreased from a high of $42-$43/lb to a low of $17 in 1982. It now hovers between $23 and $24. the contract prices negotiated between producers and consumers are not so accessible but they do not reflect the spot price. The reasons why contractual uranium prices do not follow the usual dictates of supply and demand are related to the position in which uranium and associated power industries find themselves. There is public reaction with strong emotional overtones as well as much reduced expectations about the electric power needs of the world. Furthermore the supply of uranium is not guaranteed despite present over production. However the people in the industry, taking the medium- and long-term view, are not despondent

  18. Long-term corrosion studies

    International Nuclear Information System (INIS)

    Gdowski, G.


    The scope of this activity is to assess the long-term corrosion properties of metallic materials under consideration for fabricating waste package containers. Three classes of metals are to be assessed: corrosion resistant, intermediate corrosion resistant, and corrosion allowance. Corrosion properties to be evaluated are general, pitting and crevice corrosion, stress-corrosion cracking, and galvanic corrosion. The performance of these materials will be investigated under conditions that are considered relevant to the potential emplacement site. Testing in four aqueous solutions, and vapor phases above them, and at two temperatures are planned for this activity. (The environmental conditions, test metals, and matrix are described in detail in Section 3.0.) The purpose and objective of this activity is to obtain the kinetic and mechanistic information on degradation of metallic alloys currently being considered for waste package containers. This information will be used to provide assistance to (1) waste package design (metal barrier selection) (E-20-90 to E-20-92), (2) waste package performance assessment activities (SIP-PA-2), (3) model development (E-20-75 to E-20-89). and (4) repository license application

  19. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos


    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  20. Long-term preservation of anammox bacteria. (United States)

    Rothrock, Michael J; Vanotti, Matias B; Szögi, Ariel A; Gonzalez, Maria Cruz Garcia; Fujii, Takao


    Deposit of useful microorganisms in culture collections requires long-term preservation and successful reactivation techniques. The goal of this study was to develop a simple preservation protocol for the long-term storage and reactivation of the anammox biomass. To achieve this, anammox biomass was frozen or lyophilized at two different freezing temperatures (-60°C and in liquid nitrogen (-200°C)) in skim milk media (with and without glycerol), and the reactivation of anammox activity was monitored after a 4-month storage period. Of the different preservation treatments tested, only anammox biomass preserved via freezing in liquid nitrogen followed by lyophilization in skim milk media without glycerol achieved stoichiometric ratios for the anammox reaction similar to the biomass in both the parent bioreactor and in the freshly harvested control treatment. A freezing temperature of -60°C alone, or in conjunction with lyophilization, resulted in the partial recovery of the anammox bacteria, with an equal mixture of anammox and nitrifying bacteria in the reactivated biomass. To our knowledge, this is the first report of the successful reactivation of anammox biomass preserved via sub-zero freezing and/or lyophilization. The simple preservation protocol developed from this study could be beneficial to accelerate the integration of anammox-based processes into current treatment systems through a highly efficient starting anammox biomass.

  1. Hydrological long-term dry and wet periods in the Xijiang River basin, South China

    Directory of Open Access Journals (Sweden)

    T. Fischer


    Full Text Available In this study, hydrological long-term dry and wet periods are analyzed for the Xijiang River basin in South China. Daily precipitation data of 118 stations and data on daily discharge at Gaoyao hydrological station at the mouth of the Xijiang River for the period 1961–2007 are used. At a 24-month timescale, the standardized precipitation index (SPI-24 for the six sub-basins of the Xijiang River and the standardized discharge index (SDI-24 for Gaoyao station are applied. The monthly values of the SPI-24 averaged for the Xijiang River basin correlate highly with the monthly values of the SDI-24. Distinct long-term dry and wet sequences can be detected.

    The principal component analysis is applied and shows spatial disparities in dry and wet periods for the six sub-basins. The correlation between the SPI-24 of the six sub-basins and the first principal component score shows that 67% of the variability within the sub-basins can be explained by dry and wet periods in the east of the Xijiang River basin. The spatial dipole conditions (second and third principal component explain spatiotemporal disparities in the variability of dry and wet periods. All sub-basins contribute to hydrological dry periods, while mainly the northeastern sub-basins cause wet periods in the Xijiang River. We can also conclude that long-term dry events are larger in spatial extent and cover all sub-basins while long-term wet events are regional phenomena.

    A spectral analysis is applied for the SPI-24 and the SDI-24. The results show significant peaks in periodicities of 11–14.7 yr, 2.8 yr, 3.4–3.7 yr, and 6.3–7.3 yr. The same periodic cycles can be found in the SPI-24 of the six sub-basins but with some variability in the mean magnitude. A wavelet analysis shows that significant periodicities have been stable over time since the 1980s. Extrapolations of the reconstructed SPI-24 and SDI-24 represent the continuation of observed significant periodicities

  2. Long-term Internship through Cooperative Education with Regional Industries (United States)

    Takahashi, Kenzo; Hase, Hiroyuki

    The long term internship is one of special educational programs for graduate students of Graduate School of Engineering in University of Fukui. This is a collaborative program between university and industries where selected post-graduate students are dispatched to companies for a long term and educated in real business environments. It is the final goal of the program to develop sophisticated specialists who would be able to catch the business strategy in industries and solve any problems by themselves. The program is managed in a semester (6 months) and contains 1.5 month prior education of preliminary special knowledge, ethics and secrecy, about 3 month dispatch with long-term internship, and 1.5 month post-education for complementary education and presentation. This paper presents the effect of this program which has been evolving since 2005.

  3. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.

    Directory of Open Access Journals (Sweden)

    Liesbeth Hempenius

    Full Text Available The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.Data of 260 patients (intervention n = 127, Control n = 133 were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88, an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87 and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49.A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.Nederlands Trial Register, Trial ID NTR 823.

  4. Long-term cryogenic space storage system (United States)

    Hopkins, R. A.; Chronic, W. L.


    Discussion of the design, fabrication and testing of a 225-cu ft spherical cryogenic storage system for long-term subcritical applications under zero-g conditions in storing subcritical cryogens for space vehicle propulsion systems. The insulation system design, the analytical methods used, and the correlation between the performance test results and analytical predictions are described. The best available multilayer insulation materials and state-of-the-art thermal protection concepts were applied in the design, providing a boiloff rate of 0.152 lb/hr, or 0.032% per day, and an overall heat flux of 0.066 Btu/sq ft hr based on a 200 sq ft surface area. A six to eighteen month cryogenic storage is provided by this system for space applications.

  5. The discovery of long-term potentiation. (United States)

    Lømo, Terje


    This paper describes circumstances around the discovery of long-term potentiation (LTP). In 1966, I had just begun independent work for the degree of Dr medicinae (PhD) in Per Andersen's laboratory in Oslo after an eighteen-month apprenticeship with him. Studying the effects of activating the perforant path to dentate granule cells in the hippocampus of anaesthetized rabbits, I observed that brief trains of stimuli resulted in increased efficiency of transmission at the perforant path-granule cell synapses that could last for hours. In 1968, Tim Bliss came to Per Andersen's laboratory to learn about the hippocampus and field potential recording for studies of possible memory mechanisms. The two of us then followed up my preliminary results from 1966 and did the experiments that resulted in a paper that is now properly considered to be the basic reference for the discovery of LTP.

  6. Long-term opioid therapy in Denmark

    DEFF Research Database (Denmark)

    Birke, H; Ekholm, Ola; Sjøgren, P


    significantly associated with initiation of L-TOT in individuals with CNCP at baseline. During follow-up, L-TOT in CNCP patients increased the likelihood of negative changes in pain interference with work (OR 9.2; 95% CI 1.9-43.6) and in moderate activities (OR 3.7; 95% CI 1.1-12.6). The analysis of all......,145). A nationally representative subsample of individuals (n = 2015) completed the self-administered questionnaire in both 2000 and 2013. Collected information included chronic pain (≥6 months), health behaviour, self-rated health, pain interference with work activities and physical activities. Long-term users were...... individuals indicated a dose-response relationship between longer treatment duration and the risk of experiencing negative changes. CONCLUSIONS: Individuals on L-TOT seemed not to achieve the key goals of opioid therapy: pain relief, improved quality of life and functional capacity. SIGNIFICANCE: Long...

  7. Differences in health status between long-term and short-term benzodiazepine users.

    NARCIS (Netherlands)

    Zandstra, S.M.; Furer, J.W.; Lisdonk, E.H. van de; Bor, J.H.J.; Zitman, F.G.; Weel, C. van


    BACKGROUND: Despite generally accepted advice to keep treatment short, benzodiazepines are often prescibed for more than six months. Prevention of long-term benzodiazepine use could be facilitated by the utilisation of risk indicators for long-term use. However, the characteristics of long-term

  8. Efficacy and Safety of a Traditional Herbal Medicine, Hochu-ekki-to in the Long-Term Management of Kikyo (Delicate Constitution Patients with Atopic Dermatitis: A 6-Month, Multicenter, Double-Blind, Randomized, Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Hiromi Kobayashi


    Full Text Available Hochu-ekki-to is a traditional herbal (Kampo medicine that has been shown to be effective for patients with Kikyo (delicate, easily fatigable, or hypersensitive constitution. Previous case reports have suggested that this herbal drug was effective for a certain subgroup of patients with atopic dermatitis (AD. We aimed to evaluate the efficacy and safety of Hochu-ekki-to in the long-term management of Kikyo patients with AD. In this multicenter, double blind, randomized, placebo-controlled study, 91 Kikyo patients with AD were enrolled. Kikyo condition was evaluated by a questionnaire scoring system. All patients continued their ordinary treatments (topical steroids, topical tacrolimus, emollients or oral antihistamines before and after their protocol entry. Hochu-ekki-to or placebo was orally administered twice daily for 24 weeks. The skin severity scores, total equivalent amount (TEA of topical agents used for AD treatment, prominent efficacy (cases with skin severity score = 0 at the end of the study rate and aggravated rate (more than 50% increase of TEA of topical agents from the beginning of the study were monitored and evaluated. Seventy-seven out of 91 enrolled patients completed the 24-week treatment course (Hochu-ekki-to: n = 37, placebo: n = 40. The TEA of topical agents (steroids and/or tacrolimus was significantly (P < 0.05 lower in the Hochu-ekki-to group than in the placebo group, although the overall skin severity scores were not statistically different. The prominent efficacy rate was 19% (7 of 37 in the Hochu-ekki-to group and 5% (2 of 40 in the placebo group (P = 0.06. The aggravated rate was significantly (P < 0.05 lower in the Hochu-ekki-to group (3%; 1 of 37 than in the placebo group (18%; 7 of 39. Only mild adverse events such as nausea and diarrhea were noted in both groups without statistical difference. This placebo-controlled study demonstrates that Hochu-ekki-to is a useful adjunct to conventional treatments for AD

  9. Regional parametrisation of a monthly hydrological model for estimating discharges in ungaued catchments (United States)

    Hlavcova, K.; Szolgay, J.; Kohnova, S.; Kalas, M.


    In the case of the absence of measured runoff optimisation techniques cannot be used to estimate the parameters of monthly rainfall-runoff models. In such a case usually empirical regression methods were used for relating the model parameters to the catchment characteristics in a given region. In the paper a different method for the regional calibration of a monthly water balance model, which can be used for planning purposes, is proposed. Instead of using the regional regression approach a method is proposed, which involves the calibration of a monthly water balance model to gauged sites in the given region simultaneously. A regional objective function was constructed and for the calibration a genetic programming algorithm was employed. It is expected, that the regionally calibrated model parameters can be used in ungauged basins with similar physiographic conditions. The comparison of the performance of such a regional calibration scheme was compared with two single site calibration methods in a region of West Slovakia. The results are based on a study that aimed at computing surface water inflow into a lowland area with valuable groundwater resources. Monthly discharge time series had to be estimated in small ungauged rivers entering the study area.

  10. Long-term risk of complications after mid-urethral sling IVS implantation

    Directory of Open Access Journals (Sweden)

    Grzegorz Surkont


    Full Text Available [b]Introduction[/b]. Results of short-term evaluation of multifilament microporous midurethral tape IVS differ a great deal. During the first year of implantation, erosions have been observed in 0%–26% of operated women. Long-term observations are rare. They suggest high risk of extrusion and infection even after years of implantation. [b]Objective[/b]. The purpose of the study was to evaluate long-term risk of complications after IVS implantation. Material and methods. Between 2001–2005, 72 women were operated on with the use of IVS mid-urethral tape. [b]Results[/b]. Two women had vaginal erosions during the first 3 months after the operation. Twelve women had vaginal erosions, purulent vaginal discharge, with IVS tape sticking out of the abdominal wall or vagina, and abdominal abscess. These complications were diagnosed between 9 months and 6 years after IVS implantation. The patients were operated on vaginally and open abdominally, 1–5 times because of complications after IVS implantation. [b]Conclusions[/b]. In the case of post-IVS complication, as much tape as possible should be excised. Long-term follow up on patients with IVS implantation should be recommended to the centres where IVS tape was used, even to patients after removal of the tape. Risk of erosion, extrusion and infection after midurethral multifilament microporous IVS tape implantation is too high – which is the reason it should no longer be used.

  11. Three-year-olds’ memory for a person met only once at the age of 12 months: Very long-term memory revealed by a late-manifesting novelty preference

    DEFF Research Database (Denmark)

    Kingo, Osman Skjold; Staugaard, Søren Risløv; Krøjgaard, Peter


    This study examined three-year-olds’ verbal and non-verbal memory for a person met only once after a 28 month interval. Children in the Test group (N=50) had participated in an earlier experiment at our lab at the age of 12 months where they met one of two possible experimenters. At this past event...... (the Target) and one of the other experimenter (the Foil), with whom they had no experience. When explicitly asked, the children’s responses did not differ from chance. However, eye-tracking data revealed a late-manifesting novelty preference for the “Foil” person indicating memory for the “Target...

  12. Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: Analysis of survival and prognostic markers

    Directory of Open Access Journals (Sweden)

    Wickramarachchi RE


    Full Text Available Abstract Objectives This study compares clinico-pathological features in young (50 years with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival. Materials and methods A twelve year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty seven consecutive older patients over fifty years old. An analysis of survival was undertaken in young patients using Kaplan Meier graphs, non parametric methods, Cox's Proportional Hazard Ratios and Weibull Hazard models. Results Young patients comprised 13.4 percent of 397 with colorectal cancer. Duration of symptoms and presentation in the young was similar to older patients (median, range; young patients; 6 months, 2 weeks to 2 years, older patients; 4 months, 4 weeks to 3 years, p > 0.05. In both groups, the majority presented without bowel obstruction (young - 81%, older - 94%. Cancer proximal to the splenic flexure was present more in young than in older patients. Synchronous cancers were found exclusively in the young. Mucinous tumours were seen in 16% of young and 4% of older patients (p Conclusion If patients, who are less than 40 years old with colorectal cancer, survive twenty months after operation, the prognosis improves and their survival becomes predictable.

  13. Financing long term liabilities (Germany)

    International Nuclear Information System (INIS)


    charges and fees levied from the waste producers. Altogether, financial resources for decommissioning are needed for the following steps: the post-operational phase in which the facility is prepared for dismantling after its final shut-down, dismantling of the radioactive part of the facility, management, storage and disposal of the radioactive waste, restoration of the site, licensing and regulatory supervision of all these steps. Additional means are necessary for the management, storage and disposal of the spent fuel. The way in which the availability of financial resources is secured differs between public owned installations and installations of the private power utilities. In Germany, past practices has resulted in singular contaminated sites of limited extent, mainly during the first half of the 20. century. Those contaminated sites have been or are being cleaned up and redeveloped. In large areas of Saxony and Thuringia, the geological formations permitted the surface and underground mining of Uranium ore. Facilities of the former Soviet-German WISMUT Ltd. where ore was mined and processed from 1946 until the early 1990's can be found at numerous sites. In the course of the re-unification of Germany, the soviet shares of the WISMUT were taken over by the Federal Republic of Germany and the closure of the WISMUT facilities was initiated. In that phase the extent of the damages to the environment and of the necessary remediation work became clear. All mining and milling sites are now closed and are under decommissioning. A comprehensive remediation concept covers all WISMUT sites. Heaps and mill-tailing ponds are transferred into a long-term stable condition. The area of the facilities to be remediated amounts to more than 30 km 2 . Heaps cover a total area of ca. 15,5 km 2 , tailing ponds in which the tailings resulting from the Uranium production are stored as sludges cover 6,3 km 2 ). In total, the remediation issues are very complex and without precedent. The

  14. Long term results of trabeculectomy surgery

    Directory of Open Access Journals (Sweden)

    Ferhat Evliyaoğlu


    Full Text Available Objective: Evaluation of long-term results of primary trabeculectomy operation Methods: The cases that are followed up with diagnosis of glaucoma in Okmeydanı Training and Research Hospital Eye Clinic between January 2000 and December 2001 were evaluated retrospectively. All of the cases, despite maximum therapy, have high intraocular pressure (IOP, undergone primary trabeculectomy operation, are followed at least 6 months and regularly followed through 10 years were included in this study. IOP with or without medical treatment 18mmg or less than 18 mmHg accepted as successful. IOL pressure measured with applanation tonometry. Results: 89 eyes of 70 cases were included in this study. The cases included in the study, 42 male (60%, and 28 (40% were female. The mean age was 63.65±12.18 years. Preoperative intraocular pressure determined as 30.36 ± 3.2 mmHg. In the follow up examination mean intra ocular pressure was 15.31 ± 1.2 mmHg at 1st month, 15.47± 1.1mmHg at 3rd month, 15.02±1.8 mmHg at 6th month, 15.34± 2.1 mmHg at 1st year, 15.82 ± 2.1mmHg at 2nd year, 17.06 ± 2.3mmHg at 5th year and 18.02 ± 2.2 mmHg at 10th year. Statistical analysis of these data showed significant decreased of intra ocular pressure in the post operative period in compare to the preoperative period, 1st month, 3rd month, 6th month, 1st year, 2nd year, 5th year an 10th year (p < 0.01. The follow-up period in the study was 91.10 ± 40.15 months (6-120 months. Conclusion: Primary trabeculectomy can be considered as an alternative treatment procedure especially in patients who does not use drugs regularly and unable to attend regular medical examination. J Clin Exp Invest 2015; 6 (3: 263-268

  15. Long term results of compression sclerotherapy. (United States)

    Labas, P; Ohradka, B; Cambal, M; Reis, R; Fillo, J


    To compare the short and long term results of different techniques of compression sclerotherapy. In the past 10 years the authors treated 1622 pts due to chronic venous insufficiency. There were 3 groups of patients: 1) Pts treated by Sigg's technique using Aethoxysclerol, 2) Pts treated by Fegan's technique with Fibrovein, and 3) Pts treated by Fegan's procedure, but using a combination of both sclerosants. In all cases, the techniques of empty vein, bubble air, uninterrupted 6-week compression and forced mobilisation were used. In the group of pats. treated by Sigg's procedure, the average cure rate was 67.47% after 6 months, 60.3% after 5 years of follow-up. In Fegan's group this rate was 83.6% after 6 months and 78.54% after 5 year assessment. Statistically, significant differences were found only by the disappearance of varices and reduction of pain in favour of Fegan's technique. In the group of pts treated by Fegan's (Aethoxysclerol + Fibrovein) this rate after 5 years was 86%. The only statistically significant difference was found by the disappearance of varices in favour of Fegan's technique using a combination of 2 detergent sclerosants. Sclerotherapy is effective when properly executed in any length of vein no matter how dilated it has become. The recurrences are attributed more to inadequate technique than to the shortcoming of the procedure. Sclerotherapy is miniinvasive, with few complications, and can be repeated on out-patient basis. (Tab. 1, Ref. 22.).

  16. The neuropsychological sequelae of delirium in elderly patients with hip fracture three months after hospital discharge

    NARCIS (Netherlands)

    Witlox, Joost; Slor, Chantal J.; Jansen, René W. M. M.; Kalisvaart, Kees J.; van Stijn, Mireille F. M.; Houdijk, Alexander P. J.; Eikelenboom, Piet; van Gool, Willem A.; de Jonghe, Jos F. M.


    Delirium is a risk factor for long-term cognitive impairment and dementia. Yet, the nature of these cognitive deficits is unknown as is the extent to which the persistence of delirium symptoms and presence of depression at follow-up may account for the association between delirium and cognitive

  17. The neuropsychological sequelae of delirium in elderly patients with hip fracture three months after hospital discharge

    NARCIS (Netherlands)

    Witlox, J.; Slor, C.J.; Jansen, R.W.M.M.; Kalisvaart, K.J.; van Stijn, M.F.M.; Houdijk, A.P.J.; Eikelenboom, P.; van Gool, W.A.; de Jonghe, J.F.M.


    ABSTRACT Background: Delirium is a risk factor for long-term cognitive impairment and dementia. Yet, the nature of these cognitive deficits is unknown as is the extent to which the persistence of delirium symptoms and presence of depression at follow-up may account for the association between

  18. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)


    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

  19. Virtual Models of Long-Term Care (United States)

    Phenice, Lillian A.; Griffore, Robert J.


    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  20. Long-Term Effects of Adderall XR in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The long-term tolerability and effectiveness of extended release mixed amphetamine salts (Adderall XR in children with attention deficit hyperactivity disorder (ADHD were evaluated in a 24-month, multicenter, open-label extension of 2 placebo-controlled studies at UCLA, Massachusetts General Hospital, UC-Irvine, Maitland, FL, and Shire Pharmaceutical, Wayne, PA.

  1. A Conditioning Analysis of Infant Long-Term Memory. (United States)

    Sullivan, Margaret W.; And Others


    Assesses the long-term retention of conditioned operant footkicks by three-month-old infants. Views a conditioning analysis as a logical means by which to bridge the gap between animal and adult human models of memory. (Author/RH)

  2. Insulin dependence and pancreatic enzyme replacement therapy are independent prognostic factors for long-term survival after operation for chronic pancreatitis. (United States)

    Winny, Markus; Paroglou, Vagia; Bektas, Hüseyin; Kaltenborn, Alexander; Reichert, Benedikt; Zachau, Lea; Kleine, Moritz; Klempnauer, Jürgen; Schrem, Harald


    This retrospective, single-center, observational study on postoperative long-term results aims to define yet unknown factors for long-term outcome after operation for chronic pancreatitis. We analyzed 147 consecutive patients operated for chronic pancreatitis from 2000 to 2011. Mean follow-up was 5.3 years (range, 1 month to 12.7 years). Complete long-term survival data were provided by the German citizen registration authorities for all patients. A quality-of-life questionnaire was sent to surviving patients after a mean follow-up of 5.7 years. Surgical principles were resection (n = 86; 59%), decompression (n = 29; 20%), and hybrid procedures (n = 32; 21%). No significant influences of different surgical principles and operative procedures on survival, long-term quality of life and pain control could be detected. Overall 30-day mortality was 2.7%, 1-year survival 95.9%, and 3-year survival 90.8%. Multivariate Cox regression analysis revealed that only postoperative insulin dependence at the time of hospital discharge (P = .027; Exp(B) = 2.111; 95% confidence interval [CI], 1.089-4.090) and the absence of pancreas enzyme replacement therapy at the time of hospital discharge (P = .039; Exp(B) = 2.102; 95% CI, 1.037-4.262) were significant, independent risk factors for survival with significant hazard ratios for long-term survival. Long-term improvement in quality of life was reported by 55 of 76 long-term survivors (73%). Pancreatic enzyme replacement should be standard treatment after surgery for chronic pancreatitis at the time of hospital discharge, even when no clinical signs of exocrine pancreatic failure exist. This study underlines the potential importance of early operative intervention in chronic pancreatitis before irreversible endocrine dysfunction is present. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Mapping mean annual and monthly river discharges: geostatistical developments for incorporating river network dependencies

    International Nuclear Information System (INIS)

    Sauquet, Eric


    Regional hydrology is one topic that shows real improvement in partly due to new statistical development and computation facilities. Nevertheless theoretical difficulties for mapping river regime characteristics or recover these features at un gauged location remain because of the nature of the variable under study: river flows are related to a specific area that is defined by the drainage basin, are spatially organised by the river network with upstream-downstream dependencies. Estimations of hydrological descriptors are required for studying links with ecological processes at different spatial scale, from local site where biological or/and water quality data are available to large scale for sustainable development purposes. This presentation aims at describing a method for runoff pattern along the main river network. The approach dedicated to mean annual runoff is based on geostatistical interpolation procedures to which a constraint of water budget has been added. Expansion in Empirical Orthogonal Function has been considered in combination with kriging for interpolating mean monthly discharges. The methodologies are implemented within a Geographical Information System and illustrated by two study cases (two large basins in France). River flow regime descriptors are estimated for basins of more than 50km 2 . Opportunities of collaboration with a partition of France into hydro-eco regions derived from geology and climate considerations is discussed. (Author)

  4. Long term wet spent nuclear fuel storage

    International Nuclear Information System (INIS)


    The meeting showed that there is continuing confidence in the use of wet storage for spent nuclear fuel and that long-term wet storage of fuel clad in zirconium alloys can be readily achieved. The importance of maintaining good water chemistry has been identified. The long-term wet storage behaviour of sensitized stainless steel clad fuel involves, as yet, some uncertainties. However, great reliance will be placed on long-term wet storage of spent fuel into the future. The following topics were treated to some extent: Oxidation of the external surface of fuel clad, rod consolidation, radiation protection, optimum methods of treating spent fuel storage water, physical radiation effects, and the behaviour of spent fuel assemblies of long-term wet storage conditions. A number of papers on national experience are included

  5. Industrial Foundations as Long-Term Owners

    DEFF Research Database (Denmark)

    Thomsen, Steen; Poulsen, Thomas; Børsting, Christa Winther

    Short-termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long-term decision-making. In this paper, we call attention to long-term ownership by industrial foundations, which is common in Northern Europe but little...... known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long-term owners that practice long-term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation-owned companies replace managers less...... frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long-termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures...

  6. Coping with PH over the Long Term (United States)

    ... a job, a volunteer commitment, or even a hobby can take a toll on long-term survivors ... people find solace in meditation, faith, humor, writing, hobbies and more. Find an outlet that you enjoy ...

  7. Long term effects of radiation in man

    International Nuclear Information System (INIS)

    Tso Chih Ping; Idris Besar


    An overview of the long term effects of radiation in man is presented, categorizing into somatic effects, genetic effects and teratogenic effects, and including an indication of the problems that arise in their determination. (author)

  8. Long term liquidity analysis of the firm

    Directory of Open Access Journals (Sweden)

    Jaroslav Gonos


    Full Text Available Liquidity control is a very difficult and important function. If the business is not liquid in the long term, it is under threatof bankruptcy, and on the other hand surplus of the cash in hand threaten its future efficiency, because the cash in hand is a sourceof only limited profitability. Long term liquidity is related to the ability of the short term and long term liabilities payment. Articleis trying to point out to the monitoring and analyzing of the long term liquidity in the concrete business, in this case the printing industrycompany. Hereby at the end of the article mentioned monitored and analyzed liquidity is evaluated in the five years time period.

  9. Long Term Care Minimum Data Set (MDS) (United States)

    U.S. Department of Health & Human Services — The Long-Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status that forms the foundation of the comprehensive...

  10. Sleep facilitates long-term face adaptation


    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent


    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

  11. Impact of the components of Mediterranean nutrition regimen on long-term prognosis of diabetic patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Soheila Mosharraf


    Full Text Available BACKGROUND: The impact of different nutritional regimens on long-term prognosis and outcome in diabetic patients with coronary artery disease (CAD has been questioned. Therefore, the objective of the present study was to determine the effects of different nutritional components of Mediterranean regimen on long-term cardiovascular events in diabetic patients with CAD in the Iranian population. METHODS: In a prospective cohort study, we recruited 233 consecutive patients with the diagnosis of type 2 diabetes mellitus and with at least 6 months of documented CAD. Nutritional assessment was obtained by a validated semi-quantitative food frequency questionnaire (FFQ and the diet score was calculated on the basis of the Mediterranean diet quality index (Med-DQI. For Assessing long-term CAD prognosis, the patients were followed by telephone for one year. The study endpoint was long-term major adverse cardiac and cerebrovascular event (MACCE. RESULTS: Death was observed in 19 patients (8.2% during the one-year follow-up. Two patients (0.9% suffered non-fatal myocardial infarction and 14 (6.0% needed revascularization within 1 year after discharge from hospital. Overall MACCE within one year in the study population was 12.4%. There were significant differences between number of deaths and dietary scores of saturated fatty acid, cholesterol, meats, fish, and fruit and vegetables (P < 0.05. Moreover, significant differences were found between MACCE rate and dietary scores of saturated fatty acid, cholesterol, and fruit and vegetables (P < 0.05. Using multivariate logistic regression models, Mediterranean dietary regimen could effectively predict long-term death as well as MACCE adjusted for gender and age variables. CONCLUSION: Mediterranean dietary regimens, including low level of cholesterol and saturated fatty acid, can effectively improve long-term outcome including death and MACCE in diabetic patients with CAD.   Keywords: Diabetes Mellitus, Coronary

  12. Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review. (United States)

    Mancini, Vito; Cormio, Luigi; d'Altilia, Nicola; Benedetto, Giuseppe; Ferrarese, Paolo; Balzarro, Matteo; Defidio, Lorenzo; Carrieri, Giuseppe


    To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28-77) and the mean cyst size was 53.2 ± 14.23 mm (range 35-90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3-6-12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30-80) and mean hospital stay was 3.5 days (range 2-5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients -became asymptomatic (VAS score change, p = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24-84); all patients remained asymptomatic, with no signs of recurrence. RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different -institutions. © 2018 S. Karger AG, Basel.

  13. Very long-term sequelae of craniopharyngioma. (United States)

    Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M


    Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

  14. Struggling for Independence: A Grounded Theory Study on Convalescence of ICU-survivors 12 Months Post ICU Discharge

    DEFF Research Database (Denmark)

    Ågård, Anne Sophie; Egerod, Ingrid; Tønnesen, Else Kirstine


    Objectives: To explore and explain the challenges, concerns and coping modalities in ICU-survivors living with a partner or spouse during the first 12 months post ICU discharge. Design: Qualitative, longitudinal grounded theory study. Settings: Five ICUs in Denmark, four general, one neurosurgical...

  15. Long-term prisoner in prison isolation

    Directory of Open Access Journals (Sweden)

    Karolina Grudzińska


    Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

  16. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park


    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  17. Long term health-related quality of life in survivors of sepsis in South West Wales: an epidemiological study. (United States)

    Battle, Ceri E; Davies, Gareth; Evans, Phillip A


    Survivors of sepsis report persistent problems that can last years after hospital discharge. The main aim of this study was to investigate long-term health-related quality of life in survivors of SIRS and sepsis compared with Welsh normative data, controlling for age, length of stay and pre-existing conditions. The second aim was to investigate any differences in long-term health-related quality of life specifically with the patients categorised into three groups; SIRS, uncomplicated sepsis and severe sepsis/septic shock. A prospective study design was used in order to investigate all sepsis patients either presenting to the Emergency Department or admitted to the Intensive Care Unit of a regional trauma centre. Baseline demographics, clinical characteristics and outcomes were collected and surviving patients were sent a SF-12v2 survey at between six months to two years post-hospital discharge. Quality of life was significantly reduced in all patients when compared to local normative data (all pquality of life were more pronounced in severe sepsis/septic shock patients when compared to uncomplicated sepsis and SIRS patients, when controlling for age, pre-existing conditions, hospital and ICU length of stay. This is the first observational study to specifically focus on the different groups of SIRS and sepsis patients to assess long-term quality of life. Local population norms were used for comparison, rather than UK-wide norms that fail to reflect the intricacies of a country's population.

  18. Monitoring long-term oral corticosteroids. (United States)

    Mundell, Lewis; Lindemann, Roberta; Douglas, James


    Corticosteroids are synthetic analogues of human hormones normally produced by the adrenal cortex. They have both glucocorticoid and mineralocorticoid properties. The glucocortoid components are anti-inflammatory, immunosuppressive, anti-proliferative and vasoconstrictive. They influence the metabolism of carbohydrate and protein, in addition to playing a key role in the body's stress response. Mineralocorticoid's main significance is in the balance of salt and water concentrations. Due to the combination of these effects, corticosteroids can cause many adverse effects. Oral corticosteroids are absorbed systemically and are therefore more likely to cause adverse effects than topical or inhaled corticosteroids. Furthermore, it is assumed that greater duration of treatment will lead to a greater number of adverse effects, and therefore the most at risk group are those taking high dose, long-term oral corticosteroids (LTOC). High dose is defined as a prescription of >5 mg oral prednisolone and long term as duration of treatment >1 month (based on National Institute for Health and Care Excellence guidance for patient's 'at risk' of systemic side effects). Parameters to be monitored in primary care include weight, blood pressure, triglycerides, glucose and urea and electrolytes. From clinical experience within the general practice setting, the authors propose that these patients do not receive adequate baseline monitoring before starting corticosteroids nor are these markers monitored consistently thereafter. This project intended to evidence this claim, evaluate the adverse effect profile and improve monitoring in this patient group. The initial audit of 22 patients, within a single general practice, detected at least one documented adverse effect in 64% of patients, while 41% reported more than one adverse effect. 45% had recorded weight gain, 18% had recorded osteoporosis, 18% had at least one recorded cataract, 14% had recorded Hypertension, 14% had recorded

  19. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell


    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  20. Long-term dependence in exchange rates

    Directory of Open Access Journals (Sweden)

    A. Karytinos


    Full Text Available The extent to which exchange rates of four major currencies against the Greek Drachma exhibit long-term dependence is investigated using a R/S analysis testing framework. We show that both classic R/S analysis and the modified R/S statistic if enhanced by bootstrapping techniques can be proven very reliable tools to this end. Our findings support persistence and long-term dependence with non-periodic cycles for the Deutsche Mark and the French Franc series. In addition a noisy chaos explanation is favored over fractional Brownian motion. On the contrary, the US Dollar and British Pound were found to exhibit a much more random behavior and lack of any long-term structure.

  1. Long-term complications in Hodgkin's lymphoma survivors. (United States)

    Kilickap, Saadettin; Barista, Ibrahim; Ulger, Sukran; Celik, Ismail; Selek, Ugur; Güllü, Ibrahim; Yildiz, Ferah; Kars, Ayse; Ozisik, Yavuz; Tekuzman, Gülten


    Background. Although patients with Hodgkin's lymphoma (HL) achieve prolonged survival, long-term complications are a major cause of morbidity and mortality among long-term survivors of HL. Methods. We retrospectively evaluated long-term complications in 336 HL survivors treated between January 1990 and January 2006 at the Department of Medical Oncology of the Hacettepe University Institute of Oncology who were >16 years old at presentation. All patients were regularly followed up every 3 months for the first 2 years after complete response, biannually for 3 years, and annually after 5 years. Results. Median follow-up was 8.5 years. The mean age (±SD) of the patients at the time of diagnosis was 35.7 ± 13.1 years. The male to female ratio was 61%/39%. During follow-up, 29 second malignancies (8.6%) were diagnosed in 28 patients with HL; 22 were solid tumors and 7 were hematological malignancies. Forty-seven (14.0%) of all patients with HL were found to have thyroid abnormalities. During follow-up, 54 (16.1%) patients developed cardiovascular complications. Overall, 29 (8.6%) patients developed late pulmonary toxicities. The cumulative number of chronic viral infections was 13 (3.9%). Conclusions. Long-term survivors of HL need to be properly followed up not only for disease control but also for evaluation of possible late morbidities to minimize the consequences.

  2. Long-term Outcome of Arterial Stroke in Children

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Investigators at University Children’s Hospital, Inselspital, and Universities of Bern, Geneva, Basel, and Zurich, Switzerland compared long-term outcome of children (1 month-16 years and young adults (16.1-45 years with arterial ischemic stroke (AIS using prospective data from the Swiss Neuropediatric Stroke Registry and the Adult Bernese stroke registry, between Jan 2000 and Dec 2008.

  3. Long-term elevated temperature leaching of solid waste forms

    International Nuclear Information System (INIS)

    Kenna, B.T.; Murphy, K.D.; Levine, H.S.


    Long-term soxhlet leaching of simulated waste glass and ceramic materials was initiated to elucidate leaching behavior of complex wasteforms. A cyclic leaching pattern was found in all systems over a 20 month period. Maxima and minima were observed in the leaching rates of all components studied with the minima coinciding. The data suggested several mechanistic features which are described, but they did not conform with reported simple leaching mechanisms

  4. Long term planning for wind energy development

    International Nuclear Information System (INIS)

    Trinick, M.


    In a planning system intended to be governed primarily by policies in statutory plans a reasonable horizon for long term planning is 10 years or longer. Because of statutory requirements, developers have no option but to pay due regard to, and take a full part in, long term planning. The paper examines the type of policies which have emerged in the last few years to cater for wind energy development. It canvasses the merits of different types of policies. Finally, it discusses the policy framework which may emerge to cater for development outside NFFO. (Author)

  5. Long-term characteristics of nuclear emulsion

    International Nuclear Information System (INIS)

    Naganawa, N; Kuwabara, K


    Long-term characteristics of the nuclear emulsion so called 'OPERA film' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  6. Long-term characteristics of nuclear emulsion (United States)

    Naganawa, N.; Kuwabara, K.


    Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  7. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  8. Long term storage techniques for 85Kr

    International Nuclear Information System (INIS)

    Foster, B.A.; Pence, D.T.; Staples, B.A.


    As new nuclear fuel reprocessing plants go on stream, the collection of fission product 85 Kr will be required to avoid potential local release problems and long-term atmospheric buildup. Storage of the collected 85 Kr for a period of at least 100 years will be necessary to allow approximately 99.9 percent decay before it is released. A program designed to develop and evaluate proposed methods for long-term storage of 85 Kr is discussed, and the results of a preliminary evaluation of three methods, high pressure steel cylinders, zeolite encapsulation, and clathrate inclusion are presented. (U.S.)

  9. Frozen shoulder : long-term outcome following arthrographic distension. (United States)

    Clement, Rhys G E; Ray, Andrew G; Davidson, Colin; Robinson, C Mike; Perks, Fergus J


    Arthrographic distension of the glenohumeral joint was adopted as a mainstream treatment for frozen shoulder before any randomised controlled trials were performed. Interpretation of the effectiveness of this procedure rests mostly on data from cohort studies of which there are few of high quality. Papers reporting long-term results have either excluded diabetic patients or failed to report patient orientated outcomes. The authors present a long-term prospective cohort study of 51 patients (12 diabetics and 39 non-diabetics), with 53 frozen shoulders, who had an arthrographic distension performed by a single radiologist as a primary intervention. Oxford shoulder score (OSS), visual analogue pain score (VAS), and range of movement (ROM) were recorded pre-distension, at 2 days and 1 month post-distension. OSS and VAS were recorded again at a mean of 14 months post distension (range : 8-26 months). OSS improved from a pre-distension mean of 22.3 by 16.9 points at final follow-up (p diabetic patients was the same as in non-diabetic patients. Arthrographic distension is a safe and effective treatment for frozen shoulder; it is also effective in diabetic patients. It gives long-term improvement. The authors believe that the low number of patients requiring a secondary procedure makes arthrographic distension preferable to manipulation under anaesthesia.

  10. Influence of Salmonella status on the long-term outcome of horses after colic surgery. (United States)

    Southwood, Louise L; Lindborg, Susan; Myers, Marc; Aceto, Helen W


    To compare long-term outcome of Salmonella-positive versus Salmonella-negative horses discharged from hospital after colic surgery. Retrospective case-control. Horses discharged from the hospital after colic surgery. For each horse with positive culture for Salmonella enterica (SAL-POS, n = 59), at least 2 horses testing negative for S. enterica (SAL-NEG, n = 119) were enrolled. Owners were interviewed via phone at least 12 months after surgery regarding: (1) complications after discharge from the hospital; (2) duration of survival; and (3) return to prior or intended use. Association between immediate postoperative clinical variables such as Salmonella status and long-term measures of outcome was tested via ratios (odds ratio [OR]) and 95% confidence intervals. Data were analyzed for survival using a Cox proportional hazards model and for return to use using multivariable logistic regression. SAL-POS horses had a higher OR of surgical site infection (2.7 [1.1-6.9] P = .027) and weight loss (6.8 [1.8-26.1] P = .002). At the time of follow-up, there were 53/56 (95%) SAL-POS and 99/118 (84%) SAL-NEG horses alive. The final multivariable model for nonsurvival included postoperative colic (hazard ratio 7.6 [2.8-19.2] P = .002) and the interaction between Salmonella status and duration of rectal temperature > 103°F postoperatively (SAL-POS 1.04 [1.01-1.07] and SAL-NEG 1.16 [1.06-1.25], P = .005). The majority of horses returned to their intended use regardless of their SAL-POS (38/50, 76%) or SAL-NEG (77/96, 80%, P = .498) status. Salmonella-positive horses that survive to discharge from the hospital after colic surgery have similar risks of long-term complications (colic/diarrhea), survival, and return to function than Salmonella-negative horses. © 2017 The American College of Veterinary Surgeons.

  11. Experiences of long-term tranquillizer use

    DEFF Research Database (Denmark)

    Skinhoj, K T; Larsson, S; Helweg-Joergensen, S


    , the psychodynamic perspective is integrated within a multi-dimensional model that considers biological, cognitive, identity, gender and social learning factors. The analysis reveals the possibility of achieving a detailed understanding of the dynamic processes involved in the development of long-term tranquillizer...

  12. Long-Term Orientation in Trade

    NARCIS (Netherlands)

    Hofstede, G.J.; Jonker, C.M.; Verwaart, D.


    Trust does not work in the same way across cultures. This paper presents an agent model of behavior in trade across Hofstedes cultural dimension of long-term vs. short-term orientation. The situation is based on a gaming simulation, the Trust and Tracing game. The paper investigates the

  13. Safety of long-term PPI therapy

    DEFF Research Database (Denmark)

    Reimer, Christina


    Proton pump inhibitors have become the mainstay of medical treatment of acid-related disorders. Long-term use is becoming increasingly common, in some cases without a proper indication. A large number of mainly observational studies on a very wide range of possible associations have been publishe...... to a careful evaluation of the indication for PPI treatment....

  14. Long term consequences of early childhood malnutrition

    NARCIS (Netherlands)

    Kinsey, B.H.; Hoddinott, J; Alderman, H.


    This paper examines the impact of pre-school malnutrition on subsequent human capital formation in rural Zimbabwe using a maternal fixed effects - instrumental variables (MFE-IV) estimator with a long term panel data set. Representations of civil war and drought shocks are used to identify

  15. Financial Incentives in Long-Term Care

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter)


    markdownabstract__Abstract__ Long-term care (ltc) aims to help individuals to cope with their impairments. In my thesis, I describe ltc financing alternatives and their consequences for the allocation of ltc. This thesis consists of two parts. In the first part, I investigate how alternative ways

  16. Long-term outcomes of patellofemoral arthroplasty.

    NARCIS (Netherlands)

    Jonbergen, J.P.W. van; Werkman, D.M.; Barnaart, L.F.; Kampen, A. van


    The purpose of this study was to correlate the long-term survival of patellofemoral arthroplasty with primary diagnosis, age, sex, and body mass index. One hundred eighty-five consecutive Richards type II patellofemoral arthroplasties were performed in 161 patients with isolated patellofemoral

  17. Long-Term Memory and Learning (United States)

    Crossland, John


    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  18. The 2013 Long-Term Budget Outlook (United States)


    number of years, leading to substantial additional federal spending. For example, the nation could experience a massive earthquake, a nuclear meltdown...budget surpluses remaining after paying down publicly held debt available for redemption . a. For comparison with the current long-term projections, CBO

  19. Long-term effects of ionizing radiation

    International Nuclear Information System (INIS)

    Kaul, Alexander; Burkart, Werner; Grosche, Bernd; Jung, Thomas; Martignoni, Klaus; Stephan, Guenther


    This paper approaches the long-term effects of ionizing radiation considering the common thought that killing of cells is the basis for deterministic effects and that the subtle changes in genetic information are important in the development of radiation-induced cancer, or genetic effects if these changes are induced in germ cells

  20. Pituitary diseases : long-term psychological consequences

    NARCIS (Netherlands)

    Tiemensma, Jitske


    Nowadays, pituitary adenomas can be appropriately treated, but patients continue to report impaired quality of life (QoL) despite long-term remission or cure. In patients with Cushing’s disease, Cushing’s syndrome or acromegaly, doctors should be aware of subtle cognitive impairments and the

  1. The long term stability of lidar calibrations

    DEFF Research Database (Denmark)

    Courtney, Michael; Gayle Nygaard, Nicolai

    Wind lidars are now used extensively for wind resource measurements. One of the requirements for the data to be accepted in support of project financing (so-called ‘banka-bility’) is to demonstrate the long-term stability of lidar cali-brations. Calibration results for six Leosphere WindCube li...

  2. Rebalancing for Long-Term Investors

    NARCIS (Netherlands)

    Driessen, Joost; Kuiper, Ivo


    In this study we show that the rebalance frequency of a multi-asset portfolio has only limited impact on the utility of a long-term passive investor. Although continuous rebalancing is optimal, the loss of a suboptimal strategy corresponds to up to only 30 basis points of the initial wealth of the

  3. Long-term variation of outdoor radon equilibrium equivalent concentration

    Energy Technology Data Exchange (ETDEWEB)

    Hoetzl, H. [GSF-Forschungszentrum fuer Umwelt und Gesundheit, Inst. fuer Strahlenschutz, Oberschleissheim (Germany); Winkler, R. [GSF-Forschungszentrum fuer Umwelt und Gesundheit, Inst. fuer Strahlenschutz, Oberschleissheim (Germany)


    Long-term variation of outdoor radon equilibrium equivalent concentration was investigated from 1982 to 1992 at a semi-natural location 10 km north of Munich, southern Germany. For this period the continuous measurement yielded a long-term average of 8.6 Bq.m{sup -3} (arithmetic mean) and 6.9 Bq.m{sup -3} (geometric mean), from which an average annual effective dose of 0.14 mSv due to outdoor radon can be derived. A long-term trend of the radon concentration was not detectable over the whole period of observation. However, by time series analysis, a long-term cyclic pattern was identified with two maxima (1984-1986, 1989-1991) and two minima (1982-1983, 1987-1988). The seasonal pattern is characterized by an autumn maximum and an early summer minimum. On average, the seasonal maximum in October was found to be higher by a factor of 2 than the June minimum. The diurnal variation of the radon concentration shows a maximum in the early morning and a minimum in the afternoon. On average, this maximum is a factor of 2 higher than the minimum. In the long term a seasonal pattern was observed for diurnal variation, with an average diurnal maximum to minimum ratio of 1.5 in winter compared with 3.5 in the summer months. The radon concentration is correlated with a meteorological parameter (stagnation index) which takes into account horizontal and vertical exchange processes and the wash-out of aerosols in the lower atmosphere. (orig.)

  4. Long-term variation of outdoor radon equilibrium equivalent concentration

    International Nuclear Information System (INIS)

    Hoetzl, H.; Winkler, R.


    Long-term variation of outdoor radon equilibrium equivalent concentration was investigated from 1982 to 1992 at a semi-natural location 10 km north of Munich, southern Germany. For this period the continuous measurement yielded a long-term average of 8.6 Bq.m -3 (arithmetic mean) and 6.9 Bq.m -3 (geometric mean), from which an average annual effective dose of 0.14 mSv due to outdoor radon can be derived. A long-term trend of the radon concentration was not detectable over the whole period of observation. However, by time series analysis, a long-term cyclic pattern was identified with two maxima (1984-1986, 1989-1991) and two minima (1982-1983, 1987-1988). The seasonal pattern is characterized by an autumn maximum and an early summer minimum. On average, the seasonal maximum in October was found to be higher by a factor of 2 than the June minimum. The diurnal variation of the radon concentration shows a maximum in the early morning and a minimum in the afternoon. On average, this maximum is a factor of 2 higher than the minimum. In the long term a seasonal pattern was observed for diurnal variation, with an average diurnal maximum to minimum ratio of 1.5 in winter compared with 3.5 in the summer months. The radon concentration is correlated with a meteorological parameter (stagnation index) which takes into account horizontal and vertical exchange processes and the wash-out of aerosols in the lower atmosphere. (orig.)

  5. Long-term survival of adult trauma patients. (United States)

    Davidson, Giana H; Hamlat, Christian A; Rivara, Frederick P; Koepsell, Thomas D; Jurkovich, Gregory J; Arbabi, Saman


    Inpatient trauma case fatality rates may provide an incomplete assessment for overall trauma care effectiveness. To date, there have been few large studies evaluating long-term mortality in trauma patients and identifying predictors that increase risk for death following hospital discharge. To determine the long-term mortality of patients following trauma admission and to evaluate survivorship in relationship with discharge disposition. Retrospective cohort study of 124,421 injured adult patients during January 1995 to December 2008 using the Washington State Trauma Registry linked to death certificate data. Kaplan-Meier and Cox proportional hazards models were used to evaluate long-term mortality following hospital admission for trauma. Of the 124,421 trauma patients, 7243 died before hospital discharge and 21,045 died following hospital discharge. Cumulative mortality at 3 years postinjury was 16% (95% confidence interval [CI], 15.8%-16.2%) compared with the expected population cumulative mortality of 5.9% (95% CI, 5.9%-5.9%). In-hospital mortality improved during the 14-year study period from 8% (n = 362) to 4.9% (n = 600), whereas long-term cumulative mortality increased from 4.7% (95% CI, 4.1%-5.4%) to 7.4% (95% CI, 6.8%-8.1%). After adjustments for confounders, patients who were older and those who were discharged to a skilled nursing facility had the highest risk of death. The adjusted hazard ratios (HRs) for death after discharge to a skilled nursing facility compared with that after discharge home were 1.41 (95% CI, 0.72-2.76) for patients aged 18 to 30 years, 1.92 (95% CI, 1.36-2.73) for patients aged 31 to 45 years, 2.02 (95% CI, 1.39-2.93) for patients aged 46 to 55 years, 1.93 (95% CI, 1.40-2.64) for patients aged 56 to 65 years, 1.49 (95% CI, 1.14-1.94) for patients aged 66 to 75 years, 1.54 (95% CI, 1.27-1.87) for patients aged 76 to 80 years, and 1.38 (95% CI, 1.09-1.74) for patients older than 80 years. Other significant predictors of mortality

  6. [Intensive hemoperfusion and long-term hemofiltration for treatment of paraquat poisoning: a case report]. (United States)

    Peng, Zhi-Yun; Chang, Ping; Wang, Hua; Cen, Zhong-Ran; Zhou, Jian; Liu, Zhan-Guo


    A 20-year-old male patient was admitted in our department 14 h after paraquat poisoning at the dose of about 50 mL. The patient underwent intensive hemoperfusion for 2 h (3 times a day) for 9 consecutive days and received continuous renal replacement therapy (CRRT) in the mode of continuous veno-venous hemofiltration (CVVH) for 10 consecutive days in addition to routine medications. The biochemical indexes were monitored during the therapy. After the treatment, paraquat concentrations in the blood and urine were decreased, and the patient's urine volume (UV) increased, serum creatinine (Cr) level decreased, and the oxygenation index became normal. Dynamic CT scan showed no obvious pulmonary fibrosis. The patient was followed up for 6 months after discharge and no complaint of discomforts was reported. This case suggests that early intensive hemoperfusion and long-term CVVH may help improve the prognosis after paraquat poisoning.

  7. Characteristics of asthma attack with long-term management for bronchial asthma. (United States)

    Kawahara, Noriko; Hasegawa, Shunji; Hashimoto, Kunio; Matsubara, Tomoyo; Ichiyama, Takashi; Furukawa, Susumu


    There have been no reports on the evaluation of the usefulness of long-term asthma management based on the Japanese Pediatric Guideline for the Treatment and Management of Bronchial Asthma 2005 (JPGL 2005). The purpose of the present study was to retrospectively investigate the records of 350 patients admitted to Yamaguchi University Hospital who had asthma attacks from January 2006 to June 2008. There were 149 patients who were treated for more than 3 months in accordance with the guideline (long-term management group) and 201 who were not (non-long-term management group). The patients were divided into three age groups: 100 infants, 159 toddlers, and 91 schoolchildren. The onset age of asthma in the long-term management group was earlier than that in the non-long-term management group in toddlers and schoolchildren. The white blood cell counts and C-reactive protein levels were higher in the non-long-term management group in schoolchildren, suggesting the complication of some infections. The severity of asthma in the long-term management group was greater than that in the non-long-term management group among all three age groups. There were no significant differences, however, in the severity of asthma attack at admission between the long-term and non-long-term management groups in the three age groups. Patients who had severe asthma tended to be treated with long-term management, which suggests that long-term asthma management according to JPGL 2005 may reduce the severity of asthma attack at that admission, because the severity of asthma in patients undergoing long-term management correlates with the severity of asthma attack.

  8. Birds choose long-term partners years before breeding (United States)

    Teitelbaum, Claire S.; Converse, Sarah J.; Mueller, Thomas


    Pair bonds can provide social benefits to long-term monogamous species alongside their benefits for reproduction. However, little is known about when these bonds form, in particular how long they are present before breeding. Previous studies of pair formation in long-term monogamous birds have been rather data-limited, but for many migratory birds they report pair formation on the wintering grounds. We provide the first systematic investigation of prebreeding association patterns of long-term monogamous pairs by examining entire life histories based on tracking data of migratory whooping cranes, Grus americana. We found that a substantial portion (62%) of breeding pairs started associating at least 12 months before first breeding, with 16 of 58 breeding pairs beginning to associate over 2 years before first breeding. For most pairs, these associations with future breeding partners also became unique and distinguishable from association patterns with nonpartner individuals 12 months before first breeding. In addition, 60% of pair associations began before at least one partner had reached nominal sexual maturity. Most pairs began associating in the late spring upon arrival at the summer grounds, while associations beginning at other times of the year were rare. Patterns in the associations of pairs prior to breeding can point to the potential benefits of prebreeding relationships, for instance providing support in competitive interactions or increasing partner familiarity.

  9. Long-term changes in river system hydrology in Texas

    Directory of Open Access Journals (Sweden)

    Y. Zhang


    Full Text Available Climate change and human actives are recognized as a topical issue that change long-term water budget, flow-frequency, and storage-frequency characteristics of different river systems. Texas is characterized by extreme hydrologic variability both spatially and temporally. Meanwhile, population and economic growth and accompanying water resources development projects have greatly impacted river flows throughout Texas. The relative effects of climate change, water resources development, water use, and other factors on long-term changes in river flow, reservoir storage, evaporation, water use, and other components of the water budgets of different river basins of Texas have been simulated in this research using the monthly version of the Water Rights Analysis Package (WRAP modelling system with input databases sets from the Texas Commission on Environmental Quality (TCEQ and Texas Water Development Board (TWDB. The results show that long-term changes are minimal from analysis monthly precipitation depths. Evaporation rates vary greatly seasonally and for much of the state appear to have a gradually upward trend. River/reservoir system water budgets and river flow characteristics have changed significantly during the past 75 years in response to water resources development and use.

  10. Long-term variability of precipitation in Republic of Macedonia

    International Nuclear Information System (INIS)

    Slavov, Nikola; Marinova, Tania; Ristevski, Pece


    During the last century a great attention has been spared to the water resources of the territories of different countries in the world. In the last decades investigations were directed towards the long-term variability of precipitation in the basic regions of agricultural production. Among these investigations the results that indicate decreasing of precipitation amounts during the potential crop-growing season are of especially great interest because precipitation decreasing affects harmfully crop production and population feeding. The purpose of the present work is to study the long-term variability of monthly precipitation sums for 5 representative meteorological stations in Republic of Macedonia: Skopje, Bitola, Prilep, Stip and Demir Kapija for the period 1925-2000. The duration and periodicity of precipitation variations are analyzed on the base of 5-years smooth values for different seasons, warm and cold half-year and for year. The tendencies of trend for the period 1925-2000 are found out.(Author)

  11. Long-term use of antiplatelet drugs by stroke patients

    DEFF Research Database (Denmark)

    Ostergaard, Kamilla; Hallas, Jesper; Bak, Søren


    PURPOSE: Treatment with antiplatelet drugs is a key element of secondary stroke prevention. We investigated long-term antiplatelet drug use in stroke patients with a focus on non-persistence. METHODS: Population-based prescription register data were used to determine antiplatelet drug use...... the dosage of a previous prescription had run out, or within 180 days after discharge. Cox regression was used to identify risk factors for non-persistence. RESULTS: The cohort comprised 503 patients with ischaemic stroke discharged in 1999-2001. During follow-up (median 2.8 years, interquartile range 0......-persistent. Stroke severity was inversely associated with the risk of non-persistence [NIHSS score on admission 0-3 (reference); 4-6: hazard risk (HR) 0.87, 95 % confidence interval (CI) 0.61-1.25; 7+: HR 0.47, 95 % CI 0.29-0.74]. CONCLUSIONS: Long-term non-persistence with antiplatelet treatment was high and more...

  12. Bilateral Incomplete Atypical Femoral Fracture due to Long-Term Bisphosphonate Use: A Case Report

    Directory of Open Access Journals (Sweden)

    Sibel Başaran


    Full Text Available Although the overall safety profile of bisphosphonates (BP is favorable, adverse effects associated with long-term use have came up during recent years. In this report, a case of bilateral incomplete atypical femoral fracture (AFF due to prolonged BP use was presented. A 69-year-old patient, who has been in surgical menopause for 20 years and was started on BP following vertebral fracture almost 10 years ago, was admitted with thigh pain, which was increased two weeks ago. On physical examination, she had antalgic gait, increased thoracic kyphosis and tenderness to percussion over the thoracolumbar region. Lateral cortical thickness in the subtrochanteric region of both femurs and cortical radiolucency on the left femur were observed on plain radiography. Loss of height in L3 and L4 vertebrae was detected on vertebral radiography. Serum 25-hydroxy vitamin D [25(OHD], parathyroid hormone, alkaline phosphatase and calcium levels, along with osteoporosis markers were all within the normal ranges. As the patient was diagnosed with AFF, BP therapy was terminated and vitamin D-calcium supplementation was continued. Since she did not have severe pain, conservative management (limited weight bearing, using a walking stick was recommended for 3 months. Teriparatide therapy was started and she was discharged with recommendations. AFF, which is a rare disorder, should be kept in mind in patients on long-term BP treatment who are admitted with thigh pain and, necessary interventions should be tailored before the occurrence of complete fracture.

  13. Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa. (United States)

    Krüger, C; Lewis, C


    The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related to successful community placement, in the context of limited community care facilities. Thirty-six long-term patients who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received the most interventions, and the most common type of interventions. The most significant patient factors associated with successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during the study period: The recipients were mostly female, in open wards (higher-functioning); and the social services utilised were mostly related to planning for placement and patient support. The lack of community care facilities in the Pretoria area that are able to care for the more difficult long-term psychiatry patients, limits successful placement and increases the burden of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of provincial and national health departments.

  14. Long-term selenium status in humans

    International Nuclear Information System (INIS)

    Baskett, C.K.; Spate, V.L.; Mason, M.M.; Nichols, T.A.; Williams, A.; Dubman, I.M.; Gudino, A.; Denison, J.; Morris, J.S.


    The association of sub-optimal selenium status with increased risk factors for some cancers has been reported in two recent epidemiological studies. In both studies the same threshold in selenium status was observed, below which, cancer incidence increased. To assess the use of nails as a biologic monitor to measure the long-term selenium status, an eight-year longitudinal study was undertaken with a group of 11 adult subjects, 5 women and 6 men. Selenium has been measured by instrumental neutron activation analysis. Differences between fingernails and toenails with be discussed. In addition, the results will be discussed in the context of the long-term stability of the nail monitor to measure selenium status during those periods when selenium determinants are static; and the changes that occur as a result of selenium supplementation. (author)

  15. Influenza in long-term care facilities. (United States)

    Lansbury, Louise E; Brown, Caroline S; Nguyen-Van-Tam, Jonathan S


    Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  16. Long-Term Ownership by Industrial Foundations

    DEFF Research Database (Denmark)

    Børsting, Christa Winther; Kuhn, Johan Moritz; Poulsen, Thomas


    in Denmark. Industrial foundations are independent legal entities without owners or members typically with the dual objective of preserving the company and using excess profits for charity. We use a unique Danish data set to examine the governance of foundation-owned companies. We show that they are long......-term in several respects. Foundations hold on to their shares for longer. Foundation-owned companies replace managers less frequently. They have more conservative capital structures with less leverage. Their companies survive longer. Their business decisions appear to be more long term. This paper supports...... the hypothesis that time horizons are influenced by ownership structures and particularly that industrial foundations promote longtermism. Policymakers which are interested in promoting longtermism should allow and perhaps even encourage the creation of industrial foundations. More generally they should consider...

  17. Analysis of long-term energy scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Lemming, J.; Morthorst, P.E.


    When addressing the role of fusion energy in the 21. century, the evaluation of possible future structures in the electricity market and the energy sector as a whole, can be a useful tool. Because fusion energy still needs demonstration, commercialized fusion energy is not likely to be a reality within the next few decades. Therefore long-term scenarios are needed describing the energy markets, which fusion energy eventually will be part of. This report performs an analysis of two of the most detailed existing long-term scenarios describing possible futures of the energy system. The aim is to clarify the frames in which the future development of the global energy demand, as well as the structure of the energy system can be expected to develop towards the year 2100. (au) 19 refs.

  18. Long-term effects of radiation

    International Nuclear Information System (INIS)

    Smith, J.; Smith, T.


    It is pointed out that sources of long-term damage from radiation are two-fold. People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may still suffer long-term damage from their exposure. Those who have not been exposed to early fallout may be exposed to delayed fallout, the hazards from which are almost exclusively from ingesting strontium, caesium and carbon isotopes present in food; the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout. A brief discussion is presented of the distribution of delayed long-lived isotope fallout, and an outline is sketched of late biological effects, such as malignant disease, cataracts, retarded development, infertility and genetic effects. (U.K.)

  19. Long-term course of opioid addiction. (United States)

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas


    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  20. Long-term economic outlook. Annual review

    Energy Technology Data Exchange (ETDEWEB)


    This review provides economic growth forecast tables for Ontario, Canada, the US, Western Europe, and Japan. Economic growth, government policy, the long-term prospects for inflation, interest rates and foreign exchange rates, trends in the Canadian dollar, and energy markets and prices are also reviewed. Data generally cover 1965-2025. Appendices give a summary of historical and forecast data. 18 figs., 16 tabs.

  1. Long-term data storage in diamond


    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A.


    The negatively charged nitrogen vacancy (NV?) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV? optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multic...

  2. French Approach for Long Term Storage Safety

    International Nuclear Information System (INIS)

    Marciano, Jacob; Carreton, Jean-Pierre; Lizot, Marie Therese; Lhomme, Veronique


    IRSN presents its statement regarding long-term storage facilities; in France, the regulatory documents do not define the long term duration. The storage facility lifetime can only be appreciated according to the needs and materials stored therein. However, the magnitude of the long-term can be estimated at a few hundred years compared to a few decades for current storage. Usually, in France, construction of storage facilities is driven from the necessity various necessities, linked to the management of radioactive material (eg spent fuel) and to the management of radioactive waste. Because of the variety of 'stored materials and objects' (fission product solutions, plutonium oxide powders, activated solids, drums containing technological waste, spent fuel...), a great number of storage facility design solutions have been developed (surface, subsurface areas, dry or wet conditions...) in the World. After describing the main functions of a storage facility, IRSN displays the safety principles and the associated design principles. The specific design principles applied to particular storage (dry or wet spent fuel storage, depleted uranium or reprocessed uranium storage, plutonium storage, waste containing tritium storage, HLW and ILLW storage...) are also presented. Finally, the concerns due to the long-term duration storage and related safety assessment are developed. After discussing these issues, IRSN displays its statement. The authorization procedures governing the facility lifetime are similar to those of any basic nuclear installation, the continuation of the facility operation remaining subject to periodic safety reviews (in France, every 10 years). The applicant safety cases have to show, that the safety requirements are always met; this requires, at minimum, to take into account at the design stage, comfortable design margins. (author)

  3. Accounting of Long-Term Biological Assets


    Valeriy Mossakovskyy; Vasyl Korytnyy


    The article is devoted to generalization of experience in valuation of long-term biological assets of plant-growing and animal-breeding, and preparation of suggestions concerning improvement of accounting in this field. Recommendations concerning accounting of such assets are given based on the study of accounting practice at specific agricultural company during long period of time. Authors believe that fair value is applicable only if price level for agricultural products is fixed by the gov...

  4. Optimal long-term contracting with learning


    He, Zhiguo; Wei, Bin; Yu, Jianfeng; Gao, Feng


    We introduce uncertainty into Holmstrom and Milgrom (1987) to study optimal long-term contracting with learning. In a dynamic relationship, the agent's shirking not only reduces current performance but also increases the agent's information rent due to the persistent belief manipulation effect. We characterize the optimal contract using the dynamic programming technique in which information rent is the unique state variable. In the optimal contract, the optimal effort is front-loaded and decr...

  5. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...... integral nail-plates and nailed steel and plywood gussets. The report is intended for designers and researchers in timber engineering....

  6. Inflation Hedging for Long-Term Investors


    Shaun K. Roache; Alexander P. Attie


    Long-term investors face a common problem-how to maintain the purchasing power of their assets over time and achieve a level of real returns consistent with their investment objectives. While inflation-linked bonds and derivatives have been developed to hedge the effects of inflation, their limited supply and liquidity lead many investors to continue to rely on the indirect hedging properties of traditional asset classes. In this paper, we assess these properties over different time horizons,...

  7. Long term evolution 4G and beyond

    CERN Document Server

    Yacoub, Michel; Figueiredo, Fabrício; Tronco, Tania


    This book focus on Long Term Evolution (LTE) and beyond. The chapters describe different aspects of research and development in LTE, LTE-Advanced (4G systems) and LTE-450 MHz such as telecommunications regulatory framework, voice over LTE, link adaptation, power control, interference mitigation mechanisms, performance evaluation for different types of antennas, cognitive mesh network, integration of LTE network and satellite, test environment, power amplifiers and so on. It is useful for researchers in the field of mobile communications.

  8. Long-Term Care Services for Veterans (United States)


    includes but is not limited to home physical , occupational, or speech therapy ; wound care; and intravenous (IV) care. A VA physician determines that a...restoring/rehabilitating the veteran’s health, such as skilled nursing care, physical therapy , occupational therapy , and IV therapy Same as HBPC... geriatric evaluation,  palliative care,  adult day health care,  homemaker/home health aide care,  respite care, Long-Term Care Services for

  9. Long term adequacy of uranium resources

    International Nuclear Information System (INIS)

    Steyn, J.


    This paper examines the adequacy of world economic uranium resources to meet requirements in the very long term, that is until at least 2025 and beyond. It does so by analysing current requirements forecasts, existing and potential production centre supply capability schedules and national resource estimates. It takes into account lead times from resource discovery to production and production rate limitations. The institutional and political issues surrounding the question of adequacy are reviewed. (author)

  10. Long-term outcomes of patients with Streptococcus suis infection in Viet Nam: A case-control study. (United States)

    Huong, Vu T L; Long, Hoang B; Kinh, Nguyen V; Ngan, Ta T D; Dung, Vu T V; Nadjm, Behzad; van Doorn, H Rogier; Hoa, Ngo T; Horby, Peter; Wertheim, Heiman F L


    Streptococcus suis is a zoonotic cause of severe meningitis and sepsis in humans. We aimed to assess the long-term outcomes in patients who survived S. suis infection, in particular the progress and impact of vestibulocochlear sequelae. This case-control study evaluated outcomes of S. suis infection at discharge and 3 and 9 months post-discharge for 47 prospectively enrolled cases and at 11-34 months for 31 retrospectively enrolled cases. Outcomes in patients were compared to 270 controls matched for age, sex and residency. The prevalence ratio (PR) of moderate-to-complete hearing loss was 5.0(95%CI 3.6-7.1) in cases at discharge, 3.7(2.5-5.4) at 3 months, 3.2(2.2-4.7) at 9 months, and 3.1(2.1-4.4) in retrospective cases compared to controls. Hearing improvement occurred mostly within the first 3 months with a change in hearing level of 11.1%(95%CI 7.0-15.1%) compared to discharge. The PR of vestibular dysfunction was 2.4(95%CI 1.7-3.3) at discharge, 2.2(1.4-3.1) at 3 months, 1.8(1.1-2.5) at 9 months, and 1.8(1.1-2.6) for retrospective cases compared to controls. Cases also indicated more problems with mobility, self-care and usual activities. Both hearing and vestibular impairment were common and persist in cases. Appropriate patient management strategies are needed to reduce the incidence and impact of these sequelae. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Long-term outcomes of vertebroplasty for osteoporotic compression fractures

    International Nuclear Information System (INIS)

    Thillainadesan, G.; Schlaphoff, G.; Gibson, K.A.; Hassett, G.M.; McNeil, H.P.


    This study aimed to determine outcomes of percutaneous vertebroplasty for osteoporotic vertebral compression fractures (VCFs). Prospective assessment of short-term (≤6 weeks), medium-term (6 months) and long-term (29 months) outcomes of vertebroplasty, followed by a retrospective long-term follow-up of patients treated with vertebroplasty compared with conservative therapy. Outcomes measured were visual analogue scale pain scores, analgesic use, disability scores using the Roland Morris Disability questionnaire and a number of new VCFs. In 27 patients with acute VCFs followed prospectively, vertebroplasty resulted in significant reductions in pain levels (56-mm reduction on a 100-mm scale) and disability scores (11.8-point reduction on a 24-point scale) at all follow-up points up to a mean of 29 months compared with pre-vertebroplasty levels (P < 0.001). Analgesic use was significantly less intense in the short and medium term after vertebroplasty (P < 0.005). In 25 patients who had vertebroplasty for VCF, a sustained reduction in all outcomes was demonstrated at a mean follow-up of 30 months, with less pain, significantly lower disability scores (P < 0.05) and less analgesic use (P < 0.05) compared with nine conservatively treated subjects. During the follow-up period, six new VCFs occurred in 4/25 vertebroplasty patients compared with four new VCFs in 2/9 control subjects. Vertebroplasty provides significant and clinically meaningful reductions in pain, analgesic use, and disability in the short, medium and long term. Compared with conservative therapy, vertebroplasty provides significantly greater functional improvement and reduction in analgesic use. The procedure is relatively safe with no clearly increased risk of new vertebral fractures.

  12. Long-term hearing result using Kurz titanium ossicular implants. (United States)

    Hess-Erga, Jeanette; Møller, Per; Vassbotn, Flemming Slinning


    Titanium implants in middle ear surgery were introduced in the late 90s and are now frequently used in middle ear surgery. However, long-term studies of patient outcome are few and have only been published in subgroups of patients. We report the long-term effect of titanium middle ear implants for ossicular reconstruction in chronic ear disease investigated in a Norwegian tertiary otological referral centre. Retrospective chart reviews were performed for procedures involving 76 titanium implants between 2000 and 2007. All patients who underwent surgery using the Kurz Vario titanium implant were included in the study. Audiological parameters using four frequencies, 0.5, 1, 2, and 3 kHz, according to AAO-HNS guidelines, was assessed pre and postoperatively. Otosurgical procedures, complications, revisions, and extrusion rates were analyzed. The study had no dropouts. The partial ossicular replacement prosthesis (PORP) was used in 44 procedures and the total ossicular replacement prosthesis (TORP) in 32 procedures, respectively. Mean follow-up was 5.2 years (62 months). The ossiculoplasties were performed as staging procedures or in combination with other chronic ear surgery. The same surgeon performed all the procedures. A postoperative air-bone gap of ≤ 20 dB was obtained in 74 % of the patients, 82 % for the Bell (PORP) prosthesis, and 63 % for the Arial (TORP) prosthesis. The extrusion rate was 5 %. We conclude that titanium ossicular implants give stable and excellent long-term hearing results.

  13. Long-term complications of splenectomy in adult immune thrombocytopenia. (United States)

    Thai, Lan-Huong; Mahévas, Matthieu; Roudot-Thoraval, Françoise; Limal, Nicolas; Languille, Laetitia; Dumas, Guillaume; Khellaf, Mehdi; Bierling, Philippe; Michel, Marc; Godeau, Bertrand


    The recent large decrease in splenectomy use for chronic immune thrombocytopenia (ITP) is partly due to still-unsolved questions about long-term safety. We performed the first single-center exposed/unexposed cohort study evaluating the long-term incidence of splenectomy complications in patients with primary ITP. Overall, 83 patients who underwent splenectomy more than 10 years ago (exposed) were matched with 83 nonsplenectomized patients (unexposed) on the date of ITP diagnosis ±5 years, age and gender. After a median follow-up of 192 months (range 0.5-528), 43 patients (52%) achieved overall response after splenectomy. Splenectomized patients experienced more venous thromboembolism (VTE) than controls (n = 13 vs n = 2, P = 0.005). On multivariate analysis, splenectomy was an independent risk factor of VTE (hazard ratio = 4.006, P = 0.032 [95% confidence interval: 1.13-14.21]). Splenectomized patients presented more severe infections on long-term follow-up: all required hospitalization, and 5/26 (19%) infections led to severe sepsis or septic shock and to death for 3 cases (none in controls). However, the incidence of malignancy was similar in both groups, as was cardiovascular risk, which appeared to be related more to ITP than splenectomy. Finally, splenectomy did not significantly decrease overall survival. Despite the risk of thrombosis and severe sepsis, splenectomy remains an effective and curative treatment for ITP.

  14. Infants long-term memory for complex music (United States)

    Ilari, Beatriz; Polka, Linda; Costa-Giomi, Eugenia


    In this study we examined infants' long-term memory for two complex pieces of music. A group of thirty 7.5 month-old infants was exposed daily to one short piano piece (i.e., either the Prelude or the Forlane by Maurice Ravel) for ten consecutive days. Following the 10-day exposure period there was a two-week retention period in which no exposure to the piece occurred. After the retention period, infants were tested on the Headturn Preference Procedure. At test, 8 different excerpts of the familiar piece were mixed with 8 different foil excerpts of the unfamiliar one. Infants showed a significant preference for the familiar piece of music. A control group of fifteen nonexposed infants was also tested and showed no preferences for either piece of music. These results suggest that infants in the exposure group retained the familiar music in their long-term memory. This was demonstrated by their ability to discriminate between the different excerpts of both the familiar and the unfamiliar pieces of music, and by their preference for the familiar piece. Confirming previous findings (Jusczyk and Hohne, 1993; Saffran et al., 2000), in this study we suggest that infants can retain complex pieces of music in their long-term memory for two weeks.

  15. Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment


    Lichtenberg, Peter A.


    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literatur...

  16. Applicability of long-term electroencephalography in pre-mortem diagnosis of Creutzfeldt-Jakob disease: A case report. (United States)

    Attaripour Isfahani, Sanaz; Dougherty, Michelle; Gliebus, Gediminas Peter


    Creutzfeldt-Jakob disease accounts for more than 90% of all sporadic prion disease cases. The molecular MM2 genotype has been divided into cortical and thalamic subtypes based on structures involved and is characterized clinically by progressive dementia without ataxia or typical electroencephalography changes. Proposed diagnostic criteria for MM2 cortical type sporadic Creutzfeldt-Jakob disease include progressive dementia, cortical hyper-intensity on diffusion-weighted magnetic resonance imaging, increased cerebrospinal fluid 14-3-3 protein level, and the exclusion of other types of dementia. The presence of periodic discharges on electroencephalography in MM2 cortical type were reported in 42% of the cases. We are reporting a case of sporadic Creutzfeldt-Jakob disease cortical MM2-type presenting with rapid cognitive decline, who survived 8 months since symptom onset. Brain imaging, cerebrospinal fluid analysis, and long-term electroencephalography monitoring were obtained and diagnosis was confirmed by autopsy. Short-term electroencephalography recording, performed 5 months after symptom onset, demonstrated diffuse background slowing without epileptiform activity. Long-term video electroencephalography monitoring demonstrated generalized slowing, maximum in bilateral frontal areas, which intermittently would become rhythmic (1-2 Hz) without hemispheric predominance. If the findings do not clearly meet the proposed clinical criteria for sporadic Creutzfeldt-Jakob disease, the use of long-term electroencephalography could increase the sensitivity. We question whether the lack of the characteristic findings on electroencephalography in some cases could be due to insufficient time of recording. Application of long-term electroencephalography monitoring increases the sensitivity of electroencephalography and the certainty of pre-mortem diagnosis of sporadic Creutzfeldt-Jakob disease.

  17. Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences (United States)

    von Biela, Vanessa R.; Zimmerman, Christian E.; Moulton, L. L.


    Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r2 = 0·29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r2 = 0·14-0·31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r2 = 0·13-0·50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels.

  18. Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences. (United States)

    von Biela, V R; Zimmerman, C E; Moulton, L L


    Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r² = 0·29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r² = 0·14-0·31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r² = 0·13-0·50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels. Journal of Fish Biology © 2010 The Fisheries Society of the British Isles. No claim to original US government works.

  19. Murine model of long-term obstructive jaundice. (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki


    With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Overall, 70% (7 of 10) of tCL mice died by day 7, whereas majority 67% (10 of 15) of pCL mice survived with loss of jaundice. A total of 19% (3 of 16) of LMHL mice died; however, jaundice continued beyond day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 d after ligation but jaundice rapidly decreased by day 7. The LHML group developed portal hypertension and severe fibrosis by day 14 in addition to prolonged jaundice. The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice, but long-term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Fourteen-Year Long-Term Results after Gastric Banding

    Directory of Open Access Journals (Sweden)

    Christine Stroh


    Full Text Available Background. Gastric banding (GB is a common bariatric procedure that is performed worldwide. Weight loss can be substantial after this procedure, but it is not sufficient in a significant portion of patients. Long-term rates for associated complications increase with every year of follow up, and only a few long-term studies have been published that examine these rates. We present our results after 14 years of postoperative follow up. Methods. Two hundred patients were operated upon form 01.02.1995 to 31.01.2009. Data collection was performed prospectively. In retrospective analysis, we analyzed weight loss, short- and long-term complications, amelioration of comorbidities and long-term outcome. Results. The mean postoperative follow up time was 94.4 months (range 2–144. The follow up rate was 83.5%. The incidence of postoperative complications for slippage was 2.5%, for pouch dilatation was 9.5%, for band migration was 5.5% and 12.0% for overall band removal. After 14 years, the reoperation rate was 30.5% with a reoperation rate of 2.2% for every year of follow up. Excess weight loss was 40.2% after 1 year, 46.3% after 2 years, 45.9% after 3 years, 41.9% after five years, 33.3% after 8 years, 30.8% after 10 years, 33.3% after 12 years and 15.6% after 14 years of follow up. Conclusion. The complication and reoperation rate after GB is high. Nevertheless, GB is still a therapeutic option in morbid obese patients, but the criteria for patient selection should be carefully evaluated.

  1. Memory Reactivation Enables Long-Term Prevention of Interference. (United States)

    Herszage, Jasmine; Censor, Nitzan


    The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Long-term visual damage after acute methanol poisonings: Longitudinal cross-sectional study in 50 patients. (United States)

    Zakharov, Sergey; Pelclova, Daniela; Diblik, Pavel; Urban, Pavel; Kuthan, Pavel; Nurieva, Olga; Kotikova, Katerina; Navratil, Tomas; Komarc, Martin; Belacek, Jaromir; Seidl, Zdenek; Vaneckova, Manuela; Hubacek, Jaroslav A; Bezdicek, Ondrej; Klempir, Jiri; Yurchenko, Maksim; Ruzicka, Evzen; Miovsky, Michal; Janikova, Barbara; Hovda, Knut Erik


    Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are generally transient. The subjective symptoms of visual toxicity may resolve within few weeks and fundoscopic signs of acute optic neuropathy subside within 1-2 months; therefore, the prevalence of long-term visual sequelae in the population of survivors of poisonings may be underestimated. To study the prevalence and character of long-term visual sequelae of acute methanol poisonings based on the data from the Czech mass methanol outbreak in 2012. A total of 50 patients with confirmed methanol poisoning were included in this longitudinal cross-sectional study, median age: 48 (range, 23-73) years. The following tests were performed: optical coherence tomography or OCT with evaluation of the retinal nerve fibers layer (RNFL), visual evoked potentials (VEP), magnetic resonance imaging (MRI) of brain, complete ocular examination (visual acuity/field, color vision, contrast sensitivity, and fundus), neurological examinations, and biochemical tests. Of 50 patients, 7/50 (14%) were discharged with diagnosed visual sequelae and 6/50 (12%) were discharged with both visual and central nervous system sequelae of poisoning. On the follow-up examination, 20/50 (40%) of the patients had long-term visual sequelae, with 8% of blindness. A total of 38% of the patients had abnormal (28% borderline) findings on RNFL, and 40% had abnormal (18% borderline) VEP. Among the patients discharged without detected visual sequelae, 8/37 (22%) had abnormal RNFL and VEP. Patients with visual sequelae had brain lesions more often (70% vs. 27%, p methanol, ethanol, HCO3-, formate, pH, anion gap, and base deficit (all p methanol poisonings in general.


    Schumer, Maya C; Panza, Kaitlyn E; Mulqueen, Jilian M; Jakubovski, Ewgeni; Bloch, Michael H


    To examine long-term outcome in children with trichotillomania. We conducted follow-up clinical assessments an average of 2.8 ± 0.8 years after baseline evaluation in 30 of 39 children who previously participated in a randomized, double-blind, placebo-controlled trial of N-acetylcysteine (NAC) for pediatric trichotillomania. Our primary outcome was change in hairpulling severity on the Massachusetts General Hospital Hairpulling Hospital Hairpulling Scale (MGH-HPS) between the end of the acute phase and follow-up evaluation. We also obtained secondary measures examining styles of hairpulling, comorbid anxiety and depressive symptoms, as well as continued treatment utilization. We examined both correlates and predictors of outcome (change in MGH-HPS score) using linear regression. None of the participants continued to take NAC at the time of follow-up assessment. No significant changes in hairpulling severity were reported over the follow-up period. Subjects reported significantly increased anxiety and depressive symptoms but improvement in automatic pulling symptoms. Increased hairpulling symptoms during the follow-up period were associated with increased depression and anxiety symptoms and increased focused pulling. Older age and greater focused pulling at baseline assessment were associated with poor long-term prognosis. Our findings suggest that few children with trichotillomania experience a significant improvement in trichotillomania symptoms if behavioral treatments are inaccessible or have failed to produce adequate symptom relief. Our findings also confirm results of previous cross-sectional studies that suggest an increased risk of depression and anxiety symptoms with age in pediatric trichotillomania. Increased focused pulling and older age among children with trichotillomania symptoms may be associated with poorer long-term prognosis. © 2015 Wiley Periodicals, Inc.

  4. Long-term EEG in children. (United States)

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D


    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

  5. Long-term governance for sustainability

    International Nuclear Information System (INIS)

    Martell, M.


    Meritxell Martell spoke of the long-term aspects of radioactive waste management. She pointed out that decision-making processes need to be framed within the context of sustainability, which means that a balance should be sought between scientific considerations, economic aspects and structural conditions. Focusing on structural aspects, Working Group 3 of COWAM-Spain came to the conclusion that the activity of the regulator is a key factor of long-term management. Another finding is that from a sustainability perspective multi-level governance is more effective for coping with the challenges of radioactive waste management than one tier of government-making decisions. The working group also felt that the current Local Information Committees need to evolve towards more institutionalized and legitimized mechanisms for long-term involvement. Ms. Martell introduced a study comparing the efficiency of economic instruments to advance sustainable development in nuclear communities vs. municipalities in mining areas. The study found that funds transferred to nuclear zones had become a means to facilitate local acceptance of nuclear facilities rather than a means to promote socio-economic development. Another finding is that economic instruments are not sufficient guarantees of sustainable development by themselves; additional preconditions include leadership, vision and entrepreneur-ship on the part of community leaders, private or public investments, among others. Finally, Ms. Martell summarised the challenges faced by the Spanish radioactive waste management programme, which include the need for strategic thinking, designing the future in a participatory fashion, and working with local and regional governments and citizens to devise mechanisms for social learning, economic development and environmental protection. (author)

  6. Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder (United States)

    Behjati-Ardakani, Mostafa; Behjati-Ardakani, Mohammad-Amin; Hosseini, Seyed-Habibolla; Noori, Noormohammad


    Objective Patent ductus arteriosus (PDA) is one of the most frequently seen congenital heart diseases. Its closure is recommended because of the risk of infective endocardis, as well as morbidity and mortality in the long. The aim of this study was to assess the long term results of the transcatheter closure of PDA in infants using amplatzer duct occlude (ADO). Methods From May 2004 to September 2011, forty eight infants underwent transcatheter closure of PDA. A lateral or right anterior oblique view aortogram was done to locate PDA and to measure its size. Before discharge, repeat aortogram was performed to evaluate eventual residual shunt and to confirm the appropriate deployment of the ADO. Follow up evaluations were done with transthoracic echocardiography at discharge, 1 month, 6 months, 12 months and yearly thereafter. Findings The mean age of patients at procedure was 9.18±2.32 (range 3 to 12) months, mean weight 6.73±1.16 (range 4.5 to 10.1) kg. The PDA occluded completely in 20 out of the 48 patients. Twenty four patients had trivial or mild shunt and two patients had moderate residual shunt which disappeared in one patient within 24 hours and other patient with moderate shunt in 1 month. One patient (age 8 months) had mild LPA stenosis. The device emobolization occurred in two patients, immediately after the procedure in one and during night in the other patient Conclusion The long term results suggested that transcatheter closure of PDA using Amplatzer duct occluder is a safe and effective treatment in infants less than 1 year of age with minimal complications. PMID:24427494

  7. Long term aspects of uranium tailings management

    International Nuclear Information System (INIS)

    Bragg, K.


    This paper sets out the background issues which lead to the development of interim close-out criteria for uranium mill tailings. It places the current state-of-the-art for tailings management into both a national and international perspective and shows why such interim criteria are needed now. There are seven specific criteria proposed dealing with the need to have: passive barriers, limits on surface water recharge, durable systems, long term performance guarantees, limits to access, controls on water and airborne releases and finally to have a knowledge of exposure pathways. This paper is intended to serve as a focus for subsequent discussions with all concerned parties. (auth)

  8. Human Behaviour in Long-Term Missions (United States)


    In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

  9. Optimal Long-Term Financial Contracting


    Peter M. DeMarzo; Michael J. Fishman


    We develop an agency model of financial contracting. We derive long-term debt, a line of credit, and equity as optimal securities, capturing the debt coupon and maturity; the interest rate and limits on the credit line; inside versus outside equity; dividend policy; and capital structure dynamics. The optimal debt-equity ratio is history dependent, but debt and credit line terms are independent of the amount financed and, in some cases, the severity of the agency problem. In our model, the ag...

  10. On improving the NPP construction long-term planning

    International Nuclear Information System (INIS)

    Solov'ev, M.M.


    General approaches to solving the problems of long-term planning of the construction-mounting work volume and introduction of power capacities at different paces of power unit commission and norms of construction time are considered. Problems associated with location and development of subsidiary industries providing NPP construction are discussed. It is shown that decrease of WWER-1000 reactor type NPP construction time from 24 to 12 months results in reduction of required high-skilled engineers, managerial staff, unique construction mechanisms and engines as well as in improvement of conditions for conducting measures on work arrangement during preparation of construction industry and mounting of the first assemblies

  11. Long-term hemispheric variation of the flare index

    International Nuclear Information System (INIS)

    Feng Song; Deng Lin-Hua; Xu Shi-Chun


    The long-term hemispheric variation of the flare index is investigated. It is found that, (1) the phase difference of the flare index between the northern and southern hemispheres is about 6–7 months, which is near the time delay between flare activity and sunspot activity; (2) both the dominant and phase-leading hemisphere of the flare index is the northern hemisphere in the considered time interval, implying that the hemispheric asynchrony of solar activity has a close connection with the N-S asymmetry of solar activity. (research papers)

  12. Expected long-term outcome after a tibial shaft fracture

    DEFF Research Database (Denmark)

    Faergemann, C; Frandsen, P A; Röck, N D


    OBJECTIVE: A prospective study of 207 laymen and professionals answered a questionnaire regarding the expectations of the long-term outcome 6 months after a unilateral tibial shaft fracture. The aim was (1) to disclose the expected outcome after unilateral tibial shaft fracture, and (2) to compare...... these expectations with the outcome measured in patients. METHODS: There were five groups of nonpatients: (1) 42 orthopedic surgeons, (2) 36 physiotherapists, (3) 42 students, (4) 49 white collar workers, and (5) 38 blue collar workers. Outcome was measured by Sickness Impact Profile (SIP). The SIP scores were...

  13. Exclusive Breastfeeding among Preterm Low Birth Weight Infants at One Month Follow-up after Hospital Discharge

    Directory of Open Access Journals (Sweden)

    Ishrat Jahan


    Full Text Available Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH. Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42% were female and 52 (58% were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2, and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g. At one month follow up visit 19% (17/89 were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001, method of feeding at discharge (p=0.001, mode of delivery (p=0.004, below average socio-economic status (p=0.03, maternal education (p=0.02, number of antenatal visits (p=0.02 and larger birth weight (p=0.038. Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be

  14. Long-term environmental behaviour of radionuclides

    International Nuclear Information System (INIS)

    Brechignac, F.; Moberg, L.; Suomela, M.


    The radioactive pollution of the environment results from the atmospheric nuclear weapons testing (during the mid-years of twentieth century), from the development of the civilian nuclear industry and from accidents such as Chernobyl. Assessing the resulting radiation that humans might receive requires a good understanding of the long-term behaviour of radionuclides in the environment. This document reports on a joint European effort to advance this understanding, 3 multinational projects have been coordinated: PEACE, EPORA and LANDSCAPE. This report proposes an overview of the results obtained and they are presented in 6 different themes: i) redistribution in the soil-plant system, ii) modelling, iii) countermeasures, iv) runoff v) spatial variations, and vi) dose assessment. The long term behaviour of the radionuclides 137 Cs, 90 Sr and 239-240 Pu is studied through various approaches, these approaches range from in-situ experiments designed to exploit past contamination events to laboratory simulations. A broad scope of different ecosystems ranging from arctic and boreal regions down to mediterranean ones has been considered. (A.C.)

  15. Craniopharyngioma in Children: Long-term Outcomes (United States)

    STEINBOK, Paul


    The survival rate for childhood craniopharyngioma has been improving, with more long-term survivors. Unfortunately it is rare for the patient to be normal, either from the disease itself or from the effects of treatment. Long-term survivors of childhood craniopharyngioma suffer a number of impairments, which include visual loss, endocrinopathy, hypothalamic dysfunction, cerebrovascular problems, neurologic and neurocognitive dysfunction. Pituitary insufficiency is present in almost 100%. Visual and hypothalamic dysfunction is common. There is a high risk of metabolic syndrome and increased risk of cerebrovascular disease, including stroke and Moyamoya syndrome. Cognitive, psychosocial, and emotional problems are prevalent. Finally, there is a higher risk of premature death among survivors of craniopharyngioma, and often this is not from tumor recurrence. It is important to consider craniopharyngioma as a chronic disease. There is no perfect treatment. The treatment has to be tailored to the individual patient to minimize dysfunction caused by tumor and treatments. So “cure” of the tumor does not mean a normal patient. The management of the patient and family needs multidisciplinary evaluation and should involve ophthalmology, endocrinology, neurosurgery, oncology, and psychology. Furthermore, it is also important to address emotional issues and social integration. PMID:26345668

  16. Institutionalization and Organizational Long-term Success

    Directory of Open Access Journals (Sweden)

    Denise L. Fleck


    Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.

  17. Long term testing of PSI-membranes

    Energy Technology Data Exchange (ETDEWEB)

    Huslage, J; Brack, H P; Geiger, F; Buechi, F N; Tsukada, A; Scherer, G G [Paul Scherrer Inst. (PSI), Villigen (Switzerland)


    Long term tests of PSI membranes based on radiation-grafted FEP and ETFE films were carried out and FEP-based membranes were evaluated by monitoring the in-situ membrane area resistance measured by a current pulse method. By modifying our irradiation procedure and using the double crosslinking concept we obtain reproducible membrane cell lifetimes (in term of in-situ membrane resistance) of greater than 5000 hours at 60-65{sup o}C. Preliminary tests at 80-85{sup o}C with lifetimes of greater than 2500 demonstrate the potential long term stability of PSI proton exchange membranes based on FEP over the whole operating temperature range of low-temperature polymer electrolyte fuel cells. Radiation grafted PSI membranes based on ETFE have better mechanical properties than those of the FEP membranes. Mechanical properties are particularly important in large area cells and fuel cell stacks. ETFE membranes have been tested successfully for approximately 1000 h in a 2-cell stack (100 cm{sup 2} active area each cell). (author) 4 figs., 4 refs.

  18. Neo bladder long term follow-up

    International Nuclear Information System (INIS)

    Fakhr, I.; Mohamed, A. M.; Moustafa, A.; Al-Sherbiny, M.; Salama, M.


    One of the commonest forms of orthotopic bladder substitution for bladder cancer surivors, used in our institute, is the use of ileocecal segment. Sometimes, the need for Indiana pouch heterotropic continent diversion arises. Aim: To compare the long-term effect of orthotopic ileocecal bladder and heterotropic Indiana pouch following radical cystectomy in bladder cancer patients. Patients and methods: Between January 2008 and December 2011, 91 patients underwent radical cystectomy/anterior pelvic exentration and ortho topic ileocecal bladder reconstruction (61 patients) and Indiana pouch (30 patients), when orthotopic diversion could not be technically or oncologically feasible. Results: Convalescence was uneventful in most patients. All minor and major urinary leakage cases, in both diversions groups, where successfully conservatively treated. Only one patient in the ileocecal group with major urinary leak required re-exploration with successful revision of uretro-colonic anastomosis. Only one patient in the Indiana pouch group had accidentally discovered sub-centimetric stone, which was simply expelled. The overall survival proportion of ileocecal group was 100% compared to 80% in the Indiana pouch group (p < 0.001). The disease free survival proportion of ileocecal group was 90.8% compared to 80% in the Indiana pouch group (p = 0.076). Effective comparative daytime and nighttime urinary continence as well as renal function deterioration were not statistically significant between both reconstruction types. Conclusion: Both ileocecal bladder and Indiana pouch are safe procedures in regard to long-term effects over kidney function following radical cystectomy

  19. Toward a comprehensive long term nicotine policy. (United States)

    Gray, N; Henningfield, J E; Benowitz, N L; Connolly, G N; Dresler, C; Fagerstrom, K; Jarvis, M J; Boyle, P


    Global tobacco deaths are high and rising. Tobacco use is primarily driven by nicotine addiction. Overall tobacco control policy is relatively well agreed upon but a long term nicotine policy has been less well considered and requires further debate. Reaching consensus is important because a nicotine policy is integral to the target of reducing tobacco caused disease, and the contentious issues need to be resolved before the necessary political changes can be sought. A long term and comprehensive nicotine policy is proposed here. It envisages both reducing the attractiveness and addictiveness of existing tobacco based nicotine delivery systems as well as providing alternative sources of acceptable clean nicotine as competition for tobacco. Clean nicotine is defined as nicotine free enough of tobacco toxicants to pass regulatory approval. A three phase policy is proposed. The initial phase requires regulatory capture of cigarette and smoke constituents liberalising the market for clean nicotine; regulating all nicotine sources from the same agency; and research into nicotine absorption and the role of tobacco additives in this process. The second phase anticipates clean nicotine overtaking tobacco as the primary source of the drug (facilitated by use of regulatory and taxation measures); simplification of tobacco products by limitation of additives which make tobacco attractive and easier to smoke (but tobacco would still be able to provide a satisfying dose of nicotine). The third phase includes a progressive reduction in the nicotine content of cigarettes, with clean nicotine freely available to take the place of tobacco as society's main nicotine source.

  20. Long term ground movement of TRISTAN synchrotron

    International Nuclear Information System (INIS)

    Endo, K.; Ohsawa, Y.; Miyahara, M.


    The long term ground movement is estimated through the geological survey before a big accelerator is planned. For the case of TRISTAN-MR (main ring), its site was surveyed to reflect the underground information to the building prior to the construction. The movement of the synchrotron magnet mainly results from the structure of the tunnel. If an individual movement of the magnet exceeds a certain threshold limit, it gives a significant effect on the particle behavior in a synchrotron. Height of the quadrupole magnets were observed periodically during past two years at the TRISTAN-MR and their height differences along the 3 km circumference of the accelerator ring were decomposed into the Fourier components depicting the causes of the movements. Results shows the movement of the tunnel foundation which was also observed by the simultaneous measurement of both magnets and fiducial marks on the tunnel wall. The long term movement of the magnets is summarized with the geological survey prior to construction. 1 ref., 6 figs., 1 tab

  1. Long-term environmental behaviour of radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Brechignac, F.; Moberg, L.; Suomela, M


    The radioactive pollution of the environment results from the atmospheric nuclear weapons testing (during the mid-years of twentieth century), from the development of the civilian nuclear industry and from accidents such as Chernobyl. Assessing the resulting radiation that humans might receive requires a good understanding of the long-term behaviour of radionuclides in the environment. This document reports on a joint European effort to advance this understanding, 3 multinational projects have been coordinated: PEACE, EPORA and LANDSCAPE. This report proposes an overview of the results obtained and they are presented in 6 different themes: (i) redistribution in the soil-plant system, (ii) modelling, (iii) countermeasures, (iv) runoff (v) spatial variations, and (vi) dose assessment. The long term behaviour of the radionuclides {sup 137}Cs, {sup 90}Sr and {sup 239-240}Pu is studied through various approaches, these approaches range from in-situ experiments designed to exploit past contamination events to laboratory simulations. A broad scope of different ecosystems ranging from arctic and boreal regions down to mediterranean ones has been considered. (A.C.)

  2. Andra long term memory project - 59277

    International Nuclear Information System (INIS)

    Charton, Patrick; Boissier, Fabrice; Martin, Guillaume


    Document available in abstract form only. Full text of publication follows: Long term memory of repositories is required by safety, reversibility and social expectations. Thus Andra has implemented since 2010 a long-term memory project to reinforce and diversify its current arrangements in this field, as well as to explore opportunities to extend memory keeping over thousands years. The project includes opportunity studies of dedicated facilities. The 'Ecotheque' and 'Geotheque' projects contribute to memory respectively through environmental and geological samples preservation. The options of creating (i) an archive centre for Andra's interim and permanent archives, (ii) an artist center to study the contribution of arts to memory preservation, (iii) a museum of radioactive waste disposal history and technology (radium industry..., sea disposal, current solutions...) are considered. Other studies provided by the project examine our heritage. This includes the continuity of languages and symbolic systems, the continuity of writing and engraving methods, the archaeology of landscapes (memory of the earths evolution, multi-century memory of industrial and agricultural landscapes), the archaeology practices (how might a future archaeologist be interested in our current activity?), the preservation of historical sites and industrial memory, the continuity of institutional organizations, the memory and history of science evolution as well as broad history

  3. Long term creep behavior of concrete

    International Nuclear Information System (INIS)

    Kennedy, T.W.


    This report presents the findings of an experimental investigation to evaluate the long term creep behavior of concrete subjected to sustained uniaxial loads for an extended period of time at 75 0 F. The factors investigated were (1) curing time (90, 183, and 365 days); (2) curing history (as-cast and air-dried); and (3) uniaxial stress (600 and 2400 psi). The experimental investigation applied uniaxial compressive loads to cylindrical concrete specimens and measured strains with vibrating wire strain gages that were cast in the concrete specimen along the axial and radial axes. Specimens cured for 90 days prior to loading were subjected to a sustained load for a period of one year, at which time the loads were removed; the specimens which were cured for 183 or 365 days, however, were not unloaded and have been under load for 5 and 4.5 years, respectively. The effect of each of the above factors on the instantaneous and creep behavior is discussed and the long term creep behavior of the specimens cured for 183 or 365 days is evaluated. The findings of these evaluations are summarized. (17 figures, 10 tables) (U.S.)

  4. Sleep facilitates long-term face adaptation. (United States)

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent


    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

  5. Neurologic long term outcome after drowning in children

    Directory of Open Access Journals (Sweden)

    Suominen Pertti K


    Full Text Available Abstract Drowning is a major source of mortality and morbidity in children worldwide. Neurocognitive outcome of children after drowning incidents cannot be accurately predicted in the early course of treatment. Therefore, aggressive out-of-hospital and in-hospital treatment is emphasized. There are "miracle" cases after long submersion times that have been reported in the medical literature, which mostly concern small children. However, many of the survivors will remain severely neurologically compromised after remarkably shorter submersion times and will consequently be a great burden to their family and society for the rest of their lives. The duration of submersion, the need of advanced life support at the site of the accident, the duration of cardiopulmonary resuscitation, whether spontaneous breathing and circulation are present on arrival at the emergency room are important factors related to survival with mild neurological deficits or intact function in drowned children. Data on long-term outcome are scarce. The used outcome measurement methods and the duration of follow-up have not been optimal in most of the existing studies. Proper neurological and neurophysiological examinations for drowned children are superior to outcome scales based chart reviews. There is evidence that gross neurological examination at the time of discharge from the hospital in young children does not reveal all the possible sequelae related to hypoxic brain injury and thus long-term follow-up of drowned resuscitated children is strongly recommended.

  6. Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

    Directory of Open Access Journals (Sweden)

    Evan S. Cole


    Full Text Available Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%. Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0, lengths of stay (61 versus 38 days, costs (US$143,898 versus US$115,056, but fewer discharges to the community (28.4% versus 51.8%. Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that

  7. Suicide mortality and risk factors in the 12 months after discharge from psychiatric inpatient care in Korea: 1989-2006. (United States)

    Park, Subin; Choi, Jae Won; Kyoung Yi, Ki; Hong, Jin Pyo


    This study aimed to determine the suicide mortality within 1 year after discharge from psychiatric inpatient care and identify the risk factors for suicide completion during this period. A total of 8403 patients were admitted to general hospitals in Seoul, Korea, for psychiatric disorders from January 1989 to December 2006. The suicide mortality risk of these patients within 1 year of discharge was compared with that of gender- and age-matched subjects from the general population of Korea. The standardized mortality ratios (SMR) for suicide in the year following discharge were 49.7 for males and 45.5 for females. Patients aged 15-24 years had the highest risk for suicide. Among the different diagnostic groups, patients with personality disorders, schizophrenia, or affective disorders had the highest risk for suicide completion. Suicidal ideation at admission and inpatient stay more than 1 month were also associated with increased risk of suicide. In Korean psychiatric patients, the SMR is much higher in young female patients, a high percentage of patients commit suicide by jumping, and there is a stronger association of long duration of hospitalization and suicide. These factors should be considered in the development and implementation of suicide prevention strategies for Korean psychiatric patients. Copyright © 2013. Published by Elsevier Ireland Ltd.

  8. Brain Injury and Severe Eating Difficulties at Admission-Patient Perspective Nine to Fifteen Months after Discharge

    DEFF Research Database (Denmark)

    Kjærsgaard, Annette


    The purpose of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Four individuals with acquired brain injury were ...... the patient perspective of adapting to and developing new strategies for activities related to eating, however, further prospective, longitudinal research in a larger scale and with repeated interviews is needed....... interviewed via qualitative semi-structured interviews. An explorative study was conducted to study eating difficulties. Qualitative content analysis was used. Four main themes emerged from the analysis: personal values related to eating, swallowing difficulties, eating and drinking, meals and social life...... the ability to eat reduced or lost completely, even temporarily, was unexpected and difficult, and caused strong emotional reactions, even 18 months after injury. Time spent using a feeding tube had a negative, but not persistent, impact on quality-of-life. The preliminary findings provide knowledge regarding...

  9. Equilibrium cycle of 18 months at 120% of the original nominal power with optimized fuel discharge burnt for the CLV

    International Nuclear Information System (INIS)

    Perusquia, R.; Montes, J.L.; Hernandez, J.L.; Ortiz, J.J.; Hernandez, H.; Castillo, A.


    The Federal Commission of Electricity carries out works at the moment related with the one increase from the power to original 120% of the nominal one in the rectors of water in boil (BWR) of the Laguna Verde Central (CLV). In the National Institute of Nuclear Research (ININ) are carried out studies of the impact on the design of the fuel recharge derived of this increase. As option in the ININ the feasibility of continuing using the same type of fuel assemble that one has come using recently in the CLV, the type GE12 is analyzed. To achieve it was diminished the LPPF of the power cells from 1.43 to 1.24. It was verified, with the recently acquired CMS codes system that the use of fuel assemble GE12 type with cells of low peak of local power and low gadolinia concentration (ININ4) they are suitable for cycles of 18 months at 120% of the original nominal power in the reactors of the CLV. It was decreased the recharge from 148 to 140 when using the ININ4 fuel assemble instead of one conventionally designed. This brings itself appreciable economic savings. However, the above mentioned brought itself an increase of the dispersion in the burnt of definitive fuel discharges. All this when it had already been fulfilled the goals and requirements imposed in the design of the balance cycle. It was necessary to establish a principle with base to the one which it was developed a method that allowed to reduce in efficient form the dispersion of the burnt of discharge and at the same time to already have a low impact in the operational parameters reached. The method was applied in the cycle of balance of 18 months to 120% of the original nominal power using the fuel assemble of low peak of local power being achieved the following results; it was decreased the dispersion of the burnt of definitive discharge from 5.4% to 2.2%, the maximum burnt of discharge was diminished from 50.694 GWD/M to 47.443 GWD/TM, it was increased the minimum burnt of discharge from 41.369 GWD/TM to 42

  10. Long-Term Resolution of Severe Ankle Contractures Using Botulinum Toxin, Serial Casting, Splinting, and Motor Retraining. (United States)

    Leung, Joan; Stroud, Katarina


    Purpose: Serial casting for ankle contractures is traditionally performed in prone, a position that patients may not easily tolerate. Also, although serial casting is effective in correcting contracture, its effect dissipates quickly. This case report describes a procedure for performing casting for ankle contractures in a supine or sitting position. It also describes a process that enables the effect of serial casting to be maintained long term. Client Description: The client was an adult who had suffered traumatic brain injury and severe bilateral ankle contractures. Intervention: He received botulinum toxin and serial casting for his bilateral ankle contractures, one ankle at 8 months and the other at 13 months after the injury. He then underwent a programme of splinting and motor training. Measures and Outcome: The client gained more than 40° dorsiflexion for both ankles after receiving botulinum toxin injections and serial casting. The improvement in ankle range enabled him to progress to walking practice. Ankle splinting was gradually reduced. On discharge at 25 months post-injury, the ankle joint range was maintained. Implications: The use of botulinum toxin and serial casting, followed by an intensive programme of splinting and motor training, may be an option to consider for effective long-term resolution of severe contractures after acquired brain injury.

  11. Long-term efficacy of rasagiline in early Parkinson's disease. (United States)

    Lew, Mark F; Hauser, Robert A; Hurtig, Howard I; Ondo, William G; Wojcieszek, Joanne; Goren, Tamar; Fitzer-Attas, Cheryl J


    This study was designed to follow the long-term efficacy, safety, and tolerability of rasagiline for Parkinson's disease (PD) with data collected from all patients who had ever taken rasagiline during the 12-month TEMPO monotherapy trial (N = 398) and subsequent open-label extension. Patients were followed for up to 6.5 years with a mean of 3.5 +/- 2.1 years. After 12 months, additional PD medications were added as required. Of patients remaining in the trial at 2 years, 46% were maintained on rasagiline monotherapy. The majority of patients received a dopamine agonist prior to levodopa as the first additional dopaminergic agent. Analysis using a Kaplan-Meier method indicated that by 5.4 years only 25% of patients progressed to Hoehn & Yahr stage III. Rasagiline was well tolerated, with 11.3% of patients (45/398) withdrawing because of an adverse event. Rasagiline therapy for PD was effective, well tolerated, and safe in this long-term trial.

  12. Long term follow up in hemodialysis patients with parathyroidectomy

    International Nuclear Information System (INIS)

    Alvarez, A.; Petraglia, A.; Caorsi, H.; Mazzuchi, N.; Olaizola, I.; Acuna, G.; Fajardo, L.; Ambrosoni, P.; Morelli, R.


    A retrospective study was performed in 41 patients, in chronic hemodialysis with severe hyperparathyroidism (HPT), who underwent surgery during time period from 1985 to 1997. 22 females, 19 males, aged 50 and 14 years, with PTHI 1345 and 604 pg/ml were followed up 32 and 22 months. Three surgical methods we evaluated: group I) total para thyroidectomy(PTX) with Implants(n=24); group II) subtotal PTX(n=14) and group III) total PTX(n=3). It considered recurrence of HPT when PTH levels were higher than upper range of normal, after 6 months post surgery. persistence was defined when there was no standardization of PTH levels. In group I, 9 patients had normal parathyroid function, 7 had persistent hypoparathyroidism and had hyperparathyroidism (7 recurrences). Group II patients had parathyroid over function in 5 cases (4 persistence s), 5 were normal and 4 hypoparathyroidism. All patients of the third group had hypoparathyroidism. Long term normalization of parathyroid gland activity was achieved in one third of troduccion patients (34,1%) whereas 34,1% permanent hypoparathyroidism and 31,8% hyperparathyroidism. It found no differences in recurrence and histological subtype of parathyroid gland in the different groups. In conclusion, similar long term clinical results were obtained with the different groups. The surgical ideal treatment is controversial. We think that in the long run, the evolution of parathyroid status is mostly influenced by the persistence of uremic state rather than the type of surgery performed [es

  13. Long-term stability of salivary cortisol

    DEFF Research Database (Denmark)

    Garde, A H; Hansen, Åse Marie


    either stored in small vials or spiked to polyester Salivette tampons before analysis for cortisol using Spectria RIA kits. The effects of storage were evaluated by a linear regression model (mixed procedure) on a logarithmic scale. No effects on cortisol concentrations were found after storage of saliva......The measurement of salivary cortisol provides a simple, non-invasive, and stress-free measure frequently used in studies of the hypothalamic-pituitary-adrenal axis activity. In research projects, samples are often required to be stored for longer periods of time either because of the protocol...... of the project or because of lack of funding for analysis. The aim of the present study was to explore the effects of long-term storage of samples on the amounts of measurable cortisol. Ten pools of saliva were collected on polyester Salivette tampons from five subjects. After centrifugation the samples were...

  14. Long-term control of root growth (United States)

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene


    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin.

  15. Long term performance of radon mitigation systems

    International Nuclear Information System (INIS)

    Prill, R.; Fisk, W.J.


    Researchers installed radon mitigation systems in 12 houses in Spokane, Washington and Coeur d'Alene, Idaho during the heating season 1985--1986 and continued to monitor indoor radon quarterly and annually for ten years. The mitigation systems included active sub-slab ventilation, basement over-pressurization, and crawlspace isolation and ventilation. The occupants reported various operational problems with these early mitigation systems. The long-term radon measurements were essential to track the effectiveness of the mitigation systems over time. All 12 homes were visited during the second year of the study, while a second set 5 homes was visited during the fifth year to determine the cause(s) of increased radon in the homes. During these visits, the mitigation systems were inspected and measurements of system performance were made. Maintenance and modifications were performed to improve system performance in these homes

  16. Rising Long-term Interest Rates

    DEFF Research Database (Denmark)

    Hallett, Andrew Hughes

    Rather than chronicle recent developments in European long-term interest rates as such, this paper assesses the impact of increases in those interest rates on economic performance and inflation. That puts us in a position to evaluate the economic pressures for further rises in those rates......, the first question posed in this assignment, and the scope for overshooting (the second question), and then make some illustrative predictions of future interest rates in the euro area. We find a wide range of effects from rising interest rates, mostly small and mostly negative, focused on investment...... till the emerging European recovery is on a firmer basis and capable of overcoming increases in the cost of borrowing and shrinking fiscal space. There is also an implication that worries about rising/overshooting interest rates often reflect the fact that inflation risks are unequally distributed...

  17. Prediction of long-term creep curves

    International Nuclear Information System (INIS)

    Oikawa, Hiroshi; Maruyama, Kouichi


    This paper aims at discussing how to predict long-term irradiation enhanced creep properties from short-term tests. The predictive method based on the θ concept was examined by using creep data of ferritic steels. The method was successful in predicting creep curves including the tertiary creep stage as well as rupture lifetimes. Some material constants involved in the method are insensitive to the irradiation environment, and their values obtained in thermal creep are applicable to irradiation enhanced creep. The creep mechanisms of most engineering materials definitely change at the athermal yield stress in the non-creep regime. One should be aware that short-term tests must be carried out at stresses lower than the athermal yield stress in order to predict the creep behavior of structural components correctly. (orig.)

  18. Hanford grout: predicting long-term performance

    International Nuclear Information System (INIS)

    Sewart, G.H.; Mitchell, D.H.; Treat, R.L.; McMakin, A.H.


    Grouted disposal is being planned for the low-level portion of liquid radioactive wastes at the Hanford site in Washington state. The performance of the disposal system must be such that it will protect people and the environment for thousands of years after disposal. To predict whether a specific grout disposal system will comply with existing and foreseen regulations, a performance assessment (PA) is performed. Long-term PAs are conducted for a range of performance conditions. Performance assessment is an inexact science. Quantifying projected impacts is especially difficult when only scant data exist on the behavior of certain components of the disposal system over thousands of years. To develop defensible results, we are honing the models and obtaining experimental data. The combination of engineered features and PA refinements is being used to ensure that Hanford grout will meet its principal goal: to protect people and the environment in the future

  19. Long Term Planning at IQ Metal

    DEFF Research Database (Denmark)


    This is a Danish version. This case about long term planning at the owner-managed manufacturing firm IQ Metal shows how the future management and ownership may be organized to utilize owner assets and minimize roadblocks. Initially, the owner-manager Bo Fischer Larsen explains how he acquired...... a stake in 2007 in the company which at that time was named Braendstrup Maskinfabrik. He furthermore expalins how he has developed the company based on a strategic plan focusing on professionalization and outsourcing. Next, the video shows how to type Bo Fischer Larsen's replies to the questions...... in The Owner Strategy Map into the questionnaire available on Lastly, the Owner Strategy Map's recommendation of how to organize the future management and ownership of IQ Metal is explained....

  20. Long-term Consequences of Early Parenthood

    DEFF Research Database (Denmark)

    Johansen, Eva Rye; Nielsen, Helena Skyt; Verner, Mette

    (and to lesser extent employment), as fathers appear to support the family, especially when early parenthood is combined with cohabitation with the mother and the child. Heterogeneous effects reveal that individuals with a more favorable socioeconomic background are affected more severely than......Having children at an early age is known to be associated with unfavorable economic outcomes, such as lower education, employment and earnings. In this paper, we study the long-term consequences of early parenthood for mothers and fathers. Our study is based on rich register-based data that......, importantly, merges all childbirths to the children’s mothers and fathers, allowing us to study the consequences of early parenthood for both parents. We perform a sibling fixed effects analysis in order to account for unobserved family attributes that are possibly correlated with early parenthood...

  1. Long term radiological impact of thorium extraction

    International Nuclear Information System (INIS)

    Menard, S.; Schapira, J.P.


    Thorium extraction produces a certain amount of radioactive wastes. Potential long term radiological impact of these residues has been calculated using the recent ICRP-68 ingestion dose factors in connection with the computing code DECAY, developed at Orsay and described in this work. This code solves the well known Bateman's equations which govern the time dependence of a set of coupled radioactive nuclei. Monazites will be very likely the minerals to be exploited first, in case of an extensive use of thorium as nuclear fuel. Because monazites contain uranium as well, mining residues will contain not only the descendants of 232 Th and a certain proportion of non-extracted thorium (taken here to be 5%), but also this uranium, if left in the wastes for economical reasons. If no uranium would be present at all in the mineral, the potential radiotoxicity would strongly decrease in approximately 60 years, at the pace of the 5.8 years period of 228 Ra, which becomes the longest-lived radionuclide of the 4n radioactive family in the residues. Moreover, there is no risk due to radon exhalation, because of the very short period of 220 Rn. These significant differences between uranium and thorium mining have to be considered in view of some estimated long term real radiological impacts due to uranium residues, which could reach a value of the order of 1 mSv/year, the dose limit recommended for the public by the recent ICRP-60. (authors). 15 refs., 4 figs., 3 tabs., 43 appendices

  2. Managing Records for the Long Term - 12363

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, John V. [U.S. Department of Energy, Office of Legacy Management, Morgantown, West Virginia (United States); Gueretta, Jeanie [U.S. Department of Energy, Office of Legacy Management, Grand Junction, Colorado (United States)


    The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship and long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the

  3. Long-term potentiation and long-term depression: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Timothy V.P. Bliss


    Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

  4. Long term mortality in critically ill burn survivors. (United States)

    Nitzschke, Stephanie; Offodile, Anaeze C; Cauley, Ryan P; Frankel, Jason E; Beam, Andrew; Elias, Kevin M; Gibbons, Fiona K; Salim, Ali; Christopher, Kenneth B


    Little is known about long term survival risk factors in critically ill burn patients who survive hospitalization. We hypothesized that patients with major burns who survive hospitalization would have favorable long term outcomes. We performed a two center observational cohort study in 365 critically ill adult burn patients who survived to hospital discharge. The exposure of interest was major burn defined a priori as >20% total body surface area burned [TBSA]. The modified Baux score was determined by age + %TBSA+ 17(inhalational injury). The primary outcome was all-cause 5year mortality based on the US Social Security Administration Death Master File. Adjusted associations were estimated through fitting of multivariable logistic regression models. Our final model included adjustment for inhalational injury, presence of 3rd degree burn, gender and the acute organ failure score, a validated ICU risk-prediction score derived from age, ethnicity, surgery vs. medical patient type, comorbidity, sepsis and acute organ failure covariates. Time-to-event analysis was performed using Cox proportional hazard regression. Of the cohort patients studied, 76% were male, 29% were non white, 14% were over 65, 32% had TBSA >20%, and 45% had inhalational injury. The mean age was 45, 92% had 2nd degree burns, 60% had 3rd degree burns, 21% received vasopressors, and 26% had sepsis. The mean TBSA was 20.1%. The mean modified Baux score was 72.8. Post hospital discharge 5year mortality rate was 9.0%. The 30day hospital readmission rate was 4%. Patients with major burns were significantly younger (41 vs. 47 years) had a significantly higher modified Baux score (89 vs. 62), and had significantly higher comorbidity, acute organ failure, inhalational injury and sepsis (all Pburns. In the multivariable logistic regression model, major burn was associated with a 3 fold decreased odds of 5year post-discharge mortality compared to patients with TBSAburn, gender and the acute organ failure score

  5. Long-Term Mental Health Problems after Delirium in the ICU

    NARCIS (Netherlands)

    Wolters, Annemiek E.; Peelen, Linda M.; Welling, Maartje C.; Kok, Lotte; De Lange, Dylan W.; Cremer, Olaf L.; Van Dijk, Diederik; Slooter, Arjen J C; Veldhuijzen, Dieuwke S.


    Objectives: To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder.  Design: Prospective cohort study.  Setting: Survey study, 1 year after discharge from a medical-surgical ICU

  6. Backcasting long-term climate data: evaluation of hypothesis (United States)

    Saghafian, Bahram; Aghbalaghi, Sara Ghasemi; Nasseri, Mohsen


    Most often than not, incomplete datasets or short-term recorded data in vast regions impedes reliable climate and water studies. Various methods, such as simple correlation with stations having long-term time series, are practiced to infill or extend the period of observation at stations with missing or short-term data. In the current paper and for the first time, the hypothesis on the feasibility of extending the downscaling concept to backcast local observation records using large-scale atmospheric predictors is examined. Backcasting is coined here to contrast forecasting/projection; the former is implied to reconstruct in the past, while the latter represents projection in the future. To assess our hypotheses, daily and monthly statistical downscaling models were employed to reconstruct past precipitation data and lengthen the data period. Urmia and Tabriz synoptic stations, located in northwestern Iran, constituted two case study stations. SDSM and data-mining downscaling model (DMDM) daily as well as the group method of data handling (GMDH) and model tree (Mp5) monthly downscaling models were trained with National Center for Environmental Prediction (NCEP) data. After training, reconstructed precipitation data of the past was validated against observed data. Then, the data was fully extended to the 1948 to 2009 period corresponding to available NCEP data period. The results showed that DMDM performed superior in generation of monthly average precipitation compared with the SDSM, Mp5, and GMDH models, although none of the models could preserve the monthly variance. This overall confirms practical value of the proposed approach in extension of the past historic data, particularly for long-term climatological and water budget studies.

  7. Long-term outcome in dogs with sinonasal aspergillosis treated with intranasal infusions of enilconazole


    Schuller, S.; Clercx, Cécile


    Long-term outcomes (mean 38+/-17 months) were evaluated in 27 dogs with sinonasal aspergillosis after successful medical treatment using intranasal infusions of 1% or 2% enilconazole (1%, n=15; 2%, n=12). Long-term outcomes with both treatment protocols were good, with half of the dogs being asymptomatic throughout the follow-up period. The remaining dogs showed mild clinical signs compatible with chronic rhinitis/sinusitis. These clinical signs were interpreted as chronic lymphoplasmacytic r...

  8. Long term stability of nanowire nanoelectronics in physiological environments. (United States)

    Zhou, Wei; Dai, Xiaochuan; Fu, Tian-Ming; Xie, Chong; Liu, Jia; Lieber, Charles M


    Nanowire nanoelectronic devices have been exploited as highly sensitive subcellular resolution detectors for recording extracellular and intracellular signals from cells, as well as from natural and engineered/cyborg tissues, and in this capacity open many opportunities for fundamental biological research and biomedical applications. Here we demonstrate the capability to take full advantage of the attractive capabilities of nanowire nanoelectronic devices for long term physiological studies by passivating the nanowire elements with ultrathin metal oxide shells. Studies of Si and Si/aluminum oxide (Al2O3) core/shell nanowires in physiological solutions at 37 °C demonstrate long-term stability extending for at least 100 days in samples coated with 10 nm thick Al2O3 shells. In addition, investigations of nanowires configured as field-effect transistors (FETs) demonstrate that the Si/Al2O3 core/shell nanowire FETs exhibit good device performance for at least 4 months in physiological model solutions at 37 °C. The generality of this approach was also tested with in studies of Ge/Si and InAs nanowires, where Ge/Si/Al2O3 and InAs/Al2O3 core/shell materials exhibited stability for at least 100 days in physiological model solutions at 37 °C. In addition, investigations of hafnium oxide-Al2O3 nanolaminated shells indicate the potential to extend nanowire stability well beyond 1 year time scale in vivo. These studies demonstrate that straightforward core/shell nanowire nanoelectronic devices can exhibit the long term stability needed for a range of chronic in vivo studies in animals as well as powerful biomedical implants that could improve monitoring and treatment of disease.

  9. Long-term runoff changes in regions of Slovakia

    International Nuclear Information System (INIS)

    Miklanek, Pavol; Pekarova; Pavla


    Mean annual runoff variability includes both natural and anthropogenic (climate change) impacts. Aim of the paper is to identify the long-term trends and the cyclic runoff components of selected Slovak rivers for the period 1931-2000, and of the Danube river for the period 1840-2000. The variability is analysed by the long-term runoff trends of 27 Slovak rivers for the period 1931-2000. The stations were included into the Slovak National Climate Program and they are supposed not to be influenced by anthropogenic activities except of possible climate change. Comparison of the monthly runoff series of the 27 rivers allowed us to draw 3 regions with different runoff trends on the territory of Slovakia (constant trend in Northern and Eastern Slovakia, slow decrease in Central Slovakia, and rapid decrease in Southern Slovakia; The identification of different cyclic components of the runoff series is included. The length of the series allows to identify the 22-year cycles as maximum. By means of the longer runoff series of the Danube river it is shown that the more dry periods occurred in the central Europe and Slovakia in mid 19 th century. The longer Danube series were used also to find the longer runoff cycles of about 31 and 46 years. The mean annual temperature in Europe was lower by 0.6 o C in mid 19 th century compared to 1990s. The temperature increase is put down to climate change impact. The driest period shown by Danube runoff series in mid 19 th century occurred before the start of the climate change. Therefore it is probable that the long-term runoff variability has its own dynamics as well. (Author)

  10. Long-term survivorship of stemless anatomical shoulder replacement. (United States)

    Beck, Sascha; Beck, Verena; Wegner, Alexander; Dudda, Marcel; Patsalis, Theodor; Jäger, Marcus


    Like in many other joints, current shoulder replacement designs aim at bone preservation. According to the literature available, stemless total shoulder arthroplasty (TSA) compares favourably with stemmed designs in terms of function and survivorship of the implant. However, long-term results of stemless shoulder arthroplasty are still missing. Therefore, the aim of the present study was to evaluate long-term results of stemless anatomical TSA. Between 2006 and 2009, 51 shoulders in 46 patients were resurfaced using the Biomet Total Evolutive Shoulder System (TESS). Thirty-one shoulders in 26 patients who were aged 66.7 ± 10.0 (range 34-82) years were available for review at a mean follow-up of 94.7 ± 11.3 (76-124) months. The implant survival rate was 93.5% at eight years. The overall revision rate of the TESS implant was 9.7%. Radiolucent lines were found on the glenoid side of the TESS arthroplasty in 90.9% of the cases. All stemless humeral corolla implants showed solid fixation at follow-up. Clinical scores significantly improved at long-term follow-up (VAS from 8.1 ± 0.9 to 1.0 ± 1.2, p < 0.001; Quick-DASH from 67.9 ± 13.5 to 18.7 ± 16.5, p < 0.001 and Constant score from 14.7 ± 6.1 to 68.8 ± 13.2, p < 0.001). Stemless TSA has stood the test of time at eight years in terms of clinical scores, radiographic loosening, complication rates and implant survivorship.

  11. Effects of a dietary intervention on gastrointestinal symptoms after prostate cancer radiotherapy: Long-term results from a randomized controlled trial

    International Nuclear Information System (INIS)

    Pettersson, Anna; Nygren, Peter; Persson, Christina; Berglund, Anders; Turesson, Ingela; Johansson, Birgitta


    Background and purpose: To evaluate the long-term effects of dietary intervention on gastrointestinal symptoms after highly dose-escalated radiotherapy for localized prostate cancer, using boost with protons or high-dose-rate brachytherapy. Materials and methods: Patients were randomized to an intervention group (n = 64) advised to reduce insoluble dietary fiber and lactose intake, or to a standard care group (n = 66) advised to continue their usual diet. Gastrointestinal symptoms, other domains of health-related quality of life (HRQOL), and dietary intake were evaluated for ⩽24 months post-radiotherapy with the European Organization for Research and Treatment of Cancer quality-of-life questionnaires QLQ-C30 and QLQ-PR25, Gastrointestinal Side Effects Questionnaire, and Food Frequency Questionnaire. The effect of the intervention on gastrointestinal symptoms was evaluated using generalized estimating equations. Results: Dietary intervention had no obvious effect on long-term gastrointestinal symptoms or HRQOL. The intervention group markedly reduced their dietary fiber and lactose intake during radiotherapy, but adherence tended to decline over time. The vast majority of long-term gastrointestinal symptoms were reported as ‘a little’, with a noticeable difference from pre-treatment only for unintentional stool leakage, limitations on daily activities, and mucus discharge. Conclusion: Long-term gastrointestinal symptoms were predominantly mild, and dietary intervention was not superior to a usual diet in preventing these symptoms

  12. Robotics for Long-Term Monitoring

    International Nuclear Information System (INIS)

    Shahin, Sarkis; Duran, Celso


    While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

  13. Long-Term Clock Behavior of GPS IIR Satellites

    National Research Council Canada - National Science Library

    Epstein, Marvin; Dass, Todd; Rajan, John; Gilmour, Paul


    .... Rubidium clocks, as opposed to cesium clocks, have significant long-term drift. The current literature describes an initial model of drift aging for rubidium atomic clocks followed by a long-term characteristic...

  14. Elevated rheumatoid factor and long term risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Schnohr, Peter


    To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis.......To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis....

  15. Long-term follow-up of patients after acute kidney injury: patterns of renal functional recovery.

    Directory of Open Access Journals (Sweden)

    Etienne Macedo

    Full Text Available BACKGROUND AND OBJECTIVES: Patients who survive acute kidney injury (AKI, especially those with partial renal recovery, present a higher long-term mortality risk. However, there is no consensus on the best time to assess renal function after an episode of acute kidney injury or agreement on the definition of renal recovery. In addition, only limited data regarding predictors of recovery are available. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: From 1984 to 2009, 84 adult survivors of acute kidney injury were followed by the same nephrologist (RCRMA for a median time of 4.1 years. Patients were seen at least once each year after discharge until end stage renal disease (ESRD or death. In each consultation serum creatinine was measured and glomerular filtration rate estimated. Renal recovery was defined as a glomerular filtration rate value ≥60 mL/min/1.73 m2. A multiple logistic regression was performed to evaluate factors independently associated with renal recovery. RESULTS: The median length of follow-up was 50 months (30-90 months. All patients had stabilized their glomerular filtration rates by 18 months and 83% of them stabilized earlier: up to 12 months. Renal recovery occurred in 16 patients (19% at discharge and in 54 (64% by 18 months. Six patients died and four patients progressed to ESRD during the follow up period. Age (OR 1.09, p<0.0001 and serum creatinine at hospital discharge (OR 2.48, p = 0.007 were independent factors associated with non renal recovery. The acute kidney injury severity, evaluated by peak serum creatinine and need for dialysis, was not associated with non renal recovery. CONCLUSIONS: Renal recovery must be evaluated no earlier than one year after an acute kidney injury episode. Nephrology referral should be considered mainly for older patients and those with elevated serum creatinine at hospital discharge.

  16. Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy

    Directory of Open Access Journals (Sweden)

    Steinhausen S


    Full Text Available Simone Steinhausen,1 Oliver Ommen,2 Sunya-Lee Antoine,1 Thorsten Koehler,3 Holger Pfaff,4 Edmund Neugebauer11Institute for Research in Operative Medicine (IFOM, Witten/Herdecke University, Campus Cologne-Merheim, Germany; 2Federal Centre for Health Education (BZgA, Cologne, Germany; 3Institute for Applied Social Sciences (infas, Bonn, Germany; 4Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR, Faculty of Human Science and Faculty of Medicine, University of Cologne, Germany Purpose: To investigate accident casualties’ long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon’s empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.Patients and methods: Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.Results: One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients

  17. Long term results of mandibular distraction

    Directory of Open Access Journals (Sweden)

    Batra Puneet


    Full Text Available Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  18. [Perioperative management of long-term medication]. (United States)

    Vogel Kahmann, I; Ruppen, W; Lurati Buse, G; Tsakiris, D A; Bruggisser, M


    Anesthesiologists and surgeons are increasingly faced with patients who are under long-term medication. Some of these drugs can interact with anaesthetics or anaesthesia and/or surgical interventions. As a result, patients may experience complications such as bleeding, ischemia, infection or severe circulatory reactions. On the other hand, perioperative discontinuation of medication is often more dangerous. The proportion of outpatient operations has increased dramatically in recent years and will probably continue to increase. Since the implementation of DRGs (pending in Switzerland, introduced in Germany for some time), the patient enters the hospital the day before operation. This means that the referring physician as well as anesthesiologists and surgeons at an early stage must deal with issues of perioperative pharmacotherapy. This review article is about the management of the major drug classes during the perioperative period. In addition to cardiac and centrally acting drugs and drugs that act on hemostasis and the endocrine system, special cases such as immunosuppressants and herbal remedies are mentioned.

  19. Long term agreements energy efficiency. Progress 1999

    Energy Technology Data Exchange (ETDEWEB)



    Long Term Agreements (LTAs) on energy efficiency have been contracted with various business sectors since 1992, as part of energy conservation policy: industrial sectors, commercial services, agrarian sectors and non-profit services. LTAs are voluntary agreements between a specific sector and the Minister of Economic Affairs. In some cases, the Minister of Agriculture, Nature Management and Fisheries is also involved. The sector commits to an effort to improve energy efficiency by a particular percentage within an agreed period. As at 31 December 1999, a total of 29 LTAs had been contracted with industrial sectors and 14 with non-industrial ones. This report describes the progress of the LTAs in 1999. It reviews the energy efficiency improvements realised through the LTAs, both overall and in each individual sector. The aim is to make the efforts and results in the various sectors accessible to the general public. Appendix 1 describes the positioning of the LTA instrument. This Appendix provides and insight into the position of the LTAs within the overall set of policy instruments. It also covers the subsidy schemes and fiscal instruments that support the LTAs, the relationships between LTAs and environmental policy and new developments relating to the LTAs in the years ahead. Appendices 2 to 6 contain the reports on the LTAs and a list of abbreviations (Appendix 7)

  20. Long-term outcome of neuroparacoccidioidomycosis treatment

    Directory of Open Access Journals (Sweden)

    Fabio Francesconi


    Full Text Available INTRODUCTION: Neuroparacoccidioidomycosis (NPCM is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8% cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM. A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed.

  1. Long term prospects for world gas trade

    International Nuclear Information System (INIS)

    Linder, P.T.


    Results are presented from a world gas trade model used to forecast long term gas markets. Assumptions that went into the model are described, including the extent of current proven gas reserves, production ratios, total energy and gas demand, gas supply cost curves for each producing country, available gas liquefaction and transportation facilities, and liquefied natural gas (LNG) shipping costs. The results indicate that even with generally very low supply costs for most gas producing basins, gas trade will continue to be restricted by the relatively high cost of transportation, whether by pipeline or tanker. As a consequence, future gas trade will tend to be regionally oriented. United States gas imports will come mostly from Canada, Venezuela, and Mexico; Western Europe will largely be supplied by the Soviet Union and Africa, and Japan's requirements will generally be met by Pacific Rim producers. Although the Middle East has vast quantities of gas reserves, its export growth will continue to be hampered by its remote location from major markets. 16 figs

  2. Long term results of childhood dysphonia treatment. (United States)

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr


    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Long-term data storage in diamond (United States)

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A.


    The negatively charged nitrogen vacancy (NV−) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV− optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV− ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center’s charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV− ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies. PMID:27819045

  4. Long-term data storage in diamond. (United States)

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A


    The negatively charged nitrogen vacancy (NV - ) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV - optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV - ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center's charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV - ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies.

  5. Long-term predictions using natural analogues

    International Nuclear Information System (INIS)

    Ewing, R.C.


    One of the unique and scientifically most challenging aspects of nuclear waste isolation is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10 3 -10 5 years) required by regulatory agencies for performance assessment. The direct validation of these extrapolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the lay public that there is a demonstrable and reasonable basis for accepting the long-term extrapolations. Natural systems (e.g., open-quotes natural analoguesclose quotes) provide perhaps the only means of partial open-quotes validation,close quotes as well as data that may be used directly in the models that are used in the extrapolation. Natural systems provide data on very large spatial (nm to km) and temporal (10 3 -10 8 years) scales and in highly complex terranes in which unknown synergisms may affect radionuclide migration. This paper reviews the application (and most importantly, the limitations) of data from natural analogue systems to the open-quotes validationclose quotes of performance assessments

  6. Long-term effects of islet transplantation. (United States)

    Holmes-Walker, D Jane; Kay, Thomas W H


    Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation. Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function.

  7. CERN Services for Long Term Data Preservation

    CERN Document Server

    Shiers, Jamie; Blomer, Jakob; Ganis, Gerardo; Dallmeier-Tiessen, Sunje; Simko, Tibor; Cancio Melia, German; CERN. Geneva. IT Department


    In this paper we describe the services that are offered by CERN for Long Term preservation of High Energy Physics (HEP) data, with the Large Hadron Collider (LHC) as a key use case. Data preservation is a strategic goal for European High Energy Physics (HEP), as well as for the HEP community worldwide and we position our work in this global content. Specifically, we target the preservation of the scientific data, together with the software, documentation and computing environment needed to process, (re-)analyse or otherwise (re-)use the data. The target data volumes range from hundreds of petabytes (PB – 10^15 bytes) to hundreds of exabytes (EB – 10^18 bytes) for a target duration of several decades. The Use Cases driving data preservation are presented together with metrics that allow us to measure how close we are to meeting our goals, including the possibility for formal certification for at least part of this work. Almost all of the services that we describe are fully generic – the exception being A...

  8. Containment long-term operational integrity

    International Nuclear Information System (INIS)

    Sammataro, R.F.


    Periodic integrated leak rate tests are required to assure that containments continue to meet allowable leakage limits. Although overall performance has been quite good to date, several major containment aging and degradation mechanisms have been identified. Two pilot plant life extension (PLEX) studies serve as models for extending the operational integrity of present containments for light-water cooled nuclear power plants in the United States. One study is for a Boiling-Water Reactor (BWR) and the second is for a Pressurized-Water Reactor (PWR). Research and testing programs for determining the ultimate pressure capacity and failure mechanisms for containments under severe loading conditions and studies for extending the life of current plants beyond the present 40-year licensed lifetime are under way. This paper presents an overview of containment designs in the United States. Also presented are a discussion of the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (ASME Code) and regulatory authority requirements for the design, construction, inservice inspection, leakage testing and repair of steel and concrete containments. Findings for containments from the pilot PLEX studies and continuing containment integrity research and testing programs are discussed. The ASME Code and regulatory requirements together with recommendations from the PLEX studies and containment integrity research and testing provide a basis for continued containment long-term operational integrity. (orig./GL)

  9. Transuranic waste: long-term planning

    International Nuclear Information System (INIS)

    Young, K.C.


    Societal concerns for the safe handling and disposal of toxic waste are behind many of the regulations and the control measures in effect today. Transuranic waste, a specific category of toxic (radioactive) waste, serves as a good example of how regulations and controls impact changes in waste processing - and vice versa. As problems would arise with waste processing, changes would be instituted. These changes improved techniques for handling and disposal of transuranic waste, reduced the risk of breached containment, and were usually linked with regulatory changes. Today, however, we face a greater public awareness of and concern for toxic waste control; thus, we must anticipate potential problems and work on resolving them before they can become real problems. System safety analyses are valuable aids in long-term planning for operations involving transuranic as well as other toxic materials. Examples of specific system safety analytical methods demonstrate how problems can be anticipated and resolution initiated in a timely manner having minimal impacts upon allocation of resource and operational goals. 7 refs., 1 fig

  10. Long-term plutonium storage: Design concepts

    International Nuclear Information System (INIS)

    Wilkey, D.D.; Wood, W.T.; Guenther, C.D.


    An important part of the Department of Energy (DOE) Weapons Complex Reconfiguration (WCR) Program is the development of facilities for long-term storage of plutonium. The WCR design goals are to provide storage for metals, oxides, pits, and fuel-grade plutonium, including material being held as part of the Strategic Reserve and excess material. Major activities associated with plutonium storage are sorting the plutonium inventory, material handling and storage support, shipping and receiving, and surveillance of material in storage for both safety evaluations and safeguards and security. A variety of methods for plutonium storage have been used, both within the DOE weapons complex and by external organizations. This paper discusses the advantages and disadvantages of proposed storage concepts based upon functional criteria. The concepts discussed include floor wells, vertical and horizontal sleeves, warehouse storage on vertical racks, and modular storage units. Issues/factors considered in determining a preferred design include operational efficiency, maintenance and repair, environmental impact, radiation and criticality safety, safeguards and security, heat removal, waste minimization, international inspection requirements, and construction and operational costs

  11. Imaging windows for long-term intravital imaging (United States)

    Alieva, Maria; Ritsma, Laila; Giedt, Randy J; Weissleder, Ralph; van Rheenen, Jacco


    Intravital microscopy is increasingly used to visualize and quantitate dynamic biological processes at the (sub)cellular level in live animals. By visualizing tissues through imaging windows, individual cells (e.g., cancer, host, or stem cells) can be tracked and studied over a time-span of days to months. Several imaging windows have been developed to access tissues including the brain, superficial fascia, mammary glands, liver, kidney, pancreas, and small intestine among others. Here, we review the development of imaging windows and compare the most commonly used long-term imaging windows for cancer biology: the cranial imaging window, the dorsal skin fold chamber, the mammary imaging window, and the abdominal imaging window. Moreover, we provide technical details, considerations, and trouble-shooting tips on the surgical procedures and microscopy setups for each imaging window and explain different strategies to assure imaging of the same area over multiple imaging sessions. This review aims to be a useful resource for establishing the long-term intravital imaging procedure. PMID:28243510

  12. Long-term outcomes of nasopharyngectomy using partial maxillectomy approach. (United States)

    Ng, Li Shia; Lim, Chwee Ming; Loh, Kwok Seng


    To determine the long-term outcomes of a prospective cohort of 20 patients who had nasopharyngectomy using an open partial-maxillectomy approach. A prospective cohort study of the surgical outcomes of patients with recurrent T1 (rT1) and rT2 nasopharyngeal carcinoma recurrence. There were 14 male and six female patients. The mean age was 49 years. The mean duration of follow-up was 60.4 months. All of the surgical margins were free of malignancy. Ten patients (50%) developed recurrences. The 5-year local control rate, disease-free, disease-specific, and overall survivals were 70%, 48.9%, 70.2%, and 66.7%, respectively. There were no major intraoperative complications. The most common morbidity was pain. The median length of hospitalization was 4 days. Early local recurrence of nasopharyngeal carcinoma can be treated surgically using a partial maxillectomy approach. The long-term outcomes are similar to nasopharyngectomy performed using the more common approaches. 4. Laryngoscope, 126:1103-1107, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  13. [Long-term effectiveness of psychodynamic outpatient treatment of addiction]. (United States)

    Steffen, D V; Werle, L; Steffen, R; Steffen, M; Steffen, S


    The aim of this study is to make an evaluation of the effectiveness of long-term outpatient treatment for addiction on the basis of abstinence, cognitive functions, and changes in personality structure. This is a prospective cohort study of 259 patients with registration of the German core data set "addiction", a 12-month follow-up and neuropsychological testing (personality inventory, intelligence and cognitive functions). One year after the end of the long-term treatment we see an abstinence rate (DGSS4) of 57.5 %. The most substantial factors in abstinence are the participation in a self-help-group (β = 0.734, p addiction seem to show its high effectiveness in terms of abstinence and processing of drug structures. The cognitive functions could increase. This could be determinate of a condition for the conservation and restoration of working capacity. Further studies should differentiate the effect of insight into the dependency structure from the abstinence as an specific or unspecific effect. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Health Practice in Long-Term Survivors of Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Ng, Andrea K.; Li Sigui; Recklitis, Christopher; Diller, Lisa R.; Neuberg, Donna; Silver, Barbara; Mauch, Peter M.


    Purpose: To compare the health practice of Hodgkin's lymphoma (HL) survivors and their siblings, and to assess the impact of socioeconomic status and disease history on health practice of HL survivors. Methods and Materials: We conducted a questionnaire study on long-term HL survivors and their siblings on health care utilization, health habits, and screening behavior. Results: A total of 511 HL survivors (response rate of 50%, including survivors lost to contact) and 224 siblings (response rate, 58%) participated. Median time from HL diagnosis was 15 years. Significantly more survivors than siblings had a physical examination in the past year (63% vs. 49%, p = 0.0001). Male survivors were significantly more likely than siblings to perform monthly self-testicular examinations (19% vs. 9%, p = 0.02). Among survivors, higher household income (p = 0.01) independently predicted for having had a physical examination in the past year. Lower educational level (p = 0.0004) and history of relapsed HL (p = 0.03) were independent predictors for smoking, moderate/heavy alcohol use, and/or physical inactivity. Conclusions: Compared with siblings, long-term HL survivors have a higher level of health care utilization and better screening practice. Survivors from lower socioeconomic background had lower adherence to routine health care and greater report of unhealthy habits. Survivors with history of relapsed HL were also more likely to engage in unhealthy habits

  15. Long-term outcomes for adult craniopharyngioma following radiation therapy

    International Nuclear Information System (INIS)

    Masson-Cote, Laurence; Masucci, Giuseppina Laura; Millar, Barbara-Ann; Laperriere, Normand J.; Atenafu, Eshetu G.; Cusimano, Michael; Croul, Sidney; Mason, Warren; Sahgal, Arjun; Dept. of Radiation Oncology, Sunnybrook Health Sciences Center, Univ. of Toronto, Toronto


    Background. We report long-term outcomes in adult patients with craniopharyngioma following surgery and radiation therapy (RT). Material and methods. Fifty-three patients treated with RT (median, 50 Gy in 25 fractions) between 1980 and 2009 with pathologically confirmed craniopharyngioma were reviewed (53% solid and 47% cystic/solid). The median age was 53 years (range, 22-76), 53% were female, 83% were sub-totally resected, 6% were gross totally resected and 11% had a biopsy and/or cyst aspiration alone. RT was delivered adjuvantly in 53% of patients as opposed to salvage intent upon progression. Results. Median follow-up was seven years (86 months, range, 8-259). The 5- and 10-year progression-free survival (PFS) rates were 85% and 69%, overall survival (OS) rates were 76% and 70%, and cause-specific survival (CSS) rates were both 88%, respectively. Both univariable and multivariable analysis identified age ( 2 surgeries prior to RT (p =0.01). Neither the intent of radiation or tumor type (cystic vs. solid/cystic) were prognostic or predictive. New endocrinopathies and visual dysfunction were observed in 53% and 17% of patients post-surgery, and in 11% and 6% post-RT, respectively. Conclusion. We report long-term favorable PFS, CSS and OS for craniopharyngioma post-RT. We observe age as a significant prognostic factor, however, timing of radiation was not

  16. Essays on long-term mortality and interest rate risk

    NARCIS (Netherlands)

    de Kort, J.P.


    This dissertation comprises a study of long-term risks which play a major role in actuarial science. In Part I we analyse long-term mortality risk and its impact on consumption and investment decisions of economic agents, while Part II focuses on the mathematical modelling of long-term interest

  17. Long-term consequences of an intensive care unit stay in older critically ill patients: design of a longitudinal study

    Directory of Open Access Journals (Sweden)

    Hantikainen Virpi


    Full Text Available Abstract Background Modern methods in intensive care medicine often enable the survival of older critically ill patients. The short-term outcomes for patients treated in intensive care units (ICUs, such as survival to hospital discharge, are well documented. However, relatively little is known about subsequent long-term outcomes. Pain, anxiety and agitation are important stress factors for many critically ill patients. There are very few studies concerned with pain, anxiety and agitation and the consequences in older critically ill patients. The overall aim of this study is to identify how an ICU stay influences an older person's experiences later in life. More specific, this study has the following objectives: (1 to explore the relationship between pain, anxiety and agitation during ICU stays and experiences of the same symptoms in later life; and (2 to explore the associations between pain, anxiety and agitation experienced during ICU stays and their effect on subsequent health-related quality of life, use of the health care system (readmissions, doctor visits, rehabilitation, medication use, living situation, and survival after discharge and at 6 and 12 months of follow-up. Methods/Design A prospective, longitudinal study will be used for this study. A total of 150 older critically ill patients in the ICU will participate (ICU group. Pain, anxiety, agitation, morbidity, mortality, use of the health care system, and health-related quality of life will be measured at 3 intervals after a baseline assessment. Baseline measurements will be taken 48 hours after ICU admission and one week thereafter. Follow-up measurements will take place 6 months and 12 months after discharge from the ICU. To be able to interpret trends in scores on outcome variables in the ICU group, a comparison group of 150 participants, matched by age and gender, recruited from the Swiss population, will be interviewed at the same intervals as the ICU group. Discussion Little

  18. Long-term sequelae after lung abscess in children - Two tertiary centers' experience. (United States)

    Wojsyk-Banaszak, I; Krenke, K; Jończyk-Potoczna, K; Ksepko, K; Wielebska, A; Mikoś, M; Bręborowicz, A


    The aim of the study was to describe the epidemiology and clinical characteristic of children hospitalized with pneumonia complicated by lung abscess, as well as to evaluate the long-term sequelae of the disease. A retrospective review of medical records of all patients treated for pulmonary abscess in two tertiary centers was undertaken. Pulmonary function tests and lung ultrasound were performed at a follow-up. During the study period, 5151 children with pneumonia were admitted, and 49 (0.95%) cases were complicated with lung abscess. In 38 (77.5%) patients, lung abscess was treated solely with antibiotics, and in nine cases (16.3%) surgically. In 21 (51.21%) children complete radiological regression was documented. The mean time for radiological abnormalities regression was 84.14 ± 51.57 days, regardless of the treatment mode. Fifteen patients were followed up at 61.6 ± 28.3 months after discharge. Lung ultrasound revealed minor residual abnormalities: pleural thickening, subpleural consolidations and line B artefacts in 11 (73.3%) children. Pulmonary function tests results were abnormal in eight (53.3%) patients, the most frequent abnormality being hyperinflation. We did not find a restrictive disorder in any of the children. There were no deaths in our study. Lung abscess is a rare but severe complication of pneumonia in children. Most children recover uneventfully with no significant long-term pulmonary sequelae. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. The long-term nutritional status in stroke patients and its predictive factors. (United States)

    Paquereau, Julie; Allart, Etienne; Romon, Monique; Rousseaux, Marc


    Malnutrition is common in the first few months after stroke and contributes to a poor overall outcome. We analyzed long-term weight changes and their predictive factors. A total of 71 first-ever stroke patients were included in the study and examined (1) their weight on admission to the acute stroke unit (usual weight [UW]), on admission to the rehabilitation unit, on discharge from the rehabilitation unit, and then 1 year or more after the stroke (median time: 2.5 years), (2) the presence of malnutrition after stroke, and (3) possible predictive factors, namely, sociodemographic factors, clinical characteristics (concerning the stroke, the patient's current neurologic status and the presence of diabetes mellitus and depression), and the present nutritional state (including eating difficulties, anorexia, and changes in food intake and food preferences). Body weight fell (4.0 kg) during the patients' stay in the stroke unit, increased moderately in the rehabilitation unit (2.0 kg), and returned to the UW by the long-term measurement. However, at the last observation, 40.1% of the patients weighed markedly less than their UW, 38.0% weighed markedly more, and 21.1% were relatively stable. Predictors of weight change were a change in preferences for sweet food products and a change in food intake. Malnutrition was frequent (47.9%) and associated with reduced food intake, residence in an institution, and diabetes mellitus. Malnutrition was highly prevalent, with an important role of change in food intake and food preferences, which could result from brain lesions and specific regimens. Living in an institution needs consideration, as its negative effects can be prevented. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Long term results in refractory tennis elbow using autologous blood. (United States)

    Gani, Naseem Ul; Khan, Hayat Ahmad; Kamal, Younis; Farooq, Munir; Jeelani, Hina; Shah, Adil Bashir


    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of tennis elbow should be made as there is lot of controversy regarding the treatment.

  1. The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease. (United States)

    Slovinec D'Angelo, Monika E; Pelletier, Luc G; Reid, Robert D; Huta, Veronika


    Poor adherence to regular exercise is a documented challenge among people with heart disease. Identifying key determinants of exercise adherence and distinguishing between the processes driving short- and long-term adherence to regular exercise is a valuable endeavor. The purpose of the present study was to test a model of exercise behavior change, which incorporates motivational orientations and self-efficacy for exercise behavior, in the prediction of short- and long-term exercise adherence. Male and female patients (N = 801) hospitalized for coronary heart disease were recruited from 3 tertiary care cardiac centers and followed for a period of 1 year after hospital discharge. A prospective, longitudinal design was used to examine the roles of motivation and self-efficacy (measured at recruitment and at 2 and 6 months after discharge) in the prediction of exercise behavior at 6 and 12 months. Baseline measures of exercise and clinical and demographic covariates were included in the analyses. Structural equation modeling showed that both autonomous motivation and self-efficacy were important determinants of short-term (6-month) exercise behavior regulation, but that only autonomous motivation remained a significant predictor of long-term (12-month) exercise behavior. Self-efficacy partially mediated the relationship between motivation for exercise and 6-month exercise behavior. This research confirmed the roles of autonomous motivation and self-efficacy in the health behavior change process and emphasized the key function of autonomous motivation in exercise maintenance. Theoretical and cardiac rehabilitation program applications of this research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  2. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program (United States)

    Gosz, J.


    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  3. Long-term outcome of primary external dacryocystorhinostomy

    International Nuclear Information System (INIS)

    Baig, R.; Khan, Q.A.; Ahmad, K.


    Objective: To assess the long-term functional outcome of external dacryocystorhinostomy (DCR) in terms of epiphora. Study Design: Single-group cohort study. Place and Duration of Study: Section of Ophthalmology, The Aga Khan University Hospital, Karachi, from January 2000 to June 2010. Methodology: This study included adults who underwent external DCR surgery at the AKUH during January 2000 to June 2010. The main outcome measure was the proportion of patients reporting to have developed epiphora after surgery. During the telephonic interviews participants were asked if they had a recurrence (symptoms such as watering or discharge) after surgery. Individuals answering in affirmative were asked when the symptoms started. Data on age at surgery, gender and pre-operative symptoms were collected from medical records. Recurrence-free curves were calculated according to the Kaplan-Meier method. Results: A total of 44 persons who underwent DCR surgery were contactable by telephone in 2011 and all agreed to participate in the study. The mean age of the patients at the time of surgery was 48.0 A+- 15.8 years. Overall, 38.6% (17/44) participants reported having developed epiphora after surgery. The overall median recurrence-free time was 1.7 years; there was no statistically significant difference in the median recurrence-free time between men and women. Conclusion: The long-term functional outcome of external DCR surgery does not appear to be optimal and, in fact, far worse than the short-term results reported in the international literature. (author)

  4. Energy in 2010 - 2020. Long term challenges; Energie 2010-2020. Les defis du long terme

    Energy Technology Data Exchange (ETDEWEB)

    Dessus, Benjamin [ed.] [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France)


    This report presents the results of a workshop intending to anticipate the long term challenges, to guide better the short term power options, to understand the available political, economical and technical assumptions for the prospective world situation, to give some strategic hints on the necessary transition. Indeed, the difficult issue which the workshop tried to tackle was how should we prepare to reveal the energetic challenge of the development of the eight to ten billion inhabitants of our Planet in the next century without jeopardizing its existence. The energetic problems, a hardcore of the international preoccupation of both growth and environment, as it was recently evidenced by the climatic conference in Kyoto, have ever been the object of a particular attention on the part of General Commissariat of Plan. Thus, the commission 'Energy in 2010 - 2020' has been instituted in April 1996 in order to update the works done in 1990 - 1991 by the commission 'Energy 2010'. Soon it occurred to this new commission the task of illuminating its works by a long term (2050 - 2100) world prospective analysis of the challenges and problems linked to energy, growth and environment. In conclusion, this document tried to find answers to questions like: - which are the risks the energy consumption augmentation entail? - can we control them by appropriate urbanism and transport policies or technological innovation?. Four options for immediate action are suggested: - the energy efficiency should become a priority objective of policies; -coping with the long term challenges requires acting at present; - building the transition between governmental leadership and market; - taking profit of all the possible synergies between short and long term planning.

  5. A security/safety survey of long term care facilities. (United States)

    Acorn, Jonathan R


    What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

  6. HLW Long-term Management Technology Development

    International Nuclear Information System (INIS)

    Choi, Jong Won; Kang, C. H.; Ko, Y. K.


    Permanent disposal of spent nuclear fuels from the power generation is considered to be the unique method for the conservation of human being and nature in the present and future. In spite of spent nuclear fuels produced from power generation, based on the recent trends on the gap between supply and demand of energy, the advance on energy price and reduction of carbon dioxide, nuclear energy is expected to play a role continuously in Korea. It means that a new concept of nuclear fuel cycle is needed to solve problems on spent nuclear fuels. The concept of the advanced nuclear fuel cycle including PYRO processing and SFR was presented at the 255th meeting of the Atomic Energy Commission. According to the concept of the advanced nuclear fuel cycle, actinides and long-term fissile nuclides may go out of existence in SFR. And then it is possible to dispose of short term decay wastes without a great risk bearing. Many efforts had been made to develop the KRS for the direct disposal of spent nuclear fuels in the representative geology of Korea. But in the case of the adoption of Advanced nuclear fuel cycle, the disposal of PYRO wastes should be considered. For this, we carried out the Safety Analysis on HLW Disposal Project with 5 sub-projects such as Development of HLW Disposal System, Radwaste Disposal Safety Analysis, Feasibility study on the deep repository condition, A study on the Nuclide Migration and Retardation Using Natural Barrier, and In-situ Study on the Performance of Engineered Barriers

  7. The long-term nuclear explosives predicament

    International Nuclear Information System (INIS)

    Swahn, J.


    A scenario is described, where the production of new military fissile materials is halted and where civil nuclear power is phased out in a 'no-new orders' case. It is found that approximately 1100 tonnes of weapons-grade uranium, 233 tonnes of weapons-grade plutonium and 3795 tonnes of reactor-grade plutonium have to be finally disposed of as nuclear waste. This material could be used for the construction of over 1 million nuclear explosives. Reactor-grade plutonium is found to be easier to extract from spent nuclear fuel with time and some physical characteristics important for the construction of nuclear explosives are improved. Alternative methods for disposal of the fissile material that will avoid the long-term nuclear explosives predicament are examined. Among these methods are dilution, denaturing or transmutation of the fissile material and options for practicably irrecoverable disposal in deep boreholes, on the sea-bed, and in space. It is found that the deep boreholes method for disposal should be the primary alternative to be examined further. This method can be combined with an effort to 'forget' where the material was put. Included in the thesis is also an evaluation of the possibilities of controlling the limited civil nuclear activities in a post-nuclear world. Some surveillance technologies for a post-nuclear world are described, including satellite surveillance. In a review part of the thesis, methods for the production of fissile material for nuclear explosives are described, the technological basis for the construction of nuclear weapons is examined, including use of reactor-grade plutonium for such purposes; also plans for the disposal of spent fuel from civil nuclear power reactors and for the handling of the fissile material from dismantled warheads is described. The Swedish plan for the handling and disposal of spent nuclear fuel is described in detail. (490 refs., 66 figs., 27 tabs.)

  8. Long term results of pyeloplasty in adults

    International Nuclear Information System (INIS)

    Tayib, Abdul Malik


    To determine the presenting systems, complications, stone coincidence in adult patients with primary ureteropelvic junction (UPJ) obstruction seen at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia. We are also reporting the success rate and long term results of adult pyeloplasty. We reviewed the records of 34 patients who underwent 37 pyeloplasty operations during the period January 1992 through to June 2002. The preoperative radiological diagnosis made by intravenous urogram or renal isotopes scan. We excluded from our study patients with previous history of passage of stones, renal or ureteral surgeries, large renal pelvis stone that may cause UPJ obstruction or abnormalities that may lead to secondry UPJ obstruction such as vesicoureteral reflux. There were 28 male patients and 8 females, their age varied between 16 and 51-years, the mean age was 36.1 years, and 18 (52.9%) patients had concomitant renal stones. Ispsilateral split renal function improved by 3-7% post pyeloplasty in 23 patients, while in one patient the function stayed the same, and in another patient the split function reduced by 4%. T1/2 renal isotopes washout time became less than 15 minutes in 19 patients and less than 20 minutes in 6 patients. Intravenous urogram revealed disappearence of the obstruction at UPJ in 7 patients while in 2 patients it became poorly functioning. Anderson Hynes pyeloplasty is an excellent procedure for treating UPJ obstruction in adults. Our success rate is comparable to the international repoted rates, while our study revealed a higher incidence of concomitant renal stones than the international studies. (author)

  9. Nutritional deficit and Long Term Potentiation alterations

    Directory of Open Access Journals (Sweden)

    M. Petrosino


    Full Text Available In the present work we examined the ability of prenatally malnourished offspring to produce and maintain long-term potentiation (LTP of the perforant path/dentate granule cell synapse in freely moving rats at 15,30, and 90 days of age. Population spike amplitude (PSA was calculated from dentate field potential recordings prior to and at 15, 30, 60 min. and 3, 5, 18 and 24 h following tetanization of the perforant pathway. All animals of both malnourished and well-nourished diet groups at 15 days of age showed potentiation of PSA measures but the measures obtained from 15-day-old prenatally malnourished animals were significantly less than that of age-matched, well-nourished controls. At 30 days of age, remarkable effect of tetanization was likely observed from PSA measures for this age group followed much the same pattern. At 90 days of age, PSA measures obtained from malnourished animals decreased from pretetanization levels immediately following tetanization. At this age, however, at three hours time recordings, this measure growing up to a level which did not differ significantly from that of the control group. These results indicate that the width of tetanization induced enhancement of dentate granule cell response in preweanling rats (15-day-old animals is signifacantly affected fromgestational protein malnutrition and this trend is kept in animals tested at 30 and 90 days of age. The fact, however, that considerable limitation in LTP generation was gained from prenatally malnourished animals at 90 days of age, implying that dietary rehabilitation starting at birth is an intervention strategy not capable to imbrove the effects of the gestational stress.

  10. Perinatal respiratory infections and long term consequences

    Directory of Open Access Journals (Sweden)

    Luciana Indinnimeo


    Full Text Available Respiratory syncytial virus (RSV is the most important pathogen in the etiology of respiratory infections in early life. 50% of children are affected by RSV within the first year of age, and almost all children become infected within two years. Numerous retrospective and prospective studies linking RSV and chronic respiratory morbidity show that RSV bronchiolitis in infancy is followed by recurrent wheezing after the acute episod. According to some authors a greater risk of wheezing in children with a history of RSV bronchiolitis would be limited to childhood, while according to others this risk would be extended into adolescence and adulthood. To explain the relationship between RSV infection and the development of bronchial asthma or the clinical pathogenetic patterns related to a state of bronchial hyperreactivity, it has been suggested that RSV may cause alterations in the response of the immune system (immunogenic hypothesis, activating directly mast cells and basophils and changing the pattern of differentiation of immune cells present in the bronchial tree as receptors and inflammatory cytokines. It was also suggested that RSV infection can cause bronchial hyperreactivity altering nervous airway modulation, acting on nerve fibers present in the airways (neurogenic hypothesis.The benefits of passive immunoprophylaxis with palivizumab, which seems to represent an effective approach in reducing the sequelae of RSV infection in the short- and long-term period, strengthen the implementation of prevention programs with this drug, as recommended by the national guidelines of the Italian Society of Neonatology. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the

  11. Long-term biocompatibility of implanted polymer-based intrafascicular electrodes

    DEFF Research Database (Denmark)

    Lawrence, Stephen M; Larsen, Jytte Overgaard; Horch, Kenneth W


    Polymer-based longitudinal intrafascicular electrodes (polyLIFEs) were chronically implanted into the sciatic nerve of white New Zealand rabbits (n=8) for a period of 6 months (hereafter referred to as the long-term group). The impact of the implantation procedure, as observed 6 months post surge...

  12. What Infant Memory Tells Us about Infantile Amnesia: Long-Term Recall and Deferred Imitation. (United States)

    Meltzoff, Andrew N.


    Long-term recall memory was assessed in 14- and 16 month-olds using a nonverbal method requiring subjects to reenact a past event from memory. The results demonstrated significant deferred imitation after delays of two and four months, and that the toddlers retained and imitated multiple acts. (MDM)

  13. Short-term and long-term sick-leave in Sweden

    DEFF Research Database (Denmark)

    Blank, N; Diderichsen, Finn


    The primary aim of the study was to analyse similarities and differences between repeated spells of short-term sick-leave (more than 3 spells of less than 7 days' duration in a 12-month period) and long-term absence through sickness (at least 1 spell of more than 59 days' duration in a 12-month p...

  14. Stroke and Long-Term Exposure to Outdoor Air Pollution From Nitrogen Dioxide A Cohort Study

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Kristiansen, Luise Cederkvist; Andersen, Klaus K.


    Background and Purpose-Years of exposure to tobacco smoke substantially increase the risk for stroke. Whether long-term exposure to outdoor air pollution can lead to stroke is not yet established. We examined the association between long-term exposure to traffic-related air pollution and incident...... and fatal stroke in a prospective cohort study.Methods-We followed 57 053 participants of the Danish Diet, Cancer and Health cohort in the Hospital Discharge Register for the first-ever hospital admission for stroke (incident stroke) between baseline (1993-1997) and 2006 and defined fatal strokes as death...

  15. Prognostic Factors and Decision Tree for Long-term Survival in Metastatic Uveal Melanoma. (United States)

    Lorenzo, Daniel; Ochoa, María; Piulats, Josep Maria; Gutiérrez, Cristina; Arias, Luis; Català, Jaum; Grau, María; Peñafiel, Judith; Cobos, Estefanía; Garcia-Bru, Pere; Rubio, Marcos Javier; Padrón-Pérez, Noel; Dias, Bruno; Pera, Joan; Caminal, Josep Maria


    The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristics were assessed in both groups. Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of disease.

  16. Long-Term Capital Goods Importation and Minimum Wage Relationship in Turkey: Bounds Testing Approach

    Directory of Open Access Journals (Sweden)

    Tastan Serkan


    Full Text Available In order to examine the long-term relationship between capital goods importation and minimum wage, autoregressive distributed lag (ARDL bounds testing approach to the cointegration is used in the study. According to bounds test results, a cointegration relation exists between the capital goods importation and the minimum wage. Therefore an ARDL(4,0 model is estimated in order to determine the long and short term relations between variables. According to the empirical analysis, there is a positive and significant relationship between the capital goods importation and the minimum wage in Turkey in the long term. A 1% increase in the minimum wage leads to a 0.8% increase in the capital goods importation in the long term. The result is similar for short term coefficients. The relationship observed in the long term is preserved in short term, though in a lower level. In terms of error correction model, it can be concluded that error correction mechanism works as the error correction term is negative and significant. Short term deviations might be resolved with the error correction mechanism in the long term. Accordingly, approximately 75% of any deviation from equilibrium which might arise in the previous six month period will be resolved in the current six month period. This means that returning to long term equilibrium progresses rapidly.

  17. Short- and long-term reproducibility of radioisotopic examination of gastric emptying

    Energy Technology Data Exchange (ETDEWEB)

    Jonderko, K. (Silesian School of Medicine, Katowice (Poland). Dept. of Gastroenterology)


    Reproducibility of gastric emptying (GE) of a radiolabelled solid meal was assessed. The short-term reproducibility was evaluated on the basis of 12 paired GE examinations performed 1-3 days apart. Twelve paired GE examinations taken 3-8 months apart enabled long-term reproducibility assessment. Reproducibility of GE parameters was expressed in terms of the coefficient of variation, CV. No significant between-day variation of solid GE was found either regarding the short-term or the long-term reproducibility. Although slightly higher CV values characterized the long-term reproducibility of the GE parameters considered, the variations of the differences between repeated GE examinations did not differ significantly between short- and long-term GE reproducibility. The results obtained justify the use of radioisotopic GE measurement for the assessment of early and late results of pharmacologic or surgical management. (author).

  18. A least squares approach for efficient and reliable short-term versus long-term optimization

    DEFF Research Database (Denmark)

    Christiansen, Lasse Hjuler; Capolei, Andrea; Jørgensen, John Bagterp


    The uncertainties related to long-term forecasts of oil prices impose significant financial risk on ventures of oil production. To minimize risk, oil companies are inclined to maximize profit over short-term horizons ranging from months to a few years. In contrast, conventional production...... optimization maximizes long-term profits over horizons that span more than a decade. To address this challenge, the oil literature has introduced short-term versus long-term optimization. Ideally, this problem is solved by a posteriori multi-objective optimization methods that generate an approximation...... the balance between the objectives, leaving an unfulfilled potential to increase profits. To promote efficient and reliable short-term versus long-term optimization, this paper introduces a natural way to characterize desirable Pareto points and proposes a novel least squares (LS) method. Unlike hierarchical...

  19. Long-term effects of prenatal progesterone exposure

    DEFF Research Database (Denmark)

    Vedel, C.; Larsen, H.; Holmskov, Anni


    children from 498 twin pregnancies, were followed-up. PREDICT was a placebo-controlled randomized clinical trial examining the effect of progesterone for prevention of preterm delivery in unselected twin pregnancies. Medical histories of the children were reviewed and neurophysiological development...... does not seem to have long-term harmful effects during childhood, but future studies should focus on cardiac disease in the child. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.......OBJECTIVES: To perform a neurophysiological follow-up at 48 or 60 months of age in children exposed prenatally to progesterone compared with a placebo and evaluate their medical histories up to 8 years of age. METHODS: In this study, Danish participants of the PREDICT study, including 989 surviving...

  20. Long-Term Prediction of Satellite Orbit Using Analytical Method

    Directory of Open Access Journals (Sweden)

    Jae-Cheol Yoon


    Full Text Available A long-term prediction algorithm of geostationary orbit was developed using the analytical method. The perturbation force models include geopotential upto fifth order and degree and luni-solar gravitation, and solar radiation pressure. All of the perturbation effects were analyzed by secular variations, short-period variations, and long-period variations for equinoctial elements such as the semi-major axis, eccentricity vector, inclination vector, and mean longitude of the satellite. Result of the analytical orbit propagator was compared with that of the cowell orbit propagator for the KOREASAT. The comparison indicated that the analytical solution could predict the semi-major axis with an accuarcy of better than ~35meters over a period of 3 month.

  1. [Laparoscopic management of ureteroileal stenosis: Long term follow up. (United States)

    Emiliani, Esteban; Gavrilov, Pavel; Mayordomo, Olga; Salvador, Josep; Palou, Joan; Rosales, Antonio; Villavicencio, Humberto


    To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series. A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Complications were described with the Clavien-Dindo classification. The surgical technique was described and a literature review was performed. Eleven procedures were performed in ten patients. Mean blood loss was 180 ml. All the operations were performed laparoscopically without conversion. Mean hospital stay was 10 days (4-23). Early complications were Clavien-Dindo I y II: Two cases of limited anastomosis leakage, one lymphorrea, one paralitic ileum and one accidental descent of the ureteral catheter. Mean follow-up was 56 months (12-179) No late complications have been described. Based on our series with 5 year follow up, the laparoscopic approach for uretero-ileal anastomosis strictures is feasible and safe.

  2. Long-term treatment of severe hypertension with minoxidil. (United States)

    Nawar, T.; Nolin, L.; Plante, G. E.; Caron, C.; Montambault, P.


    Minoxidil, a new potent hypotensive agent, was used as the primary antihypertensive agent in 11 patients--10 men and 1 woman aged 35 to 54 years with severe hypertension that was refractory to treatment with maximal (or maximally tolerated) doses of conventional antihypertensive agents. Six patients had severely impaired renal function and three of them were undergoing long-term hemodialysis. The patients were given 2.5 to 40 mg/d of minoxidil for periods of 2 to 29 months. All except one who was almost anuric received propranolol and diuretics. Blood pressure was controlled satisfactorily in all patients. In two patients the hypertension became partially resistant after 1 year of treatment. The main side effects were sodium retention, tachycardia and hirsutism. Renal function remained stable or improved and hemodialysis was discontinued in two patients. Minoxidil is a remarkably potent hypotensive with relatively few side effects and seems particularly advantageous in patients with chronic renal failure. PMID:603847

  3. GEMS: Underwater spectrometer for long-term radioactivity measurements

    Energy Technology Data Exchange (ETDEWEB)

    Sartini, Ludovica, E-mail: ludovica.sartini@ingv.i [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Sect.Roma 2, Roma (Italy); Genoa University, Genoa (Italy); Simeone, Francesco; Pani, Priscilla [' Sapienza' University and Istituto Nazionale di Fisica Nucleare (INFN), Sect.Roma, Roma (Italy); Lo Bue, Nadia; Marinaro, Giuditta [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Sect.Roma 2, Roma (Italy); Grubich, Andry; Lobko, Alexander [Institute for Nuclear Problems (INP), Belarus State University, Minsk (Belarus); Etiope, Giuseppe [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Sect.Roma 2, Roma (Italy); Capone, Antonio [' Sapienza' University and Istituto Nazionale di Fisica Nucleare (INFN), Sect.Roma, Roma (Italy); Favali, Paolo [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Sect.Roma 2, Roma (Italy); Gasparoni, Francesco; Bruni, Federico [Tecnomare S.p.A., Venice (Italy)


    GEMS (Gamma Energy Marine Spectrometer) is a prototype of an autonomous radioactivity sensor for underwater measurements, developed in the framework for a development of a submarine telescope for neutrino detection (KM3NeT Design Study Project). The spectrometer is highly sensitive to gamma rays produced by {sup 40}K decays but it can detect other natural (e.g., {sup 238}U,{sup 232}Th) and anthropogenic radio-nuclides (e.g., {sup 137}Cs). GEMS was firstly tested and calibrated in the laboratory using known sources and it was successfully deployed for a long-term (6 months) monitoring at a depth of 3200 m in the Ionian Sea (Capo Passero, offshore Eastern Sicily). The instrument recorded data for the whole deployment period within the expected specifications. This monitoring provided, for the first time, a continuous time-series of radioactivity in deep-sea.

  4. Long-term safety of left renal vein division and ligation to expedite complex abdominal aortic surgery. (United States)

    Samson, Russell H; Lepore, Michael R; Showalter, David P; Nair, Deepak G; Lanoue, Julien B


    Left renal vein division and ligation (LRVDAL) is performed to facilitate complex abdominal aortic surgery. Surgeons restore continuity of the vein due to concern that ligation could cause renal compromise or hematuria. However, we report the short and long-term safety of left renal vein division and ligation. Between 1992 and 2007, we divided the left renal vein in 56 patients (40 males, 16 females) ages 57 to 84 (average 74-years-old) who were treated for aortic occlusive disease (9) or abdominal aortic aneurysm (47). Patients requiring concomitant renal artery reconstruction were excluded from this review. Suprarenal cross-clamp was used in 51 patients with temporary vessel-loop control of the renal arteries. Creatinine (Cr) and glomerular filtration rates (eGFR) were measured pre-, post-, and long-term after surgery. Outpatient records of all patients that had survived more than 12 months were also reviewed in order to evaluate the late effects on renal function or symptoms possibly related to LRVDAL. Median procedure duration was 157 (61-375) minutes. Median cross-clamp time was 16 (10-45) minutes. Median intensive care unit (ICU) and hospital length of stays were 2 (1-11) days and 7 (4-58) days, respectively. There were no deaths. There were no complications directly related to renal vein ligation. Hematuria, seen in 2 patients, was a result of traumatic insertion of a Foley catheter. Median pre-op and discharge Cr levels were 1.1 mg/dL (0.7-2.4 mg/dL) and 1.1 mg/dL (0.6-2.1 mg/dL), respectively (P 2.0 mg/dL remained unchanged post-op. Only 2 patients with a Cr of 2.0 mg/dL and both returned to normal by day 3 post-op. Thirty-six patients have been followed for more than a year (median 34.5 months, maximum 144 months) and Cr has remained stable in all but 2 patients. These 2 patients, both with a pre-op Cr of 1.5 mg/dL, subsequently developed Cr levels of 2.1 mg/dL and 2.4 mg/dL but maintained baseline Cr levels for 25 and 34 months, respectively, before

  5. Long term results of 125I for treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Bremner, W.F.; McDougall, I.R.; Greig, W.R.; Ratcliffe, J.G.


    125 I emits very low energy conversion and Auger electrons. This radionuclide has been used in place of 131 I with the hope of reducing the incidence of post treatment hypothyroidism. 303 of 360 patients treated have been reviewed. Originally very large doses of 125 I were prescribed (751-1,600 μCi/g) but 9 out of 15 patients (60%) became hypothyroid, therefore 4 smaller therapeutic regimes were employed. (1) 55 patients received doses of 200 μCi or less/g thyroid, 69% are euthyroid and 24% hypothyroid after an average of 33 months from treatment. (2) 87 patients received doses of 201-350 μCi/g thyroid, 67% are euthyroid and 21% hypothyroid after an average follow up of 30 months. (3) 70 patients received doses of 351-500 μCi/g thyroid, 77% are euthyroid and 18% hypothyroid 36 months after treatment and (4) 76 patients received doses of 501-750 μCi/g, 41% are euthyroid and 56% hypothyroid 49 months after therapy. No long term complications such as thyroid cancer or leukaemia have occurred but because 125 I does not eliminate or reduce the incidence of post treatment hypothyroidism it probably should not be used in preference to 131 I for the routine treatment of hyperthyroidism

  6. Long-term Study of a Quadrivalent Human Papillomavirus Vaccine

    DEFF Research Database (Denmark)

    Ferris, Daron; Samakoses, Rudiwilai; Block, Stan L


    BACKGROUND: We present a long-term safety, immunogenicity, and effectiveness study of a quadrivalent human papillomavirus (HPV4) vaccine. METHODS: Sexually naive boys and girls aged 9 to 15 years (N = 1781) were assigned (2:1) to receive HPV4 vaccine or saline placebo at day 1 and months 2 and 6...... objective was to estimate vaccine effectiveness against HPV6/11/16/18-related persistent infection or disease. RESULTS: For each of the HPV4 vaccine types, vaccination-induced anti-HPV response persisted through month 96. Among 429 subjects who received HPV4 vaccine at a mean age of 12, none developed HPV6....../11/16/18-related disease or persistent infection of ≥12 months' duration. Acquisition of new sexual partners (among those ≥16 years) was ∼1 per year. Subjects receiving HPV4 vaccine at month 30 (mean age 15 years) had a similar baseline rate of seropositivity to ≥1 of the 4 HPV types to those vaccinated at day 1...

  7. Long term surgical treatment outcome of talar body fracture

    Directory of Open Access Journals (Sweden)

    Sen Ramesh Kumar


    Full Text Available 【Abstract】Objective: Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures. Methods: Eight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level I trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot (antero-posterior, lateral and oblique views and ankle (antero-posterior, lateral and mortise views were obtained. The patients were followed up both radiologically and functionally (foot function index, FFI after 3 weeks, 6 weeks, 3 months, 6 months and then annually. Results: There were five crush fractures and three shear fractures (two sagittal shear and one coronal shear, with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis of talar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological outcome. Conclusions: Late complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation. Key words: Fractures, bone; Talus; Fracture fixation, internal

  8. Socioeconomics of long-term glaucoma therapy in India

    Directory of Open Access Journals (Sweden)

    Bhagabat Nayak


    Full Text Available Purpose: To determine the socioeconomic impact of long-term glaucoma therapy. Materials and Methods: One hundred and fifty consecutive glaucoma patients on medical therapy, following up at our glaucoma service for at least 6 months were recruited. A questionnaire regarding monthly income, cost of glaucoma medications prescribed, availability of medications, travel time, time spent in review clinics, compliance, education status, medical insurance and systemic or local side-effects was administered. Results: The patients seen at the tertiary government hospital had an average monthly income of Rs. 10,912/- (range: Rs. 500/- to Rs. 50,000/- with approximately 56% of the patients having an income of less than Rs. 5000/month. The expenditure on anti-glaucoma medications ranged from 0.3% in high income group to 123% of their monthly gross income in low income group (P < 0.0001. The total expenditure including travel, stay, and loss of wages of patients and accompanying persons ranged from 1.6% in high income group to 137% of the monthly income in low income group (P < 0.0001. Mean time required for a glaucoma clinic visit was 15.66 h, (range: 6-96 h/month. About 2.7% experienced systemic side-effects and 21.3% had complaints of ocular adverse effects. About 90% of the patients were compliant. 92% were not covered by any insurance plan/government reimbursement for their treatment. Conclusions: Medical therapy for glaucoma is an economic burden to many patients and should be individualized, according to the socioeconomic status, availability of drugs and the required distance to travel to reach the specialist clinics.

  9. Northern European long term climate archives

    Energy Technology Data Exchange (ETDEWEB)

    Hohl, Veronica [Stockholm Univ. (Sweden)


    The Swedish Nuclear Fuel and Waste Management Company is responsible for the management and disposal of Sweden's radioactive waste. It is intended to deposit the spent nuclear fuel in a deep geological repository. This repository shall keep the radiotoxic material separated from humans and the environment for extended periods, from decades to millennia and possibly to geological timescales. During this time perspective climate induced changes such as shore-level displacement and evolution of permafrost and ice sheets are expected to occur which may affect the repository. The possible occurrence, extent and duration of these long-term changes, are therefore of interest when considering the assessment of repository performance and safety. The main climate parameters determining both surface and subsurface conditions are temperature and precipitation. As a result of the last advance of the Weichselian ice sheet only few geological archives exist, which contain information on past climatic conditions in Sweden before c 16,000 years BP. The purpose of this literature review is to compile and evaluate available information from Scandinavian, Northern and Central European geological archives, which record climatic conditions during the Weichselian time period. The compilation provides paleotemperature data sets, which may be used to explore the possible evolution of periglacial permafrost in Sweden. This report is a synopsis of 22 publications detailing climatic and environmental changes during the Weichselian time period in Northwestern Europe based on quantified paleotemperature records. Some of the data is presented as temperature curves which were digitised specifically for this report. The time range covered by the different publications varies considerably. Only few authors dealt with the whole Weichselian period and the majority cover only a few thousand years. This however is not considered to influence the reliability of the archives. The reason for the

  10. Northern European long term climate archives

    International Nuclear Information System (INIS)

    Hohl, Veronica


    The Swedish Nuclear Fuel and Waste Management Company is responsible for the management and disposal of Sweden's radioactive waste. It is intended to deposit the spent nuclear fuel in a deep geological repository. This repository shall keep the radiotoxic material separated from humans and the environment for extended periods, from decades to millennia and possibly to geological timescales. During this time perspective climate induced changes such as shore-level displacement and evolution of permafrost and ice sheets are expected to occur which may affect the repository. The possible occurrence, extent and duration of these long-term changes, are therefore of interest when considering the assessment of repository performance and safety. The main climate parameters determining both surface and subsurface conditions are temperature and precipitation. As a result of the last advance of the Weichselian ice sheet only few geological archives exist, which contain information on past climatic conditions in Sweden before c 16,000 years BP. The purpose of this literature review is to compile and evaluate available information from Scandinavian, Northern and Central European geological archives, which record climatic conditions during the Weichselian time period. The compilation provides paleotemperature data sets, which may be used to explore the possible evolution of periglacial permafrost in Sweden. This report is a synopsis of 22 publications detailing climatic and environmental changes during the Weichselian time period in Northwestern Europe based on quantified paleotemperature records. Some of the data is presented as temperature curves which were digitised specifically for this report. The time range covered by the different publications varies considerably. Only few authors dealt with the whole Weichselian period and the majority cover only a few thousand years. This however is not considered to influence the reliability of the archives. The reason for the varying

  11. Hot functional test chemistry - long term experience

    International Nuclear Information System (INIS)

    Vonkova, K.; Kysela, J.; Marcinsky, M.; Martykan, M.


    Primary circuit materials undergo general corrosion in high temperature, deoxygenated, neutral or mildly alkaline solutions to form thin oxide films. These oxide layers (films) serve as protective film and mitigate the further corrosion of primary materials. Inner chromium-rich oxide layer has low cation diffusion coefficients and thus control iron and nickel transport from the metal surface to the outer layer and their dissolution into the coolant. Much less corrosion products are generated by the compact, integral and stable oxide (passivation) layer. For the latest Czech and Slovak stations commissioned (Temelin and Mochovce) a modified Hot Functional Test (HFT) chemistry was developed in the NRI Rez. Chromium rich surface layer formatted due to modified HTF chemistry ensures lower corrosion rates and radiation field formation and thus also mitigates crud formation during operation. This procedure was also designed to prepare the commissioned unit for the further proper water chemistry practise. Mochovce 1 (SK) was the first station commissioned using these recommendations in 1998. Mochovce 2 (1999) and Temelin 1 and 2 (CZ - 2000 and 2002) were subsequently commissioned using these guidelines too. The main principles of the controlled primary water chemistry applied during the hot functional tests are reviewed and importance of the water chemistry, technological and other relevant parameters is stressed regarding to the quality of the passive layer formed on the primary system surfaces. Samples from Mochovce indicated that duplex oxide layers up to 20 μm thick were produced, which were mainly magnetite substituted with nickel and chromium (e.g. 60-65% Fe, 18-28% Cr, 9-12% Ni, <1% Mn and 1-2% Si on a stainless steel primary circuit sample). Long term operation experience from both nuclear power plants are discussed in this paper. Radiation field, occupational radiation exposure and corrosion layers evolution during the first c. ten years of operation are

  12. Beyond Initial Encoding: Measures of the Post-Encoding Status of Memory Traces Predict Long-Term Recall during Infancy (United States)

    Pathman, Thanujeni; Bauer, Patricia J.


    The first years of life are witness to rapid changes in long-term recall ability. In the current research we contributed to an explanation of the changes by testing the absolute and relative contributions to long-term recall of encoding and post-encoding processes. Using elicited imitation, we sampled the status of 16-, 20-, and 24-month-old…

  13. What Three-Year-Olds Remember from Their Past: Long-Term Memory for Persons, Objects, and Actions (United States)

    Hirte, Monika; Graf, Frauke; Kim, Ziyon; Knopf, Monika


    From birth on, infants show long-term recognition memory for persons. Furthermore, infants from six months onwards are able to store and retrieve demonstrated actions over long-term intervals in deferred imitation tasks. Thus, information about the model demonstrating the object-related actions is stored and recognition memory for the objects as…

  14. Long-term experience on surgical treatment of alveolar echinococcosis. (United States)

    Buttenschoen, Klaus; Carli Buttenschoen, Daniela; Gruener, Beate; Kern, Peter; Beger, Hans G; Henne-Bruns, Doris; Reuter, Stefan


    Alveolar echinococcosis (AE) is life-threatening and reports on surgical procedures and results are rare, but essential. Longitudinal surveillance and long-term follow-up of patients surgically treated for AE during the periods 1982-1999 (group A) and 2000-2006 (group B). University hospital within an endemic area. The median (min-max) follow-up period was 141 (5-417) months. Forty-eight surgical procedures were performed in 36 patients with AE: 63% were partial resections of the liver (additional extrahepatic resection in ten of them), 17% just extrahepatic resections, 10% biliodigestive anastomosis, and 10% exploratory laparotomies. Seventy-five percent of the operations were first-time procedures, 25% done due to a relapse. Forty-two percent of the operations were estimated to be curative (R0), whereas 58% were palliative (R1, R2). All patients had additional medical treatment and periodical follow-up. Two out of 18 (11%) patients, estimated to have had curative surgery, developed a relapse 42 and 54 months later. R0-resection rates depended on the primary, neighboring, metastasis stage of AE (S1, 100%; S2, 100%; S3a, 33%; S3b, 27%; S4, 11%). During the period 2000-2006 elective radical surgery for AE was done only if a safe distance of at least 2 cm was attainable. This concept was associated with an increased R0-resection rate of 87% for group B compared to 24% for group A. Operative procedures done to control complicated courses of AE (jaundice, cholangitis, vascular compression, bacterial superinfection) have not been curative (R2) in 82% because the disease had spread into irresectable structures. Morbidity was 19%. All patients with curative resections are alive. Fifty-six percent of the patients with palliative treatment are alive as long as 14-237 months, 28% died from AE 164-338 months after diagnosis (late lethality), and 17% died due to others diseases 96-417 months after diagnosis of AE. One out of seven (14%) patients suffering from suppurative

  15. Endoscopic rendezvous procedure for ureteral iatrogenic detachment: report of a case series with long-term outcomes. (United States)

    Pastore, Antonio Luigi; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Autieri, Domenico; Ripoli, Andrea; Maggioni, Cristina; Al Salhi, Yazan; Carbone, Antonio


    Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment. Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases. The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted.

  16. Dystrophic Cutaneous Calcification and Metaplastic Bone Formation due to Long Term Bisphosphonate Use in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Ali Murat Tatlı


    Full Text Available Bisphosphonates are widely used in the treatment of breast cancer with bone metastases. We report a case of a female with breast cancer presented with a rash around a previous mastectomy site and a discharge lesion on her right chest wall in August 2010. Biopsy of the lesion showed dystrophic calcification and metaplastic bone formation. The patient’s history revealed a long term use of zoledronic acid for the treatment of breast cancer with bone metastasis. We stopped the treatment since we believed that the cutaneous dystrophic calcification could be associated with her long term bisphosphonate therapy. Adverse cutaneous events with bisphosphonates are very rare, and dystrophic calcification has not been reported previously. The dystrophic calcification and metaplastic bone formation in this patient are thought to be due to long term bisphosphonate usage.

  17. Endogenous, reactive and neurotic depression -- diagnostic stability and long-term outcome

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel


    with a diagnosis of endogenous, reactive or neurotic depression according to ICD-8 were identified in a nationwide register of admissions to psychiatric wards. Patients were followed up to 1999 and the long-term diagnostic stability, the risk of relapse leading to readmission and the risk of suicide was analysed...... with reactive depression had less risk of relapse. No differences were found in the risk of completed suicide between the three groups of patients during long-term follow-up. CONCLUSIONS: The study does not provide evidence for re-establishing prior diagnostic systems of depressive disorders based......BACKGROUND: No larger long-term study has been conducted of outcomes of patients diagnosed with endogenous, reactive or neurotic depression and using survival methods in the analyses. SAMPLING AND METHODS: All patients who had had their first-ever discharge in the period from 1970 to 1994...

  18. Single-Incision Versus Three-Port Laparoscopic Appendectomy: Short- and Long-Term Outcomes. (United States)

    Vellei, Samatha; Borri, Alessandro


    To compare the outcome of patients who had undergone single-incision laparoscopic appendectomy (SILA) with others who had undergone three-port laparoscopic appendectomy (3-PORT). Data from all adults with uncomplicated appendicitis treated by laparoscopic appendectomy between June 2012 and December 2015 were prospectively collected. Patients with chronic pain, appendix malignancy, at least two previous laparotomies, and those undergoing concomitant surgery for different condition were excluded from analysis. Postoperative pain was assessed by a visual analog scale (VAS). Patients were reviewed postoperatively at 7 days and 1 month in the outpatient clinic. Late complications were assessed with a telephonic interview. A total of 91 patients were included (46 SILA; 45 3-PORT). There were 16 males and 30 females in the SILA group (mean age = 26.76 ± 10.58 years) and 18 males and 27 females in the 3-PORT group (mean age = 26.84 ± 10.79 years). The mean operative time for SILA was 48.54 ± 12.80 min, for the 3-PORT group the mean operative time was 46.33 ± 15.54 min (P = 0.46). No case required conversion. Mean postoperative hospital length of stay was 1.87 ± 0.69 days for SILA and 2.38 ± 1.11 days for 3-PORT (P = 0.01). VAS value of 3.91 ± 1.96 and mean ketorolac usage of 0.38 ± 0.65 in 3-PORT group and SILA patients reported 3.70 ± 1.58 and 0.39 ± 0.58, respectively (P = 0.91). Our mean follow-up in SILA group was 25.75 ± 10.82 months, for 3-PORT group the mean follow-up was 26.9 ± 11.8 months. Eleven patients missed long-term follow-up. No incisional hernia was found. There is a statistically significant difference in cosmetic evaluation in favor of SILA (P PORT laparoscopic appendectomy, but after SILA procedure discharge was quicker and long-term cosmetic satisfaction was superior.

  19. Balloon dilatation of tuberculous bronchial stenosis: immediate and long term effect

    International Nuclear Information System (INIS)

    Lee, Sang Yoon; Kwak, Byung Kook; Kang, Ho Yeong; Kim, Tae Hoon; Kim, Soo Rhan; Park, Hyun Sun; Lee, Shin Hyung; Lee, Chang Joon


    To evaluate the long-term immediate effects of balloon dilatation of the tuberculous bronchial stenosis. Twenty-three women with tuberculous bronchial stenosis (19, left main bronchus ; 4, right main bronchus) underwent balloon dilatation (13 bronchoscopically guided ; 10 fluoroscopically guided). Immediate (n=23) and long-term follow-up (mean, 17.2 months; range, 1month-6years 3months ; n=20) assessments focused on changes in the results of the pulmonary function test (PFT). An increase in FVC or FEVI of more than 10% after the procedure was considered effective. In all patients, any complications were evaluated. Balloon dilatation was effective at immediate follow-up in 69.5% of patients(16/23) and in 75.0%(15/20) at long-term follow-up. Bronchoscopically and fluoroscopically-guided balloon dilatation proved effective in 61.5%(8/13) and 80.0% of patients(8/10) on immediate follow-up respectively, but in 90.0%(9/10) and 60.0%(6/10) on long term follow-up respectively. Balloon dilatation was effective in the active(n 10) and inactive(n = 13) stage of tuberculous bronchitis in 80.0%(8/10) and 61.5% of cases(8/13) on immediate follow-up respectively, but in 66.6%(6/9) and 81.8%(9/11) on long term follow-up study, respectively. On immediate follow-up, balloon dilatation of tubular bronchial stenosis was more effective in the active than in the inactive stage, but on long-term follow-up was less effective ; long-term improvement in the inactive stage was, however, well-maintained

  20. Long-Term Quality of Life Outcome After Proton Beam Monotherapy for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Coen, John J., E-mail: [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Paly, Jonathan J.; Niemierko, Andrzej; Weyman, Elizabeth [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Rodrigues, Anita [Department of Medical Oncology, Massachusetts General Hospital, Boston, MA (United States); Shipley, William U.; Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Talcott, James A. [Department of Medical Oncology, Massachusetts General Hospital, Boston, MA (United States)


    Objectives: High-dose external radiation for localized prostate cancer results in favorable clinical outcomes and low toxicity rates. Here, we report long-term quality of life (QOL) outcome for men treated with conformal protons. Methods: QOL questionnaires were sent at specified intervals to 95 men who received proton radiation. Of these, 87 men reported 3- and/or 12-month outcomes, whereas 73 also reported long-term outcomes (minimum 2 years). Symptom scores were calculated at baseline, 3 months, 12 months, and long-term follow-up. Generalized estimating equation models were constructed to assess longitudinal outcomes while accounting for correlation among repeated measures in an individual patient. Men were stratified into functional groups from their baseline questionnaires (normal, intermediate, or poor function) for each symptom domain. Long-term QOL changes were assessed overall and within functional groups using the Wilcoxon signed-rank test. Results: Statistically significant changes in all four symptom scores were observed in the longitudinal analysis. For the 73 men reporting long-term outcomes, there were significant change scores for incontinence (ID), bowel (BD) and sexual dysfunction (SD), but not obstructive/irritative voiding dysfunction (OID). When stratified by baseline functional category, only men with normal function had increased scores for ID and BD. For SD, there were significant changes in men with both normal and intermediate function, but not poor function. Conclusions: Patient reported outcomes are sensitive indicators of treatment-related morbidity. These results quantitate the long-term consequences of proton monotherapy for prostate cancer. Analysis by baseline functional category provides an individualized prediction of long-term QOL scores. High dose proton radiation was associated with small increases in bowel dysfunction and incontinence, with more pronounced changes in sexual dysfunction.

  1. Development of long-term event memory in preverbal infants: an eye-tracking study


    Nakano, Tamami; Kitazawa, Shigeru


    The development of long-term event memory in preverbal infants remains elusive. To address this issue, we applied an eye-tracking method that successfully revealed in great apes that they have long-term memory of single events. Six-, 12-, 18- and 24-month-old infants watched a video story in which an aggressive ape-looking character came out from one of two identical doors. While viewing the same video again 24?hours later, 18- and 24-month-old infants anticipatorily looked at the door where ...

  2. Long term lymphocyte reconstitution after alemtuzumab treatment of multiple sclerosis

    KAUST Repository

    Hill-Cawthorne, Grant A.; Button, Tom; Tuohy, Orla C.; Jones, Joanne L.; May, Karen; Somerfield, Jennifer; Green, Alison J E; Giovannoni, Gavin; Compston, Alastair D.; Fahey, Michael T.; Coles, Alasdair J.


    Background: Alemtuzumab is a lymphocyte depleting monoclonal antibody that has demonstrated superior efficacy over interferon β-1a for relapsing-remitting multiple sclerosis (MS), and is currently under investigation in phase 3 trials. One unresolved issue is the duration and significance of the lymphopenia induced. The long term effects on lymphocyte reconstitution of a single course, and the consequences that this has on disability, morbidity, mortality and autoimmunity, were examined. Methods: The lymphocyte reconstitution (n=36; 384 person years) and crude safety data (n=37; 447 person years) are reported for the first patients with progressive MS to receive alemtuzumab (1991-1997). Reconstitution time was expressed as a geometric mean or, when a non-negligible number of individuals failed to recover, as a median using survival analysis. Results: Geometric mean recovery time (GMRT) of total lymphocyte counts to the lower limit of the normal range (LLN; ≥1.0×10 9 cells/l) was 12.7 months (95% CI 8.8 to 18.2 months). For B cells, GMRT to LLN (≥0.1×10 9/l) was 7.1 months (95% CI 5.3 to 9.5); median recovery times for CD8 (LLN ≥0.2×10 9 cells/l) and CD4 lymphocytes (LLN ≥0.4×10 9 cells/l) were 20 months and 35 months, respectively. However, CD8 and CD4 counts recovered to baseline levels in only 30% and 21% of patients, respectively. No infective safety concerns arose during 447 person years of follow-up. Conclusions: Lymphocyte counts recovered to LLN after a single course of alemtuzumab in approximately 8 months (B cells) and 3 years (T cell subsets), but usually did not recover to baseline values. However, this long lasting lymphopenia in patients with a previously normal immune system was not associated with an increased risk of serious opportunistic infection.

  3. Long term lymphocyte reconstitution after alemtuzumab treatment of multiple sclerosis

    KAUST Repository

    Hill-Cawthorne, Grant A.


    Background: Alemtuzumab is a lymphocyte depleting monoclonal antibody that has demonstrated superior efficacy over interferon β-1a for relapsing-remitting multiple sclerosis (MS), and is currently under investigation in phase 3 trials. One unresolved issue is the duration and significance of the lymphopenia induced. The long term effects on lymphocyte reconstitution of a single course, and the consequences that this has on disability, morbidity, mortality and autoimmunity, were examined. Methods: The lymphocyte reconstitution (n=36; 384 person years) and crude safety data (n=37; 447 person years) are reported for the first patients with progressive MS to receive alemtuzumab (1991-1997). Reconstitution time was expressed as a geometric mean or, when a non-negligible number of individuals failed to recover, as a median using survival analysis. Results: Geometric mean recovery time (GMRT) of total lymphocyte counts to the lower limit of the normal range (LLN; ≥1.0×10 9 cells/l) was 12.7 months (95% CI 8.8 to 18.2 months). For B cells, GMRT to LLN (≥0.1×10 9/l) was 7.1 months (95% CI 5.3 to 9.5); median recovery times for CD8 (LLN ≥0.2×10 9 cells/l) and CD4 lymphocytes (LLN ≥0.4×10 9 cells/l) were 20 months and 35 months, respectively. However, CD8 and CD4 counts recovered to baseline levels in only 30% and 21% of patients, respectively. No infective safety concerns arose during 447 person years of follow-up. Conclusions: Lymphocyte counts recovered to LLN after a single course of alemtuzumab in approximately 8 months (B cells) and 3 years (T cell subsets), but usually did not recover to baseline values. However, this long lasting lymphopenia in patients with a previously normal immune system was not associated with an increased risk of serious opportunistic infection.

  4. Long-term follow-up of psilocybin-facilitated smoking cessation. (United States)

    Johnson, Matthew W; Garcia-Romeu, Albert; Griffiths, Roland R


    A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

  5. Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator. (United States)

    Bigliazzi, Renato; Franchi, Lorenzo; Bertoz, André Pinheiro de Magalhães; McNamara, James A; Faltin, Kurt; Bertoz, Francisco Antonio


    To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

  6. Long-term socioeconomic impacts of flooding in Bangladesh (United States)

    Jina, A.


    Natural disasters lead to myriad negative impacts upon society, causing loss of life, property, and income. Among disasters, floods annually affect the most people, and lead to widespread negative outcomes, particularly in developing countries. While immediate effects of disasters are readily observed, long-term socioeconomic effects have received little attention. Recent work in development economics finds that environmental exposure in early life can have negative impacts upon later outcomes in health, education, and labor markets. Such research is problematic for disasters, however, as objective measurements of hazard exposure are difficult to obtain. This study develops a remote sensing method to detect flooding in Bangladesh, one of the most flood-prone countries, using MODIS 8-day composite data. This approach addresses one of the main problems in the literature on the social impacts of disasters by deriving an objective measure rather than using self-reported damages. Flood data from 2000-2012 is matched to geolocated social surveys conducted by the Bangladesh government to identify impacts of exposure to floods at critical periods of life. While flooding is noted to be a natural and important part of ecosystem functioning in Bangladesh, we aim to understand the impacts of a flood of greater than normal magnitude or abnormal timing to identify the effects on human capital formation. We find that an increase in flooding of one standard deviation (SD) above the mean in the birth month leads to a 3% increase in stunting (2 SD below cohort height). This has implications for physical and cognitive development, shown elsewhere to persist to adulthood. We find that children from households that are exposed to floods while in elementary school are more likely to drop out. Other impacts will be identified in the course of this research. The stated impacts suggest that the long-term health and economic fortunes of the rural poor in Bangladesh are significantly

  7. Reforming Long-Term Care Funding in Alberta. (United States)

    Crump, R Trafford; Repin, Nadya; Sutherland, Jason M


    Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

  8. Anticipatory eye movements and long-term memory in early infancy. (United States)

    Wong-Kee-You, Audrey M B; Adler, Scott A


    Advances in our understanding of long-term memory in early infancy have been made possible by studies that have used the Rovee-Collier's mobile conjugate reinforcement paradigm and its variants. One function that has been attributed to long-term memory is the formation of expectations (Rovee-Collier & Hayne, 1987); consequently, a long-term memory representation should be established during expectation formation. To examine this prediction and potentially open the door on a new paradigm for exploring infants' long-term memory, using the Visual Expectation Paradigm (Haith, Hazan, & Goodman, 1988), 3-month-old infants were trained to form an expectation for predictable color and spatial information of picture events and emit anticipatory eye movements to those events. One day later, infants' anticipatory eye movements decreased in number relative to the end of training when the predictable colors were changed but not when the spatial location of the predictable color events was changed. These findings confirm that information encoded during expectation formation are stored in long-term memory, as hypothesized by Rovee-Collier and colleagues. Further, this research suggests that eye movements are potentially viable measures of long-term memory in infancy, providing confirmatory evidence for early mnemonic processes. © 2016 Wiley Periodicals, Inc.

  9. Representativeness of shorter measurement sessions in long-term indoor air monitoring. (United States)

    Maciejewska, M; Szczurek, A


    Indoor air quality (IAQ) considerably influences health, comfort and the overall performance of people who spend most of their lives in confined spaces. For this reason, there is a strong need to develop methods for IAQ assessment. The fundamental issue in the quantitative determination of IAQ is the duration of measurements. Its inadequate choice may result in providing incorrect information and this potentially leads to wrong conclusions. The most complete information may be acquired through long-term monitoring. However it is typically perceived as impractical due to time and cost load. The aim of this study was to determine whether long-term monitoring can be adequately represented by a shorter measurement session. There were considered three measurable quantities: temperature, relative humidity and carbon dioxide concentration. They are commonly recognized as indicatives for IAQ and may be readily monitored. Scaled Kullback-Leibler divergence, also called relative entropy, was applied as a measure of data representativeness. We considered long-term monitoring in a range from 1 to 9 months. Based on our work, the representative data on CO2 concentration may be acquired while performing measurements during 20% of time dedicated to long-term monitoring. In the case of temperature and relative humidity the respective time demand was 50% of long-term monitoring. From our results, in indoor air monitoring strategies, there could be considered shorter measurement sessions, while still collecting data which are representative for long-term monitoring.

  10. Tiagabine improves hippocampal long-term depression in rat pups subjected to prenatal inflammation.

    Directory of Open Access Journals (Sweden)

    Aline Rideau Batista Novais

    Full Text Available Maternal inflammation during pregnancy is associated with the later development of cognitive and behavioral impairment in the offspring, reminiscent of the traits of schizophrenia or autism spectrum disorders. Hippocampal long-term potentiation and long-term depression of glutamatergic synapses are respectively involved in memory formation and consolidation. In male rats, maternal inflammation with lipopolysaccharide (LPS led to a premature loss of long-term depression, occurring between 12 and 25 postnatal days instead of after the first postnatal month, and aberrant occurrence of long-term potentiation. We hypothesized this would be related to GABAergic system impairment. Sprague Dawley rats received either LPS or isotonic saline ip on gestational day 19. Male offspring's hippocampus was studied between 12 and 25 postnatal days. Morphological and functional analyses demonstrated that prenatal LPS triggered a deficit of hippocampal GABAergic interneurons, associated with presynaptic GABAergic transmission deficiency in male offspring. Increasing ambient GABA by impairing GABA reuptake with tiagabine did not interact with the low frequency-induced long-term depression in control animals but fully prevented its impairment in male offspring of LPS-challenged dams. Tiagabine furthermore prevented the aberrant occurrence of paired-pulse triggered long-term potentiation in these rats. Deficiency in GABA seems to be central to the dysregulation of synaptic plasticity observed in juvenile in utero LPS-challenged rats. Modulating GABAergic tone may be a possible therapeutic strategy at this developmental stage.

  11. The Baltic Sea natural long-term variability of salinity (United States)

    Schimanke, Semjon; Markus Meier, H. E.


    The Baltic Sea is one of the largest brackish sea areas of the world. The sensitive state of the Baltic Sea is sustained by a fresh-water surplus by river discharge and precipitation on one hand as well as inflows of highly saline and oxygen-rich water masses from the North Sea on the other. Major inflows which are crucial for the renewal of the deep water occur very intermittent with a mean frequency of approximately one per year. Stagnation periods (periods without major inflows) lead for instance to a reduction of oxygen concentration in the deep Baltic Sea spreading hypoxic conditions. Depending on the amount of salt water inflow and fresh-water supply the deep water salinity of the Baltic Sea varies between 11 to 14 PSU on the decadal scale. The goal of this study is to understand the contribution of different driving factors for the decadal to multi-decadal variability of salinity in the Baltic Sea. Continuous measurement series of salinity exist from the 1950 but are not sufficiently long for the investigation of long-term fluctuations. Therefore, a climate simulation of more than 800 years has been carried out with the Rossby Center Ocean model (RCO). RCO is a biogeochemical regional climate model which covers the entire Baltic Sea. It is driven with atmospheric data dynamical downscaled from a GCM mimicking natural climate variability. The analysis focus on the role of variations in river discharge and precipitation, changes in wind speed and direction, fluctuations in temperature and shifts in large scale pressure patterns (e.g. NAO). Hereby, the length of the simulation will allow to identify mechanisms working on decadal to multi-decadal time scales. Moreover, it will be discussed how likely long stagnation periods are under natural climate variability and if the observed exceptional long stagnation period between 1983-1993 might be related to beginning climate change.

  12. Estimating mean long-term hydrologic budget components for watersheds and counties: An application to the commonwealth of Virginia, USA (United States)

    Sanford, Ward E.; Nelms, David L.; Pope, Jason P.; Selnick, David L.


    Mean long-term hydrologic budget components, such as recharge and base flow, are often difficult to estimate because they can vary substantially in space and time. Mean long-term fluxes were calculated in this study for precipitation, surface runoff, infiltration, total evapotranspiration (ET), riparian ET, recharge, base flow (or groundwater discharge) and net total outflow using long-term estimates of mean ET and precipitation and the assumption that the relative change in storage over that 30-year period is small compared to the total ET or precipitation. Fluxes of these components were first estimated on a number of real-time-gaged watersheds across Virginia. Specific conductance was used to distinguish and separate surface runoff from base flow. Specific-conductance (SC) data were collected every 15 minutes at 75 real-time gages for approximately 18 months between March 2007 and August 2008. Precipitation was estimated for 1971-2000 using PRISM climate data. Precipitation and temperature from the PRISM data were used to develop a regression-based relation to estimate total ET. The proportion of watershed precipitation that becomes surface runoff was related to physiographic province and rock type in a runoff regression equation. A new approach to estimate riparian ET using seasonal SC data gave results consistent with those from other methods. Component flux estimates from the watersheds were transferred to flux estimates for counties and independent cities using the ET and runoff regression equations. Only 48 of the 75 watersheds yielded sufficient data, and data from these 48 were used in the final runoff regression equation. Final results for the study are presented as component flux estimates for all counties and independent cities in Virginia. The method has the potential to be applied in many other states in the U.S. or in other regions or countries of the world where climate and stream flow data are plentiful.

  13. Long-term outcomes five years after selective dorsal rhizotomy

    Directory of Open Access Journals (Sweden)

    Lagergren Jan


    Full Text Available Abstract Background Selective dorsal rhizotomy (SDR is a well accepted neurosurgical procedure performed for the relief of spasticity interfering with motor function in children with spastic cerebral palsy (CP. The goal is to improve function, but long-term outcome studies are rare. The aims of this study were to evaluate long-term functional outcomes, safety and side effects during five postoperative years in all children with diplegia undergoing SDR combined with physiotherapy. Methods This study group consisted of 35 children, consecutively operated, with spastic diplegia, of which 26 were Gross Motor Function Classification System (GMFCS levels III–V. Mean age was 4.5 years (range 2.5–6.6. They were all assessed by the same multidisciplinary team at pre- and at 6, 12, 18 months, 3 and 5 years postoperatively. Clinical and demographic data, complications and number of rootlets cut were prospectively registered. Deep tendon reflexes and muscle tone were examined, the latter graded with the modified Ashworth scale. Passive range of motion (PROM was measured with a goniometer. Motor function was classified according to the GMFCS and measured with the Gross Motor Function Measure (GMFM-88 and derived into GMFM-66. Parent's opinions about the children's performance of skills and activities and the amount of caregiver assistance were measured with Pediatric Evaluation Disability Inventory (PEDI. Results The mean proportion of rootlets cut in S2-L2 was 40%. Muscle tone was immediately reduced in adductors, hamstrings and dorsiflexors (p Conclusion SDR is a safe and effective method for reducing spasticity permanently without major negative side effects. In combination with physiotherapy, in a group of carefully selected and systematically followed young children with spastic diplegia, it provides lasting functional benefits over a period of at least five years postoperatively.

  14. Hypothenar hammer syndrome: long-term results of vascular reconstruction. (United States)

    Endress, Ryan D; Johnson, Craig H; Bishop, Allen T; Shin, Alexander Y


    To evaluate long-term patency rates and related outcomes after vascular reconstruction of hypothenar hammer syndrome and identify patient- or treatment-related factors that may contribute to differences in outcome. We used color flow ultrasound to determine the patency of 18 vein graft reconstructions of the ulnar artery at the wrist in 16 patients. Validated questionnaires evaluated patients' functional disability with the Disabilities of the Arm, Shoulder, and Hand score, pain with the visual analog scale, and cold intolerance with the Cold Intolerance Symptom Severity survey. Patient demographics, clinical data, and surgical factors were analyzed for association with graft failure. Patients were asked to grade the result of treatment on a scale of 0 to 10. Of 18 grafts, 14 (78%) were occluded at a mean of 118 months postoperatively. Patients with patent grafts had significantly less disability related to cold intolerance according to the Cold Intolerance Symptom Severity survey in addition to significantly less pain on the visual analog scale. There was no statistical difference in Disabilities of the Arm, Shoulder, and Hand scores between patients with patent or occluded grafts. Patients graded the result significantly higher in patent reconstructions. We noted a higher incidence of graft occlusion than previously reported at a mean follow-up of 9.8 years, which represents a long-duration follow-up study of surgical treatment of hypothenar hammer syndrome. Despite a high percentage of occlusion, overall, patients remained satisfied with low functional disability and all would recommend surgical reconstruction. This study suggests that improved outcomes may result from patent grafts in the long term. Prognostic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  15. Long-term nutritional impact of sleeve gastrectomy. (United States)

    Caron, M; Hould, F S; Lescelleur, O; Marceau, S; Lebel, S; Julien, F; Simard, S; Biertho, Laurent


    Sleeve gastrectomy (SG) has become a predominant bariatric procedure throughout the world. However, the long-term nutritional impact of this procedure is unknown. To describe the nutritional deficiencies before and after SG and to analyze the influence of baseline weight on nutritional status. University-affiliated tertiary care center. All patients who underwent SG as a standalone procedure between 2008 and 2012 were included in this study. Patients were given multivitamin supplementation. Data were obtained from our prospectively maintained electronic database and are reported as mean ± standard deviation and percentage. Bivariate analyses were conducted to evaluate the influence of selected variables on outcomes. The mean age of the 537 patients was 48.0 ± 11.3 years, with an initial body mass index of 48.1 ± 8.7 kg/m 2 . Excess weight loss and total weight loss were 56.2% and 28.0% at 1 year and 43.0% and 21.1% at 5 years, respectively (Pvitamin B12 in 30.3% and 16.4% (Pvitamin D 63.2% and 24.3% (Pvitamin A insufficiency peaked from 7.9% preoperatively to 28.7% at 3 months (Pvitamin B12 and vitamin D. Nutritional deficiencies are common in patients with morbid obesity before and after surgery. Preoperative supplementation and long-term nutritional follow-up are required to prevent nutritional deficiencies. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  16. Long-term outcomes for adult craniopharyngioma following radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Masson-Cote, Laurence; Masucci, Giuseppina Laura; Millar, Barbara-Ann; Laperriere, Normand J. [Dept. of Radiation Oncology, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Atenafu, Eshetu G. [Dept. of Biostatistics, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Cusimano, Michael [Dept. of Surgery, Div. of Neurosurgery, St. Michaels Hospital, Toronto (Canada); Croul, Sidney [Dept. of Pathology, Univ. of Toronto, Toronto (Canada); Mason, Warren [Dept. of Medicine, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada); Sahgal, Arjun [Dept. of Radiation Oncology, Princess Margaret Hospital, Univ. of Toronto, Toronto (Canada), E-mail:; Dept. of Radiation Oncology, Sunnybrook Health Sciences Center, Univ. of Toronto, Toronto (Canada)


    Background. We report long-term outcomes in adult patients with craniopharyngioma following surgery and radiation therapy (RT). Material and methods. Fifty-three patients treated with RT (median, 50 Gy in 25 fractions) between 1980 and 2009 with pathologically confirmed craniopharyngioma were reviewed (53% solid and 47% cystic/solid). The median age was 53 years (range, 22-76), 53% were female, 83% were sub-totally resected, 6% were gross totally resected and 11% had a biopsy and/or cyst aspiration alone. RT was delivered adjuvantly in 53% of patients as opposed to salvage intent upon progression. Results. Median follow-up was seven years (86 months, range, 8-259). The 5- and 10-year progression-free survival (PFS) rates were 85% and 69%, overall survival (OS) rates were 76% and 70%, and cause-specific survival (CSS) rates were both 88%, respectively. Both univariable and multivariable analysis identified age (<53 or {>=}53) as a prognostic factor for OS (p =0.0003) and CSS (p =0.05). PFS was observed to be worse in patients with >2 surgeries prior to RT (p =0.01). Neither the intent of radiation or tumor type (cystic vs. solid/cystic) were prognostic or predictive. New endocrinopathies and visual dysfunction were observed in 53% and 17% of patients post-surgery, and in 11% and 6% post-RT, respectively. Conclusion. We report long-term favorable PFS, CSS and OS for craniopharyngioma post-RT. We observe age as a significant prognostic factor, however, timing of radiation was not.

  17. Long-term visual outcomes of craniopharyngioma in children. (United States)

    Wan, Michael J; Zapotocky, Michal; Bouffet, Eric; Bartels, Ute; Kulkarni, Abhaya V; Drake, James M


    Visual function is a critical factor in the diagnosis, monitoring, and prognosis of craniopharyngiomas in children. The aim of this study was to report the long-term visual outcomes in a cohort of pediatric patients with craniopharyngioma. The study design is a retrospective chart review of craniopharyngioma patients from a single tertiary-care pediatric hospital. 59 patients were included in the study. Mean age at presentation was 9.4 years old (range 0.7-18.0 years old). The most common presenting features were headache (76%), nausea/vomiting (32%), and vision loss (31%). Median follow-up was 5.2 years (range 1.0-17.2 years). During follow-up, visual decline occurred in 17 patients (29%). On Kaplan Meier survival analysis, 47% of the cases of visual decline occurred within 4 months of diagnosis, with the remaining cases occurring sporadically during follow-up (up to 8 years after diagnosis). In terms of risk factors, younger age at diagnosis, optic nerve edema at presentation, and tumor recurrence were found to have statistically significant associations with visual decline. At final follow-up, 58% of the patients had visual impairment in at least one eye but only 10% were legally blind in both eyes (visual acuity 20/200 or worse or < 20° of visual field). Vision loss is a common presenting symptom of craniopharyngiomas in children. After diagnosis, monitoring vision is important as about 30% of patients will experience significant visual decline. Long-term vision loss occurs in the majority of patients, but severe binocular visual impairment is uncommon.

  18. Long-term outcomes of treatment of hyperthyroidism in Ireland.

    LENUS (Irish Health Repository)

    Leary, A C


    We investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1\\/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves\\' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves\\' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.

  19. Long-term mobile phone use and acoustic neuroma risk. (United States)

    Pettersson, David; Mathiesen, Tiit; Prochazka, Michaela; Bergenheim, Tommy; Florentzson, Rut; Harder, Henrik; Nyberg, Gunnar; Siesjö, Peter; Feychting, Maria


    There is concern about potential effects of radiofrequency fields generated by mobile phones on cancer risk. Most previous studies have found no association between mobile phone use and acoustic neuroma, although information about long-term use is limited. We conducted a population-based, nation-wide, case-control study of acoustic neuroma in Sweden. Eligible cases were persons aged 20 to 69 years, who were diagnosed between 2002 and 2007. Controls were randomly selected from the population registry, matched on age, sex, and residential area. Postal questionnaires were completed by 451 cases (83%) and 710 controls (65%). Ever having used mobile phones regularly (defined as weekly use for at least 6 months) was associated with an odds ratio (OR) of 1.18 (95% confidence interval = 0.88 to 1.59). The association was weaker for the longest induction time (≥10 years) (1.11 [0.76 to 1.61]) and for regular use on the tumor side (0.98 [0.68 to 1.43]). The OR for the highest quartile of cumulative calling time (≥680 hours) was 1.46 (0.98 to 2.17). Restricting analyses to histologically confirmed cases reduced all ORs; the OR for ≥680 hours was 1.14 (0.63 to 2.07). A similar pattern was seen for cordless land-line phones, although with slightly higher ORs. Analyses of the complete history of laterality of mobile phone revealed considerable bias in laterality analyses. The findings do not support the hypothesis that long-term mobile phone use increases the risk of acoustic neuroma. The study suggests that phone use might increase the likelihood that an acoustic neuroma case is detected and that there could be bias in the laterality analyses performed in previous studies.

  20. Long-term consequences of vocal fold hemorrhage. (United States)

    Kerwin, Lewis J; Estes, Christine; Oromendia, Clara; Christos, Paul; Sulica, Lucian


    To assess the long-term impact of vocal fold hemorrhage (VFH) on vocal function and health, and compare these parameters to those in similar patients who have not had VFH. Retrospective cohort study. Patients with a history of VFH (N = 41) were characterized through a review of records and assessed by means of a survey for vocal health and professional functioning as well as the Voice Handicap Index-10 (VHI-10) and, if appropriate (n = 30, 73.2%), the Singing Voice Handicap Index (SVHI-10). They were compared to a group of demographically and occupationally similar patients without VFH (N = 25, 60.9%). Patients with multiple episodes of VFH (n = 9, 22.0%) were compared to patients with a single event. After a median of 41 months follow-up, patients with VFH had favorable vocal function assessment and low median VHI-10 and SVHI-10 scores (4 and 6, respectively), substantially similar to patients without VFH (VHI-10, P = .905 and SVHI 10, P =.991). The two groups showed similarly low rates of change in occupation (7.3%vs. 8.0%, P =.999). Patients with VFH were more likely to have missed days of work due to a voice problem. Analysis of patients with one versus multiple VFH episodes showed no differences, except patients with multiple episodes had significantly greater confidence in their ability to address future VFH. Contrary to commonly held belief, VFH appears to have no significant long-term impact on vocational stability, subjective voice quality, or perceptions of vocal function. Moreover, among those with VFH, recurrence seems only to diminish anxiety over this transient injury. 4 Laryngoscope, 127:900-906, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  1. A mechanism of midlatitude noontime foE long-term variations inferred from European observations (United States)

    Mikhailov, A. V.; Perrone, L.; Nusinov, A. A.


    Manually scaled June noontime monthly median foE values at three European stations Rome, Juliusruh, and Slough/Chilton were used to understand the mechanism of foE long-term variations. The 11 year running mean smoothed foE manifests long-term (for some solar cycles) variations with the rising phase at the end of 1960-1985 and the falling phase after 1985. A close relationship (even in details) between (foEave)11y and (R12)11y variations with the correlation coefficient of 0.996 (absolutely significant according to Fisher F criterion) suggests that the Sun is the source of these (foEave)11y long-term variations. After removing solar activity long-term variations the residual (foEave)11y trend is very small ( 0.029% per decade) being absolutely insignificant. This means that all (foEave)11y variations are removed with one solar activity index, (R12)11y, i.e., this means that long-term variations are fully controlled by solar activity. Theory of midlatitude daytime E region tells us that long-term variations of solar EUV in two lines λ = 977 Å (CIII) and λ = 1025.7 Å (HLyβ) and X-ray radiation with λ foE long-term variations have a natural (not anthropogenic) origin related to long-term variations of solar activity. No peculiarities in relation with the last deep solar minimum in 2008-2009 have been revealed.

  2. A cost of long-term memory in Drosophila


    Mery, Frederic; Kawecki, Tadeusz J.


    Two distinct forms of consolidated associative memory are known in Drosophila: long-term memory and so-called anesthesia-resistant memory. Long-term memory is more stable, but unlike anesthesia-resistant memory, its formation requires protein synthesis. We show that flies induced to form long-term memory become more susceptible to extreme stress (such as desiccation). In contrast, induction of anesthesia-resistant memory had no detectable effect on desiccation resistance. This finding may hel...

  3. Private long-term care insurance and state tax incentives. (United States)

    Stevenson, David G; Frank, Richard G; Tau, Jocelyn


    To increase the role of private insurance in financing long-term care, tax incentives for long-term care insurance have been implemented at both the federal and state levels. To date, there has been surprisingly little study of these initiatives. Using a panel of national data, we find that market take-up for long-term care insurance increased over the last decade, but state tax incentives were responsible for only a small portion of this growth. Ultimately, the modest ability of state tax incentives to lower premiums implies that they should be viewed as a small piece of the long-term care financing puzzle.

  4. Random fractional ultrapulsed CO2 resurfacing of photodamaged facial skin: long-term evaluation. (United States)

    Tretti Clementoni, Matteo; Galimberti, Michela; Tourlaki, Athanasia; Catenacci, Maximilian; Lavagno, Rosalia; Bencini, Pier Luca


    Although numerous papers have recently been published on ablative fractional resurfacing, there is a lack of information in literature on very long-term results. The aim of this retrospective study is to evaluate the efficacy, adverse side effects, and long-term results of a random fractional ultrapulsed CO2 laser on a large population with photodamaged facial skin. Three hundred twelve patients with facial photodamaged skin were enrolled and underwent a single full-face treatment. Six aspects of photodamaged skin were recorded using a 5 point scale at 3, 6, and 24 months after the treatment. The results were compared with a non-parametric statistical test, the Wilcoxon's exact test. Three hundred one patients completed the study. All analyzed features showed a significant statistical improvement 3 months after the procedure. Three months later all features, except for pigmentations, once again showed a significant statistical improvement. Results after 24 months were similar to those assessed 18 months before. No long-term or other serious complications were observed. From the significant number of patients analyzed, long-term results demonstrate not only how fractional ultrapulsed CO2 resurfacing can achieve good results on photodamaged facial skin but also how these results can be considered stable 2 years after the procedure.

  5. The community impact of consolidating long-term inpatient care at a single state hospital. (United States)

    Wolff, N


    A community impact model was used to estimate how consolidation of all long-term inpatient care at one state mental hospital affected the town in which the hospital was located. Qualitative and quantitative methods were used to measure objective and subjective impacts of the hospital's expanded role. Objective impacts included employment, retail sales, and use of local services such as police, welfare, and education. Subjective impacts included residents' perceptions of safety. Data were obtained from hospital records, service providers, merchants, residents, and persons living on the streets or in shelters. Overall, the policy had a positive net impact on the community, estimated at roughly $4 million during the 18 months after implementation. Nearly $1 million was a direct payment from the state in lieu of taxes for the property occupied by the hospital. The hospital's payments to businesses in the town increased 10 percent. The number of hospital employees increased by 61 percent, to 1,336. The number of local residents working in the hospital grew from 200 to 320, and the proportion of the hospital's annual payroll paid to local residents increased from 14 to 24 percent. Local service use did not increase, and no change was noted in the crime rate. More patients were discharged to other towns than were admitted from the host town. Eighty percent of the residents surveyed said the town had either improved or had not changed. The benefits brought by the consolidation are likely to be sustained in the long run if the state continues the current rate of payments to the community and the hospital continues its policy of discharging patients to the town where they resided before hospitalization.

  6. Iron Deficiency in Long-Term Parenteral Nutrition Therapy. (United States)

    Hwa, Yi L; Rashtak, Shahrooz; Kelly, Darlene G; Murray, Joseph A


    Iron is not routinely added to parenteral nutrition (PN) formulations in the United States because of the risk of anaphylaxis and concerns about incompatibilities. Studies have shown that iron dextran in non-lipid-containing PN solutions is safe. Data are limited on iron status, prevalence of iron deficiency anemia (IDA), and efficacy of intravenous iron infusion in long-term home PN (HPN). We aimed to determine the incidence of IDA and to examine the effectiveness of parenteral iron replacement in patients receiving HPN. Medical records of patients receiving HPN at the Mayo Clinic from 1977 to 2010 were reviewed. Diagnoses, time to IDA development, and hemoglobin, ferritin, and mean corpuscular volume (MCV) values were extracted. Response of iron indices to intravenous iron replacement was investigated. Of 185 patients (122 women), 60 (32.4%) were iron deficient. Five patients were iron deficient, and 18 had unknown iron status before HPN. Of 93 patients who had sufficient iron storage, 37 had IDA development after a mean of 27.2 months (range, 2-149 months) of therapy. Iron was replaced by adding maintenance iron dextran to PN or by therapeutic iron infusion. Patients with both replacement methods had significant improvement in iron status. With intravenous iron replacement, mean ferritin increased from 10.9 to 107.6 mcg/L (P Parenteral and Enteral Nutrition.

  7. Cognitive effects of pregabalin in the treatment of long-term benzodiazepine-use and dependence. (United States)

    Oulis, Panagiotis; Kalogerakou, Stamatina; Anyfandi, Eleni; Konstantakopoulos, George; Papakosta, Vassiliki-Maria; Masdrakis, Vasilios; Tsaltas, Eleftheria


    Long-term benzodiazepine (BDZ) use and dependence affect cognitive functioning adversely and partly irreversibly. Emerging evidence suggests that pregabalin (PGB) might be a safe and efficacious treatment of long-term BDZ use. The aim of the present study was to investigate the changes in several core cognitive functions after successful treatment of long-term BDZ use and dependence with PGB. Fourteen patients with long-term BDZ use (mean duration >15 years) underwent neuropsychological assessment with the mini-mental state examination and four tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) battery before the initiation of PGB treatment and at a two months follow-up after the cessation of BDZs. Patients' CANTAB percentile score distributions were compared with normative CANTAB data. Patients improved on cognitive measures of global cognitive functioning, time orientation, psychomotor speed, and visuospatial memory and learning with strong effect sizes. By contrast, they failed to improve on measures of attentional flexibility. Despite their significant improvement, patients' scores on most tests remained still at the lower percentiles of CANTAB normative scores. Although preliminary, our findings suggest that successful treatment of long-term BDZ use with PGB is associated with a substantial, though only partial, recovery of BDZ-compromised neuropsychological functioning, at least at a 2-month follow-up. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Gender differences in success at quitting smoking: Short- and long-term outcomes. (United States)

    Marqueta, Adriana; Nerín, Isabel; Gargallo, Pilar; Beamonte, Asunción


    Smoking cessation treatments are effective in men and women. However, possible sex-related differences in the outcome of these treatments remain a controversial topic. This study evaluated whether there were differences between men and women in the success of smoking cessation treatment, including gender-tailored components, in the short and long term (> 1 year). A telephone survey was carried out between September 2008 and June 2009 in smokers attended in a Smoking Cessation Clinic. All patients who have successfully completed treatment (3 months) were surveyed by telephone to determine their long-term abstinence. Those who remained abstinent were requested to attend the Smoking Cessation Clinic for biochemical validation (expired CO ≤10 ppm). The probability of remaining abstinent in the long-term was calculated using a Kaplan-Meier survival analysis. The treatment success rate at 3-months was 41.3% (538/1302) with no differences by sex 89% (479/538) among those located in the telephonic follow-up study and 47.6% (256/479) were abstinent without differences by sex (p = .519); abstinence was validated with CO less than 10 ppm in 191 of the 256 (53.9% men and 46.1% women). In the survival analysis, the probability of men and women remaining abstinent in the long-term was not significant. There are no differences by sex in the outcome of smoking cessation treatment that included gender-tailored components in the short and long term (> 1 year).

  9. Persistent increased PKMζ in long-term and remote spatial memory. (United States)

    Hsieh, Changchi; Tsokas, Panayiotis; Serrano, Peter; Hernández, A Iván; Tian, Dezhi; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton


    PKMζ is an autonomously active PKC isoform that is thought to maintain both LTP and long-term memory. Whereas persistent increases in PKMζ protein sustain the kinase's action in LTP, the molecular mechanism for the persistent action of PKMζ during long-term memory has not been characterized. PKMζ inhibitors disrupt spatial memory when introduced into the dorsal hippocampus from 1day to 1month after training. Therefore, if the mechanisms of PKMζ's persistent action in LTP maintenance and long-term memory were similar, persistent increases in PKMζ would last for the duration of the memory, far longer than most other learning-induced gene products. Here we find that spatial conditioning by aversive active place avoidance or appetitive radial arm maze induces PKMζ increases in dorsal hippocampus that persist from 1day to 1month, coinciding with the strength and duration of memory retention. Suppressing the increase by intrahippocampal injections of PKMζ-antisense oligodeoxynucleotides prevents the formation of long-term memory. Thus, similar to LTP maintenance, the persistent increase in the amount of autonomously active PKMζ sustains the kinase's action during long-term and remote spatial memory maintenance. Copyright © 2016. Published by Elsevier Inc.

  10. Discharges with surgical procedures performed less often than once per month per hospital account for two-thirds of hospital costs of inpatient surgery. (United States)

    O'Neill, Liam; Dexter, Franklin; Park, Sae-Hwan; Epstein, Richard H


    Most surgical discharges (54%) at the average hospital are for procedures performed no more often than once per month at that hospital. We hypothesized that such uncommon procedures would be associated with an even greater percentage of the total cost of performing all surgical procedures at that hospital. Observational study. State of Texas hospital discharge abstract data: 4th quarter of 2015 and 1st quarter of 2016. Inpatients discharged with a major therapeutic ("operative") procedure. For each of N=343 hospitals, counts of discharges, sums of lengths of stay (LOS), sums of diagnosis related group (DRG) case-mix weights, and sums of charges were obtained for each procedure or combination of procedures, classified by International Classification of Diseases version 10 Procedure Coding System (ICD-10-PCS). Each discharge was classified into 2 categories, uncommon versus not, defined as a procedure performed at most once per month versus those performed more often than once per month. Major procedures performed at most once per month per hospital accounted for an average among hospitals of 68% of the total inpatient costs associated with all major therapeutic procedures. On average, the percentage of total costs associated with uncommon procedures was 26% greater than expected based on their share of total discharges (Pcosts among surgical patients can be attributed to procedures performed at most once per month per hospital. The finding that such uncommon procedures account for a large percentage of costs is important because methods of cost accounting by procedure are generally unsuitable for them. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity. (United States)

    Blomquist, Caroline; Alvehus, Malin; Burén, Jonas; Ryberg, Mats; Larsson, Christel; Lindahl, Bernt; Mellberg, Caroline; Söderström, Ingegerd; Chorell, Elin; Olsson, Tommy


    Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed. Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent control diet (CD) for 24 months. Blood samples and fat biopsies were collected at baseline, 6 months, and 24 months to analyze inflammation-related parameters. Android fat decreased significantly more in the PD group (P = 0.009) during the first 6 months with weight maintenance at 24 months in both groups. Long-term significant effects (P obesity in postmenopausal women is linked to specific changes in inflammation-related adipose gene expression. © 2017 The Obesity Society.

  12. A Comparative Study of Glasgow Coma Scale and Full Outline of Unresponsiveness Scores for Predicting Long-Term Outcome After Brain Injury. (United States)

    McNett, Molly M; Amato, Shelly; Philippbar, Sue Ann


    The aim of this study was to compare predictive ability of hospital Glasgow Coma Scale (GCS) scores and scores obtained using a novel coma scoring tool (the Full Outline of Unresponsiveness [FOUR] scale) on long-term outcomes among patients with traumatic brain injury. Preliminary research of the FOUR scale suggests that it is comparable with GCS for predicting mortality and functional outcome at hospital discharge. No research has investigated relationships between coma scores and outcome 12 months postinjury. This is a prospective cohort study. Data were gathered on adult patients with traumatic brain injury admitted to urban level I trauma center. GCS and FOUR scores were assigned at 24 and 72 hours and at hospital discharge. Glasgow Outcome Scale scores were assigned at 6 and 12 months. The sample size was n = 107. Mean age was 53.5 (SD = ±21, range = 18-91) years. Spearman correlations were comparable and strongest among discharge GCS and FOUR scores and 12-month outcome (r = .73, p coma scores performed best for both tools, with GCS discharge scores predictive in multivariate models.

  13. A new image for long-term care. (United States)

    Wager, Richard; Creelman, William


    To counter widely held negative images of long-term care, managers in the industry should implement quality-improvement initiatives that include six key strategies: Manage the expectations of residents and their families. Address customers' concerns early. Build long-term customer satisfaction. Allocate resources to achieve exceptional outcomes in key areas. Respond to adverse events with compassion. Reinforce the facility's credibility.

  14. Setting the stage for long-term reproductive health. (United States)

    Payne, Craig A; Vander Ley, Brian; Poock, Scott E


    This article discusses some of the aspects of heifer development that contribute to long-term health and productivity, such as disease prevention and control. Nutrition is also an important component of long-term health, and body condition score is discussed as a way to determine whether the nutrient demands of heifers are being met. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Long-term effects of a preoperative smoking cessation programme

    DEFF Research Database (Denmark)

    Villebro, Nete Munk; Pedersen, Tom; Møller, Ann M


    Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation.......Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation....

  16. Pediatric polytrauma : Short-term and long-term outcomes

    NARCIS (Netherlands)

    vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

    Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

  17. Inflammatory markers in relation to long-term air pollution

    NARCIS (Netherlands)

    Mostafavi Montazeri, Nahid|info:eu-repo/dai/nl/375290575; Vlaanderen, Jelle|info:eu-repo/dai/nl/31403160X; Chadeau-Hyam, Marc; Beelen, Rob|info:eu-repo/dai/nl/30483100X; Modig, Lars; Palli, Domenico; Bergdahl, Ingvar A; Vineis, Paolo; Hoek, Gerard|info:eu-repo/dai/nl/069553475; Kyrtopoulos, Soterios Α; Vermeulen, Roel|info:eu-repo/dai/nl/216532620

    Long-term exposure to ambient air pollution can lead to chronic health effects such as cancer, cardiovascular and respiratory disease. Systemic inflammation has been hypothesized as a putative biological mechanism contributing to these adverse health effects. We evaluated the effect of long-term

  18. Factors associated with long-term mortality in acute pancreatitis

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Matzen, Peter; Bendtsen, Flemming


    Knowledge of the long-term prognosis of acute pancreatitis (AP) is limited. The aims were to investigate: (1) prognostic factors associated with long-term mortality in patients with AP; (2) whether or not the level of serum (S-)amylase at admission had an impact on the prognosis; (3) causes...

  19. Sacrococcygeal teratoma: Clinical characteristics and long-term ...

    African Journals Online (AJOL)

    Background/Purpose : The excision of sacrococcygeal teratoma (SCT) may be associated with significant long-term morbidity for the child. We reviewed our experience with SCT in a tertiary health care facility in a developing country with particular interest on the long-term sequelae. Methods : Between January 1990 and ...

  20. Albumin: Creatinine Ratio during long term Diabetes Mellitus in the ...

    African Journals Online (AJOL)

    Albumin: Creatinine Ratio during long term Diabetes Mellitus in the Assessment of early Nephropathy in Sudanese Population. ... Further studies with 24 hour urine sample are recommended for assessment of Microalbuminuria in long term Diabetic patients, provided that the patients are on a normal diet with regular ...

  1. Developmental Dyslexia and Explicit Long-Term Memory (United States)

    Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano


    The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

  2. Long term physical and chemical stability of polyelectrolyte multilayer membranes

    NARCIS (Netherlands)

    de Grooth, Joris; Haakmeester, Brian; Wever, Carlos; Potreck, Jens; de Vos, Wiebe Matthijs; Nijmeijer, Dorothea C.


    This work presents a detailed investigation into the long term stability of polyelectrolyte multilayer (PEM) modified membranes, a key factor for the application of these membranes in water purification processes. Although PEM modified membranes have been frequently investigated, their long term

  3. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko


    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  4. Quantification of long term emission potential from landfills

    NARCIS (Netherlands)

    Heimovaara, T.J.


    Novel approaches for the after-care of Municipal Solid Waste (MSW) landfills are based on technological measures to reduce the long term emission potential in a short time period. Biological degradation in landfills is a means to significantly reduce the long term emission potential. Leachate

  5. Long-term effects of childbirth in MS

    NARCIS (Netherlands)

    D'hooghe, M.B.; Nagels, G.; Uitdehaag, B.M.J.


    Background: The uncertainty about long-term effects of childbirth presents MS patients with dilemmas. Methods: Based on clinical data of 330 female MS patients, the long-term effects of childbirth were analysed, using a cross-sectional study design. Four groups of patients were distinguished: (1)

  6. Long-Term Orientation and Educational Performance. Working Paper 174 (United States)

    Figlio, David; Giuliano, Paola; Özek, Umut; Sapienza, Paola


    We use remarkable population-level administrative education and birth records from Florida to study the role of Long-Term Orientation on the educational attainment of immigrant students living in the US. Controlling for the quality of schools and individual characteristics, students from countries with long-term oriented attitudes perform better…

  7. Improved work ability and return to work following vocational multidisciplinary rehabilitation of subjects on long-term sick leave


    Braathen, Tore; Veiersted, Kaj Bo; Heggenes, Jan


    Objective: To evaluate a vocational multidisciplinary rehabilitation programme for patients on long-term sick leave with respect to their work ability and return to work. Methods: A multidisciplinary rehabilitation programme was administered to an intervention group of 183 patients on long-term sick leave (mean 12.2 months). Effects of the treatment were compared with a control group (n = 96) recruited from the national sickness insurance record of patients on sick leave of 6??2 month...

  8. Augmented Reality in Informal Learning Environments: Investigating Short-term and Long-term Effects

    DEFF Research Database (Denmark)

    Sommerauer, Peter; Müller, Oliver


    field experiment with 24 participants at a mathematics exhibition to measure the effect of AR on acquiring and retaining mathematical knowledge in an informal learning environment, both short-term (i.e., directly after visiting the exhibition) and long-term (i.e., two months after the museum visit). Our...

  9. Long-term health effects on the next generation of Ramadan fasting during pregnancy

    NARCIS (Netherlands)

    van Ewijk, R.


    Each year, many pregnant women fast from dawn to sunset during the Islamic holy month of Ramadan. Medical theory suggests that this may have negative long-term health effects on their offspring. Building upon the work of Almond and Mazumder (2008), and using Indonesian crosssectional data, I show

  10. Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women

    DEFF Research Database (Denmark)

    Krustrup, Peter; Hansen, Peter Riis; Andersen, Lars Juel


    We examined long-term musculoskeletal and cardiac adaptations elicited by recreational football (FG, n=9) and running (RG, n=10) in untrained premenopausal women in comparison with a control group (CG, n=9). Training was performed for 16 months ( approximately 2 weekly 1-h sessions). For FG, right...

  11. Long-Term Follow-Up of Echolalia and Question Answering. (United States)

    Foxx, R. M.; Faw, Gerald D.


    A long-term followup (from 26 to 57 months) of echolalia and correct question-answering was conducted with six mentally retarded adult subjects identified from three previously published studies. Echolalia was lower than in baseline in 80.6 percent of the followups. Issues related to the study of maintenance are discussed. (Author/DB)

  12. Long-term leukopenia in a lung transplanted patient with cystic fibrosis treated with zoledronic acid

    DEFF Research Database (Denmark)

    Karahasanovic, A; Thorsteinsson, A-L; Bjarnason, N H


    report a case of a young woman with CF, lung transplantation and low bone mass developing long-term leukopenia after treatment with zoledronic acid. The leukopenia, with a strong affection of the neutrocytes, lasted for 4 months and the condition only went into remission after granulocyte-colony...

  13. Understanding the Long-Term Benefits of a Latino Financial Literacy Education Program (United States)

    Meraz, Antonio Alba; Petersen, Cindy M.; Marczak, Mary S.; Brown, Arthur; Rajasekar, Neeraj


    The long-term impact of a Latino financial literacy program was evaluated with a sample of relatively recent immigrant populations in southern Minnesota. Telephone and face-to-face interviews were conducted with participants 6 months post program completion. Results indicate that improvements in knowledge and skills were retained and that these…

  14. Long-term memory of hierarchical relationships in free-living greylag geese

    NARCIS (Netherlands)

    Weiss, Brigitte M.; Scheiber, Isabella B. R.

    Animals may memorise spatial and social information for many months and even years. Here, we investigated long-term memory of hierarchically ordered relationships, where the position of a reward depended on the relationship of a stimulus relative to other stimuli in the hierarchy. Seventeen greylag

  15. Patient Characteristics and Outcomes in Institutional and Community Long-Term Care. (United States)

    Braun, Kathryn L.; And Others


    Examined three-way relationships among patient characteristics, type of care (admission to nursing home or community setting), and 6-month outcomes of 352 long-term care patients. Found that patient characteristics influenced type of care received and that substantial portions of variance in outcomes were attributable to initial differences among…

  16. Long-term outcome of neurosurgical untethering on neurosegmental motor and ambulation levels

    NARCIS (Netherlands)

    Schoenmakers, M. A. G. C.; Gooskens, R. H. J. M.; Gulmans, V. A. M.; Hanlo, P. W.; Vandertop, W. P.; Uiterwaal, C. S. P. M.; Helders, P. J. M.


    The aim of this study was to determine the long-term outcome of neurosurgical untethering on neurosegmental motor level and ambulation level in children with tethered spinal cord syndrome. Forty-four children were operated on (17 males, 27 females; mean age at operation 6 years 2 months, SD 5

  17. Proteome modification in tomato plants upon long-term aluminum treatment (United States)

    This study aimed to identify the aluminum (Al)-induced proteomes in tomato (Solanum lycopersicum, “Micro-Tom”) after long-term exposure to the stress factor. Plants were treated in Magnavaca’s solution (pH 4.5) supplemented with 7.5 uM Al3+ ion activity over a 4 month period beginning at the emergen...

  18. Long-term visual changes following pituitary irradiation

    International Nuclear Information System (INIS)

    Movsas, Benjamin; Movsas, Tammy Z.; Steinberg, Seth M.; Okunieff, Paul


    Purpose: To analyze possible long-term effects of pituitary irradiation on visual fields and acuity. Methods and Materials: Eighty-six patients were treated with radiotherapy for pituitary tumors at the National Cancer Institute between 1980 and 1991. Twenty-one patients had baseline preradiation and long-term follow-up visual fields. Eyes were followed with serial Goldmann or Humphrey visual field testing. Neuroradiologic correlation was made with the available brain scans. There were 12 females and 9 males with an median age of 44. Eighteen patients had hormone-secreting tumors and three had chromophobe adenomas. All but one patient with an inoperable invasive macroadenoma were irradiated after one or more transphenoidal resections or a craniotomy. The indications for radiation in the operable patients were: nine patients, partial tumor resection; nine patients, tumor recurrence; and two patients, persistent hormonal elevation after surgery. The median dose delivered was 50 Gy (45-59.4 Gy). The average field size was 6 x 6 cm (5 x 5 cm to 10 x 12.5 cm). Results: With a median follow-up of 48 months (14-128) after radiotherapy, 1 out of 21 patients has recurred (at 8 months) and all patients are alive. Of the 38 sighted eyes, 27 had normal visual fields before and after radiation, 7 eyes showed improvement, and 4 eyes had a stable defect, mostly in the superior temporal region. There were no cases of radiation-induced visual field or acuity deterioration. Six out of 21 patients (29%) had neurologic symptoms in follow-up, most of which appeared vascular in nature. Four patients complained of atypical migranous-like headaches that first began 1.5-3 years following treatment. One patient complained of recurrent vertical diplopia and one patient had a cerebral vascular accident 7 years following therapy. A dose-related association with these neurovascular symptoms approached statistical significance. Only 1 out of 11 (9%) patients who received doses less than or equal

  19. Development of long-term event memory in preverbal infants: an eye-tracking study. (United States)

    Nakano, Tamami; Kitazawa, Shigeru


    The development of long-term event memory in preverbal infants remains elusive. To address this issue, we applied an eye-tracking method that successfully revealed in great apes that they have long-term memory of single events. Six-, 12-, 18- and 24-month-old infants watched a video story in which an aggressive ape-looking character came out from one of two identical doors. While viewing the same video again 24 hours later, 18- and 24-month-old infants anticipatorily looked at the door where the character would show up before it actually came out, but 6- and 12-month-old infants did not. Next, 12-, 18- and 24-month-old infants watched a different video story, in which a human grabbed one of two objects to hit back at the character. In their second viewing after a 24-hour delay, 18- and 24-month-old infants increased viewing time on the objects before the character grabbed one. In this viewing, 24-month-old infants preferentially looked at the object that the human had used, but 18-month-old infants did not show such preference. Our results show that infants at 18 months of age have developed long-term event memory, an ability to encode and retrieve a one-time event and this ability is elaborated thereafter.

  20. Long-Term Dynamics of Autonomous Fractional Differential Equations (United States)

    Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

    This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

  1. Experimental Researches on Long-Term Strength of Granite Gneiss

    Directory of Open Access Journals (Sweden)

    Lin Liu


    Full Text Available It is important to confirm the long-term strength of rock materials for the purpose of evaluating the long-term stability of rock engineering. In this study, a series of triaxial creep tests were conducted on granite gneiss under different pore pressures. Based on the test data, we proposed two new quantitative methods, tangent method and intersection method, to confirm the long-term strength of rock. Meanwhile, the isochronous stress-strain curve method was adopted to make sure of the accuracy and operability of the two new methods. It is concluded that the new methods are suitable for the study of the long-term strength of rock. The effect of pore pressure on the long-term strength of rock in triaxial creep tests is also discussed.

  2. Long-Term Memory Performance in Adult ADHD. (United States)

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya


    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  3. Long-term Simulation of the Removal of Pollutants in Retention Basins

    DEFF Research Database (Denmark)

    Larsen, Torben; Neerup-Jensen, Ole; Kaasgaard, Mogens


    -dependant sedimentation and the variation of the settling velocity of the particles. The results show that including these effects lead to significant lower discharges of pollutants compared to conventional methods of estimation. As an example computations with a spectrum of basins which cover realistic sizes show......The paper describes a method for the long-term simulation of the discharge of pollutants to the environment from storm sewer overflows in combined sewer systems, which has a connected retention basin. This study covers Cd, Cu, Ni, Pb, Zn and PAH. The method includes both the influence of the flow...

  4. Long Term Estimates of Removal of Heavy Metals and PAH in Retention Basins

    DEFF Research Database (Denmark)

    Larsen, Torben; Neerup-Jensen, O.


    The paper describes a method for the long-term simulation of the discharge of pollutants to the environment from storm sewer overflows in combined sewer systems, which have a connected retention basins. This study covers heavy metals (Cd, Cu, Ni, Pb, Zn) and PAH. The method includes both...... the influence of the flow-dependant sedimentation and the variation of the settling velocity of the particles. The results show that including these effects lead to significant lower discharges of pollutants compared to conventional methods of estimation. As an example computations with a spectrum of basins...

  5. Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long-Term Registry. (United States)

    Chioncel, Ovidiu; Mebazaa, Alexandre; Harjola, Veli-Pekka; Coats, Andrew J; Piepoli, Massimo Francesco; Crespo-Leiro, Maria G; Laroche, Cecile; Seferovic, Petar M; Anker, Stefan D; Ferrari, Roberto; Ruschitzka, Frank; Lopez-Fernandez, Silvia; Miani, Daniela; Filippatos, Gerasimos; Maggioni, Aldo P


    To identify differences in clinical epidemiology, in-hospital management and 1-year outcomes among patients hospitalized for acute heart failure (AHF) and enrolled in the European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry, stratified by clinical profile at admission. The ESC-HF-LT Registry is a prospective, observational study collecting hospitalization and 1-year follow-up data from 6629 AHF patients. Among AHF patients enrolled in the registry, 13.2% presented with pulmonary oedema (PO), 2.9% with cardiogenic shock (CS), 61.1% with decompensated heart failure (DHF), 4.8% with hypertensive heart failure (HT-HF), 3.5% with right heart failure (RHF) and 14.4% with AHF and associated acute coronary syndromes (ACS-HF). The 1-year mortality rate was 28.1% in PO, 54.0% in CS, 27.2% in DHF, 12.8% in HT-HF, 34.0% in RHF and 20.6% in ACS-HF patients. When patients were classified by systolic blood pressure (SBP) at initial presentation, 1-year mortality was 34.8% in patients with SBP 140 mmHg. These differences tended to diminish in the months post-discharge, and 1-year mortality for the patients who survived at least 6 months post-discharge did not vary significantly by either clinical profile or SBP classification. Rates of adverse outcomes in AHF remain high, and substantial differences have been found when patients were stratified by clinical profile or SBP. However, patients who survived at least 6 months post-discharge represent a more homogeneous group and their 1-year outcome is less influenced by clinical profile or SBP at admission. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  6. Long-term outcome of pediatric patients with intracranial germinomas

    International Nuclear Information System (INIS)

    Jinguji, Shinya; Yoshimura, Junichi; Aoki, Hiroshi; Natsumeda, Manabu; Yoneoka, Yuichiro; Nishiyama, Kenichi; Fujii, Yukihiko; Nagasaki, Keisuke


    Intracranial germinomas are sensitive to both chemotherapy and radiotherapy. For this reason, long-term survival or cure rate is excellent. It is therefore important for such patients, especially for younger children, to keep a high quality of life (QOL) after the treatment. Recently, whole ventricle radiotherapy with chemotherapy has been the treatment of choice for these tumors. However, in our institute, we perform radiotherapy alone as a standard treatment, using prophylactic craniospinal irradiation (CSI) or whole brain irradiation (WBI) with local tumor booster. The purpose of this study is to assess the long-term outcome of pediatric patients with intracranial germinomas in our institute. Twenty-three young patients (17 males and 6 females) ranging from 5 to 15 years were treated between 1990 and 2009 at University of Niigata. Mean age at the time of diagnosis was 10.7 years. Tumor locations were as follows: pineal regions in 6, suprasellar in 6, basal ganglia in 4, ventricles in 1, bifocal regions (pineal and suprasellar) in 2, and dissemination in 4 patients. Twenty (88%) patients had received radiotherapy alone: 15 (66%) with CSI, and 5 (22%) with WBI. Median doses for the whole brain, spine, and primary site were 26.6 Gy (range, 23.8-35.0), 25.9 Gy (range, 23.8-30.6), 49.8 Gy (range, 44.7-52.8), respectively. Three (12%) received chemotherapy with or without radiotherapy. We analyzed the survival and long-term QOL including hormonal sequel after the above treatments. The median follow-up period was 126 months (26 to 235 months). None of the 20 patients with radiotherapy alone suffered tumor recurrence, while 2 of the 3 with chemotherapy developed recurrences. Eleven (48%), including 9 with supurasellar region required hormone replacement therapy. Two (9%) were short stature compared with normal (mean-2 standard deviation). One (4%) developed a possible radiation-induced menigioma. In 15 patients aged 19 years or older, 13 (87%) graduated from senior high

  7. Long-Term Follow-Up of Impulse Control Disorders in Parkinson’s Disease


    Mamikonyan, Eugenia; Siderowf, Andrew D.; Duda, John E.; Potenza, Marc N.; Horn, Stacy; Stern, Matthew B.; Weintraub, Daniel


    Recent studies have linked dopamine agonist (DA) usage with the development of impulse control disorders (ICDs) in Parkinson’s disease (PD). Little is known about optimal management strategies or the long-term outcomes of affected patients. To report on the clinical interventions and long-term outcomes of PD patients who developed an ICD after DA initiation. Subjects contacted by telephone for a follow-up interview after a mean time period of 29.2 months. They were administered a modified Min...

  8. Effectiveness of India ink as a long-term colonic mucosal marker. (United States)

    Fennerty, M B; Sampliner, R E; Hixson, L J; Garewal, H S


    We prospectively studied the use of India ink as a long-term or "permanent" mucosal marker as part of a study investigating the natural history of diminutive distal colorectal polyps. Twenty-six patients had 32 India ink tatoos implanted. The tatoo sites of the 19 patients who were followed at least 6 months continued to display intensely stained mucosa at the original sites. No side effects or complications were encountered. India ink appears to be a safe and effective long-term marker for colonic mucosal lesions.

  9. Postural adaptations to long-term training in Prader-Willi patients (United States)


    Background Improving balance and reducing risk of falls is a relevant issue in Prader-Willi Syndrome (PWS). The present study aims to quantify the effect of a mixed training program on balance in patients with PWS. Methods Eleven adult PWS patients (mean age: 33.8 ± 4.3 years; mean BMI: 43.3 ± 5.9 Kg/m2) attended a 2-week training program including balance exercises during their hospital stay. At discharge, Group 1 (6 patients) continued the same exercises at home for 6 months, while Group 2 (5 patients) quitted the program. In both groups, a low-calorie, well-balanced diet of 1.200 kcal/day was advised. They were assessed at admission (PRE), after 2 weeks (POST1) and at 6-month (POST2). The assessment consisted of a clinical examination, video recording and 60-second postural evaluation on a force platform. Range of center of pressure (CoP) displacement in the antero-posterior direction (RANGEAP index) and the medio-lateral direction (RANGEML index) and its total trajectory length were computed. Results At POST1, no significant changes in all of the postural parameters were observed. At completion of the home program (POST2), the postural assessment did not reveal significant modifications. No changes in BMI were observed in PWS at POST2. Conclusions Our results showed that a long-term mixed, but predominantly home-based training on PWS individuals was not effective in improving balance capacity. Possible causes of the lack of effectiveness of our intervention include lack of training specificity, an inadequate dose of exercise, an underestimation of the neural and sensory component in planning rehabilitation exercise and failed body weight reduction during the training. Also, the physiology of balance instability in these patients may possibly compose a complex puzzle not affected by our exercise training, mainly targeting muscle weakness. PMID:21575153

  10. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper. (United States)

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  11. Robust estimation and forecasting of the long-term seasonal component of electricity spot prices

    International Nuclear Information System (INIS)

    Nowotarski, Jakub; Tomczyk, Jakub; Weron, Rafał


    We present the results of an extensive study on estimation and forecasting of the long-term seasonal component (LTSC) of electricity spot prices. We consider a battery of over 300 models, including monthly dummies and models based on Fourier or wavelet decomposition combined with linear or exponential decay. We find that the considered wavelet-based models are significantly better in terms of forecasting spot prices up to a year ahead than the commonly used monthly dummies and sine-based models. This result questions the validity and usefulness of stochastic models of spot electricity prices built on the latter two types of LTSC models. - Highlights: • First comprehensive study on the forecasting of the long-term seasonal components • Over 300 models examined, including commonly used and new approaches • Wavelet-based models outperform sine-based and monthly dummy models. • Validity of stochastic models built on sines or monthly dummies is questionable

  12. The long-term use of cyproterone acetate in pedophilia: a case study. (United States)

    Cooper, A J; Cernovsky, Z; Magnus, R V


    This investigation reports the long-term use of the antiandrogen cyproterone acetate (CPA) in a pedophile, who was studied continuously over 38 months. Measures of sexual arousal, serum testosterone, and gonadotropin levels were significantly reduced by the drug as compared with placebo and no treatment; prolactin levels were significantly elevated. Some workers have observed that long-term administration of CPA (more than one year, which was then discontinued) produced enduring (in some cases apparently permanent) anti-libidinal effects; however, in the case described, within three weeks of stopping the drug, all measures had returned to pretrial levels. The importance of continuous long-term monitoring in sex offenders receiving an antiandrogen is discussed.

  13. Audit of long-term and short-term liabilities

    Directory of Open Access Journals (Sweden)

    Korinko M.D.


    Full Text Available The article determines the importance of long-term and short-term liabilities for the management of financial and material resources of an enterprise. It reviews the aim, objects and information generators for realization of audit of short-term and long-term obligations. The organizing and methodical providing of audit of long-term and short-term liabilities of an enterprise are generalized. The authors distinguish the stages of realization of audit of long-term and short-term liabilities, the aim of audit on each of the presented stages, and recommend methodical techniques. It is fixed that it is necessary to conduct the estimation of the systems of internal control and record-keeping of an enterprise by implementation of public accountant procedures for determination of volume and maintenance of selection realization. After estimating the indicated systems, a public accountant determines the methodology for realization of public accountant verification of long-term and short-term liabilities. The analytical procedures that public accountants are expedient to use for realization of audit of short-term and long-term obligations are determined. The authors suggest the classification of the educed defects on the results of the conducted public accountant verification of short-term and long-term obligations.

  14. Modeling long-term dynamics of electricity markets

    International Nuclear Information System (INIS)

    Olsina, Fernando; Garces, Francisco; Haubrich, H.-J.


    In the last decade, many countries have restructured their electricity industries by introducing competition in their power generation sectors. Although some restructuring has been regarded as successful, the short experience accumulated with liberalized power markets does not allow making any founded assertion about their long-term behavior. Long-term prices and long-term supply reliability are now center of interest. This concerns firms considering investments in generation capacity and regulatory authorities interested in assuring the long-term supply adequacy and the stability of power markets. In order to gain significant insight into the long-term behavior of liberalized power markets, in this paper, a simulation model based on system dynamics is proposed and the underlying mathematical formulations extensively discussed. Unlike classical market models based on the assumption that market outcomes replicate the results of a centrally made optimization, the approach presented here focuses on replicating the system structure of power markets and the logic of relationships among system components in order to derive its dynamical response. The simulations suggest that there might be serious problems to adjust early enough the generation capacity necessary to maintain stable reserve margins, and consequently, stable long-term price levels. Because of feedback loops embedded in the structure of power markets and the existence of some time lags, the long-term market development might exhibit a quite volatile behavior. By varying some exogenous inputs, a sensitivity analysis is carried out to assess the influence of these factors on the long-run market dynamics

  15. Long-term memory of relative reward values. (United States)

    Soldati, Francesca; Burman, Oliver H P; John, Elizabeth A; Pike, Thomas W; Wilkinson, Anna


    Long-term memory can be adaptive as it allows animals to retain information that is crucial for survival, such as the appearance and location of key resources. This is generally examined by comparing choices of stimuli that have value to the animal with those that do not; however, in nature choices are rarely so clear cut. Animals are able to assess the relative value of a resource via direct comparison, but it remains unclear whether they are able to retain this information for a biologically meaningful amount of time. To test this, captive red-footed tortoises (Chelonoidis carbonaria) were first trained to associate visual cues with specific qualities and quantities of food, and their preferences for the different reward values determined. They were then retested after an interval of 18 months. We found that the tortoises were able to retain the information they had learned about the cues as indicators of relative reward values over this interval, demonstrating a memory for the relative quantity and quality of food over an extended period of time. This is likely to impact directly on an animal's foraging decisions, such as the exploitation of seasonally varying resources, with obvious fitness implications for the individual; however, the implications may also extend to the ecological interactions in which the animal is involved, affecting processes such as herbivory and seed dispersal. © 2017 The Author(s).

  16. Long-term biological consequences of nuclear war

    International Nuclear Information System (INIS)

    Ehrlich, P.R.; Harte, J.; Harwell, M.A.


    Subfreezing temperatures, low light levels, and high doses of ionizing and ultraviolet radiation extending for many months after a large-scale nuclear war could destroy the biological support systems of civilization, at least in the Northern Hemisphere. Productivity in natural and agricultural ecosystems could be severely restricted for a year or more. Postwar survivors would face starvation as well as freezing conditions in the dark and be exposed to near-lethal doses of radiation. If, as now seems possible, the Southern Hemisphere were affected also, global disruption of the biosphere could ensue, In any event, there would be severe consequences, even in the areas not affected directly, because of the interdependence of the world economy. In either case the extinction of a large fraction of the Earth's animals, plants, and microorganisms seems possible. The population size of Homo sapiens conceivably could be reduced to prehistoric levels or below and extinction of the human species itself cannot be excluded. These conclusions are the concensus from the meeting on Long-Term Worldwide Biological Consequences of Nuclear War

  17. Long-term neuromuscular training and ankle joint position sense. (United States)

    Kynsburg, A; Pánics, G; Halasi, T


    Preventive effect of proprioceptive training is proven by decreasing injury incidence, but its proprioceptive mechanism is not. Major hypothesis: the training has a positive long-term effect on ankle joint position sense in athletes of a high-risk sport (handball). Ten elite-level female handball-players represented the intervention group (training-group), 10 healthy athletes of other sports formed the control-group. Proprioceptive training was incorporated into the regular training regimen of the training-group. Ankle joint position sense function was measured with the "slope-box" test, first described by Robbins et al. Testing was performed one day before the intervention and 20 months later. Mean absolute estimate errors were processed for statistical analysis. Proprioceptive sensory function improved regarding all four directions with a high significance (pneuromuscular training has improved ankle joint position sense function in the investigated athletes. This joint position sense improvement can be one of the explanations for injury rate reduction effect of neuromuscular training.

  18. Long-term Dental Visiting Patterns and Adult Oral Health (United States)

    Thomson, W.M.; Williams, S.M.; Broadbent, J.M.; Poulton, R.; Locker, D.


    To date, the evidence supporting the benefits of dental visiting comes from cross-sectional studies. We investigated whether long-term routine dental visiting was associated with lower experience of dental caries and missing teeth, and better self-rated oral health, by age 32. A prospective cohort study in New Zealand examined 932 participants’ use of dentistry at ages 15, 18, 26, and 32. At each age, routine attenders (RAs) were identified as those who (a) usually visited for a check-up, and (b) had made a dental visit during the previous 12 months. Routine attending prevalence fell from 82% at age 15 to 28% by 32. At any given age, routine attenders had better-than-average oral health, fewer had teeth missing due to caries, and they had lower mean DS and DMFS scores. By age 32, routine attenders had better self-reported oral health and less tooth loss and caries. The longer routine attendance was maintained, the stronger the effect. Routine dental attendance is associated with better oral health. PMID:20093674

  19. Long-term results of irradiation for paraganglioma

    International Nuclear Information System (INIS)

    Krych, Aaron J.; Foote, Robert L.; Brown, Paul D.; Garces, Yolanda I.; Link, Michael J.


    Purpose: The management of paragangliomas is controversial. Observation, surgery, external-beam radiotherapy (EBRT), and stereotactic radiosurgery (SRS) may, alone or in combination, be appropriate, depending on the size and extent of the tumor, previous treatment, and patient age, general health, and neurologic condition. Few data exist regarding long-term tumor control and late effects after EBRT or SRS. Methods and Materials: We performed a retrospective review of all patients treated with EBRT or SRS for paraganglioma at our institution between 1967 and 1994. The endpoints of the study were tumor control and late complications. Results: The 33 patients in this study had a median follow-up of 13 years (range, 4 months to 36 years). The 10-year tumor control rate was 92% (95% confidence interval, 75-98%). At the last follow-up visit, no patient had developed a radiation-induced malignancy. Conclusion: External-beam RT and SRS are safe and effective for enlarging and/or symptomatic paragangliomas. The risk of developing a delayed radiation-induced malignancy after EBRT or SRS is low. This risk must be weighed against the significant immediate and permanent risk of cranial nerve deficits if the tumor is untreated or is surgically resected. This risk must also be weighed against the immediate but low risk of surgical mortality

  20. Maintenance management during long-term stop of JRR-3

    International Nuclear Information System (INIS)

    Matsui, Yutaka; Suwa, Masayuki; Wada, Shigeru


    JRR-3 has been continuing its stop state for more than 5 years as of FY2015 after stopping the use operation of the reactor in November 2010. Different responses are required in the maintenance management for operation resumption, compared with those in normal operation. This paper introduces part of the maintenance managements that are performed during long-term stop. The water qualities of primary coolant and secondary coolant are controlled by measuring pH and conductivity, and the prevention of crevice corrosion of equipment is performed. In the management of pumps for coolant circulation, vibration measurement is performed to confirm that there are no signs of abnormality. As the management of the core structure, the bend measurement of beryllium reflector is performed to confirm that there is no hindrance to operation resumption, and the visual inspection of high burnup fuel elements is performed to confirm that abnormality has not occurred. As for the management of monitoring equipment, the equipment required in shutdown period is subjected to calibration work, and the equipment required in operation period is subjected to soundness check based on the results of cooling system operation. As the functional maintenance of the cooling system, cooling system operating test and 10-day continuous operation of the cooling system are monthly performed to confirm the soundness of equipment. In addition, the competence maintenance and capacity improvement of operators are performed through the cooling system operation and reactor simulator training. (A.O.)

  1. Long-term effect of urethral dilatation and internal urethrotomy for urethral strictures. (United States)

    Veeratterapillay, Rajan; Pickard, Rob S


    Urethral dilatation and direct visual internal urethrotomy (DVIU) are widely used minimally invasive options to manage men with urethral strictures. Advances in open urethroplasty with better long-term cure rates have fuelled the continuing debate as to which treatment is best for primary and recurrent urethral strictures. We reviewed recent literature to identify contemporary practice of urethral dilatation and DVIU and the long-term outcome of these procedures. Systematic literature search for the period January 2010 to December 2011 showed that urethral dilatation and DVIU remain frequently used treatment options as confirmed by surveys of urologists in the USA and the Netherlands. Multiple reports of laser DVIU confirm the safety of this approach but long-term data were lacking. Stricture free rates from urethra dilatation and DVIU vary from 10 to 90% at 12 months, although adjunctive intermittent self-dilatation can reduce time to recurrence. Although quality-of-life benefit appears good in the short term, repeated procedures may harm sexual function in the long-term. Urethral dilatation and DVIU remain widely used in urethral stricture management but high-level comparative evidence of benefit and harms against urethroplasty in the short and long-term is still lacking.

  2. Maternity Leave and Mothers' Long-Term Sickness Absence: Evidence From West Germany. (United States)

    Guertzgen, Nicole; Hank, Karsten


    Exploiting unique German administrative data, we estimate the association between an expansion in maternity leave duration from two to six months in 1979 and mothers' postbirth long-term sickness absence over a period of three decades after childbirth. Adopting a difference-in-difference approach, we first assess the reform's labor market effects and, subsequently, prebirth and postbirth maternal long-term sickness absence, accounting for the potential role of the reform in mothers' selection into employment. Consistent with previous research, our estimates show that the leave extension caused mothers to significantly delay their return to work within the first year after childbirth. We then provide difference-in-difference estimates for the number and length of spells of long-term sickness absence among returned mothers. Our findings suggest that among those returned, mothers subject to the leave extension exhibit a higher incidence of long-term sickness absence compared with mothers who gave birth before the reform. This also holds true after we control for observable differences in prebirth illness histories. At the same time, we find no pronounced effects on mothers' medium-run labor market attachment following the short-run delay in return to work, which might rationalize a negative causal health effect. Breaking down the results by mothers' prebirth health status suggests that the higher incidence of long-term sickness absence among mothers subject to the reform may be explained by the fact that the reform facilitated the reentry of a negative health selection into the labor market.

  3. Comparison of two humidification systems for long-term noninvasive mechanical ventilation. (United States)

    Nava, S; Cirio, S; Fanfulla, F; Carlucci, A; Navarra, A; Negri, A; Ceriana, P


    There is no consensus concerning the best system of humidification during long-term noninvasive mechanical ventilation (NIMV). In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded. Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different. In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.

  4. Fondaparinux in the initial and long-term treatment of venous thromboembolism. (United States)

    Pesavento, Raffaele; Amitrano, Maria; Trujillo-Santos, Javier; Di Micco, Pierpaolo; Mangiacapra, Sara; López-Jiménez, Luciano; Falgá, Conxita; García-Bragado, Fernando; Piovella, Chiara; Prandoni, Paolo; Monreal, Manuel


    Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer. Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05). An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Long-Term Resource Adequacy, Long-Term Flexibility Requirements, and Revenue Sufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, Michael [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bloom, Aaron P [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Townsend, Aaron [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Ela, Erik [Electric Power Research Institute; Botterud, Audun [Argonne National Laboratory; Levin, Todd [Argonne National Laboratory


    Variable generation (VG) can reduce market prices over time and also the energy that other suppliers can sell in the market. The suppliers that are needed to provide capacity and flexibility to meet the long-term reliability requirements may, therefore, earn less revenue. This chapter discusses the topics of resource adequacy and revenue sufficiency - that is, determining and acquiring the quantity of capacity that will be needed at some future date and ensuring that those suppliers that offer the capacity receive sufficient revenue to recover their costs. The focus is on the investment time horizon and the installation of sufficient generation capability. First, the chapter discusses resource adequacy, including newer methods of determining adequacy metrics. The chapter then focuses on revenue sufficiency and how suppliers have sufficient opportunity to recover their total costs. The chapter closes with a description of the mechanisms traditionally adopted by electricity markets to mitigate the issues of resource adequacy and revenue sufficiency and discusses the most recent market design changes to address these issues.

  6. Long-Term Stewardship Baseline Report and Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith


    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  7. Long-term Prognosis in COPD Exacerbation: Role of Biomarkers, Clinical Variables and Exacerbation Type. (United States)

    Grolimund, Eva; Kutz, Alexander; Marlowe, Robert J; Vögeli, Alaadin; Alan, Murat; Christ-Crain, Mirjam; Thomann, Robert; Falconnier, Claudine; Hoess, Claus; Henzen, Christoph; Zimmerli, Werner; Mueller, Beat; Schuetz, Philipp


    Long-term outcome prediction in COPD is challenging. We conducted a prospective 5-7-year follow-up study in patients with COPD to determine the association of exacerbation type, discharge levels of inflammatory biomarkers including procalctionin (PCT), C-reactive protein (CRP), white blood cell count (WBC) and plasma proadrenomedullin (ProADM), alone or combined with demographic/clinical characteristics, with long-term all-cause mortality in the COPD setting. The analyzed cohort comprised 469 patients with index hospitalization for pneumonic (n = 252) or non-pneumonic (n = 217) COPD exacerbation. Five-to-seven-year vital status was ascertained via structured phone interviews with patients or their household members/primary care physicians. We investigated predictive accuracy using univariate and multivariate Cox regression models and area under the receiver operating characteristic curve (AUC). After a median [25th-75th percentile] 6.1 [5.6-6.5] years, mortality was 55% (95%CI 50%-59%). Discharge ProADM concentration was strongly associated with 5-7-year non-survival: adjusted hazard ratio (HR)/10-fold increase (95%CI) 10.4 (6.2-17.7). Weaker associations were found for PCT and no significant associations were found for CRP or WBC. Combining ProADM with demographic/clinical variables including age, smoking status, BMI, New York Heart Association dyspnea class, exacerbation type, and comorbidities significantly improved long-term predictive accuracy over that of the demographic/clinical model alone: AUC (95%CI) 0.745 (0.701-0.789) versus 0.727 (0.681-0.772), (p) = .043. In patients hospitalized for COPD exacerbation, discharge ProADM levels appeared to accurately predict 5-7-year all-cause mortality and to improve long-term prognostic accuracy of multidimensional demographic/clinical mortality risk assessment.

  8. Long-term management of chronic spontaneous urticaria with omalizumab. (United States)

    Pinto Gouveia, M; Gameiro, A; Pinho, A; Gonçalo, M


    Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking. To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens. This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines. Patients were started on omalizumab 150 mg subcutaneously every 4 weeks. Dose and interval between administrations were adjusted according to clinical response (189 administrations; treatment duration range 2-38 months). Mean UAS7 was 36.3 ± 5.4. Of the 13 patients, all had experienced angio-oedema, while in addition, 7 had delayed pressure urticaria (DPU) and 1 had solar urticaria (SU). After omalizumab treatment, 4 (30.8%) of the 13 patients had complete response (CR), and the remaining 8 (61.5%) had partial response. CR was achieved with a dose of 150 mg every 4 (n = 2 patients) or 5 (n = 2) weeks. One of these patients remained disease-free after stopping treatment. Partial responses were achieved with 150 mg every 4 weeks (n = 4) and with 300 mg (n = 4) at intervals of 5 weeks (n = 1), 4 weeks (n = 2) or 3 weeks (n = 1). Only one patient (7.7%) did not show significant improvement, despite a dose of 300 mg every 4 weeks. There were no significant differences in epidemiological, clinical and laboratory data between the different response groups. Only two adverse events were observed: one was mild headache and the other was severe angio-oedema and aggravation of urticaria within 6 h of omalizumab administration. Omalizumab dose and interval between administrations could be individualized for long-term management of CSU. © 2017 British Association of Dermatologists.

  9. Cognitive performance in long-term abstinent elderly alcoholics. (United States)

    Fein, George; McGillivray, Shannon


    To date, there is a wealth of literature describing the deleterious effects of active alcoholism on cognitive function. There is also a growing body of literature on the extent of cognitive recovery that can occur with abstinence. However, there is still a dearth of published findings on cognitive functioning in very long-term abstinence alcoholics, especially in the elderly population. The current study examines 91 elderly abstinent alcoholics (EAA) (49 men and 42 women) with an average age of 67.3 years, abstinent for an average of 14.8 years (range 0.5 to 45 years), and age and gender comparable light/nondrinking controls. The EAA group was divided into 3 subgroups: individuals that attained abstinence before age 50 years, between the ages 50 and 60 years, and after age 60 years. Attention, verbal fluency, abstraction/cognitive flexibility, psychomotor, immediate memory, delayed memory, reaction time, spatial processing, and auditory working memory were assessed. The AMNART and cranium size were used as estimates of brain reserve capacity, and the association of all variables with alcohol use measures was examined. Overall, the EAA groups performed comparably to controls on the assessments of cognitive function. Only the abstinent in group before 50 years of age performed worse than controls, and this was only in the domain of auditory working memory. EAAs had larger craniums than their controls. This effect was strongest for those who drank the longest and had the shortest abstinence. Such individuals also performed better cognitively. Our data showed that elderly alcoholics that drank late into life, but with at least 6 months abstinence can exhibit normal cognitive functioning. Selective survivorship and selection bias probably play a part in these findings. Cognitively healthier alcoholics, with more brain reserve capacity, may be more likely to live into their 60s, 70s, or 80s of age with relatively intact cognition, and to volunteer for studies such as

  10. Accumulation and long term behavior of radiocesium in tropical plants

    International Nuclear Information System (INIS)

    Anjos, R.M.; Carvalho, C.; Mosquera, B.; Macario, K.; Veiga, R.; Sanches, N.; Bastos, J.; Saavedra, R.; Iguatemy, M.


    and the long term behavior of radiocesium. These trees were planted at one site that was contaminated by 137 Cs due to a radiological accident occurred in the city of Goiania, Brazil, in 1987. Longitudinal and radial distributions of 137 Cs and 40 K for these trees were obtained. In particular, the study of biological half-life due to 137 Cs translocation from the tree reservoir performed in this work indicate that its values are of the order of months, calling the attention to the importance of such information in the reclaiming of agricultural ecosystems after a nuclear fallout. (authors)

  11. Accumulation and long term behavior of radiocesium in tropical plants

    Energy Technology Data Exchange (ETDEWEB)

    Anjos, R.M.; Carvalho, C.; Mosquera, B.; Macario, K.; Veiga, R.; Sanches, N.; Bastos, J.; Saavedra, R.; Iguatemy, M. [Universidade Federal Fluminense, Niteroi (Brazil)


    the long term behavior of radiocesium. These trees were planted at one site that was contaminated by 137 Cs due to a radiological accident occurred in the city of Goiania, Brazil, in 1987. Longitudinal and radial distributions of 137 Cs and 40 K for these trees were obtained. In particular, the study of biological half-life due to 137 Cs translocation from the tree reservoir performed in this work indicate that its values are of the order of months, calling the attention to the importance of such information in the reclaiming of agricultural ecosystems after a nuclear fallout. (authors)

  12. The long-term power purchase: Recovery of capacity costs

    International Nuclear Information System (INIS)

    Cross, P.S.


    As electric utilities increase their reliance on the long-term power purchase as an alternative to utility-owned generation, the appropriate rate treatment of the costs established in the purchase agreement assumes growing importance. In the November 9, 1989, issue, the authors examined the recent trend among state regulators to treat the long-term purchase in a manner similar to the addition by a utility of a new plant, including a full-scale prudence review. This installment will review recent rulings on the related issue of rate recovery of long-term capacity costs through the fuel cost adjustment clause

  13. Space ventures and society long-term perspectives (United States)

    Brown, W. M.


    A futuristic evaluation of mankind's potential long term future in space is presented. Progress in space will not be inhibited by shortages of the Earth's physical resources, since long term economic growth will be focused on ways to constrain industrial productivity by changing social values, management styles, or government competence. Future technological progress is likely to accelerate with an emphasis on international cooperation, making possible such large joint projects as lunar colonies or space stations on Mars. The long term future in space looks exceedingly bright even in relatively pessimistic scenarios. The principal driving forces will be technological progress, commercial and public-oriented satellites, space industrialization, space travel, and eventually space colonization.

  14. Long-term care financing through Federal tax incentives. (United States)

    Moran, D W; Weingart, J M


    Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost.

  15. Evaluation of long term leaching of borosilicate glasses

    International Nuclear Information System (INIS)

    Lanza, F.; Parnisari, E.


    For the evaluation of long term hazard of glass, data on long term glass leaching are needed. Moreover for long term leaching a model of homogeneous dissolution seems reasonable and ask for confirmation. Tests were performed at 30 0 , 80 0 , 100 0 , using an apparatus of the Soxhlet type, to 3.600 hours. Results were obtained as a weight loss and analysed following a relation with time composed by a parabolic and a linear part. Analysis of the surface layer using energy dispersion X ray spectrometry were performed. A critical analysis of the results and of the apparatus is presented

  16. Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study.

    Directory of Open Access Journals (Sweden)

    Gilles Cambonie

    Full Text Available The principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour.OLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS scale, which includes two behavioural subscales, for the mother (m-ADS and her infant (i-ADS. Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant's social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale.At discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour.The ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.

  17. Long term results in refractory tennis elbow using autologous blood

    Directory of Open Access Journals (Sweden)

    Naseem ul Gani


    Full Text Available Tennis elbow (TE is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years. Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years. The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment.

  18. Long-term potentiation and depression after unilateral labyrinthectomy in the medial vestibular nucleus of rats. (United States)

    Pettorossi, Vito Enrico; Dutia, Mayank; Frondaroli, Adele; Dieni, Cristina; Grassi, Silvarosa


    We previously demonstrated in rat brainstem slices that high-frequency stimulation (HFS) of the vestibular afferents induces long-term potentiation (LTP) in the ventral part (Vp) of the medial vestibular nucleus (MVN) and long-term depression (LTD) in the dorsal part (Dp). Both LTP and LTD depend on N-methyl-D-aspartate receptor activation, which increases synaptic efficacy; however, in the Dp, LTP reverses to LTD because of the activation of gamma-aminobutyric acid-ergic neurons. Here we show that the probability of inducing long-term effects in the MVN of rat brainstem slices is altered after unilateral labyrinthectomy (UL). In fact, LTP occurs less frequently in the ventral contra-lesional side compared with sham-operated rats. In the dorsal ipsi-lesional side, LTD is reduced and LTP enhanced, while the opposite occurs in the dorsal contra-lesional side. These changes in synaptic plasticity may be useful for re-balancing the tonic discharge of the MVN of the two sides during vestibular compensation, and for enhancing the dynamic responses of the deafferented MVN neurons in the long term.

  19. Development of prediction models of stress and long-term disability among claimants to injury compensation systems: a cohort study. (United States)

    Spittal, Matthew J; Grant, Genevieve; O'Donnell, Meaghan; McFarlane, Alexander C; Studdert, David M


    We sought to develop prognostic risk scores for compensation-related stress and long-term disability using markers collected within 3 months of a serious injury. Cohort study. Predictors were collected at baseline and at 3 months postinjury. Outcome data were collected at 72 months postinjury. Hospitalised patients with serious injuries recruited from four major trauma hospitals in Australia. 332 participants who made claims for compensation for their injuries to a transport accident scheme or a workers' compensation scheme. 12-item WHO Disability Assessment Schedule and 6 items from the Claims Experience Survey. Our model for long-term disability had four predictors (unemployed at the time of injury, history of a psychiatric disorder at time of injury, post-traumatic stress disorder symptom severity at 3 months and disability at 3 months). This model had good discrimination (R 2 =0.37) and calibration. The disability risk score had a score range of 0-180, and at a threshold of 80 had sensitivity of 56% and specificity of 86%. Our model for compensation-related stress had five predictors (intensive care unit admission, discharged to home, number of traumatic events prior to injury, depression at 3 months and not working at 3 months). This model also had good discrimination (area under the curve=0.83) and calibration. The compensation-related stress risk score had score range of 0-220 and at a threshold of 100 had sensitivity of 74% and specificity of 75%. By combining these two scoring systems, we were able to identify the subgroup of claimants at highest risk of experiencing both outcomes. The ability to identify at an early stage claimants at high risk of compensation-related stress and poor recovery is potentially valuable for claimants and the compensation agencies that serve them. The scoring systems we developed could be incorporated into the claims-handling processes to guide prevention-oriented interventions. © Article author(s) (or their employer

  20. Transcriptional diversity of long-term glioblastoma survivors. (United States)

    Gerber, Naamit K; Goenka, Anuj; Turcan, Sevin; Reyngold, Marsha; Makarov, Vladimir; Kannan, Kasthuri; Beal, Kathryn; Omuro, Antonio; Yamada, Yoshiya; Gutin, Phillip; Brennan, Cameron W; Huse, Jason T; Chan, Timothy A


    Glioblastoma (GBM) is a highly aggressive type of glioma with poor prognosis. However, a small number of patients live much longer than the median survival. A better understanding of these long-term survivors (LTSs) may provide important insight into the biology of GBM. We identified 7 patients with GBM, treated at Memorial Sloan-Kettering Cancer Center (MSKCC), with survival >48 months. We characterized the transcriptome of each patient and determined rates of MGMT promoter methylation and IDH1 and IDH2 mutational status. We identified LTSs in 2 independent cohorts (The Cancer Genome Atlas [TCGA] and NCI Repository for Molecular Brain Neoplasia Data [REMBRANDT]) and analyzed the transcriptomal characteristics of these LTSs. The median overall survival of our cohort was 62.5 months. LTSs were distributed between the proneural (n = 2), neural (n = 2), classical (n = 2), and mesenchymal (n = 1) subtypes. Similarly, LTS in the TCGA and REMBRANDT cohorts demonstrated diverse transcriptomal subclassification identities. The majority of the MSKCC LTSs (71%) were found to have methylation of the MGMT promoter. None of the patients had an IDH1 or IDH2 mutation, and IDH mutation occurred in a minority of the TCGA LTSs as well. A set of 60 genes was found to be differentially expressed in the MSKCC and TCGA LTSs. While IDH mutant proneural tumors impart a better prognosis in the short-term, survival beyond 4 years does not require IDH mutation and is not dictated by a single transcriptional subclass. In contrast, MGMT methylation continues to have strong prognostic value for survival beyond 4 years. These findings have substantial impact for understanding GBM biology and progression. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail:

  1. Outcomes of low-weight patients with avoidant/restrictive food intake disorder and anorexia nervosa at long-term follow-up after treatment in a partial hospitalization program for eating disorders. (United States)

    Bryson, Amanda E; Scipioni, Anna M; Essayli, Jamal H; Mahoney, Johnna R; Ornstein, Rollyn M


    To assess long-term outcomes of patients with avoidant/restrictive food intake disorder (ARFID) treated in a partial hospitalization program (PHP) for eating disorders (ED). A cross-sectional study comparing patients with ARFID to those with anorexia nervosa (AN) who had been discharged from a PHP for at least 12 months was performed. Percent median body mass index (%MBMI), scores on the Children's Eating Attitudes Test (ChEAT), and treatment utilization were assessed, with intake and discharge data collected via retrospective chart review. Of the 137 eligible patients, 62 (45.3%) consented to follow-up data collection. Patients with ARFID and AN exhibited similar increases in %MBMI from intake to discharge and reported low scores on the ChEAT by discharge. Patients with ARFID and AN maintained good weight outcomes and low ChEAT scores at follow-up. Most participants were still receiving outpatient treatment from a variety of providers, although fewer with ARFID than AN continued to receive services from our multidisciplinary ED clinic. Patients with ARFID and AN exhibit similar improvements in %MBMI when treated in the same PHP and appear to maintain treatment gains at long-term follow-up. Additionally, most patients continue to utilize outpatient services after being discharged from a PHP. © 2018 Wiley Periodicals, Inc.

  2. Numerical simulation of gender differences in a long-term microgravity exposure (United States)

    Perez-Poch, Antoni

    that significant differences appear between men and women physiological response after long-term exposure (more than three months) to microgravity. Risk evaluation for every gender, and specific risk thresholds are provided. Initial results are compatible with the existing data, and provide unique information regarding different patterns of microgravity exposure. We conclude that computer-based models such us NELME are a promising line of work to predict health risks in long-term missions. More experimental work is needed to adjust some parameters of the model. This work may be seen as another contribution to a better understanding of the underlying processes involved for both women in man adaptation to long-term microgravity.

  3. Managerial Long-Term Responsibility in Family-Controlled Firms

    Directory of Open Access Journals (Sweden)

    Dietmar Sternad


    Full Text Available Evidence suggests that long-term orientation (LTO as a dominantstrategic logic contributes to the sustainable performance offamily-controlled firms (FCFS. Combining a review of the literatureon lto with stewardship theory and upper echelons theoryreasoning, this article presents a typology of managerial responsibilityand introduces the concept of long-term responsibility as amanagerial characteristic constituting a major driving force behindcreating lto. The antecedents of long-term responsibilityunder family firm-specific conditions (stemming from the familysystem, the governance system, and family-firm managers’ personalcharacteristics are also identified and presented in an integratedmodel. The paper contributes to a more comprehensiveunderstanding of intertemporal choice in fcfs and explains whythey tend to be more long-term oriented than other types of firms.

  4. Long-term bridge performance high priority bridge performance issues. (United States)


    Bridge performance is a multifaceted issue involving performance of materials and protective systems, : performance of individual components of the bridge, and performance of the structural system as a whole. The : Long-Term Bridge Performance (LTBP)...

  5. Long-Term Visual Prognosis of Peripheral Multifocal Chorioretinitis

    NARCIS (Netherlands)

    Ossewaarde-van Norel, J; ten Dam-van Loon, NH; de Boer, JH; Rothova, A.


    Purpose To report on the clinical manifestations, complications, and long-term visual prognosis of patients with peripheral multifocal chorioretinitis and to search for predictors for a lower visual outcome. Design Retrospective consecutive observational case series. Methods setting: Institutional.

  6. In search of the elusive long-term price

    International Nuclear Information System (INIS)

    Connor, M.J.; Combs, J.


    The Uranium Institute, WNFM, and past USCEA sessions described and compared existing price reporting systems. The McGraw-Hill conference led to a rather heated discussion as to the propriety of spot prices having the influence they do on amounts paid in long-term contracts. The Ux representative proposed a future's market as a way that producers could hedge against some of the uncertainty of volatile spot market. In discussing the search for the elusive long-term price, there are two interrelated issues. The first is obvious-the search for a starting or initializing price that is representative of recently-signed or pending long-term contracts. The second is less obvious, but perhaps more important-the search for a successful mechanism for determining later delivery values in long-term contracts. This paper addresses the question of pricing mechanisms first

  7. Long-Term Stewardship Science and Technology Requirements

    International Nuclear Information System (INIS)

    McDonald, J.K.; Nickelson, R.A.


    To ensure technology developed for long-term stewardship will meet existing requirements, a review of requirements was performed. In addition to identifying existing science and technology related requirements, gaps and conflicts of requirements were identified

  8. Advancing an ethical framework for long-term care. (United States)

    Carter, Mary Whelan


    This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

  9. Vulnerable long-term psychiatric in- patients need screening for ...

    African Journals Online (AJOL)

    as prominent medical issues in long-term care and provide guidelines for their ..... described in the literature.7,28 These patients might benefit from a renewed emphasis on ..... costs associated with marijuana comorbidity. Drug & Alcohol.

  10. Long-term performance potential of concentrated photovoltaic (CPV) systems

    KAUST Repository

    Burhan, Muhammad; Shahzad, Muhammad Wakil; Ng, Kim Choon


    estimation of a large PV field, the long term performance as electrical output is a more rational approach over the conventional testing methods, such as at Standard Testing Conditions (STC) and at the Nominal Operating Cell Temperature (NOCT) available

  11. Strategies to meet the need for long-term data. (United States)

    Chalmers, John; Woodward, Mark; Borghi, Claudio; Manolis, Athanasios; Mancia, Giuseppe


    Chronic diseases afflict patients for many years, often to the end of life, and there is increasing need for estimating lifelong risk and for evaluating the effects of treatment in the long term. Yet recommendations for lifelong treatment are most frequently based on findings from randomized clinical trials lasting only a few years. There is therefore a clear need for much longer term data, and here we present the advantages and disadvantages of many strategies, including the use of long-term posttrial follow-up, of long-term prospective cohort studies, registry databases, and of administrative databases. We also emphasize the need for long-term cost-effectiveness studies. One of the most promising strategies comes from linkage of data gathered through the ever-expanding pool of administrative databases worldwide with data from other sources, including randomized trials and the many forms of observational study.

  12. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    International Nuclear Information System (INIS)

    T. Haney R. VanHorn


    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used to determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality

  13. Long-term memory, sleep, and the spacing effect. (United States)

    Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody


    Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

  14. The Long-Term Retention of Knowledge and Skills

    National Research Council Canada - National Science Library

    Healy, Alice


    .... The second class of guidelines concerned ways to optimize the strategies used. We found that in tasks that require deliberate retrieval from memory, training that promotes efficient encoding strategies maximizes long-term retention...

  15. Radiation effects after low dose chronic long-term exposure

    International Nuclear Information System (INIS)

    Fliedner, T.M.; Friesecke, I.


    This document approaches the radiation effects after low dose chronic long-term exposure, presenting examples occurred, the pathophysiologic mechanisms for cell system tolerance in elevated radiation fields, and the diagnostic and therapeutic possibilities

  16. Statistical analysis of long term spatial and temporal trends of ...

    Indian Academy of Sciences (India)

    Statistical analysis of long term spatial and temporal trends of temperature ... CGCM3; HadCM3; modified Mann–Kendall test; statistical analysis; Sutlej basin. ... Water Resources Systems Division, National Institute of Hydrology, Roorkee 247 ...

  17. Modelled long term trends of surface ozone over South Africa

    CSIR Research Space (South Africa)

    Naidoo, M


    Full Text Available timescale seeks to provide a spatially comprehensive view of trends while also creating a baseline for comparisons with future projections of air quality through the forcing of air quality models with modelled predicted long term meteorology. Previous...

  18. Long-term risks of kidney living donation

    DEFF Research Database (Denmark)

    Maggiore, Umberto; Budde, Klemens; Heemann, Uwe


    Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science...... and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information...... to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors...

  19. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    Energy Technology Data Exchange (ETDEWEB)

    T. Haney


    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.

  20. Long-term Consequences of Childhood ADHD on Criminal Activities*


    Fletcher, Jason; Wolfe, Barbara


    The question of whether childhood mental illness has long term consequences in terms of criminal behavior has been little studied, yet it could have major consequences for both the individual and society more generally. In this paper, we focus on Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most prevalent mental conditions in school-age children, to examine the long-term effects of childhood mental illness on criminal activities, controlling for a rich set of individual, family...

  1. Long-term patient survival in ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten


    Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain.......Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain....

  2. Aspects of long-term variability in sun and stars

    International Nuclear Information System (INIS)

    Skumanich, A.; Eddy, J.A.


    Evidence of long-term solar variability is reviewed, including historical data and the tree-ring record of radiocarbon. Epochs of suppressed activity like the Maunder Minimum are shown to be frequent occurences of the last several thousand years, but without no obvious period of recurrence. Weak evidence exists for the 11-year cycle as early as Medieval times, although with insufficient accuracy to establish long-term phase stability. (orig.)

  3. Rapid internationalization and long-term performance: The knowledge link


    García-García, Raquel; García-Canal, Esteban; Guillén, Mauro F.


    Drawing on the knowledge-based view and organizational learning theory, we develop and test a set of hypotheses to provide a first attempt at analyzing the effect of speed of internationalization on long-term performance. Using a panel-data sample of Spanish listed firms (1986-2010), we find that there is an inverted U-shaped relationship between speed of internationalization and long-term performance. We also find that whereas technological knowledge steepens this relationship, the diversity...

  4. Long-term outcome of craniopharyngioma in children. A review

    International Nuclear Information System (INIS)

    Tamiya, Takashi; Okada, Masaki; Miyake, Keisuke; Kawai, Nobuyuki


    The treatment for pediatric craniopharyngioma remains challenging and controversial. Although this tumor is histologically benign, the treatments include radical surgery, conservative surgery, radiotherapy, intracystic chemotherapy and multimodality approaches. In addition, the long-term functional outcomes including visual function, endocrine function, cognitive function, hypothalamic function, and quality of life are complex and major problems among survivors. In this paper, we reviewed the recent treatments for pediatric craniopharyngioma and the long-term outcomes after treatment in literatures. (author)

  5. Long-term care: a substantive factor in financial planning. (United States)

    Willis, D A


    More than 50 percent of women will enter a nursing home at some point in their lives. About one-third of men living to age 65 will also need nursing home care. Planning for long-term care is even more important since Medicare covers very little of the cost of such care. The Indiana Partnership Plan is one program designed to help fund the long-term care costs while allowing individuals protect other financial assets.

  6. The Myth That Insulating Boards Serves Long-Term Value


    Bebchuk, Lucian Arye


    According to an influential view in corporate law writings and debates, pressure from shareholders leads companies to take myopic actions that are costly in the long term, and insulating boards from such pressure serves the long-term interests of companies as well as their shareholders. This board insulation claim has been regularly invoked in a wide range of contexts to support existing or tighter limits on shareholder rights and involvement. This paper subjects this view to a comprehensive ...

  7. Long-Term Prognosis of Ischemic Stroke in Young Adults


    Varona, Jose F.


    There is limited information about long-term prognosis of ischemic stroke in young adults. Giving the potentially negative impact in physical, social, and emotional aspects of an ischemic stroke in young people, providing early accurate long-term prognostic information is very important in this clinical setting. Moreover, detection of factors associated with bad outcomes (death, recurrence, moderate-to-severe disability) help physicians in optimizing secondary prevention strategies. The prese...

  8. Introduction of long term cycle of reactor operation

    International Nuclear Information System (INIS)

    Aoyati, M.; Tanaka, T.


    Introduction of long term cycle of LWR reactor operation at NPP in Japan is considered, and problems of technical, legislative and economical character, increase of power coefficient are discussed. More long term operation period provides decreasing frequency of periodic inspections and reduction of personnel radiation doses. Reliability of fuel, energetic equipment, mechanisms and devices must be taken into account for the decision of technical problems. Consumptions for electric power generation are studied [ru

  9. Long term acroecosystem research in the Southern Plains (United States)

    Jean L. Steiner; Patrick J. Starks; Jurgen Garbrecht; Daniel Moriasi; Paul Bartholomew; Jim Neel; Kenneth E. Turner; Brian Northup


    The Southern Plains (SP) site of the Long Term Agroecosystem Research (LTAR) network is headquartered at the USDA-ARS Grazinglands Research Laboratory (GRL) in El Reno, Oklahoma. The GRL was established in 1948. A long-term watershed and climate research program was established in the Little Washita River Experimental Watershed (LWREW) in 1961 and in the Fort Cobb...

  10. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kuzmanović Ilija B.


    Full Text Available INTRODUCTION Abdominal aortic aneurysm can be repaired by elective procedure while asymptomatic, or immediately when it is complicated - mostly due to rupture. Treating abdominal aneurysm electively, before it becomes urgent, has medical and economical reason. Today, the first month mortality after elective operations of the abdominal aorta aneurysm is less than 3%; on the other hand, significant mortality (25%-70% has been recorded in patients operated immediately because of rupture of the abdominal aneurysm. In addition, the costs of elective surgical treatment are significantly lower. OBJECTIVE The objective of this study is to compare long-term survival of patients that underwent elective or immediate repair of abdominal aortic aneurysm (due to rupture, and to find out the factors influencing the long-term survival of these patients. MATERIAL AND METHODS Through retrospective review of prospectively collected data of the Institute for Cardiovascular Diseases of Clinical Center of Serbia, Belgrade, 56 patients that had elective surgery and 35 patients that underwent urgent operation due to rupture of abdominal aneurysm were followed up. Only the patients that survived 30 postoperative days were included in this review, and were followed up (ranging from 2 to 126 months. Electively operated patients were followed during 58.82 months on the average (range 7 to 122, and urgently operated were followed over 52.26 months (range 2 to 126. There was no significant difference of the length of postoperative follow-up between these two groups. RESULTS During this period, out of electively operated and immediately operated patients, 27 and 22 cases died, respectively. There was no significant difference (p>0,05a of long-term survival between these two groups. Obesity and early postoperative complications significantly decreased long-term survival of both electively and immediately operated patients. Graft infection, ventral hernia, aneurysm of

  11. The Impact of Long-Term Climate Change on Nitrogen Runoff at the Watershed Scale. (United States)

    Dorley, J.; Duffy, C.; Arenas Amado, A.


    The impact of agricultural runoff is a major concern for water quality of mid-western streams. This concern is largely due to excessive use of agricultural fertilizer, a major source of nutrients in many Midwestern watersheds. In order to improve water quality in these watersheds, understanding the long-term trends in nutrient concentration and discharge is an important water quality problem. This study attempts to analyze the role of long-term temperature and precipitation on nitrate runoff in an agriculturally dominated watershed in Iowa. The approach attempts to establish the concentration-discharge (C-Q) signature for the watershed using time series analysis, frequency analysis and model simulation. The climate data is from the Intergovernmental Panel on Climate Change (IPCC), model GFDL-CM3 (Geophysical Fluid Dynamic Laboratory Coupled Model 3). The historical water quality data was made available by the IIHR-Hydroscience & Engineering at the University of Iowa for the clear creek watershed (CCW). The CCW is located in east-central Iowa. The CCW is representative of many Midwestern watersheds with humid-continental climate with predominantly agricultural land use. The study shows how long-term climate changes in temperature and precipitation affects the C-Q dynamics and how a relatively simple approach to data analysis and model projections can be applied to best management practices at the site.

  12. Adverse event reporting in Czech long-term care facilities. (United States)

    Hěib, Zdenřk; Vychytil, Pavel; Marx, David


    To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

  13. Changing incentives for long-term gas contracts

    International Nuclear Information System (INIS)

    Bohi, D.R.


    There is much concern about the absence of long-term gas contracts with fixed price and quantity conditions, which until recent years was the standard way of doing business in the gas industry. These types of contracts performed a valuable service in the development of the gas industry, and there comparative absence today is sometimes thought to be one reason for the current malaise in the industry. One hears the argument that there must be some kind of 'market failure' that prevents buyers and sellers from entering into these long term arrangements, and recent changes in state and federal regulations are often cited as the cause of the problem. The purpose of the author's remarks is to argue that what is taken as a breakdown in the market may be simply a reaction to a decline in economic incentives to enter into long-term contracts with rigid price and quantity terms. This is, in other words, simply one more aspect of change in the gas business that Frank Heintz referred to in his opening remarks this morning. The author starts by giving a brief description of the motives for engaging in long-term contracts, and then describes how incentives to use long-term contracts have declined for both gas buyers and gas sellers. He concludes that the decline in the use of long-term contracts is not cause for regulatory concern, but a result of the continuing transformation of the gas business to one that more closely resembles other commodity markets

  14. Trauma in adolescents causes long-term marked deficits in quality of life: adolescent children do not recover preinjury quality of life or function up to two years postinjury compared to national norms. (United States)

    Holbrook, Troy Lisa; Hoyt, David B; Coimbra, Raul; Potenza, Bruce; Sise, Michael J; Sack, Dan I; Anderson, John P


    Injury is a leading cause of death and preventable morbidity in adolescents. Little is known about long-term quality of life (QoL) outcomes in injured adolescents. The objectives of the present report are to describe long-term QoL outcomes and compare posttrauma QoL to national norms for QoL in uninjured adolescents from the National Health Interview Survey (NHIS). In all, 401 trauma patients aged 12 to 19 years were enrolled in the study. Enrollment criteria excluded spinal cord injury. QoL after trauma was measured using the Quality of Well-being (QWB) scale, a sensitive and well-validated functional index (range: 0 = death to 1.000 = optimum functioning). Patient outcomes were assessed at discharge, and 3, 6, 12, 18, and 24 months after discharge. NHIS data were based on 3 survey years and represent a population-based U.S. national random sample of uninjured adolescents. Major trauma in adolescents was associated with significant and marked deficits in QoL throughout the 24-month follow-up period, compared with NHIS norms for this age group. Compared with NHIS norms for QoL in uninjured adolescents aged 12 to 19 years (N = 81,216,835; QWB mean = 0.876), injured adolescents after major trauma had striking and significant QoL deficits beginning at 3-month follow-up (QWB mean = 0.694, p or=15 years) and female sex. Other significant risk factors for poor QoL outcomes were perceived threat to life, pedestrian struck mechanism, and Injury Severity Scores >16. Major trauma in adolescents is associated with significant and marked deficits in long-term QoL outcomes, compared with U.S. norms for healthy adolescents. Early identification and treatment of risk factors for poor long-term QoL outcomes must become an integral component of trauma care in mature trauma care systems.

  15. The mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization

    International Nuclear Information System (INIS)

    Li Weiduo; Yang Jianyong; Zhuang Wenquan; Chen Wei; Li Heping


    Objective: To explore the mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization. Methods: Twenty-five patients of Graves' disease treated with interventional embolization were followed up for 24-57 months. T 3 and T 4 were monitored at pre-operation, six months, 12 months, 2, 3 and 4 years after operation, respectively. Other references included pulse, thyroid size, and vessel's murmur. Results: Twenty-two patients completely relieved from the hyperthyroidism during the follow-up. Only one patient suffered from recurrence. Other two patients were still on maintaining dosage of antithyroid drug therapy. No hypothyroidism or hypoparathyroidism was found during this term. Conclusion: Mid-to-long term follow-up showed satisfactory efficacy of interventional therapy, offering another alternative for treatment of refractory Graves' disease

  16. The influence of flood frequency, riparian vegetation and threshold on long-term river transport capacity (United States)

    Croissant, Thomas; Lague, Dimitri; Davy, Philippe


    Climate fluctuations at geological timescales control the capacity of rivers to transport sediment with consequences on geochemical cycles, sedimentary basins dynamics and sedimentation/tectonics interactions. While the impact of differential friction generated by riparian vegetation has been studied for individual flood events, its impact on the long-term sediment transport capacity of rivers, modulated by the frequency of floods remains unknown. Here, we investigate this effect on a simplified river-floodplain configuration obeying observed hydraulic scaling laws. We numerically integrate the full-frequency magnitude distribution of discharge events and its impact on the transport capacity of bedload and suspended material for various level of vegetation-linked differential friction. We demonstrate that riparian vegetation by acting as a virtual confinement of the flow i) increases significantly the instantaneous transport capacity of the river independently of the transport mode and ii) increases the long term bedload transport rates as a function of discharge variability. Our results expose the dominance of flood frequency rather than riparian vegetation on the long term sediment transport capacity. Therefore, flood frequency has to be considered when evaluating long-term bedload transport capacity while floodplain vegetation is important only in high discharge variability regimes. By comparing the transport capacity of unconfined alluvial rivers and confined bedrock gorges, we demonstrate that the latter always presents the highest long term transport capacity at equivalent width and slope. The loss of confinement at the transition between bedrock and alluvial river must be compensated by a widening or a steepening of the alluvial channel to avoid infinite storage. Because steepening is never observed in natural system, we compute the alluvial widening factor value that varies between 3 to 11 times the width of the bedrock channel depending on riparian

  17. A study to assess the long-term stability of the ionization chamber reference system in the LNMRI (United States)

    Trindade Filho, O. L.; Conceição, D. A.; da Silva, C. J.; Delgado, J. U.; de Oliveira, A. E.; Iwahara, A.; Tauhata, L.


    Ionization chambers are used as secondary standard in order to maintain the calibration factors of radionuclides in the activity measurements in metrology laboratories. Used as radionuclide calibrator in nuclear medicine clinics to control dose in patients, its long-term performance is not evaluated systematically. A methodology for long-term evaluation for its stability is monitored and checked. Historical data produced monthly of 2012 until 2017, by an ionization chamber, electrometer and 226Ra, were analyzed via control chart, aiming to follow the long-term performance. Monitoring systematic errors were consistent within the limits of control, demonstrating the quality of measurements in compliance with ISO17025.

  18. Long-Term Effects and Prognosis in Acute Heart Failure Treated with Tolvaptan: The AVCMA Trial

    Directory of Open Access Journals (Sweden)

    Satoshi Suzuki


    Full Text Available Background. Diuresis is a major therapy for the reduction of congestive symptoms in acute decompensated heart failure (ADHF patients. We previously reported the efficacy and safety of tolvaptan compared to carperitide in hospitalized patients with ADHF. There were some reports of cardio- and renal-protective effects in carperitide; therefore, the purpose of this study was to compare the long-term effects of tolvaptan and carperitide on cardiorenal function and prognosis. Methods and Results. One hundred and five ADHF patients treated with either tolvaptan or carperitide were followed after hospital discharge. Levels of plasma B-type natriuretic peptide, serum sodium, potassium, creatinine, and estimated glomerular filtration rate were measured before administration of tolvaptan or carperitide at baseline, the time of discharge, and one year after discharge. These data between tolvaptan and carperitide groups were not different one year after discharge. Kaplan-Meier survival curves demonstrated that the event-free rate regarding all events, cardiac events, all cause deaths, and rehospitalization due to worsening heart failure was not significantly different between tolvaptan and carperitide groups. Conclusions. We demonstrated that tolvaptan had similar effects on cardiac and renal function and led to a similar prognosis in the long term, compared to carperitide.

  19. [Falls and fractures among older adults living in long-term care]. (United States)

    Del Duca, Giovâni Firpo; Antes, Danielle Ledur; Hallal, Pedro Curi


    To investigate the prevalence of falls and fractures over the past 12 months and associated factors among older adults living in long-term care. Census of all long-term care located in the city of Pelotas, Brazil, in 2008. Falls over the past 12 months were assessed using the following question: "Over the last 12 months, have you fallen?" For those who replied positively, another question was asked: "In any of these falls, have you fractured a bone?" Sex, age, schooling, disability relating to basic activities of daily living, type of financing of the long-term care and hospital admissions were the independent variables. We used chi-square tests for heterogeneity and linear trend in the unadjusted analysis, and Poisson regression with robust variance in the adjusted one. Within the 24 long-term care studied, we collected data for 466 individuals. The prevalence of falls in the past year was 38.9% (95%CI 34.5; 43.4). Among those who have fallen, 19.2% had fractures. Femur (hip) was the most frequent site fractured (43.4%), followed by wrist (10%). In the adjusted analysis, older age, disability for 1-5 basic activities of daily living, living in public institutions and hospital admissions in the last year were associated with higher risk of falls. The high prevalence of falls and fractures highlights the fragility of the individuals living in long-term care. Special attention should be paid to older adults and those with hospital admissions in the last year.

  20. Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use. (United States)

    Deng, Xianhua; Huang, Zhibiao; Li, Xuewu; Li, Yi; Wang, Yi; Wu, Dongling; Gao, Beiling; Yang, Xi


    The long-term outcome of patients diagnosed with drug-induced psychotic disorders in China is unknown. Assess the course of illness and severity of psychiatric symptoms in patients previously admitted to a psychiatric hospital for treatment of psychotic symptoms that were induced by the use of illicit drugs. Patients with psychotic symptoms at the time of their first psychiatric admission who had used illicit drugs in the month prior to admission were followed up 13 to 108 months after admission. Patients and coresident family members were interviewed about post-discharge drug use and psychotic symptoms. The 258 identified patients were primarily young, unemployed males whose most common drug of abuse was methamphetamines and who had been abusing drugs for an average of 7 years at the time of admission. Among these patients 189 (73%) were located and reinterviewed; 168 (89%) had restarted illicit drug use and 25 (13%) had required rehospitalization over the follow-up period. In 114 patients (60%) the psychotic symptoms resolved in less than 1 month after stopping the drugs, in 56 (30%) the symptoms persisted for 1 to 6 months, and in 19 (10%) the symptoms persisted for longer than 6 months (in 8 of these the diagnosis had changed to schizophrenia). Compared to the other two groups, patients whose symptoms persisted more than 6 months were more likely to have a family history of mental illness, an earlier age of onset and a longer duration of drug abuse prior to the index admission; they were also more likely to have been re-hospitalized during the follow-up period and to have psychotic symptoms at the time of follow-up. Most patients with substance-induced psychotic disorders in our sample had a good long-term prognosis but those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis. Further prospective studies are needed to determine the relationship of