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Sample records for patients conclusions presence

  1. Conclusion

    International Nuclear Information System (INIS)

    Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

    1997-01-01

    In this chapter of book authors made following summary: the cancerous growths of anal canal is rare form of growths; extension of anal canal depends from sex, age, weight and growth of patient; the developed schemes of classification and staging of cancerous growths of anal canal have important role for growths systematization; typical symptoms are blood in excrement, pains in anus, presence of swelling in anus, the treatment of the cancerous growths of anal canal must be varied

  2. Conclusion

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusion. Problems of an Under-developed Economy. Geographical Location. Terrain. Change in attitude of mainstream India required. Using Technology to overcome problems.

  3. Conclusions

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions. Be it 2G or 4G, networks are vulnerable to unwanted access and thus should be protected. 4G networks would be more sensitive as its core network will be TCP/IP based. Accordingly, resource and security management schemes with seamless ...

  4. Conclusions:

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions: Extended objects – “D-branes” – appear naturally in theories of strings. They manifest themselves as new types of physical particles in string models. They provide a powerful handle on the symmetries and dynamics of strings. Branes will play a key role ...

  5. Conclusions :

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions : No dramatic difference in the dynamics of anion-water and water-water hydrogen bonds are found for Cl- and Br- ions. Solvation shells of these ions are not rigid. For OH- in water, HB dynamics in the hydration shell determines the rate of proton transfer.

  6. Conclusion

    DEFF Research Database (Denmark)

    Sandøy, Helge; Kristiansen, Tore

    2010-01-01

    1. Comparing empirical findings with the “mountain peak model” In the introduction to this volume, we presented a “mountain peak model” of Nordic purism based on evidence showing that language scholars and lay people are very much in agreement as to where we find the more purist languages......-speaking Finland to Finnish-speaking Finland. In this conclusion to the volume, we will summarize the empirical findings presented in the volume, findings for use and attitudes alike, and compare them with the mountain peak model. That way, we may be able to estimate the nature of the cross-national ideological...

  7. Conclusion

    International Nuclear Information System (INIS)

    2000-01-01

    In the monograph peculiarities of radioinduced sexual dysfunctions of Chernobyl accident liquidators are described. It is shown, that ones of principal clinical manifestations of stochastic radio-genetic effects are sexual dysfunctions. Assessment in point of view of stages and components of copulative cycle is carried out. Authors made attempt to take in account all involved in sexual dysfunctions systems for examined contingent. It is noted, that genesis of radioinduced sexual dysfunctions is complex and it includes both the influence of vegetative nervous system damage and the direct damage of gonads. During clinical examination with patients it is revealed that both vegetative-vascular dysfunctions and asteno-neurotic dysfunctions are dominating. Authors noting that mentioned sexual dysfunctions are caused by low dose irradiation, and they have certain distinctions. Measures for comprehensive rehabilitation of suffered contingent in late period after irradiation are developed

  8. Presence

    Directory of Open Access Journals (Sweden)

    Pamela Renee Boeck

    2014-03-01

    Full Text Available Healthy therapeutic relationships enhance wholeness and healing; they are the key to effective health promotion. Therapeutic nursing presence demonstrates caring, empathy, and connection, qualities required to build rapport and trust between nurse and patient. This concept analysis’ purpose was to illuminate the various forms of the meanings of presence and the value placed on them. The science of nursing often precedes the art and spirituality of nursing. This is due to focusing primarily on the high acuity of the patients being seen in conjunction with shortage of personnel and resources. Patient dissatisfaction continues to be a growing concern. The nursing shortage crisis continues along with more nurses experiencing moral distress, compassion fatigue, and/or burnout. In nurses’ haste to complete their duties, are we facing the risk of overlooking one of the original gifts of the nursing profession? This would be the gift of genuine presence. This concept analysis aims to identify the attributes that are essential to the concept of presence, and to clarify its nursing usage, by following the strategy suggested by Walker and Avant. It is important to reflect on various ways of providing presence in the clinical setting. By exploring the spiritual, literary, psychological, and nursing literature, there is a diverse yet similar interconnectivity of what presence may represent. Observations and experiences of a range of sensatory and kinesthetic perceptions are revealed to ascertain the attributes discerning commonalities and themes of presence. Nursing presence is considered to be an essential state of holistic nursing as well as a core competency in contemporary nursing. Clarifying the significance of presence in nursing invites the prospect of additional evidence-based research that may place the intrinsic value of presence as a continuing theoretical foundation.

  9. Sweet Conclusion

    Science.gov (United States)

    Shirley, Britt M.; Wooldridge, Barbara Ross; Camp, Kerri M.

    2012-01-01

    Jen Harrington is the owner and pastry chef of Sweet Conclusion, a bakery in Tampa, Florida. Most of Harrington's business comes from baking wedding cakes, but she has been attempting to attract customers to her retail bakery, where she sells cupcakes, pies, ice cream, and coffee. Nearly four years she opened Sweet Conclusion, the retail part of…

  10. A transdiagnostic investigation of 'theory of mind' and 'jumping to conclusions' in patients with persecutory delusions.

    Science.gov (United States)

    Corcoran, R; Rowse, G; Moore, R; Blackwood, N; Kinderman, P; Howard, R; Cummins, S; Bentall, R P

    2008-11-01

    A tendency to make hasty decisions on probabilistic reasoning tasks and a difficulty attributing mental states to others are key cognitive features of persecutory delusions (PDs) in the context of schizophrenia. This study examines whether these same psychological anomalies characterize PDs when they present in the context of psychotic depression. Performance on measures of probabilistic reasoning and theory of mind (ToM) was examined in five subgroups differing in diagnostic category and current illness status. The tendency to draw hasty decisions in probabilistic settings and poor ToM tested using story format feature in PDs irrespective of diagnosis. Furthermore, performance on the ToM story task correlated with the degree of distress caused by and preoccupation with the current PDs in the currently deluded groups. By contrast, performance on the non-verbal ToM task appears to be more sensitive to diagnosis, as patients with schizophrenia spectrum disorders perform worse on this task than those with depression irrespective of the presence of PDs. The psychological anomalies associated with PDs examined here are transdiagnostic but different measures of ToM may be more or less sensitive to indices of severity of the PDs, diagnosis and trait- or state-related cognitive effects.

  11. Conclusion; Zaklyuchenie

    Energy Technology Data Exchange (ETDEWEB)

    Nikitin, V I

    1961-07-01

    In this chapter of book are present conclusions about work done by author, in particular that he found comparatively simple and available ways of synthesis of glycerin of acetylene line and glycerin of ethylen line which before was unknown or almost unknown in the chemical literature.

  12. Presence of third molars in orthodontic patients from northern Greece

    Directory of Open Access Journals (Sweden)

    Barka G

    2012-05-01

    Full Text Available Georgia Barka,1 Georgios Tretiakov,1 Theodosios Theodosiou,2 Ioulia Ioannidou-Marathiotou31School of Dentistry, 2Biostatistics, Department of Informatics, School of Natural Sciences, 3Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, GreeceObjective: The purpose of the present study was to investigate the frequency of presence of third molar teeth and their distribution in each jaw and each side, according to sex, in a group of orthodontic patients with permanent dentition from northern Greece.Methods: The sample included panoramic radiographs from 220 patients with permanent dentition (mean age 13.62 ± 1.81. The Χ2 test was used to assess the relationships between the variables, and the Fisher's exact test was used in cases where the expected frequencies in each cell were <5.Results: The frequency of third molar presence was 79.1%, and 20.9% was the frequency of third molar agenesis. Intersexual differences in the number of third molars was not statistically significant. There was a correlation between the distribution of third molars on the right and the left side (Fisher's exact test = 100.788; P = 0. The two sides showed the same tendency toward the presence or absence of third molars. A correlation was also found between the distribution of maxillary and mandibular third molars (Fisher's exact test = 24.372; P = 0. In each jaw, the presence or absence of third molars was highly related to the number of third molars found in the other jaw.Conclusion: The present results showed that in this orthodontic group of northern Greek patients, presence accounted for 79.1% and agenesis for 20.9%. No significant difference was found between the frequencies of third molar presence on the left and right sides in either the maxilla or mandible.Keywords: third molars, presence, orthodontic population, Greeks

  13. General conclusions

    International Nuclear Information System (INIS)

    Tubiana, M.

    1993-01-01

    In conclusion, a general consensus of a number of points which the author endeavours to summarize in this article: -doctors are an excellent channel for passing on information to the public -doctors feel that they do not know enough about the subject and a training on radiobiology and radiation protection is a necessity for them -communication between doctors and the general public is poor in this field -research should be encouraged in numerous areas such as: carcinogenic effect of low doses of radiation, pedagogy and risk perception

  14. [The doctor-patient relationship against the backdrop of patient-centered medicine. The conclusions of dialogical ethics].

    Science.gov (United States)

    Kreß, H

    2012-09-01

    "Health" and "illness" are multilayered terms. The understanding of human health depends, apart from scientific aspects, on people's individual perceptions as well as on aspects of culture and world view. The ideal of patient-centered medicine requires that a physician does not merely have to establish an objectifiable diagnosis. Rather, a physician should also respect the patients' right to self-determination, their personal values, and their subjective view of health and illness. The philosophy of dialogue, which developed in the twentieth century, offers a conceptual background for this ideal. On an empirical basis, the successful communication between doctor and patient can be interpreted as a useful placebo phenomenon. Alternative medicine puts great emphasis on the doctor's attentive care. This also explains why the alternative branch of medicine has appealed to many patients. Therefore, science-oriented medicine should review methods in which the doctor's empathy and dialogue ability are crucial to treatment success. It is part of the physician's responsibility to appreciate the personal perspectives of patients, to respect them and, if necessary, to engage with them critically.

  15. Presence of Fragmented QRS Complexes in Patients with Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Muhammet Rasit Sayin

    2015-01-01

    Conclusions: In our study fragmented QRS frequency and QRS duration were found to increase in OSAS patients. Both parameters are related with increased cardiovascular mortality. Considering the prognostic importance of ECG parameters, it may be reasonable to recommend more detailed evaluation of OSAS patients with fragmented or prolonged QRS complexes with respect to presence of cardiovascular diseases.

  16. Epidemiological analysis of demographic characteristics and type of injuries in patients with multiple trauma with respect to conclusive treatment outcome

    Directory of Open Access Journals (Sweden)

    Zagorac Slaviša

    2008-01-01

    Full Text Available Introduction Multiple trauma is one of the leading causes of mortality and morbidity in the population of people under 45 years of age. The consequences of multiple trauma have huge epidemiological, social and economic significance. Objective The aim of the paper was to analyze the conclusive treatment outcome of multiply traumatized patients with respect to their sex, age, injury mechanism and type. METHOD This retrospective study included 100 patients with multiple injuries (ISS>16 treated in the Emergency Room of the Clinical Centre of Serbia in the course of 2004. Clinical, X-ray, laboratory and numerical presentation methods - scores (ISS and GCS were used to show the injury severity. Results Most of the injured were males (80%, and the average age was 40±20 (5-83. Out of the total number of patients who died, 23 (82% were males, and 5 (18% were females. The average age of the patients with fatal outcomes was 48±21 (8-86. Traffic accidents were the leading cause of injury (59%. The median GCS was 10±3 (3-15. The average ISS was 30 (20-66 in the surviving patients, and 53 (27-77 in those who died. Conclusion With respect to sex, in most cases multiple trauma affects males (p<0.01, with the average age of about 40. With respect to injury mechanism, the main cause of the occurrence of multiple trauma is traffic accidents (p<0.01. There is a statistically significant difference in the values of GCS and ISS relative to the definitive outcome (p<0.01. Statistical data processing indicated that there was a statistically significant correlation between mortality and type of injury in a given organic system (p<0.01, but that there was no statistically significant correlation between mortality and age. .

  17. Shared presence in physician-patient communication: A graphic representation.

    Science.gov (United States)

    Ventres, William B; Frankel, Richard M

    2015-09-01

    Shared presence is a state of being in which physicians and patients enter into a deep sense of trust, respect, and knowing that facilitates healing. Communication between physicians and patients (and, in fact, all providers and recipients of health care) is the medium through which shared presence occurs, regardless of the presenting problem, time available, location of care, or clinical history of the patient. Conceptualizing how communication leads to shared presence has been a challenging task, however. Pathways of this process have been routinely lumped together as the biopsychosocial model or patient, person, and relationship-centered care--all deceptive in their simplicity but, in fact, highly complex--or reduced to descriptive explications of one constituent element (e.g., empathy). In this article, we reconcile these pathways and elements by presenting a graphic image for clinicians and teachers in medical education. This conceptual image serves as a framework to synthesize the vast literature on physician-patient communication. We place shared presence, the fundamental characteristic of effective clinical communication, at the center of our figure. Around this focal point, we locate four elemental factors that either contribute to or result from shared presence, including interpersonal skills, relational contexts, actions in clinical encounters, and healing outcomes. By visually presenting various known and emergent theories of physician-patient communication, outlining the flow of successful encounters between physicians and patients, and noting how such encounters can improve outcomes, physicians, other health care professionals, and medical educators can better grasp the complexity, richness, and potential for achieving shared presence with their patients. (c) 2015 APA, all rights reserved).

  18. A comprehensive strategy for the subtyping of patients with Fanconi anaemia: conclusions from the Spanish Fanconi Anemia Research Network.

    Science.gov (United States)

    Antonio Casado, José; Callén, Elsa; Jacome, Ariana; Río, Paula; Castella, Maria; Lobitz, Stephan; Ferro, Teresa; Muñoz, Arturo; Sevilla, Julián; Cantalejo, Angeles; Cela, Elena; Cervera, José; Sánchez-Calero, Jesús; Badell, Isabel; Estella, Jesús; Dasí, Angeles; Olivé, Teresa; José Ortega, Juan; Rodriguez-Villa, Antonia; Tapia, María; Molinés, Antonio; Madero, Luis; Segovia, José C; Neveling, Kornelia; Kalb, Reinhard; Schindler, Detlev; Hanenberg, Helmut; Surrallés, Jordi; Bueren, Juan A

    2007-04-01

    Fanconi anaemia is a heterogeneous genetic disease, where 12 complementation groups have been already described. Identifying the complementation group in patients with Fanconi anaemia constitutes a direct procedure to confirm the diagnosis of the disease and is required for the recruitment of these patients in gene therapy trials. To determine the subtype of Fanconi anaemia patients in Spain, a Mediterranean country with a relatively high population (23%) of Fanconi anaemia patients belonging to the gypsy race. Most patients could be subtyped by retroviral complementation approaches in peripheral blood T cells, although some mosaic patients were subtyped in cultured skin fibroblasts. Other approaches, mainly based on western blot analysis and generation of nuclear RAD51 and FANCJ foci, were required for the subtyping of a minor number of patients. From a total of 125 patients included in the Registry of Fanconi Anaemia, samples from 102 patients were available for subtyping analyses. In 89 cases the subtype could be determined and in 8 cases exclusions of common complementation groups were made. Compared with other international studies, a skewed distribution of complementation groups was observed in Spain, where 80% of the families belonged to the Fanconi anaemia group A (FA-A) complementation group. The high proportion of gypsy patients, all of them FA-A, and the absence of patients with FA-C account for this characteristic distribution of complementation groups.

  19. Maintaining relationships with your patients by maximizing your online presence.

    Science.gov (United States)

    Donnelly, John; Kaaihue, Maarit

    2011-01-01

    Medical practices that take full advantage of today's online consumer-driven culture will leave other practices in their wake. With today's modern consumers looking to the Internet more and more for finding medical solutions for their family, it is imperative that your practice uses all of the tools available for creating and maintaining its online presence. We all know that having a functional Web site these days is a necessity for practically any business in any industry; however, taking your online presence further by using a few techniques can set up your practice for great success. Your online marketing should help your practice with managing patient relationships at all levels. To best reach this goal, continually analyzing data and updating your online marketing approach will help further drive leads and conversions. Using a few search engine optimization techniques as well as optimal design and marketing methods will allow you to more easily find prospective patients, build trust and credibility with your current patients, and manage your reputation.

  20. Observations on the presence of insulin resistance in patients with essential hypertension and coronary heart disease

    International Nuclear Information System (INIS)

    Zhu Mei; Wu Guo

    2006-01-01

    Objective: To investigate the presence of insulin resistance in patients with essential hypertension (EH) and coronary heart disease (CHD). Methods: Fasting and 2h post oral 75g glucose blood sugar (with oxidase method), insulin and C-peptide (with RIA) levels were examined in 52 patients with EH, 40 patients with CHD and 35 controls. Results: The fasting and 2h post o- ral glucose serum levels of glucose, insulin and C-peptide in the patients were significantly higher than those in the controls (P < 0.01), suggesting presence of impaired glucose tolerance and insulin resistance. Conclusion: Impaired glucose tolerance due to insulin resistance was demonstrated in the studied patients with EH or CHD. (authors)

  1. Correlation between aromatase expression in the eutopic endometrium of symptomatic patients and the presence of endometriosis

    Directory of Open Access Journals (Sweden)

    Maia Jr H

    2012-02-01

    Full Text Available Hugo Maia Jr1,2, Clarice Haddad1,2, Julio Casoy11CEPARH, 2Itaigara Memorial Day Hospital, Salvador, Bahia, BrazilObjective: To investigate whether aromatase expression in the eutopic endometrium correlates with the presence and severity of endometriosis in patients with infertility and/or dysmenorrhea undergoing laparoscopy and hysteroscopy.Patients: The study involved 106 patients of reproductive age with symptoms of dysmenorrhea and infertility. Sixteen endometriosis-free asymptomatic patients were used as a control group.Methods: Concomitant laparoscopy and hysteroscopy was carried out in all cases. An endometrial biopsy was taken to determine aromatase p450 expression by immunohistochemistry. Endometriosis was staged according to the American Society of Reproductive Medicine classification.Results: Endometriosis was diagnosed by laparoscopy in 92/106 symptomatic patients. In this group, aromatase expression was detected in the eutopic endometrium of 66/92 patients with endometriosis (72% and in 13/14 (95% patients in the symptomatic, endometriosis-free group (P = 0.09. Aromatase expression was not detected in any patients from the control group. In the endometriosis group, aromatase expression was detected in the eutopic endometrium of 28/45 patients (62% with American Society of Reproductive Medicine classification stage 1 of the disease, in 11/14 patients (78% with stage II, 14/20 patients (70% with stage III, and in 12/13 patients (92% with stage IV; however, the difference was only statistically significant between stages I and IV (P = 0.04.Conclusion: Aromatase expression in the endometrium was associated with the presence of dysmenorrhea and infertility irrespective of the presence of endometriosis. When endometriosis was present, however, there was a tendency for aromatase expression to be positively correlated with dysmenorrhea severity.Keywords: aromatase, endometrium, endometriosis, Cox-2, dysmenorrhea

  2. Presence of Dry Eye in Patients with Hashimoto’s Thyroiditis

    Directory of Open Access Journals (Sweden)

    Emrah Kan

    2014-01-01

    Full Text Available Purpose. To evaluate the tear function tests in patients with Hashimoto’s thyroiditis and to compare the results with healthy subjects. Methods. A hundred and ten patients with Hashimoto’s thyroiditis and 100 healthy subjects were included in this study. The presence of thyroid-associated ophthalmopathy and tear function tests were evaluated clinically. The results were first compared between the patients and the control groups and then compared between patients with NOSPECS and patients without NOSPECS. Logistic regression analyses of the risk factors for dry eye including sex, gender, free plasma thyroxine, proptosis, upper eyelid margin-reflex distance, and duration of the disease were also evaluated. Results. The mean ocular surface disease index score was significantly higher and mean Schirmer and mean tear break-up time scores were significantly lower in patients compared to control subjects. Mean Schirmer and tear break-up time scores were found to be significantly lower in patients with NOSPECS when compared to the patients without NOSPECS. Both proptosis and free plasma thyroxine levels were significantly associated with dry eye. Conclusions. Patients with Hashimoto’s thyroiditis tend to develop dry eye more common than healthy subjects. Proptosis and lower free plasma thyroxine levels were found to be risk factors for the presence of dry eye.

  3. Presence and significant determinants of cognitive impairment in a large sample of patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Martina Borghi

    Full Text Available OBJECTIVES: To investigate the presence and the nature of cognitive impairment in a large sample of patients with Multiple Sclerosis (MS, and to identify clinical and demographic determinants of cognitive impairment in MS. METHODS: 303 patients with MS and 279 healthy controls were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N; measures of pre-morbid verbal competence and neuropsychiatric measures were also administered. RESULTS: Patients and healthy controls were matched for age, gender, education and pre-morbid verbal Intelligence Quotient. Patients presenting with cognitive impairment were 108/303 (35.6%. In the overall group of participants, the significant predictors of the most sensitive BRB-N scores were: presence of MS, age, education, and Vocabulary. The significant predictors when considering MS patients only were: course of MS, age, education, vocabulary, and depression. Using logistic regression analyses, significant determinants of the presence of cognitive impairment in relapsing-remitting MS patients were: duration of illness (OR = 1.053, 95% CI = 1.010-1.097, p = 0.015, Expanded Disability Status Scale score (OR = 1.247, 95% CI = 1.024-1.517, p = 0.028, and vocabulary (OR = 0.960, 95% CI = 0.936-0.984, p = 0.001, while in the smaller group of progressive MS patients these predictors did not play a significant role in determining the cognitive outcome. CONCLUSIONS: Our results corroborate the evidence about the presence and the nature of cognitive impairment in a large sample of patients with MS. Furthermore, our findings identify significant clinical and demographic determinants of cognitive impairment in a large sample of MS patients for the first time. Implications for further research and clinical practice were discussed.

  4. The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus

    Directory of Open Access Journals (Sweden)

    Magdalena Kazanowska-Dygdała

    2016-02-01

    Full Text Available ABSTRACT Objective Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. Material and Methods The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. Results In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients. The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. Conclusion These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions.

  5. Patient Self-Report of Prior Laser Treatment Reliably Indicates Presence of Severe Diabetic Retinopathy

    Science.gov (United States)

    GRASSI, MICHAEL A.; MAZZULLA, D. ANTHONY; KNUDTSON, MICHAEL D.; HUANG, WENDY W.; LEE, KRISTINE E.; KLEIN, BARBARA E.; NICOLAE, DAN L.; KLEIN, RONALD

    2009-01-01

    PURPOSE To determine whether patient self-report of prior laser treatment can be used as a reliable tool for assessing the presence of severe diabetic retinopathy. DESIGN This was a retrospective study on two groups of diabetic subjects. METHODS One hundred patients with diabetes were recruited from the general eye and retina clinics at the University of Chicago Hospitals. The patients were asked, “Have you ever received laser treatment for your diabetic eye disease (DED)?” A chart review was then conducted noting if the patient had received either focal laser treatment for diabetic macular edema or panretinal photocoagulation for proliferative diabetic retinopathy. Data from the Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR) were also analyzed. Participant responses to the question “Have you had laser photocoagulation treatment for your eyes?” were analyzed with documentation of photocoagulation scars determined by grading seven-standard field color fundus photographs. RESULTS In the University of Chicago group, 96 of 100 (96%) of patients were accurate in reporting whether they had received previous laser treatment for DED (sensitivity 95.8%, specificity 96.1%, and positive predictive value 88.5%). In the WESDR analysis, 2,329 of 2,348 (99%) of participants were accurate in reporting whether they had prior laser treatment for DED (sensitivity 96.0%, specificity 99.5%, and positive predictive value 95.6%). CONCLUSIONS The high sensitivity and specificity of our results validate the use of patient self-report as a useful tool in assessing past laser treatment for severe diabetic retinopathy. Patient self-report may be a useful surrogate to clinical examination or medical record review to determine the presence of severe diabetic retinopathy. PMID:19054495

  6. General conclusions on workshop

    International Nuclear Information System (INIS)

    Rustand, H.

    2006-01-01

    The author proposes a general conclusion on the second workshop on the indemnification of damage in the event of a nuclear accident, organized in Bratislava, the 18-20 May 2005. He pointed out the most important discussions and the results revealed during these two days. (A.L.B.)

  7. Conclusions and recommendations

    International Nuclear Information System (INIS)

    1984-01-01

    The FAO/IAEA/GSF/SIDA Co-ordinated Research Programme on Cereal Grain Protein Improvement by Nuclear Techniques was a follow-up to the FAO/IAEA/GSF Co-ordinated Research Programme on the Use of Nuclear Techniques for Seed Protein Improvement. It was initiated in 1969 and ended in 1981. The objectives of the meeting were to review and evaluate the achievements of the current and previous programmes in order to draw conclusions on the possibility of genetic improvement of cereal grain protein using nuclear techniques, to identify unsolved problems and to discuss and propose possible approaches for their solution. Through reviews and discussions, conclusions and recommendations were made by the participants

  8. Uterine adenomyosis in infertile patients: MR imaging findings and clinical conclusions; MRT der uterinen Adenomyose bei infertilen Patientinnen: Ergebnisse und klinische Rueckschluesse

    Energy Technology Data Exchange (ETDEWEB)

    Zangos, S.; Eichler, K.; Herzog, C.; Marquardt, F.; Peters, J.; Jacobi, V.; Mack, M.G.; Vogl, T.J. [Inst. fuer Diagnostische und Interventionelle Radiologie, J.W. Goethe-Univ. Frankfurt (Germany); Kissler, S.; Mueller, A.; Siebzehnruebl, E.; Kaufmann, M. [Klinik fuer Gynaekologie und Geburtshilfe, J. W. Goethe-Univ. Frankfurt (Germany); Hamscho, N.; Gruenwald, F. [Klinik fuer Nuklearmedizin, J. W. Goethe-Univ. Frankfurt (Germany)

    2004-11-01

    Purpose: To evaluate the clinical value of magnetic resonance imaging (MRI) of the uterus and the pelvis in infertile female with symptomatic endometriosis for the assessment of uterine morphology and function. Materials and Methods: Forty-one infertile women (mean age: 33.2 years) with symptomatic endometriosis documented by laparoscopy were evaluated with highfield MRI (Sonata, Siemens) using T2- and T1-weighted sequences. In addition, the patients underwent hysterosalpingoscintigraphy (HSSG) for evaluation of the uterotubal transport capacity. Pathologic findings of the uterine junction zone were correlated with the laparoscopic results, clinical symptoms and uterotubal transport capacity. Results: Adenomyosis was diagnosed on T2-weighted MR-images in 35 (85.4%) patients (focal adenomatosis in 26 patients and diffuse adenomatosis in 9). Patients showing signs of adenomyosis tended to be older than patients without adenomyosis (mean age 34.1 years vs. 30.1 years) and showed a longer history of symptomatic endometriosis. A positive transport capacity in HSSG was observed in 73.1% (19/26) of the patients with focal adenomyosis and only 22.2% (2/9) of patients with diffuse adenomyosis. In 83.3% (5/6) of the patients without signs of adenomyosis, a positive uterotubal transport was documented. Conclusion: MRI of the uterus is a helpful diagnostic tool for the diagnosis of adenomyosis and for planning further therapies. Patients with the diagnosis of adenomyosis showed a reduced uterotubal transport capacity that depended on the severity of adenomyotic changes and might be a possible cause of infertility. (orig.)

  9. 7. Conclusions and reflections

    OpenAIRE

    Nettle, Daniel

    2016-01-01

    But now your eyes sing the sad, sad song,Of how you lived so fast and died so young. Introduction We’ve now finished the data chapters of this book, and some conclusions are in order. In this chapter, I summarise what strike me as the main things we have learned, and suggest what their implications might be. I then devote a more extended discussion to the issue of causes of patterns of social behaviour, and how our data might bear on it. From this follows a brief consideration of what kinds o...

  10. Conclusions and recommendations

    International Nuclear Information System (INIS)

    Carrette, M.

    1997-01-01

    The paper presents conclusions and recommendations at the closing session of the NEA/OECD Workshop held at Fontenay-aux-Roses on 12-14 June 1995. The conclusions refer to issues like: public reaction to foodstuffs containing radioisotope concentrations under the danger standards, possible non-adherence of manufacturers, processors, distributors, et al, to the instructions and guidance from radiation protection specialists, integration of all the food chain factors in the elaboration of the emergency intervention programs, etc. Among the most significant recommendations the following may be mentioned: 1. Differences between different intervention levels and the maximum admissible levels agreed upon by national, regional or international nutrition authorities should be further studied; 2. Problems created by the Chernobyl accident (as for instance, the methods of treatment of food chain products containing unacceptable radioactivity concentrations) are still present and must be solved; 3. Further studies should be done on the socio-cultural aspects of the communication, particularly on the information in rural environment; 4. The preventive measures in agriculture should be implemented as rapidly as possible; 5. In elaborating programmes of agriculture countermeasures, the management of contaminated media, particularly, of forests and their effect on agriculture

  11. Presence of Cognitive Deterioration and Anatomical-Clinical Topography in Patients with Epilepsy in Cienfuegos

    Directory of Open Access Journals (Sweden)

    Rolando Lázaro Rivera López

    2015-02-01

    Full Text Available Background: epilepsy is a pathological condition characterized by a recurrent non-provoked crisis, however, the presence of the crisis is a fraction of the global problem, patients with epilepsy develop a variety of neuropsychiatry problems, as cognitive affection, most of all, in the space of memory. Objective: evaluating the behavior of the cognitive deterioration and focalization according to anatomical- clinical topography in patients with epilepsy. Methods: a descriptive, correlational, cross-section and follow-up study of cases. The techniques used were: structured interview, the Montreal Cognitive Assessment's evaluation, and Luria´s neuropsychological exam. It was used SPDD statical parcel, version 1.5 to process the information that made possible the study of the obtained data, with the aim of expressing the results in chart of frequency and relation of variables in number and percent. Results: the 71.4 % of evaluated patients presented cognitive deterioration in any of its of measurement scales and they focalized according to neuropsychological exam. Conclusions: as the time of evolution of the disease increases, the frequency and duration of the crises, the grade of the cognitive deterioration in patients with epilepsy increases, focalizing with dysfunction majority fronto-temporary level according to anatomical-clinical topography.

  12. Summary and conclusions

    International Nuclear Information System (INIS)

    Bates, T.D.

    1980-01-01

    Various aspects of a clinical session on 'High dose-rate afterloading in the treatment of cancer of the uterus' at the International Workshop, London in April 1978 are discussed. The results of high dose-rate afterloading treatment were at least as good as those of conventional low dose-rate therapy. However, there is still a need to optimize dose fractionation and technique according to the type and stage of the disease to achieve the best results with the least distress for the patient. It would appear that, at the doses used, side effects with high dose-rate afterloading were few and probably related to the external rather than to the intracavitary therapy. High dose-rate afterloading therapy has obvious social and economic advantages and is thus of interest to all countries. (U.K.)

  13. Summary and Conclusions

    International Nuclear Information System (INIS)

    2013-01-01

    This section summarizes the presentations and Panel discussions of the 4 technical sessions of the workshop: 1 - Regulatory cooperation on generic and design specific issues, MDEP working groups (EPR, AP1000), vendor inspection co-operation, digital I and C, and codes and standards (7 presentations); 2 - Regulatory positions on siting practices and enhancements as a result of lessons learned from Fukushima accident (5 presentations); 3 - Construction experience and regulatory oversight of new reactor construction activities (6 presentations); 4 - Lessons learned from regulatory licensing reviews of new reactor designs (6 presentations). The main workshop conclusions are listed as follows: - Harmonization is a long term goal and significant progress has been made. However, this long term objective needs to be associated with short term measurable steps; - MDEP approach to tackle on one side with specific technical subjects, and to strive harmonisation on generic topics was considered appropriate; - Convergence on technical requirements is more realistic than harmonization of codes and standard; - Beneficial early engagement of different stakeholders specially at the siting stage has been acknowledged; - Need to characterise the hazards and to keep updated the safety assessment (PSR); - Land use issues are important particularly after Fukushima; - Commissioning aspects (e.g. training aspects for inspectors) should be addressed by WGRNR taking into account MDEP interaction; - Importance of WGRNR ConEx Programme: construction experience sharing is a leverage for quality and so for a future safe operation of NPPs; - Capability of licensee to follow the responsibility of design changes (could be an issue for small utilities); - Importance of Periodic Safety Reviews to review and account for the design. Finally, the WGRNR has convened that a third conference should be held in about two years time (2014- 2015)

  14. Summary and conclusions

    International Nuclear Information System (INIS)

    2011-01-01

    authorities, reactor designers, and operators/ licensees perspectives on the various practices used in the regulation of nuclear power plant siting (selection, evaluation and site preparation). This session was also aimed to address issues on sites where a mixture of activities are taking place (e.g., operating units, new construction, decommissioning, etc.) including organisation of the regulators and licensee/engineering organisation, methods, systems, etc. Conclusions: In general workshop participants agreed on the need to regularly have these kind of forums to discuss relevant regulatory issues for new builds. One important aspect of this workshop was the participation of 'New Entrants'. The interaction between NEA member countries with mature nuclear power plants and newcomers was quite important since it gave newcomers the possibility to benefit of mature international practices in order to focus their regulatory oversight and control. NEA members could also benefit from insights the New Entrants discover as they develop or enhance their regulatory controls. In addition technical exchanges associated with construction experience of New Entrants as they begin to license, build and operate NPP could benefit NEA members

  15. Conclusions

    Indian Academy of Sciences (India)

    In long-term better adapted varieties are needed to adapt to multiple stresses linked with climate change. ... and water management are available which can help minimize negative impacts. ... Adaptation practices take time to become effective.

  16. Conclusion

    NARCIS (Netherlands)

    Grignon, F.; Mazrui, A.; Rutten, M.M.E.M.; Rutten, M.M.E.M.; Mazrui, A.; Grignon, F.

    2001-01-01

    The outcome of a three-day conference held at the African Studies Centre, Leiden, The Netherlands, in September 1998, this book on the 1997 Kenya general elections is organized in four parts: the direct pre-electoral background; technical and national analysis of the general elections, including the

  17. Conclusion

    OpenAIRE

    Rainhorn, Jean-Daniel; Boudamoussi, Samira El

    2017-01-01

    “Science without conscience is but the ruin of the soul.”—François Rabelais, 1542 A special feature of this book is to bring together the work of researchers coming from different disciplines and having various themes of reflection or practices in the field of biomedicine. While the general trend of science goes towards increasing specialization, the project of this book is to look at the use of medical advances in a transversal perspective. In other words, it intends to highlight what unregu...

  18. Conclusions

    International Nuclear Information System (INIS)

    Mandil, C.

    1994-01-01

    The renewable energies and the nuclear one are complementary. They belong to the french energy policy, which has three aims: strategic, economic and environmental. They contribute to the diversification of the energy balance and to the energy competitiveness. Energy savings might be achieved and renewable energies might be developed for the future

  19. Conclusions

    Indian Academy of Sciences (India)

    Confounding effect of obesity and associated co-morbidities (especially on metabolic abnormalities, cardiovascular and cerebrovascular morbidity) should be clearly dissected out in future studies ...

  20. Conclusion

    OpenAIRE

    Houmed Soulé, Aramis

    2018-01-01

    Au cours de son règne qui a duré plus d’une quarantaine d’années, en une période cruciale de l’histoire de la Corne de l’Afrique, Maḥammad Ḥanfaré parvient à préserver son sultanat, à défaut de l’ensemble du pays ‘Afar, des visées impérialistes d’où qu’elles viennent. Malheureusement, l’indépendance de cette entité politique ‘Afar ne lui survit pas, du moins sur le plan international. Des luttes fratricides pour sa succession qui opposent ses nombreux héritiers et dont les prémices apparaisse...

  1. Conclusion

    DEFF Research Database (Denmark)

    Fahnøe, Kristian Relsted; Warming, Hanne

    2017-01-01

    analysis approach reveal how clients’ struggles in intimate and societal life, and in public and private spaces, are intertwined with geo-politics and global flows of governance strategies, e.g. neoliberalism and managerialism, which also condition social work practices. Indeed, social work constitutes......Fahnøe and Warming provide a cogent overview of how a lived citizenship approach enables critical analyses of social work and social policies by addressing challenges related to rights, recognition, participation, belonging and identity. The sub-concept of intimate citizenship and a spatial...... a kind of sociological magnifying glass through which broader social changes can be studied, including dynamics of inclusion and exclusion, new conflicts and modes of resistance, and new social pathologies....

  2. Conclusion

    DEFF Research Database (Denmark)

    Warming, Hanne; Fahnøe, Kristian

    2017-01-01

    analysis approach reveal how clients’ struggles in intimate and societal life, and in public and private spaces, are intertwined with geo-politics and global flows of governance strategies, e.g. neoliberalism and managerialism, which also condition social work practices. Indeed, social work constitutes......Warming and Fahnøe provide a cogent overview of how a lived citizenship approach enables critical analyses of social work and social policies by addressing challenges related to rights, recognition, participation, belonging and identity. The sub-concept of intimate citizenship and a spatial...... a kind of sociological magnifying glass through which broader social changes can be studied, including dynamics of inclusion and exclusion, new conflicts and modes of resistance, and new social pathologies....

  3. Conclusion

    DEFF Research Database (Denmark)

    de Vreese, Claes; Reinemann, Carsten; Esser, Frank

    2017-01-01

    At the outset, we asked if there is any good news about the news and, if so, where the good news is. In academic research and public discussions about news and democracy, one fi nds different interpretations of the state of current news provision. A tendency towards pessimism about current news...... is seen as having a negative impact on the quality of political life and democracy. Set against the pessimism and caution in the public debate and literature on news quality and the performance of political journalism, we were not optimistic that we would fi nd good-quality news or that we would be able...... to offer some good news as a positive antidote, so to speak, to the pervasive pessimism in the literature....

  4. Conclusions

    International Nuclear Information System (INIS)

    Brookes, L.G.; Motamen, H.

    1984-01-01

    The paper covers the following: economics of nuclear power; nuclear or fossil-fuel plants; power systems; methods of capital investment appraisal; size factor; nuclear industry; uranium demand; fuel cycle; fast reactors; choice of reactors; case studies from France; power plants in USA and West Germany; electricity tariffs; nuclear energy in Middle Eastern states; energy growth and economic growth; nuclear energy as macroeconomic influence; future energy options. (U.K.)

  5. Conclusion

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms; Wallo, Andreas; Toiviainen, Hanna

    2015-01-01

    Work in times of globalisation and uncertainty is undergoing considerable changes, which has strengthened the importance of work as a site of learning. New trends in production, such as digitalisation, challenge traditional modes of producing goods and services. Emerging forms of flexible...... production and knowledge-work offer growing learning opportunities to people throughout their active working life. In contrast to the stable and standardised modes of Fordist production, modern working life is characterised by rapid changes and employees interacting across globally distributed professional...... explores the challenges of working and learning on the boundaries between education and working life. Globalisation affects the transition patterns from vocational education to the labour market in many ways (Schoon & Silbereisen, 2009), even though the specific challenges to national-level policies vary...

  6. Conclusions

    Science.gov (United States)

    Ahonen, Pasi; Alahuhta, Petteri; Daskala, Barbara; Delaitre, Sabine; Hert, Paul De; Lindner, Ralf; Maghiros, Ioannis; Moscibroda, Anna; Schreurs, Wim; Verlinden, Michiel

    Some say that an increase in security does not necessarily mean a further encroachment on privacy - indeed, security is necessary to protect personal data and our privacy. Networks must be secure, our personal devices, reliable, dependable and trustworthy. But security is a multifaceted term, with many dimensions. We are of the view that an increase in security most likely will encroach upon our privacy in an ambient intelligence world. Surveillance cameras will continue to proliferate. We assume that, whatever the law is, whatever privacy protections government and business say they honour, our telecommunications, e-mails and Internet usage will be monitored to an increasing degree. The same will be true of our interfaces with the world of ambient intelligence.

  7. Conclusion

    International Nuclear Information System (INIS)

    Ainul Hayati Daud; Hazmimi Kasim

    2010-01-01

    In Asia, Japan and the Republic of Korea have conducted similar studies but relying on statistical data and used inputs and outputs (I-O) methodology, utilizing on general macro-level data. In contrast, this study captures data directly through surveys using questionnaires, face-to-face interviews, case studies and focus group discussions. The impact of nuclear technology applications in Malaysia were evaluated both quantitatively and qualitatively. These impacts are then linked to a broader objective associated with technological development, namely wealth generation, knowledge generation and societal well-being. In the process of the study, users and practitioners of the technology highlighted issues and challenges faced by them. To cap the study, the level of activities of nuclear technology in Malaysia was benchmarked against those in Japan and the Republic of Korea. This chapter highlights the results of the study, the outcome of the study, followed by recommendations as response to issues and challenges raised by respondents, and finally the way forward for monitoring and charting further progress of nuclear technology in the country. (author)

  8. Conclusions

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. First study on fHSC. First study on fHSC. fHSC exhibit embryonic stem cell like properties. fHSC therapy results in myocardial regeneration in rat model of MI. fHSC may be a novel stem cell type for cardiovascular regeneration.

  9. Conclusions

    Indian Academy of Sciences (India)

    Microbial organisms play a major role in assimilation of P from the water column and also from the interstitial waters. Mineralisation of microbial bodies is a very rapid process and autophosphatization may occur within few hours or days after death. Geo-microbiology is an important subject and needs to be developed.

  10. Current practices related to family presence during acute deterioration in adult emergency department patients.

    Science.gov (United States)

    Youngson, Megan J; Currey, Judy; Considine, Julie

    2017-11-01

    To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Descriptive exploratory study using nonparticipatory observation. Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. © 2017 John Wiley & Sons Ltd.

  11. Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

    Directory of Open Access Journals (Sweden)

    D'Elia JA

    2017-06-01

    Full Text Available John A D’Elia,1 Alissa R Segal,1,2 George P Bayliss,3 Larry A Weinrauch1 1Kidney and Hypertension Section, Joslin Diabetes Center, Harvard Medical School, 2Department of Pharmacy Practice, MCPHS University, Boston, MA, 3Division of Kidney Diseases and Hypertension, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, RI, USA Objective: To evaluate whether adverse event reports to the US Food and Drug Administration on incidents of ketoacidosis from use of sodium glucose cotransport inhibitors (SGLT2 inhibitors provide insight into ways this new class of drugs is being prescribed with other antihyperglycemic agents; to examine possible mechanisms to explain ketoacidosis.Design and methods: Reports of adverse events concerned to SGLT2 inhibitors, namely, empagliflozin, dapagliflozin, and canagliflozin were obtained under the Freedom of Information Act for 5 years ending in August 31, 2015. The data were evaluated for incidents of ketoacidosis by looking for keywords such as diabetic ketoacidosis, ketoacidosis, lactic acidosis, acidosis, and metabolic acidosis. Results were tabulated individually for empagliflozin (n=260 adverse event reports, dapagliflozin (n=520, and canagliflozin (n=2159. Adverse events were categorized according to age, gender, and insulin use.Results: There were 46, 144, and 450 reports of ketoacidosis concerned with the use of empagliflozin, dapagliflozin, and canagliflozin, respectively. The use of SGLT2 inhibitors was not strictly limited to patients with type 2 diabetes but was cut across categories of insulin use, including a total of 172 cases of SGLT2-related ketoacidosis in individuals above the age of 40 who were not on insulin.Conclusion: Further studies should focus to detect pleiotropic effects of SGLT2 inhibitors, particularly with other oral antihyperglycemic drugs or insulin. A review of the literature suggests that patients with type 2 diabetes with low C-peptide level may be at

  12. Spleen Stiffness Correlates with the Presence of Ascites but Not Esophageal Varices in Chronic Hepatitis C Patients

    Directory of Open Access Journals (Sweden)

    Kazuyo Mori

    2013-01-01

    Full Text Available Although spleen stiffness has recently been identified as potential surrogate marker for portal hypertension, the relationship between spleen stiffness and portal hypertension has not been fully elucidated. We attempted to determine the relationship between the liver or spleen stiffness and the presence of ascites or esophageal varices by acoustic radiation force impulse (ARFI imaging. A total of 33 chronic hepatitis C (CHC patients (median age 68; range 51–84 were enrolled. We evaluated the relationship between the liver or spleen stiffness and indicators of portal hypertension as well as clinical and biochemical parameters. Fourteen healthy volunteers were used for validating the accuracy of AFRI imaging. The liver and spleen stiffness increased significantly with progression of liver disease. A significant positive correlation was observed between the liver and spleen stiffness. However, spleen stiffness, but not liver stiffness, was significantly associated with the presence of ascites (, while there was no significant association between the spleen stiffness and spleen index/presence of esophageal varices in CHC patients. The area under the receiver operating characteristic curve based on the spleen stiffness was 0.80. In conclusion, spleen stiffness significantly correlates with the presence of ascites but not esophageal varices in CHC patients.

  13. Transient ischemic attacks and presence of an acute brain lesion in diffusion-weighted MRI: study of 50 patients

    Directory of Open Access Journals (Sweden)

    Sabeti M

    2012-10-01

    Full Text Available Background: Finding an acute brain lesion by diffusion-weighted (DW MRI upon an episode of transient ischemic attack (TIA is a predictor of imminent stroke in the near future. Therefore, exploring risk factors associated with lesions in DW-MRI of the brain is important in adopting an approach to TIA management. In the current study, we tried to determine the risk factors associated with lesions in DW-MRI of the brain in patients experiencing TIA episodes.Methods: Fifty patients with TIA were recruited consecutively in Sina Hospital, Tehran, Iran, over a 6-month period between July 2008 and January 2009. All of the patients underwent a complete neurological examination and laboratory tests. Brain DW-MRIs were performed for all the patients within 72 hours of a TIA episode.Results: DW-MRI revealed an acute lesion in 16% of the participants. There was a significant correlation between presence of an acute lesion in DW-MRI and TIA duration, history of diabetes mellitus and presence of unilateral facial palsy (P=0.0003, P=0.02 and P=0.008, respectively. Other variables such as age, hypertension, hyperlipidemia, past history of TIA, headache, vertigo, and sensory or visual disturbances had no significant relation with the presence of an acute lesion in DW-MRI.Conclusion: Duration of TIA, presence of diabetes mellitus and unilateral facial palsy are risk factors for an acute lesion in DW-MRI, meaning that patients with such risk factors are at risk for stroke in the near future.

  14. [Clinical and laboratory parameters in patients with urolithiasis in the presence and absence of primary hyperparathyroidism].

    Science.gov (United States)

    Dzerganov, N K; Egshatian, L V; Mokrysheva, N G; Peretokina, E V

    2013-01-01

    The clinical and laboratory findings in 78 patients with various forms of urolithiasis depending on the presence of primary hyperparathyroidism (PHPT) were analyzed. PHPT was diagnosed in 17 patients. Group "without PHPT" and group "with PHPT" differed significantly in terms of parathyroid hormone (PTH) level, serum calcium, phosphorus, chloride, alkaline phosphatase, calciuria and kaliuria. In patients with staghorn calculi, PHPT was diagnosed in 12.5%, and staghorn calculi in the presence of PHPT were identified in 17.7% of cases. Hypercalciuria in the group "with PHPT" was detected in 82.4% of patients (all 3 patients with staghorn calculi), and in the group "without PHPT"--in 18% of patients (2 of 21 patients with staghorn calculi). Hyperoxaluria was observed in 42.3% of patients "without PHPT" and in 35.3% of patients "with PHPT", in 36.8% of patients with simple stones and in 57.2%--with staghorn calculi. In 39% of patients "without PHPT", secondary hyperparathyroidism (SHPT) was diagnosed. SHPT prevalence was 28% in patients with staghorn calculi, and 45% in patients with simple stones. In 87.5% of patients with hypomagnesemia, staghorn calculi were observed. Significant relationship between magnesium and triglycerides (r(s) = -0.296; P = 0.041), and magnesium and high-density lipoproteins (r(s) = 0.339; P = 0.032) in all patients with urolithiasis were revealed. Thus, the study found no association between staghorn nephrolithiasis and PHPT. Elevated PTH levels usually indicate SHPT rather than PHPT. In hypocalcemia, there was more strong association between PTH and calcium, in normocalcaemia--between PTH and magnesium.

  15. Parameters of platelet activity in patients with thyrotoxicosis in the presence of chronic hyperglycemia and atrial fibrillation

    Directory of Open Access Journals (Sweden)

    G G Petrik

    2011-06-01

    Full Text Available Object. The study of platelet hemostasis in patients with thyrotoxicosis in the presence of chronic hyperglycemia and atrial fibrillation to prevent coagulation disorders. Material and methods. A comprehensive analysis of the parameters of platelet and coagulation hemostasis in 91 patients (67 women and 24 men with uncomplicated thyrotoxicosis, as well as with the atrial fibrillation or a combination of hyperthyroidism with diabetes has been completed. Results. The aggregation activity of platelets in uncomplicated thyrotoxicosis comparable with that of healthy people. atrial fibrillation, as well as chronic hyperglycemia, modify platelet activity by increasing the average volume of platelets, their ability to aggregate intensification of the release reaction and along with the decrease of disaggregation properties. Regardless of the presence of diabetes or atrial fibrillation, hyperthyroidism is accompanied by the activation of coagulation. Conclusion. The presence of transforming effects of chronic hyperglycemia and atrial fibrillation on the platelet activity determines the feasibility of differentiated approach to the prevent of coagulation disorders in patients with thyrotoxicosis.

  16. The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus.

    Science.gov (United States)

    Kazanowska-Dygdała, Magdalena; Duś, Irena; Radwan-Oczko, Małgorzata

    2016-01-01

    Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR) method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients). The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions.

  17. Elevated serum triglycerides is the strongest single indicator for the presence of metabolic syndrome in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Dimou Eleni

    2006-10-01

    Full Text Available Abstract Background Patients with diabetes already fulfill one diagnostic criterion for MS according to the existing classifications. Our aim was to identify one single clinical parameter, which could effectively predict the presence of MS in patients with type 2 diabetes. Methods We studied all patients with type 2 diabetes who attended our Diabetes Outpatient Clinic during a three-month period. Waist circumference, blood pressure and serum lipids were measured. Establishment of MS diagnosis was based a on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III criteria and b on International Diabetes Federation (IDF criteria. Receiver operating characteristic (ROC analysis was applied in order to identify the clinical parameter with the highest predictive capability for MS. Among the 500 participating patients (231 males, 269 females, MS was diagnosed in 364 patients (72.8% according to the NCEP ATP III criteria and in 408 patients (81.6% according to the IDF criteria. Results For the NCEP ATP III classification, serum triglycerides (in the overall population, waist and HDL (in female population demonstrated the highest predictive capability for MS (AUCs:0.786, 0.805 and 0.801, respectively. For the IDF classification, no single parameter reached an AUC > 0.800 in the overall population. In females, HDL displayed a satisfactory predictive capability for MS with an AUC which was significantly higher than the one in males (0.785 vs. 0.676, respectively, p Conclusion Elevated serum triglycerides strongly indicate the presence of MS in patients with type 2 diabetes. In female patients with type 2 diabetes, central obesity was the second stronger predictor of MS besides hypertriglyceridemia.

  18. Association of prolidase activity, oxidative parameters, and presence of atrial fibrillation in patients with mitral stenosis.

    Science.gov (United States)

    Rabus, Murat; Demirbag, Recep; Yildiz, Ali; Tezcan, Orhan; Yilmaz, Remzi; Ocak, A Riza; Alp, Mete; Erel, Ozcan; Aksoy, Nurten; Yakut, Cevat

    2008-07-01

    Mitral stenosis (MS) is a common cause of atrial fibrillation (AF). Oxidative stress and inflammation factors were shown to be involved in atrial remodeling. The study aim was to compare the oxidative parameters and prolidase activity in severe MS patients with and without AF. The study population was comprised of 33 patients with MS and sinus rhythm (group I), 27 patients with MS and AF (group II), and 25 healthy controls (group III). Plasma prolidase activity, total antioxidant capacity (TAC), total oxidative status (TOS), and oxidative stress index (OSI) were determined. Additionally, we measured tissue TOS and TAC in patients with mitral valve replacement. TAC and OSI were higher, but TOS and prolidase were lower in patients with MS than control (all p 0.05). Tissue TAC was significantly lower in group II than group I (0.015 +/- 0.01 vs. 0.026 +/- 0.01 mmol Trolox equiv/L, p = 0.014), tissue TOS was similar between groups I and II (0.24 +/- 0.06 vs. 0.22 +/- 0.05 mmol Trolox equiv/L, p = 0.161). Presence of AF was correlated with systolic blood pressure, left atrial diameter, plasma TAC, tissue TAC, plasma TOS, plasma OSI, and plasma prolidase activity. Tissue TAC level (beta = -0.435, p = 0.006) and left atrial diameter (beta = 0.460, p = 0.003) were independently related with presence of AF in patients with MS. This study suggested that the presence of AF in patients with severe MS may be associated with the plasma prolidase activity, tissue and plasma oxidative parameters.

  19. Presence of anxiety and depression in patients with bronchiectasis unrelated to cystic fibrosis.

    Science.gov (United States)

    Girón Moreno, Rosa María; Fernandes Vasconcelos, Gilda; Cisneros, Carolina; Gómez-Punter, Rosa Mar; Segrelles Calvo, Gonzalo; Ancochea, Julio

    2013-10-01

    Patients with chronic bronchiectasis (BQ) may suffer from psychological disorders. The objective of this study was to assess the presence of anxiety and depression in patients from a specialised BQ Unit, using validated questionnaires. We included patients consecutively diagnosed with BQ (unrelated to cystic fibrosis) by high resolution computed tomography in the study. Patients were clinically stable in the previous three weeks and voluntarily completed the Beck Depression Inventory, State-Trait Anxiety Inventory and St. George's Respiratory Questionnaire, after signing the informed consent. They were classified according to their scores on the psychological screening questionnaires, and their results were compared with the clinical, radiological and functional parameters and Quality of Life. Seventy patients were included, 48 women and 22 men, with a mean age of 64.19years. Thirty-four percent (34%) of patients showed symptoms of depression, and around 55% had scores above the 50th percentile in trait and state anxiety. The amount of sputum was associated with trait anxiety. Bacterial colonization was related to anxiety (trait and state), especially Pseudomonas aeruginosa colonization. Female patients showed a higher risk of depression. There was no relationship between the Quality of Life scores and the established classifications of anxiety and depression. A high percentage of patients with BQ presented anxiety (trait and state) and depression. The daily sputum production and bacterial colonization (especially with P. aeruginosa) were the variables most related to anxiety; depression was more common in women. We believe that the presence of psychological disorders should be evaluated, especially in patients with this profile. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  20. Family presence preference when patients are receiving resuscitation in an accident and emergency department.

    Science.gov (United States)

    Hung, Maria S Y; Pang, Samantha M C

    2011-01-01

    This paper is a report of a study to illuminate the experience of family members whose relatives survived the resuscitation in an accident and emergency department, and their preferences with regard to being present. Family presence during resuscitation can offer benefits to both patient and family members, and large healthcare organizations support and recommend offering the option for their presence. However, many staff believe that this is too distressing or traumatic for families and that they would interfere with the resuscitation process. An interpretive phenomenological approach was used to collect data in 2007-2008 with 18 family members of patients who survived life-sustaining interventions in an accident and emergency department in Hong Kong. Audio-recorded interviews were transcribed verbatim for thematic analysis and verified with the participants in second interviews. None of the family members was present in resuscitation room during the life-sustaining interventions, and five entered the room after the patients' condition was stable. The majority indicated a strong preference to be present if given the option. Three interrelated themes emerged: (i) emotional connectedness, (ii) knowing the patient, and (iii) perceived (in)appropriateness, with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. The interplay of these determinants and how they contributed to strong or weak preference for family presence was analysed. Variations among the contributing determinants to each family member's preference to be present were revealed. Appropriate nursing interventions, policy and guidelines should be developed to meet individualized needs during such critical and life-threatening moments in accident and emergency departments. © 2010 Blackwell Publishing Ltd.

  1. Clinical Significance of the Presence of Autonomic and Vestibular Dysfunction in Diabetic Patients with Peripheral Neuropathy

    Directory of Open Access Journals (Sweden)

    Soo Kyoung Kim

    2012-02-01

    Full Text Available BackgroundWe investigated the prevalence of diabetic autonomic neuropathy (DAN and vestibular dysfunction (VD in diabetic patients with peripheral neuropathy.MethodsThirty-five diabetic patients with peripheral neuropathy were enrolled from August 2008 to July 2009. All subjects underwent autonomic function tests. Nineteen of the patients (54.3% underwent videonystagmography.ResultsDiabetic autonomic neuropathy was observed in 28 patients (80%. A mild degree of autonomic failure was observed in 18 patients (64.3%, and a moderate degree of autonomic failure was observed in ten patients (35.7%. Factors related to DAN included diabetic nephropathy (P=0.032, degree of chronic kidney disease (P=0.003, and duration of diabetes (P=0.044. Vestibular dysfunction was observed in 11 of 19 patients (57.9%. There was no significant association between DAN and VD.ConclusionDiabetic autonomic neuropathy was observed in 28 diabetic patients (80% with peripheral neuropathy. Vestibular dysfunction was observed in nearly 60% of diabetic patients with peripheral neuropathy who complained of dizziness but showed no significant association with DAN. Diabetic patients who complained of dizziness need to examine both autonomic function and vestibular function.

  2. Is the experience of pain in patients with temporomandibular disorder associated with the presence of comorbidity?

    Science.gov (United States)

    Visscher, Corine M; van Wesemael-Suijkerbuijk, Erin A; Lobbezoo, Frank

    2016-10-01

    The aim of this study was to explore the association between the presence of comorbidities and the pain experience in individual patients with temporomandibular disorder (TMD). This clinical trial comprised 112 patients with TMD pain. For all participants the presence of the following comorbid factors was assessed: pain in the neck; somatization; impaired sleep; and depression. Pain experience was evaluated using the McGill Pain Questionnaire (MPQ). For each subject the TMD-pain experience was assessed for three dimensions - sensory, affective, and evaluative - as specified in the MPQ. The association between comorbid factors and these three dimensions of TMD-pain experience was then evaluated using linear regression models. Univariable regression analyses showed that all comorbid factors, except for one factor, were positively associated with the level of pain, as rated by the sensory description of pain, the affective component of pain, and the evaluative experience of pain. The multivariable regression analyses showed that for all MPQ dimensions, depression showed the strongest associations with pain experience. It was found that in the presence of comorbid disorders, patients with TMD experience elevated levels of TMD pain. This information should be taken into consideration in the diagnostic process, as well as in the choice of treatment. © 2016 Eur J Oral Sci.

  3. Evaluation of Cognitive Schemas Based on the Presence of Anxiety Disorder among Coronary Artery Disease Patients

    Directory of Open Access Journals (Sweden)

    Huri ASLAN

    2012-12-01

    Results: Disconnection, rejection, impaired autonomy self-manifestation, extreme vigilance, unrelenting standards, other-directedness, and impaired limits schema domain scores were significantly higher in coronary artery disease patients with anxiety disorder comorbidity compared to coronary artery disease patients without anxiety disorder. Conclusion: Our study has revealed significant differences in cognitive profiles of coronary artery disease patients with comorbidity of anxiety disorders. These findings show the importance of cognitive profiles which were observed in coronary artery disease patients with anxiety disorders. Schema-focused approach might be useful in the treatment of such patients. Further studies with schema-focused therapy approaches are needed to illustrate the issue. [JCBPR 2012; 1(3.000: 171-177

  4. [Presence of Helicobacter pylori in gastric biopsies and feces of pediatric patients with celiac disease].

    Science.gov (United States)

    Medina, M G; Medina, M L; Martín, G T; Dikstein, B C; Picón, S O; Gorodner, J O; Merino, L A

    2009-01-01

    Helicobacter pylori (H. pylori) is the main etiologic agent of chronic gastritis and it is an important cause of gastric damage. The celiac disease can affect the morphology and the function of the gastrointestinal tract from the stomach to the colon and it is frequently associated with chronic gastritis. to assess the presence of H. pylori in gastric biopsies and in feces of pediatric patients with celiac disease and to relate it with the symptoms. Pediatric patients with celiac disease attending the Gastroenterology Service at the "Avelino Castelán" Hospital in Resistencia (Argentina) were included in the study. Gastric biopsies samples were obtained by endoscopy for histological studies, the symptoms and socio-epidemiological characteristics were recorded and the polimerase chain reaction(PCR) was applied in feces in order to detect the presence of H. pylori. Thirty one patients with celiac disease were studied (16 female and 15 male; age range:1-14 years; median 6.7 years); 14 (45.2%) were positive for H. pylori in gastric biopsy and among them, only 2 (14.2%) were positive for H. pylori in stool samples. There were not significant differences between symptoms between H. pylori positive and negative patients. 45.2% of the patients with celiac disease were infected by H. pylori. There was no correlation between the frequencies of bacterial detection in feces and in gastric biopsies. The clinical manifestations of celiac disease did not increase in children infected with H. pylori.

  5. Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Zheng Hong

    2011-02-01

    Full Text Available Abstract Background Glucose variability is one of components of the dysglycemia in diabetes and may play an important role in development of diabetic vascular complications. The objective of this study was to assess the relationship between glycemic variability determined by a continuous glucose monitoring (CGM system and the presence and severity of coronary artery disease (CAD in patients with type 2 diabetes mellitus (T2DM. Methods In 344 T2DM patients with chest pain, coronary angiography revealed CAD (coronary stenosis ≥ 50% luminal diameter narrowing in 252 patients and 92 patients without CAD. Gensini score was used to assess the severity of CAD. All participants' CGM parameters and biochemical characteristics were measured at baseline. Results Diabetic patients with CAD were older, and more were male and cigarette smokers compared with the controls. Levels of the mean amplitude of glycemic excursions (MAGE (3.7 ± 1.4 mmol/L vs. 3.2 ± 1.2 mmol/L, p 1c (HbA1c, hs-CRP and total cholesterol (TC. Multivariate analysis indicated that age (p 1c (p = 0.022 and hs-CRP (p = 0.005 were independent determinants for Gensini score. Logistic regression analysis revealed that MAGE ≥ 3.4 mmol/L was an independent predictor for CAD. The area under the receiver-operating characteristic curve for MAGE (0.618, p = 0.001 was superior to that for HbA1c (0.554, p = 0.129. Conclusions The intraday glycemic variability is associated with the presence and severity of CAD in patients with T2DM. Effects of glycemic excursions on vascular complications should not be neglected in diabetes.

  6. HLA class II alleles and the presence of circulating Epstein-Barr virus DNA in greek patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Karanikiotis, C.; Daniilidis, M.; Karyotis, N.; Nikolaou, A.; Bakogiannis, C.; Economopoulos, T.; Murray, S.; Papamichael, D.; Samantas, E.; Skoura, L.; Tselis, N.; Zamboglou, N.; Fountzilas, G.

    2008-01-01

    Background and purpose: nasopharyngeal carcinoma (NPC) represents a seldom malignancy in most developed countries. Nevertheless, NPC receives an endemic form in concrete racial entities. The aims of this study were to detect the presence of Epstein-Barr virus DNA (EBV-DNA) in peripheral blood of NPC patients, to molecularly define human leukocyte antigens (HLA) DRB1*, DQA1* and DQB1* allele frequencies, and, finally, to determine whether the genetic predisposition of an individual to NPC depends on the liability to EBV infection. Patients and methods: a total of 101 patients of Hellenic origin and nationality, with histologically proven NPC, participated in this study. EBV-DNA detection was also applied in 66 patients with EBV-related malignancies (Hodgkin's [HL] and non-Hodgkin's lymphoma [NHL]) and infectious mononucleosis (IM), as well as in 80 healthy EBV-seropositive controls. Results: 81% of the NPC patients, 77.8% with HL, 72.2% with NHL, and 66.7% with IM were EBV-DNA positive, whereas the EBV genome was detected only in 15% of the healthy controls. These differences were statistically significant in all cases. Analysis of HLA class II antigens showed decreased frequency of the DRB1*07 (p 0.003), DQA1*0103 (p = 0.002), and DQA1*0201 (p = 0.003) alleles among NPC patients. A significant association between the HLA-DR/DQ alleles and the presence of EBV-DNA in peripheral whole blood was not established. Conclusion: circulating EBV-DNA and specific HLA class II alleles may predispose to or protect from NPC. However, the results of this study suggest that the genetic predisposition of an individual to NPC is independent of the liability to EBV infection. (orig.)

  7. HLA class II alleles and the presence of circulating Epstein-Barr virus DNA in greek patients with nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Karanikiotis, C. [424 Army General Hospital, Thessaloniki (Greece); Daniilidis, M.; Karyotis, N.; Nikolaou, A. [AHEPA Hospital, Aristotle Univ. of Thessaloniki School of Medicine (Greece); Bakogiannis, C. [Hygeia Hospital, Athens (Greece); Economopoulos, T. [' Attikon' Univ. Hospital, Athens (Greece); Murray, S. [Metropolitan Hospital, Athens (Greece); Papamichael, D. [Bank of Cyprus Oncology Center, Nicosia, Cyprus (Greece); Samantas, E. [' Agii Anargiri' Cancer Hospital, Athens (Greece); Skoura, L. [' Hippokration' Hospital, Thessaloniki (Greece); Tselis, N.; Zamboglou, N. [Dept. of Radiotherapy, Offenbach Hospital (Germany); Fountzilas, G. [' Papageorgiou' Hospital, Aristotle Univ. of Thessaloniki School of Medicine (Greece)

    2008-06-15

    Background and purpose: nasopharyngeal carcinoma (NPC) represents a seldom malignancy in most developed countries. Nevertheless, NPC receives an endemic form in concrete racial entities. The aims of this study were to detect the presence of Epstein-Barr virus DNA (EBV-DNA) in peripheral blood of NPC patients, to molecularly define human leukocyte antigens (HLA) DRB1*, DQA1* and DQB1* allele frequencies, and, finally, to determine whether the genetic predisposition of an individual to NPC depends on the liability to EBV infection. Patients and methods: a total of 101 patients of Hellenic origin and nationality, with histologically proven NPC, participated in this study. EBV-DNA detection was also applied in 66 patients with EBV-related malignancies (Hodgkin's [HL] and non-Hodgkin's lymphoma [NHL]) and infectious mononucleosis (IM), as well as in 80 healthy EBV-seropositive controls. Results: 81% of the NPC patients, 77.8% with HL, 72.2% with NHL, and 66.7% with IM were EBV-DNA positive, whereas the EBV genome was detected only in 15% of the healthy controls. These differences were statistically significant in all cases. Analysis of HLA class II antigens showed decreased frequency of the DRB1*07 (p = 0.003), DQA1*0103 (p = 0.002), and DQA1*0201 (p = 0.003) alleles among NPC patients. A significant association between the HLA-DR/DQ alleles and the presence of EBV-DNA in peripheral whole blood was not established. Conclusion: circulating EBV-DNA and specific HLA class II alleles may predispose to or protect from NPC. However, the results of this study suggest that the genetic predisposition of an individual to NPC is independent of the liability to EBV infection. (orig.)

  8. Association Between Neighborhood Supermarket Presence and Glycated Hemoglobin Levels Among Patients With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Zhang, Y Tara; Mujahid, Mahasin S; Laraia, Barbara A; Warton, E Margaret; Blanchard, Samuel D; Moffet, Howard H; Downing, Janelle; Karter, Andrew J

    2017-06-15

    We estimated associations between neighborhood supermarket gain or loss and glycemic control (assessed by glycated hemoglobin (HbA1c) values) in patients from the Kaiser Permanente Northern California Diabetes Registry (n = 434,806 person-years; 2007-2010). Annual clinical measures were linked to metrics from a geographic information system for each patient's address of longest residence. We estimated the association between change in supermarket presence (gain, loss, or no change) and change in HbA1c value, adjusting for individual- and area-level attributes and according to baseline glycemic control (near normal, Supermarket loss was associated with worse HbA1c trajectories for those with good, moderate, and poor glycemic control at baseline, while supermarket gain was associated with marginally better HbA1c outcomes only among patients with near normal HbA1c values at baseline. Patients with the poorest baseline HbA1c values (≥9.0%) had the worst associated changes in glycemic control following either supermarket loss or gain. Differences were not clinically meaningful relative to no change in supermarket presence. For patients with type 2 diabetes mellitus, gaining neighborhood supermarket presence did not benefit glycemic control in a substantive way. The significance of supermarket changes on health depends on a complex interaction of resident, neighborhood, and store characteristics. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Assessing physician/patient relationships in the presence of HIV/AIDS: an exploratory study.

    Science.gov (United States)

    Taylor, S A; Madrigal, C

    1998-01-01

    The following study investigates the nature of the relationship between physicians and HIV/AIDS patients within the context of the rapidly evolving services/relationship marketing literatures. The emerging evidence suggests that service providers generally play a critical role in the development of positive consumer attitudes and behaviors, and that relationship marketing practices can contribute to the delivery of health services. However, to date, there appears little evidence supporting the efficacy of employing relationship marketing practices in relation to a target market of HIV/AIDS patients. This exploratory study contributes to the body of knowledge by more closely investigating the nature of the patient-physician relationship relative to HIV/AIDS patients' attitudes, marketing-related behaviors, and overall quality-of-life/life satisfaction judgments. The results of this study first suggest that HIV/AIDS patients use the expectancy disconfirmation model when evaluating the performance of their physician. A reliance on expectancy disconfirmation suggests the likely prevalent role of service quality perceptions and satisfaction judgments in evaluating their relationship with their physician. Second, the results appear to support the conclusion that the patient's evaluation of their physician relationship and subsequent behaviors (e.g., word-of-mouth) are directly related to the patient's general perception of received health services. Thus, the patient/physician relationship may play a particularly powerful role in determining patient (marketing related) outcomes relative to other health service settings. Third, a direct influence is supported between negative affective reactions by patients and subsequent outcome behaviors. This finding lends support for the potential efficacy of service recovery efforts when rendering treatment to HIV/AIDS patients. Finally, evidence is presented demonstrating the effect of positive perceptions of the patient

  10. [Enhanced lymphocyte proliferation in the presence of epidermal cells of HIV-infected patients in vitro].

    Science.gov (United States)

    Kappus, R P; Berger, S; Thomas, C A; Ottmann, O G; Ganser, A; Stille, W; Shah, P M

    1992-07-01

    Clinical observations show that the HIV infection is often associated with affections of the skin. In order to examine the involvement of the epidermal immune system in the HIV infection, we determined accessory cell function of epidermal cells from HIV-1-infected patients. For this we measured the proliferative response of enriched CD(4+)-T-lymphocytes from HIV-infected patients and noninfected controls to stimulation with anti-CD3 and IL-2 in the presence of epidermal cells; the enhancement of the response is dependent on the presence of functionally intact accessory cells. The capacity of epidermal cells to increase the anti-CD3-stimulated T-cell proliferative response was significantly enhanced in HIV patients (CDC III/IVA) as compared with noninfected donors. It is discussed, whether the increased activity of epidermal cells from HIV-infected patients may be responsible for several of the dermal lesions in the course of an HIV infection as due to an enhanced production and release of epidermal cell-derived cytokines.

  11. Presence of neuropathic pain may explain poor performances on olfactory testing in diabetes mellitus patients.

    Science.gov (United States)

    Brady, Shauna; Lalli, Paul; Midha, Nisha; Chan, Ayechen; Garven, Alexandra; Chan, Cynthia; Toth, Cory

    2013-07-01

    Olfactory dysfunction in neurodegenerative conditions such as Parkinson's syndrome and Alzheimer's disease can hallmark disease onset. We hypothesized that patients with diabetes mellitus, a condition featuring peripheral and central neurodegeneration, would have decreased olfaction abilities. We examined participants with diabetic peripheral neuropathy, participants with diabetes without diabetic peripheral neuropathy, and control participants in blinded fashion using standardized Sniffin' Sticks. Diabetic peripheral neuropathy severity was quantified using the Utah Early Neuropathy Scale. Further subcategorization of diabetic peripheral neuropathy based on presence of neuropathic pain was performed with Douleur Neuropathique 4 Questionnaires. Participants with diabetes had decreased olfactory sensitivity, impaired olfactory discrimination abilities, and reduced odor identification skills when compared with controls. However, loss of olfaction ability was, at least partially, attributed to presence of neuropathic pain on subcategory assessment, although pain severity was not associated with dysfunction. Those participants with diabetes without diabetic peripheral neuropathy and those with diabetic peripheral neuropathy without neuropathic pain had similar olfactory function as controls in general. The presence of neuropathic pain, associated with limited attention and concentration, may explain at least a portion of the olfactory dysfunction witnessed in the diabetic patient population.

  12. Evaluation of Cognitive Schemas Based on the Presence of Anxiety Disorder among Coronary Artery Disease Patients

    Directory of Open Access Journals (Sweden)

    Huri ASLAN

    2012-11-01

    Full Text Available Objective: The relationship between psychological factors and cardiac diseases has been concerned for a long but our knowledge about the cognitive profiles which could be important etiological factor in cardiac disease and comorbid psychiatric disorders is limited. In this study, we aimed to compare the cognitive profiles of coronary artery disease patients with or without comorbid anxiety disorder. Method: A total of 35 coronary artery disease patients with anxiety disorder and 20 coronary artery disease patients without comorbid anxiety disorders were enrolled into the study. Beck Anxiety Inventory and the Young Schema Questionnaire-Short Form 3 were applied to each participant. Results: Disconnection, rejection, impaired autonomy self-manifestation, extreme vigilance, unrelenting standards, other-directedness, and impaired limits schema domain scores were significantly higher in coronary artery disease patients with anxiety disorder comorbidity compared to coronary artery disease patients without anxiety disorder. Conclusion: Our study has revealed significant differences in cognitive profiles of coronary artery disease patients with comorbidity of anxiety disorders. These findings show the importance of cognitive profiles which were observed in coronary artery disease patients with anxiety disorders. Schema-focused approach might be useful in the treatment of such patients. Further studies with schema-focused therapy approaches are needed to illustrate the issue.

  13. Presence of anatomical variations of the circle of Willis in patients undergoing surgical treatment for ruptured intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Stojanović Nebojša

    2009-01-01

    Full Text Available Background/Aim. The presence of aneurysmal changes on the brain blood vessels has been subject to numerous research. This study investigated the relation between ruptured aneurysms and anatomical configuration of the Circle of Willis, with the purpose to obtain an insight into their mutual connection. Methods. The analysis included 114 patients suffering from ruptured intracranial aneurysms. Preoperative cerebral angiography was performed and compared with the intraoperative findings in order to attain a precise insight into morphological changes occurring on the circle of Willis. Results. The prevalence of asymmetrical Willis in the whole group of patients was 64%. Within the group of patients suffering from multiple aneurysms, the presence of asymmetrical Willis' circle was 75.7%. The highest incidence of the asymmetrical Circle of Willis was found among patients with aneurysmal rupture detected at the anterior comunicative artery (ACoA site (72.7% among cases with solitary and 100% among those with multiple aneurysms. Morphological changes on the A1 segment of ACoA were observed in 50 (44% cases, with higher incidence found on the right side (60%. When comparing location of ruptured aneurysms between genders, a statistically significant prevalence of the ruptured aneurisms on ACoA was present in men, whereas women showed higher incidence of ruptured aneurysms on interior cartid artery (ICA site (p < 0.01. The linkage between aneurysms with hypoplasia of the A1 segment of ACA and decreasing of the angle at which segments A1 and A2 join suggests the relationship between their onset, corresponding configuration type of Willis and subsequent hemodynamic changes. Conclusion. High incidence of asymmetry of Willis circle in the group of patients with ruptured aneurysms imply association of asymmetrical configuration and disorder in haemodynamic relations with forming and rupture of intracranial aneurysms.

  14. CONCLUSIONS Urban Children and Adolescents

    Indian Academy of Sciences (India)

    CONCLUSIONS Urban Children and Adolescents. Increasing prevalence of overweight and obesity and measures of regional (central) adiposity. High prevalence of markers of dysmetabolic state in urban adolescents. ~10% prevalence of dysglycemia in overweight / obese school children.

  15. Chapter 6: Conclusions and recommendations

    International Nuclear Information System (INIS)

    1995-01-01

    This chapter provides a brief summary of conclusions with respect to project implementation issues. Furthermore, the chapter contains recommendations on future applications of the modelling system and on water resources management in the project area

  16. Summary and conclusions [Chapter 11

    Science.gov (United States)

    Daniel G. Neary; John N. Rinne; Alvin L.. Medina

    2012-01-01

    Summaries and conclusions of each chapter are compiled here to provide a “Quick Reference” guide of major results and recommendations for the UVR. More detail can be obtained from individual chapters.

  17. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  18. Presence of angina pectoris is related to extensive coronary artery disease in diabetic patients.

    Science.gov (United States)

    Celik, Atac; Karayakali, Metin; Erkorkmaz, Unal; Altunkas, Fatih; Karaman, Kayihan; Koc, Fatih; Ceyhan, Koksal; Kadi, Hasan; Avsar, Alaettin

    2013-08-01

    Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM. The aim of the study was to understand if angina pectoris is related to extensive coronary artery disease (CAD) in patients with DM. The study included 530 patients with DM who underwent coronary angiography at our center in 2009 and 2010. Patients were divided into 4 groups according to type of chest pain: group 1, noncardiac chest pain or no pain; group 2, angina equivalent; group 3, atypical angina; and group 4, typical angina. All angiograms were re-evaluated and Gensini scores were calculated. Three-vessel disease was diagnosed in the presence of stenosis >50% in all 3 coronary artery systems. There were no statistically significant differences between the groups with regard to age, sex, systolic or diastolic blood pressures, body mass index, creatinine clearance, or lipid profile. Fasting blood glucose was significantly higher in group 4 than in group 2. Gensini scores were not statistically different between groups 1 and 2 or between groups 3 and 4; however, the scores for groups 3 and 4 were higher than the score for either group 1 or group 2. Prevalence of 3-vessel disease was significantly higher in groups 3 and 4 compared with the other groups. The presence of angina pectoris was related to extensive CAD in patients with DM. The extent of CAD was not correlated with the type of angina (typical or atypical). © 2013 Wiley Periodicals, Inc.

  19. Presence of viable Mycobacterium leprae in environmental specimens around houses of leprosy patients.

    Science.gov (United States)

    Turankar, R P; Lavania, M; Singh, M; Sengupta, U; Siva Sai, Ksr; Jadhav, R S

    2016-01-01

    Leprosy is a chronic systemic infectious disease caused by Mycobacterium leprae, one of the first organisms to be established as the cause for disease in humans. Because of high prevalence pockets of leprosy in the endemic regions, it is necessary to identify the possible sources of M. leprae in the environment and its mode of transmission. Slit skin smears (SSSs) from lesions were collected in 70% ethanol from 50 leprosy cases staying in the leprosy resettlement village and hospital from a high endemic area. One hundred and sixty soil samples were collected from different areas around the leprosy hospital and from the resettlement village of cured leprosy patients where active cases also resided at the time of sample collection. M. leprae specific gene region (RLEP 129 bp) and 16S rRNA targets were used for polymerase chain reaction (PCR) based detection for the presence and viability of M. leprae. An rpoT region was also amplified to determine presence of numbers of 6 bp tandem repeats. All the SSS samples collected from patients showed three copies of rpoT region (6 bp tandem repeat, an ancient Indian type). Fifty-two soil samples showed presence of M. leprae DNA whereas M. leprae specific 16S rRNA gene was amplified in sixteen of these samples. PCR amplification and fragment length analysis showed 91 bp, i.e., three copies of the rpoT 6 bp tandem repeats from soil samples and similar three copies observed in patient samples. Presence of viable M. leprae in the soil having same rpoT genotype of M. leprae noted in patients suggests that it could be the same strain of M. leprae. M. leprae found in the soil could be the one that is excreted out by the patient. Significance of its viability in the environment and its pathogenicity with respect to transmission needs to be further explored. Findings of this study might provide possible insights for further exploration into understanding transmission patterns in leprosy and also will throw light on identifying

  20. Presence of gingivitis and periodontitis significantly increases hospital charges in patients undergoing heart valve surgery.

    Science.gov (United States)

    Allareddy, Veerasathpurush; Elangovan, Satheesh; Rampa, Sankeerth; Shin, Kyungsup; Nalliah, Romesh P; Allareddy, Veerajalandhar

    2015-01-01

    To examine the prevalence and impact of gingivitis and periodontitis in patients having heart valve surgical procedures. Nationwide Inpatient Sample for the years 2004-2010 was used. All patients who had heart valve surgical procedures were selected. Prevalence of gingivitis/periodontitis was examined in these patients. Impact of gingivitis/periodontitis on hospital charges, length of stay, and infectious complications was examined. 596,190 patients had heart valve surgical procedures. Gingivitis/periodontitis was present in 0.2 percent. Outcomes included: median hospital charges ($175,418 with gingivitis/ periodontitis versus $149,353 without gingivitis/periodontitis) and median length of stay (14 days with gingivitis/periodontitis versus 8 days without gingivitis/periodontitis). After adjusting for the effects of patient- and hospital-level confounding factors, hospital charges and length of stay were significantly higher (p gingivitis/periodontitis compared to their counterparts. Further, patients with gingivitis/periodontitis had significantly higher odds for having bacterial infections (OR = 3.41, 95% CI = 2.33-4.98, p gingivitis/periodontitis. Presence of gingivitis and periodontitis is associated with higher risk for bacterial infections and significant hospital resource utilization.

  1. Presence of enthesopathy in patients with primary Sjogren's syndrome: ultrasonographic study of a local cohort.

    Science.gov (United States)

    Sag, Sinem; Sag, Mustafa Serdar; Tekeoglu, Ibrahim; Kamanlı, Ayhan; Nas, Kemal

    2018-01-01

    Musculoskeletal findings in Sjögren's syndrome are arthralgia, arthritis, myalgia, myositis, fibromyalgia, and chronic fatigue. Enthesis zones are important in the formation of pain in the musculoskeletal system. Musculoskeletal ultrasound (US) may show subclinical enthesitis in the synovial joints and in the axial skeleton before joint swelling in inflammatory diseases characterized by arthritis. In this study, we aimed to determine the presence of enthesopathy using the Madrid sonographic enthesitis index (MASEI) in patients with primary Sjögren's syndrome (PSS). Consecutive patients with PSS and age-matched healthy controls were included in this study. All the patients met the 2002 American College of Rheumatology/European League against Rheumatism classification criteria for PSS. The demographic characteristics of the patients were recorded. Six enthesis sites were evaluated using gray-scale and Doppler US with a linear transducer, and they were scored using the MASEI. They were assessed by the EULAR Sjögren's syndrome disease activity index (ESSDAI). We evaluated 40 patients with PSS (average age 48.67 ± 11.23 years) and 30 healthy controls (average age 45.40 ± 8.24 years). Patients with PSS had significantly higher MASEI scores than the healthy controls. Plantar fascia, Achilles tendon, and distal patellar tendons were significantly thicker in the PSS group than in the healthy controls. The MASEI total score had a positive correlation with age. There was no correlation between MASEI total score and BMI and ESSDAI. In this study, it was shown that the MASEI scores assessed by US were significantly higher in patients with PSS than in healthy controls. Plantar fascia, Achilles tendon, and distal patellar tendon were significantly thicker in the PSS group than in the healthy controls. This result suggests that PSS may be one of the causes of musculoskeletal pain that can be seen in patients with PSS. Our study was the first study to use an enthesis

  2. A prospective study evaluating the presence of Rickettsia in Danish patients with sarcoidosis

    DEFF Research Database (Denmark)

    Svendsen, Claus Bo; Milman, Nils; Nielsen, Henrik Winther

    2009-01-01

    Rickettsia helvetica has previously been proposed as an aetiological agent in sarcoidosis. The purpose of the present study was to detect possible signs of Rickettsia infection in a Danish population of patients with sarcoidosis. Twenty-six patients with newly diagnosed sarcoidosis were...... interview. Evidence of rickettsial infection was assessed by an immunofluorescence assay testing for antibodies towards Rickettsia as well as specific real-time polymerase chain reaction (PCR) on lung biopsy specimens. We performed fluorescent in situ hybridization (FISH) on the biopsies to detect....... There was no difference in the reported frequency of tick bite between patients and controls. In conclusion, we found no evidence of Rickettsia being involved in the pathogenesis of sarcoidosis in Denmark....

  3. CONCLUSIONS New Delhi Birth Cohort

    Indian Academy of Sciences (India)

    CONCLUSIONS New Delhi Birth Cohort. Crossing BMI centiles and early adiposity rebound associated with adult metabolic syndrome. BMI gain in infancy and early childhood – associated more with adult lean mass. BMI gain in later childhood / adolescence – associated more with adult fat mass and constituents of ...

  4. Presence of tau pathology within foetal neural allografts in patients with Huntington's and Parkinson's disease.

    Science.gov (United States)

    Cisbani, Giulia; Maxan, Alexander; Kordower, Jeffrey H; Planel, Emmanuel; Freeman, Thomas B; Cicchetti, Francesca

    2017-11-01

    Cell replacement has been explored as a therapeutic strategy to repair the brain in patients with Huntington's and Parkinson's disease. Post-mortem evaluations of healthy grafted tissue in such cases have revealed the development of Huntington- or Parkinson-like pathology including mutant huntingtin aggregates and Lewy bodies. An outstanding question remains if tau pathology can also be seen in patients with Huntington's and Parkinson's disease who had received foetal neural allografts. This was addressed by immunohistochemical/immunofluorescent stainings performed on grafted tissue of two Huntington's disease patients, who came to autopsy 9 and 12 years post-transplantation, and two patients with Parkinson's disease who came to autopsy 18 months and 16 years post-transplantation. We show that grafts also contain tau pathology in both types of transplanted patients. In two patients with Huntington's disease, the grafted tissue showed the presence of hyperphosphorylated tau [both AT8 (phospho-tau Ser202 and Thr205) and CP13 (pSer202) immunohistochemical stainings] pathological inclusions, neurofibrillary tangles and neuropil threads. In patients with Parkinson's disease, the grafted tissue was characterized by hyperphosphorylated tau (AT8; immunofluorescent staining) pathological inclusions, neurofibrillary tangles and neuropil threads but only in the patient who came to autopsy 16 years post-transplantation. Abundant tau-related pathology was observed in the cortex and striatum of all cases studied. While the striatum of the grafted Huntington's disease patient revealed an equal amount of 3-repeat and 4-repeat isoforms of tau, the grafted tissue showed elevated 4-repeat isoforms by western blot. This suggests that transplants may have acquired tau pathology from the host brain, although another possibility is that this was due to acceleration of ageing. This finding not only adds to the recent reports that tau pathology is a feature of these neurodegenerative

  5. Psychological aspects of patients with breast cancer depending on the presence of visible postoperative defect

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev

    2015-01-01

    Full Text Available Objective. The study of coping behavior of patients with breast cancer (I, II stages in the postoperative period with «externally visible postoperative defect".Materials and methods. We studied the psychological characteristics of 35 patients with breast cancer (I, II stage, who underwent radical mastectomy, women were characterized in the postoperative period as "externally visible postoperative defect" ("e.v.p.d.", 35 patients with breast cancer (I, II stage who underwent ablative and reconstructive plastic surgery, women were characterized in the postoperative period as "without an externally visible postoperative defect" ("without an e.v.p.d.".The results and conclusions. The results of the study of women in both groups indicate that the patients are moderately using coping strategies for coping with the disease, preferring the strategy of "problem resolution" and "search of social support". Patients with breast cancer "with externally visible postoperative defect in comparing with patients with breast cancer "without an externally visible postoperative defect" often use positive religious coping in coping with the disease. The group of women with «externally visible postoperative defect" usually operate with negative religious coping. Both groups of women focused on the perception of social support. In a greater degree of social support they perceive from family and significant for them. Women with breast cancer and "externally visible postoperative defect” compared with women “without an externally visible postoperative defect" are not satisfied with your opportunities, have a feeling of weakness, doubt ability to evoke respect, sympathy, understanding and approval from others. They seek to change, doubt their self-worth, willing to put themselves in the guilt of their mistakes, failures, have low self-esteem. The group of patients with breast cancer "with externally visible postoperative defect" has an external locus of control

  6. Gene Profiling in Patients with Systemic Sclerosis Reveals the Presence of Oncogenic Gene Signatures

    Directory of Open Access Journals (Sweden)

    Marzia Dolcino

    2018-03-01

    Full Text Available Systemic sclerosis (SSc is a rare connective tissue disease characterized by three pathogenetic hallmarks: vasculopathy, dysregulation of the immune system, and fibrosis. A particular feature of SSc is the increased frequency of some types of malignancies, namely breast, lung, and hematological malignancies. Moreover, SSc may also be a paraneoplastic disease, again indicating a strong link between cancer and scleroderma. The reason of this association is still unknown; therefore, we aimed at investigating whether particular genetic or epigenetic factors may play a role in promoting cancer development in patients with SSc and whether some features are shared by the two conditions. We therefore performed a gene expression profiling of peripheral blood mononuclear cells (PBMCs derived from patients with limited and diffuse SSc, showing that the various classes of genes potentially linked to the pathogenesis of SSc (such as apoptosis, endothelial cell activation, extracellular matrix remodeling, immune response, and inflammation include genes that directly participate in the development of malignancies or that are involved in pathways known to be associated with carcinogenesis. The transcriptional analysis was then complemented by a complex network analysis of modulated genes which further confirmed the presence of signaling pathways associated with carcinogenesis. Since epigenetic mechanisms, such as microRNAs (miRNAs, are believed to play a central role in the pathogenesis of SSc, we also evaluated whether specific cancer-related miRNAs could be deregulated in the serum of SSc patients. We focused our attention on miRNAs already found upregulated in SSc such as miR-21-5p, miR-92a-3p, and on miR-155-5p, miR 126-3p and miR-16-5p known to be deregulated in malignancies associated to SSc, i.e., breast, lung, and hematological malignancies. miR-21-5p, miR-92a-3p, miR-155-5p, and miR-16-5p expression was significantly higher in SSc sera compared to

  7. Presence of c.3956delC mutation in familial adenomatous polyposis patients from Brazil.

    Science.gov (United States)

    Moreira-Nunes, Caroline Aquino; Alcântara, Diego di Felipe Ávila; Lima-Júnior, Sérgio Figueiredo; Cavalléro, Sandro Roberto de Araújo; Rey, Juan Antonio; Pinto, Giovanny Rebouças; de Assumpção, Paulo Pimentel; Burbano, Rommel Rodriguez

    2015-08-21

    To characterize APC gene mutations and correlate them with patient phenotypes in individuals diagnosed with familial adenomatous polyposis (FAP) in northern Brazil. A total of 15 individuals diagnosed with FAP from 5 different families from the north of Brazil were analyzed in this study. In addition to patients with histopathological diagnosis of FAP, family members who had not developed the disease were also tested in order to identify mutations and for possible genetic counseling. All analyzed patients or their guardians signed a consent form approved by the Research Ethics Committee of the João de Barros Barreto University Hospital (Belem, Brazil). DNA extracted from the peripheral blood of a member of each of the affected families was subjected to direct sequencing. The proband of each family was sequenced to identify germline mutations using the Ion Torrent platform. To validate the detected mutations, Sanger sequencing was also performed. The samples from all patients were also tested for the identification of mutations by real-time quantitative polymerase chain reaction using the amplification refractory mutation system. Through interviews with relatives and a search of medical records, it was possible to construct genograms for three of the five families included in the study. All 15 patients from the five families with FAP exhibited mutations in the APC gene, and all mutations were detected in exon 15 of the APC gene. In addition to the patients with a histological diagnosis of FAP, family members without disease symptoms showed the mutation in the APC gene. In the present study, we detected two of the three most frequent germline mutations in the literature: the mutation at codon 1309 and the mutation at codon 1061. The presence of c.3956delC mutation was found in all families from this study, and suggests that this mutation was introduced in the population of the State of Pará through ancestor immigration (i.e., a de novo mutation that arose in one

  8. Jumping to conclusions in schizophrenia

    Directory of Open Access Journals (Sweden)

    Evans SL

    2015-07-01

    Full Text Available Simon L Evans,1 Bruno B Averbeck,2 Nicholas Furl31School of Psychology, University of Sussex, Brighton, East Sussex, UK; 2Laboratory of Neuropsychology, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA; 3Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UKAbstract: Schizophrenia is a mental disorder associated with a variety of symptoms, including hallucinations, delusions, social withdrawal, and cognitive dysfunction. Impairments on decision-making tasks are routinely reported: evidence points to a particular deficit in learning from and revising behavior following feedback. In addition, patients tend to make hasty decisions when probabilistic judgments are required. This is known as “jumping to conclusions” (JTC and has typically been demonstrated by presenting participants with colored beads drawn from one of two “urns” until they claim to be sure which urn the beads are being drawn from (the proportions of colors vary in each urn. Patients tend to make early decisions on this task, and there is evidence to suggest that a hasty decision-making style might be linked to delusion formation and thus be of clinical relevance. Various accounts have been proposed regarding what underlies this behavior. In this review, we briefly introduce the disorder and the decision-making deficits associated with it. We then explore the evidence for each account of JTC in the context of a wider decision-making deficit and then go on to summarize work exploring JTC in healthy controls using pharmacological manipulations and functional imaging. Finally, we assess whether JTC might have a role in therapy.Keywords: ketamine, decision making, delusions, fMRI, urn task

  9. Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members.

    Science.gov (United States)

    Zali, Mahnaz; Hassankhani, Hadi; Powers, Kelly A; Dadashzadeh, Abbas; Rajaei Ghafouri, Rouzbeh

    2017-09-01

    Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Presence of bacterial DNA and bacterial peptidoglycans in joints of patients with rheumatoid arthritis and other arthritides

    NARCIS (Netherlands)

    van der Heijden, I. M.; Wilbrink, B.; Tchetverikov, I.; Schrijver, I. A.; Schouls, L. M.; Hazenberg, M. P.; Breedveld, F. C.; Tak, P. P.

    2000-01-01

    The continuous presence of bacteria or their degraded antigens in the synovium may be involved in the pathogenesis of rheumatoid arthritis (RA). The aim of this study was to determine the presence of bacterial nucleic acids and bacterial cell wall constituents in the joints of patients with RA and

  11. Impact of underlying diabetes and presence of lung cavities on treatment outcomes in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Nakamura, A; Hagiwara, E; Hamai, J; Taguri, M; Terauchi, Y

    2014-06-01

    We investigated the effects of diabetes and the presence of lung cavities on treatment outcomes in patients with pulmonary tuberculosis. We conducted a retrospective review of the clinical records of all consecutive patients admitted to the Kanagawa Cardiovascular and Respiratory Centre with the diagnosis of pulmonary tuberculosis. The study outcomes examined were time to sputum culture conversion and percentage of patients with sputum culture conversion by the time 2 months of treatment, and these outcomes were compared between patients with and without diabetes. Of the 260 patients enrolled in the study, 69 were diagnosed as having diabetes mellitus, while the remaining 191 did not have diabetes. The percentage of patients with cavities was higher in the patients with diabetes (71.0%) than in those without (45.5%; P = 0.0003). The time to sputum culture conversion was significantly longer in the patients with diabetes than in those without (P = 0.0005), and the percentage of patients with a positive sputum culture at 2 months was higher in the patients with diabetes (43.5%) than in those without (18.8%; P = 0.0001). Multivariate analyses revealed that the presence/absence of lung cavities was a more important determinant of treatment outcomes than the presence/absence of diabetes. The presence of lung cavities was found to be a more important determinant of the treatment outcomes than that of diabetes per se in patients with pulmonary tuberculosis. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  12. Noninvasive assessment of oesophageal varices presence and size in patients with liver cirrhosis using right liver lobe/serum albumin concentration

    Directory of Open Access Journals (Sweden)

    Alempijević Tamara

    2007-01-01

    Full Text Available Background/Aim. Liver cirrhosis is a chronic, progressive disease and it is usually accompanied by portal hypertension. The development of oesophageal varices (OV is one of the major complications of portal hypertension. Cirrhotic patients should be screened for the presence of OV when portal hypertension is diagnosed. In order to reduce the increasing burden that endoscopy units have to bear, some studies have attempted to identify parameters for noninvasive prediction of OV presence. The aim of our study was to evaluate the value of biochemical and ultrasonography parameters for prediction of OV presence. Methods. This study included 58 cirrhotic patients who underwent a complete biochemical workup, ultrasonography examination and upper digestive endoscopy. Right liver lobe diameter/albumin ratio was calculated and its correlation to the presence and degree of OV, and Child-Pugh score of liver cirrhosis explored. Results. The mean age of the patients included in the study was 53.07±13.09 years; 40 were males and 18 females. In the Child-Pugh class A were 53.4% patients, class B 39.7%, whereas 6.9% were in the class C. In 24.1% of the patients no OV were identified by upper digestive endoscopy, 19% had OV grade I, 34.5% grade II, 20.7% grade III, and 1.7% OV grade IV. The mean value of the right liver lobe diameter/ albumin ratio was 5.43±1.79 (range of 2.76−11.44. Statistically significant correlation (p < 0.01 was confirm by Spearman's test between OV grade and calculated index (ρ = 0.441. Conclusion. The right liver lobe diameter/albumin ratio is a noninvasive parameter which provides an accurate information pertinent to the determination of OV presence and their grading in patients with liver cirrhosis. .

  13. Impact of Chronic Kidney Disease on the Presence and Severity of Aortic Stenosis in Patients at High Risk for Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Masuda Chiaki

    2011-11-01

    Full Text Available Abstract Objective We evaluated the impact of chronic kidney disease (CKD on the presence and severity of aortic stenosis (AS in patients at high risk for coronary artery disease (CAD. Methods One hundred and twenty consecutive patients who underwent invasive coronary angiography were enrolled. Aortic valve area (AVA was calculated by the continuity equation using transthoracic echocardiography, and was normalized by body surface area (AVA index. Results Among all 120 patients, 78% had CAD, 55% had CKD (stage 3: 81%; stage 4: 19%, and 34% had AS (AVA 2. Patients with AS were older, more often female, and had a higher frequency of CKD than those without AS, but the prevalence of CAD and most other coexisting conventional risk factors was similar between patients with and without AS. Multivariate linear regression analysis indicated that only CKD and CAD were independent determinants of AVA index with standardized coefficients of -0.37 and -0.28, respectively. When patients were divided into 3 groups (group 1: absence of CKD and CAD, n = 16; group 2: presence of either CKD or CAD, n = 51; and group 3: presence of both CKD and CAD, n = 53, group 3 had the smallest AVA index (1.19 ± 0.30*# cm2/m2, *p 2/m2, and #p 2/m2 and the highest peak velocity across the aortic valve (1.53 ± 0.41*# m/sec; *p Conclusion CKD, even pre-stage 5 CKD, has a more powerful impact on the presence and severity of AS than other conventional risk factors for atherosclerosis in patients at high risk for CAD.

  14. Antioxidant Enzymes Activity in Patients with Peripheral Vascular Disease, with and without Presence of Diabetes Mellitus

    OpenAIRE

    Jandrić-Balen, Marica; Božikov, Veljko; Bistrović, Dragica; Jandrić, Ivan; Božikov, Jadranka; Romić, Željo; Balen, Ivan

    2003-01-01

    The study evaluated antioxidant status in patients with peripheral vascular disease (PVD), with and without concomitant diabetes mellitus (DM). 211 participants were divided into standardized 4 groups: patients with PVD and DM (PVD+DM+), patients with PVD without DM (PVD+DM-), patients without PVD with DM (PVD-DM+) and patients without PVD and DM (PVD-DM-). The diagnosis of PVD was established by Doppler sonography analysis, including determination of the ankle brachial index (...

  15. Sclerostin and Antisclerostin Antibody Serum Levels Predict the Presence of Axial Spondyloarthritis in Patients with Inflammatory Bowel Disease.

    Science.gov (United States)

    Luchetti, Michele Maria; Ciccia, Francesco; Avellini, Chiara; Benfaremo, Devis; Guggino, Giuliana; Farinelli, Alessia; Ciferri, Monia; Rossini, Matteo; Svegliati, Silvia; Spadoni, Tatiana; Bolognini, Laura; Fava, Giammarco; Mosca, Piergiorgio; Gesuita, Rosaria; Skrami, Edlira; Triolo, Giovanni; Gabrielli, Armando

    2018-05-01

    The early diagnosis of inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA/IBD) in patients affected by IBD represents a major topic in clinical practice; in particular, to date there are no available serum biomarkers revealing the presence of joint inflammation in these patients. Sclerostin (SOST), an antagonist of the Wnt/β-catenin pathway, and antisclerostin-immunoglobulin G (anti-SOST-IgG) have been recently studied in patients with ankylosing spondylitis (AS) as a putative marker of disease activity. SOST and anti-SOST-IgG serum levels were assayed in 125 patients with IBD, 85 with axial or peripheral SpA, and in control groups (patients with AS and rheumatoid arthritis, and healthy individuals). The diagnostic performance in discriminating the presence of SpA/IBD was assessed for both candidate biomarkers. Patients affected by SpA/IBD with axial involvement displayed significantly lower levels of SOST and higher levels of anti-SOST-IgG compared to patients with only peripheral arthritis, IBD, and controls. Moreover, SOST and anti-SOST-IgG serum levels were inversely correlated and were associated with the duration of articular symptoms. Both biomarkers showed good accuracy in predicting the presence of axial SpA in patients with IBD. We demonstrated that in patients with IBD, SOST and anti-SOST-IgG might represent novel biomarkers to assess the presence of axial joint involvement. Moreover, the development of anti-SOST-IgG and the subsequent decrease of SOST serum levels could play a role in the pathogenesis of SpA/IBD.

  16. Presence of small parathyroid glands in renal transplant patients supports less-than-total parathyroidectomy to treat hypercalcemic hyperparathyroidism.

    Science.gov (United States)

    Jäger, Mark D; Emmanouilidis, Nikos; Jackobs, Steffan; Kespohl, Holger; Hett, Julian; Musatkin, Denis; Tränkenschuh, Wolfgang; Schrem, Harald; Klempnauer, Jürgen; Scheumann, Georg F W

    2014-01-01

    Parathyroid glands (PG) are rarely analyzed in renal transplant (RTX) patients. This study analyzes comparatively PG of RTX and end-stage renal disease (ESRD) patients. The clinical part of the study evaluates if total parathyroidectomy with autotransplantation (TPT+AT) treats appropriately hypercalcemic hyperparathyroidism in RTX patients. TPT+AT was performed in 15 of 23 RTX and 21 of 27 ESRD patients. Remaining patients underwent less-than-total PT. Volume and stage of hyperplasia were determined from 86 PG of RTX and 109 PG of ESRD patients. Patients were categorized according to the presence of small PG (volume hyperparathyroidism were evaluated 2 years after PT in RTX patients. PG of RTX patients were significantly smaller, but similar hyperplastic in comparison to PG of ESRD patients. Small PG were more frequent in RTX than in ESRD patients (19% vs 6%) and mainly graded normal or diffuse hyperplastic (94%). Forty-seven percent of RTX, but only 14% of ESRD, patients receiving a total PT possessed ≥1 small PG (P hyperparathyroidism. However, TPT+AT caused permanent hypocalcemia in 50% of RTX patients without small PG and even in 83% of RTX patients with small PG. All RTX patients receiving less-than-total PT were normocalcemic at 2-year follow-up. Logistic regression revealed a 10.7 times greater risk of permanent hypocalcemia in RTX patients with small PG receiving TPT+AT compared with RTX patients without small PG receiving TPT+AT or RTX patients undergoing less-than-total PT. Surgeons performing PT should be aware of the high frequency of small and less diseased PG in RTX patients. In this context, TPT+AT might overtreat hypercalcemic hyperparathyroidism in RTX patients, especially when small PG are present. Copyright © 2014 Mosby, Inc. All rights reserved.

  17. The presence of a patient's voice in the care process: Implications ...

    African Journals Online (AJOL)

    Although there is no agreed-upon definition of patient-centred care, literature on this ... Despite ample literature on the value of patient-centred care and the patient's voice ... There is even less literature on the subject based on research conducted in Sub-Saharan Africa, where multilingual healthcare systems are prevalent ...

  18. Assessment of the presence and quality of osteoporosis prevention education among at-risk internal medicine patients.

    Science.gov (United States)

    Shulha, Jennifer A; Sviggum, Cortney B; O'Meara, John G; Berg, Melody L

    2014-01-01

    Appropriate calcium and vitamin D intake for the prevention of osteoporosis represents an important component of osteoporosis prevention education (OPE). We sought to assess the presence and quality of OPE among osteoporotic and at-risk inpatients. Prospective chart review plus cross-sectional interview. One academic tertiary referral medical center in Rochester, Minnesota. Adults admitted to an inpatient medicine service who were determined to be at risk for osteoporosis based on an investigator-developed screening tool or previously diagnosed with osteoporosis. Four hundred sixtyfour patients were screened, 192 patients were approached for participation, and 150 patients consented to be interviewed for the study. Source of OPE, rates of appropriate calcium intake and supplementation. OPE from a health care provider was reported by 31.3% of patients, with only one patient reporting education from a pharmacist. Self OPE and no OPE were received by 29.3% and 39.3% of patients, respectively. Appropriate overall calcium intake was found in 30.7% of patients, and only 21.3% of patients were taking an appropriate calcium salt. Patients with osteoporosis and risk factors for osteoporosis lack adequate education from health care providers regarding appropriate intake of dietary and supplemental calcium and vitamin D. A particular deficit was noted in pharmacist-provided education. Specific education targeting elemental calcium amounts, salt selection, and vitamin D intake should be provided to increase the presence of appropriate overall calcium consumption.

  19. Orientation to time as a guide to the presence and severity of cognitive impairment in older hospital patients.

    LENUS (Irish Health Repository)

    O'Keeffe, Emma

    2011-05-01

    Testing of orientation to time is an important part of mental status examination. The validity of errors in different aspects of temporal orientation was examined in older hospital patients as a guide to the presence of dementia or delirium and as a measure of the severity of dementia, as defined by the Global Deterioration Scale.

  20. Prevalence of and risk factors associated with the presence of Staphylococcus aureus in the chronic wounds of patients treated in primary health care settings in Brazil

    Directory of Open Access Journals (Sweden)

    Eliane Patricia Lino Pereira-Franchi

    Full Text Available Abstract INTRODUCTION: Wounds can be colonized by methicillin-resistant Staphylococcus aureus (MRSA. METHODS: We evaluated the prevalence of S. aureus and MRSA in the wounds of patients treated at Basic Health Units in Brazil and identified risk factors associated with their presence. RESULTS: The prevalence rates of S. aureus and MRSA were 51.5% and 8.7%, respectively. There was a correlation between the presence of S. aureus in wounds and nostrils (p<0.01. A positive association was detected between S. aureus infection and previous benzylpenicillin use (p=0.02. No associations were observed for MRSA. CONCLUSIONS: Multidrug-resistant pathogens are present in primary healthcare settings in Brazil.

  1. Presence and significance of TT virus in Danish patients on maintenance hemodialysis

    DEFF Research Database (Denmark)

    Boysen, Trine; Christensen, Jens K; Madsen, Chris D

    2003-01-01

    OBJECTIVES: To determine the prevalence of TT virus (TTV) in a population of Danish hemodialysis patients and evaluate possible relations between TTV infection and elevated levels of C-reactive protein (CRP) and hypo-response to treatment with erythropoietin (EPO). MATERIAL AND METHODS: Patients......-positive patients were significantly older than TTV-negative patients (p = 0.011). No relations were found between TTV infection and elevated levels of alanine aminotransferase (ALT) or CRP or hypo-response to EPO treatment. The mean hemoglobin concentration was 11.24 +/- 1.48 g/dl. Patients with a high TTV viral...... load had a lower level of hemoglobin (10.86 +/- 1.47 g/dl) than the others (p = 0.01). This trend suggested a positive relation between TTV infection and the number of blood transfusions. A restriction fragment length polymorphism assay suggested that patients were infected with different TTV strains...

  2. Presence and significance of TT virus in Danish patients on maintenance hemodialysis

    DEFF Research Database (Denmark)

    Boysen, T.; Christensen, J. K.; Madsen, C. D.

    2003-01-01

    -positive patients were significantly older than TTV-negative patients (p = 0.011). No relations were found between TTV infection and elevated levels of alanine aminotransferase (ALT) or CRP or hypo-response to EPO treatment. The mean hemoglobin concentration was 11.24 +/- 1.48 g/dl. Patients with a high TTV viral...... load had a lower level of hemoglobin (10.86 +/- 1.47 g/dl) than the others (p = 0.01). This trend suggested a positive relation between TTV infection and the number of blood transfusions. A restriction fragment length polymorphism assay suggested that patients were infected with different TTV strains......Objectives: To determine the prevalence of TT virus (TTV) in a population of Danish hemodialysis patients and evaluate possible relations between TTV infection and elevated levels of C-reactive protein (CRP) and hypo-response to treatment with erythropoietin (EPO). Material and Methods: Patients...

  3. The presence of obesity paradox in Greek patients with chronic heart failure.

    Science.gov (United States)

    Vlaras, Efstratios; Giakoumidakis, Konstantinos; Fotos, Nikolaos V; Chatziefstratiou, Anastasia A; Brokalaki, Hero

    2017-01-01

    To investigate the effect of body mass index (BMI) values on 1- and 2-year mortality rates in patients with chronic heart failure (HF). We conducted a retrospective cohort study of 112 patients with confirmed HF who visited the HF outpatient unit of a tertiary hospital of Athens, Greece, during a 5-month period (December 2012 - April 2013). These patients were assigned to four groups based on their BMI category. Data collection was carried out through a review of the medical patient records and the filling in of a structured questionnaire, including information on the demographic and clinical patient variables. Additionally, 1- and 2-year patient mortality was recorded. The statistical significance was two-tailed, and p -values of less than 0.05 were considered significant. The statistical analysis was performed with Mann-Whitney U test, χ 2 test, and Student's t -test using the SPSS software (IBM SPSS 21.0 for Windows). Obese patients had significantly lower 1-year (13% vs 34.6%, p =0.039) and 2-year (4% vs 21.4%, p =0.022) mortality rates compared with those with normal BMI values. Additionally, we found clinically and not statistically significant lower mortality in overweight and obese patients, when compared with normal BMI and overweight patients, respectively. Obesity paradox seems to be present in our study, translating to significantly lower long-term mortality rates of obese patients compared to those with normal BMI. The significantly higher left ventricular ejection fraction and hematocrit levels among obese HF patients could justify our study findings. Further research is needed due to the inherent weaknesses of BMI and the other study limitations.

  4. Collateral circulation as a marker of the presence of viable myocardium in patients with recent myocardial infarction

    International Nuclear Information System (INIS)

    Fujita, M.; Ohno, A.; Wada, O.; Miwa, K.; Nozawa, T.; Yamanishi, K.; Sasayama, S.

    1991-01-01

    The relationship between the presence of viable myocardium and the extent of coronary collateral circulation to the infarct area was evaluated in 20 patients with a recent anterior myocardial infarction who had complete obstruction of the left anterior descending coronary artery. The viability of myocardial tissue was assessed by exercise thallium-201 myocardial scintigraphy, and the collateral circulation was angiographically evaluated by means of a collateral index ranging from 0 to 3. Patients were divided into two groups according to the presence (group 1, n = 10) or absence (group 2, n = 10) of viable myocardium in the perfusion territory of the infarct-related artery. The collateral index in group 1 was 2.5 ± 0.5 (SD), which was significantly higher than the 0.7 ± 0.8 in group 2. These findings indicate that the presence of ischemic but viable myocardium is intimately related to the development of collateral circulation in patients with myocardial infarction, and the existence of well-developed collateral channels predicts the presence of viable myocardium in the infarct area

  5. Associations between advanced cancer patients' survival and family caregiver presence and burden.

    Science.gov (United States)

    Dionne-Odom, J Nicholas; Hull, Jay G; Martin, Michelle Y; Lyons, Kathleen Doyle; Prescott, Anna T; Tosteson, Tor; Li, Zhongze; Akyar, Imatullah; Raju, Dheeraj; Bakitas, Marie A

    2016-05-01

    We conducted a randomized controlled trial (RCT) of an early palliative care intervention (ENABLE: Educate, Nurture, Advise, Before Life Ends) for persons with advanced cancer and their family caregivers. Not all patient participants had a caregiver coparticipant; hence, we explored whether there were relationships between patient survival, having an enrolled caregiver, and caregiver outcomes prior to death. One hundred and twenty-three patient-caregiver dyads and 84 patients without a caregiver coparticipant participated in the ENABLE early versus delayed (12 weeks later) RCT. We collected caregiver quality-of-life (QOL), depression, and burden (objective, stress, and demand) measures every 6 weeks for 24 weeks and every 3 months thereafter until the patient's death or study completion. We conducted survival analyses using log-rank and Cox proportional hazards models. Patients with a caregiver coparticipant had significantly shorter survival (Wald = 4.31, HR = 1.52, CI: 1.02-2.25, P = 0.04). After including caregiver status, marital status (married/unmarried), their interaction, and relevant covariates, caregiver status (Wald = 6.25, HR = 2.62, CI: 1.23-5.59, P = 0.01), being married (Wald = 8.79, HR = 2.92, CI: 1.44-5.91, P = 0.003), and their interaction (Wald = 5.18, HR = 0.35, CI: 0.14-0.87, P = 0.02) were significant predictors of lower patient survival. Lower survival in patients with a caregiver was significantly related to higher caregiver demand burden (Wald = 4.87, CI: 1.01-1.20, P = 0.03) but not caregiver QOL, depression, and objective and stress burden. Advanced cancer patients with caregivers enrolled in a clinical trial had lower survival than patients without caregivers; however, this mortality risk was mostly attributable to higher survival by unmarried patients without caregivers. Higher caregiver demand burden was also associated with decreased patient survival. © 2016 The Authors. Cancer Medicine published by

  6. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

    Science.gov (United States)

    van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

    2016-09-01

    Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

  7. Presence of herpesvirus DNA in cerebrospinal fluid of patients with tick-borne encephalitis and enteroviral meningoencephalitis.

    Science.gov (United States)

    Labská, Klára; Roubalová, Kateřina; Pícha, Dušan; Marešová, Vilma

    2015-07-01

    Reactivation of HHVs in the CNS due to inflammation has not been well described yet. The primary aim of this study was to investigate the frequency of HHV DNA detection in the cerebrospinal fluid (CSF) of immunocompetent patients with meningoencephalitis of other than HHV origin. The secondary aim of this study was to evaluate the impact of herpesvirus co-infection on the clinical course and patient outcome. Ninety-six patients with clinically and laboratory proven tick-borne encephalitis (TBE) and 77 patients with a confirmed diagnosis of enteroviral meningitis (EVM), along with a control group of 107 patients without evidence of inflammation in the CSF were retrospectively tested by nested PCR for the presence of DNA of the neurotropic herpesviruses HSV1, HSV2, VZV, and HHV6 in the CSF. The clinical course, laboratory tests, antiviral treatment, and neurological complications in a 6-month follow-up were compared between the groups positive or negative for HHV DNA in the CSF. HHV DNA was found in the CSF of 12 (6.9%) patients (6.3% and 7.8% in the TBE and EVM groups, respectively) and in 1 (0.9%) control patient. None of the patients had recent blisters or rash. The clinical course was comparably mild in all patients. No permanent neurological sequelae were observed. Only the CSF total protein level was significantly higher in HHV DNA-positive than in HHV-negative patients. © 2015 Wiley Periodicals, Inc.

  8. Dilatation of the ascending aorta is associated with presence of aortic regurgitation in patients after repair of tetralogy of Fallot

    Science.gov (United States)

    Ordovas, Karen Gomes; Keedy, Alexander; Naeger, David M.; Kallianos, Kimberly; Foster, Elyse; Liu, Jing; Saloner, David; Hope, Michael D.

    2016-01-01

    To evaluate the association between aortic morphology and elasticity with aortic regurgitation in surgically corrected of tetralogy of Fallot (TOF) patients. We retrospectively identified 72 consecutive patients with surgically corrected TOF and 27 healthy controls who underwent cardiac MRI evaluation. Velocity-encoded cine MRI was used to quantify degree of aortic regurgitation (AR) in TOF patients. Ascending aorta diameters were measured at standard levels on MRA images. Aortic pulse-wave velocity (PWV) was quantified with MRI. Morphological and functional MRI variables were compared between groups of TOF patients with and without clinically relevant AR and controls. The association between aortic morphology and elasticity with the presence of AR was evaluated using univariate and multivariate logistic regression. The majority of TOF patients had only trace AR. Nine TOF patients (12 %) had an AR fraction higher than 15 %. Indexed aorta diameter at the sinotubular junction (p = 0.007), at the RPA level (p = 0.006), and low left ventricular ejection fraction (LVEF) (p = 0.015) showed the strongest associations with the presence of at least mild AR, which persisted after controlling for age and gender. Increased ascending aorta dimension is associated with AR in patients after repair of TOF. LVEF was also low in the group of patients with relevant AR compared to those without, suggesting even mild to moderate AR may contribute to LV dysfunction in these patients. Enlarged ascending aorta may be an indication for precise quantification of regurgitant fraction with MRI, since symptomatic patients may need aortic valve repair when moderate regurgitation is present. PMID:27240599

  9. Presence of left atrial diverticula, accessory appendages, and normal variant pulmonary venous anatomy diagnosed using MDCT and adverse outcomes following radiofrequency catheter ablation therapy in patients with drug-refractory atrial fibrillation: An exploratory study

    International Nuclear Information System (INIS)

    Patel, S.N.; French, A.; Mathias, H.; Lyen, S.; Hamilton, M.C.K.; Manghat, N.E.

    2013-01-01

    Aim: To determine the frequency of normal variation left atrial anatomy (NVLAA) (diverticula, accessory appendages) and normal variation pulmonary venous anatomy (NVPVA) in patients with atrial fibrillation (AF), and to determine whether the presence of these entities is associated with an increased recurrence of atrial arrhythmias following radiofrequency catheter ablation (RFCA). Materials and methods: All cardiac MDCT images performed prior to RFCA between November 2009 and May 2011 in patients with drug-refractory AF were retrospectively evaluated. The presence, type, and location of NVLAA and NVPVA, and outcome of RFCA were recorded. Success was defined as restoration of sinus rhythm. Results: Forty-six consecutive patients with a mean age of 59.8 (±9.7) years (76.1% male) underwent cardiac MDCT for anatomical planning prior to RFCA procedures. Fourteen (30.4%) patients had NVLAA, 35% of patients had NVPVA. Thirty (65%) patients had successful RFCA: 57% of these had a NVLAA, 67% had NVPVA. Sixteen (35%) patients had unsuccessful RFCA: 63% of these had a NVLAA, 56% had NVPVA. There was no significant association between the presence of NVLAA (p = 0.699), NVPVA (p = 0.197), or “NVLAA in the presence of normal pulmonary venous anatomy” (p = 0.589) and the outcome of RFCA. Conclusion: The presence of NVLAA and NVPVA appears unrelated to adverse outcome in patients undergoing RFCA for the treatment of drug-refractory AF

  10. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis

    DEFF Research Database (Denmark)

    Grønkjær, Lea Ladegaard; Holmstrup, Palle; Schou, Søren

    2016-01-01

    interval [CI] 1.43-6.79) and severe periodontitis (OR 3.98, 95% CI 1.04-15.20). Also old age (OR 1.10, 95% CI 1.01-1.19) and smoking (OR 3.24, 95% CI 1.02-17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors......, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05). CONCLUSION: Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings....

  11. Peritoneal cavity lavage reduces the presence of mitochondrial damage associated molecular patterns in open abdomen patients.

    Science.gov (United States)

    Martinez-Quinones, Patricia A; McCarthy, Cameron G; Mentzer, Caleb J; Wenceslau, Camilla F; Holsten, Steven B; Webb, R Clinton; O'Malley, Keith

    2017-12-01

    Mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA and N-formylated peptides, are endogenous molecules released from tissue after traumatic injury. mtDAMPs are potent activators of the innate immune system. They have similarities with bacteria, which allow mtDAMPs to interact with the same pattern recognition receptors and mediate the development of systemic inflammatory response syndrome (SIRS). Current recommendations for management of an open abdomen include returning to the operating room every 48 hours for peritoneal cavity lavage until definitive procedure. These patients are often critically ill and develop SIRS. We hypothesized that mitochondrial DAMPs are present in the peritoneal cavity fluid in this setting, and that they accumulate in the interval between washouts. We conducted a prospective pilot study of critically ill adult patients undergoing open abdomen management in the surgical and trauma intensive care units. Peritoneal fluid was collected daily from 10 open abdomen patients. Specimens were analyzed via quantitative polymerase chain reaction (qPCR) for mitochondrial DNA (mtDNA), via enzyme immunoassay for DNAse activity and via Western blot analysis for the ND6 subunit of the NADH: ubiquinone oxidoreductase, an N-formylated peptide. We observed a reduction in the expression of ND6 the day after lavage of the peritoneal cavity, that was statistically different from the days with no lavage (% change in ND6 expression, postoperative from washout: -50 ± 11 vs. no washout day, 42 ± 9; p abdomen. It is possible that increased frequency of peritoneal cavity lavage may lead to decreased systemic absorption of mtDAMPs, thereby reducing the risk of SIRS. Prospective study, Case Series, Level V.

  12. Presence of diabetic microvascular complications does not incrementally increase risk of ischemic stroke in diabetic patients with atrial fibrillation

    Science.gov (United States)

    Chou, Annie Y.; Liu, Chia-Jen; Chao, Tze-Fan; Wang, Kang-Ling; Tuan, Ta-Chuan; Chen, Tzeng-Ji; Chen, Shih-Ann

    2016-01-01

    Abstract Conventional stroke risk prediction tools used in atrial fibrillation (AF) incorporate the presence of diabetes mellitus (DM) as a risk factor. However, it is unknown whether this risk is homogenous or dependent on the presence of diabetic microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy. The present study examined the risk of ischemic stroke in diabetic patients with and without microvascular complications. The present study used the National Health Insurance Research Database in Taiwan with detailed healthcare data on all-comers to the Taiwanese medical system from January 1, 1996 to December 31, 2011. AF and DM were identified when listed as discharge diagnoses or confirmed more than twice in the outpatient department. Patients on antithrombotic agents were excluded. The clinical endpoint was ischemic stroke. Among the 50,180 AF patients with DM, the majority had no microvascular complications (72.7%), while 2.6% had diabetic retinopathy, 8.4% had diabetic nephropathy, and 16.1% had diabetic neuropathy. Ischemic stroke occurred in 6003 patients, with a 4.74% annual risk of ischemic stroke. When compared with DM patients without microvascular complications, those with diabetic retinopathy, nephropathy, or neuropathy had higher incidences of ischemic stroke (4.65 vs 5.07, 4.77, or 5.20 per 100 person-years, respectively). However, after adjusting for confounding factors, the differences were no longer significant. In a large nationwide AF cohort with DM, risk of ischemic stroke was similar between patients with and without microvascular complications, suggesting that risk stratification of these patients does not require inclusion of diabetic retinopathy, nephropathy, and neuropathy. PMID:27399075

  13. Presence of atypical thrombopoietin receptor (MPL) mutations in triple-negative essential thrombocythemia patients.

    Science.gov (United States)

    Cabagnols, Xénia; Favale, Fabrizia; Pasquier, Florence; Messaoudi, Kahia; Defour, Jean Philippe; Ianotto, Jean Christophe; Marzac, Christophe; Le Couédic, Jean Pierre; Droin, Nathalie; Chachoua, Ilyas; Favier, Remi; Diop, M'boyba Khadija; Ugo, Valérie; Casadevall, Nicole; Debili, Najet; Raslova, Hana; Bellanné-Chantelot, Christine; Constantinescu, Stefan N; Bluteau, Olivier; Plo, Isabelle; Vainchenker, William

    2016-01-21

    Mutations in signaling molecules of the cytokine receptor axis play a central role in myeloproliferative neoplasm (MPN) pathogenesis. Polycythemia vera is mainly related to JAK2 mutations, whereas a wider mutational spectrum is detected in essential thrombocythemia (ET) with mutations in JAK2, the thrombopoietin (TPO) receptor (MPL), and the calreticulin (CALR) genes. Here, we studied the mutational profile of 17 ET patients negative for JAK2V617F, MPLW515K/L, and CALR mutations, using whole-exome sequencing and next-generation sequencing (NGS) targeted on JAK2 and MPL. We found several signaling mutations including JAK2V617F at very low allele frequency, 1 homozygous SH2B3 mutation, 1 MPLS505N, 1 MPLW515R, and 2 MPLS204P mutations. In the remaining patients, 4 presented a clonal and 7 a polyclonal hematopoiesis, suggesting that certain triple-negative ETs are not MPNs. NGS on 26 additional triple-negative ETs detected only 1 MPLY591N mutation. Functional studies on MPLS204P and MPLY591N revealed that they are weak gain-of-function mutants increasing MPL signaling and conferring either TPO hypersensitivity or independence to expressing cells, but with a low efficiency. Further studies should be performed to precisely determine the frequency of MPLS204 and MPLY591 mutants in a bigger cohort of MPN. © 2016 by The American Society of Hematology.

  14. Being present with the patient-A critical investigation of bodily sensitivity and presence in the field of physiotherapy.

    Science.gov (United States)

    Engelsrud, Gunn; Øien, Ingvil; Nordtug, Birgit

    2018-04-12

    This article advocates integrating ideas from phenomenological theory regarding the body with a psychoanalytical theory of language to enrich our understanding of the meaning of bodily presence in the practice of physiotherapy. The authors use this theoretical framework to explore bodily presence as a source for physiotherapists' professional development. They are using research on children as moving and meaning-producing subjects 1 1 The concept of subject is used in different ways in phenomenology and psychoanalysis, and also in varying ways in each of the two traditions. However, here the concept is used more in line with ordinary language, in the sense that it emphasizes the child's active position in her/his being in the world. to illustrate the relevance of their perspectives. They argue that the perspectives might contribute to a physiotherapeutic practice that incorporates bodily presence in the professional language in addition to specific methods and techniques. Understanding bodily presence involves the physiotherapist recognizing the Other (i.e., the patient/child) in the present moment and trusting her/his own capacity to become aware of her/his own bodily presence. The authors assert that being aware of one's own bodily presence enables therapists to develop an appreciation of their own bodies and the bodies of their patients as they are and move in mutual relation to each other. Applying the article's theoretical framework, the authors consider the body as the starting point for speech, 2 2 The concept of speech is used in a wide sense, including voice, tone, and rhythm in line with the article's psychoanalytical framework of Kristeva and the late Lacan. Thus, the call for being present for the child (as a patient) in the here and now includes participating in the speech of the child, even though the child does not use words. and suggest that introducing a richer professional language encourages practitioners to become more aware of the dialectic

  15. Is the presence of a validated malnutrition screening tool associated with better nutritional care in hospitalized patients?

    Science.gov (United States)

    Eglseer, Doris; Halfens, Ruud J G; Lohrmann, Christa

    2017-05-01

    The aims of this study were to evaluate the association between the use of clinical guidelines and the use of validated screening tools, evaluate the nutritional screening policy in hospitals, and examine the association between the use of validated screening tools and the prevalence of malnutrition and nutritional interventions in hospitalized patients. This was a cross-sectional, multicenter study. Data were collected using a standardized questionnaire on three levels: institution (presence of a guideline for malnutrition), department (use of a validated screening tool), and patient (e.g., malnutrition prevalence). In all, 53 hospitals with 5255 patients participated. About 45% of the hospitals indicated that they have guidelines for malnutrition. Of the departments surveyed, 38.6% used validated screening tools as part of a standard procedure. The nutritional status of 74.5% of the patients was screened during admission, mostly on the basis of clinical observation and patient weight. A validated screening tool was used for 21.2% of the patients. Significant differences between wards with and without validated screening tools were found with regard to malnutrition prevalence (P = 0.002) and the following interventions: referral to a dietitian (P malnutrition screening tools is associated with better nutritional care and lower malnutrition prevalence rates in hospitalized patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Evaluation of the presence of Epstein-Barr virus (EBV) in Iranian patients with thyroid papillary carcinoma.

    Science.gov (United States)

    Homayouni, Maryam; Mohammad Arabzadeh, Seyed Ali; Nili, Fatemeh; Razi, Farideh; Amoli, Mahsa Mohammad

    2017-07-01

    Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. EBV is one of the most important viruses related to different types of malignancies. This study investigated the relationship between EBV and papillary thyroid carcinoma. In this study the presence of Epstein-Barr Nuclear Antigen 1 (EBNA1) gene in papillary thyroid carcinoma tissues were examined by nested-PCR method. Paraffin-embedded tissues (N=41) blocks of thyroid cancer were used. DNA was extracted from all samples and then samples were evaluated for the presence of EBV gene. In 41 samples, EBNA1 was detected in 65.8% of patients with papillary thyroid carcinoma which was significantly higher in younger ages. The significant presence of EBV genome in papillary thyroid carcinoma suggests that this virus may play a role in this cancer especially in younger ages. As a result, monitoring of patients with EBV latent infection for PTC can be very important. Copyright © 2017 Elsevier GmbH. All rights reserved.

  17. Spontaneous presence of FOXO3-specific T cells in cancer patients

    DEFF Research Database (Denmark)

    Larsen, Stine Kiaer; Ahmad, Shamaila Munir; Idorn, Manja

    2014-01-01

    In the present study, we describe forkhead box O3 (FOXO3)-specific, cytotoxic CD8(+) T cells existent among peripheral-blood mononuclear cells (PBMCs) of cancer patients. FOXO3 immunogenicity appears specific, as we did not detect reactivity toward FOXO3 among T cells in healthy individuals. FOXO3...... may naturally serve as a target antigen for tumor-reactive T cells as it is frequently over-expressed in cancer cells. In addition, expression of FOXO3 plays a critical role in immunosuppression mediated by tumor-associated dendritic cells (TADCs). Indeed, FOXO3-specific cytotoxic T lymphocytes (CTLs......) were able to specifically recognize and kill both FOXO3-expressing cancer cells as well as dendritic cells. Thus, FOXO3 was processed and presented by HLA-A2 on the cell surface of both immune cells and cancer cells. As FOXO3 programs TADCs to become tolerogenic, FOXO3 signaling thereby comprises...

  18. Cardiac auscultation poorly predicts the presence of valvular heart disease in asymptomatic primary care patients.

    Science.gov (United States)

    Gardezi, Syed K M; Myerson, Saul G; Chambers, John; Coffey, Sean; d'Arcy, Joanna; Hobbs, F D Richard; Holt, Jonathan; Kennedy, Andrew; Loudon, Margaret; Prendergast, Anne; Prothero, Anthony; Wilson, Joanna; Prendergast, Bernard D

    2018-05-24

    Cardiac auscultation is a key clinical skill, particularly for the diagnosis of valvular heart disease (VHD). However, its utility has declined due to the widespread availability of echocardiography and diminishing emphasis on the importance of clinical examination. We aim to determine the contemporary accuracy of auscultation for diagnosing VHD in primary care. Cardiac auscultation was undertaken by one of two experienced general practitioners (primary care/family doctors) in a subset of 251 asymptomatic participants aged >65 years undergoing echocardiography within a large community-based screening study of subjects with no known VHD. Investigators were blinded to the echocardiographic findings. Newly detected VHD was classified as mild (mild regurgitation of any valve or aortic sclerosis) or significant (at least moderate regurgitation or mild stenosis of any valve). Newly identified VHD was common, with mild disease in 170/251 participants (68%) and significant disease in 36/251 (14%). The sensitivity of auscultation was low for the diagnosis of mild VHD (32%) but slightly higher for significant VHD (44%), with specificities of 67% and 69%, respectively. Likelihood ratios were not statistically significant for the diagnosis of either mild or significant VHD in the overall cohort, but showed possible value for auscultation in non-overweight subjects (body mass index auscultation has limited accuracy for the detection of VHD in asymptomatic patients and is a poor diagnostic screening tool in primary care, particularly for overweight subjects. Ensuring easy access to echocardiography in patients with symptoms suggesting VHD is likely to represent a better diagnostic strategy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Only one simple conclusion about the climate

    Energy Technology Data Exchange (ETDEWEB)

    Jaremko, G.

    2000-07-24

    Findings concerning climate change, by a three-man team of scientists from the North Dakota Geological Survey, which were presented in a paper read at the Eight International Williston Basin Horizontal Well Workshop, are discussed. The survey by the three scientists covered more than 6,000 scholarly publications. It reported that while the rise in the Earth's temperature is beyond argument, there is anything but agreement as to the causes, or whether the trend is unusual enough to justify concerted and costly actions to change lifestyles. It is shown by direct instrumental measurements that the average temperature at the Earth's surface increased about 0.8 degree Celsius between 1866 and 1998. During that time the concentration of carbon dioxide in the atmosphere increased from 280 to 353 parts per million. While it is generally assumed that the global warming was caused by human activities, new techniques of measurement such as glacier ice coring, dendrochronology (tree-growth rings), lichenometry (measuring the diameter of lichens) and counting concentrations of oxygen 18 and 16 (isotopes whose presence in marine fossils varies depending on temperature) suggest that most of the global warming took place before the increase in carbon dioxide concentration occurred, raising the possibility that the increase in average temperature had causes other than the increase in greenhouse gases. Some of the studies reviewed by the group show that in Europe between ice ages during the Eemian period, some 135,000 to 110,000 years ago, temperature variations of seven degrees Celsius took place; they dropped from two degree Celsius warmer than today to five degree Celsius colder than today. Based on these findings the group's only firm conclusion was that climate is in a continual flux.

  20. Immunophenotype and increased presence of CD4(+)CD25(+) regulatory T cells in patients with acute lymphoblastic leukemia.

    Science.gov (United States)

    Wu, Cui-Ping; Qing, Xi; Wu, Cui-Yun; Zhu, Hong; Zhou, Hai-Yan

    2012-02-01

    Acute lymphoblastic leukemia (ALL), cancer of the white blood cells, is a heterogeneous disease that mainly occurs due to the malignant cloning of original and naive lymphocytes. The aim of this study was to explore the immunophenotype, the percentage of CD4(+)CD25(+) regulatory T cells (Tregs) and the expression of cytokines interleukin (IL)-2, IL-10 and TGF-β in patients with ALL. The immunophenotype and levels of CD4(+)CD25(+) Tregs were detected using flow cytometry in the peripheral blood of 35 ALL patients, with 18 healthy individuals being selected as controls. The results suggested that 22 patients had B cell ALL (B-ALL) and 13 had T cell ALL (T-ALL) among the 35 ALL patients. In B-ALL patients, the surface antigen CD19 was most commonly expressed; in T-ALL patients, CD7 was most common. Furthermore, the percentage of CD4(+)CD25(+) Treg cells in the peripheral blood of B-ALL and T-ALL patients was higher compared to that of healthy individuals (Pcell culture supernatants from B-ALL and T-ALL patients were higher compared to those in the controls (Pcells, IL-2, IL-10 or TGF-β in B-ALL versus T-ALL patients. The authors concluded that CD19 and CD7 may serve as diagnostic markers of B-ALL and T-ALL, respectively. The increased presence of CD4(+)CD25(+) Treg cells and the altered levels of secreted cytokines are indicative of an immunosuppressive mechanism in the pathogenesis of ALL.

  1. Association between competing interests and authors' conclusions

    DEFF Research Database (Denmark)

    Kjaergard, Lise L; Als-Nielsen, Bodil

    2002-01-01

    To assess the association between competing interests and authors' conclusions in randomised clinical trials.......To assess the association between competing interests and authors' conclusions in randomised clinical trials....

  2. Are Changes in Heart Rate Variability During Hypoglycemia Confounded by the Presence of Cardiovascular Autonomic Neuropathy in Patients with Diabetes?

    DEFF Research Database (Denmark)

    Cichosz, Simon Lebech; Frystyk, Jan; Tarnow, Lise

    2017-01-01

    BACKGROUND: We have recently shown how the combination of information from continuous glucose monitor (CGM) and heart rate variability (HRV) measurements can be used to construct an algorithm for prediction of hypoglycemia in both bedbound and active patients with type 1 diabetes (T1D). Questions...... with CGM and a Holter device while they performed normal daily activities. CAN was diagnosed using two cardiac reflex tests: (1) deep breathing and (2) orthostatic hypotension and end organ symptoms. Early CAN was defined as the presence of one abnormal reflex test and severe CAN was defined as two...

  3. Predictive factors for the presence of tumor cells in bone marrow and peripheral blood in breast cancer patients.

    Science.gov (United States)

    Cabinakova, M; Mikulova, V; Malickova, K; Vrana, D; Pavlista, D; Petruzelka, L; Zima, T; Tesarova, P

    2015-01-01

    Simultaneous detection of disseminated tumor cells (DTCs) and circulating tumor cells (CTCs) was shown to be associated with an especially poor prognosis and increased incidence of disease-related deaths in non-metastatic breast cancer patients. We analyzed the occurance of DTCs and CTCs in patients with primary breast cancer and evaluated the correlation of their presence with other prognostic markers and investigated the changes in DTCs/CTCs number at different time points during treatment.Blood of 50 patients with primary breast cancer were used for immunomagnetic separation and detection of circulating tumor cells using the commercial available system the AdnaTest Breast Cancer™ (AdnaGen GmbH, Langenhagen, Germany). Bone marrow aspirates from 50 patients were analyzed for DTCs by immunocytochemistry using the pan-cytokeratin antibody conjugated with FITC (Monoclonal Anti-Cytokeratin antibody F3418, Sigma Aldrich).DTCs were identified in 30% (15/50) and CTCs in 22% (11/50) of patients. We found that DTC positivity could point to a significantly high risk of larger primary tumor size (p-value 0.011) and significantly higher risk of lymph node involvement (p-value 0.002). For CTC positivity, no such relationship was proven. DTCs have shown significantly higher prevalence in ER/PR-negative females and in HER2-positive cases. CTCs were equally prevalent in patients with the presence and absence of standard prognostic and predictive markers such as ER, PR and HER2. We found no correlation between CTCs and DTCs findings (r = -0.097, p = 0.504). We used DTCs/CTCs analysis for therapy monitoring in a small group of 29 patients, who underwent neoadjuvant chemotherapy (NACT). We find out no significant correlation between DTCs/CTCs detection and the primary tumor response to NACT. A pathologic complete response (pCR) was achieved by 31% (9/29) of the patients in our study, however, no association was observed between pCR and the detection of DTCs after NACT

  4. The Presence of Thyroid-Stimulation Blocking Antibody Prevents High Bone Turnover in Untreated Premenopausal Patients with Graves' Disease.

    Directory of Open Access Journals (Sweden)

    Sun Wook Cho

    Full Text Available Osteoporosis-related fractures are one of the complications of Graves' disease. This study hypothesized that the different actions of thyroid-stimulating hormone receptor (TSHR antibodies, both stimulating and blocking activities in Graves' disease patients might oppositely impact bone turnover. Newly diagnosed premenopausal Graves' disease patients were enrolled (n = 93 and divided into two groups: patients with TSHR antibodies with thyroid-stimulating activity (stimulating activity group, n = 83 and patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity (blocking activity group, n = 10. From the stimulating activity group, patients who had matched values for free T4 and TSH binding inhibitor immunoglobulin (TBII to the blocking activity group were further classified as stimulating activity-matched control (n = 11. Bone turnover markers BS-ALP, Osteocalcin, and C-telopeptide were significantly lower in the blocking activity group than in the stimulating activity or stimulating activity-matched control groups. The TBII level showed positive correlations with BS-ALP and osteocalcin levels in the stimulating activity group, while it had a negative correlation with the osteocalcin level in the blocking activity group. In conclusion, the activation of TSHR antibody-activated TSH signaling contributes to high bone turnover, independent of the actions of thyroid hormone, and thyroid-stimulation blocking antibody has protective effects against bone metabolism in Graves' disease.

  5. The Presence of Thyroid-Stimulation Blocking Antibody Prevents High Bone Turnover in Untreated Premenopausal Patients with Graves' Disease.

    Science.gov (United States)

    Cho, Sun Wook; Bae, Jae Hyun; Noh, Gyeong Woon; Kim, Ye An; Moon, Min Kyong; Park, Kyoung Un; Song, Junghan; Yi, Ka Hee; Park, Do Joon; Chung, June-Key; Cho, Bo Youn; Park, Young Joo

    2015-01-01

    Osteoporosis-related fractures are one of the complications of Graves' disease. This study hypothesized that the different actions of thyroid-stimulating hormone receptor (TSHR) antibodies, both stimulating and blocking activities in Graves' disease patients might oppositely impact bone turnover. Newly diagnosed premenopausal Graves' disease patients were enrolled (n = 93) and divided into two groups: patients with TSHR antibodies with thyroid-stimulating activity (stimulating activity group, n = 83) and patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity (blocking activity group, n = 10). From the stimulating activity group, patients who had matched values for free T4 and TSH binding inhibitor immunoglobulin (TBII) to the blocking activity group were further classified as stimulating activity-matched control (n = 11). Bone turnover markers BS-ALP, Osteocalcin, and C-telopeptide were significantly lower in the blocking activity group than in the stimulating activity or stimulating activity-matched control groups. The TBII level showed positive correlations with BS-ALP and osteocalcin levels in the stimulating activity group, while it had a negative correlation with the osteocalcin level in the blocking activity group. In conclusion, the activation of TSHR antibody-activated TSH signaling contributes to high bone turnover, independent of the actions of thyroid hormone, and thyroid-stimulation blocking antibody has protective effects against bone metabolism in Graves' disease.

  6. Presence of histopathological premalignant lesions and infection caused by high-risk genotypes of human papillomavirus in patients with suspicious cytological and colposcopy results: A prospective study

    Directory of Open Access Journals (Sweden)

    Golubović Mileta

    2017-01-01

    Full Text Available Background/Aim. In patients with premalignant cervical lesions, human papillomavirus (HPV infection, at any moment, may be spontaneously eliminated, or may persist or transform cervical epithelium from a lower to a higher degree. Due to that, it is necessary to wisely select the patients who are at high risk of cancer development. The aim of the study was to establish the interdependence between a suspicious Papanicolaou (Pap test and colposcopy with the infection caused by high-risk genotypes of human papillomavirus and the presence of premalignant cervical lesions. Methods. This prospective study used cytological, colposcopy, real-time polymerase chain reaction (PCR of high-risk genotypes of human papillomavirus and histopathological analysis of cervical biopsy specimen. Out of 2,578 female patients sent to cytological analyses in Clinical Center of Montenegro, during 2012, 2013 and 2014, the study included 80 women who had to submit their biopsy specimens due to a suspicious Pap test and atypical colposcopy results. Results. In the group of 80 (3.1%; n = 80/2,578 of the selected female patients with suspicious Pap test and colposcopy, 2/3 or 56 (70% of them had cervicitis, and 1/3 or 24 (30% had cervical intraepithelial neoplasia. The most common type in cervical intraepithelial neoplasia was HPV16 in 8 female patients, ie 61.53% out of the number of infected, or 33.33% out of the total number of premalignant lesions. Conclusion. Patients with suspicious Papanicolaou test, colposcopy results and infection which is caused by high-risk HPV infection (HPV 16 in particular often have premalignant cervical lesions. In these cases, histopathological confirmation of lesions is mandatory, since it serves as a definitive diagnostic procedure.

  7. The frequency of secondary glaucoma in patients with iridocorneal endothelial syndrome in correlation to the presence of uveal ectropion

    Directory of Open Access Journals (Sweden)

    Marković Vujica

    2017-01-01

    Full Text Available Introduction/Objective. Iridocorneal endothelial (ICE syndrome incudes 3 clinical forms: progressive iris atrophy, Chandler’s syndrome, and Cogan–Reese syndrome. It is characterized by various degrees of iris atrophy, corneal endothelial changes, uveal ectropion, corectopia, peripheral anterior synechiae (PAS and secondary glaucoma. The aim of the study was to illustrate forms of ICE syndrome, determine frequency of secondary glaucoma with emphasis on cases with uveal ectropion, analyze response to medicament treatment and the need for surgical treatment in intraocular pressure (IOP control. Methods. Patients underwent slit lamp examination, applanation tonometry, gonioscopy, ophthalmoscopy, Humphrey visual field testing and Heidelberg retina tomography. Patients were divided into two groups: group I, without uveal ectropion (22 patients and group II, with uveal ectropion (14 patients. Results. A total of 36 patients were examined in a 10-year period. The average age was 38 years, male to female ratio 1:2. Secondary glaucoma was confirmed in 26 (72.2% patients, out of which 12 (54.5% in group I and 14 (100% in group II. PAS were more frequent in group II. In group I, mean initial IOP was 37 mmHg, and after medicament treatment 26 mmHg. Secondary glaucoma was controlled in 50% and remaining 50% underwent surgical treatment. In group II, mean initial IOP was 49 mmHg, and after medicament treatment 32 mmHg. All 14 patients (100% underwent surgical treatment in order to achieve IOP control. Conclusion. ICE syndrome is a rare, progressive disease, with high incidence of secondary glaucoma, which is more frequent in cases with uveal ectropion. In these cases, medicament treatment is not effective and trabeculectomy with antimetabolite application is necessary.

  8. An analysis of the persistent presence of opportunistic pathogens on patient-derived dental impressions and gypsum casts.

    Science.gov (United States)

    Egusa, Hiroshi; Watamoto, Takao; Abe, Keike; Kobayashi, Munemasa; Kaneda, Yoshitoshi; Ashida, Shunji; Matsumoto, Takuya; Yatani, Hirofumi

    2008-01-01

    This study aimed to assess the persistent presence of microorganisms on patient-derived dental impressions and gypsum casts, while highlighting important human pathogens such as Candida, methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa. The practices and opinions regarding cross-infection control from 59 general dentists in Japan were obtained via a questionnaire. Alginate impressions were made from 56 patients. Using a brain heart infusion agar medium, impression and imprint cultures were carried out to visualize the microbial contamination on the surfaces of the impressions and gypsum casts, respectively. The colonies on the surfaces of the 30 impression cultures and 26 imprint cultures were collected by swabbing and then inoculated onto selective agar plates to detect streptococci, staphylococci, Candida, MRSA, and P aeruginosa. The questionnaire showed that only 54% of general dentists had a cross-infection policy in their dental clinics, and only 30% to 40% were aware of the possible persistence of MRSA or P aeruginosa on impressions and gypsum casts. The impression/imprint cultures grew a large number of visible bacterial colonies on all of impression/gypsum cast samples investigated. Selective agar cultures demonstrated the presence of streptococci (100, 100%), staphylococci (56.7, 65.4%), Candida (30, 46.2%), MRSA (26.7, 15.4%), and P aeruginosa (6.7, 7.7%) on the impressions and the gypsum casts, respectively. This investigation showed that patient-derived dental impressions and gypsum casts are contaminated with numerous microbes, including Candida, MRSA, and P aeruginosa, which are known pathogens responsible for nosocomial and/or life-threatening infection in the immunocompromised host.

  9. LATE-NIGHT SALIVARY CORTISOL IS UNALTERED IN PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME (PCOS), IRRESPECTIVE OF DISEASE PHENOTYPE, AND IN OBESE WOMEN, IRRESPECTIVE OF THE PRESENCE OF PCOS.

    Science.gov (United States)

    Ozkaya, Hande Mefkure; Keskin, Fatma Ela; Tuten, Abdullah; Korkmaz, Ebru; Oktay, Hulya Zeynep; Kadioglu, Pinar

    2017-09-01

    To determine cutoff values of late-night salivary cortisol (LNSC) using an electrochemiluminescent immunoassay and investigate whether the diagnostic performance of the assay is influenced by the presence of obesity or polycystic ovary syndrome (PCOS). A total of 124 subjects comprising 25 patients with Cushing syndrome (CS), 44 with PCOS (22 nonobese and 22 obese), 21 with constitutional obesity (CO), and 34 healthy subjects (HS) were included in the study. Two consecutive LNSC samples were collected from all participants. The median LNSC levels of patients with CS were significantly higher than LNSC levels of HS, patients with CO, and obese and nonobese patients with PCOS, respectively (P.05 for all). The cutoff values and corresponding sensitivity and specificity were similar between the groups. The comparisons of the area under curve of the first LNSC (0.963; 95% confidence interval [CI], 0.910 to 0.989), second LNSC (0.954; 95% CI, 0.898 to 0.984), and the mean of two consecutive LNSC (mLNSC) values (0.962; 95% CI, 0.909 to 0.989) did not differ significantly (P>.05 for all). A cutoff value for mLNSC of 7.45 nmol/L yielded a sensitivity of 100% and specificity of 87.5% in HS. In conclusion, LNSC is a reliable test with high diagnostic accuracy in both HS and patients with PCOS and obesity. ACTH = adrenocorticotropic hormone AUC = area under the curve BMI = body mass index CO = constitutional obesity CS = Cushing syndrome E2 = estradiol ECLIA = electrochemiluminescent immunoassay FPG = fasting plasma glucose FSH = follicle-stimulating hormone HOMA-IR = homeostasis model assessment of insulin resistance HPA = hypothalamo-pituitary-adrenal HS = healthy subjects IQR = interquartile range LH = luteinizing hormone LNSC = late-night salivary cortisol LR = likelihood ratio mLNSC = mean of two consecutive LNSC samples PCOS = polycystic ovarian syndrome ROC = receiver operating characteristic UFC = urinary free cortisol WHR = waist-to-hip ratio.

  10. Associations between presence of relevant information in referrals to radiology and prevalence rates in patients with suspected pulmonary embolism.

    Science.gov (United States)

    Hedner, Charlotta; Sundgren, Pia C; Kelly, Aine Marie

    2013-09-01

    The purpose of this study was to assess if the presence of information including the pretest probability (Wells score), other known risk factors, and symptoms given on referrals for computed tomography (CT) pulmonary angiography correlated with prevalence rates for pulmonary embolism (PE). Also, to evaluate for differences between a university and a regional hospital setting regarding patient characteristics, amount of relevant information provided on referrals, and prevalence rates for pulmonary embolism. Retrospective review of all consecutive referrals (emergency room, inpatient, and outpatient) for CT performed on children and adults for suspected PE from two sites: a tertiary (university) hospital (site 1) and a secondary (regional) hospital (site 2) over a 5-year period. The overall prevalence rate was 510/3641 or 14% of all referrals. Significantly higher number of males had a positive CT compared to women (18% versus 12%, P relevant information on the referral and the probability for positive finding existed, a slight trend was noted (P = .09). In two categories, "hypoxia" and "signs of deep vein thrombosis," the presence of this information conferred a higher probability for pulmonary embolism, P information conferred a higher probability for pulmonary embolism. The amount of relevant clinical information on the request did not correlate with prevalence rates, which may reflect a lack of documentation on the part of emergency physicians who may use a "gestalt" approach. Request forms likely did not capture all relevant patient risks and many factors may interact with each other, both positively and negatively. Pretest probability estimations were rarely performed, despite their inclusion in major society guidelines. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  11. Characteristics of cognitive function in patients with adult-onset diabetes mellitus type 2 depending on the presence of depressions

    Directory of Open Access Journals (Sweden)

    N.M. Zherdova

    2017-02-01

    Full Text Available Background. Patients with diabetes mellitus (DM suffer comorbid depression 1.4–3 times more often than those without DM. According to the latest data, DM in the world is on the 8th place as a cause of disability in the population, while depressive disorders occupy the 4th position. Depression affects emotion, cognition, and behavior, which results in the patient’s failure to carry out adequate treatment of the disease as a consequence of decompensation. The aim of the study was to examine the relationship between cognitive status and the presence of depression in patients with adult-onset DM. Materials and methods. 81 patients with type 2 DM were examined, including 43 women and 38 men. Patients were divided into 2 groups, with and without depressive disorders. Assessment of depressive symptoms was conducted using questionnaires filled in by the patient himself, including: Centre for Epidemiologic Studies Depression Scale, Hospital Anxiety and Depression Scale. Results. According to the Centre for Epidemiologic Studies Depression Scale, the incidence of depressive disorders was 38.3 %. During examination of cognitive function, there was noted a significant decrease in performance of neuropsychological tests, namely clock drawing test and Frontal Assessment Battery (FABбы in patients with depressive disorders. In the study of the relationship of various factors, such as the duration of the disease, body mass index, systolic blood pressure, diastolic blood pressure, levels of total cholesterol, triglycerides, vibration sensitivity and the severity of depressive symptoms, no significant differences were found, while the level of glycated haemoglobin had a significant correlation with depression. Conclusions. Patients with depression had a significant decline of cognitive function according to the FAB, Mini-Mental State Examination and clock drawing test that determines the defeat of the frontal lobe of the brain. There was found

  12. [Investigation of the presence of human metapneumovirus in patients with chronic obstructive pulmonary disease and asthma and its relationship with the attacks].

    Science.gov (United States)

    Ilvan, Ahmet; Aslan, Gönül; Serin, Mehmet Sami; Calıkoğlu, Mukadder; Yılmaz, Fatma Mehtap; Tezcan, Seda; Taş, Dilaver; Ayrık, Cüneyt; Uygungül, Evren; Sezer, Ogün; Emekdaş, Gürol

    2013-10-01

    Human metapneumovirus (hMPV), an enveloped RNA virus classified in Paramyxoviridae family, was first characterized in 2001 from children with acute respiratory tract infection. Recent studies have suggested hMPV to play a role in chronic obstructive pulmonary disease (COPD) and asthma attacks. The aims of this study were to investigate the frequency of hMPV in patients with COPD and asthma, its effects on the severity of the attacks and the relationship between demographical and clinical factors. A total of 123 patients, including 66 with COPD (45 were in attack and 21 were stable) and 57 with asthma (33 were in attack and 24 were under control) diagnosed according to the criteria of Global Initiative for Chronic Obstructive Lung Disease and the Global Strategy for Asthma Management and Prevention, respectively, were included in the study. Nasopharyngeal lavage samples collected from all of the patients have been evaluated for the presence of hMPV-RNA by using a reverse transcriptase-polymerase chain reaction (RT-PCR) targeting F gene region of the virus. hMPV-RNA positivity rates in patients with COPD and asthma were observed as 30.3% (20/66) and 31.6% (18/57), respectively, and the difference between the groups were not statistically significant (p= 1.00). When patients were compared according to their disease status, hMPV was detected in 31.1% (14/45) of patients with COPD attack and 28.6% of stable patients (p> 0.05). These rates were found as 36.4% (12/33) and 25% (6/24) in patients with asthma attack and controlled asthma, respectively (p> 0.05). Although the virus detection rates in patients with COPD and asthma attacks (26/78; 33.3%) were higher than the patients with stable/controlled disease (12/45; 26.7%), the difference was not found as statistically significant (p= 0.57). The detection rate of hMPV-RNA was 26.1% in patients who can be treated at home and hospital without any need of intensive care and mechanical ventilation, while this rate was 36

  13. Diagnostic and Prognostic Particularities of the Implications of the Presence of Tumor Necrosis Factor Alpha in Patients with Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Yero Ieremie Lia Maria

    2014-12-01

    Full Text Available Periodontal disease can have significant effects by increasing the circulating levels of TNF-α, therefore its prevention and treatment is important in maintaining the overall health of the body. Objective: The aim of our research was to assess the differences in the salivary concentration of TNF-α between patients with periodontal disease and those free of the disease and to studz whether it can represent an indicator of the evolution of periodontal disease. We also aimed to assess the practical applicability of the method for the determination of this cytokine in the saliva. Materials and methods: Our study included two groups of subjects, the first group consisting in patients diagnosed with periodontal disease, while the control group included subjects free of periodontal disease. TNF-α concentration was determined with the ELISA test for human TNF-α and the results were expressed in pg/ mL. The data were statistically processed with GraphPad software and the statistical nonparametric Mann-Whitney test was applied. Results: We observe nearly double values of the TNF-α salivary level in the group of patients suffering from periodontal disease compared to the subjects free of periodontal disease, which allows us to notice that saliva analysis is a useful and safely enough method for the diagnosis and follow-up in the development of periodontal disease. Conclusion: The salivary level of TNF-α in patients with periodontal disease is not only an indicator of periodontal disease progression, but also a reflection of the pathogen potential that periodontal disease may have on the overall health of the body.

  14. Data, Model, Conclusions, Doing It Again.

    Science.gov (United States)

    Molenaar, Ivo W.

    1998-01-01

    Explores the robustness of conclusions from a statistical model against variations in model choice with an illustration from G. Box and G. Tiao (1973). Suggests that simultaneous consideration of a class of models for the same data is sometimes superior to analyzing the data under one model and demonstrates advantages to Adaptive Bayesian…

  15. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.

    2009-01-01

    Dr Cuijpers and Colleagues Reply To the Editor: We thank Dr Gaudiano and colleagues for their contribution to the discussion about psychotherapy for dysthymia. We agree very much with Gaudiano et al that we should be careful about drawing definite conclusions about the comparative efficacy of

  16. Data, model, conclusion, doing it again

    NARCIS (Netherlands)

    Molenaar, W.

    1998-01-01

    This paper explores the robustness of conclusions from a statistical model against variations in model choice (rather than variations in random sampling and random assignment to treatments, which are the usual variations covered by inferential statistics). After the problem formulation in section 1,

  17. Results and conclusion; Resultados e conclusoes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    This chapter shows the results and conclusions of the ordered studies by the Science and Technology Ministry from Brazil to the Center of Management and Strategic Studies (CGEE), executed by a multidisciplinary team, most of UNICAMP - State University of Campinas, SP - for evaluation of Brazilian capacity and potential in the production of fuel bioethanol.

  18. Power and Democracy in Denmark. Conclusions

    DEFF Research Database (Denmark)

    Andersen, Jørgen Goul; Christiansen, Peter Munk; Beck Jørgensen, Torben

    In 1997, the Danish Parliament decided to launch a power study, officially An Analysis of Democracy and Power in Denmark. A steering committee consisting of five independent researchers was assigned responsibility for the project. The Steering Committee has gathered the overall conclusions from...... the numerous projects under the Power Study, and this book is a short presentation of these conclusions.The main focus of the book is the state of democracy in Denmark at the dawn of the 21st century. How has democracy fared, has the development made things better or worse, and to which extent does......, and the political institutions show considerable democratic robustness. However, not everything has gone or is going well. There are still pronounced social divisions in Danish society, although their nature has changed somewhat. The ideal of an informed public debate does not always enjoy the best conditions...

  19. Imputation by the mean score should be avoided when validating a Patient Reported Outcomes questionnaire by a Rasch model in presence of informative missing data

    LENUS (Irish Health Repository)

    Hardouin, Jean-Benoit

    2011-07-14

    Abstract Background Nowadays, more and more clinical scales consisting in responses given by the patients to some items (Patient Reported Outcomes - PRO), are validated with models based on Item Response Theory, and more specifically, with a Rasch model. In the validation sample, presence of missing data is frequent. The aim of this paper is to compare sixteen methods for handling the missing data (mainly based on simple imputation) in the context of psychometric validation of PRO by a Rasch model. The main indexes used for validation by a Rasch model are compared. Methods A simulation study was performed allowing to consider several cases, notably the possibility for the missing values to be informative or not and the rate of missing data. Results Several imputations methods produce bias on psychometrical indexes (generally, the imputation methods artificially improve the psychometric qualities of the scale). In particular, this is the case with the method based on the Personal Mean Score (PMS) which is the most commonly used imputation method in practice. Conclusions Several imputation methods should be avoided, in particular PMS imputation. From a general point of view, it is important to use an imputation method that considers both the ability of the patient (measured for example by his\\/her score), and the difficulty of the item (measured for example by its rate of favourable responses). Another recommendation is to always consider the addition of a random process in the imputation method, because such a process allows reducing the bias. Last, the analysis realized without imputation of the missing data (available case analyses) is an interesting alternative to the simple imputation in this context.

  20. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest.......James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...

  1. Unique spectrum of SPAST variants in Estonian HSP patients: presence of benign missense changes but lack of exonic rearrangements

    Directory of Open Access Journals (Sweden)

    Gross-Paju Katrin

    2010-03-01

    Full Text Available Abstract Background Hereditary spastic paraplegia (HSP is a clinically and genetically heterogeneous disorder that can be an autosomal-dominant, autosomal-recessive, or X-linked disease. The most common autosomal-dominant form of the disease derives from mutations in the SPAST gene. Methods The aim of this study was to analyze 49 patients diagnosed with HSP from the Estonian population for sequence variants of the SPAST gene and to describe the associated phenotypes. Healthy control individuals (n = 100 with no family history of HSP were also analyzed. All patient samples were screened using denaturing high performance liquid chromatography (DHPLC and multiplex ligation-dependent probe amplification (MLPA assay. Samples with abnormal DHPLC and MLPA profiles were sequenced, with the same regions sequenced in control samples. Results Sequence variants of SPAST were identified in 19/49 HSP patients (38.8%, twelve among them had pathogenic mutations. Within the latter group there was one sporadic case. Eight patients had pure, and four - complex HSP. The twelve variants were identified: seven pathogenic (c.1174-1G>C, c.1185delA, c.1276C>T, c.1352_1356delGAGAA, c.1378C>A, c.1518_1519insTC, c.1841_1842insA and five non-pathogenic (c.131C>T, c.484G>A, c.685A>G, c.1245+202delG, c.1245+215G>C. Only 2 of these mutations had previously been described (c.131C>T, c.1245+202delG. Three mutations, c.1174-1G>C, c.1276 C>T, c.1378C>A, showed intrafamilial segregation. Conclusion This study identified new variants of the SPAST gene which included benign missense variants and short insertions/deletions. No large rearrangements were found. Based on these data, 7 new pathogenic variants of HSP are associated with clinical phenotypes.

  2. Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Sadeghi A

    2017-02-01

    Full Text Available Afsaneh Sadeghi, Ahmad Khaleghnejad Tabari, Alireza Mahdavi, Sara Salarian, Seyed Sajjad Razavi Department of Anesthesiology, Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Introduction: Anesthesia induction is a stressful event for children and their parents, and may have potentially harmful consequences on the patient’s physiological and mental situation. Stressful anesthesia induction has psychological adverse effects that recur with repeated anesthesia, can lead to increased pediatric discomfort during the recovery period, and may even induce reactionary postoperative behavior. A randomized controlled trial was performed to assess the impact of parental presence during induction of anesthesia (PPIA on preoperative anxiety of pediatric patients and their parents at three different times, cooperation of child with anesthesiologist at induction of anesthesia, and parental satisfaction.Patients and methods: A total of 96 pediatric patients undergoing elective minor surgery (ASA 1–2 were randomly divided into two groups. Both groups received oral midazolam (0.5 mg/kg at least 20 minutes before surgery, but in the PPIA group, the parents were also present in the operating room until loss of consciousness of child at anesthesia induction. Anxiety in the patients (as measured by the modified Yale Preoperative Anxiety Scale [mYPAS] and parents (as measured by the State and Trait Anxiety Inventory [STAI], the Induction Compliance Checklist (ICC, and parental satisfaction (as measured by visual analog scale were assessed. Results: There was no significant difference in the mean anxiety scores (mYPAS of participants in the control and PPIA groups at ward T0 and upon arrival to operating room T1 (P>0.05. However, between the PPIA and control groups, mean mYPAS score was different at the time of induction of anesthesia T2 (35.5±16.6 vs 59.8±22.4; P<0.001. The ICC scores showed that perfect score was

  3. Dose perturbation due to the presence of a prostatic urethral stent in patients receiving pelvic radiotherapy: an in vitro study.

    Science.gov (United States)

    Gez, E; Cederbaum, M; Yachia, D; Bar-Deroma, R; Kuten, A

    1997-01-01

    Temporary metallic intraprostatic stent is a new alternative treatment for patients with urinary obstructive syndrome caused by prostate cancer. Definitive radiotherapy is a treatment of choice for localized prostate cancer. This study evaluates in vitro the effect of a urethral intraprostatic metallic stent on the dose absorbed by the surrounding tissue. The study was designed to mimic the conditions under which the prostatic stent is placed in the body during pelvic irradiation. A urethral stent composed of a 50% nickel-50% titanium alloy (Uracoil-InStent) was imbedded in material mimicking normal tissue (bolus) at a simulated body depth of 10 cm. The distribution of the absorbed dose of irradiation was determined by film dosimetry using Kodak X-Omat V film. Irradiation was done in a single field at the isocenter of a 6 MV linear accelerator with a field size of 7 x 7 cm. The degree of film blackening was in direct proportion to the absorbed dose. The measurements showed an increase in dose of up to 20% immediately before the stent and a decrease of up to 18% immediately after the stent. These changes occurred within a range of 1-3 mm from both sides of the stent. In practice, irradiation in prostate cancer is given by two pairs of opposed co-axial fields; a total of four fields (Box Technique). The dose perturbations are partly cancelled in a pair of opposed beams resulting in a net variation of +/- 4%; therefore, the presence of the intraprostatic stent should not influence radiotherapy planning for prostate cancer.

  4. Global Advisory Group: conclusions and recommendations.

    Science.gov (United States)

    1986-02-01

    The conclusions and recommendations formulated for the global program by the 8th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group, which took place during November 1985, are summarized. The Global Advisory Group recommends that, in furtherance of the Five-Point Action Program endorsed by the World Health Assembly in 1983, 3 general and 4 specific actions be taken by national immunization programs with the support of the World Health Organization (WHO) to accelerate EPI progress. These recommendations reflect optimism that the 1990 goal of reducing morbidity and mortality by providing immunization for all children of the world can be realized but also acknowledge that many fundamental problems of national program management remain to be resolved. The general actions are: to promote the achievement of the 1990 immunization goal at national and international levels through collaboration among ministries, organizations, and individuals in both the public and private sectors; to adopt a mix of complementary strategies for program acceleration; and to ensure that rapid increases in coverage can be sustained through mechanisms which strengthen th delivery of other primary health care interventions. The specific actions are as follows: to provide immunization at every contact point; to reduce dropout rates between 1st and last immunizations; to improve immunization services to the disadvantaged in urban areas; and to increase priority for the control of measles, poliomyelitis, and neonatal tetanus. The WHO and the UN International Children's Emergency Fund (UNICEF) have collaborated in support of the EPI since the early days of the program. The acceleration of national efforts heightens the importance of this collaboration, particularly at the national level. It may be further facilitated by the provision of policy guidance from global and regional levels, by WHO and UNICEF collaborative agreements at the regional level, and by country agreements

  5. The presence of tumor associated macrophages in tumor stroma as a prognostic marker for breast cancer patients

    International Nuclear Information System (INIS)

    Medrek, Catharina; Pontén, Fredrik; Jirström, Karin; Leandersson, Karin

    2012-01-01

    specific survival. These findings highlight the importance of analyzing the localization rather than merely the presence of TAMs as a prognostic marker for breast cancer patients

  6. Conclusion: imaging in strategy of endocrine diagnosis and therapeutics

    International Nuclear Information System (INIS)

    Mornex, R.

    1995-01-01

    Images in medicine have to help the doctor in a diagnostic or therapeutic aim. The choice must be made in function of pathology or organ as known (it is not necessary to ask for a computed tomography where we know that only an echography can give the answer to the question we ask ), the criteria must stay the best performance for the cheapest price, but the quality of interpretation is a more important thing. It is important to avoid a lot of examinations which do not give better informations but are heavy to endure for the patients. In conclusion, the aim of this kind of proceedings is to assure to the patients who come confidently to us, the best service at the less constraints price without forgetting that a conclusion depends on a given methodological situation and reminding of beside machines we have not to forget the men

  7. Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data.

    Science.gov (United States)

    Cené, Crystal W; Haymore, Beth; Laux, Jeffrey P; Lin, Feng-Chang; Carthron, Dana; Roter, Debra; Cooper, Lisa A; Chang, Patricia P; Jensen, Brian C; Miller, Paula F; Corbie-Smith, Giselle

    2017-02-01

    To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors. We collected survey data and audiotaped a single medical visit for 93 HF patients (36 brought a companion into the examination room) and their cardiology provider. Communication data was analyzed using the Roter Interaction Analysis System. There were 32% more positive rapport-building statements (p<0.01) and almost three times as many social rapport-building statements (p<0.01) from patients and companions in accompanied visits versus unaccompanied patient visits. There were less psychosocial information giving statements in accompanied visits compared to unaccompanied patient visits (p<0.01.) Providers made 25% more biomedical information giving statements (p=0.04) and almost three times more social rapport-building statements (p<0.01) in accompanied visits. Providers asked fewer biomedical and psychosocial questions in accompanied versus unaccompanied visits. Providers made 16% fewer partnership-building statements in accompanied versus unaccompanied visits (p=0.01). Our findings are mixed regarding the benefits of accompaniment for facilitating patient-provider communication based on survey and audiotaped data. Strategies to enhance engagement during visits, such as pre-visit question prompt lists, may be beneficial. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Risk factors associated with the presence of pneumonia in patients with brain injury Factores de riesgo asociados a neumonía en pacientes

    Directory of Open Access Journals (Sweden)

    David Yepes

    2009-06-01

    Full Text Available Introduction. Pneumonia in patients with head trauma occurs commonly; however, few data are available to evaluate the effects of the infection on the prognosis.
    Objective. The incidence and microbiological findings were described, and the associated risk factors were established with the appearance of pneumonia in patients with severe brain trauma.
    Materials and methods. A prospective cohort study was conducted that included 39 patients with severe brain trauma and who required mechanical ventilation; initially, none had pneumonia. These patients were observed during a 24-month period in an attempt to discern the principal risk factors associated with the onset of pneumonia.
    Results. Pneumonia occurred in 31 (80% of the 39 patients, and 28 of these presented early pneumonia. The most frequent germ in patients with pneumonia was Staphylococcus aureus with a percentage of the 42.4%. In the multivariate analysis, the single statistically significant risk factor was the presence of hypotension and vasopressor support with a RR=27.9 (95% CI=1.0-749.9, p<0.05. No significant differences in the days of mechanical ventilation or mortality in both groups. The major mortality-associated risk factor in patients with pneumonia was a low Glasgow score at admittance with an OR=2.19 (95% CI 1.03 - 4.65, p<0.05.
    Conclusions. The incidence of pneumonia in patients with severe brain trauma is high; however, its appearance does not affect the prognosis. The single significant risk factor was the presence of hypotension and vasopressor support.Introducción. La neumonía en los pacientes con trauma craneoencefálico es frecuente; a pesar de esto, hay pocos datos locales y no sabemos si su aparición afecta el pronóstico.
    Objetivo. Describir la incidencia y los hallazgos microbiológicos, y establecer los factores de riesgo asociados con la aparición de neumonía en los pacientes con trauma craneoencefálico grave.
    Materiales y m

  9. Presence of micro- and macroalbuminuria and the association with cardiac mechanics in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Jørgensen, Peter Godsk; Biering-Sørensen, Tor; Mogelvang, Rasmus

    2017-01-01

    diabetes from two secondary care centres and stratified according to albuminuria status in normo-, micro-, and macroalbuminuria. We performed comprehensive echocardiography including conventional imaging, tissue Doppler imaging, and 2D speckle tracking. Cardiac remodelling occurred in patients...

  10. Organizing Medical Care to Patients with Severe Pneumonias in the Presence of A/H1N1 Influenza

    Directory of Open Access Journals (Sweden)

    K. G. Shapovalov

    2010-01-01

    Full Text Available The paper describes the way medical and intensive cares are organized to patients with complicated forms of A/H1N1 and seasonal influenzas in the Trans-Baikal Territory in the fall of 2009.

  11. Plasma level of cyclophilin A is increased in patients with type 2 diabetes mellitus and suggests presence of vascular disease.

    Science.gov (United States)

    Ramachandran, Surya; Venugopal, Anila; Kutty, V Raman; A, Vinitha; G, Divya; Chitrasree, V; Mullassari, Ajit; Pratapchandran, N S; Santosh, K R; Pillai, M Radhakrishna; Kartha, C C

    2014-02-07

    Cyclophilin A, an immunophilin is secreted from human monocytes activated by high glucose. Given its role as an inflammatory mediator of vascular tissue damage associated with inflammation and oxidative stress, we examined plasma levels of cyclophilin A in normal healthy volunteers and patients with type 2 diabetes (DM), with or without coronary artery disease (CAD). Study subjects comprised of 212 patients with DM and CAD,101 patients with diabetes, 122 patients with CAD and 121 normal healthy volunteers. Diabetes was assessed by HbA1c levels while coronary artery disease was established by a positive treadmill test and/or coronary angiography. Plasma cyclophilin A was measured using a cyclophilin A ELISA Kit. Relationship of plasma cyclophilin A levels with blood markers of type 2 diabetes, blood lipid levels and medication for diabetes and coronary artery disease were also explored. Plasma Cyclophilin levels were higher in diabetes patients with or without CAD compared to normal subjects (P levels and HbA1C levels were positively associated with increased plasma cyclophilin. Patients using metformin had reduced levels of plasma cyclophilin (p levels of total cholesterol, LDL cholesterol and triglycerides had no significant association with plasma cyclophilin levels. In patients with increased serum CRP levels, plasma cyclophilin A was also elevated (p = 0.016). Prevalence odds for DM, DM + CAD and CAD are higher in those with high cyclophilin values, compared to those with lower values, after adjusting for age and sex, indicating strong association of high cyclophilin values with diabetes and vascular disease. Our study demonstrates that patients with type 2 diabetes have higher circulating levels of cyclophilin A than the normal population. Plasma cyclophilin levels were increased in patients with diabetes and coronary artery disease suggesting a role of this protein in accelerating vascular disease in type 2 diabetes. Considering the evidence that

  12. Prediction of presence of kidney disease in a general patient population undergoing intravenous iodinated contrast enhanced computed tomography.

    Science.gov (United States)

    Moos, Shira I; Stoker, Jaap; Nagan, Gajenthiran; de Weijert, Roderick S; van Vemde, David N H; Bipat, Shandra

    2014-06-01

    To assess which risk factors can be used to reduce superfluous estimated glomerular filtration rate (eGFR) measurements before intravenous contrast medium administration. In consecutive patients, all decreased eGFR risk factors were assessed: diabetes mellitus (DM), history of urologic/nephrologic disease (HUND), nephrotoxic medication, cardiovascular disease, hypertension, age > 60 years, anaemia, malignancy and multiple myeloma/M. Waldenström. We studied four models: (1) all risk factors, (2) DM, HUND, hypertension, age > 60 years; (3) DM, HUND, cardiovascular disease, hypertension; (4) DM, HUND, age > 75 years and congestive heart failure. For each model, association with eGFR < 60 ml/min/1.73 m(2) or eGFR < 45 ml/min/1.73 m(2) was studied. A total of 998 patients, mean age 59.94 years were included; 112 with eGFR < 60 ml/min/1.73 m(2) and 30 with eGFR < 45 ml/min/1.73 m(2). Model 1 detected 816 patients: 108 with eGFR < 60 ml/min/1.73 m(2) and all 30 with eGFR < 45 ml/min/1.73 m(2). Model 2 detected 745 patients: 108 with eGFR < 60 ml/min/1.73 m(2) and all 30 with eGFR < 45 ml/min/1.73 m(2). Model 3 detected 622 patients: 100 with eGFR < 60 ml/min/1.73 m(2) and all 30 with eGFR < 45 ml/min/1.73 m(2). Model 4 detected 440 patients: 86 with eGFR < 60 ml/min/1.73 m(2) and all 30 with eGFR < 45 ml/min/1.73 m(2). Associations were significant (p < 0.001). Model 4 is most effective, resulting in the lowest proportion of superfluous eGFR measurements while detecting all patients with eGFR < 45 ml/min/1.73 m(2) and most with eGFR < 60 ml/min/1.73 m(2). A major risk factor for contrast-induced nephropathy (CIN) is kidney disease. Risk factors are used to identify patients with pre-existent kidney disease. Evidence for risk factors to identify patients with kidney disease is limited. The number of eGFR measurements to detect kidney disease can be reduced.

  13. Prediction of presence of kidney disease in patients undergoing intravenous iodinated contrast enhanced computed tomography: a validation study

    Energy Technology Data Exchange (ETDEWEB)

    Schreuder, Sanne M.; Stoker, Jaap; Bipat, Shandra [University of Amsterdam, Department of Radiology, Academic Medical Centre, G1-212, Amsterdam (Netherlands)

    2017-04-15

    To validate two previously presented models containing risk factors to identify patients with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m{sup 2} or eGFR <45 ml/min/1.73 m{sup 2}. In random patients undergoing intravenous contrast-enhanced computed tomography (CECT) the following risk factors were assessed: history of urological/nephrological disease, hypertension, diabetes mellitus, anaemia, congestive heart failure, other cardiovascular disease or multiple myeloma or Waldenstroem disease. Data on kidney function, age, gender and type and indication of CECT were also registered. We studied two models: model A - diabetes mellitus, history of urological/nephrological disease, cardiovascular disease, hypertension; model B - diabetes mellitus, history of urological/nephrological disease, age >75 years and congestive heart failure. For each model, associations with eGFR <60 ml/min/1.73 m{sup 2} or eGFR <45 ml/min/1.73 m{sup 2} was studied. A total of 1,001 patients, mean age 60.36 years were included. In total, 92 (9.2 %) patients had an eGFR <60 ml/min/1.73 m{sup 2} and 11 (1.1 %) patients an eGFR <45 ml/min/1.73 m{sup 2}. Model A detected 543 patients: 81 with eGFR <60 ml/min/1.73 m{sup 2} (missing 11) and all 11 with eGFR <45 ml/min/1.73 m{sup 2}. Model B detected 420 patients: 70 (missing 22) with eGFR <60 ml/min/1.73 m{sup 2} and all 11 with eGFR <45 ml/min/1.73 m{sup 2}. Associations were significant (p < 0.05). Model B resulted in the lowest superfluous eGFR measurements while detecting all patients with eGFR <45 ml/min/1.73 m{sup 2} and nearly all with eGFR <60 ml/min/1.73 m{sup 2}. (orig.)

  14. Stress-induced ST-segment deviation in relation to the presence and severity of coronary artery disease in patients with normal myocardial perfusion imaging.

    Science.gov (United States)

    Weinsaft, Jonathan W; Manoushagian, Shant J; Patel, Taral; Shakoor, Aqsa; Kim, Robert J; Mirchandani, Sunil; Lin, Fay; Wong, Franklin J; Szulc, Massimiliano; Okin, Peter M; Kligfield, Paul D; Min, James K

    2009-01-01

    To assess the utility of stress electrocardiography (ECG) for identifying the presence and severity of obstructive coronary artery disease (CAD) defined by coronary computed tomographic angiography (CCTA) among patients with normal nuclear myocardial perfusion imaging (MPI). The study population comprised 119 consecutive patients with normal MPI who also underwent CCTA (interval 3.5+/-3.8 months). Stress ECG was performed at the time of MPI. CCTA and MPI were interpreted using established scoring systems, and CCTA was used to define the presence and extent of CAD, which was quantified by a coronary artery jeopardy score. Within this population, 28 patients (24%) had obstructive CAD identified by CCTA. The most common CAD pattern was single-vessel CAD (61%), although proximal vessel involvement was present in 46% of patients. Patients with CAD were nearly three times more likely to have positive standard test responses (1 mm ST-segment deviation) than patients with patent coronary arteries (36 vs. 13%, P=0.007). In multivariate analysis, a positive ST-segment test response was an independent marker for CAD (odds ratio: 2.02, confidence interval: 1.09-3.78, P=0.03) even after adjustment for a composite of clinical cardiac risk factors (odds ratio: 1.85, confidence interval: 1.05-3.23, P=0.03). Despite uniformly normal MPI, mean coronary jeopardy score was three-fold higher among patients with positive compared to those with negative ST-segment response to exercise or dobutamine stress (1.9+/-2.7 vs. 0.5+/-1.4, P=0.03). Stress-induced ST-segment deviation is an independent marker for obstructive CAD among patients with normal MPI. A positive stress ECG identifies patients with a greater anatomic extent of CAD as quantified by coronary jeopardy score.

  15. The Effect of Topical Anesthesia on Pharmacological Mydriasis in Diabetic Patients Depends on the Presence of Retinopathy

    DEFF Research Database (Denmark)

    Clausen, Susanne; Jørgensen, Christina Mørup; Bek, Toke

    2015-01-01

    Abstract Purpose: Instillation of topical anesthetics with or without preservatives in normal persons has been shown to enhance the effect of mydriatic eye drops. The purpose of the present investigation was to study whether a similar effect can be observed in diabetic patients screened for retin...

  16. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    van der Valk, Eline S.; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H.; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

    BACKGROUND: Health related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

  17. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    Valk, E.S. Van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M de; Backx, F.J.; Hermus, A.R.M.M.; Zelissen, P.M.J.

    2016-01-01

    BACKGROUND: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

  18. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    Valk, E.S. van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M. de; Backx, F.J.G.; Hermus, A.R.M.M.; Zelissen, P.M.J.

    2016-01-01

    Background: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. Objective: The aim of this study was to

  19. Consequences of the presence and absence of empathy during consultations in primary care: A focus group study with patients.

    NARCIS (Netherlands)

    Derksen, F.; Olde Hartman, T.C.; Dijk, A. van; Plouvier, A.; Bensing, J.; Lagro-Janssen, A.

    2017-01-01

    There is general consensus that explicit expression of empathy in patient-GP communication is highly valued. Yet, little is known so far about patients’ personal experiences with and expectations of empathy. Insight into these experiences and expectations can help to achieve more person-centeredness

  20. Patient and Disease Characteristics Associated With the Presence of Diabetes Mellitus in Adults With Chronic Pancreatitis in the United States.

    Science.gov (United States)

    Bellin, Melena D; Whitcomb, David C; Abberbock, Judah; Sherman, Stuart; Sandhu, Bimaljit S; Gardner, Timothy B; Anderson, Michelle A; Lewis, Michele D; Alkaade, Samer; Singh, Vikesh K; Baillie, John; Banks, Peter A; Conwell, Darwin; Cote, Gregory A; Guda, Nalini M; Muniraj, Thiruvengadam; Tang, Gong; Brand, Randall E; Gelrud, Andres; Amann, Stephen T; Forsmark, Christopher E; Wilcox, C Mel; Slivka, Adam; Yadav, Dhiraj

    2017-09-01

    Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model. Diabetics were more likely to be black (P=0.02), overweight, or obese (Ppancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, Prisk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2). In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.

  1. Prediction of presence of kidney disease in a general patient population undergoing intravenous iodinated contrast enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moos, Shira I.; Stoker, Jaap; Nagan, Gajenthiran; Weijert, Roderick S. de; Vemde, David N.H. van; Bipat, Shandra [Academic Medical Center, University of Amsterdam, Department of Radiology, G1-215, Amsterdam (Netherlands)

    2014-06-15

    To assess which risk factors can be used to reduce superfluous estimated glomerular filtration rate (eGFR) measurements before intravenous contrast medium administration. In consecutive patients, all decreased eGFR risk factors were assessed: diabetes mellitus (DM), history of urologic/nephrologic disease (HUND), nephrotoxic medication, cardiovascular disease, hypertension, age > 60 years, anaemia, malignancy and multiple myeloma/M. Waldenstroem. We studied four models: (1) all risk factors, (2) DM, HUND, hypertension, age > 60 years; (3) DM, HUND, cardiovascular disease, hypertension; (4) DM, HUND, age > 75 years and congestive heart failure. For each model, association with eGFR < 60 ml/min/1.73 m{sup 2} or eGFR < 45 ml/min/1.73 m{sup 2} was studied. A total of 998 patients, mean age 59.94 years were included; 112 with eGFR < 60 ml/min/1.73 m{sup 2} and 30 with eGFR < 45 ml/min/1.73 m{sup 2}. Model 1 detected 816 patients: 108 with eGFR < 60 ml/min/1.73 m{sup 2} and all 30 with eGFR < 45 ml/min/1.73 m{sup 2}. Model 2 detected 745 patients: 108 with eGFR < 60 ml/min/1.73 m{sup 2} and all 30 with eGFR < 45 ml/min/1.73 m{sup 2}. Model 3 detected 622 patients: 100 with eGFR < 60 ml/min/1.73 m{sup 2} and all 30 with eGFR < 45 ml/min/1.73 m{sup 2}. Model 4 detected 440 patients: 86 with eGFR < 60 ml/min/1.73 m{sup 2} and all 30 with eGFR < 45 ml/min/1.73 m{sup 2}. Associations were significant (p < 0.001). Model 4 is most effective, resulting in the lowest proportion of superfluous eGFR measurements while detecting all patients with eGFR < 45 ml/min/1.73 m{sup 2} and most with eGFR < 60 ml/min/1.73 m{sup 2}. (orig.)

  2. The relationship between the presence and extent of lobular carcinoma in situ (LCIS) and the risk of local recurrence (LR) in patients with infiltrating cancer of the breast treated with conservative surgery (CS) and radiation therapy (RT)

    International Nuclear Information System (INIS)

    Abner, A.; Schnitt, S.; Connolly, J.; Recht, A.; Bornstein, B.; Nixon, A.; Hetelekidis, S.; Silver, B.; Harris, J.R.

    1997-01-01

    Purpose: Lobular carcinoma in situ, when found in an otherwise benign breast biopsy, is associated with an increased risk of developing a subsequent invasive breast cancer. Among patients with an infiltrating cancer resected without margin assessment, the extent of ductal carcinoma in situ is an established risk factor for LR after CS and RT. However, the association between the presence and extent of LCIS and the risk of recurrence in patients treated with CS and RT for infiltrating breast cancer remains at issue. Materials and Methods: Between 1968 and 1986, 1625 patients with clinical stage T1 and T2 invasive breast cancer were treated at the Joint Center for Radiation Therapy with complete gross tumor excision and RT to a total of ≥60 Gy. Of these, 1160 had infiltrating ductal cancer (IDC), infiltrating lobular cancer (ILC), or mixed IDC/ILC (IMC) and sufficient pathologic material for review by the study pathologists (SS and JC) to establish the presence or absence of LCIS and were evaluable at 10 years. LCIS was present adjacent to the invasive cancer in (43(1027)) IDC (4%), and either within or adjacent to the infiltrating tumor in (70(82)) ILC (85%) and (26(51)) IMC (51%). Margins were evaluable in 35% of LCIS-positive patients and 33% of LCIS-negative patients. The median follow-up time was 153 months for surviving patients. Results: The 10-year crude risk of recurrence by first site of failure for all patients was as follows: Furthermore, there was no significant relationship between the extent of the LCIS adjacent to the invasive tumor and the LR risk: The 10-year crude risk of contralateral breast cancer was 7% for the patients with LCIS and 7% for those without LCIS. CONCLUSION: We conclude that neither the presence nor the extent of LCIS is related to the risk of LR in patients with invasive breast cancer treated with CS and RT. Thus, LCIS should not be considered a contraindication to breast conservation with CS and RT

  3. The Presence of Periodic Limb Movement Disorder in a Patient with Diabetes Mellitus and Optic Atrophy (Wolfram Syndrome

    Directory of Open Access Journals (Sweden)

    Bo Seong Kwon

    2014-12-01

    Full Text Available Wolfram syndrome (WFS is characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD, together known as DIDMOAD. This syndrome is a rare autosomal recessive neurodegenerative disorder and typically begins wtih insulin-dependent diabetes mellitus. Periodic limb movement disorder (PLMD is characterized by periodic episodes of repetitive, highly stereotyped, limb movement during sleep, which results in disturbed sleep. Its pathophysiology is unclear. It is associated with many conditions, but we were unable to find a previous report regarding WFS accompanied by PLMD. We therefore report, for the first time, about a patient with WFS presenting with PLMD and discuss its pathomechanism with a literature review.

  4. Immunophenotype and increased presence of CD4+CD25+ regulatory T cells in patients with acute lymphoblastic leukemia

    OpenAIRE

    WU, CUI-PING; QING, XI; WU, CUI-YUN; ZHU, HONG; ZHOU, HAI-YAN

    2011-01-01

    Acute lymphoblastic leukemia (ALL), cancer of the white blood cells, is a heterogeneous disease that mainly occurs due to the malignant cloning of original and naive lymphocytes. The aim of this study was to explore the immunophenotype, the percentage of CD4+CD25+ regulatory T cells (Tregs) and the expression of cytokines interleukin (IL)-2, IL-10 and TGF-β in patients with ALL. The immunophenotype and levels of CD4+CD25+ Tregs were detected using flow cytometry in the peripheral blood of 35 ...

  5. Deterioration of lung function is associated with presence of IgM rheumatoid factor and smoking in patients with systemic sclerosis

    DEFF Research Database (Denmark)

    Broholm, B.; Ullman, S.; Halberg, P.

    2008-01-01

    of patients with systemic sclerosis (SSc) the influence of smoking and IgM RF on the lung function was calculated. One hundred fifty-five persons with SSc had vital capacity (VC) and diffusing capacity (DLco) measured at least twice with at least 1-year interval as percents of predicted values according......Smoking is a known risk factor for the development of several lung diseases, autoimmune diseases, and IgM rheumatoid factor (RF) in nonrheumatic persons. In patients with rheumatoid arthritis and IgM RF the diffusion capacity is decreased in smokers but not in nonsmokers. In the present study......M RF was found only in smokers or previous smokers, P = 0.007 and P = 0.01, respectively. These findings were confirmed by means of multiple regression analyses. The presence of IgM RF in smoking SSc patients is associated with deteriorating lung function. Whether this is a causal association...

  6. Palliative Radiotherapy in the Presence of Well-Controlled Metastatic Disease after Initial Chemotherapy May Prolong Survival in Patients with Metastatic Esophageal and Gastric Cancer.

    Science.gov (United States)

    Hingorani, Mohan; Dixit, Sanjay; Johnson, Miriam; Plested, Victoria; Alty, Kevin; Colley, Peter; Beavis, Andrew W; Roy, Rajarshi; Maraveyas, Anthony

    2015-10-01

    We report the outcomes of patients treated with palliative radiotherapy (pRT) to the primary tumour in the context of well-controlled metastatic disease after initial chemotherapy. Clinical records of 132 patients with metastatic esophago-gastric (OG) cancer treated with palliative chemotherapy (pCT) between January 2009 and June 2013 were reviewed. Ninetyseven patients had responding or stable disease after 3 months of chemotherapy, of whom 53 patients received pRT to the primary tumour after initial chemotherapy in the presence of well-controlled metastatic disease (group A, pCT-RT). The remaining 44 patients were treated with pCT alone (group B, pCT). Treatment-related outcomes were assessed in above groups including time to local progression (TTLP), progression-free and overall survival. The median overall survival for patients treated with pRT after initial chemotherapy (group A) was 23.3 months (95% confidence interval [CI], 17.70 to 28.89 months) and significantly higher than the 14 months (95% CI, 10.91 to 17.08 months) in patients treated with pCT alone (group B) (p < 0.001). The use of pCT-RT was an independent predictor of OS in multivariate analysis. Local recurrence was observed in 12/53 of patients (23%) in group A compared to 16/44 (36%) in group B. The median TTLP was significantly higher in patients after pCT-RT at 17.3 months (5.23 months to 44.50 months) compared to 8.3 months (range, 4.10 to 25.23 months) in patients treated with pCT alone (p=0.006). The possibility of pRT influencing systemic disease in advanced OG cancer has not been reported, and results from the present study present strong arguments for investigation of this therapeutic strategy in a randomized trial.

  7. Diversity of apolipoprotein E genetic polymorphism significance on cardiovascular risk is determined by the presence of metabolic syndrome among hypertensive patients.

    Science.gov (United States)

    Teixeira, Andrei Alkmim; Marrocos, Mauro Sergio; Quinto, Beata Marie Redublo; Dalboni, Maria Aparecida; Rodrigues, Cassio Jose de Oliveira; Carmona, Silmara de Melo; Kuniyoshi, Mariana; Batista, Marcelo Costa

    2014-11-20

    Hypertension has a significant relevance as a cardiovascular risk factor. A consistent increase on world's Metabolic Syndrome (MetS) incidence has been associated with an epidemic cardiovascular risk in different populations. Dislipidemia plays a major role determining the epidemic CV burden attributed to MetS. Apolipoprotein E (ApoE) is involved on cholesterol and triglycerides metabolism regulation. Once ApoE polymorphism may influence lipid metabolism, it is possible that it brings on individual susceptibility consequences for the development of MetS and cardiovascular risk. The objective of the study is to measure the discriminatory power of ApoE polymorphism in determining cardiovascular risk stratification based on the presence MetS in a cohort of hypertensive patients. It was enrolled 383 patients, divided in two groups, classified by MetS presence (IDF criteria): Group 1: 266 patients with MetS (MetS +) and Group 2: 117 patients without Mets (MetS -). Patient's data were collected by clinical evaluation, physical exam, file reviews and laboratory testing. Polymorphic ApoE analysis was performed by PCR amplification. Groups were compared on clinical and laboratory characteristics as well as allele and genotype distribution towards ApoE polymorphism. Mets CVD prevalence was analysed according to E4 allele prevalence. The results evidenced 184 men (48%), 63,7% whites, 45,1% diabetics and 11,7% of patients were smokers. Mean age was 64,0 ± 12,0 years. When genotypic distribution was analyzed, E3/3 genotype and E3 allele frequencies were more prevalent. Among patients with MetS, we observed an independent association between CVD prevalence and E4 allele frequency (OR 2.42 (1.17- 5.0, p < 0,05)). On the opposite direction, in those without MetS, there was lesser CVD burden in E4 allele carriers (OR 0,14 (0,02-0,75)). These associations remained significant even after confounding factor corrections. The results presented demonstrate that the association

  8. Presence of non-hypervascular hypointense nodules on Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Inoue, Masanori; Ogasawara, Sadahisa; Chiba, Tetsuhiro; Ooka, Yoshihiko; Wakamatsu, Toru; Kobayashi, Kazufumi; Suzuki, Eiichiro; Tawada, Akinobu; Yokosuka, Osamu

    2017-04-01

    Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) performed before curative therapy for hepatocellular carcinoma (HCC) can distinguish between intrahepatic distant recurrence and hypervascularization. This study aimed to retrospectively evaluate the presence of non-hypervascular hypointense nodules on hepatobiliary phase images from Gd-EOB-DTPA-enhanced MRI as a risk factor of the intrahepatic distant recurrence of early stage HCC following radiofrequency ablation (RFA). A total of 132 patients who underwent preprocedural Gd-EOB-DTPA-enhanced MRI followed by initial RFA were retrospectively analyzed. Post-RFA intrahepatic distant recurrence, which excluded the hypervascularization of non-hypervascular hypointense nodules detected by preprocedural Gd-EOB-DTPA-enhanced MRI, was evaluated according to the presence of non-hypervascular hypointense nodules on preprocedural Gd-EOB-DTPA-enhanced MRI. Intrahepatic distant recurrence rates following RFA were higher in patients with non-hypervascular hypointense nodules (1-year: 22.5%, 2-year: 52.1%, 5-year: 89.1%) compared with in patients without non-hypervascular hypointense nodules (1-year: 7.0%, 2-year: 28.8%, 5-year: 48.7%). The presence of non-hypervascular hypointense nodules was associated with markedly increased cumulative recurrence rates of both identical and different subsegment intrahepatic distant recurrence, being an independent risk factor for post-RFA identical and different subsegment intrahepatic distant recurrence (identical: HR = 2.365, P = 0.027; different: HR = 3.276, P DTPA-enhanced MRI obtained prior to RFA is an important predictive factor of intrahepatic distant recurrence following RFA of HCC. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  9. Presence of pain on three or more days of the week is associated with worse patient reported outcomes in adults with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Bakshi N

    2018-02-01

    Full Text Available Nitya Bakshi,1,2 Diana Ross,1 Lakshmanan Krishnamurti1,2 1Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; 2Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, USA Abstract: While acute episodic pain is the hallmark of sickle cell disease (SCD, transition to chronic pain is a major cause of morbidity and impaired quality of life. One of the core diagnostic criteria used by Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy (AAPT to define chronic SCD pain is the presence of pain on a “majority of days” in the past 6 months in one or more locations. The frequency characteristic of “majority of days” is adapted from the criteria of 15 days or more per month, used to define chronic migraine, but there are inadequate data to support this cutoff in SCD. Using an existing dataset of adults with SCD who completed patient-reported outcomes of pain interference, physical functioning, anxiety, depression, and fatigue using the National Institutes of Health (NIH patient-reported outcomes measures information system (PROMIS short-form instruments, we examined the association of the presence of pain on 3 or more days per week with patient-reported outcomes of functioning. In unadjusted analyses, presence of pain on 3 or more days a week was associated with higher median PROMIS scores of pain interference, anxiety, and depression. Median PROMIS scores of fatigue and physical function were worse in women compared with men in unadjusted analyses. We did not find any difference in median PROMIS pain scores between adults aged ≤35 years compared with those aged ≥35 years. In linear regression models, after adjustment for age and sex, the presence of pain on 3 or more days a week was found to be associated with worse pain interference and anxiety. These data support

  10. The presence of nonthoracic distracting injuries does not affect the initial clinical examination of the cervical spine in evaluable blunt trauma patients: a prospective observational study.

    Science.gov (United States)

    Konstantinidis, Agathoklis; Plurad, David; Barmparas, Galinos; Inaba, Kenji; Lam, Lydia; Bukur, Marko; Branco, Bernardino C; Demetriades, Demetrios

    2011-09-01

    A distracting injury mandates cervical spine (c-spine) imaging in the evaluable blunt trauma patient who demonstrates no pain or tenderness over the c-spine. The purpose of this study was to examine which distracting injuries can negatively affect the sensitivity of the standard clinical examination of the c-spine. This is a prospective observational study conducted at a Level I Trauma Center from January 1, 2008, to December 31, 2009. After institutional review board approval, all evaluable (Glasgow Coma Scale score ≥13) blunt trauma patients older than 16 years sustaining a c-spine injury were enrolled. A distracting injury was defined as any immediately evident bony or soft tissue injury or a complaint of non-c-spine pain whether or not an actual injury was subsequently diagnosed. Information regarding the initial clinical examination and the presence of a distracting injury was collected from the senior resident or attending trauma surgeon involved in the initial management. During the study period, 101 evaluable patients sustained a c-spine injury. Distracting injuries were present in 88 patients (87.1%). The most common was rib fracture (21.6%), followed by lower extremity fracture (20.5%) and upper extremity fracture (12.5%). Only four (4.0%) patients had no pain or tenderness on the initial examination of the c-spine. All four patients had bruising and tenderness to the upper anterior chest. None of these four patients developed neurologic sequelae or required a surgical stabilization or immobilization. C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. Further definition of distracting injuries is mandated to avoid unnecessary utilization of resources and to reduce the imaging burden associated with the evaluation of the c-spine.

  11. The presence of plasmid-mediated resistance genes among uropathogenes isolated from diabetic and non-diabetic patients with chronic pyelonephritis

    Directory of Open Access Journals (Sweden)

    O.I. Chub

    2014-10-01

    Full Text Available Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs compromises the efficacy of treatment of urinary tract infections. The objective of this study is to determine the prevalence of ESBL-producing uropathogens from patients with chronic pyelonephritis (CP and to evaluate the risk factors of these types of infections. Screening for the presence of plasmid-mediated ESBL was performed by polymerase chain reaction. Out of 105 patients, 22 (20.9% revealed strains with resistance genes: 11 (36.7%, 11 (36.7% and 8 (26.7% were identified to carry bla(TEM, bla(SHV and bla(CTX-M beta-lactamase genes, respectively. We have demonstrated that prevalence of the resistance among patients with CP combined with type 2 DM was 31.3%, while among patients with CP without type 2 DM was 27.4%; however the difference between these groups was not significant. The main factors related with appearance of plasmid-mediated resistance genes were age range above 55 years, Chronic Kidney Disease stage ІІІ and ІV, in-patient treatment history, history of using antibiotics last year. Isolation and detection of ESBL-producing strains are essential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.

  12. Evaluation of data completeness in the electronic health record for the purpose of patient recruitment into clinical trials: a retrospective analysis of element presence

    Science.gov (United States)

    2013-01-01

    Background Computerized clinical trial recruitment support is one promising field for the application of routine care data for clinical research. The primary task here is to compare the eligibility criteria defined in trial protocols with patient data contained in the electronic health record (EHR). To avoid the implementation of different patient definitions in multi-site trials, all participating research sites should use similar patient data from the EHR. Knowledge of the EHR data elements which are commonly available from most EHRs is required to be able to define a common set of criteria. The objective of this research is to determine for five tertiary care providers the extent of available data compared with the eligibility criteria of randomly selected clinical trials. Methods Each participating study site selected three clinical trials at random. All eligibility criteria sentences were broken up into independent patient characteristics, which were then assigned to one of the 27 semantic categories for eligibility criteria developed by Luo et al. We report on the fraction of patient characteristics with corresponding structured data elements in the EHR and on the fraction of patients with available data for these elements. The completeness of EHR data for the purpose of patient recruitment is calculated for each semantic group. Results 351 eligibility criteria from 15 clinical trials contained 706 patient characteristics. In average, 55% of these characteristics could be documented in the EHR. Clinical data was available for 64% of all patients, if corresponding data elements were available. The total completeness of EHR data for recruitment purposes is 35%. The best performing semantic groups were ‘age’ (89%), ‘gender’ (89%), ‘addictive behaviour’ (74%), ‘disease, symptom and sign’ (64%) and ‘organ or tissue status’ (61%). No data was available for 6 semantic groups. Conclusions There exists a significant gap in structure and content

  13. Presence of Mycoplasma fermentans in the bloodstream of Mexican patients with rheumatoid arthritis and IgM and IgG antibodies against whole microorganism

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    Salinas Salvador

    2009-08-01

    Full Text Available Abstract Background Increasing evidence incriminates bacteria, especially Mycoplasma fermentans, as possible arthritogenic agents in humans. The purpose of this study was to investigate M. fermentans in the bloodstream of patients with rheumatoid arthritis. Methods Two hundred and nineteen blood samples from patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, and healthy individuals were screened by bacterial culture and direct PCR in order to detect mycoplasmas; IgM and IgG against M. fermentans PG18 were also detected by ELISA and Immunoblotting assays in patients with rheumatoid arthritis and healthy individuals. Results Blood samples from patients with antiphospholipid syndrome and healthy individuals were negative for mycoplasma by culture or direct PCR. In blood samples from patients with systemic lupus erythematosus were detected by direct PCR M. fermentans in 2/50 (2%, M. hominis in 2/50 (2% and U. urealyticum in 1/50 (0.5%. In patients with RA M. fermentans was detected by culture in 13/87 blood samples and in 13/87 by direct PCR, however, there was only concordance between culture and direct PCR in six samples, so M. fermentans was detected in 20/87(23% of the blood samples from patients with RA by either culture or PCR. Antibody-specific ELISA assay to M. fermentans PG18 was done, IgM was detected in sera from 40/87 patients with RA and in sera of 7/67 control individuals, IgG was detected in sera from 48/87 RA patients and in sera from 7/67 healthy individuals. Antibody-specific immunoblotting to M. fermentans PG18 showed IgM in sera from 35/87 patients with RA and in sera from 4/67 healthy individuals, IgG was detected in sera from 34/87 patients and in sera from 5/67 healthy individuals. Conclusion Our findings show that only M. fermentans produce bacteremia in a high percentage of patients with RA. This finding is similar to those reported in the literature. IgM and IgG against M

  14. Fusion positron emission/computed tomography underestimates the presence of hilar nodal metastases in patients with resected non-small cell lung cancer.

    Science.gov (United States)

    Carrillo, Sergio A; Daniel, Vincent C; Hall, Nathan; Hitchcock, Charles L; Ross, Patrick; Kassis, Edmund S

    2012-05-01

    The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges from 40% to 55%. No data exist addressing the benefit of neoadjuvant therapy for patients with stage II disease. This is largely in part due to the lack of a reliable, minimally invasive method to assess hilar nodes. This study is aimed at determining the ability of fusion positron emission/computed tomography (PET/CT) to identify hilar metastases in patients with resected non-small cell lung cancer. A retrospective review of surgically resected patients with fusion PET/CT within 30 days of resection was performed. The sensitivity, specificity, positive predictive value, and negative predictive value for PET/CT in detecting hilar nodal metastases was calculated for a range of maximum standardized uptake values (SUVmax). Hilar nodes from patients with falsely positive PET/CT scans were analyzed for the presence of histoplasmosis. Additionally, the impact of hilar node size greater than 1 centimeter on the calculated values was assessed. There were 119 patients evaluated. The number of lymph nodes resected ranged from 1 to 12 (X=2.98). There was decreased sensitivity and increased specificity with higher SUVmax cutoff values. At the standard SUVmax value of 2.5, the sensitivity and specificity were only 48.5% and 80.2%. The addition of size of hilar node by CT led to a modest improvement in sensitivity at all SUVmax cutoff values. Fusion PET/CT lacks sensitivity and specificity in identifying hilar nodal metastasis in patients with resected non-small cell lung cancer. Further prospective studies assessing the utility of PET/CT versus alternative sampling techniques are warranted. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Positive impact of omalizumab on angioedema and quality of life in patients with refractory chronic idiopathic/spontaneous urticaria: analyses according to the presence or absence of angioedema.

    Science.gov (United States)

    Maurer, M; Sofen, H; Ortiz, B; Kianifard, F; Gabriel, S; Bernstein, J A

    2017-06-01

    Approximately 50% of patients with chronic idiopathic/spontaneous urticaria (CIU/CSU) report hives and angioedema; some experience hives/angioedema only. Assess omalizumab's effect on angioedema and quality of life (QoL) in subgroups with refractory CIU/CSU: those with and without angioedema. Patients received omalizumab (75, 150 or 300 mg) or placebo every 4 weeks for 12/24 weeks. Angioedema and QoL were assessed [Urticaria Patient Daily Diary and Dermatology Quality of Life Index (DLQI)]. Subgroups were based on the presence/absence of baseline angioedema 7 days prior to randomization. Patients with baseline angioedema randomized to omalizumab 300 mg had a greater reduction in mean weekly incidence of angioedema and mean number of days/week with angioedema vs. placebo at 12 and 24 weeks. A 3.3- to 4.5-point greater mean reduction in DLQI score was achieved with omalizumab 300 mg treatment vs. placebo, above the minimal clinically important difference threshold. Results with lower doses vs. placebo were variable. Compared with placebo, omalizumab 300 mg treatment over 12-24 weeks resulted in marked reduction in incidence and number of days/week with angioedema accompanied by clinically relevant improvement in QoL. © 2016 European Academy of Dermatology and Venereology.

  16. Presence of Epstein-Barr virus-infected B lymphocytes with thyrotropin receptor antibodies on their surface in Graves' disease patients and in healthy individuals.

    Science.gov (United States)

    Nagata, Keiko; Higaki, Katsumi; Nakayama, Yuji; Miyauchi, Hiromi; Kiritani, Yui; Kanai, Kyosuke; Matsushita, Michiko; Iwasaki, Takeshi; Sugihara, Hirotsugu; Kuwamoto, Satoshi; Kato, Masako; Murakami, Ichiro; Nanba, Eiji; Kimura, Hiroshi; Hayashi, Kazuhiko

    2014-05-01

    Graves' disease is an autoimmune hyperthyroidism caused by thyrotropin receptor antibodies (TRAbs). Because Epstein-Barr virus (EBV) persists in B cells and is occasionally reactivated, we hypothesized that EBV contributes to TRAbs production in Graves' disease patients by stimulating the TRAbs-producing B cells. In order for EBV to stimulate antibody-producing cells, EBV must be present in those cells but that have not yet been observed. We examined whether EBV-infected (EBV(+)) B cells with TRAbs on their surface (TRAbs(+)) as membrane immunoglobulin were present in peripheral blood of Graves' disease patients. We analyzed cultured or non-cultured peripheral blood mononuclear cells (PBMCs) from 13 patients and 11 healthy controls by flow-cytometry and confocal laser microscopy, and confirmed all cultured PBMCs from 8 patients really had TRAbs(+) EBV(+) double positive cells. We unexpectedly detected TRAbs(+) cells in all healthy controls, and TRAbs(+) EBV(+) double positive cells in all cultured PBMC from eight healthy controls. The frequency of TRAbs(+) cells in cultured PBMCs was significantly higher in patients than in controls (p = 0.021). In this study, we indicated the presence of EBV-infected B lymphocytes with TRAbs on their surface, a possible player of the production of excessive TRAbs, the causative autoantibody for Graves' disease. This is a basic evidence for our hypothesis that EBV contributes to TRAbs production in Graves' disease patients. Our results further suggest that healthy controls have the potential for TRAbs production. This gives us an important insight into the pathogenesis of Graves' disease.

  17. A Preoperative Measurement of Serum MicroRNA-125b May Predict the Presence of Microvascular Invasion in Hepatocellular Carcinomas Patients

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    Mei Liu

    2016-06-01

    Full Text Available The high recurrence rate remains a major problem that strongly influenced the prognosis of hepatocellular carcinoma (HCC patients who received hepatectomy. The presence of microvascular invasion (MVI is regarded as the most important risk factor that contributes to the postoperative recurrence. Our previous study has hinted that serum microRNA-125b (miR-125b was associated with MVI. The aim of the present study was to identify whether serum miR-125b can serve as a biomarker to reliably predict microvascular invasion (MVI preoperatively. MiR-125b was quantified in 108 HCC patients’ serum before they received surgery by quantitative real-time PCR (qRT-PCR. Our results revealed that MVI was associated with relapse free survival (RFS of postoperative HCC patients; surgical margin width was associated with postoperative RFS in MVI present patients, but not in the patients without MVI. Multivariate analysis revealed that miR-125b, tumor size and AFP were the independent predictive factors associated with MVI in this cohort (P = .001, .001, .003, respectively. The probability of the predictive accuracy of miR-125b was 76.95% (51.32% specificity and 87.50% sensitivity, which was almost equal to the classifier established by combination of AFP and tumor size (78.82% probability, 65.63% specificity and 84.21% sensitivity. Furthermore, the combination of tumor size, AFP and miR-125b yielded a ROC curve area of 86.68% (72.37% specificity and 84.38% sensitivity. Our study indicated that serum miR-125b can be used to predict MVI of HCC patients before they received hepatic resection. Therefore, miR-125b can potentially guide individualized treatment, which helps HCC patients, with or without MVI, to benefit from different surgical approach.

  18. Download Your Doctor: Implementation of a Digitally Mediated Personal Physician Presence to Enhance Patient Engagement With a Health-Promoting Internet Application.

    Science.gov (United States)

    Lygidakis, Charilaos; Wallace, Paul; Tersar, Costanza; Marcatto, Francesco; Ferrante, Donatella; Della Vedova, Roberto; Scafuri, Francesca; Scafato, Emanuele; Struzzo, Pierluigi

    2016-03-04

    Brief interventions delivered in primary health care are effective in reducing excessive drinking; online behavior-changing technique interventions may be helpful. Physicians may actively encourage the use of such interventions by helping patients access selected websites (a process known as "facilitated access"). Although the therapeutic working alliance plays a significant role in the achievement of positive outcomes in face-to-face psychotherapy and its development has been shown to be feasible online, little research has been done on its impact on brief interventions. Strengthening patients' perception of their physician's endorsement of a website could facilitate the development of an effective alliance between the patient and the app. We describe the implementation of a digitally mediated personal physician presence to enhance patient engagement with an alcohol-reduction website as part of the experimental online intervention in a noninferiority randomized controlled trial. We also report the feedback of the users on the module. The Download Your Doctor module was created to simulate the personal physician presence for an alcohol-reduction website that was developed for the EFAR-FVG trial conducted in the Italian region of Friuli-Venezia-Giulia. The module was designed to enhance therapeutic alliance and thus improve outcomes in the intervention group (facilitated access to the website). Participating general and family practitioners could customize messages and visual elements and upload a personal photo, signature, and video recordings. To assess the perceptions and attitudes of the physicians, a semistructured interview was carried out 3 months after the start of the trial. Participating patients were invited to respond to a short online questionnaire 12 months following recruitment to investigate their evaluation of their online experiences. Nearly three-quarters (23/32, 72%) of the physicians interviewed chose to customize the contents of the interaction

  19. Postchallenge responses of nitrotyrosine and TNF-alpha during 75-g oral glucose tolerance test are associated with the presence of coronary artery diseases in patients with prediabetes

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    Chu Chih-Sheng

    2012-03-01

    Full Text Available Abstract Background Meta-analysis has demonstrated an exponential relationship between 2-hr postchallenge hyperglycemia and coronary artery disease (CAD. Pulsatile hyperglycemia can acutely increase proinflammatory cytokines by oxidative stress. We hypothesized that postchallenge proinflammatory and nitrosative responses after 75 g oral glucose tolerance tests (75 g-OGTT might be associated with CAD in patients without previously recognized type 2 diabetes mellitus (T2DM. Methods Serial changes of plasma glucose (PG, tumor necrosis factor-alpha (TNF-α, interleukin-6 (IL-6 and nitrotyrosine levels were analyzed during 75 g-OGTT in 120 patients (81 male; age 62 ± 11 years before coronary angiography. Patients were classified as normal (NGT; 42%, impaired (IGT; 34% and diabetic (T2DM; 24% glucose tolerance by 75 g-OGTT. Results Postchallenge hyperglycemia elicited TNF-α, IL-6 and nitrotyrosine levels time-dependently, and 2-hr median levels of TNF-α (7.1 versus 6.4 pg/ml; P μmol/l; P P Conclusions These results highlight postchallenge proinflammatory and nitrosative responses by 75 g-OGTT, rather than hyperglycemia per se, are associated with CAD in patients without previous recognized diabetes.

  20. Analysis of the presence or absence of atrophy of the subgenual and subcallosal cingulate cortices using voxel-based morphometry on MRI is useful to select prescriptions for patients with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Niida A

    2014-12-01

    Full Text Available Akira Niida,1 Richi Niida,2 Hiroshi Matsuda,3 Makoto Motomura,4 Akihiko Uechi5 1Department of Radiology, Nanbu Hospital, Itoman City, Okinawa, Japan; 2Department of Psychiatry, Nanto Clinic, Urasoe City, Okinawa, Japan; 3Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira City, Tokyo, Japan; 4Department of Human Sciences, University of the Ryukyus, Nakagami County, Okinawa, Japan; 5Cognitive Neuroscience Research Project, Kansai Gaidai University, Hirakata City, Osaka, Japan Objective: We objectively evaluated the presence or absence of atrophy of the subgenual anterior cingulate cortex (sgACC and the subcallosal anterior cingulate cortex (scACC, using new voxel-based morphometry (VBM software employing Statistical Parametric Mapping software v8 and diffeomorphic anatomic registration through an exponentiated lie algebra. We prepared a database covering young-mature adulthood and investigated the clinical usefulness of the evaluation. Subjects and methods: One hundred seven patients with major depressive disorder (MDD, 74 patients with bipolar disorder (BD, and 240 healthy control subjects underwent 1.5T magnetic resonance imaging scanning. Using new VBM software and databases covering young-mature adults and the elderly, target volumes of interest were set in the sgACC and scACC, four indicators (severity, extent, ratio, and whole-brain extent were determined, and the presence or absence of atrophy of the sgACC and scACC was evaluated on the basis of the indicators. In addition, the relationships between the presence or absence of atrophy of the sgACC and scACC and performance of diagnosing MDD and BD and therapeutic drugs were investigated. Results: It was clarified that the disease is likely to be MDD when atrophy is detected in the sgACC, and likely to be BD when no atrophy is detected in the sgACC but is detected in the scACC. Regarding the relationship with therapeutic drugs, it was clarified that, when

  1. SU-F-T-451: Doses to Organs-At-Risk in the Presence and Absence of a 1.5 T Magnetic Field for NSCLC Patients Undergoing SABR

    Energy Technology Data Exchange (ETDEWEB)

    Al-Ward, S; Kim, A; McCann, C; Ruschin, M; Cheung, P; Sahgal, A; Keller, B [Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)

    2016-06-15

    Purpose: To determine whether the electron return effect (ERE) has deleterious effects on lung SABR plans optimized in the presence of an orthogonal 1.5 T magnetic field. Methods: Data from five NSCLC-SABR patients were used. The Dose was modeled with a 2.5 mm dose grid in the presence and absence of a magnetic field using the Monaco (Elekta) TPS with the Monte Carlo GPUMCD (v5.1) algorithm. For each patient, two plans were generated, one using our conventional Elekta Agility linac beam model and another using the Elekta MRI Linac (MRL) model. Both plans were generated on the average CT using similar dose constraints and a 5 mm PTV. The optimization was performed using our clinic’s planning criteria, with normalization of the targets such that their V99% was equal to 99%. The OAR DVHs were compared for each patient. Results: The DVH plots revealed that there were limited differences when optimizing plans in the presence or absence of the magnetic field. The mean of the absolute differences, between the two planning types, in the equivalent uniform doses (EUDs) for the OARs were: 0.3 Gy (range of 0.0 - 1.0 Gy) for the esophagus, 0.6 Gy (range of 0.1 – 1.9 Gy) for the heart, 0.5 Gy (range of 0.2 – 0.8 Gy) for the lungs, and 0.6 Gy (range of 0.2 – 1.5 Gy) for the spinal canal. Regarding the maximum doses to the serial organs, the mean of the differences were 3.0 Gy (esophagus) and 0.9 Gy (spinal canal). No trends in the differences were observed. Conclusion: This study has demonstrated that there were no major differences between plans optimized using a conventional linac and those optimized using an MRI linac with an orthogonal 1.5 T magnetic field. This is attributed to the consideration of the ERE in the optimization. This project was made possible with the financial support of Elekta.

  2. Association of the positive results of the myocardial perfusion SPECT with 99mTc-MIBI, with the presence of Dyslipidemia in patient with 40 years or more age

    International Nuclear Information System (INIS)

    Rochela Vazquez, Luis Manuel; Batista Cuellar, Juan F.; Romero Collado, Susana; Oviedo Perez, Lourdes; Penna Quian, Yamile; Hernandez Cairo, Abel; Peix Gonzalez, Amalia; Fernandez-Britto, Jose E.

    2012-01-01

    Know the association of the Dyslipidemia (DLP) with the positive results of the Myocardial Perfusion SPECT (MPSPECT), for the optimization of the use of this. MATERIAL AND METHOD: Analyze 152 MPSPECT, different day, age average: 58.32 years, 86(56.6%), were masculine. Alone differed by the presence of DLP, according to were divided in DLP, n=37(24.3%) and NDLP (Not-Dyslipidemia), n=115(75.7%), didn't present significant differences in the age average (59.59/57.90 p=0.284), body mass index (24.85/25.03, p=0.739), neither of the frequency of mature, therefore the additional risk alone contributes the DLP. RESULTS: 102(67.1%) MPSPECT were positive, in the comparison among groups was not observed significant difference in the incidence of positive results (67.60/67.00, p=0.945), which stayed when the groups were subdivided in symptomatic and asymptomatic CONCLUSION: The Dyslipidemia doesn't contribute significant risk of ischemic cardiopathy in patient in age of risk, therefore there is not significant association with positive results of the SPECTPM, in patient in age of risk. (author)

  3. Itopride hydrochloride efficacy in the management of delayed gastric emptying in type 1 diabetis mellitus patients in the presence of autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Irina Yur’evna Budennaya

    2014-06-01

    Full Text Available Aim. Evaluation of the itopride (Ganaton?, Abbot therapy efficacy in the management of gastrointestinal (GI symptoms and gastric motor function (GMF in type 1 diabetis mellitus (T1DM patients (pts in the presence of GMF dysfunction and other forms of diabetic autonomic neuropathy (DAN. Materials and Methods. The total of 34 patients with T1DM, GMF dysfunction and DAN were selected for randomized, prospective, open-label, comparative study. The duration of the study was 6 weeks. The study group (17 pts received itopride 150 mg total daily. The control group (17 pts did not receive any treatment for GMF. А questionnaire was used for the assessment of gastrointestinal (GI symptoms. Gastric emptying velocity was evaluated with 13C-octanoate breath test. Results. As a result of itopride therapy there was a statistically significant decrease in the amount of time (T1/2 needed for the gastric emptying. The median amount of time decreased from 89.0 [82.3; 101.0] min to 53.0 [82.3; 101.0] min (p

  4. PRESENCE OF THYMIC TISSUE IN THE ANTERIOR MEDIASTINAL FATTY TISSUE AND ITS SIGNIFICANCE IN THYMECTOMY FOR MYASTHENIA GRAVIS PATIENT: A CASE REPORT

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    Athouba

    2016-03-01

    Full Text Available In 1970s, presence of thymic tissue in anterior mediastinal adipose tissue around the thymus was found. Here we report a case of ectopic thymic tissue in the mediastinum and the possible relevance of this distribution of thymic tissue outside thymus to the therapeutic yield of thymectomies in myasthenia gravis. A 30-year lady with myasthenia gravis (nonthymomatous presented with difficulty in swallowing and breathing for the last 1 years. She was under medical treatment but with little improvement. She underwent extended thymectomy, after which an en bloc resection of the anterior mediastinal fat tissues from pericardium and pleura, including the thymus, was performed. Grossly the soft tissue specimen taken from near left lateral area of heart was fibrofatty tissue. Microscopically isolated thymic tissues were seen interspersed among the fatty tissues composed of mature lymphocytes, epithelial cells and few Hassall's corpuscles were observed. Thymus specimen was within normal histological limits. To ensure complete removal, the adipose tissue at the anterior mediastinum as well as the gross thymus should be removed. Thymic tissue incidence in individual locations was as follows: Retrothyroid, 3(6%; peritracheal, 5 (10%; retrotracheal, 1 (2%; right phrenic nerve, 2 (4%; left phrenic nerve, 14 (28%; right recurrent laryngeal nerve, 2 (4%; left recurrent laryngeal nerve, 2 (4% and periaortic, 0. Trans-sternal thymectomy was found to be beneficial to all patients of mild-to-moderate myasthenia gravis with 70.2% patients showing improvement postoperatively.

  5. Sucralose enhances GLP-1 release and lowers blood glucose in the presence of carbohydrate in healthy subjects but not in patients with type 2 diabetes.

    Science.gov (United States)

    Temizkan, S; Deyneli, O; Yasar, M; Arpa, M; Gunes, M; Yazici, D; Sirikci, O; Haklar, G; Imeryuz, N; Yavuz, D G

    2015-02-01

    Artificial sweeteners were thought to be metabolically inactive, but after demonstrating that the gustatory mechanism was also localized in the small intestine, suspicions about the metabolic effects of artificial sweeteners have emerged. The objective of this study was to determine the effect of artificial sweeteners (aspartame and sucralose) on blood glucose, insulin, c-peptide and glucagon-like peptide-1 (GLP-1) levels. Eight newly diagnosed drug-naive type 2 diabetic patients (mean age 51.5±9.2 years; F/M: 4/4) and eight healthy subjects (mean age 45.0±4.1 years; F/M: 4/4) underwent 75 g oral glucose tolerance test (OGTT). During OGTT, glucose, insulin, c-peptide and GLP-1 were measured at 15- min intervals for 120 min. The OGTTs were performed at three settings on different days, where subjects were given 72 mg of aspartame and 24 mg of sucralose in 200 ml of water or 200 ml of water alone 15 min before OGTT in a single-blinded randomized order. In healthy subjects, the total area under the curve (AUC) of glucose was statistically significantly lower in the sucralose setting than in the water setting (P=0.002). There was no difference between the aspartame setting and the water setting (P=0.53). Total AUC of insulin and c-peptide was similar in aspartame, sucralose and water settings. Total AUC of GLP-1 was significantly higher in the sucralose setting than in the water setting (P=0.04). Total AUC values of glucose, insulin, c-peptide and GLP-1 were not statistically different in three settings in type 2 diabetic patients. Sucralose enhances GLP-1 release and lowers blood glucose in the presence of carbohydrate in healthy subjects but not in newly diagnosed type 2 diabetic patients.

  6. Number of objectives and conclusions in dissertations and thesis

    Directory of Open Access Journals (Sweden)

    Liebano Richard Eloin

    2005-01-01

    Full Text Available PURPOSE: To analyze the number of objectives and conclusions presented in dissertations and thesis defended at Federal University of São Paulo - Paulista School of Medicine (UNIFESP - EPM. METHODS: It was realized a search in the master degree dissertations and doctor degree thesis defended at Federal University of São Paulo - Paulista School of Medicine in the years 2002 and 2003 that were found available in the central library of this university. RESULTS: From 723 master dissertations analyzed, 62 (8,57% presented only one objective and one conclusion, 134 (18,53% presented one objective and more than one conclusion and 527 (72,89% had more than one objective and more than one conclusion. From 502 doctor thesis analyzed, 23 (4,58% presented only one objective and one conclusion, 123 (24,50% presented one objective and more than one conclusion and 376 (74,90% had more than one objective and more than one conclusion.. CONCLUSIONS: It wasn't found in researched literature the number of objectives and conclusions a scientific work must have. A highest number of thesis and dissertations presented more than one objective and more than one conclusion.

  7. Presence of Borrelia spp. DNA in ticks, but absence of Borrelia spp. and of Leptospira spp. DNA in blood of fever patients in Madagascar.

    Science.gov (United States)

    Hagen, Ralf Matthias; Frickmann, Hagen; Ehlers, Julian; Krüger, Andreas; Margos, Gabriele; Hizo-Teufel, Cecilia; Fingerle, Volker; Rakotozandrindrainy, Raphael; Kalckreuth, Vera von; Im, Justin; Pak, Gi Deok; Jeon, Hyon Jin; Rakotondrainiarivelo, Jean Philibert; Heriniaina, Jean Noël; Razafindrabe, Tsiry; Konings, Frank; May, Jürgen; Hogan, Benedikt; Ganzhorn, Jörg; Panzner, Ursula; Schwarz, Norbert Georg; Dekker, Denise; Marks, Florian; Poppert, Sven

    2018-01-01

    The occurrence of tick-borne relapsing fever and leptospirosis in humans in Madagascar remains unclear despite the presence of their potential vectors and reservoir hosts. We screened 255 Amblyomma variegatum ticks and 148 Rhipicephalus microplus ticks from Zebu cattle in Madagascar for Borrelia-specific DNA. Borrelia spp. DNA was detected in 21 Amblyomma variegatum ticks and 2 Rhipicephalus microplus ticks. One Borrelia found in one Rhipicephalus microplus showed close relationship to Borrelia theileri based on genetic distance and phylogenetic analyses on 16S rRNA and flaB sequences. The borreliae from Amblyomma variegatum could not be identified due to very low quantities of present DNA reflected by high cycle threshold values in real-time-PCR. It is uncertain whether these low numbers of Borrelia spp. are sufficient for transmission of infection from ticks to humans. In order to determine whether spirochaete infections are relevant in humans, blood samples of 1009 patients from the highlands of Madagascar with fever of unknown origin were screened for Borrelia spp. - and in addition for Leptospira spp. - by real-time PCR. No target DNA was detected, indicating a limited relevance of these pathogens for humans in the highlands of Madagascar. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis.

    Science.gov (United States)

    Yin, Shande; Chuai, Yunhai; Wang, Aiming; Zhang, Lanmei

    2015-06-01

    To assess the conclusiveness of Cochrane reviews in the field of gynaecological cancer. The Cochrane Library was searched for reviews regarding gynaecological cancer published between 1 January 2000 and 1 November 2014. Data were extracted from each paper and the conclusiveness of each review was assessed. The study included 66 reviews, 41 (62.1%) of which were conclusive. Of these, 58 included randomized controlled trials (RCTs), 37 (63.8%) of which were conclusive. Conclusive reviews of RCTs included significantly more patients than inconclusive reviews, but there was no difference in the number of included studies. Of the eight reviews of nonrandomized studies, four (50.0%) were conclusive. The majority of reviews recognized the need for additional studies. In the field of gynaecological cancer, reviews are more likely to be conclusive when they include RCTs, as well as large numbers of patients. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Relationship between dietary approaches to stop hypertension score and presence or absence of coronary heart diseases in patients referring to Imam Hossein Hospital, Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Zeinab Mokhtari

    2013-11-01

    Full Text Available BACKGROUND: The dietary approaches to stop hypertension (DASH dietary pattern reduces blood pressure. However, there is little information about the relationship between DASH and coronary heart diseases. This study aimed to assess the relationship between a DASH-style diet adherence score and coronary heart diseases (CHD in patients referring for coronary angiography. METHODS: In this study, 201 adults (102 males, 99 females within the age range of 40-80 years who referred for coronary angiography were selected. Diet was evaluated using a validated food frequency questionnaire. DASH score was calculated based on 8 food components (fruits, vegetables, whole grains, nuts and legumes, low fat dairy, red/processed meats, soft drinks/sweets, and sodium. The relationship between DASH score and CHD was assessed using logistic regression analysis. RESULTS: Mean of DASH score was 23.99 ± 4.41. Individuals in the highest quartile of DASH score were less likely to have CHD [odds ratio (OR = 0.38, 95% confidence interval (CI: 0.16-0.86]. However, after adjustment for gender or smoking, there was little evidence that coronary heart disease was associated with DASH diet score. There was a significant negative correlation between DASH score and diastolic blood pressure (P ≤ 0.05. CONCLUSION: In conclusion, having a diet similar to DASH plan was not independently related to CHD in this study. This might indicate that having a healthy dietary pattern, such as DASH pattern, is highly related to gender (dietary pattern is healthier in women than men or smoking habit (non-smokers have healthier dietary pattern compared to smokers.   Keywords: Coronary Heart Disease, Dietary Approach to Stop Hypertension, Blood Pressure 

  10. Hepatic fat quantification using chemical shift MR imaging and MR spectroscopy in the presence of hepatic iron deposition: validation in phantoms and in patients with chronic liver disease.

    Science.gov (United States)

    Lee, Seung Soo; Lee, Youngjoo; Kim, Namkug; Kim, Seong Who; Byun, Jae Ho; Park, Seong Ho; Lee, Moon-Gyu; Ha, Hyun Kwon

    2011-06-01

    To compare the accuracy of four chemical shift magnetic resonance imaging (MRI) (CS-MRI) analysis methods and MR spectroscopy (MRS) with and without T2-correction in fat quantification in the presence of excess iron. CS-MRI with six opposed- and in-phase acquisitions and MRS with five-echo acquisitions (TEs of 20, 30, 40, 50, 60 msec) were performed at 1.5 T on phantoms containing various fat fractions (FFs), on phantoms containing various iron concentrations, and in 18 patients with chronic liver disease. For CS-MRI, FFs were estimated with the dual-echo method, with two T2*-correction methods (triple- and multiecho), and with multiinterference methods that corrected for both T2* and spectral interference effects. For MRS, FF was estimated without T2-correction (single-echo MRS) and with T2-correction (multiecho MRS). In the phantoms, T2*- or T2-correction methods for CS-MRI and MRS provided unbiased estimations of FFs (mean bias, -1.1% to 0.5%) regardless of iron concentration, whereas the dual-echo method (-5.5% to -8.4%) and single-echo MRS (12.1% to 37.3%) resulted in large biases in FFs. In patients, the FFs estimated with triple-echo (R = 0.98), multiecho (R = 0.99), and multiinterference (R = 0.99) methods had stronger correlations with multiecho MRS FFs than with the dual-echo method (R = 0.86; P ≤ 0.011). The FFs estimated with multiinterference method showed the closest agreement with multiecho MRS FFs (the 95% limit-of-agreement, -0.2 ± 1.1). T2*- or T2-correction methods are effective in correcting the confounding effects of iron, enabling an accurate fat quantification throughout a wide range of iron concentrations. Spectral modeling of fat may further improve the accuracy of CS-MRI in fat quantification. Copyright © 2011 Wiley-Liss, Inc.

  11. Hypothesis, Prediction, and Conclusion: Using Nature of Science Terminology Correctly

    Science.gov (United States)

    Eastwell, Peter

    2012-01-01

    This paper defines the terms "hypothesis," "prediction," and "conclusion" and shows how to use the terms correctly in scientific investigations in both the school and science education research contexts. The scientific method, or hypothetico-deductive (HD) approach, is described and it is argued that an understanding of the scientific method,…

  12. Conclusion Chapters in Doctoral Theses: Some International Findings

    Science.gov (United States)

    Trafford, Vernon; Leshem, Shosh; Bitzer, Eli

    2014-01-01

    This study investigated how candidates claimed to have made an original contribution to knowledge in the conclusion chapters of 100 PhD theses. Documentary analysis was used to discover how this was explained within theses at selected universities in three countries. No other documents were accessed and neither were candidates, supervisors or…

  13. Overview of human health in the Arctic: conclusions and recommendations.

    Science.gov (United States)

    Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

    2016-01-01

    This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

  14. 20 CFR 901.48 - Proposed findings and conclusions.

    Science.gov (United States)

    2010-04-01

    ... Law Judge, before making his/her decision, shall give the parties a reasonable opportunity to submit... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE...

  15. Actual Problems of Conclusion and Discharge of Urgent Labour Contracts

    Directory of Open Access Journals (Sweden)

    Shevelyova A. A.

    2013-05-01

    Full Text Available This article is devoted to the consideration of the questions connected with the conclusion and the termination of the urgent labour contract. The author, analyzing judicial practice, allocates the problems of separate regulation of the RF labour legislation enforcement.

  16. Cosmological Gamma-Ray Bursts and Hypernovae Conclusively Linked

    Science.gov (United States)

    2003-06-01

    . Thousands of years prior to this explosion, a very massive star, running out of hydrogen fuel, let loose much of its outer envelope, transforming itself into a bluish Wolf-Rayet star [3]. The remains of the star contained about 10 solar masses worth of helium, oxygen and heavier elements. In the years before the explosion, the Wolf-Rayet star rapidly depleted its remaining fuel. At some moment, this suddenly triggered the hypernova/gamma-ray burst event. The core collapsed, without the outer part of the star knowing. A black hole formed inside, surrounded by a disk of accreting matter. Within a few seconds, a jet of matter was launched away from that black hole. The jet passed through the outer shell of the star and, in conjunction with vigorous winds of newly formed radioactive nickel-56 blowing off the disk inside, shattered the star. This shattering, the hypernova, shines brightly because of the presence of nickel. Meanwhile, the jet plowed into material in the vicinity of the star, and created the gamma-ray burst which was recorded some 2,650 million years later by the astronomers on Earth. The detailed mechanism for the production of gamma rays is still a matter of debate but it is either linked to interactions between the jet and matter previously ejected from the star, or to internal collisions inside the jet itself. This scenario represents the "collapsar" model, introduced by American astronomer Stan Woosley (University of California, Santa Cruz) in 1993 and a member of the current team, and best explains the observations of GRB 030329. " This does not mean that the gamma-ray burst mystery is now solved ", says Woosley . " We are confident now that long bursts involve a core collapse and a hypernova, likely creating a black hole. We have convinced most skeptics. We cannot reach any conclusion yet, however, on what causes the short gamma-ray bursts, those under two seconds long ."

  17. Presence of Social Presence during Disasters

    DEFF Research Database (Denmark)

    Mukkamala, Alivelu Manga; Beck, Roman

    2017-01-01

    During emergencies, affected people use social media platforms for interaction and collaboration. Social media is used to ask for help, provide moral support, and to help each other, without direct face-to-face interactions. From a social presence point of view, we analyzed Twitter messages...... to understand how people cooperate and collaborate with each other during heavy rains and subsequent floods in Chennai, India. We conducted a manual content analysis to build social presence classifiers comprising intimacy and immediacy concepts which we used to train a machine learning approach to subsequently...

  18. Conclusive identification of quantum channels via monogamy of quantum correlations

    International Nuclear Information System (INIS)

    Kumar, Asutosh; Singha Roy, Sudipto; Pal, Amit Kumar; Prabhu, R.; Sen, Aditi; Sen, Ujjwal

    2016-01-01

    We investigate the action of global noise and local channels, namely, amplitude-damping, phase-damping, and depolarizing channels, on monogamy of quantum correlations, such as negativity and quantum discord, in three-qubit systems. We discuss the monotonic and non-monotonic variation, and robustness of the monogamy scores. By using monogamy scores, we propose a two-step protocol to conclusively identify the noise applied to the quantum system, by using generalized Greenberger–Horne–Zeilinger and generalized W states as resource states. We discuss a possible generalization of the results to higher number of parties. - Highlights: • Monogamy score monotonically decays with noise for generalized GHZ state as input. • Non-monotonically decaying monogamy score with noise for generalized W state as input. • Characterizing the dynamics of monogamy score. • Dynamics terminal quantifying robustness of monogamy score against noise. • Conclusively identifying the type of noise using monogamy score.

  19. Conclusive identification of quantum channels via monogamy of quantum correlations

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Asutosh; Singha Roy, Sudipto; Pal, Amit Kumar [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Prabhu, R. [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Department of Physics, Indian Institute of Technology Patna, Bihta 801103, Bihar (India); Sen, Aditi, E-mail: aditi@hri.res.in [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Sen, Ujjwal [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India)

    2016-10-23

    We investigate the action of global noise and local channels, namely, amplitude-damping, phase-damping, and depolarizing channels, on monogamy of quantum correlations, such as negativity and quantum discord, in three-qubit systems. We discuss the monotonic and non-monotonic variation, and robustness of the monogamy scores. By using monogamy scores, we propose a two-step protocol to conclusively identify the noise applied to the quantum system, by using generalized Greenberger–Horne–Zeilinger and generalized W states as resource states. We discuss a possible generalization of the results to higher number of parties. - Highlights: • Monogamy score monotonically decays with noise for generalized GHZ state as input. • Non-monotonically decaying monogamy score with noise for generalized W state as input. • Characterizing the dynamics of monogamy score. • Dynamics terminal quantifying robustness of monogamy score against noise. • Conclusively identifying the type of noise using monogamy score.

  20. Biogeochemistry of uranium mill wastes program overview and conclusions

    International Nuclear Information System (INIS)

    Dreesen, D.R.

    1981-05-01

    The major findings and conclusions are summarized for research on uranium mill tailings for the US Department of Energy and the US Nuclear Regulatory Commission. An overview of results and interpretations is presented for investigations of 222 Rn emissions, revegetation of tailings and mine spoils, and trace element enrichment, mobility, and bioavailability. A brief discussion addresses the implications of these findings in relation to tailings disposal technology and proposed uranium recovery processes

  1. Summary and Conclusions. Final chapter of Scholarly Communication for Librarians.

    OpenAIRE

    Morrison, Heather

    2008-01-01

    Summary and Conclusions of Scholarly Communication for Librarians, a book designed to provide librarians at all levels with the basics of how scholarly communication works, an understanding of the academic library as an essential support for scholarly communication, the impact of the decisions librarians make, and emerging roles for libraries and librarians in scholarly communication. Includes major points from all chapters, on: scholarship, scholarly journals, the scholarly publishing indus...

  2. Review conclusions by Ernst and Canter regarding spinal manipulation refuted

    Directory of Open Access Journals (Sweden)

    Evans Roni

    2006-08-01

    Full Text Available Abstract In the April 2006 issue of the Journal of Royal Society of Medicine, Ernst and Canter authored a review of the most recent systematic reviews on the effectiveness of spinal manipulation for any condition. The authors concluded that, except for back pain, spinal manipulation is not an effective intervention for any condition and, because of potential side effects, cannot be recommended for use at all in clinical practice. Based on a critical appraisal of their review, the authors of this commentary seriously challenge the conclusions by Ernst and Canter, who did not adhere to standard systematic review methodology, thus threatening the validity of their conclusions. There was no systematic assessment of the literature pertaining to the hazards of manipulation, including comparison to other therapies. Hence, their claim that the risks of manipulation outweigh the benefits, and thus spinal manipulation cannot be recommended as treatment for any condition, was not supported by the data analyzed. Their conclusions are misleading and not based on evidence that allow discrediting of a large body of professionals using spinal manipulation.

  3. Presence of Essential Hypertension or Diabetes Mellitus Is a Predictor of Intracranial Bleeding in Elderly Patients: A Study of 108 Patients with Isolated Thrombocytopenia from a Single Reference Center

    Directory of Open Access Journals (Sweden)

    Rajan Kapoor

    2015-06-01

    Full Text Available INTRODUCTION: Thrombocytopenia poses a significant problem in the elderly. Not only are there varied causes, but it is also associated with significant morbidity and mortality. We carried out a study to learn the causes of isolated thrombocytopenia in elderly patients and to correlate the severity of thrombocytopenia and bleeding manifestations with various etiologic factors and comorbidities. METHODS: A total of 108 patients above 50 years of age presenting with isolated thrombocytopenia (platelet counts of <100x109/L with normal hemoglobin and total leukocyte counts were enrolled in the study. Detailed history and clinical examinations were carried out for each patient. Complete blood counts were analyzed by automated cell counter. Peripheral smears were examined in all cases. HbsAg, anti-HCV, and anti-HIV testing by enzyme-linked immunosorbent assay was done in all patients. Wherever clinically indicated, bone marrow aspiration biopsy and cytogenetic studies were done. RESULTS: Out of 108 patients, 102 (94.4% presented with bleeding tendencies. Twenty-nine (26.8% presented with serious (World Health Organization grade 3/4 bleedings. Major findings were immune thrombocytopenic purpura in 79 (73.1%, myelodysplastic syndrome in 7 (6.5%, drug-induced thrombocytopenia in 7 (6.5%, and connective tissue disorder in 4 (3.7% cases. Ten patients presented with intracranial bleedings. Upon logistic regression analysis, comorbidities in the form of essential hypertension and diabetes mellitus were significantly associated with occurrence of intracranial bleeding. There was no correlation of serious bleedings with platelet counts. DISCUSSION AND CONCLUSION: Isolated thrombocytopenia in the elderly is associated with significant morbidity. Diligent clinical and laboratory evaluation is required to elucidate the cause of thrombocytopenia in the elderly. Comorbidities in this population are associated with serious bleedings and not low platelet counts as is

  4. Gait analysis in prosthetics: Opinions, ideas and conclusions

    NARCIS (Netherlands)

    Rietman, J.S.; Postema, K.; Geertzen, J.H.B.

    2002-01-01

    A review was performed of the literature of the last eleven years (1990-2000) with the topic: "clinical use of instrumented gait analysis in patients wearing a prosthesis of the lower limb". To this end a literature search was performed in Embase, Medline and Recal. Forty-five (45) articles were

  5. It pays to be green. A premature conclusion?

    International Nuclear Information System (INIS)

    Telle, K.

    2006-01-01

    It has been claimed that good environmental performance can improve firms' economic performance. However, because of e.g. data limitations, the methods applied in most previous quantitative empirical studies on effects of environmental performance on economic performance of firms suffer from several shortcomings. We discuss these shortcomings and conclude that previously applied methods are unsatisfactory as support for a conclusion that it pays for firms to be green. Then we illustrate the consequences of these shortcomings by performing several regression analyses of the effect of environmental performance on economic performance using a panel data set of Norwegian plants. A pooled regression where observable firm characteristics like e.g. size or industry are controlled for, confirms a positive effect of environmental performance on economic performance. However, the estimated positive effect could be due to omitted unobserved variables like management or technology. When the regression model controls for unobserved plant heterogeneity, the effect is generally no longer statistically significant. Hence, although greener plants tend to perform economically better, the analysis provides little support for the claim that it is because they are greener. These empirical findings further indicate that a conclusion that it pays to be green is premature

  6. Presence of acute and chronic renal failure in patients with paroxysmal nocturnal hemoglobinuria: results of a retrospective analysis from the Spanish PNH Registry.

    Science.gov (United States)

    Villegas, Ana; Núñez, Ramiro; Gaya, Anna; Cuevas-Ruiz, María Victoria; Bosch, José Miguel; Carral, Anna; Arrizabalaga, Beatriz; Gómez-Roncero, María Isabel; Mora, Asunción; Bravo, Pilar; Lavilla, Esperanza; Monteserín, Carmen; Hernández, Belén; Martínez-Barranco, Pilar; Jarque, Isidro; Urquía, María Anunciación; García-Donas, Gloria; Brunet, Salut; González, Fernando Ataulfo; Urbano, Álvaro

    2017-10-01

    Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening blood disease. With the advent of eculizumab treatment, renal function has substantially improved, although no data from real-world clinical practice are available. An observational, retrospective, multicenter study was conducted in Spain on clinical data obtained from outpatient visits of patients with PNH (Spanish PNH Registry) who had experienced acute (ARF) or chronic (CRF) renal failure. Of the 128 patients registered (April 2014), 60 were diagnosed with classic PNH. Twenty-seven (45.0%) patients with a mean age of 48.5 (±16.2) years had renal failure, ARF or CRF, and were included in this study. Near half of the patients (n = 13; 48.1%) presented with ARF alone, 33.3% (n = 9) had CRF with episodes of ARF, while 18.5% (n = 5) were diagnosed with CRF alone. For patients with diagnosis of PNH and renal failure (n = 27), the median time to the first ARF episode was 6.5 (CI 95%; 2.2, 14.9) years, whereas the median to the diagnosis of CRF was 14.5 (CI 95%; 3.8, 19.2) years after the diagnosis of PNH. Patients with ARF (n = 22) were treated with eculizumab and did not experience new episodes of ARF, except for one patient with sepsis. Of the patients with CRF, two received treatment without experiencing further episodes of ARF. Sixteen patients who completed treatment (11 with ARF and 5 with ARF + CRF) recovered from the episode of ARF or from CRF. Of the remaining patients treated with eculizumab, one patient improved from stages III to II, three patients stabilized without showing disease progression, and one patient progressed from stages III to IV. Treatment with eculizumab in PNH patients has beneficial effects on renal function, preventing ARF and progression to CRF.

  7. Optimal cut?off value of alanine aminotransferase level to precisely estimate the presence of fatty liver in patients with poorly controlled type?2 diabetes

    OpenAIRE

    Tanabe, Akihito; Tatsumi, Fuminori; Okauchi, Seizo; Yabe, Hiroki; Tsuda, Tomohiro; Okutani, Kazuma; Yamashita, Kazuki; Nakashima, Koji; Kaku, Kohei; Kaneto, Hideaki

    2016-01-01

    Optimal cut?off value of ALT level to precisely estimate the presence of fatty liver was as low as 28.0?U/L. We should consider the possibility of fatty liver even when ALT level is within normal range in subjects with poorly controlled type 2 diabetes.

  8. Conclusion of the I.C.T. benchmark exercise

    International Nuclear Information System (INIS)

    Giacometti, A.

    1991-01-01

    The ICT Benchmark exercise made within the RIV working group of ESARDA on reprocessing data supplied by COGEMA for 53 routines reprocessing input batches made of 110 irradiated fuel assemblies from KWO Nuclear Power Plant was finally evaluated. The conclusions are: all seven different ICT methods applied verified the operator data on plutonium within about one percent; anomalies intentionally introduced to the operator data were detected in 90% of the cases; the nature of the introduced anomalies, which were unknown to the participants, was completely resolved for the safeguards relevant cases; the false alarm rate was in a few percent range. The ICT Benchmark results shows that this technique is capable of detecting and resolving anomalies in the reprocessing input data to the order of a percent

  9. The no conclusion intervention for couples in conflict.

    Science.gov (United States)

    Migerode, Lieven

    2014-07-01

    Dealing with difference is central to all couple therapy. This article presents an intervention designed to assist couples in handling conflict. Central to this approach is the acceptance that most conflicts cannot be solved. Couples are in need of a different understanding of couples conflict. This understanding is found in the analysis of love in context and in relational dialectics. Couples are guided through different steps: deciding on the valence of the issue as individuals, helping them decide which differences can be resolved and which issues demand new ways of living with the inevitable, and the introduction in the suggested no conclusion dialogue. This article briefly describes the five day intensive couple therapy program, in which the no intervention is embedded. The theoretical foundation of the intervention, followed by the step by step description of the intervention forms the major part of the article. A case vignette illustrates this approach. © 2012 American Association for Marriage and Family Therapy.

  10. The European Food Consumption Validation Project: conclusions and recommendations

    DEFF Research Database (Denmark)

    de Boer, E. J.; Slimani, N.; van 't Veer, P.

    2011-01-01

    Background/Objectives: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. Subjects/Methods: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1...... showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals...... according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary...

  11. The accident at the Harrisburg nuclear reactor - Interim conclusions

    International Nuclear Information System (INIS)

    Yiftah, S.

    1979-07-01

    This work describes the first minutes, first day and first week following the Three Mile Island accident. It shows the failures that occurred and the lessons which should be derived. It is pointed out that the doses of radiation that escaped from the TMI plant were at no time large enough to have had any effect on the 2 million people living on a radius of 80 km from the plant. Although no casualties occurred the Harrisburg accident will create an impulse for a new study and understanding of the nuclear plant safety and might serve as a live safety laboratory. After the TMI accident nuclear plants are already safer, one of the conclusions being that a new planning of the operation room is required, with the operators acquiring a better understanding of what is going on during a nuclear reactor accident. (B.G.)

  12. Workshop on large molten pool heat transfer summary and conclusions

    International Nuclear Information System (INIS)

    1994-01-01

    The CSNI Workshop on Large Molten Heat Transfer held at Grenoble (France) in March 1994 was organised by CSNI's Principal Working Group on the Confinement of Accidental Radioactive Releases (PWG4) with the cooperation of the Principal Working Group on Coolant System Behaviour (FWG2) and in collaboration with the Grenoble Nuclear Research Centre of the French Commissariat a l'Energie Atomique (CEA). Conclusions and recommendations are given for each of the five sessions of the workshops: Feasibility of in-vessel core debris cooling through external cooling of the vessel; Experiments on molten pool heat transfer; Calculational efforts on molten pool convection; Heat transfer to the surrounding water - experimental techniques; Future experiments and ex-vessel studies (open forum discussion)

  13. Jumping to conclusions and the continuum of delusional beliefs.

    Science.gov (United States)

    Warman, Debbie M; Lysaker, Paul H; Martin, Joel M; Davis, Louanne; Haudenschield, Samantha L

    2007-06-01

    The present study examined the jumping to conclusions reasoning bias across the continuum of delusional ideation by investigating individuals with active delusions, delusion prone individuals, and non-delusion prone individuals. Neutral and highly self-referent probabilistic reasoning tasks were employed. Results indicated that individuals with delusions gathered significantly less information than delusion prone and non-delusion prone participants on both the neutral and self-referent tasks, (preferent task (p=.002). Those with delusions and those who were delusion prone reported higher confidence in their performance on the self-referent task than they did the neutral task (p=.02), indicating that high self-reference impacted information processing for individuals in both of these groups. The results are discussed in relation to previous research in the area of probabilistic reasoning and delusions.

  14. Snakebites in French Guiana: Conclusions of an international symposium.

    Science.gov (United States)

    Kallel, Hatem; Hommel, Didier; Mehdaoui, Hossein; Megarbane, Bruno; Resiere, Dabor

    2018-05-01

    A workshop on epidemiology and management of snakebites in French Guiana was performed at Cayenne, French Guiana from September 15 to September 16, 2017, under the auspices of the French Regional Health Agency (ARS) and the Pan American Health Organization (PAHO). The activity was attended by experts from France (Angers, Martinique, French Guiana, Guadeloupe, and Paris), Costa Rica, Brazil, Saint Lucia, and Surinam. The epidemiology, clinical manifestations, clinical grading and the management of snakebite in French Guiana were discussed. The conclusions of this symposium illustrated the urgent need to ensure accessibility of effective and safe polyvalent viperid antivenom in French Guiana. Finally, the results of this symposium have forged ties based on mutual goals and objectives. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Conclusions regarding geotechnical acceptability of the WIPP site

    International Nuclear Information System (INIS)

    Weart, W.D.

    1983-01-01

    The Waste Isolation Pilot Plant (WIPP) was authorized by Congress in 1980 as an unlicensed research and development (R and D) facility to demonstrate the safe disposal of radioactive wastes arising from the defense activities and programs of the United States. WIPP is now being constructed in southeast New Mexico, using salt beds about 655 m below the surface of the ground. Construction of the full WIPP facility will not commence until a preliminary underground excavation phase, called Site and Preliminary Design Validation (SPDV), is satisfactorily concluded in the summer of 1983. This SPDV program permits confirmation of subsurface geology, in drifts at planned facility depth that extend for 1555 m in a north-south direction, and in the two vertical shafts that provide access to these drifts. The subsurface studies are nearing completion, and it is therefore appropriate to draw conclusions regarding the geotechnical acceptability of the WIPP site. Four geotechnical elements are discussed: dissolution, deformation, hydrologic regime, and natural resources

  16. The presence of advanced lesions and associating risk factors for advanced cervical carcinoma in patients with atypical sguamous cells of undetermined significance.

    Science.gov (United States)

    Sun, L L; Chen, W; Fan, Y Y; Wang, M L; Wang, L N

    2015-01-01

    To characterize histopathological status, high-risk human papillomavirus (hr-HPV) infection status, and associated risk factors in patients with atypical squamous cells of undetermined significance (ASCUS). Cervical biopsies obtained from 130 ASCUS patients were subjected to histopathological examination and hr-HPV testing. Associations between advanced lesions and hr-HPV load or age were analyzed, and the confounding factors for high-grade cervical lesions were identified. Cervical biopsies from ASCUS patients had a wide range of pathological states, ranging from normal to invasive cervical carcinoma. High-risk HPV infection was significantly associated with advanced cervical lesions in ASCUS patients; hr-HPV infection and the number of gestations were risk factors for developing advanced cervical disease. A significant portion of ASCUS patients harbor advanced cervical lesions. The number of gestations and hr-HPV infection can increase the risk of developing advanced cervical lesions in ASCUS patients.

  17. ANCLI's conclusions and recommendations made after the ANCLI colloquium 'Tritium, discrete, but present everywhere'

    International Nuclear Information System (INIS)

    Sene, M.

    2009-01-01

    The authors briefly state the conclusions of the colloquium about the presence of tritium in the environment, its sanitary impact, the re-examination of a management based on release, the need to reduce tritium production. The recommendations are also indicated: to continue researches on organically bound tritium, not to allow any release increase as long as effects are not better known. The role of the ANCLI is outlined

  18. Presence of elevated non-HDL among patients with T2DM with CV events despite of optimal LDL-C – A report from South India

    Directory of Open Access Journals (Sweden)

    Satyavani Kumpatla

    2016-05-01

    Full Text Available Elevated non-high density lipoprotein cholesterol (non-HDL-C was the commonest lipid abnormality among T2DM patients with cardiovascular events (CV events. Prevalence of elevated non-HDL-C was 21.6% among patients who were on statin therapy and with optimal low density lipoprotein-cholesterol (LDL-C levels. Despite an optimal LDL-C level, 47% of the T2DM patients with CV events had elevated non-HDL-C.

  19. Standardized uptake value for (18)F-fluorodeoxyglucose is correlated with a high International Prognostic Index and the presence of extranodal involvement in patients with diffuse large B-cell lymphoma.

    Science.gov (United States)

    Akkas, B E; Vural, G U

    2014-01-01

    The aim of this study was to evaluate whether the maximum standardized uptake value (SUVmax) of (18)F-fluorodeoxyglucose (FDG) correlates with the International Prognostic Index (IPI) and the presence of extranodal involvement in patients with Diffuse Large B-Cell Lymphoma (DLBCL). 77 patients (age: 57.2±18.5, 40F, 37M) with DLBCL who underwent FDG PET/CT for initial staging were included. SUVmax of the predominant lesions were compared to Ann Arbor stage, IPI scores, the presence of extranodal involvement and the number extranodal sites. PET/CT detected nodal (n:25) and extranodal involvement (n:52) in all the patients. In 27 patients, extranodal disease could only be detected by PET. SUVmax of the predominant lesion in patients with extranodal disease was significantly higher than that of the patients who had only nodal disease (25±12 vs. 15.3±10 respectively, p=0.001). SUVmax significantly correlated with IPI scores; the average SUVmax was significantly correlated with the IPI: Mean SUVmax of the predominant lesion was 13.9±9.5 in patients with low risk (IPI=0-1), 14.2±8.8 in low-intermediate risk group (IPI=2) whereas 26.6±9.5 in high-intermediate risk group (IPI=3) and 25±13.6 in high risk group patients (IPI=4-5) (p=0.002). SUVmax was not correlated with clinical stage, the number of extranodal sites and serum LDH levels. FDG uptake correlates with IPI and the presence of extranodal involvement in DLBCL. PET is a powerful method to detect extranodal disease in DLBCL. The correlation of SUVmax with these prognostic factors may highlight the importance of pretreatment FDG uptake as a metabolic marker of poor prognosis for patients with DLBCL. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  20. A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

    OpenAIRE

    Sheng, Chew Keng; Lim, Chee Kean; Rashidi, Ahmad

    2010-01-01

    Abstracts Background The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied. Aim We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation. Me...

  1. Summary of the discussion, Conclusion of the meeting

    International Nuclear Information System (INIS)

    Crutzen, S.

    1997-01-01

    The discussion was organised in three major periods corresponding to the main themes developed by the programme of the meeting: the qualification approaches, the qualification experience accumulated so far, one particular frame or motivation of the ISI qualification: the risk based (or informed) ISI. The qualification approaches presented by national representatives raised few questions. More discussion was induced on the qualification concepts, responsibilities, need and writing of the technical justification, motivation for the open trials, similitude between concepts, benefit deriving from the qualification of inspection procedures and further motivation. the conclusion could be as the following: the evolution of qualification applications, even if issued from harmonised concepts, appears to be nationalistically based. It is a thought that emulation and harmonisation could actually produce both savings and improvements in this area. 'The wheel does not have to be re-invented in each country' and it is the declared objective of ENIQ. There seems to be a need for some international agreement in the setting of standards for qualification. One area which seems to continue to be of underlying concern is in the characterisation of defects. There seems to be a need for appropriate 'defected blocks' satisfying the criteria of representativeness, quality, low cost, reproducibility, etc. More specific cases of Technical Justification development are needed to serve as examples and incentive for the case of this element of inspection qualification

  2. Medical irradiation of children. Beware of too fast conclusion

    International Nuclear Information System (INIS)

    Brisse, H.; Sirinelli, D.; Adamsbaum, C.; Chateil, J.F.; Claudon, M.; Geoffray, A.; Petit, P.; Rausin, L.; Panuel, M.

    2004-01-01

    The publication in january 2004 in the British medical journal of the article of P. Hall and coll. 'Effect of low doses of ionizing irradiation in infancy on cognitive function in adulthood: Swedish population based cohort study, has been noticed by the Radiation protection group of the French speaking society of pediatrics imaging. The authors evaluate the psycho-motor development of less eighteen months years old children and irradiated between 1930 and 1959 for a face angioma. They study for each dose of irradiation ( from 0 to 250 m Gy) the level of school attendance and their results to the psycho-motor tests made during conscription medical examination. They noticed a diminution of 50% of the access success rate to university for the children having received an irradiation dose of 250 mG. No effect is noticed under the irradiation dose of 100 mGy. In their conclusions the authors compare these irradiation doses to these ones delivered in brain scanner examination. These results seem overestimated compared with the work made on fetuses ( publication 84 of ICRP) then the fetus is considered as more sensitive to ionizing radiations than the infant. The dose of 120 mGy is found in the literature and now the dose delivered in pediatrics are in the area of 0 and 100 mGy where no effect has been revealed in the cohort of irradiated children. The article does not include the principle of justification that is used nowadays and the replacement by the trans fontanel echography has allowed to reduce the number of brain scanner, used only for limited cases where the benefit is superior the the risk of irradiation. (N.C.)

  3. Plurihormonal cells of normal anterior pituitary: Facts and conclusions

    Science.gov (United States)

    Mitrofanova, Lubov B.; Konovalov, Petr V.; Krylova, Julia S.; Polyakova, Victoria O.; Kvetnoy, Igor M.

    2017-01-01

    Introduction plurihormonality of pituitary adenomas is an ability of adenoma cells to produce more than one hormone. After the immunohistochemical analysis had become a routine part of the morphological study, a great number of adenomas appeared to be multihormonal in actual practice. We hypothesize that the same cells of a normal pituitary gland releases several hormones simultaneously. Objective To analyse a possible co-expression of hormones by the cells of the normal anterior pituitary of adult humans in autopsy material. Materials and methods We studied 10 pituitary glands of 4 women and 6 men with cardiovascular and oncological diseases. Double staining immunohistochemistry using 11 hormone combinations was performed in all the cases. These combinations were: prolactin/thyroid-stimulating hormone (TSH), prolactin/luteinizing hormone (LH), prolactin/follicle-stimulating hormone (FSH), prolactin/adrenocorticotropic hormone (ACTH), growth hormone (GH)/TSH, GH/LH, GH/FSH, GH/ACTH, TSH/LH, TSH/FSH, TSH/ACTH. Laser Confocal Scanning Microscopy with a mixture of primary antibodies was performed in 2 cases. These mixtures were ACTH/prolactin, FSH/prolactin, TSH/prolactin, ACTH/GH, and FSH/GH. Results We found that the same cells of the normal adenohypophysis can co-express prolactin with ACTH, TSH, FSH, LH; GH with ACTH, TSH, FSH, LH, and TSH with ACTH, FSH, LH. The comparison of the average co-expression coefficients of prolactin, GH and TSH with other hormones showed that the TSH co-expression coefficient was significantly the least (9,5±6,9%; 9,6±7,8%; 1,0±1,3% correspondingly). Conclusion Plurihormonality of normal adenohypophysis is an actually existing phenomenon. Identification of different hormones in pituitary adenomas enables to find new ways to improve both diagnostic process and targeted treatment. PMID:28418929

  4. Waste Handling Shaft concrete liner degradation conclusions and recommendations

    International Nuclear Information System (INIS)

    1992-10-01

    The primary function of the Waste Handling Shaft (WHS) at the Waste Isolation Pilot Plant (WIPP) is to permit the transfer of radioactive waste from the surface waste handling building to the underground storage area. It also serves as an intake shaft for small volumes of air during normal storage operations and as an emergency escape route. Part of the construction was the placement of a concrete liner and steel reinforced key in 1984. During a routine shaft inspection in May 1990, some degradation of the WHS concrete liner was observed between the depths of 800 and 900 feet below the ground surface. Detailed investigations of the liner had been carried out by Sandia National Laboratories and by Westinghouse Electric Corporation Waste Isolation Division (WID) through Lankard Materials Laboratory. Observations, reports, and data support the conclusion that the concrete degradation, resulting from attack by chemically aggressive brine, is a localized phenomena. It is the opinion of the WID that the degradation is not considered an immediate or near term concern; this is supported by technical experts. WID recommendations have been made which, when implemented, will ensure an extended liner life. Based on the current assessment of available data and the proposed shaft liner monitoring program described in this report, it is reasonable to assume that the operational life of the concrete shaft liner can safely support the 25-year life of the WIPP. Analysis of data indicates that degradation of the shaft's concrete liner is attributed to chemically aggressive brine seeping through construction joints and shrinkage cracks from behind the liner in and around the 834-foot depth. Chemical and mechanical components of concrete degradation have been identified. Chemical attack is comprised of several stages of concrete alteration. The other component, mechanical degradation, results from the expansive forces of crystals forming in the concrete pore space

  5. The Danish energy crop research and development project - main conclusions

    International Nuclear Information System (INIS)

    Gylling, Morten

    2003-01-01

    Production of energy crops in Denmark is more or less non-existent in Denmark at the time being. However, the need for biomass on the other side of year 2005 exceeds the existing biomass resources and a substantial amount of energy crops will be necessary in order to fulfil the goals in Energy 21. The targeted share of the use of renewable energy sources by year 2030 is approximately 30%. Energy crops are seen as the most important new resource in order to create a balanced input mix of renewable in the energy system. The energy crops are mainly seen as fuel in small and medium sized CHP plants and in the big power plants. The Danish energy crop project consists of three main parts: a demonstration part, a research and development part, and an overall assessment part. Based on the results from the project the following overall conclusions can be made: Seen from a strictly market and production economic point of view energy crops will not be competitive in a foreseeable future, neither as a production for farmers nor as a fuel at the utility companies; The costs per GJ of energy crops are still higher than a GJ of straw; The cost difference between annual and perennial energy crops are slightly in favour of perennials, however the conditions on the individual farms should govern the choice between annual and perennial energy crops; Energy crops must be seen as part of an overall environmental scheme covering both agriculture and the energy sector; Given the right production scheme energy crops can be grown on environmental sensitive areas and on most ground water protection areas; Adding the potential sustainability benefits like reduced nutrient leakage and reduced CO 2 emissions energy crops seem to be a sensible and sustainable solution; Due to different handling, storage and fuel characteristics an all year delivery scheme of energy crops should include a mix of different energy crops to keep overall cost down. (BA)

  6. Presence in Virtual Reality Exposure Therapy Systems

    OpenAIRE

    Ling, Y.

    2014-01-01

    Experiencing anxiety is essential for virtual reality exposure therapy (VRET) to be effective in curing patients suffering from anxiety disorders. However, some patients drop out in VRET due to the lack of feeling anxiety. Presence - which refers to the feeling of being in the virtual environment - has been considered an important mechanism that leads to the experience of anxiety. Therefore, understanding the relationship between presence and anxiety and finding ways to improve presence in VR...

  7. Fatores associados com a gastrite crônica em pacientes com presença ou ausência do Helicobacter pylori Factors associated with chronic gastritis in patients with presence and absence of Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Lissa Chamse Ddine

    2012-06-01

    , doenças associadas e nutrição inadequada, interagem para o início das manifestações clínicas, e a presença ou ausência de H. pylori não mostrou diferenças significativas no estado clínico dos pacientes.BACKGROUND - Chronic gastritis is an inflammation of the stomach mucosa, which is considered its main etiological factor the Helicobacter pylori. AIM - To observe the differences in patients with chronic gastritis as well as the presence and absence of H. pylori, to obtain a better understanding of the etiological factors, clinical, dietary and lifestyle habits and associated diseases. METHODS - This was a descriptive study, retrospective medical records of patients with chronic gastritis treated as outpatients. Endoscopy and research of H. pylori was used in the diagnosis of chronic gastritis. The survey was conducted through a questionnaire to ascertain the risk factors for chronic gastritis and the clinical manifestations of disease, dietary and lifestyle habits, family history of the disease, weight changes and medications. For statistical analysis was used Spearman coefficient. Data were considered statistically significant p<0.05. RESULTS - Of the 94 patients evaluated were symptomatic with heartburn, belching, epigastric pain, fullness and nausea. In 56.6% (n = 54 of individuals was detected the presence of bacteria and in 43.6% (n = 40 was not found any specific etiologic factor. Was performed chi-square statistical test of clinical manifestations and factors such as stress and anxiety, leading to positive correlation. It became evident that the risk factors for disease are diverse, including the use of drugs, alcoholism, eating quickly, talking during meals, with significant relation to abdominal distension and reflux. The patients with the bacteria, had a higher risk of experiencing these symptoms. CONCLUSION - Various etiological factors in eating habits and lifestyle, as smoking, alcoholism, anxiety, stress, associated diseases and inadequate

  8. Implementation of severe accident management measures - Summary and conclusions

    International Nuclear Information System (INIS)

    2002-01-01

    implemented in various ways in many plants, but not yet in all plants. A systematic approach, which is based upon a clearly defined decision-making process, is one of the features implemented in many cases. Available means are determined and priorities are set. This approach is made up of strategies intended to become an optimum approach to prevent or mitigate the consequences of beyond-design basis accidents. It is based upon a prepared information package about plant-specific behaviour to be expected in beyond design scenarios. The approaches followed in the different countries do not fit one single pattern. Harmonization, to the extent it is desirable, does not seem feasible at this stage. As a rule, the responsibility of the plant owner for the safety of his plant remains untouched. Also, safety goals may vary between countries. This report presents the general conclusion and recommendations of the workshop and the summaries of the sessions

  9. A qualitative study examining the presence and consequences of moral framings in patients' and mental health workers' experiences of community treatment orders.

    Science.gov (United States)

    Lawn, Sharon; Delany, Toni; Pulvirenti, Mariastella; Smith, Ann; McMillan, John

    2015-11-06

    Mental health recovery involves acknowledging the importance of building the person's capacity for agency. This might be particularly important for patients on community treatment orders (CTOs - which involve enforced treatment for their mental illness), given limited international evidence for their effectiveness and underlying concerns about the use of coercion by workers and systems of care towards this population of people with mental illness. This study sought to understand how the meaning of CTOs is constructed and experienced, from the perspective of patients on CTOs and workers directly administering CTOs. Qualitative interviews were conducted with South Australian community mental health patients (n = 8) and mental health workers (n = 10) in 2013-14. During thematic analysis of data, assisted by NVIVO software, the researchers were struck by the language used by both groups of participants and so undertook an examination of the moral framings apparent within the data. Moral framing was apparent in participants' constructions and evaluations of the CTO experience as positive, negative or justifiable. Most patient participants appeared to use moral framing to: try to understand why they were placed on a CTO; make sense of the experience of being on a CTO; and convey the lessons they have learnt. Worker participants appeared to use moral framing to justify the imposition of care. Empathy was part of this, as was patients' positive right to services and treatment, which they believed would only occur for these patients via a CTO. Workers positioned themselves as trying to put themselves in the patients' shoes as a way of acting virtuously towards them, softening the coercive stick approach. Four themes were identified: explicit moral framing; best interests of the patient; lessons learned by the patient; and, empathy. Experiences of CTOs are multi-layered, and depend critically upon empathy and reflection on the relationship between what is done and

  10. CSNI/NEA Rasplav seminar 2000. Summary and conclusions

    International Nuclear Information System (INIS)

    2001-01-01

    various boundary conditions were investigated. The work involved a combination of integral and separate effect tests including molten-salt tests to investigate non-eutectic mixtures and the effects of stratification, extension of the material property database to allow interpretation and modelling of the experimental data. The CSNI decided to hold a seminar where the major outcome of the RASPLAV Project could be presented and discussed also in the context of other experienced activities on Severe Accidents. The objectives of the seminar are: - to review the experimental results of the RASPLAV Project; - to exchange information on complementary research; - to discuss the progress made on understanding severe accident progression; - to discuss the applicability to nuclear power plants and use of the results. The Seminar was intended to provide an in-depth review of the RASPLAV Project in terms of the technical capabilities, results and analyses produced during the project execution. The application of the results and their significance for power plant applications were addressed. Relevant results of the complementary research carried out at various laboratories were also presented. The seminar consisted of five sessions organised as follows: - Opening and overview; - Experimental results; - Theoretical Analyses; - Application and complementary research; - Conclusion

  11. CSNI/NEA Rasplav seminar 2000. Summary and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-01-15

    various boundary conditions were investigated. The work involved a combination of integral and separate effect tests including molten-salt tests to investigate non-eutectic mixtures and the effects of stratification, extension of the material property database to allow interpretation and modelling of the experimental data. The CSNI decided to hold a seminar where the major outcome of the RASPLAV Project could be presented and discussed also in the context of other experienced activities on Severe Accidents. The objectives of the seminar are: - to review the experimental results of the RASPLAV Project; - to exchange information on complementary research; - to discuss the progress made on understanding severe accident progression; - to discuss the applicability to nuclear power plants and use of the results. The Seminar was intended to provide an in-depth review of the RASPLAV Project in terms of the technical capabilities, results and analyses produced during the project execution. The application of the results and their significance for power plant applications were addressed. Relevant results of the complementary research carried out at various laboratories were also presented. The seminar consisted of five sessions organised as follows: - Opening and overview; - Experimental results; - Theoretical Analyses; - Application and complementary research; - Conclusion.

  12. Funding source, conflict of interest and positive conclusions in neuro-oncology clinical trials.

    Science.gov (United States)

    Moraes, Fabio Y; Mendez, Lucas C; Taunk, Neil K; Raman, Srinivas; Suh, John H; Souhami, Luis; Slotman, Ben; Weltman, Eduardo; Spratt, Daniel E; Berlin, Alejandro; Marta, Gustavo N

    2018-02-01

    We aimed to test any association between authors' conclusions and self-reported COI or funding sources in central nervous system (CNS) studies. A review was performed for CNS malignancy clinical trials published in the last 5 years. Two investigators independently classified study conclusions according to authors' endorsement of the experimental therapy. Statistical models were used to test for associations between positive conclusions and trials characteristics. From February 2010 to February 2015, 1256 articles were retrieved; 319 were considered eligible trials. Positive conclusions were reported in 56.8% of trials with industry-only, 55.6% with academia-only, 44.1% with academia and industry, 77.8% with none, and 76.4% with not described funding source (p = 0.011). Positive conclusions were reported in 60.4% of trials with unrelated COI, 60% with related COI, and 60% with no COI reported (p = 0.997). Factors that were significantly associated with the presence of positive conclusion included trials design (phase 1) [OR 11.64 (95 CI 4.66-29.09), p source [OR 2.45 (95 CI 1.22-5.22), p = 0.011]. In a multivariable regression model, all these factors remained significantly associated with trial's positive conclusion. Funding source and self-reported COI did not appear to influence the CNS trials conclusion. Funding source information and COI disclosure were under-reported in 14.1 and 17.2% of the CNS trials. Continued efforts are needed to increase rates of both COI and funding source reporting.

  13. Medical irradiation of children. Beware of too fast conclusion; Irradiation medicale de l'enfant. Attention aux conclusions hatives

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, H. [Institut Curie, Dept. d' Imagerie, 75 - Paris (France); Sirinelli, D. [Hopital Clocheville, Service de Radiologie et Echographie, 37 - Tours (France); Adamsbaum, C. [Hopital Saint-Vincent-de-Paul, Service de Radiologie, 75 - Paris (France); Chateil, J.F. [Hopital Pellegrin, Unite de Radiopediatrie, 33 - Bordeaux (France); Claudon, M. [Centre Hospitalier Universitaire Nancy-Hopital Brabois Enfants, Service de Radiologie, 54 - Vandoeuvre-les-Nancy (France); Geoffray, A. [Fondation Lenval, Service de Radiologie, 06 - Nice (France); Petit, P. [Hopital de la Timone, Service de Radiologie, 13 - Marseille (France); Rausin, L. [Centre Hospitalier Regional de la Citadelle, Service de Radiologie, Liege (Belgium); Panuel, M. [Hopital Nord, Service de Radiologie, 13 - Marseille (France)

    2004-10-01

    The publication in january 2004 in the British medical journal of the article of P. Hall and coll. 'Effect of low doses of ionizing irradiation in infancy on cognitive function in adulthood: Swedish population based cohort study, has been noticed by the Radiation protection group of the French speaking society of pediatrics imaging. The authors evaluate the psycho-motor development of less eighteen months years old children and irradiated between 1930 and 1959 for a face angioma. They study for each dose of irradiation ( from 0 to 250 m Gy) the level of school attendance and their results to the psycho-motor tests made during conscription medical examination. They noticed a diminution of 50% of the access success rate to university for the children having received an irradiation dose of 250 mG. No effect is noticed under the irradiation dose of 100 mGy. In their conclusions the authors compare these irradiation doses to these ones delivered in brain scanner examination. These results seem overestimated compared with the work made on fetuses ( publication 84 of ICRP) then the fetus is considered as more sensitive to ionizing radiations than the infant. The dose of 120 mGy is found in the literature and now the dose delivered in pediatrics are in the area of 0 and 100 mGy where no effect has been revealed in the cohort of irradiated children. The article does not include the principle of justification that is used nowadays and the replacement by the trans fontanel echography has allowed to reduce the number of brain scanner, used only for limited cases where the benefit is superior the the risk of irradiation. (N.C.)

  14. The application of cure models in the presence of competing risks: a tool for improved risk communication in population-based cancer patient survival.

    Science.gov (United States)

    Eloranta, Sandra; Lambert, Paul C; Andersson, Therese M-L; Björkholm, Magnus; Dickman, Paul W

    2014-09-01

    Quantifying cancer patient survival from the perspective of cure is clinically relevant. However, most cure models estimate cure assuming no competing causes of death. We use a relative survival framework to demonstrate how flexible parametric cure models can be used in combination with competing-risks theory to incorporate noncancer deaths. Under a model that incorporates statistical cure, we present the probabilities that cancer patients (1) have died from their cancer, (2) have died from other causes, (3) will eventually die from their cancer, or (4) will eventually die from other causes, all as a function of time since diagnosis. We further demonstrate how conditional probabilities can be used to update the prognosis among survivors (eg, at 1 or 5 years after diagnosis) by summarizing the proportion of patients who will not die from their cancer. The proposed method is applied to Swedish population-based data for persons diagnosed with melanoma, colon cancer, or acute myeloid leukemia between 1973 and 2007.

  15. Debris impact on emergency coolant recirculation - summary and conclusions

    International Nuclear Information System (INIS)

    Jain, Bhagwat; Hsia, Anthony; Armand, Yves; Mattei, Jean-Marie; Hyvaerinen, Juhani; Maqua, Michael; Puetter, Bernhard; Sandervaag, Oddbjoern; Vandewalle, Andre; Tombuyses, Beatrice; Pyy, Pekka; Royen, Jacques

    2004-01-01

    to two orders of magnitude because of strainer clogging. Consequently, the CSNI decided to continue its previous efforts in the area. The overall purpose of the 2004 Workshop was to discuss the impact of new information made available since 1996 and to promote consensus among member countries on identification of remaining technical issues important to safety, and on possible paths for their resolution. The specific purposes of the Workshop were: a. To review the knowledge base and in particular information developed after 1999, and to consider the validity of the conclusions drawn. b. To exchange information on the current status of research related to debris generation, debris transportation, and sump strainer clogging and penetration phenomena, in particular for PWRs, and to assess uncertainties. c. To exchange and disseminate information on recent and current activities and practices in these areas. d. To identify and discuss differences between approaches relevant to reactor safety. e. To identify technical issues and programs of interest for international collaborative research and develop an Action Plan outlining activities that CSNI should undertake in the area of strainer or sump screen clogging during the next few years. Summary of the main findings: a. The safety significance of the sump strainer clogging depends on the plant design (e.g. sump strainer, ECCS) and backfitting measures performed. b. The following are examples of PWR design features that could influence the debris impact on the ECCS sump performance: - Type of insulation (material, combination of materials, protection). - Break size to be postulated. - Transport in containment with or without containment spray system (CSS). - Degree of turbulence and flow velocities in the sump influenced by CSS, water level, break flow location and sump geometry. - Redundancy of sumps and residual heat removal system (RHRS). - Strainer design (area, mesh size). - Positioning of recirculation pumps and vortex

  16. The Alaska earthquake, March 27, 1964: lessons and conclusions

    Science.gov (United States)

    Eckel, Edwin B.

    1970-01-01

    local waves. Better earthquake-hazard maps, based on improved knowledge of regional geology, fault behavior, and earthquake mechanisms, are needed for the entire country. Their preparation will require the close collaboration of engineers, seismologists, and geologists. Geologic maps of all inhabited places in earthquake-prone parts of the country are also needed by city planners and others, because the direct relationship between local geology and potential earthquake damage is now well understood. Improved and enlarged nets of earthquake-sensing instruments, sited in relation to known geology, are needed, as are many more geodetic and hydrographic measurements. Every large earthquake, wherever located, should be regarded as a full-scale laboratory experiment whose study can give scientific and engineering information unobtainable from any other source. Plans must be made before the event to insure staffing, funding, and coordination of effort for the scientific and engineering study of future earthquakes. Advice of earth scientists and engineers should be used in the decision-making processes involved in reconstruction after any future disastrous earthquake, as was done after the Alaska earthquake. The volume closes with a selected bibliography and a comprehensive index to the entire series of U.S. Geological Survey Professional Papers 541-546. This is the last in a series of six reports that the U.S. Geological Survey published on the results of a comprehensive geologic study that began, as a reconnaissance survey, within 24 hours after the March 27, 1964, Magnitude 9.2 Great Alaska Earthquake and extended, as detailed investigations, through several field seasons. The 1964 Great Alaska earthquake was the largest earthquake in the U.S. since 1700. Professional Paper 546, in 1 part, describes Lessons and Conclusions.

  17. A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients.

    Science.gov (United States)

    Sheng, Chew Keng; Lim, Chee Kean; Rashidi, Ahmad

    2010-08-21

    The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied. We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation. Using a bilingual questionnaire (in Malay and English language), we asked our respondents about their attitudes towards allowing family presence (FP) as well as their actual experience of requests from families to be allowed to witness resuscitations. Multiple logistic regression was used to analyze the association between the many variables and a positive attitude towards FP. Out of 300 health care professionals who received forms, 270 responded (a 90% response rate). Generally only 15.8% of our respondents agreed to allow relatives to witness resuscitations, although more than twice the number (38.5%) agreed that relatives do have a right to be around during resuscitation. Health care providers are significantly more likely to allow FP if the procedures are perceived as likely to be successful (e.g., intravenous cannulation and blood taking as compared to chest tube insertion). Doctors were more than twice as likely as paramedics to agree to FP (p-value = 0.002). This is probably due to the Malaysian work culture in our health care systems in which paramedics usually adopt a 'follow-the-leader' attitude in their daily practice. The concept of allowing FP is not well accepted among our Malaysian health care providers.

  18. Altered structural network architecture is predictive of the presence of psychotic symptoms in patients with 22q11.2 deletion syndrome

    Directory of Open Access Journals (Sweden)

    Maria C. Padula

    2017-01-01

    Our results point to alterations in structural network architecture and white matter microstructure in patients with 22q11DS with attenuated positive symptoms, mainly involving connections of the limbic system. These alterations may therefore represent a potential biomarker for an increased risk of psychosis that should be further tested in longitudinal studies.

  19. A novel method for the detection of antibodies to adalimumab in the presence of drug reveals "hidden" immunogenicity in rheumatoid arthritis patients

    NARCIS (Netherlands)

    van Schouwenburg, Pauline A.; Bartelds, Geertje M.; Hart, Margreet H.; Aarden, Lucien; Wolbink, Gerrit Jan; Wouters, Diana

    2010-01-01

    Production of anti drug antibodies (ADA) in adalimumab treated RA patients is associated with reduced serum adalimumab levels and less clinical response. However, most current assays to measure ADA are unable to detect ADA in complex with adalimumab. Thus, ADA is only measured if antibody production

  20. Time to initial antibiotic administration, and short-term mortality among patients admitted with community-acquired severe infections with and without the presence of systemic inflammatory response syndrome

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Laursen, Christian B; Hallas, Jesper

    2015-01-01

    (SIRS) at arrival, and to ascertain whether the presence of SIRS might affect the timing of antibiotic administration. METHODS: In this retrospective follow-up study, we included all adult patients (≥15 years) presenting to a medical emergency department in the period between September 2010 and August...... Medicine (ACCP/SCCM) definitions. Cases were identified by manual chart review using predefined criteria of infection. Data on vital signs, laboratory values and antibiotic treatment were obtained electronically. RESULTS: We included 1169 patients with infection and organ dysfunction, treated...

  1. Family presence at resuscitation attempts.

    Science.gov (United States)

    Jaques, Helen

    UK resuscitation guidelines suggest that parents and carers should be allowed to be present during a resuscitation attempt in hospital but no guidance is available regarding family presence when resuscitation takes place out of hospital. A new research study has suggested that relatives who were offered the opportunity to witness resuscitation were less likely to develop symptoms of post-traumatic stress disorder than those who were not given the chance. This article summarises the results of this study and provides an expert commentary on its conclusions.

  2. Urinary creatinine concentration is inversely related to glycaemic control and the presence of some diabetic complications in patients with newly diagnosed Type 2 diabetes

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Andreasen, Anne H; Vestbo, Else

    2006-01-01

    BACKGROUND: The ratio between urinary albumin concentration (UAC) and urinary creatinine concentration (UCC) is widely used to estimate renal involvement. We examined how UAC and UCC associate with each other, with other risk factors, and with diabetic complications in a population-based sample...... of Type 2 diabetic patients. METHODS: A freshly voided morning urine specimen was provided by 1,284 consecutive, newly diagnosed diabetic patients aged 40 years or over in general practice. Albumin was measured by a polyethyleneglycol radioimmunoassay and creatinine by a modified Jaffe method. RESULTS......: In a multivariate model including UAC, UCC, age, sex, HbA1c, and urinary glucose concentration, UAC increased with both age (P=.042) and HbA1c (P=.014), while UCC decreased (Phigh resting heart...

  3. "Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients.

    Science.gov (United States)

    Pijuan-Domenech, Antonia; Pineda, Victor; Castro, Miguel Angel; Sureda-Barbosa, Carlos; Ribera, Aida; Cruz, Luz M; Ferreira-Gonzalez, Ignacio; Dos-Subirà, Laura; Subirana-Domènech, Teresa; Garcia-Dorado, David; Casaldàliga-Ferrer, Jaume

    2014-11-15

    Pulmonary valve replacement (PVR) reduces right ventricular (RV) volumes in the setting of long-term pulmonary regurgitation after Tetralogy of Fallot (ToF) repair; however, little is known of its effect on RV diastolic function. Right atrial volumes may reflect the burden of RV diastolic dysfunction. The objective of this paper is to evaluate the clinical, echocardiographic, biochemical and cardiac magnetic resonance (CMR) variables, focusing particularly on right atrial response and right ventricular diastolic function prior to and after elective PVR in adult patients with ToF. This prospective study was conducted from January 2009 to April 2013 in consecutive patients > 18 years of age who had undergone ToF repair in childhood and were accepted for elective PVR. Twenty patients (mean age: 35 years; 70% men) agreed to enter the study. PVR was performed with a bioporcine prosthesis. Concomitant RV reduction was performed in all cases when technically possible. Pulmonary end-diastolic forward flow (EDFF) decreased significantly from 5.4 ml/m(2) to 0.3 ml/m(2) (p volumes by 25% (p = 0.0024): mean indexed diastolic/systolic atrial volumes prior to surgery were 43 ml/m(2) (SD+/-4.6)/63 ml/m(2) (SD+/-5.5), and dropped to 33 ml/m(2) (SD+/-3)/46 ml/m(2) (SD+/-2.55) post-surgery. All patients presented right ventricular diastolic and systolic volume reductions, with a mean volume reduction of 35% (p volumes in keeping with the known reduction in RV volumes, after PVR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Presence of S100A9-positive inflammatory cells in cancer tissues correlates with an early stage cancer and a better prognosis in patients with gastric cancer

    International Nuclear Information System (INIS)

    Fan, Biao; Li, Ying-Ai; Du, Hong; Zhao, Wei; Niu, Zhao-Jian; Lu, Ai-Ping; Li, Ji-You; Ji, Jia-Fu; Zhang, Lian-Hai; Jia, Yong-ning; Zhong, Xi-Yao; Liu, Yi-Qiang; Cheng, Xiao-Jing; Wang, Xiao-Hong; Xing, Xiao-Fang; Hu, Ying

    2012-01-01

    S100A9 was originally discovered as a factor secreted by inflammatory cells. Recently, S100A9 was found to be associated with several human malignancies. The purpose of this study is to investigate S100A9 expression in gastric cancer and explore its role in cancer progression. S100A9 expression in gastric tissue samples from 177 gastric cancer patients was assessed by immunohistochemistry. The expression of its dimerization partner S100A8 and the S100A8/A9 heterodimer were also assessed by the same method. The effect of exogenous S100A9 on motility of gastric cancer cells AGS and BGC-823 was then investigated. S100A9 was specifically expressed by inflammatory cells such as macrophages and neutrophils in human gastric cancer and gastritis tissues. Statistical analysis showed that a high S100A9 cell count (> = 200) per 200x magnification microscopic field in cancer tissues was predictive of early stage gastric cancer. High S100A9-positive cell count was negatively correlated with lymph node metastasis (P = 0.009) and tumor invasion (P = 0.011). S100A9 was identified as an independent prognostic predictor of overall survival of patients with gastric cancer (P = 0.04). Patients with high S100A9 cell count were with favorable prognosis (P = 0.021). Further investigation found that S100A8 distribution in human gastric cancer tissues was similar to S100A9. However, the number of S100A8-positive cells did not positively correlate with patient survival. The inflammatory cells infiltrating cancer were S100A8/A9 negative, while those in gastritis were positive. Furthermore, exogenous S100A9 protein inhibited migration and invasion of gastric cancer cells. Our results suggested S100A9-positive inflammatory cells in gastric cancer tissues are associated with early stage of gastric cancer and good prognosis

  5. Presence of Mycobacterium leprae DNA and PGL-1 antigen in household contacts of leprosy patients from a hyperendemic area in Brazil.

    Science.gov (United States)

    Pinho, J D; Rivas, P M S; Mendes, M B P; Soares, R E P; Costa, G C; Nascimento, F R F; Paiva, M F L; Aquino, D M C; Figueireido, I A; Santos, A M; Pereira, S R F

    2015-11-19

    Leprosy is a highly infectious disease endemic to underdeveloped countries. In Maranhão State, Northeastern Brazil, the hyperendemic rate of 56.11 cases/100,000 inhabitants increased the necessity of better understanding the epidemiological profile of this population, particularly regarding efficient methods for evaluating individuals residing with diagnosed patients to understand disease transmission and the risk of infection. In this study, we examined the percentage of contacts with positive indices for Mycobacterium leprae DNA and phenol-glycolipid-1 antigen (PGL-1). PGL-1 was analyzed by an enzyme-linked immunosorbent assay, the ML-Flow test, and polymerase chain reaction of oral and nasal secretions of 808 leprosy contacts from Maranhão. PGL-1 was detected in 14.0% of patients and differed by operational classification of the index case (P leprae DNA in 5.6% of oral samples and 4.6% of nasal tissues, and 87% of subjects resided with high bacillary load patients. This study reinforces the efficacy of combining molecular and serological techniques to identify potential bacillus carriers in the asymptomatic stage of infection, such as in household contacts, highlighting the importance of these meth-ods for monitoring hyperendemic populations.

  6. Survey of gastrointestinal reactions to foods in adults in relation to atopy, presence of mucus in the stools, swelling of joints and arthralgia in patients with gastrointestinal reactions to foods.

    Science.gov (United States)

    Bengtsson, U; Hanson, L A; Ahlstedt, S

    1996-12-01

    Food intolerance in adults is mostly associated with vague symptoms and not clearly related to atopy and food allergy. A combination of different pathogenetic mechanisms may be responsible for the symptoms. The aim of this study was to describe patients with a history of food-related gastrointestinal symptoms in relation to the presence of mucus in the stools, joint swelling and arthralgia and to determine whether or not there is an association between the presence of these parameters, atopic disease and the presence of immune complexes in serum. Fifty-eight patients consecutively referred to our clinic with food-related gastrointestinal symptoms were investigated. Thirty-five patients (60%) had mucus in their stools, 24 patients (41%) complained about joint swelling and 41 patients (71%) had arthralgia. There were no correlations between these parameters and atopy according to Phadiatope test or skin prick test (SPT). No correlations were found between the occurrence of mucus in the stools, arthralgia and joint swelling. There were significantly higher levels of circulating immune complexes in patients with a history of arthralgia compared with patients with no such history (P mucus in the stools. However, there were significant positive correlations between food-related gastrointestinal symptoms in the following instances: chocolate-induced gastrointestinal symptoms and mucus in the stools (P = 0.006), vegetable-induced gastrointestinal symptoms and mucus in the stools (P = 0.002) and meat-induced gastrointestinal symptoms and mucus in the stools (P = 0.003). In a group of individuals without food-related symptoms investigated separately, a very low frequency of mucus in the stools, joint swelling and arthralgia was seen (none, two and three individuals of the 20 subjects, respectively). Of 41 patients with immediate onset of gastrointestinal symptoms, 20 were atopic according to Phadiatope and SPT. Of 11 patients with late onset of symptoms 10 were negative in

  7. The MMP-9 -1562 C/T polymorphism in the presence of metabolic syndrome increases the risk of clinical events in patients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Trine B Opstad

    Full Text Available Elevated levels of matrix metalloproteinase (MMP-9 have been associated with the metabolic syndrome (MetS and cardiovascular events. The MMP-9 -1562 C/T polymorphism has furthermore been shown as a risk factor for coronary artery disease (CAD. The non-favourable cardiometabolic state in MetS may increase the risk. We aimed to investigate the influence of MMP-9 -1562 C/T polymorphism in subjects with CAD and MetS.Patients (n = 1000 with verified CAD stratified in Mets +/- (n = 244/756, were analyzed for the MMP-9 -1562 C/T polymorphism and related to clinical events after 2 years follow-up. Serum levels of total MMP-9 and tissue inhibitor of matrix metalloproteinases (TIMP-1 were analyzed in all, whereas MMP-9 activity, extracellular matrix metalloproteinase inducer (EMMPRIN, and expression of the two genes were analyzed in a subset of 240 randomly selected patients.Totally, 106 clinical endpoints were recorded. In MetS; the T-allele associated with 5.5 fold increase in event rate (p<0.0001, increased with number of MetS components, a 117% increase in total MMP-9 levels (TT homozygous, p = 0.05, significantly higher total- and endogenous active MMP-9 and TIMP-1 levels (p<0.01 all, and EMMPRIN was inversely correlated with pro- and endogenous active MMP-9 (p<0.05, both. In non-MetS; the T-allele was not associated with new events, nor higher MMP-9 levels. EMMPRIN was significantly correlated with total MMP-9 and TIMP-1 (p<0.01, both and the two genes were inter-correlated (p<0.001.In CAD patients with MetS, the MMP-9 T-allele increased the risk of clinical events, probably mediated through elevated MMP-9 levels and altered MMP-9 regulation.

  8. Long term presence of a single predominant tyrosinase-specific T-cell clone associated with disease control in a patient with metastatic melanoma.

    Science.gov (United States)

    Ochsenreither, Sebastian; Fusi, Alberto; Busse, Antonia; Letsch, Anne; Haase, Doreen; Thiel, Eckhard; Scheibenbogen, Carmen; Keilholz, Ulrich

    2010-05-15

    In an earlier study, we described a patient who developed an anti-tyrosinase T-cell response leading to long-term tumor control. Here we analyzed this response with regard to T-cell receptor (TCR) Vbeta family usage and clonality in order to further elucidate the nature of the T cell response in this patient. For identification of expanded specific cytotoxic T-cell (CTL) clones, tetramer enrichment of tyrosinase reactive T-cells was followed by comparative quantitative reverse transcribed PCR (qRT PCR) quantification of all TCR Vbeta-families and sequencing of family Vbeta4 elevated in the enriched fraction. The predominant specific clone was quantified by clonotypic qRT PCR in multiple samples from blood, bone marrow, and tumor tissue. FACS analyses with staining of TYR.A2 and TCR Vbeta4 were performed. Epitope specific enrichment revealed an isolated increase of Vbeta-family 4. FACS analysis showed a shift of specific CTLs to Vbeta-family 4 during tumor regression with a maximum of 80% of all TYR.A2 specific cells belonging to this family. Sequencing revealed a single predominant clone against polyclonal background coding for identical CDR3 loops. The predominant clone was highly expressed in bone marrow and tumor tissue, and was detectable in blood over a period of ten years. Considering the results of previous studies showing a specific effector phenotype in blood and a specific memory compartment in bone marrow of this patient, this data implicate the predominant clone featured all attributes of a sufficient CTL response including homing capacity and memory formation resulting in long term clonal persistence and tumor control.

  9. Presence While Watching Movies

    Directory of Open Access Journals (Sweden)

    Tom Troscianko

    2011-05-01

    Full Text Available “Presence” is the illusion of being in a mediated experience rather than simply being an observer. It is a concept often applied to the question of realism of virtual environments. However, it is equally applicable to the act of watching a movie. A movie provides a markedly different visual environment to that given by the natural world—particularly because of frequent edits. And yet, the audience in a movie achieves high levels of presence. We investigate the relationship between presence and the optical and temporal parameters of movies. We find effects of mean shot length, colour/b&w, and 3D/2D. We find that short shots, while being unnatural, are associated with high levels of presence. We consider why such artificial stimuli should appear so real and immersive.

  10. Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis?

    Science.gov (United States)

    Fazal, Akil; Yoo, Andrew; Bendo, John A

    2013-08-01

    Recent research describes the use of a nerve root sedimentation sign to diagnose lumbar spinal stenosis (LSS). The lack of sedimentation of the nerve roots (positive sedimentation sign) to the dorsal part of the dural sac is the characteristic feature of this new radiological parameter. To demonstrate how the nerve root sedimentation sign compares with other more traditional radiological parameters in patients who have been operated for LSS. A retrospective chart and image review. Preoperative magnetic resonance images (MRIs) were reviewed from 71 consecutive operative patients who presented with LSS and received spinal decompression surgery from 2006 to 2010. Preoperative T2-weighted MRIs were reviewed for each patient. One hundred thirty-four vertebral levels from L1 to L5 were measured for: sedimentation sign, cross-sectional area (CSA) and anterior/posterior (A/P) diameter of the dural sac, thickness of the ligamentum flavum, and Fujiwara grade of facet hypertrophy. Radiological measurements were made using Surgimap 1.1.2.169 software (Nemaris, Inc., New York, NY, USA). Statistical analyses were performed using the SPSS 17.0 statistical software (SPSS Inc., Chicago, IL, USA). Significance was demonstrated using unpaired t tests and chi-squared tests. Study funding was departmental. There were no study-specific conflicts of interest-associated biases. A positive sedimentation sign was determined in 120 operated levels (89.5%), whereas 14 levels (10.5%) had no sign (negative sedimentation sign). The mean CSA and A/P diameter were 140.62 mm(2) (standard deviation [SD]=53) and 11.76 mm (SD=3), respectively, for the no-sign group; the mean CSA and A/P diameter were 81.87 mm(2) (SD=35) and 8.76 mm (SD=2.2), respectively, for the sedimentation sign group (p<.001). We found that 60% of levels with Fujiwara Grade A facet hypertrophy did not have a sedimentation sign, whereas 86.3% of levels with Grade B, 93.2% of levels with Grade C, and 100.0% of levels with Grade D

  11. Comparison of T stage, N stage, multifocality, and bilaterality in papillary thyroid carcinoma patients according to the presence of coexisting lymphocytic thyroiditis.

    Science.gov (United States)

    Park, Jin Young; Kim, Dong Wook; Park, Ha Kyung; Ha, Tae Kwun; Jung, Soo Jin; Kim, Do Hun; Bae, Sang Kyun

    2015-01-01

    This study aimed to assess the relationship between coexisting lymphocytic thyroiditis and T-N stages of papillary thyroid carcinoma (PTC) by histopathological analysis. The study included 653 patients who underwent thyroid surgery for PTC at our hospital. Each case was classified as either Hashimoto's thyroiditis (HT), non-Hashimoto type of lymphocytic thyroiditis (NHLT), or normal according to the histopathology of thyroid parenchyma. Patient age, gender, surgical modality, location, T stage, N stage, multifocality and bilaterality were compared according to the histopathology. The prevalence of coexisting lymphocytic thyroiditis was 25.8% (169/653); HT (7.5%, 49/653) and NHLT (18.3%, 120/653). There were no significant differences in T stage, N stage, multifocality and bilaterality with regard to coexisting lymphocytic thyroiditis, regardless of whether HT and NHLT were considered collectively or discretely. Primary tumor size (p thyroiditis did not differ from those with normal parenchyma in terms of T stage, N stage, multifocality and bilaterality.

  12. 5. Conclusion

    OpenAIRE

    Beerli, Monique Jo

    2013-01-01

    Attracted by conflict and war, starvation and disease, natural disasters and underdevelopment, discrimination and injustice, solidarity organizations and their supporters engage themselves in struggles for the acquisition of benefits that they themselves will not receive. In the absence of political solutions addressing the demands of a given people, non-state actors are capable of appropriating functions and responsibilities upon themselves which the state is unwilling or unable to perform. ...

  13. Conclusion conference

    International Nuclear Information System (INIS)

    Tubiana, M.

    1997-01-01

    Radioactive isotopes are the basis of spectacular advancements in biology, but also in medicine, not only indirectly with progress in disease and human body understanding, but also directly through nuclear medicine and radiotherapy. The important role of the Cea in the development of French radiotherapy, dosimetry and radioactive isotopes (especially cobalt) is reviewed

  14. Presence of pleural effusion is associated with a poor prognosis in patients with epidermal growth factor receptor-mutated lung cancer receiving tyrosine kinase inhibitors as first-line treatment.

    Science.gov (United States)

    Wang, Tso-Fu; Chu, Sung-Chao; Lee, Jen-Jyh; Yang, Gee-Gwo; Huang, Wei-Han; Chang, En-Ting; Low, Tissot; Wu, Yi-Feng; Kao, Ruey-Ho; Lin, Chih-Bin

    2017-08-01

    This study was conducted to evaluate the effect of clinical factors on the treatment outcomes of lung cancer patients with active epidermal growth factor receptor (EGFR) mutations treated by first-line tyrosine kinase inhibitors (TKIs). Patients of stage IIIb or IV lung adenocarcinoma harboring mutated EGFR were enrolled between March 2010 and June 2014 and followed up until December 2015. The effects of various clinical features, such as age, sex, smoking history, EGFR mutation types, TKIs used, presence of pleural effusion, metastatic sites on progression-free survival (PFS) and overall survival (OS), were analyzed retrospectively. A total of 104 patients were included in this study. Patients with pleural effusion at initial diagnosis had significantly shorter PFS and OS than those without pleural effusion (median PFS: 8.2 months vs 15.3 months, P = 0.0004; median OS: 16.3 months vs 28.2 months, P = 0.0003). Univariate analysis revealed that being male or a smoker was associated with short PFS, whereas smoking history, bony metastasis and malignant pleural effusion were associated with poor OS. Stepwise multivariate Cox regression analysis showed that the presence of pleural effusion and different TKI use were independent prognostic factors for PFS [hazard ratio [HR] = 2.50 (95% confidence interval [CI], 1.53-4.10), P = 0.0003 and HR = 0.55 (95% CI, 0.31-0.97), P = 0.0396, respectively], whereas the presence of pleural effusion and liver metastasis were associated with poor OS [HR = 2.79 (95% CI: 1.46-5.30), P = 0.0018 and HR = 2.12 (95% CI, 1.02-4.40), P = 0.0440, respectively]. The presence of pleural effusion predicts poor PFS and OS in lung adenocarcinoma patients receiving TKIs as the first-line treatment. Additional studies are warranted to elucidate the underlying mechanisms and determine novel strategies for improving the outcome of these patients. © 2017 John Wiley & Sons Australia, Ltd.

  15. Presence of post-systolic shortening is an independent predictor of heart failure in patients following ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Brainin, Philip; Haahr-Pedersen, Sune; Sengeløv, Morten

    2018-01-01

    echocardiography (STE) in six myocardial walls from all three apical projections. During a median follow-up period of 5.4 years (interquartile range, 4.1-6.0 years), 180 events occurred: 59 deaths, 70 heart failures (HF) and 51 new myocardial infarctions (MI). In multivariable analysis adjusting for: age, sex......Following an ischemic event post systolic shortening (PSS) may occur. We investigated the association between PSS in patients with ST-segment elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI) and occurrence of cardiovascular events at follow...... incrementally with increasing numbers of walls displaying PSS. The increased risk of HF was confirmed when assessing the post-systolic index by STE (HR 1.29 95% CI 1.09-1.53, P = 0.003, per 1% increase). A regional analysis showed that PSS by TDI in the septal wall was the strongest predictor of HF (HR 1.77, 95...

  16. PresenceRemote

    DEFF Research Database (Denmark)

    Sokoler, Tomas; Svensson, Marcus Sanchez

    2008-01-01

    how these technologies can accommodate the specific challenges related to the everyday life of elderly people. In particular, using an example concept – the PresenceRemote – we will discuss how the stigma associated with being lonely, an inherent part of senior living, can be addressed by leaving room...

  17. The presence of ADHD

    DEFF Research Database (Denmark)

    Breining, Sanni Nørgaard

    2014-01-01

    This paper uses high quality register-data to study the spillover effects on firstborns from having a younger sibling suffering from ADHD. Using OLS and cousin fixed effects analyses it is found that the educational outcomes of healthy firstborn children are significantly reduced by the presence...

  18. Connected media and presence

    NARCIS (Netherlands)

    Kort, J.; Nefs, H.T.; Gullström, C.; Greef, T.J. de; Parnes, P.

    2013-01-01

    Effective design of shared mediated spaces, information and connectedness requires theory and practice from a range of disciplines such as found in European projects like Together Anywhere, Together Anytime (TA2) and the EIT ICT Labs Mediating Presence activity. Building on this work we continue to

  19. A Longitudinal Study of the Presence of Dental Anomalies in the Primary and Permanent Dentitions of Cleft Lip and/or Palate Patients.

    Science.gov (United States)

    Suzuki, Akira; Nakano, Masayuki; Yoshizaki, Keigo; Yasunaga, Atsushi; Haruyama, Naoto; Takahashi, Ichiro

    2017-05-01

      The aim is to survey primary and permanent dental anomalies: hypodontia, microdontia, a supernumerary tooth, and fused teeth in patients with cleft lip and/or palate.   Retrospective longitudinal study Subjects :  The subjects were selected from all 1724 patients with cleft lip and/or palate who were registered at the orthodontic clinic of Kyushu University Hospital, Fukuoka, Japan, from 1970 to 2009. Finally, 994 subjects were evaluated for primary dentition, 1352 for permanent dentition, and 871 for the longitudinal changes from primary to permanent dentition.   The prevalence of dental anomalies was compared for each tooth type, among various cleft types, between males and females, and between the alveolar cleft area and the noncleft area.   The prevalence of hypodontia was 16.2% for primary dentition and 52.7% for permanent dentition in the subjects with cleft lip and/or palate. Hypodontia increased with the severity of the cleft type. Multiple hypodontia was found more frequently in the subjects with bilateral cleft lip and palate and the subjects with unilateral cleft lip and palate. Microformed lateral incisors were found in 22.7% of permanent lateral incisors but not in primary dentition. Supernumerary teeth were found in 17.7% of the subjects with cleft lip and/or palate for primary maxillary dentition and in 5.7% for permanent maxillary dentition.   The prevalence of hypodontia was greater in permanent dentition than in primary dentition; although, it was not much different between males and females or between the right and left sides. The prevalence of dental anomalies was significantly different among four groups by cleft type: cleft lip, cleft lip and alveolus, cleft lip and palate, and cleft palate.

  20. Presence of human papilloma virus, herpes simplex virus and Epstein-Barr virus DNA in oral biopsies from Sudanese patients with regard to toombak use.

    Science.gov (United States)

    Jalouli, Jamshid; Ibrahim, Salah O; Sapkota, Dipak; Jalouli, Miranda M; Vasstrand, Endre N; Hirsch, Jan M; Larsson, Per-Anders

    2010-09-01

    Using PCR/DNA sequencing, we investigated the prevalence of human papillomavirus (HPV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) DNA in brush biopsies obtained from 150 users of Sudanese snuff (toombak) and 25 non-users of toombak in formalin-fixed paraffin-embedded tissue samples obtained from 31 patients with oral dysplasias (25 toombak users and 6 non-users), and from 217 patients with oral cancers (145 toombak users and 72 non-users). In the brush tissue samples from toombak users, HPV was detected in 60 (40%), HSV in 44 (29%) and EBV in 97 (65%) of the samples. The corresponding figures for the 25 samples from non-users were 17 (68%) positive for HPV, 6 (24%) positive for HSV and 21 (84%) for EBV. The formalin-fixed samples with oral dysplasias were all negative for HPV. In the 145 oral cancer samples from toombak users, HPV was detected in 39 (27%), HSV in 15 (10%) and EBV in 53 (37%) of the samples. The corresponding figures for the samples from non-users were 15 (21%) positive for HPV, 5 (7%) for HSV and 16 (22%) for EBV. These findings illustrate that prevalence of HSV, HPV and EBV infections are common and may influence oral health and cancer development. It is not obvious that cancer risk is increased in infected toombak users. These observations warrant further studies involving toombak-associated oral lesions, to uncover the possible mechanisms of these viral infections in the development of oral cancer, and the influence of toombak on these viruses. © 2010 John Wiley & Sons A/S.

  1. Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort.

    Science.gov (United States)

    Moon, Su-Jin; Kang, Kwi Young; Kwok, Seung-Ki; Ju, Ji Hyeon; Hong, Yeon-Sik; Park, Sung-Hwan; Jeon, Chan Hong; Choi, Sang Tae; Song, Jung-Soo; Min, Jun-Ki

    2018-06-01

    The purpose of this study was to identify whether determinants of health-related quality of life (HRQoL) in middle-aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia. One hundred and fifty-two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36-Item Short Form (SF-36) and EuroQol EQ-5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI). The mean EQ-5D and physical and mental components of SF-36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF-36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K-PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia. Poor sleep quality is the common independent risk factor for poor HRQoL in both middle-aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  2. The presence of PAI-1 4G/5G and ACE DD genotypes increases the risk of early-stage AVF thrombosis in hemodialysis patients.

    Science.gov (United States)

    Güngör, Yahya; Kayataş, Mansur; Yıldız, Gürsel; Özdemir, Öztürk; Candan, Ferhan

    2011-01-01

    In this study, we investigated the relationship between early arteriovenous fistula (AVF) thrombosis with angiotensin-converting enzyme (ACE) gene and thrombophilic factor gene polymorphisms. Thirty-five patients who suffered from three or more fistula thrombosis episodes in the early period after AVF operation and 33 control patients with no history of thrombosis for at least 3 years were enrolled in this study. Factor V G1691A Leiden, factor V H1299R (R2), prothrombin G20210A, factor XIIIV34L, β-fibrinogen-455 G-A, glycoprotein IIIa L33P human platelet antigens (HPA-1), methylenetetrahydrofolate reductase C677T, and methylenetetrahydrofolate reductase A1298C gene polymorphisms were similar in both groups (p > 0.05). Plasminogen activator inhibitor 1 (PAI-1) 4G/5G genotype in the study group and 4G/4G genotype in the control group were significantly higher (p = 0.014). No significant difference was detected in terms of the 5G/5G genotype. With regard to the ACE gene polymorphism, the control group showed more ID genotype (19/33, 57.6%), whereas the study group showed more DD genotype (17/35, 48.6%). II genotype was similar in both groups (x(2) = 7.40, p = 0.025). The rate of ACE inhibitor-angiotensin II receptor blockers use was 5/35 in the study group (14.3%) and 5/33 in the control group (15.2%). Individuals with PAI-1 4G/5G genotype showed 5.03 times more risk of thrombosis when compared with 4G/4G and 5G/5G genotypes [p = 0.008, OR = 5.03, 95% confidence interval (1.44:17.64)]. Individuals with ACE DD genotype showed 4.25 times more risk of thrombosis when compared with II and ID [p = 0.008, OR = 4.25, 95% confidence interval (1.404:12.83)]. PAI-1 4G/5G and ACE DD genotypes are associated with increased risk for early AVF thrombosis.

  3. Permutation entropy based time series analysis: Equalities in the input signal can lead to false conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Zunino, Luciano, E-mail: lucianoz@ciop.unlp.edu.ar [Centro de Investigaciones Ópticas (CONICET La Plata – CIC), C.C. 3, 1897 Gonnet (Argentina); Departamento de Ciencias Básicas, Facultad de Ingeniería, Universidad Nacional de La Plata (UNLP), 1900 La Plata (Argentina); Olivares, Felipe, E-mail: olivaresfe@gmail.com [Instituto de Física, Pontificia Universidad Católica de Valparaíso (PUCV), 23-40025 Valparaíso (Chile); Scholkmann, Felix, E-mail: Felix.Scholkmann@gmail.com [Research Office for Complex Physical and Biological Systems (ROCoS), Mutschellenstr. 179, 8038 Zurich (Switzerland); Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich (Switzerland); Rosso, Osvaldo A., E-mail: oarosso@gmail.com [Instituto de Física, Universidade Federal de Alagoas (UFAL), BR 104 Norte km 97, 57072-970, Maceió, Alagoas (Brazil); Instituto Tecnológico de Buenos Aires (ITBA) and CONICET, C1106ACD, Av. Eduardo Madero 399, Ciudad Autónoma de Buenos Aires (Argentina); Complex Systems Group, Facultad de Ingeniería y Ciencias Aplicadas, Universidad de los Andes, Av. Mons. Álvaro del Portillo 12.455, Las Condes, Santiago (Chile)

    2017-06-15

    A symbolic encoding scheme, based on the ordinal relation between the amplitude of neighboring values of a given data sequence, should be implemented before estimating the permutation entropy. Consequently, equalities in the analyzed signal, i.e. repeated equal values, deserve special attention and treatment. In this work, we carefully study the effect that the presence of equalities has on permutation entropy estimated values when these ties are symbolized, as it is commonly done, according to their order of appearance. On the one hand, the analysis of computer-generated time series is initially developed to understand the incidence of repeated values on permutation entropy estimations in controlled scenarios. The presence of temporal correlations is erroneously concluded when true pseudorandom time series with low amplitude resolutions are considered. On the other hand, the analysis of real-world data is included to illustrate how the presence of a significant number of equal values can give rise to false conclusions regarding the underlying temporal structures in practical contexts. - Highlights: • Impact of repeated values in a signal when estimating permutation entropy is studied. • Numerical and experimental tests are included for characterizing this limitation. • Non-negligible temporal correlations can be spuriously concluded by repeated values. • Data digitized with low amplitude resolutions could be especially affected. • Analysis with shuffled realizations can help to overcome this limitation.

  4. Body: presence and transience

    Directory of Open Access Journals (Sweden)

    Marcelo Andrés Comandú

    2012-11-01

    Full Text Available We conceive presence as an event that takes place in the body and among the bodies. In the work of making themselves present, the performer creates a territory-body of habitability/inter-penetration of states, actions, thoughts, voices, sonorities; a body-space with multiple trajectories, withdrawn and projected from its own existence/subjectivity, extended in other matters and exposed to other odies/subjects/objects. We regard the performer’s body as an intense, outstretched, and expanded body. We deal with these categories from the standpoint of various practices and conceptualizations of body and event, in order to reflect on the constitution/construction of presence in performance.

  5. Capturing Online Presence

    DEFF Research Database (Denmark)

    de Bakker, Frank; Hellsten, Lina

    2013-01-01

    The rise of Internet-mediated communication poses possibilities and challenges for organisation studies, also in the area of corporate social responsibility (CSR) and business and society interactions. Although social media are attracting more and more attention in this domain, websites also remain...... an important channel for CSR debate. In this paper, we present an explorative study of activist groups’ online presence via their websites and propose a combination of methods to study both the structural positioning of websites (hyperlink network analysis) and the meanings in these websites (semantic co...... activist networks’ online presence can provide insights into the tactics these networks apply to achieve institutional change on CSR issues. Meanwhile, we identify some notable differences between styles and word use in the two organisations’ websites. We conclude with a set of suggestions for future...

  6. A fine-grained analysis of the jumping-to-conclusions bias in schizophrenia

    Directory of Open Access Journals (Sweden)

    Steffen Moritz

    2009-12-01

    Full Text Available Impaired decision behavior has been repeatedly observed in schizophrenia patients. We investigated several cognitive mechanisms that might contribute to the jumping-to-conclusions bias (JTC seen in schizophrenia patients: biases in information-gathering, information weighting and integration, and overconfidence, using the process tracing paradigm Mouselab. Mouselab allows for an in-depth exploration of various decision-making processes in a structured information environment. A total of 37 schizophrenia patients and 30 healthy controls participated in the experiment. Although showing less focused and systematic information search, schizophrenia patients practically considered all pieces of information and showed no JTC in the sense of collecting less pieces of evidence. Choices of patients and controls both approximated a rational solution quite well, but patients showed more extreme confidence ratings. Both groups mainly used weighted additive decision strategies for information integration and only a small proportion relied on simple heuristics. Under high stress induced by affective valence plus time pressure, however, schizophrenia patients switched to equal weighting strategies: less valid cues and more valid ones were weighted equally.

  7. Association of the Shared Epitope, Smoking and the Interaction Between the Two With the Presence of Autoantibodies (Anti-CCP and FR) in Patients With Rheumatoid Arthritis in a Hospital in Seville, Spain.

    Science.gov (United States)

    García de Veas Silva, José Luis; González Rodríguez, Concepción; Hernández Cruz, Blanca

    2017-11-01

    To evaluate the association of shared epitope, smoking and their interaction on the presence of autoantibodies (anti-cyclic citrullinated peptide [CCP] antibodies and rheumatoid factor) in patients with rheumatoid arthritis in our geographical area. A descriptive and cross-sectional study was carried out in a cohort of 106 patients diagnosed with RA. Odds ratios (OR) for antibody development were calculated for shared epitope, tobacco exposure and smoking dose. Statistical analysis was performed with univariate and multivariate statistics using ordinal logistic regression. Odds ratios were calculated with 95% confidence interval (95% CI) and a value of P20 packs/year) (OR=8.93; 95% CI: 1.95-40.82) were associated with the presence of anti-CCP antibodies. For rheumatoid factor, the association was only significant for tobacco exposure (OR=3.89; 95% CI: 1.06-14.28) and smoking dose (OR=8.33; 95% CI: 1.05-66.22). By ordinal logistic regression analysis, an association with high titers of anti-CCP (>200U/mL) was identified with South American mestizos, patients with homozygous shared epitope, positive FR and heavy smokers. Being a South American mestizo, having a shared epitope, rheumatoid factor positivity and a smoking dose>20 packs/year are independent risk factors for the development of rheumatoid arthritis with a high titer of anti-CCP (>200U/mL). In shared epitope-positive rheumatoid arthritis patients, the intensity of smoking is more strongly associated than tobacco exposure with an increased risk of positive anti-CCP. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  8. Presence of the gift

    Directory of Open Access Journals (Sweden)

    Game, Ann

    2010-01-01

    Full Text Available Philosophers, social theorists and cultural theorists have generally followed Mauss in assuming that gifts entail obligatory exchanges between distinct parties who give, receive and reciprocate, and, that the social emerges through this sequence of obligations. It is the obligation to reciprocate, for example, that led Derrida to claim that the gift is impossible. We consider the alternative ideas that non-exchange gifts are not only possible but the basis of social life: that the social arises from the nonsequential giving-and-receiving of a gift relation. To develop this claim, we draw on a research project on the phenomenology of teaching. While many interviewees, teachers and students, spoke of the gift in exchange terms, many also spoke of classroom experiences in which there is a giving and receiving that is neither sequential nor locatable. Through the resonances of the concept of presence, we draw out the time, space and ontology of the gift.

  9. Presence of the Gift

    Directory of Open Access Journals (Sweden)

    Ann Game

    2010-03-01

    Full Text Available Philosophers, social theorists and cultural theorists have generally followed Mauss in assuming that gifts entail obligatory exchanges between distinct parties who give, receive and reciprocate, and, that the social emerges through this sequence of obligations. It is the obligation to reciprocate, for example, that led Derrida to claim that the gift is impossible. We consider the alternative ideas that non-exchange gifts are not only possible but the basis of social life: that the social arises from the nonsequential giving-and-receiving of a gift relation. To develop this claim, we draw on a research project on the phenomenology of teaching. While many interviewees, teachers and students, spoke of the gift in exchange terms, many also spoke of classroom experiences in which there is a giving and receiving that is neither sequential nor locatable. Through the resonances of the concept of presence, we draw out the time, space and ontology of the gift.

  10. Presence in Virtual Reality Exposure Therapy Systems

    NARCIS (Netherlands)

    Ling, Y.

    2014-01-01

    Experiencing anxiety is essential for virtual reality exposure therapy (VRET) to be effective in curing patients suffering from anxiety disorders. However, some patients drop out in VRET due to the lack of feeling anxiety. Presence - which refers to the feeling of being in the virtual environment -

  11. The Relationship Between Serum Endocan Levels With the Presence of Slow Coronary Flow: A Cross-Sectional Study.

    Science.gov (United States)

    Kundi, Harun; Gok, Murat; Kiziltunc, Emrullah; Topcuoglu, Canan; Cetin, Mustafa; Cicekcioglu, Hulya; Ugurlu, Burcu; Ulusoy, Feridun Vasfi

    2017-07-01

    The aim of this study was to investigate the relationship between endocan levels with the presence of slow coronary flow (SCF). In this cross-sectional study, a total of 88 patients, who admitted to our hospital, were included in this study. Of these, 53 patients with SCF and 35 patients with normal coronary flow were included in the final analysis. Coronary flow rates of all patients were determined by the Timi Frame Count (TFC) method. In correlation analysis, endocan levels revealed a significantly positive correlation with high sensitive C-reactive protein and corrected TFC. In multivariate logistic regression analysis, the endocan levels were found as independently associated with the presence of SCF. Finally, using a cutoff level of 2.3, endocan level predicted the presence of SCF with a sensitivity of 77.2% and specificity of 75.2%. In conclusion, our study showed that higher endocan levels were significantly and independently related to the presence of SCF.

  12. [Whooping cough in an urban high school in Hungary. Conclusions of a local pertussis outbreak].

    Science.gov (United States)

    Schneider, Ferenc; Stánitz, Eva; Kalácska, Judit; Tompity, Tünde; Gábor, Beáta

    2009-08-16

    Although incidence of pertussis has been gradually decreased with the introduction of active immunization, total eradication is not possible. This has been shown by national and international data, as well. In the early 2000's, slow increase in incidence of pertussis was observed. To demonstrate the presence of Bordetella pertussis in the Hungarian population by presenting 17 cases of adolescent pertussis. Etiology of pertussis was confirmed by quantification of pertussis-antibodies in blood samples taken from permanently coughing patients in the firstly identified subject's vicinity which latter was explored by retrospective data collection. In the vicinity of the first identified patient epidemiologic research identified another 16 patients all of which were confirmed by serological tests. If permanent coughing is present, pertussis needs to be ruled out. Immunity against pertussis obtained by vaccination fades by the end of childhood. Bordetella pertussis circulates in the national population. A booster-vaccination against pertussis in the regular vaccination course for the 11-year old children is recommended. Pertussis in adolescents and in adults is mild and atypical, but in case of prolonged coughing it needs to be considered.

  13. Association of the positive results of the myocardial perfusion SPECT with 99mTc-MIBI, with the presence of Dyslipidemia in patient with 40 years or more age; Asociacion de los resultados positivos del SPECT de Perfusion Miocardica con 99mTc-MIBI, con la presencia de Dislipidemia en pacientes 40 annos de edad

    Energy Technology Data Exchange (ETDEWEB)

    Rochela Vazquez, Luis Manuel; Batista Cuellar, Juan F.; Romero Collado, Susana; Oviedo Perez, Lourdes; Penna Quian, Yamile; Hernandez Cairo, Abel, E-mail: rochela@infomed.sld.cu [Centro de Investigaciones Clinicas (C.I.C), La Habana (Cuba); Peix Gonzalez, Amalia [Instituto de Cardiologia y Cirugia Cardiovascular, La Habana (Cuba); Fernandez-Britto, Jose E. [Centro de Investigaciones, Referencia de Aterosclerosis (CIRAH) (Cuba)

    2012-07-01

    Know the association of the Dyslipidemia (DLP) with the positive results of the Myocardial Perfusion SPECT (MPSPECT), for the optimization of the use of this. MATERIAL AND METHOD: Analyze 152 MPSPECT, different day, age average: 58.32 years, 86(56.6%), were masculine. Alone differed by the presence of DLP, according to were divided in DLP, n=37(24.3%) and NDLP (Not-Dyslipidemia), n=115(75.7%), didn't present significant differences in the age average (59.59/57.90 p=0.284), body mass index (24.85/25.03, p=0.739), neither of the frequency of mature, therefore the additional risk alone contributes the DLP. RESULTS: 102(67.1%) MPSPECT were positive, in the comparison among groups was not observed significant difference in the incidence of positive results (67.60/67.00, p=0.945), which stayed when the groups were subdivided in symptomatic and asymptomatic CONCLUSION: The Dyslipidemia doesn't contribute significant risk of ischemic cardiopathy in patient in age of risk, therefore there is not significant association with positive results of the SPECTPM, in patient in age of risk. (author)

  14. No Conclusive Evidence for Transits of Proxima b in MOST Photometry

    Energy Technology Data Exchange (ETDEWEB)

    Kipping, David M.; Chen, Jingjing; Sandford, Emily [Department of Astronomy, Columbia University, 550 W. 120th Street, New York, NY 10027 (United States); Cameron, Chris [Department of Mathematics, Physics and Geology, Cape Breton University, 1250 Grand Lake Road, Sydney, NS B1P 6L2 (Canada); Hartman, Joel D.; Bakos, Gáspár Á.; Penev, Kaloyan; Csubry, Zoltan [Department of Astrophysical Sciences, 4 Ivy Lane, Princeton, NJ 08544 (United States); Davenport, James R. A. [Department of Physics and Astronomy, Western Washington University, 516 High Street, Bellingham, WA 98225 (United States); Matthews, Jaymie M. [Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1 (Canada); Sasselov, Dimitar [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Rowe, Jason [Observatoire Astronomque du Mont Mégantic, Départment de Physique, Université de Montréal C. P. 6128, Succursale, Centre-Ville, Montréal, QC H3C 3J7 (Canada); Siverd, Robert J. [Las Cumbres Observatory Global Telescope Network, 6740 Cortona Drive, Suite 102, Santa Barbara, CA 93117 (United States); Jordán, Andrés [Instituto de Astrofísica, Universidad Católica de Chile, Av. Vicuña Mackenna 4860, 7820436 Macul, Santiago (Chile); Bayliss, Daniel [Observatoire Astronomique de Universite de Genéve, 51 ch. des Maillettes, 1290 Versoix (Switzerland); Henning, Thomas; Mancini, Luigi [Max Plank Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); and others

    2017-03-01

    The analysis of Proxima Centauri’s radial velocities recently led Anglada-Escudé et al. to claim the presence of a low-mass planet orbiting the Sun’s nearest star once every 11.2 days. Although the a priori probability that Proxima b transits its parent star is just 1.5%, the potential impact of such a discovery would be considerable. Independent of recent radial velocity efforts, we observed Proxima Centauri for 12.5 days in 2014 and 31 days in 2015 with the Microwave and Oscillations of Stars space telescope. We report here that we cannot make a compelling case that Proxima b transits in our precise photometric time series. Imposing an informative prior on the period and phase, we do detect a candidate signal with the expected depth. However, perturbing the phase prior across 100 evenly spaced intervals reveals one strong false positive and one weaker instance. We estimate a false-positive rate of at least a few percent and a much higher false-negative rate of 20%–40%, likely caused by the very high flare rate of Proxima Centauri. Comparing our candidate signal to HATSouth ground-based photometry reveals that the signal is somewhat, but not conclusively, disfavored (1 σ –2 σ ), leading us to argue that the signal is most likely spurious. We expect that infrared photometric follow-up could more conclusively test the existence of this candidate signal, owing to the suppression of flare activity and the impressive infrared brightness of the parent star.

  15. Total Knee Arthroplasty for Knee Osteoarthritis: Support for a Foregone Conclusion?

    Science.gov (United States)

    Steinhaus, Michael E; Christ, Alexander B; Cross, Michael B

    2017-07-01

    Total knee arthroplasty (TKA) is generally accepted as the definitive treatment for advanced knee arthritis after patients fail nonoperative treatments; however, the safety and efficacy of TKA compared to continued nonoperative treatment has never been proven in high-quality, randomized controlled trials. Recently, a 2015 Danish study published a 12-month follow-up on a cohort of patients randomized to either a TKA or continued nonsurgical management for advanced knee osteoarthritis (OA). The authors reported significantly greater improvement in the TKA group in functional outcome scores such as the overall Knee Injury and Osteoarthritis Outcome Score (KOOS 4 score), the KOOS subscales, EQ-5D descriptive index, and timed get up-and-go and 20-m walk tests; however, patients in the TKA did suffer significantly more serious adverse events (SAE). The authors concluded that TKA combined with additional nonoperative care postoperatively is more efficacious than nonsurgical treatment alone in terms of improving pain, function, and quality of life at 12 months but is associated with more SAE. The purpose of this review is to identify the strengths and weaknesses of this trial, interpret its outcomes within the context of prior literature, and evaluate the validity of its conclusions.

  16. Is extra-glandular organ damage in primary Sjögren's syndrome related to the presence of systemic auto-antibodies and/or hypergammaglobulinemia? A long-term cohort study with 110 patients from the Netherlands.

    Science.gov (United States)

    Ter Borg, Evert-Jan; Kelder, Johannes Cornelis

    2017-07-01

    To test the hypothesis that systemic auto-antibodies or hypergammaglobulinemia are related to the prevalence of extra-glandular tissue organ damage (EGOD) in primary Sjögren's syndrome (SS). A real practice-based investigation of a relatively large (n = 110) Dutch cohort of primary SS patients systematically followed up in a large non-academic hospital. After a follow up of mean 8.2 years a significant correlation was found between disease duration and the prevalence of EGOD. We did not observe a relationship between the total number or type of systemic auto-antibodies or hypergammaglobulinemia and the total number of EGOD. However, there was a correlation between the prevalence of polyneuropathy (PNP) and antinuclear antibodies (ANA) as well as anti-Ro/SS-A positivity and there was an inverse relationship between the presence of anti-Ro/SS-A antibodies and primary biliary cirrhosis (PBC). All PBC cases were anti-Ro/SS-A and anti-La/SS-B negative but ANA positive. There was a trend for a higher occurrence of pleuro-pulmonary disease in the ANA negative cases. Although we did not find a relationship between the total number or type of systemic auto-antibodies and the total number of EGOD, there were correlations between specific systemic auto-antibodies and specific types of EGOD. The presence of ANA and anti-Ro/SS-A was associated with the occurrence of PNP, as well as was the absence of anti-Ro/SS-A with PBC. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  17. Sickness presence, sick leave and adjustment latitude

    Directory of Open Access Journals (Sweden)

    Joachim Gerich

    2014-10-01

    Full Text Available Objectives: Previous research on the association between adjustment latitude (defined as the opportunity to adjust work efforts in case of illness and sickness absence and sickness presence has produced inconsistent results. In particular, low adjustment latitude has been identified as both a risk factor and a deterrent of sick leave. The present study uses an alternative analytical strategy with the aim of joining these results together. Material and Methods: Using a cross-sectional design, a random sample of employees covered by the Upper Austrian Sickness Fund (N = 930 was analyzed. Logistic and ordinary least square (OLS regression models were used to examine the association between adjustment latitude and days of sickness absence, sickness presence, and an estimator for the individual sickness absence and sickness presence propensity. Results: A high level of adjustment latitude was found to be associated with a reduced number of days of sickness absence and sickness presence, but an elevated propensity for sickness absence. Conclusions: Employees with high adjustment latitude experience fewer days of health complaints associated with lower rates of sick leave and sickness presence compared to those with low adjustment latitude. In case of illness, however, high adjustment latitude is associated with a higher pro­bability of taking sick leave rather than sickness presence.

  18. Evaluation of Serum Fibrinogen, Plasminogen, α2-Anti-Plasmin, and Plasminogen Activator Inhibitor Levels (PAI and Their Correlation with Presence of Retinopathy in Patients with Type 1 DM

    Directory of Open Access Journals (Sweden)

    Sefika Burcak Polat

    2014-01-01

    Full Text Available Background. Diabetic retinopathy (DR is the leading cause of blindness in the world. Retinopathy can still progress despite optimal metabolic control. The aim of the study was to determine whether different degrees of DR (proliferative or nonproliferative were associated with abnormally modulated hemostatic parameters in patients with T1DM. Method. 52 T1DM patients and 40 healthy controls were enrolled in the study. Patients were subdivided into three categories. Group I was defined as those without retinopathy, group II with NPRP, and group III with PRP. We compared these subgroups with each other and the control group (Group IV according to the serum fibrinogen, plasminogen, alpha2-anti-plasmin (α2-anti-plasmin, and PAI. Results. We detected that PAI-1, serum fibrinogen, and plasminogen levels were similar between the diabetic and control groups (P=0.209, P=0.224, and P=0.244, resp., whereas α2-anti-plasmin was higher in Groups I, II, and III compared to the control group (P<0.01, P<0.05, and P<0.001, resp.. There was a positive correlation between serum α2-anti-plasmin and HbA1c levels (r=0,268, P=0.031. Conclusion. To our knowledge there is scarce data in the literature about α2-anti-plasmin levels in type 1 diabetes. A positive correlation between α2-anti-plasmin with HbA1c suggests that fibrinolytic markers may improve with disease regulation and better glycemic control.

  19. Family presence during cardiopulmonary resuscitation and invasive procedures in children

    Directory of Open Access Journals (Sweden)

    Cristiana Araujo G. Ferreira

    2014-03-01

    Full Text Available Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%, in Medicine and Nursing (46%, and were surveys (72% with healthcare team members (67% as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a to develop a sensitizing program for healthcare team; b to educate the healthcare team to include the family in these circumstances; c to develop a written institutional policy; d to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes.

  20. Jumping to conclusions style along the continuum of delusions: delusion-prone individuals are not hastier in decision making than healthy individuals.

    Directory of Open Access Journals (Sweden)

    Suzanne Ho-wai So

    Full Text Available Literature comparing 'jumping to conclusions' (JTC between patients and healthy controls has demonstrated the importance of the reasoning bias in the development of delusions. When groups that vary along the entire delusional continuum are included, the relationship between JTC and delusionality is less clear. This study compared JTC and delusional dimensions between 28 patients with delusions, 35 delusion-prone individuals and 32 non-delusion-prone individuals. Delusion proneness was defined by an established threshold based on the Peters et al. Delusions Inventory. Two versions of the beads task (85:15 and 60:40 were used to measure JTC. As hypothesized, patients manifested hastier data gathering than the two non-clinical groups on both beads tasks. However, delusion-prone individuals did not manifest a hastier decision making style than non-delusion prone individuals. Instead, non-delusion-prone participants showed more JTC bias than delusion-prone individuals on the easier beads task. There was no evidence for a dose-response relationship between JTC and delusional dimensions, with correlations between JTC and PDI scores found in the non-delusion-prone group only. The present finding confirms the link between an extreme JTC bias and the presence of clinical delusions, and argues against a linear relationship between JTC and delusionality along the symptomatic continuum.

  1. Presence Management and Merging Presence Information for NGN Services

    Science.gov (United States)

    Schumann, Sebastian; Mikoczy, Eugen; Podhradsky, Pavol; Muruchi, Feliciano; Maruschke, Michael

    This paper describes an approach for interworking scenarios between Session Initiation Protocol (SIP) based and non SIP based frameworks (e.g. web services) in case of the presence management service. The characteristics of the concept of a centralized presence management will be introduced.

  2. [Presence of islands of fatty tissue in struma].

    Science.gov (United States)

    Lax, S; Beham, A; Langsteger, W; Schmid, C

    1988-04-01

    We examined 929 surgically obtained thyroid glands derived from 791 female and 138 male patients and found intrathyroidal adipose tissue in 18 cases (1.94%). Only the thyroid glands of middle aged and older women (mean age 51 years) were affected, as well as in the case of follicular adenomas and nodular and diffuse hyperplasia. With respect to localization in the interstitial connective tissue, as well as between thyroid follicles, interstitial, parenchymatous and mixed types are proposed. In addition to sex and age there is a high correlation with obesity, which is suggestive of hormonal influences. Knowledge of the presence of intrathyroidal fat tissue is of interest to the pathologist since it may lead to erroneous interpretations of histological and cytological specimens of the thyroid gland. In conclusion, not one case of hypothyroidism was detected amongst the 18 cases investigated in this study.

  3. Presence : concept, determinants and measurement

    NARCIS (Netherlands)

    IJsselsteijn, W.A.; Ridder, de H.; Freeman, J.; Avons, S.E.; Rogowitz, B.E.; Pappas, T.N.

    2000-01-01

    The concept of presence, i.e. the sensation of 'being there' in a mediated environment, has received substantial attention from the virtual reality community, and is becaming increasingly relevant both to broadcasters and display developers. Although research into presence is still at an early stage

  4. Gulf War Illnesses: DOD's Conclusions about U.S. Troops' Exposure Cannot Be Adequately Supported

    National Research Council Canada - National Science Library

    Rhodes, Keith

    2004-01-01

    ... (MOD) conclusions about troops' exposure. The GAO found that DoD's and MOD's conclusions about troops' exposure to CW agents, based on DoD and CIA plume modeling, cannot be adequately supported...

  5. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild

    2013-01-01

    self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear.......self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear....

  6. Move Analysis of the Conclusion Sections of Research Papers in Persian and English

    Science.gov (United States)

    Zamani, Gerannaz; Ebadi, Saman

    2016-01-01

    The structure of the conclusion sections in Research Papers (RPs) is of significance in academic writing. The conclusion section in spite of providing an outline of the article, states other essential components, such as recommendations, implications and statements of possible lines of future research. This paper analyses the conclusion parts of…

  7. Presence and HRCT quantification of bronchiectasis in coal workers

    International Nuclear Information System (INIS)

    Altin, Remzi; Savranlar, Ahmet; Kart, Levent; Mahmutyazicioglu, Kamran; Ozdemir, Huseyin; Akdag, Beyza; Gundogdu, Sadi

    2004-01-01

    Purpose: The purpose of this study was to evaluate the presence of bronchiectasis in coal workers with or without coal worker pneumoconiosis (CWP) and to assess the extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high resolution computed tomography (HRCT). Materials and methods: The retrospective study consisted of HRCT archives of 93 coal workers. The coal workers with previous diagnosis of COPD (six), asthma (one) and tuberculosis (three) were excluded. Five coal workers with progressive massive fibrosis were not included into the study. The resulting patient group consisted of 78 patients (43 CWP; 35 non-CWP). Pneumoconiosis profusions of CWP workers were between p0/1 and p2/2 according to ILO 1980 chest X-ray classification. HRCT examinations of all subjects were evaluated for the presence, extent, dilatation and thickness of bronchiectasis. Analysis of extent, dilatation and thickness were performed according to established criteria. Results: The diagnosis of bronchiectasis was put on 19 of 43 CWP (44.1%) and 7 of 35 non-CWP workers (20.0%). There were statistically significant differences between bronchiectasis positive and negative coal workers with CWP concerning age and exposure duration (P = 0.012 and 0.009, respectively). Then, multiple logistic regression analysis was performed to define exact risk factors. Exposure duration was only found to be related with presence of bronchiectasis [(odds ratio) OR = 1.494, 95% confidence interval 1.168-1.912]. Conclusions: The data from the present study shows that bronchiectasis is frequent and severe in CWP workers than without. Bronchiectasis is influenced by coal dust exposure. Thus, coal dust protection measures must be controlled efficiently to prevent bronchiectasis in coal workers

  8. Presence of thyroid-associated ophthalmopathy in Hashimoto’s thyroiditis

    Directory of Open Access Journals (Sweden)

    Emrah Kan

    2014-08-01

    Full Text Available AIM:To determine the prevalence of ophthalmopathy in Hashimoto’s patients and to make a comparison in subgroups of patientsMETHODS:The study involved 110 Hashimoto’s thyroiditis patients and 50 control subjects attending to the endocrinology department of the hospital. Subgroup classification of patientswas made as euthyroid, subclinic and clinic in Hashimato’s thyroiditis. All patients were evaluated by a single experienced ophthalmologist for the prevalence and characteristics of eye signs.RESULTS: The overall prevalences of eye changes were 22.7% (25 patients in patients and 4% (2 persons in control subjects respectively (P=0.002. In patients the most common symptom was retrobulbar eye pain with or without any eye movement. Thirteen patients had significant upper eyelid retraction (11.8%. Six patients had eye muscle dysfunction as reduced eye movements in up gaze. In control patients one person had proptosis and another had lid retraction. The clinical activity score and classification of the ophthalmopathy did not show any significant differences among subgroups.CONCLUSION:The eye signs were mostly mild (22.7% and the most common eye sign was the presence of upper eyelid retraction (11.8%. Additionally six patients had eye muscle dysfunction as reduced eye movements in up gaze. Therefore we recommend to make a routine ophthalmic examination in Hashimoto’s thyroiditis patients in order not to omit the associated ophthalmopathy.

  9. The use of remote presence for health care delivery in a northern Inuit community: a feasibility study

    Science.gov (United States)

    Mendez, Ivar; Jong, Michael; Keays-White, Debra; Turner, Gail

    2013-01-01

    Objective To evaluate the feasibility of remote presence for improving the health of residents in a remote northern Inuit community. Study design A pilot study assessed patient's, nurse's and physician's satisfaction with and the use of the remote presence technology aiding delivery of health care to a remote community. A preliminary cost analysis of this technology was also performed. Methods This study deployed a remote presence RP-7 robot to the isolated Inuit community of Nain, Newfoundland and Labrador for 15 months. The RP-7 is wirelessly controlled by a laptop computer equipped with audiovisual capability and a joystick to maneuver the robot in real time to aid in the assessing and care of patients from a distant location. Qualitative data on physician's, patient's, caregiver's and staff's satisfaction were collected as well as information on its use and characteristics and the number of air transports required to the referral center and associated costs. Results A total of 252 remote presence sessions occurred during the study period, with 89% of the sessions involving direct patient assessment or monitoring. Air transport was required in only 40% of the cases that would have been otherwise transported normally. Patients and their caregivers, nurses and physicians all expressed a high level of satisfaction with the remote presence technology and deemed it beneficial for improved patient care, workloads and job satisfaction. Conclusions These results show the feasibility of deploying a remote presence robot in a distant northern community and a high degree of satisfaction with the technology. Remote presence in the Canadian North has potential for delivering a cost-effective health care solution to underserviced communities reducing the need for the transport of patients and caregivers to distant referral centers. PMID:23984292

  10. Relationship between funding source and conclusion among nutrition-related scientific articles.

    Science.gov (United States)

    Lesser, Lenard I; Ebbeling, Cara B; Goozner, Merrill; Wypij, David; Ludwig, David S

    2007-01-01

    Industrial support of biomedical research may bias scientific conclusions, as demonstrated by recent analyses of pharmaceutical studies. However, this issue has not been systematically examined in the area of nutrition research. The purpose of this study is to characterize financial sponsorship of scientific articles addressing the health effects of three commonly consumed beverages, and to determine how sponsorship affects published conclusions. Medline searches of worldwide literature were used to identify three article types (interventional studies, observational studies, and scientific reviews) about soft drinks, juice, and milk published between 1 January, 1999 and 31 December, 2003. Financial sponsorship and article conclusions were classified by independent groups of coinvestigators. The relationship between sponsorship and conclusions was explored by exact tests and regression analyses, controlling for covariates. 206 articles were included in the study, of which 111 declared financial sponsorship. Of these, 22% had all industry funding, 47% had no industry funding, and 32% had mixed funding. Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding. Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors' products, with potentially significant implications for public health.

  11. Conclusiveness of fine needle aspiration in 2419 histologically confirmed benign and malignant breast lesions

    NARCIS (Netherlands)

    Kooistra, B.; Wauters, C.; Wobbes, T.; Strobbe, L.

    2011-01-01

    We aimed to retrospectively assess (1) the conclusiveness of breast fine needle aspiration (FNA) in a histologically confirmed population and (2) the clinical and radiologic determinants of a conclusive diagnosis. Aspirates were diagnosed as inadequate, benign, atypical, suspicious or malignant. We

  12. 20 CFR 410.471 - Conclusion by physician regarding miner's disability or death.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conclusion by physician regarding miner's disability or death. 410.471 Section 410.471 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.471 Conclusion...

  13. Diffusion versus linear ballistic accumulation: different models but the same conclusions about psychological processes?

    NARCIS (Netherlands)

    Donkin, C.; Brown, S.; Heathcote, A.; Wagenmakers, E.-J.

    2011-01-01

    Quantitative models for response time and accuracy are increasingly used as tools to draw conclusions about psychological processes. Here we investigate the extent to which these substantive conclusions depend on whether researchers use the Ratcliff diffusion model or the Linear Ballistic

  14. Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events

    DEFF Research Database (Denmark)

    Eapen, Danny J; Manocha, Pankaj; Ghasemzedah, Nima

    2014-01-01

    (PPPPP...-statistic for a model based on traditional risk factors was improved from 0.72 to 0.74 (P=0.008) with the addition of suPAR. CONCLUSION: Elevated levels of plasma suPAR are associated with the presence and severity of CAD and are independent predictors of death and MI in patients with suspected or known CAD....

  15. Presence of depressive symptoms in patients with a first episode of acute Coronary Syndrome Presencia de síntomas depresivos en pacientes con primer episodio de Síndrome coronario agudo Presença de sintomas depressivos em pacientes com primeiro episódio de Síndrome coronariana aguda

    Directory of Open Access Journals (Sweden)

    Carina Aparecida Marosti Dessotte

    2013-02-01

    Full Text Available AIM: to compare possible differences regarding the presence of depressive symptoms according to the clinical diagnosis of Acute Coronary Syndrome, gender and age, one week before the first cardiac event. METHOD: cross-sectional, descriptive and exploratory study, which used the Beck Depression Inventory. The sample consisted of 253 patients. RESULTS: it was found that patients with a clinical diagnosis of unstable angina, female and under 60 years of age reported the presence of depressive symptoms more frequently. CONCLUSION: a high percentage of patients presented depressive symptoms at the time of hospitalization for the first episode of Acute Coronary Syndrome, and this prevalence was significantly higher among women, under 60 years of age, with unstable angina. These results should provide support for the care in the hospitalization, discharge and planning of the rehabilitation of these patients, as it is known that depression impairs the control of coronary disease.OBJETIVO: comparar posibles diferencias en cuanto a la presencia de síntomas depresivos según el diagnóstico clínico del Síndrome Coronario Agudo, sexo y banda etaria, una semana antes del primer evento cardíaco. MÉTODO: estudio transversal, descriptivo y exploratorio, que utilizó el Inventario de Depresión de Beck. La muestra fue compuesta por 253 pacientes. RESULTADOS: los pacientes con diagnóstico clínico de angina inestable, del sexo femenino y con edad inferior a sesenta años relataron con mayor frecuencia la presencia de síntomas depresivos. CONCLUSIONES: un elevado porcentaje de pacientes presentaba síntomas depresivos en el momento de la internación por el primer episodio del Síndrome Coronario Agudo, y esa superioridad fue significativamente mayor entre las mujeres, con menos de 60 años y con angina inestable. Estos resultados deberán hacer el embasamiento el servicio en la internación, alta y planificación de la rehabilitación de eses pacientes

  16. Forensic scientists' conclusions: how readable are they for non-scientist report-users?

    Science.gov (United States)

    Howes, Loene M; Kirkbride, K Paul; Kelty, Sally F; Julian, Roberta; Kemp, Nenagh

    2013-09-10

    Scientists have an ethical responsibility to assist non-scientists to understand their findings and expert opinions before they are used as decision-aids within the criminal justice system. The communication of scientific expert opinion to non-scientist audiences (e.g., police, lawyers, and judges) through expert reports is an important but under-researched issue. Readability statistics were used to assess 111 conclusions from a proficiency test in forensic glass analysis. The conclusions were written using an average of 23 words per sentence, and approximately half of the conclusions were expressed using the active voice. At an average Flesch-Kincaid Grade level of university undergraduate (Grade 13), and Flesch Reading Ease score of difficult (42), the conclusions were written at a level suitable for people with some tertiary education in science, suggesting that the intended non-scientist readers would find them difficult to read. To further analyse the readability of conclusions, descriptive features of text were used: text structure; sentence structure; vocabulary; elaboration; and coherence and unity. Descriptive analysis supported the finding that texts were written at a level difficult for non-scientists to read. Specific aspects of conclusions that may pose difficulties for non-scientists were located. Suggestions are included to assist scientists to write conclusions with increased readability for non-scientist readers, while retaining scientific integrity. In the next stage of research, the readability of expert reports in their entirety is to be explored. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Conclusions of the presidency. European council of Barcelona, March 15 and 16 2002; Conclusions de la presidence. Conseil europeen de Barcelone 15 et 16 mars 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This document summarizes the conclusions of the European Council held in Barcelona (Spain) on March 15 and 16, 2002. Among the priority actions listed by the council figure the integration of energy, transportation and communication networks at the European scale. In particular, the council commits the Parliament and itself to start the final phase of opening of gas and electricity markets: free choice of a supplier, obligation of public utility, security of supplies, separation between transmission and distribution and between production and supply, non-discriminatory access of consumers and suppliers to networks with transparent tariffs, establishment of a regulatory agency in each member state, agreement for a tariffing system for the international electricity trades etc.. Concerning the sustainable development strategy of the European union, the council is pressing the member states for the completion of the national procedures of ratification of the Kyoto protocol. However, new measures need to be taken to develop technologies respectful for the environment, in particular in the domain of energy and transports. (J.S.)

  18. Drug-induced hepatitis superimposed on the presence of anti-SLA antibody: a case report

    Directory of Open Access Journals (Sweden)

    Etxagibel Aitziber

    2008-01-01

    Full Text Available Abstract Introduction Autoimmune hepatitis is a necroinflammatory disorder of unknown etiology characterized by the presence of circulating antibodies, hypergammaglobulinemia, and response to immunosuppression. It has the histological features of chronic hepatitis. The onset is usually insidious, but in some patients the presentation may be acute and occasionally severe. Certain drugs can induce chronic hepatitis mimicking autoimmune hepatitis. Different autoantibodies have been associated with this process but they are not detectable after drug withdrawal and clinical resolution. Case presentation We describe a case of drug-induced acute hepatitis associated with antinuclear, antisoluble liver-pancreas and anti-smooth muscle autoantibodies in a 66-year-old woman. Abnormal clinical and biochemical parameters resolved after drug withdrawal, but six months later anti-soluble liver-pancreas antibodies remained positive and liver biopsy showed chronic hepatitis and septal fibrosis. Furthermore, our patient has a HLA genotype associated with autoimmune hepatitis. Conclusion Patient follow-up will disclose whether our patient suffers from an autoimmune disease and if the presence of anti-soluble liver antigens could precede the development of an autoimmune hepatitis, as the presence of antimitochondrial antibodies can precede primary biliary cirrhosis.

  19. Three Mile Island unit 2 vessel investigation project. Conclusions and significance

    International Nuclear Information System (INIS)

    Beckjord, E.S.

    1994-01-01

    At the conclusion of the TMI-2 Vessel Investigation Project, additional insights about the accident have been gained, specifically in the area of reactor vessel integrity and the conditions of the lower head of the reactor vessel. This paper discusses three topics: the evolving views about the TMI-2 accident scenario over time, the technical conclusions of the TMI-2 VIP (recovery of samples from the vessel lower head), and the broad significance of these findings (accident management). 4 refs

  20. Application of Artificial Neural Networks in the Heart Electrical Axis Position Conclusion Modeling

    Science.gov (United States)

    Bakanovskaya, L. N.

    2016-08-01

    The article touches upon building of a heart electrical axis position conclusion model using an artificial neural network. The input signals of the neural network are the values of deflections Q, R and S; and the output signal is the value of the heart electrical axis position. Training of the network is carried out by the error propagation method. The test results allow concluding that the created neural network makes a conclusion with a high degree of accuracy.

  1. Presence of lead in opium.

    Science.gov (United States)

    Aghaee-Afshar, Mahmoud; Khazaeli, Payam; Behnam, Behzad; Rezazadehkermani, Mohammad; Ashraf-Ganjooei, Narges

    2008-09-01

    Opium addiction is a common form of addiction in Middle East countries such as Iran. Recently several reports suggested some kinds of pathologic findings such as abdominal pain, nephropathy, and anemia in opium addict patients. Such pathologic findings suggest lead poisoning in the patients. In this study, the concentration of lead in 10 opium samples was evaluated. The mean concentration of lead in the opium samples was 1.88 ppm. This may explain some of the pathologic findings found in addict patients. The authors would suggest further investigations to evaluate the lead concentration in opium addicts' sera and also routine screening for lead poisoning in opium addict patients.

  2. Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research.

    Science.gov (United States)

    Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Su, Edwin P; Grauer, Jonathan N

    2018-03-01

    Despite the advantages of large, national datasets, one continuing concern is missing data values. Complete case analysis, where only cases with complete data are analyzed, is commonly used rather than more statistically rigorous approaches such as multiple imputation. This study characterizes the potential selection bias introduced using complete case analysis and compares the results of common regressions using both techniques following unicompartmental knee arthroplasty. Patients undergoing unicompartmental knee arthroplasty were extracted from the 2005 to 2015 National Surgical Quality Improvement Program. As examples, the demographics of patients with and without missing preoperative albumin and hematocrit values were compared. Missing data were then treated with both complete case analysis and multiple imputation (an approach that reproduces the variation and associations that would have been present in a full dataset) and the conclusions of common regressions for adverse outcomes were compared. A total of 6117 patients were included, of which 56.7% were missing at least one value. Younger, female, and healthier patients were more likely to have missing preoperative albumin and hematocrit values. The use of complete case analysis removed 3467 patients from the study in comparison with multiple imputation which included all 6117 patients. The 2 methods of handling missing values led to differing associations of low preoperative laboratory values with commonly studied adverse outcomes. The use of complete case analysis can introduce selection bias and may lead to different conclusions in comparison with the statistically rigorous multiple imputation approach. Joint surgeons should consider the methods of handling missing values when interpreting arthroplasty research. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Presença de refluxo em pacientes com sintomas típicos de doença do refluxo gastroesofágico Factors related to the presence of reflux in patients with typical symptoms of gastroesophageal reflux disease (GERD

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Corsi

    2007-04-01

    GERD symptoms. Clinical data, Body Mass Index, abdominal ultrasound aspects and upper digestive endoscopic data are reported. Manometry and esophageal pH-monitoring were performed. RESULTS: One-hundred-and-seventy-two patients were female (68.5%. Mean age of the total was 51.8 years. Ultrasound examination revealed colelithiasis in 23 patients and PC in 21 patients. Hiatal hernia was diagnosed in 177 patients (71%, with an average size of 3.0cm. Erosive esophagitis was found in 168 patients (66.9% and Barrett's esophagus in 23 patients (9.2%. A combination of hiatal hernia and esophagitis was diagnosed in 131 patients (52.3% while only 37 patients (14.7% did not present either. The mean extension of the lower esophageal sphincter (LES was 2.6 cm, whereas in 132 patients (52.6% the LES was shorter. The mean pressure of the LES was 18.9 mmHg; 46 patients (18.3% had pressures below 14 mmHg. The mean number of reflux episodes on prolonged esophageal monitoring was 42.9; the mean number of prolonged episodes of reflux was 4.6, and the mean percentage of total acid time was 8.4%. DeMeester scores were high in 175 patients (69.7%. CONCLUSION: In patients with typical GERD symptoms, factors influencing the presence of pathological reflux as confirmed by prolonged esophageal pH-monitoring were: age, hiatal hernia associated to erosive esophagitis, a smaller extension, low baseline pressure and smaller volume vector of the LES.

  4. Breathing life into social presence

    DEFF Research Database (Denmark)

    Cowley, Stephen; Fester, Marie-Theres

    2018-01-01

    Whilst many studies focus on human-to-media interactions, this paper turns to how a multimodal medium influences human-to-human contact. By bringing together both radical embodied cognitive science (Chemero 2009) and dialogism (Linell 2009), the paper develops an anti-representationalist approach...... to the concept of social presence. We use an exploratory study of close friendships that maintain their interaction through the use of the mobile instant messaging service WhatsApp. In so doing, we describe texting as language-activity where people engage with each other by using resources from body, environment...... attention to this kind of heightened social presence that we choose to call “co-imagining”....

  5. Ciemat Relational Capital: Institutional Presence

    International Nuclear Information System (INIS)

    Vaquero Ortiz, E. M.; González Pineda, L. M.; Cascante Díaz, E.

    2015-01-01

    The resources in any organization for its activity development can be divided into two main groups: tangible assets and intangible assets. In recent decades there has been a recognition of the importance of the intangible assets as value generators for the development and growth of organizations. And the so called Relational Capital is among them Relational Capital arises from the relationship processes that an organization maintains with external agents. Thus, in the case of a public research institution, such as CIEMAT, it includes the relations with projects financing organizations, with partners and with customers (both public and private entities which are serviced), as well as the institutional presence understood as the participation in discussion and coordination forums (foundations, associations, committees…). This report presents a study of CIEMAT institutional presence in the year 2015.

  6. Measuring Presence in Virtual Environments

    Science.gov (United States)

    1994-10-01

    viewpoint to change what they see, or to reposition their head to affect binaural hearing, or to search the environment haptically, they will experience a...increase presence in an alternate environment. For example a head mounted display that isolates the user from the real world may increase the sense...movement interface devices such as treadmills and trampolines , different gloves, and auditory equipment. Even as a low end technological implementation of

  7. Investigation of the role of the jumping-to-conclusions bias for short-term functional outcome in schizophrenia.

    Science.gov (United States)

    Andreou, Christina; Treszl, András; Roesch-Ely, Daniela; Köther, Ulf; Veckenstedt, Ruth; Moritz, Steffen

    2014-08-30

    Symptom severity and neuropsychological deficits negatively influence functional outcomes in patients with schizophrenia. Recent research implicates specific types of biased thinking styles (e.g. jumping-to-conclusions) in the pathogenesis of schizophrenia. This is the first study to test the impact of jumping-to-conclusions on functional outcome in schizophrenia. The aim of the study was to investigate the association of psychopathology, neuropsychology and JTC with subjective quality of life, vocational outcome and housing status in schizophrenia. Analyses were carried out both cross-sectionally at baseline, and longitudinally over the course of symptomatic improvement in the immediate aftermath of a psychotic exacerbation. Seventy-nine patients with schizophrenia were included in the study. Data concerning the variables of interest were collected at baseline, after one month, and after six months. Positive symptomatology was the most significant predictor of subjective and vocational outcome and changes across time. Verbal memory deficits were associated with functional status cross-sectionally, whereas general cognitive capacity significantly predicted functional changes over time. Improvement of the jumping-to-conclusions bias positively affected vocational outcome. Though limited, the observed effect of this bias on real-world functioning highlights the possible usefulness of interventions aimed at improving (meta)cognitive deficits in schizophrenia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. A fallacious jar? The peculiar relation between descriptive premises and normative conclusions in neuroethics.

    Science.gov (United States)

    Wagner, Nils-Frederic; Northoff, Georg

    2015-06-01

    Ethical questions have traditionally been approached through conceptual analysis. Inspired by the rapid advance of modern brain imaging techniques, however, some ethical questions appear in a new light. For example, hotly debated trolley dilemmas have recently been studied by psychologists and neuroscientists alike, arguing that their findings can support or debunk moral intuitions that underlie those dilemmas. Resulting from the wedding of philosophy and neuroscience, neuroethics has emerged as a novel interdisciplinary field that aims at drawing conclusive relationships between neuroscientific observations and normative ethics. A major goal of neuroethics is to derive normative ethical conclusions from the investigation of neural and psychological mechanisms underlying ethical theories, as well as moral judgments and intuitions. The focus of this article is to shed light on the structure and functioning of neuroethical arguments of this sort, and to reveal particular methodological challenges that lie concealed therein. We discuss the methodological problem of how one can--or, as the case may be, cannot--validly infer normative conclusions from neuroscientific observations. Moreover, we raise the issue of how preexisting normative ethical convictions threaten to invalidate the interpretation of neuroscientific data, and thus arrive at question-begging conclusions. Nonetheless, this is not to deny that current neuroethics rightly presumes that moral considerations about actual human lives demand empirically substantiated answers. Therefore, in conclusion, we offer some preliminary reflections on how the discussed methodological challenges can be met.

  9. Acceleration toward the conclusion negotiation of bilateral nuclear cooperation agreements indispensable for globalization

    International Nuclear Information System (INIS)

    Mitsumata, Hiroki; Hattori, Takuya; Ake, Yutaka

    2011-01-01

    According to Japan's basic policies of new growth strategy, it would be one option of the economic growth to increase exports of nuclear power plant system or its equipments. However, bilateral nuclear cooperation agreements are indispensable for business activities on nuclear power. Recently signature of agreement with Jordan, agreed conclusion negotiation with Vietnam and Korea, under negotiation with India and expected negotiation with Indonesia and Malaysia. Signed agreements with Russia and Kazakhstan will be coming into effect and contribute nuclear fuel supply at export of nuclear power system. This special article consists of four expert's papers titled as (1) necessity of conclusion negotiation of nuclear cooperation agreements with several countries simultaneously and in parallel, (2) Japan's nuclear cooperation in new era, (3) desirable acceleration of conclusion negotiation of nuclear cooperation agreements and (4) insurance of nuclear fuel supply fundamental for global business activities of Japan's nuclear industries-best choice to establish cooperative relations with US and Russia. (T. Tanaka)

  10. The grand leap of the whale up the Niagara Falls: converting philosophical conclusions into policy prescriptions.

    Science.gov (United States)

    Holm, Søren

    2015-04-01

    This article analyzes a neat conjuring trick employed in bioethics, that is, the immediate conversion of a philosophical conclusion into a policy prescription, and compares it to the "grand leap of the whale up the Niagara Falls" mentioned by Benjamin Franklin. It is shown that there is no simple and easy way to achieve the conversion, by considering arguments falling under four headings: (1) reasonable disagreement about values and theories, (2) general jurisprudential arguments, (3) the differences between policymaking and philosophy, and (4) the messy world of implementation. The particular issue used to illustrate the difficulties in moving from philosophical conclusion to policy description is infanticide of healthy infants, but the analysis is general, and the conclusion that the immediate move to policy is illegitimate is quite general.

  11. MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Orhan, Kaan [Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, 06500 Besevler, Ankara (Turkey)]. E-mail: call53@yahoo.com; Nishiyama, Hideyoshi [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Tadashi, Sasaki [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Shumei, Murakami [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Furukawa, Souhei [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan)

    2005-07-01

    Objective: : The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders. Materials and methods: : 2270 temporomandibular joint magnetic resonance images and patients' data were retrospectively investigated. Magnetic resonance images were obtained from the patients who referred to Osaka University Dental Hospital Outpatient Clinic with TMJ complaints for the last four years (from January 1998 to January 2003). The patients, who were diagnosed as otomastoiditis based on their temporomandibular joint magnetic resonance images, were sent to Osaka University Hospital Department of Otolaryngology for a medical consultation in order to have their pathologies certified following their MR process. Age and sex were recorded for all patients and for otomastoiditis cases; location of the disease, symptoms of patients and TMJ findings were noted as well. Results: : Seven patients were diagnosed as acute otomastoiditis and one patient diagnosed as chronic active otitis media with cholesteatoma in the series of 2270 MR, which were representing a prevalence of 0.39%. Neurilemoma diagnosed in left mastoid process in one patient. The final diagnoses of all patients were made after medical consultation. Conclusion: : While examining temporomandibular joint magnetic resonance images; it is not only important to examine just the TMJ structures, but also to look at the nearby anatomical features to check evidence for inflammatory disease.

  12. Atherogenic index and coronarian risk – comparative assessment regarding the particularities of chronic autoimmune thyroiditis presence

    Directory of Open Access Journals (Sweden)

    Seceleanu Mihaela

    2015-08-01

    Full Text Available Objectives: Assessment of autoimmune cause hypothyroidism and dyslipidemia involvement in the apparition of major vascular complications. Methods: A total of 152 patients were investigated appreciating in comparison to a healthy control lot the hormone serum level, the presence of antimicrosomal thyroid antibodies and the serum levels of lipids. Atherogenic index and coronarian risk were calculated and correlated with the incidence of coronarian and cerebral vascular accidents. Results: Among the patients with goiter it was noted a high incidence of a subclinical hypothyroidism (31,58%. Thyroid autoimmunity was involved in 94,4% of the patients with clinical hypothyroidism, in 93,7 % with subclinical hypothyroidism and 100% in the patients with thyrotoxicosis. Low serum level of HDL-cholesterol was identified in 66,6% of patients with clinical hypothyroidism and 64,5% patients with subclinical hypothyroidism. The assessment of atherogenic index and coronarian risk was significantly higher (p<0,01 in patients with hypothyroidism in comparison to healthy control subjects. The incidence of vascular accidents was significantly higher (p<0,01 among the hypothyroid patients ( 19,7%/ 10,8%, of masculine gender (12,7% where the main cause of hypothyroidism was autoimmunity. Conclusions: The atherogenic index and coronarian risk were higher in patients with hypothyroidism associated to thyroid autoimmunity resulting in an increased probability in producing vascular accidents

  13. MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders

    International Nuclear Information System (INIS)

    Orhan, Kaan; Nishiyama, Hideyoshi; Tadashi, Sasaki; Shumei, Murakami; Furukawa, Souhei

    2005-01-01

    Objective: : The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders. Materials and methods: : 2270 temporomandibular joint magnetic resonance images and patients' data were retrospectively investigated. Magnetic resonance images were obtained from the patients who referred to Osaka University Dental Hospital Outpatient Clinic with TMJ complaints for the last four years (from January 1998 to January 2003). The patients, who were diagnosed as otomastoiditis based on their temporomandibular joint magnetic resonance images, were sent to Osaka University Hospital Department of Otolaryngology for a medical consultation in order to have their pathologies certified following their MR process. Age and sex were recorded for all patients and for otomastoiditis cases; location of the disease, symptoms of patients and TMJ findings were noted as well. Results: : Seven patients were diagnosed as acute otomastoiditis and one patient diagnosed as chronic active otitis media with cholesteatoma in the series of 2270 MR, which were representing a prevalence of 0.39%. Neurilemoma diagnosed in left mastoid process in one patient. The final diagnoses of all patients were made after medical consultation. Conclusion: : While examining temporomandibular joint magnetic resonance images; it is not only important to examine just the TMJ structures, but also to look at the nearby anatomical features to check evidence for inflammatory disease

  14. N Reactor Production Assurance Program blance of plant evaluation: report of findings and conclusions

    International Nuclear Information System (INIS)

    Hurd, E.N.; Bitten, E.J.

    1985-03-01

    Fourteen tasks were identified by UNC Nuclear Industries for evaluating the life expectancy of N Reactor structures, systems and components in the Balance of Plant portion of the Production Assurance Program. A Westinghouse Hanford Company (WHC) evaluation team was assigned to each of these fourteen tasks. A uniform set of criteria was used by all teams in evaluating the problems that may be encountered during the extended plant operating lifetime. The overall conclusion is that extended life to those Balance of Plant components and systems studied can be achieved. Problems with the potential for compromising that conclusion are identified, and feasible solutions are provided

  15. Optimal conclusive teleportation of a d-dimensional two-particle unknown quantum state

    Institute of Scientific and Technical Information of China (English)

    Yang Yu-Guang; Wen Qiao-Yan; Zhu Fu-Chen

    2006-01-01

    A conclusive teleportation protocol of a d-dimensional two-particle unknown quantum state using three ddimensional particles in an arbitrary pure state is proposed. A sender teleports the unknown state conclusively to a receiver by using the positive operator valued measure(POVM) and introducing an ancillary qudit to perform the generalized Bell basis measurement. We calculate the optimal teleportation fidelity. We also discuss and analyse the reason why the information on the teleported state is lost in the course of the protocol.

  16. Benchmark exercises on PWR level-1 PSA (step 3). Analyses of accident sequence and conclusions

    International Nuclear Information System (INIS)

    Niwa, Yuji; Takahashi, Hideaki.

    1996-01-01

    The results of level 1 PSA generate fluctuations due to the assumptions based on several engineering judgements set in the stages of PSA analysis. On the purpose of the investigation of uncertainties due to assumptions, three kinds of a standard problem, what we call benchmark exercise have been set. In this report, sensitivity studies (benchmark exercise) of sequence analyses are treated and conclusions are mentioned. The treatment of inter-system dependency would generate uncertainly of PSA. In addition, as a conclusion of the PSA benchmark exercise, several findings in the sequence analysis together with previous benchmark analyses in earlier INSS Journals are treated. (author)

  17. CONCLUSION It is obvious that a diagnosis of breast cancer causes ...

    African Journals Online (AJOL)

    Sitwala

    Psychology.1989; 56 (2) 267-183. 5. Kearney, N. and Richardson, A. (2006). Nursing. Patients with Cancer: Principles and Practice. Elsevier, London. 6. .... These patients may have normal vision, a normal neurological examination and normal plain radiographs, despite trauma that may. 2 lead to significant Complications.

  18. Sonic Virtuality, Environment, and Presence

    DEFF Research Database (Denmark)

    Grimshaw, Mark

    2018-01-01

    The article presents a brief introduction to the concept of sonic virtuality, a view of sound as a multi-modal, emergent perception that provides a framework that has since been used to provide an explanation of the formation of environments. Additionally, the article uses such concepts to explain...... the phenomenon of presence, not only in virtual worlds but also in actual worlds. The view put forward is that environment is an emergent perception, formed from the hypothetical modelling of salient worlds of sensory things, and it is in the environment that we feel present. The article ends with some thoughts...

  19. The medical eye: Conclusions from eye tracking research on expertise development in medicine

    NARCIS (Netherlands)

    Jarodzka, Halszka; Jaarsma, Thomas; Dewhurst, Richard; Boshuizen, Els

    2013-01-01

    Jarodzka, H., Jaarsma, T., Dewhurst, R., & Boshuizen, H. P. A. (2012, October). The medical eye: Conclusions from eye tracking research on expertise development in medicine. Paper presented at the New tools and practices for seeing and learning in medicine ’12, University of Turku, Turku, Finland.

  20. Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions.

    Science.gov (United States)

    Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

    2014-10-30

    Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data ('jumping to conclusions', JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. 19 CFR 210.63 - Proposed findings and conclusions and briefs.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Proposed findings and conclusions and briefs. 210.63 Section 210.63 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.63 Proposed findings...

  2. 19 CFR 210.40 - Proposed findings and conclusions and briefs.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Proposed findings and conclusions and briefs. 210.40 Section 210.40 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Prehearing Conferences and Hearings § 210...

  3. Conclusions and recommendations. [for problems in energy situation, air transportation, and hydrogen fuel

    Science.gov (United States)

    1973-01-01

    Conclusions and recommendations are presented for an analysis of the total energy situation; the effect of the energy problem on air transportation; and hydrogen fuel for aircraft. Properties and production costs of fuels, future prediction for energy and transportation, and economic aspects of hydrogen production are appended.

  4. 20 CFR 220.112 - Conclusions by physicians concerning the claimant's disability.

    Science.gov (United States)

    2010-04-01

    ... medically determinable physical or mental impairment which can be expected to result in death or which has... may have to consider such factors as age, education and past work experience. Such vocational factors... opinion by a treating source will be conclusive as to the medical issues of the nature and severity of a...

  5. Oklo: The fossil nuclear reactors. Physics study - Translation of chapters 6, 13 and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Naudet, R [CEA, Paris (France)

    1996-09-01

    Three parts of the 1991 book `Oklo: reacteurs nucleaires fossiles. Etude physique` have been translated in this report. The chapters bear the titles `Study of criticality`(45 p.), `Some problems with the overall functioning of the reactor zones`(45 p.) and `Conclusions` (15 p.), respectively.

  6. Oklo: The fossil nuclear reactors. Physics study - Translation of chapters 6, 13 and conclusions

    International Nuclear Information System (INIS)

    Naudet, R.

    1996-09-01

    Three parts of the 1991 book 'Oklo: reacteurs nucleaires fossiles. Etude physique' have been translated in this report. The chapters bear the titles 'Study of criticality'(45 p.), 'Some problems with the overall functioning of the reactor zones'(45 p.) and 'Conclusions' (15 p.), respectively

  7. Tritium in precipitation of Vostok (Antarctica): conclusions on the tritium latitude effect.

    Science.gov (United States)

    Hebert, Detlef

    2011-09-01

    During the Antarctic summer of 1985 near the Soviet Antarctic station Vostok, firn samples for tritium measurements were obtained down to a depth of 2.40 m. The results of the tritium measurements are presented and discussed. Based on this and other data, conclusions regarding the tritium latitude effect are derived.

  8. Increase of doses delivered to patients during medical imagery examinations. Conclusions of 16 September 2010 seminar organized by the ASN

    International Nuclear Information System (INIS)

    2011-01-01

    This document reports the contributions of the participants to the seminar which aimed at discussing the increase of doses delivered in medical imagery, and the actions to undertake to limit this increase. The authors recall the regulatory and legal context regarding the optimization of medical procedures and the organisation of radiation protection for medical exposures, comment the assessment of exposures by medical imagery in 2007, comment the CE marking of medical devices, the recent evolutions in dose optimization of radiology and scanography devices. Other sets of interventions address the application of the justification and optimization principle by professionals (in new scanography practices, in radio-paediatrics), the professional training issue (radiologist continuous training, electro-radiology operator training), the comparison between scanner and RMI (new fields for RMI, imagery benchmark), the assessment of professional practices (tools for continuous professional development of health professionals, medical imagery initiatives in Belgium), and international recommendations (by the IAEA, the WHO, the European Union)

  9. The presence of non-carious lesions in children

    Directory of Open Access Journals (Sweden)

    Demko-Rihter Ivana

    2015-01-01

    Full Text Available Introduction. A non-carious lesion (NCL is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. Objective. The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH, as well as their possible risk factors in children, in the population of the city of Novi Sad. Methods. A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. Results. The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (χ2=3.86, df=1, p=0.04. The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65% and canine permanent teeth (51%. BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36% did not respond to air stimulus, while most patients with permanent teeth (74.29% did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. Conclusion. Research

  10. Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins.

    Science.gov (United States)

    Moon, K H; Dharmarajah, B; Bootun, R; Lim, C S; Lane, Tra; Moore, H M; Sritharan, K; Davies, A H

    2017-07-01

    Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

  11. 1st International Experts’ Meeting on Agitation: Conclusions Regarding the Current and Ideal Management Paradigm of Agitation

    Directory of Open Access Journals (Sweden)

    José Martínez-Raga

    2018-02-01

    Full Text Available Agitation is a heterogeneous concept without a uniformly accepted definition, however, it is generally considered as a state of cognitive and motor hyperactivity characterized by excessive or inappropriate motor or verbal activity with marked emotional arousal. Not only the definition but also other aspects of agitated patients’ care are still unsolved and need consensus and improvement. To help the discussion about agitation among experts and improve the identification, management, and treatment of agitation, the 1st International Experts’ Meeting on Agitation was held in October 2016 in Madrid. It was attended by 20 experts from Europe and Latin America with broad experience in the clinical management of agitated patients. The present document summarizes the key conclusions of this meeting and highlights the need for an updated protocol of agitation management and treatment, the promotion of education and training among healthcare professionals to improve the care of these patients and the necessity to generate clinical data of agitated episodes.

  12. Hospital ventilation standards and energy conservation: a summary of the literature with conclusions and recommendations. Final report, FY 78

    Energy Technology Data Exchange (ETDEWEB)

    Hollowell, C.; Rosenfeld, A.

    1978-09-01

    This research examines the basis of current hospital HVAC standards and determines if they can be relaxed on criteria that do not compromise the health, safety, and comfort of patients and staff and has acceptance of the health care community. Chapter 2 summarizes existing standards in use throughout the United States governing hospital ventilation systems and the thermal environment. Chapter 3 explores the role of air in hospital-acquired infections. Chapter 4 explores the realm of indoor air quality within the hospital. Chapter 5 contains a discussion concerning the influence of thermal factors on patient comfort. Chapter 6 discusses the hospital odor problem with regards to ventilation rates. The final chapter includes conclusions and recommendations developed from the literature review and from a small working conference sponsored by the University of Minnesota School of Public Health.

  13. Neurocognitive deficits are relevant for the jumping-to-conclusions bias, but not for delusions: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Christina Andreou

    2015-03-01

    Full Text Available Patients with delusions exhibit an increased tendency to arrive at decisions based on very limited evidence (jumping-to-conclusions; JTC, making this reasoning bias relevant for the treatment of delusions. Neurocognitive deficits contribute to JTC, but it is not known whether this has any bearing on the clinical syndrome of delusions. We addressed this question by reanalyzing data from an efficacy study of non-pharmacological interventions as adjunctive treatments in schizophrenia. We investigated the longitudinal associations of cognitive functioning, JTC and delusions in patients with psychotic disorders receiving either a metacognitive intervention addressing reasoning biases (n = 59, or cognitive remediation (n = 58. Both interventions improved JTC; in the cognitive remediation group, tentative evidence suggested that better neurocognitive performance contributed to this improvement. However, JTC gains were associated with delusion improvement only in the metacognitive intervention group, suggesting a content-specific mechanism of action.

  14. Energy 2000: effects of the program and conclusions from its evaluation

    International Nuclear Information System (INIS)

    Balthasar, A.

    2000-01-01

    The action program Energy 2000 has been continually reviewed by independent experts in view of its effects. This resulted in around 50 scientific studies between 1991 and 1999, dealing with different aspects of the program. In the book 'Energy 2000: effects of the program and conclusions from its evaluation', the results of these evaluations are summarised, and conclusions for the design of the follow-up program are drawn. The organisational frame of the program is presented and the question answered whether the determining principles of the program proved practical. Besides, the effects of state intervention, of the conflict solving groups and the voluntary actions of Energy 2000 are appraised. A separate chapter is dedicated to the evaluation strategy of the program, its implementation and the benefits of the evaluations. Propositions for the evaluation of the follow-up program are formulated as well. Dr. Andreas Balthasar is President of the Swiss Evaluation Society. (author)

  15. The 1993 Finnish Interdisciplinary Seminar on SETI - A review of aims, approaches and conclusions

    Science.gov (United States)

    Seppanen, Jouko

    1993-10-01

    The communications of the International Interdisciplinary Seminar on SETI, held on March 6-7, 1993 in Vantaa, Finland, are reviewed and the contents and conclusions of papers summarized. The seminar was organized jointly by the Finnish Artificial Intelligence Society (FAIS), Finnish Astronomical Society, Ursa Astronomical Association and Heureka - The Finnish Science Centre. As the ninth in a series of intelligence-related seminars of FAIS, SETI was chosen as the topic for spring 1993, noting the new ten year NASA SETI program HRMS (High Resolution Micro-wave Survey), commenced on Columbus Day, October 12, 1992. The aims and the interdisciplinary format of the seminar are described, the main results and conclusions of papers are restated, and the seminar publications introduced. The summaries of papers are based on their abstracts and contain excerpts from texts.

  16. Conclusions on the two technical panels on HLW-disposal and waste treatment processes respectively

    International Nuclear Information System (INIS)

    Dinkespiller, J.A.; Dejonghe, P.; Feates, F.

    1986-01-01

    The paper reports the concluding panel session at the European Community Conference on radioactive waste management and disposal, Luxembourg 1985. The panel considered the conclusions of two preceeding technical panels on high level waste (HLW) disposal and waste treatment processes. Geological disposal of HLW, waste management, safety assessment of waste disposal, public opinion, public acceptance of the manageability of radioactive wastes, international cooperation, and waste management in the United States, are all discussed. (U.K.)

  17. "Jumping to conclusions" in delusion-prone participants: an experimental economics approach.

    Science.gov (United States)

    van der Leer, Leslie; McKay, Ryan

    2014-01-01

    That delusional and delusion-prone individuals "jump to conclusions" on probabilistic reasoning tasks is a key finding in cognitive neuropsychiatry. Here we focused on a less frequently investigated aspect of "jumping to conclusions" (JTC): certainty judgments. We incorporated rigorous procedures from experimental economics to eliminate potential confounds of miscomprehension and motivation and systematically investigated the effect of incentives on task performance. Low- and high-delusion-prone participants (n = 109) completed a series of computerised trials; on each trial, they were shown a black or a white fish, caught from one of the two lakes containing fish of both colours in complementary ratios. In the betting condition, participants were given £4 to distribute over the two lakes as they wished; in the control condition, participants simply provided an estimate of how probable each lake was. Deviations from Bayesian probabilities were investigated. Whereas high-delusion-prone participants in both the control and betting conditions underestimated the Bayesian probabilities (i.e. were conservative), low-delusion-prone participants in the control condition underestimated but those in the betting condition provided accurate estimates. In the control condition, there was a trend for high-delusion-prone participants to give higher estimates than low-delusion-prone participants, which is consistent with previous reports of "jumping to conclusions" in delusion-prone participants. However, our findings in the betting condition, where high-delusion-prone participants provided lower estimates than low-delusion-prone participants (who were accurate), are inconsistent with the jumping-to-conclusions effect in both a relative and an absolute sense. Our findings highlight the key role of task incentives and underscore the importance of comparing the responses of delusion-prone participants to an objective rational standard as well as to the responses of non

  18. Chernobyl accident: causes and consequences (expert conclusion). Part 3. Chernobyl accident effect on Belarus

    International Nuclear Information System (INIS)

    Nesterenko, V.B.

    1992-01-01

    Expert conclusion is presented on the Chernobyl accident effect on Belarus. Problems of ground and food contamination, medical and biological radiation effects on the population are considered. Attention is paid to the radiation monitoring and radiometric gages. Scale of the damage for forestry and agriculture is described and recommendations on the agriculture is described and recommendations on the agricultural production and forest utilization at contaminated areas are given. 24 refs.; 4 figs.; 24 tabs

  19. Cognitive control in belief-laden reasoning during conclusion processing: An ERP study

    OpenAIRE

    Junlong Luo, Xiumin Du , Edward J. N. Stupple, Xiao Xiao, Lei Jia , Qinglin Zhang ,

    2012-01-01

    Belief-bias is the tendency to accept conclusions that are compatible with existing beliefs more frequently than those that contradict beliefs. It is one of the most replicated behavioral findings in the reasoning literature. Recently, neuroimaging studies using functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) have provided a new perspective and have demonstrated neural correlates of belief bias that have been viewed as supportive of dual process theories of be...

  20. International senior expert symposium on electricity and the environment: Highlights and conclusions from Helsinki

    International Nuclear Information System (INIS)

    Bennett, L.L.

    1991-01-01

    This article summarizes briefly the Senior Expert Symposium on Electricity and the Environment, held in May 1991. Four Expert Groups considered key issues: the implications for the global environment of energy and electricity supply and demand; energy sources and technologies for electricity generation; comparative environmental and health effects of different energy sources for electricity generation; and the incorporation of environmental and health impacts into policy, planning and decision making for the electricity sector. The conclusions of these groups are presented

  1. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities

    OpenAIRE

    M?rsdorf, Martin A.; Ravolainen, Virve T.; St?vern, Leif Einar; Yoccoz, Nigel G.; J?nsd?ttir, Ingibj?rg Svala; Br?then, Kari Anne

    2015-01-01

    In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is ...

  2. Regret and Responsibility Resolved? Evaluating Ordóñez and Connolly's (2000) Conclusions.

    Science.gov (United States)

    Zeelenberg; van Dijk WW; Manstead

    2000-01-01

    T. Connolly, L. D. Ordo;aan;atez, and R. Coughlan (1997, Organizational Behavior and Human Decision Processes, 70, 73-85) argued, on the basis of 5 experiments, that regret need not be related to a sense of responsibility for the regretted outcome. We (M. Zeelenberg, W. W. van Dijk, & A. S. R. Manstead, 1998, Organizational Behavior and Human Decision Processes, 74, 254-272) showed in 2 experiments that this conclusion was premature, because it was based on an indirect measure of regret (i.e., overall happiness with the decision outcome). When regret was directly measured, the predicted effects of responsibility were found. L. D. Ordo;aan;atez and T. Connolly (2000, Organizational Behavior and Human Decision Processes, 81, 132-142) replicated our findings in 2 experiments. Based on their findings they arrived at 4 conclusions. In this rejoinder we first discuss Ordóñez and Connolly's new studies and we then discuss the validity of their 4 conclusions. Copyright 2000 Academic Press.

  3. Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions

    Science.gov (United States)

    Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

    2014-01-01

    Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data (‘jumping to conclusions’, JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. PMID:24958065

  4. Monitoring presence of chemical agents

    International Nuclear Information System (INIS)

    Preston, J.M.

    1984-01-01

    The specification describes a case for use with a hand-portable chemical agent detector for continuously monitoring an atmosphere for the presence of predetermined chemical agents. The detector having means for ionizing air samples and providing at an output terminal electrical signals representative of the mobility spectrum of ionized chemical vapours produced by the ionizing means. The case comprises means for defining a chamber in the case for supporting and removably enclosing the detector, means for communicating ambient atmosphere to the chamber, electrical circuit means in the case, the circuit means being adapted to be detachably connected to the detector output terminal when the detector is positioned in the chamber and being responsive to the electrical signals for producing an alarm signal when the signals detect a chemical agent concentration in the atmosphere exceeding a predetermined concentration level, and alarm means responsive to the alarm signal. (author)

  5. How often do sensitivity analyses for economic parameters change cost-utility analysis conclusions?

    Science.gov (United States)

    Schackman, Bruce R; Gold, Heather Taffet; Stone, Patricia W; Neumann, Peter J

    2004-01-01

    There is limited evidence about the extent to which sensitivity analysis has been used in the cost-effectiveness literature. Sensitivity analyses for health-related QOL (HR-QOL), cost and discount rate economic parameters are of particular interest because they measure the effects of methodological and estimation uncertainties. To investigate the use of sensitivity analyses in the pharmaceutical cost-utility literature in order to test whether a change in economic parameters could result in a different conclusion regarding the cost effectiveness of the intervention analysed. Cost-utility analyses of pharmaceuticals identified in a prior comprehensive audit (70 articles) were reviewed and further audited. For each base case for which sensitivity analyses were reported (n = 122), up to two sensitivity analyses for HR-QOL (n = 133), cost (n = 99), and discount rate (n = 128) were examined. Article mentions of thresholds for acceptable cost-utility ratios were recorded (total 36). Cost-utility ratios were denominated in US dollars for the year reported in each of the original articles in order to determine whether a different conclusion would have been indicated at the time the article was published. Quality ratings from the original audit for articles where sensitivity analysis results crossed the cost-utility ratio threshold above the base-case result were compared with those that did not. The most frequently mentioned cost-utility thresholds were $US20,000/QALY, $US50,000/QALY, and $US100,000/QALY. The proportions of sensitivity analyses reporting quantitative results that crossed the threshold above the base-case results (or where the sensitivity analysis result was dominated) were 31% for HR-QOL sensitivity analyses, 20% for cost-sensitivity analyses, and 15% for discount-rate sensitivity analyses. Almost half of the discount-rate sensitivity analyses did not report quantitative results. Articles that reported sensitivity analyses where results crossed the cost

  6. Clinical effects of early angiotensin-converting enzyme inhibitor treatment for acute myocardial infarction are similar in the presence and absence of aspirin: systematic overview of individual data from 96,712 randomized patients. Angiotensin-converting Enzyme Inhibitor Myocardial Infarction Collaborative Group

    DEFF Research Database (Denmark)

    Latini, R; Tognoni, G; Maggioni, A P

    2000-01-01

    (and for none of 1,556 patients in the one other eligible trial). RESULTS: Overall 30-day mortality was 7.1% among patients allocated to ACEi and 7.6% among those allocated to control, corresponding to a 7% (standard deviation [SD], 2%) proportional reduction (95% confidence interval 2% to 11%, p = 0...... = 0.4; p = 0.5). Angiotensin-converting enzyme inhibitor produced definite increases in the incidence of persistent hypotension (17.9% ACEi vs. 9.4% control) and of renal dysfunction (1.3% ACEi vs. 0.6% control), but there was no good evidence that these effects were different in the presence...

  7. Workshop on iodine aspects of severe accident management. Summary and conclusions

    International Nuclear Information System (INIS)

    2000-03-01

    Following a recommendation of the OECD Workshop on the Chemistry of Iodine in Reactor Safety held in Wuerenlingen (Switzerland) in June 1996 [Summary and Conclusions of the Workshop, Report NEA/CSNI/R(96)7], the CSNI decided to sponsor a Workshop on Iodine Aspects of Severe Accident Management, and their planned or effective implementation. The starting point for this conclusion was the realization that the consolidation of the accumulated iodine chemistry knowledge into accident management guidelines and procedures remained, to a large extent, to be done. The purpose of the meeting was therefore to help build a bridge between iodine research and the application of its results in nuclear power plants, with particular emphasis on severe accident management. Specifically, the Workshop was expected to answer the following questions: - what is the role of iodine in severe accident management? - what are the needs of the utilities? - how can research fulfill these needs? The Workshop was organized in Vantaa (Helsinki), Finland, from 18 to 20 May 1999, in collaboration with Fortum Engineering Ltd. It was attended by forty-six specialists representing fifteen Member countries and the European Commission. Twenty-eight papers were presented. These included four utility papers, representing the views of Electricite de France (EDF), Teollisuuden Voima Oy and Fortum Engineering Ltd (Finland), the Nuclear Energy Institute (USA), and Japanese utilities. The papers were presented in five sessions: - iodine speciation; - organic compound control; - iodine control; - modeling; - iodine management; A sixth session was devoted to a general discussion on iodine management under severe accident conditions. This report summarizes the content of the papers and the conclusions of the workshop

  8. Specialist meeting on selected containment severe accident management strategies. Summary and conclusions

    International Nuclear Information System (INIS)

    1994-01-01

    The CSNI Specialist Meeting on Selected Containment Severe Accident Management Strategies held in Stockholm, Sweden in June 1994 was organised by the Task Group on Containment Aspects of Severe Accident Management (CAM) of CSNI's Principal Working Group on the Confinement of Accidental Radioactive Releases (PWG4) in collaboration with the Swedish Nuclear Power Inspectorate (SKI). Conclusions and recommendations are given for each of the sessions of the workshops: Containment accident management strategies (general aspects); hydrogen management techniques and other containment accident management techniques; surveillance and protection of containment function

  9. Some conclusions about the concrete strength of the bored piles of Angra 2 nuclear power plant

    International Nuclear Information System (INIS)

    Thomaz, E.C.S.; Joia, L.A.

    1984-01-01

    The concrete of the bored piles of Angra 2 was submitted to a deep control, so more than five thousand core samples were analyzed to verify the quality of the concrete. Based on these samples and using statistics regression theory some conclusions could be done. It was analyzed the dependence of the concrete strength upon the depth of the pile. Also based on these samples some probability distribution functions that could simulate the concrete strength were studied applying the Kolmogorov - Smirnov fitness test. Finally, a method for evaluating a confidence interval of one of the probability function (Weibull distribution) was developed adopting the Monte Carlo simulation technique. (Author) [pt

  10. One metric does not tell the whole story of scientific production. III. Management and conclusions

    Directory of Open Access Journals (Sweden)

    Nieves GONZÁLEZ-FERNÁNDEZ-VILLAVICENCIO

    2016-09-01

    Full Text Available Introduction: There are different strategies for scientific publication that can be addressed from the perspective of management, ahead of the assessment by national agencies. Rising of alternative metrics, services and suppliers. Method: Narrative review. Results: the characteristic features of the evaluation criteria of scientific publications by Spanish agencies evaluation are presented and described altmetrics services. Conclusions: The need for national evaluation systems of scientific production to avoid the current bias and ignorance of the publishing sector which suffer WoS and Scopus arises. And also the need for other altmetric systems, complementary to traditional, to expand the type of scientific products and evaluate the scientific social impact.

  11. The successful conclusion of the Deep Space 1 Mission: important results without a flashy title

    Science.gov (United States)

    Rayman, M. D.

    2002-01-01

    In September 2001, Deep Space 1 (DS1) completed a high-risk and flawless encounter with comet 19P/Borrelly. Its data provide a detailed view of this comet and offere surprising and exciting insights. With this successful conclusion of its extended mission, DS1 undertook a hyperextended mission. Following this period of extremely agressive testing, with no further technology or science objectives, the mission was terminated on December 18, 2001, with the powering off of the spacecraft's trnasmitter, although the receiver was left on. By the end of its mission, DS1 had returned a wealth of important science data and engineering data for future missions.

  12. Epidemiology, biology and therapy of Merkel cell carcinoma: conclusions from the EU project IMMOMEC

    DEFF Research Database (Denmark)

    Becker, Juergen C.; Stang, Andreas; zur Hausen, Axel

    2018-01-01

    Merkel cell carcinoma (MCC) is a highly aggressive, often lethal neuroendocrine cancer. Its carcinogenesis may be either caused by the clonal integration of the Merkel cell polyomavirus into the host genome or by UV-induced mutations. Notably, virally-encoded oncoproteins and UV-induced mutations...... knowledge on epidemiology, biology and therapy of MCC as conclusion of the project 'Immune Modulating strategies for treatment of Merkel Cell Carcinoma', which was funded over a 5-year period by the European Commission to investigate innovative immunotherapies for MCC....

  13. Scene Integration Without Awareness: No Conclusive Evidence for Processing Scene Congruency During Continuous Flash Suppression.

    Science.gov (United States)

    Moors, Pieter; Boelens, David; van Overwalle, Jaana; Wagemans, Johan

    2016-07-01

    A recent study showed that scenes with an object-background relationship that is semantically incongruent break interocular suppression faster than scenes with a semantically congruent relationship. These results implied that semantic relations between the objects and the background of a scene could be extracted in the absence of visual awareness of the stimulus. In the current study, we assessed the replicability of this finding and tried to rule out an alternative explanation dependent on low-level differences between the stimuli. Furthermore, we used a Bayesian analysis to quantify the evidence in favor of the presence or absence of a scene-congruency effect. Across three experiments, we found no convincing evidence for a scene-congruency effect or a modulation of scene congruency by scene inversion. These findings question the generalizability of previous observations and cast doubt on whether genuine semantic processing of object-background relationships in scenes can manifest during interocular suppression. © The Author(s) 2016.

  14. The prospects for nuclear power in the UK. Conclusions of the Government's nuclear review

    International Nuclear Information System (INIS)

    1995-05-01

    The conclusions of the United Kingdom government's review of the nuclear industry in Britain were presented to Parliament in May 1995. The provision of public sector support for a new nuclear power station is deemed unwarranted against the background of the current electricity market. In reaching this conclusion the government considered possible environmental and strategic advantages, the question of diversity of fuel sources, and wider economic benefits. It is intended to privatize parts of Nuclear Electric and Scottish Nuclear in 1996 as subsidiaries of a single holding company to take over the UK's AGR and PWR stations together with a significant level of their associated liabilities. A publicly owned company will continue to run the magnox stations and retain their liabilities. British Nuclear Fuels Ltd (BNFL) will continue to offer nuclear fuel services and to receive government support in developing business in overseas markets. Since their formation in 1990, Nuclear Electric and Scottish Nuclear have improved their financial performance significantly. At privatisation the nuclear component of the fossil fuel levy will cease to be paid to Nuclear Electric and Scottish Nuclear will no longer receive the current premium price paid under the Nuclear Energy Agreement. The current regulatory regime and rigorous safety standards for nuclear power will remain substantially unchanged. (UK)

  15. Comparative analysis of sustainable consumption and production in Visegrad region - conclusions for textile and clothing sector

    Science.gov (United States)

    Koszewska, M.; Militki, J.; Mizsey, P.; Benda-Prokeinova, R.

    2017-10-01

    Gradual environmental degradation, shrinking of non-renewable resources, and lower quality of life are directly or indirectly arising from snowballing consumption. These unfavorable processes concern increasingly textile and clothing sector and are increasingly being felt in Visegrad Region (V4). The objective of the article was to access current consumption patterns in V4 countries, identify the factors that influence those patterns and finally to draw the conclusions for more sustainable consumption and production models as well as to make a comparative analysis of the results across V4 countries. A consumer survey was conducted to examine V4 citizens’ attitudes and behaviors in the context of sustainable consumption. To ensure sample size and comparability across countries 2000 randomly-selected V4 citizens, aged 18 and over, were interviewed. To analyze the supply side of the market and legal framework, the desk research was used. The results allowed to give some guidelines for the joint V4 strategy for solving ecological and social problems of V4 countries as well as the conclusions for textile and clothing sector.

  16. [Sexual child abuse: correlation between medical certificates' conclusions and judiciary sanctions].

    Science.gov (United States)

    Soumah, M M; Bah, H; Mbaye, I; Fall, M C; Yetognon, C; Sow, M L

    2005-01-01

    Sexual child abuse, comprises of indecency attitudes and physical misbehaviours, directed towards children are dominated by rape. The objective of our study was to assess in sexual child abuse the relation between the conclusion of medical certificates and court decision. It is a retrospective study carried out from 1994 to 1998 on the clerk's office correctional repertories in Dakar regional court. An overall number of 79 cases of child abuse were collected in 5 years period. Children under 18 years old of of both sex, were concerned. Data found were correlated with a review of requisition cases received by the of gynaecology and obstetrics clinic of Aristide Dantec Hospital. This facilitates the establishement of the relationship between the offences and the pronounced sanctions, as well as the initial medical certificate and these sanctions. The sanctions were severe whenever rape had been retained. Some cases were disqualified in indecent assault and were judged as such. The judge decision, which follow the medical certificate conclusions in 11 cases out of 14 shows the importance and reliability of this medical document. All files reviewed at the medical and legal level were incomplete. The difficulty of the materiality of the rape and the psychological consequences in the long run and especially HIV infection should invite to a multidisciplinary, specialized and organized management of sexual child abuse. This study has shown the importance of a correct and complete drafting of the medical certificate, to enable the establishment by the judge the materiality of the facts.

  17. Attaining and Maintaining a Continuity of Knowledge to Draw Safeguards Conclusions with Confidence.

    Energy Technology Data Exchange (ETDEWEB)

    Bean, Robert [Purdue Univ., West Lafayette, IN (United States); Blair, Dianna S. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Pickett, Chris [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-11-01

    As the 21st century progresses, new nuclear facilities and the expansion of nuclear activities into new countries will require the International Atomic Energy Agency (IAEA) to place a higher reliance on attaining and maintaining a Continuity of Knowledge (CoK) of its safeguards information than is currently practiced. Additionally, a conceptual view of where and how CoK can be applied will need to evolve to support improved efficiency and efficacy of drawing a safeguards conclusion for each Member State. The ability to draw a safeguards conclusion for a Member State will be predicated on the confidence that CoK has been attained and subsequently maintained with respect to the data and information streams used by the IAEA. This confidence can be described as a function of factors such as elapsed time since the measurement, surveillance of attributes, authentication of information, historic knowledge of potential system failures, and the number and type of data collections. A set of general scenarios are further described for determining what is required to attain CoK and whether CoK has been maintained. A high-level analysis of example scenarios is presented to identify failures or gaps that could cause a loss of CoK. Potential areas for technological research and development are discussed for the next generation of CoK tools.

  18. Presence of intestinal Mycobacterium avium subspecies paratuberculosis (MAP DNA is not associated with altered MMP expression in ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Halwe Jörg M

    2011-04-01

    Full Text Available Abstract Background Mycobacterium avium subspecies paratuberculosis (MAP is suspected to be a causative agent in human Crohn's disease (CD. Recent evidence suggests that pathogenic mycobacteria and MAP can induce the expression of Matrix Metalloproteinases (MMP, which are the main proteases in the pathogenesis of mucosal ulcerations in inflammatory bowel disease (IBD. Within this study we assessed the prevalence of intestinal MAP specific DNA in patients with Crohn's disease, ulcerative colitis (UC, and healthy controls. We further analysed regulation patterns of MMPs in mucosal tissues of UC patients with and without intestinal MAP DNA detection. Methods Colonic biopsy samples were obtained from 63 Norwegian and German IBD patients and 21 healthy controls. RNA was quantified by quantitative real-time polymerase chain reaction (PCR to study MMP gene expression in both pathological and healthy mucosal specimens. The presence of MAP DNA in colonic mucosa was examined using MAP specific PCR. Results MAP DNA was detected in 20% of UC patients and 33% of healthy controls but only in 7% of patients with CD. UC patients treated with corticosteroids exhibited a significantly increased frequency of intestinal MAP DNA compared to those not receiving corticosteroids. Expression of MMP-1, -2, -7, -9, -13, -19, -28 and TNF-α did not differ between UC patients with presence of intestinal MAP DNA compared to those without. MMP-2, MMP-9 and MMP-13 were significantly decreased in UC patients receiving corticosteroids. Conclusions The presence of intestinal MAP specific DNA is not associated with altered MMP expression in UC in vivo. Corticosteroids are associated with increased detection of intestinal MAP DNA and decreased expression of certain MMPs. Frequent detection of MAP DNA in healthy controls might be attributable to the wide environmental distribution of MAP and its presence in the food-chain.

  19. Presence and enactment as a vehicle of psychotherapeutic change.

    Science.gov (United States)

    Viederman, M

    1999-01-01

    This article addresses an aspect of psychoanalytic and psychotherapeutic process that leads to change. Focusing on an aspect of the patient-therapist interaction that the author calls "presence" of the therapist, it demonstrates how the experience of this may lead the patient to unconscious enactment of early wishful fantasies concerning the good parent. The gratification of these wishes implicit in the interaction influences the therapist-patient relationship and plays a significant role in change.

  20. Analysing and exemplifying forensic conclusion criteria in terms of Bayesian decision theory.

    Science.gov (United States)

    Biedermann, A; Bozza, S; Taroni, F

    2018-03-01

    There is ongoing discussion in forensic science and the law about the nature of the conclusions reached based on scientific evidence, and on how such conclusions - and conclusion criteria - may be justified by rational argument. Examples, among others, are encountered in fields such as fingermarks (e.g., 'this fingermark comes from Mr. A's left thumb'), handwriting examinations (e.g., 'the questioned signature is that of Mr. A'), kinship analyses (e.g., 'Mr. A is the father of child C') or anthropology (e.g., 'these are human remains'). Considerable developments using formal methods of reasoning based on, for example (Bayesian) decision theory, are available in literature, but currently such reference principles are not explicitly used in operational forensic reporting and ensuing decision-making. Moreover, applied examples, illustrating the principles, are scarce. A potential consequence of this in practical proceedings, and hence a cause of concern, is that underlying ingredients of decision criteria (such as losses quantifying the undesirability of adverse decision consequences), are not properly dealt with. There is merit, thus, in pursuing the study and discussion of practical examples, demonstrating that formal decision-theoretic principles are not merely conceptual considerations. Actually, these principles can be shown to underpin practical decision-making procedures and existing legal decision criteria, though often not explicitly apparent as such. In this paper, we will present such examples and discuss their properties from a Bayesian decision-theoretic perspective. We will argue that these are essential concepts for an informed discourse on decision-making across forensic disciplines and the development of a coherent view on this topic. We will also emphasize that these principles are of normative nature in the sense that they provide standards against which actual judgment and decision-making may be compared. Most importantly, these standards are

  1. Frequent occurrence of mitochondrial DNA mutations in Barrett's metaplasia without the presence of dysplasia.

    Directory of Open Access Journals (Sweden)

    Soong Lee

    Full Text Available BACKGROUND: Barrett's esophagus (BE is one of the most common premalignant lesions and can progress to esophageal adenocarcinoma (EA. The numerous molecular events may play a role in the neoplastic transformation of Barrett's mucosa such as the change of DNA ploidy, p53 mutation and alteration of adhesion molecules. However, the molecular mechanism of the progression of BE to EA remains unclear and most studies of mitochondrial DNA (mtDNA mutations in BE have performed on BE with the presence of dysplasia. METHODS/FINDINGS: Thus, the current study is to investigate new molecular events (Barrett's esophageal tissue-specific-mtDNA alterations/instabilities in mitochondrial genome and causative factors for their alterations using the corresponding adjacent normal mucosal tissue (NT and tissue (BT from 34 patients having Barrett's metaplasia without the presence of dysplasia. Eighteen patients (53% exhibited mtDNA mutations which were not found in adjacent NT. mtDNA copy number was about 3 times higher in BT than in adjacent NT. The activity of the mitochondrial respiratory chain enzyme complexes in tissues from Barrett's metaplasia without the presence of dysplasia was impaired. Reactive oxygen species (ROS level in BT was significantly higher than those in corresponding samples. CONCLUSION/SIGNIFICANCE: High ROS level in BT may contribute to the development of mtDNA mutations, which may play a crucial role in disease progression and tumorigenesis in BE.

  2. Status of maintenance in the US nuclear power industry 1985. Volume 1. Findings and conclusions

    International Nuclear Information System (INIS)

    1986-06-01

    This report presents the findings, conclusions and recommendations derived from activities performed under Phase I of the NRC Maintenance and Surveillance Program (MSP). Findings are based on trends and patterns derived from operational data compiled by the NRC for the period 1980 through 1985, site surveys conducted at eight plants, and questionnaires administered to NRC Resident Inspectors to characterize nuclear power plant maintenance programs and practices. These activities have shown that plant maintenance programs and practices are highly variable from plant-to-plant and are currently undergoing major changes. While measured plant performance has improved overall since 1980, the maintenance-related contribution to reportable events and challenges to safety systems remains high and is increasing by some measures. The findings of Phase I of the MSP confirmed a number of problems in nuclear power plant maintenance which warrant further NRC and industry attention

  3. The international INTRAVAL project. Summary and conclusions by the TVO/VTT Team

    International Nuclear Information System (INIS)

    Hautojaervi, A.

    1994-12-01

    Teollisuuden Voima Oy (TVO) participated the international cooperation project INTRAVAL and VTT Energy acted as a project team. The Finnish participation focused on flow and transport in crystalline fractured rock and six test cases out of thirteen were tackled. The experimental results were evaluated mainly by means of analytical transport models. The report presents a short review of the experience obtained in the course of the project. It concentrates on the issues revealed in the discussions and analyses of the six test cases in which the TVO/VTT team actively participated but some of the conclusions are even more general in nature. Some suggestions are made for future experimental and theoretical work in the field of geosphere. (15 refs., 2 tabs.)

  4. The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

    Directory of Open Access Journals (Sweden)

    Phillips James

    2012-12-01

    Full Text Available Abstract In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined.

  5. Conclusive evidence of abrupt coagulation inside the void during cyclic nanoparticle formation in reactive plasma

    International Nuclear Information System (INIS)

    Wetering, F. M. J. H. van de; Nijdam, S.; Beckers, J.

    2016-01-01

    In this letter, we present scanning electron microscopy (SEM) results that confirm in a direct way our earlier explanation of an abrupt coagulation event as the cause for the void hiccup. In a recent paper, we reported on the fast and interrupted expansion of voids in a reactive dusty argon–acetylene plasma. The voids appeared one after the other, each showing a peculiar, though reproducible, behavior of successive periods of fast expansion, abrupt contraction, and continued expansion. The abrupt contraction was termed “hiccup” and was related to collective coagulation of a new generation of nanoparticles growing in the void using relatively indirect methods: electron density measurements and optical emission spectroscopy. In this letter, we present conclusive evidence using SEM of particles collected at different moments in time spanning several growth cycles, which enables us to follow the nanoparticle formation process in great detail.

  6. Gasification of waste. Summary and conclusions of twenty-five years of development

    Energy Technology Data Exchange (ETDEWEB)

    Rensfelt, Erik [TPS Termiska Processer AB, Nykoeping (Sweden); Oestman, Anders [Kemiinformation AB, Stockholm (Sweden)

    2000-04-01

    An overview of nearly thirty years development of waste gasification and pyrolysis technology is given, and some major general conclusions are drawn. The aim has been to give new developers an overview of earlier major attempts to treat MSW/RDF with thermochemical processes, gasification or pyrolysis. Research work in general is not covered, only R and D efforts that have led to substantial testing in pilot scale or demonstration. For further details, especially related to ongoing R and D, readers are referred to other recent reviews. The authors' view is that gasification of RDF with appropriate gas cleaning can play an important role in the future, for environmentally acceptable and efficient energy production. A prerequisite is that some of the major mistakes can be avoided, such as: (1) too rapid scale-up without experimental base, (2) unsuitable pretreatment of MSW to RDF and poor integration with material recycling, and (3) too limited gas/flue gas cleaning.

  7. Any value in a specialist review of liver biopsies? Conclusions of a 4-year review.

    Science.gov (United States)

    Paterson, Anna L; Allison, Michael E D; Brais, Rebecca; Davies, Susan E

    2016-08-01

    Liver pathology is a challenging subspeciality, with histopathologists frequently seeking specialist opinions. This study aims to determine the impact of specialist reviews on the final diagnosis and patient management. Agreement with the initial reporting centre in the histopathological diagnosis of 1265 liver biopsies was determined. The nature of differences was explored in more depth for 103 discrepant cases. Differences in the histopathological interpretation were present in 749 of 1265 (59%) biopsies, of which 505 of 749 (67%) were predicted at the time of reporting to impact upon patient management. Agreement was good in cases with chronic viral hepatitis, fatty liver disease, malignancy and minimal pathological changes, while diagnostic differences occurred in more than 70% with biliary disease, autoimmune hepatitis or vascular/architectural changes. A clinical review of a subset of reports with histopathological differences predicted changes in patient management in 63 of 103 (61%). Clinically significant differences in liver biopsy interpretation between local pathologists and subspecialists are common. Diagnoses with frequent discrepancies, such as biliary disease, may benefit from a specialist review as standard when diagnosed initially, while cases requiring specialist advice from disease subgroups where discrepancies are less common, such as chronic viral hepatitis, could be selected during the clinicopathological conference process. © 2016 John Wiley & Sons Ltd.

  8. The 2015 Dietary Guidelines Advisory Committee Scientific Report: Development and Major Conclusions.

    Science.gov (United States)

    Millen, Barbara E; Abrams, Steve; Adams-Campbell, Lucile; Anderson, Cheryl Am; Brenna, J Thomas; Campbell, Wayne W; Clinton, Steven; Hu, Frank; Nelson, Miriam; Neuhouser, Marian L; Perez-Escamilla, Rafael; Siega-Riz, Anna Maria; Story, Mary; Lichtenstein, Alice H

    2016-05-01

    The Dietary Guidelines for Americans (DGA) is published every 5 y jointly by the Department of Health and Human Services (HHS) and the USDA and provides a framework for US-based food and nutrition programs, health promotion and disease prevention initiatives, and research priorities. Summarized in this report are the methods, major conclusions, and recommendations of the Scientific Report of the 2015 US Dietary Guidelines Advisory Committee (DGAC). Early in the process, the DGAC developed a conceptual model and formulated questions to examine nutritional risk and determinants and impact of dietary patterns in relation to numerous health outcomes among individuals aged ≥2 y. As detailed in the report, an expansive, transparent, and comprehensive process was used to address each question, with multiple opportunities for public input included. Consensus was reached on all DGAC's findings, including each conclusion and recommendation, and the entire report. When research questions were answered by original systematic literature reviews and/or with existing, high-quality expert reports, the quality and strength of the evidence was formally graded. The report was organized around the following 5 themes: 1) food and nutrient intakes and health: current status and trends; 2) dietary patterns, foods and nutrients, and health outcomes; 3) diet and physical activity behavior change; 4) food and physical activity environments; and 5) food sustainability and food safety. The following 3 cross-cutting topics were addressed: 1) sodium, 2) saturated fat, and 3) added sugars. Physical activity recommendations from recent expert reports were endorsed. The overall quality of the American diet was assessed to identify overconsumed and underconsumed nutrients of public health concern. Common food characteristics of healthy dietary patterns were determined. Features of effective interventions to change individual and population diet and physical activity behaviors in clinical, public

  9. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities.

    Science.gov (United States)

    Mörsdorf, Martin A; Ravolainen, Virve T; Støvern, Leif Einar; Yoccoz, Nigel G; Jónsdóttir, Ingibjörg Svala; Bråthen, Kari Anne

    2015-01-01

    In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in ecology as only rules

  10. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities

    Directory of Open Access Journals (Sweden)

    Martin A. Mörsdorf

    2015-03-01

    Full Text Available In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in

  11. Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye

    Directory of Open Access Journals (Sweden)

    Sambursky R

    2016-11-01

    Full Text Available Robert Sambursky Coastal Eye Institute, Cornea and Comprehensive Ophthalmology, Bradenton, FL, USA Background: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes.Patients and methods: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9. InflammaDry-positive patients were started on a combination of cyclosporine 0.05% twice daily, 2,000–4,000 mg oral omega-3 fatty acids, and frequent artificial tear replacement. InflammaDry-negative patients were started on 2,000–4,000 mg of oral omega-3 fatty acids and frequent artificial tear replacement. Each patient was retested at ~90 days. A symptom questionnaire was performed at the initial visit and at 90 days.Results: 60% of the patients with dry eye symptoms tested positive for elevated MMP-9 at the initial visit. 78% of all patients returned for follow-up at ~90 days including 80% (48/60 of the previously InflammaDry-positive patients and 75% (30/40 of the previously InflammaDry-negative patients. A follow-up symptom questionnaire reported at least 75% symptomatic improvement in 65% (31/48 of the originally InflammaDry-positive patients and in 70% (21/30 of the initially InflammaDry-negative patients. Symptomatic improvement of at least 50% was reported in 85% (41/48 of previously InflammaDry-positive patients and 86% (26/30 of previously InflammaDry-negative patients. Following treatment, 54% (26/48 of previously InflammaDry-positive patients converted to a negative InflammaDry result.Conclusion: Identifying which symptomatic dry eye

  12. OECD/CSNI Workshop on In-Vessel Core Debris Retention and Coolability - Summary and Conclusions

    International Nuclear Information System (INIS)

    Behbahani, Ali-Reza; Drozd, Andrzej; Kim, Sang-Baik; Micaelli, Jean-Claude; Okkonen, Timo; Sugimoto, Jun; Trambauer, Klaus; Tuomisto, Harri

    1999-01-01

    In the spring of 1994 an OECD Workshop on Large Pool Heat transfer was held in Grenoble. The scope of this workshop was the investigation of (1) molten pool heat transfer, (2) heat transfer to the surrounding water, and (3) the feasibility of in-vessel core debris cooling through external cooling of the vessel. Since this time, experimental test series have been completed (e.g., COPO, ULPU, CORVIS) and new experimental programs (e.g., BALI, SONATA, RASPLAV, debris and gap heat transfer) have been established to consolidate and expand the data base for further model development and to improve the understanding of in-vessel debris retention and coolability in a nuclear power plant. Discussions within the CSNI's PWG-2 and the Task Group on Degraded Core Cooling (TG-DCC) have led to the conclusion that the time was ripe for organizing a new international Workshop with the objectives: - to review the results of experimental research that has been conducted in this area; - to exchange information on the results of member countries experiments and model development on in-vessel core debris retention and coolability; - to discuss areas where additional experimental research is needed in order to provide an adequate data base for analytical model development for core debris retention and coolability. The scope of this workshop was limited to the phenomena connected to in-vessel core debris retention and coolability and did not include steam explosion and fission product issues. The workshop was structured into the following sessions: Key note papers; Experiments and model development; Debris bed heat transfer; Corium properties, molten pool convection and crust formation; Gap formation and gap cooling; Creep behaviour of reactor pressure vessel lower head; Ex-vessel boiling and critical heat flux phenomena; Scaling to reactor severe accident conditions and reactor applications. Compared to the previous workshop held in Grenoble in 1994, large progress has been made in the

  13. Conclusions of the book "eHealth, care and quality of life"

    CERN Document Server

    Capello, Fabio; Manca, Marco

    2014-01-01

    The rising of a new era––mostly based on ICT tools and models––for health has brought new perspectives and new opportunities for the care. The implementation of eHealth models is likely to become the future of medicine, able to give new and more effective tools to the doctors and an active role to the patients. Nonetheless, many are the threats that lie beneath these new approaches. A systematic analysis by some of the experts in this field shows the critical issues that developers, decision-makers, and final users have to know and consider in order to avoid a waste of time, resources, and opportunities.

  14. Financial conflicts of interest and conclusions about neuraminidase inhibitors for influenza: an analysis of systematic reviews.

    Science.gov (United States)

    Dunn, Adam G; Arachi, Diana; Hudgins, Joel; Tsafnat, Guy; Coiera, Enrico; Bourgeois, Florence T

    2014-10-07

    Industry funding and financial conflicts of interest may contribute to bias in the synthesis and interpretation of scientific evidence. To examine the association between financial conflicts of interest and characteristics of systematic reviews of neuraminidase inhibitors. Retrospective analysis. Reviews that examined the use of neuraminidase inhibitors in the prophylaxis or treatment of influenza, were published between January 2005 and May 2014, and used a systematic search protocol. Two investigators blinded to all information regarding the review authors independently assessed the presentation of evidence on the use of neuraminidase inhibitors as favorable or not favorable. Financial conflicts of interest were identified using the index reviews, other publications, and Web-based searches. Associations between financial conflicts of interest, favorability assessments, and presence of critical appraisals of evidence quality were analyzed. Twenty-six systematic reviews were identified, of which 13 examined prophylaxis and 24 examined treatment, accounting for 37 distinct assessments. Among assessments associated with a financial conflict of interest, 7 of 8 (88%) were classified as favorable, compared with 5 of 29 (17%) among those without a financial conflict of interest. Reviewers without financial conflicts of interest were more likely to include statements about the quality of the primary studies than those with financial conflicts of interest. The heterogeneity in populations and outcomes examined in the reviews precluded analysis of the contribution of selective inclusion of evidence on the discordance of the assessments made in the reviews. Many of the systematic reviews had overlapping authorship. Reviewers with financial conflicts of interest may be more likely to present evidence about neuraminidase inhibitors in a favorable manner and recommend the use of these drugs than reviewers without financial conflicts of interest. Australian National Health and

  15. Cranberry juice for prophylaxis of urinary tract infections--conclusions from clinical experience and research.

    Science.gov (United States)

    Nowack, Rainer; Schmitt, Wilhelm

    2008-09-01

    Cranberry juice (Vaccinium macrocarpon) is a widely used and recommended North-American folk remedy for prophylaxis of urinary tract infections (UTI). Clinical trials have documented its efficacy in women with recurrent UTI, but so far not in other groups of patients. The composition of effective cranberry products and its dosage in UTI prophylaxis have not been defined. Intriguing experimental research has identified an anti-adhesive mechanism of cranberry juice that prevents docking of bacteria on host tissues. This efficacy mechanism can be traced in patients' urine following oral intake of cranberry products and appears to be due to proanthocyanidins with an A-type linkage of flavanols. The application of this anti-adhesion mechanism of cranberry-proanthocyandins is currently also investigated in other common diseases of bacterial pathogenesis, for example Helicobacter pylori-associated gastritis and dental caries/periodontal disease. The use of cranberry products appears to be safe and provide additional benefits by anti-oxidant and cholesterol-lowering activity.

  16. Tics in TACs: A Step into an Avalanche? Systematic Literature Review and Conclusions.

    Science.gov (United States)

    Wöber, Christian

    2017-11-01

    Trigeminal autonomic cephalalgias (TACs) comprise cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. In some cases, trigeminal neuralgia (TN, "tic douloureux") or TN-like pain may co-occur with TACs. This article will review the co-occurrence and overlap of TACs and tics in order to contribute to a better understanding of the issue and an improved management of the patients. For performing a systematic literature review Pubmed was searched using a total of ten terms. The articles identified were screened for further articles of relevance. TACs are related to tics in various ways. TN or TN-like paroxysms may co-occur with CH, PH, and HC, labeled as cluster-tic syndrome, PH-tic syndrome, and HC-tic syndrome. Such co-occurrence was not only found in the primary TACs but also in secondary headaches resembling TACs. The initial onset of TAC and tic may be simultaneous or separated by months or years. In acute attacks, tic and TAC may occur concurrently or much more often independently of each other. The term "cluster-tic syndrome" was also used in patients with a single type of pain in a twilight zone between TACs and TN fulfilling none of the relevant diagnostic criteria. Short-lasting neuralgiform headache attacks overlap with TN in terms of clinical features, imaging findings, and therapy. © 2017 American Headache Society.

  17. On an experimental curiosity that if undetected may lead to erroneous far-reaching conclusions

    International Nuclear Information System (INIS)

    Noninski, V.C.; Ciottone, J.L.; White, P.J.

    1997-01-01

    This letter gives a brief discussion of the possibilities of inducing nuclear effects by carrying out only chemical reactions. Undoubtedly, this interest is a result of the still unresolved problem of 'cold fusion,' and some colleagues tend to see a clear connection, and even an extension of the studies, between cold fusion and the alleged chemical transmutation of elements. While we have already published thorough reports (negative so far) of our studies with regard to the claimed increase of gamma-ray emission and beta decay after burning of a mixture of chemicals, this letter informs the Fusion Technology readership of an experimental curiosity that is encountered during similar studies that initially led us to an erroneous conclusion. As in previous studies, we compared certain radiochemical properties of a mixture of chemicals before and after a chemical reaction (burning). Under discussion here is a peak that we observed in the range of 412 keV in the gamma spectrum in one of the burned samples after neutron activating it for 3 min at 1 kW. This peak was ostensibly not present in the same sample unburned. 4 refs., 2 figs

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

    Science.gov (United States)

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

    2005-09-01

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

  19. Development integration via real and technological convergence. Experience of Poland and conclusions for Ukraine

    Directory of Open Access Journals (Sweden)

    Michał G. Woźniak

    2014-09-01

    Full Text Available The paper summarizes main achievements, losses and gains during the first decade of Poland's membership in the EU, while also aiming at development of suggestions for the Polish economic policy in the years to come, as well as draws conclusions for Ukraine, which has now elected the strategy of international economic cooperation. The first part of the paper presents an empirical analysis of Poland's both real and technological convergence with the developed EU countries. These data show that since 1994, as the process of Poland integration with the EU commenced, our country significantly reduced the income and technology gap as compared to the EU. During the financial crisis, Poland 'felt' better than most European countries. In the second part of the paper we attempt to answer the question as to the current conditions of Polish economy development. It is demonstrated that Poland's economic success was due to multiple factors such as endogenous and exogenous, historical and those derived from present events. However, it can be assumed that integration with the EU has been an important positive factor in development of Poland during recent 20 years. Great importance was also vested in the implementation of economic reforms in Poland as well as in policy of the government, although not faultless. The last section of the paper identifies problems now faced by the EU and individual member states, including Poland as regards future years till 2020

  20. Paradigm, experiment and conclusion: La Casa by Bernard Rudofsky in three acts

    Directory of Open Access Journals (Sweden)

    Héctor García-Diego Villarías

    2018-04-01

    Full Text Available La Casa –or in English, the house– that Bernard Rudofsky built on the Spanish Mediterranean coast in 1971 is a valuable case study on the operational possibilities of popular architecture in the practice of this contemporary discipline. It is a repository of theoretical references typical of the vernacular world; its author, known for the exhibition Architecture without Architects, is emblematic of this type of architecture to which he dedicated much of his efforts as a theorist and polemicist throughout the course of his life. Additionally, La Casa is a unique architectural feat as it involves the practical materialization of its implicated theoretical position. It is possible that a concrete conclusion can be drawn from this case, which may shed light on the possible operability of a type of architecture that presents more than a few difficulties for the current context of the discipline, despite being habitually admired and praised. Additionally, the text presented here brings to light unpublished information found in the personal diaries of the architect that allows for the recreation of the circumstances surrounding the ideation and construction of this piece of architecture.

  1. Evaluating Behaviorally Oriented Aviation Maintenance Resource Management (MRM) Training and Programs: Methods, Results, and Conclusions

    Science.gov (United States)

    Taylor, James C.; Thomas, Robert L., III

    2003-01-01

    Assessment of the impact of Aviation Resource Management Programs on aviation culture and performance has compelled a considerable body of research (Taylor & Robertson, 1995; Taylor, 1998; Taylor & Patankar, 2001). In recent years new methods have been applied to the problem of maintenance error precipitated by factors such as the need for self-assessment of communication and trust. The present study - 2002 -- is an extension of that past work. This research project was designed as the conclusion of a larger effort to help understand, evaluate and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2002, three issues were addressed. First, the evaluation of two (independent & different) MRM programs for changing behaviors was undertaken. In one case we were able to further apply the approach to measuring written communication developed during 2001 (Taylor, 2002; Taylor & Thomas, 2003). Second, the MRM/TOQ surveys were made available for completion on the internet. The responses from these on-line surveys were automatically linked to a results calculator (like the one developed and described in Taylor, 2002) to aid industry users in analyzing and evaluating their local survey data on the internet. Third, the main trends and themes from our research about MRM programs over the past dozen years were reviewed.

  2. Pressure Measurement Techniques for Abdominal Hypertension: Conclusions from an Experimental Model.

    Science.gov (United States)

    Chopra, Sascha Santosh; Wolf, Stefan; Rohde, Veit; Freimann, Florian Baptist

    2015-01-01

    Introduction. Intra-abdominal pressure (IAP) measurement is an indispensable tool for the diagnosis of abdominal hypertension. Different techniques have been described in the literature and applied in the clinical setting. Methods. A porcine model was created to simulate an abdominal compartment syndrome ranging from baseline IAP to 30 mmHg. Three different measurement techniques were applied, comprising telemetric piezoresistive probes at two different sites (epigastric and pelvic) for direct pressure measurement and intragastric and intravesical probes for indirect measurement. Results. The mean difference between the invasive IAP measurements using telemetric pressure probes and the IVP measurements was -0.58 mmHg. The bias between the invasive IAP measurements and the IGP measurements was 3.8 mmHg. Compared to the realistic results of the intraperitoneal and intravesical measurements, the intragastric data showed a strong tendency towards decreased values. The hydrostatic character of the IAP was eliminated at high-pressure levels. Conclusion. We conclude that intragastric pressure measurement is potentially hazardous and might lead to inaccurately low intra-abdominal pressure values. This may result in missed diagnosis of elevated abdominal pressure or even ACS. The intravesical measurements showed the most accurate values during baseline pressure and both high-pressure plateaus.

  3. Micah 7:8-20: An apt conclusion to the book of Micah

    Directory of Open Access Journals (Sweden)

    W J Wessels

    2003-10-01

    Full Text Available It is argued in this article that Micah 7:8-20 forms an apt conclusion to the book of Micah. As was the case with Micah 1, the concluding section also focusses on Yahweh and his dealings with the people of the earth. There is a universal tendency to be detected in this section as well. An important aspect to notice� is� the liturgical nature of chapters six and seven, especially 7:8-20. There is a vagueness, almost a timelessness, imbuing this section. This could be intended allowing later generations of believers to apply these words to� their� own� circumstances. With Micah 7:8-20 as the concluding section of the book, one is left with a sense of well-roundedness, of completeness. The collection of oracles attributed� to Micah in general has a sombre tone. For this very reason Micah� 7:8-20� seems� to� change� the mood. It breathes hope into a negative atmosphere of judgment. It ends with a strong emphasis on the power of Yahweh, the power of forgiveness.

  4. A conclusive scalable model for the complete actuation response for IPMC transducers

    International Nuclear Information System (INIS)

    McDaid, A J; Aw, K C; Haemmerle, E; Xie, S Q

    2010-01-01

    This paper proposes a conclusive scalable model for the complete actuation response for ionic polymer metal composites (IPMC). This single model is proven to be able to accurately predict the free displacement/velocity and force actuation at varying displacements, with up to 3 V inputs. An accurate dynamic relationship between the force and displacement has been established which can be used to predict the complete actuation response of the IPMC transducer. The model is accurate at large displacements and can also predict the response when interacting with external mechanical systems and loads. This model equips engineers with a useful design tool which enables simple mechanical design, simulation and optimization when integrating IPMC actuators into an application. The response of the IPMC is modelled in three stages: (i) a nonlinear equivalent electrical circuit to predict the current drawn, (ii) an electromechanical coupling term and (iii) a segmented mechanical beam model which includes an electrically induced torque for the polymer. Model parameters are obtained using the dynamic time response and results are presented demonstrating the correspondence between the model and experimental results over a large operating range. This newly developed model is a large step forward, aiding in the progression of IPMCs towards wide acceptance as replacements to traditional actuators

  5. Results and Conclusions from the NASA Isokinetic Total Water Content Probe 2009 IRT Test

    Science.gov (United States)

    Reehorst, Andrew; Brinker, David

    2010-01-01

    The NASA Glenn Research Center has developed and tested a Total Water Content Isokinetic Sampling Probe. Since, by its nature, it is not sensitive to cloud water particle phase nor size, it is particularly attractive to support super-cooled large droplet and high ice water content aircraft icing studies. The instrument comprises the Sampling Probe, Sample Flow Control, and Water Vapor Measurement subsystems. Results and conclusions are presented from probe tests in the NASA Glenn Icing Research Tunnel (IRT) during January and February 2009. The use of reference probe heat and the control of air pressure in the water vapor measurement subsystem are discussed. Several run-time error sources were found to produce identifiable signatures that are presented and discussed. Some of the differences between measured Isokinetic Total Water Content Probe and IRT calibration seems to be caused by tunnel humidification and moisture/ice crystal blow around. Droplet size, airspeed, and liquid water content effects also appear to be present in the IRT calibration. Based upon test results, the authors provide recommendations for future Isokinetic Total Water Content Probe development.

  6. Conclusions from working group 2 - the analyses of the WIPP-2 experiments

    International Nuclear Information System (INIS)

    Jackson, C.P.

    1995-01-01

    The INTRAVAL WIPP-2 test case is based on data from site investigations carried out at the Waste Isolation Pilot Plant (WIPP) in New Mexico, USA. The site has been chosen as a potential location for a radioactive waste repository. Extensive investigations have been carried out, focused mainly on groundwater flow and transport in the Culebra Dolomite, the main pathway for transport of radionuclides off the site by groundwater in the case of an accidental borehole intrusion into the repository. Five teams studied the test case. Two teams addressed issues involved in the treatment of heterogeneity. Stochastic models and a Monte Carlo approach were used. One team quantified the increased uncertainty resulting from fewer data and explored the issues involved in validation of stochastic models. A second team developed a new method for conditioning stochastic models on head data. Two other teams examined issues relating to the choice of conceptual models. Two-dimensional vertical cross-section models were used to explore the importance of vertical flow. The fifth team advocate the use of a variety of models to highlight the most important processes and parameters. Conclusions from each team experiment are analysed. (J.S.). 4 refs., 11 figs

  7. Methodology and conclusions of activation calculations of WWER-440 type nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Babcsány, Boglárka, E-mail: boglarka.babcsany@reak.bme.hu; Czifrus, Szabolcs; Fehér, Sándor

    2015-04-01

    Highlights: • Activation calculation of two WWER-440 type nuclear power plants. • Detailed description of the applied activation calculation methodology. • Graphical results for total activity and waste index categorization. • General conclusions for activation applicable in the case of PWR reactors. - Abstract: Activation calculations for two nuclear power plants of WWER-440 type have been performed by the authors in order to assist the decommissioning planning by assessing the radioactive inventory present at the time of and at different times after the final shutdown. According to related international literature and studies performed earlier by the authors, considering the activity more than 99% of this inventory is concentrated in the materials directly surrounding the reactor core, where the predominant evolution of radionuclides is generated by neutron induced nuclear reactions. In order to obtain the highest possible accuracy in modelling, three-dimensional Monte Carlo neutron transport calculations were performed. Besides the methods and models applied to these analyses, the paper also summarizes the results that can be generally applied to such nuclear power plant types. At the time of shutdown, the total activity of the stainless steel components is about 6 × 10{sup 16} Bq and 1.3 × 10{sup 17} Bq for the two NPPs considered. The biological shielding concrete constitutes approximately 7 × 10{sup 13} Bq and 1.1 × 10{sup 14} Bq.

  8. Iron deficiency anaemia: with the conclusion of a need for iron reader

    Science.gov (United States)

    Lim, Wai Feng; Yap, Boon Kar; Lai, Mei I.; Talik, Noorazrina; Nasser, Ammar Ahmed; Al-Haiqi, Ahmed Mubarak Ahmed; Sankar Krishnan, Prajindra

    2017-10-01

    In our bloodstream, there are plenty of red blood cells (RBC), which function as an important oxygen carrier in our bodies. Each RBC consists of millions of haemoglobin (Hb), which is made up from globin and iron. If any deficiency/malfunction of any globin, it will lead to anaemia as indicated in low Hb level while iron deficiency anaemia (IDA) is anaemic due to the lacking of iron as indicated in low Hb and ferritin levels. IDA affects almost two billion people globally while anaemia without iron deficiency, such as thalassaemia, affects almost 4.5% in Malaysian population. These anaemic conditions have similar clinical symptoms like fatigue, dizziness, in which disturb their cognitive development and productivity in workplace. In areas without proper medical access, many anaemic individuals were misdiagnosed and treated with iron tablets because they were thought to have iron deficiency anaemia due to low Hb content. But, excess iron is toxic to the body. Misdiagnosis can be avoided by iron status assessment. We hereby review the currently available iron status parameters in laboratory and field study with the conclusion of demonstrating the importance of a need for iron reader, in the effort to reduce the prevalence of IDA globally.

  9. Blast Testing Issues and TBI; Experimental Models that Lead to Wrong Conclusions

    Directory of Open Access Journals (Sweden)

    Charles E. Needham

    2015-04-01

    Full Text Available Over the past several years we have noticed an increase in the number of blast injury studies published in peer-reviewed biomedical journals that have utilized improperly conceived experiments. Data from these studies will lead to false conclusions and more confusion than advancement in the understanding of blast injury, particularly blast neurotrauma. Computational methods to properly characterize the blast environment have been available for decades. These methods, combined with a basic understanding of blast wave phenomena enable researchers to extract useful information from well documented experiments. This basic understanding must include the differences and interrelationships of static pressure, dynamic pressure, reflected pressure, and total or stagnation pressure in transient shockwave flows, how they relate to loading of objects, and how they are properly measured. However, it is critical that the research community effectively overcomes the confusion that has been compounded by a misunderstanding of the differences between the loading produced by a free field explosive blast and loading produced by a conventional shock tube. The principles of blast scaling have been well established for decades and when properly applied will do much to repair these problems.This paper provides guidance regarding proper experimental methods and offers insights into the implications of improperly designed and executed tests. Through application of computational methods, useful data can be extracted from well documented historical tests, and future work can be conducted in a way to maximize the effectiveness and use of valuable biological test data.

  10. Osiris and SOMBRERO inertial fusion power plant designs - summary, conclusions, and recommendations

    International Nuclear Information System (INIS)

    Meier, Wayne R.

    1994-01-01

    An 18 month study to evaluate the potential of inertial fusion energy (IFE) for electric power production has been completed. The primary objective of the study was to provide the US Department of Energy with an evaluation of the potential of inertial fusion for electric power production. The study included the conceptual design of two inertial fusion power plants. Osiris uses an induction linac heavy ion beam driver, and SOMBRERO uses a krypton fluoride laser driver. Conceptual designs were completed for the reactors, power conversion and plant facilities, and drivers. Environmental and safety aspects, technical issues, technology development needs, and economics of the final point designs were assessed and compared. This paper summarizes the results and conclusions of the conceptual designs and results of the assessment studies. We conclude that IFE has the potential of producing technically credible designs with environmental, safety, and economics characteristics that are just as attractive as magnetic fusion. Realizing this potential will require additional research and development on target physics, chamber design, target production and injection systems, and drivers. ((orig.))

  11. Conclusions from some unusual events in the field of ionizing radiation in the German Democratic Republic

    International Nuclear Information System (INIS)

    Schuettmann, W.; Koenig, W.

    1977-01-01

    In the GDR all unusual events in the field of ionizing radiation have been recorded and analysed since 1963. This is done by a central governmental institution, the National Board of Nuclear Safety and Radiation Protection established in 1962, and responsible for all relevant measures throughout the country. An unusual event is defined by radiation protection legislation as an event which deviates from the planned operation programme whether the incident has caused injury or not. The obligation to report such events rests on all licensed users, from users of X-ray machines to operators of reactors in research and nuclear power production. The listed events are continually assessed by the Board. The results of the assessment are evaluated in summary. There has not been a single event with a fatal outcome arising from ionizing radiation. Over the same period there were only seventeen occurrences which resulted in permanent injury to persons, mainly effected by acute external irradiation of parts of the body, especially of hands and forearms. Among the detected causes of unusual events described in detail, human failure predominates by far. Finally, conclusions are drawn from these results. The measures suggested all aim to reduce the frequency of radiation accidents and to minimize their consequences. The main measures concern ways of reducing human error in all fields of radiation protection. Among these, the education and training and the medical examination of radiation workers are discussed in somewhat more detail. (author)

  12. KiKK: An endless story or the long way to come to a conclusion?

    International Nuclear Information System (INIS)

    Michel, Rolf; Mueller, Wolfgang-Ulrich

    2009-01-01

    More than one year after the publication of the KiKK-Study (Epidemiological Study on Childhood Cancer in the Vicinity of Nuclear Power Plants), which reported a statistical correlation between the proximity of a person's residence to the nearest nuclear power plant, at the time of diagnosis, and the person's risk of contracting cancer (or leukaemia) prior to his or her fifth birthday, the SSK presented its assessment and the related scientific explanatory statement to the public on the occasion of an expert discussion in Bonn on February 26, 2009, This article describes the background of the SSK deliberations and gives a survey of its essential results and conclusions. In total, the results are unsatisfactory, since the SSK was not able to explain the findings of the KiKK-Study. However, this was not unexpected considering the international state of knowledge regarding the development of childhood cancer. Considering the fact, that the radiation exposure of members of the public, originating from the nuclear power plants even at the locations of the potentially highest exposures, is by orders of magnitude lower than the natural radiation exposures, the SSK was able to exclude the radiation from the nuclear power plants as cause of the observed increased relative risks. Any more far-reaching explanation attempts would be mere speculation. It is still a long way to know how childhood cancer develops and how the results of the KiKK-Study or other small-scale enhancements of the cancer risk can be explained. (orig.)

  13. Summary and conclusions of the specialist meeting on severe accident management programme development

    International Nuclear Information System (INIS)

    1992-01-01

    The CSNI Specialist meeting on severe accident management programme development was held in Rome and about seventy experts from thirteen countries attended the meeting. A total of 27 papers were presented in four sessions, covering specific aspects of accident management programme development. It purposely focused on the programmatic aspects of accident management rather than on some of the more complex technical issues associated with accident management strategies. Some of the major observations and conclusions from the meeting are that severe accident management is the ultimate part of the defense in depth concept within the plant. It is function and success oriented, not event oriented, as the aim is to prevent or minimize consequences of severe accidents. There is no guarantee it will always be successful but experts agree that it can reduce the risks significantly. It has to be exercised and the importance of emergency drills has been underlined. The basic structure and major elements of accident management programmes appear to be similar among OECD member countries. Dealing with significant phenomenological uncertainties in establishing accident management programmes continues to be an important issue, especially in confirming the appropriateness of specific accident management strategies

  14. The yield of adequate and conclusive fine-needle aspiration results in thyroid nodules is uniform across functional and goiter types.

    Science.gov (United States)

    Liel, Y

    1999-01-01

    Relatively little is known about the cytological characteristics of hyperfunctioning (hot) thyroid nodules. Concern has been expressed that fine-needle aspiration (FNA) identifies hot nodules as follicular tumors or indeterminate, and as a consequence patients could be unnecessarily referred for surgery. Between 1979 and 1996, thyroid FNA was performed on 829 patients. Result of thyroid scan was available in 326; 69 (21%) patients had hot, and 257 (79%) had warm or cold thyroid nodules. Nodules in each of these major groups were divided into 2 subgroups: clinically solitary nodules and dominant nodules in multinodular goiters (MNG). The frequencies of adequate versus inadequate FNA samples, and of conclusive versus indeterminate FNA results were determined separately for each of the groups and subgroups. In addition, patients with hot nodules and overt hyperthyroidism were identified and evaluated separately. Bivariate analyses were performed for the frequency of adequate versus inadequate smears and conclusive versus indeterminate results between hot, toxic, and cold-warm nodules, and between solitary nodules and MNG. The frequency of adequate aspirations and conclusive results in the various groups and subgroups was found to be statistically indistinguishable. In conclusion, the yield of adequate samples and the rate of conclusive results of FNA in thyroid nodules is similar, irrespective of the functional state or of goiter presentation. Hot thyroid nodules do not seem to produce an increase in the rate of inadequate or indeterminate FNA results, and therefore, do not affect the overall performance of thyroid FNA.

  15. Autopsy findings in surgical-radiotherapeutically treated bladder carcinoma - conclusions for optimization of radiotherapy

    International Nuclear Information System (INIS)

    Fueller, J.; Kob, D.; Fritzsche, V.

    1989-01-01

    Autopsy findings in patients with bladder carcinoma, treated by combined operation and radiotherapy, revealed tendencies of tumor spread as well as complications and late effects of radiotherapy. In 24.5% of the cases tumor tissue was found within the bladder and in 30.5% within the minor pelvis. Metastases were found in 24.1% in iliac lymph nodes, in 21.3% in abdominal lymph nodes. Liver, lungs, bones, and kidneys are main organs for hematological metastasizing. Little or undifferentiated carcinomas and squamous cell carcinomas showed a greater tendency to metastasize than highly and medium-differentiated ureteral carcinomas. The least radiotherapeutical complications and late effects were found in a fractionation with daily 1.5 Gy and a total dose of 60 Gy. (author)

  16. Twenty years of children’s health monitoring: organization, results, conclusions

    Directory of Open Access Journals (Sweden)

    Aleksandra Anatol’evna Shabunova

    2015-05-01

    Full Text Available Deep understanding of human potential reproduction, presenting it as a continuous cycle and reflecting the continuity of generations, is significant for the formation of health and development of children. Today’s children will determine the future of Russian society. It is they who in 10–15 years will be a major part of the labor and creative population, a demographic base of the country. The research into children’s problems through the prism of socio-economic development helps identify targets of the state many-sided policy. The article presents results of the long-term medical sociological monitoring on the formation of child health carried out by the Institute of Socio-Economic Development of Territories of RAS with the support of the Vologda Oblast Healthcare Department since 1995. The special monitoring study of health dynamics in real time is unique not only for the Vologda Oblast, but for Russia as well. It reveals the transformation of a personality and the dependence of these changes on direct and indirect factors. The work’s feature is that it addresses an extremely important and wide range of issues: whether man was born healthy or not, if he/she is unhealthy, then why and why he/she was born unhealthy; whether his/her health after the birth is improving or deteriorating; if health is changing, what causes the changes. The 15 year observations disclose the dynamics of child health in the conditions of transformation processes taking place in the country. If the official statistics only records certain health trends, the monitoring results allow us to talk about them at a qualitatively new level. They reveal the underlying causes of demographic processes. The conclusion is, on the one hand, obvious and, on the other hand, it can not be neglected: economic stability and orderly development of the social sphere are critical for family well-being and child health. The reverse situation leads to the destruction of the family

  17. [Domestic elder abuse and neglect--conclusions from the evaluation of a model project].

    Science.gov (United States)

    Görgen, T; Nägele, B

    2005-02-01

    The main task of a federally funded model project in the German city of Hannover was to develop approaches for prevention and intervention in the field of domestic elder abuse. Over a three year period (1998-2001), different approaches--like a telephone helpline for senior citizens, and social workers operating as counsellors for elderly people and their relatives--were tested at a local level. The paper presents results from the evaluation of the project and draws conclusions for future prevention and intervention in the field. The authors argue that the explicit use of the conceptual framework of "violence"/"abuse" creates potentials for scandalizing the issue and is therefore supportive for media appearance, whereas it can impede the approach to the main target groups (elderly people and their relatives) and reduce accessibility of counselling services for potential clients. In the light of evaluation results the focus of the project ("domestic elder abuse" or "violence against elderly people in close relationships") was too narrow for a local project. Counselling services were used in a relatively small number of cases; analyses of cases show that incidents of domestic elder abuse are often embedded in complex problem constellations. Cases brought to the attention of the model project were multifaceted and not limited to incidents of neglect and abuse of elderly care recipients caused by caregiver overload. Cases of intimate violence in partnerships and of intergenerational violence without any of the participants being dependent on care show the need to develop a broader concept of domestic elder abuse. Integration of the concepts of domestic violence, violence against women, elder abuse/neglect and abuse/neglect in caregiving relationships is necessary on a conceptual level as well as on the level of interagency cooperation of institutions dealing with cases of "elder abuse".

  18. On the challenges of drawing conclusions from p-values just below 0.05

    Science.gov (United States)

    2015-01-01

    In recent years, researchers have attempted to provide an indication of the prevalence of inflated Type 1 error rates by analyzing the distribution of p-values in the published literature. De Winter & Dodou (2015) analyzed the distribution (and its change over time) of a large number of p-values automatically extracted from abstracts in the scientific literature. They concluded there is a ‘surge of p-values between 0.041–0.049 in recent decades’ which ‘suggests (but does not prove) questionable research practices have increased over the past 25 years.’ I show the changes in the ratio of fractions of p-values between 0.041–0.049 over the years are better explained by assuming the average power has decreased over time. Furthermore, I propose that their observation that p-values just below 0.05 increase more strongly than p-values above 0.05 can be explained by an increase in publication bias (or the file drawer effect) over the years (cf. Fanelli, 2012; Pautasso, 2010, which has led to a relative decrease of ‘marginally significant’ p-values in abstracts in the literature (instead of an increase in p-values just below 0.05). I explain why researchers analyzing large numbers of p-values need to relate their assumptions to a model of p-value distributions that takes into account the average power of the performed studies, the ratio of true positives to false positives in the literature, the effects of publication bias, and the Type 1 error rate (and possible mechanisms through which it has inflated). Finally, I discuss why publication bias and underpowered studies might be a bigger problem for science than inflated Type 1 error rates, and explain the challenges when attempting to draw conclusions about inflated Type 1 error rates from a large heterogeneous set of p-values. PMID:26246976

  19. Beads task vs. box task: The specificity of the jumping to conclusions bias.

    Science.gov (United States)

    Balzan, Ryan P; Ephraums, Rachel; Delfabbro, Paul; Andreou, Christina

    2017-09-01

    Previous research involving the probabilistic reasoning 'beads task' has consistently demonstrated a jumping-to-conclusions (JTC) bias, where individuals with delusions make decisions based on limited evidence. However, recent studies have suggested that miscomprehension may be confounding the beads task. The current study aimed to test the conventional beads task against a conceptually simpler probabilistic reasoning "box task" METHODS: One hundred non-clinical participants completed both the beads task and the box task, and the Peters et al. Delusions Inventory (PDI) to assess for delusion-proneness. The number of 'draws to decision' was assessed for both tasks. Additionally, the total amount of on-screen evidence was manipulated for the box task, and two new box task measures were assessed (i.e., 'proportion of evidence requested' and 'deviation from optimal solution'). Despite being conceptually similar, the two tasks did not correlate, and participants requested significantly less information on the beads task relative to the box task. High-delusion-prone participants did not demonstrate hastier decisions on either task; in fact, for box task, this group was observed to be significantly more conservative than low-delusion-prone group. Neither task was incentivized; results need replication with a clinical sample. Participants, and particularly those identified as high-delusion-prone, displayed a more conservative style of responding on the novel box task, relative to the beads task. The two tasks, whilst conceptually similar, appear to be tapping different cognitive processes. The implications of these results are discussed in relation to the JTC bias and the theoretical mechanisms thought to underlie it. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Managing nuclear waste: a better idea (Excerpt of conclusions and recommendations)

    International Nuclear Information System (INIS)

    1984-12-01

    The panel concludes that an immediate effort must be made to improve the credibility, internal flexibility and cost-effectiveness of the Office of Civilian Radioactive Waste Management (OCRWM). However, in recognition that no modification to DOE/OCRWM organization would necessarily provide adequate stability and continuity, it is our principal recommendation that investigation of the specific steps necessary to implement, for example, a dedicated federally chartered corporation (the first choice of the Panel voting on organizational tests), should be undertaken immediately so that Congress can have a precise understanding of the legislative changes required to bring about such an organization. The main thrust of the Panel study has dealt with the structure and capabilities of various organizational alternatives for managing the high-level radioactive waste management program. The Panel also gave consideration to the financing processes of the Nuclear Waste Policy Act (NWPA), and to certain financing alternatives which might be substituted for the existing mechanisms. In doing so, the Panel encountered an array of financial uncertainties which confront the radioactive waste management program as it moves forward over the next two decades. At this juncture, it is extremely difficult to predict how future events, programmatic developments, and economic influences will affect the financing structure and cost level over the term of the program. It is the Panel's conclusion that the financing mechanism provided by Congress under the Nuclear Waste Policy Act appears to be fair, amenable to administrative implementation and cost controls, and sufficiently flexible to accommodate the full-recovery requirement of the legislation. Under NWPA, utilities are assessed a fee of 1 mill per kilowatthour of nuclear-generated electricity, plus a one-time fee for spent fuel accumulated prior to April 7, 1983

  1. The chooz a expert survey program and its main conclusions for plant life management

    International Nuclear Information System (INIS)

    Barthelet, B.; Heuze, A.; Hennart, J.C.; Havard, P.

    2001-01-01

    Because of the importance of PWR components life management represents for Electricity Companies, significant R and D programs are dedicated to identifying and analysing mechanisms and damage rates of the different degradation modes of these components, systems and structures. To assess R and D assumptions and to validate non destructive test results through reviews, expert survey programs on in-situ equipment may enhance the knowledge about most of the various phenomena involved. In this regard, an extensive program was launched after the Chooz A NPP was decommissioned in 1991, after 24 years in operation. This program gathered EDF, IPSN, FRAMATOME, ELECTRABEL and TRACTEBEL into partnership. The expert survey program was performed in various laboratories between 1995 and 1999 and includes: - on-site non destructive testing before sampling, - and metallurgical and mechanical tests performed on samples taken from the nuclear and non nuclear part of the unit. The expert survey program performed by Utilities in various laboratories involved the following equipment: - reactor vessel and internal equipment, - reactor coolant system (dissimilar metal welds, SS welds, cast austenitic ferritic steels), - feedwater plant piping (erosion-corrosion), - electric cables susceptible of temperature and irradiation induced ageing, - anchoring in civil engineering structures, - main primary circuit concerning activation measurement. In conclusion, the extensive Chooz A expert survey program yields numerous significant results. The main outcomes will contribute to validate non destructive tests and enhance our knowledge of some degradation mechanisms of often quite similar components present in units in operation. It is worthy to note that this program is of prime importance for operation feedback; the cost of the whole study amounts to approximately 10 Million Euros. (author)

  2. Radioactive-waste ocean dumping will have negligible enviromental impact. Conclusion of draft assessment of NSB

    Energy Technology Data Exchange (ETDEWEB)

    1976-11-01

    This draft report is the result of extensive studies based on the best available information in the field of oceanography, marine radiobiology and health physics. On various basic considerations, assessment was undertaken, and the following conclusion was reached. The quantity of radioactivity to be dumped at one time is assumed to be 500 Ci in the case of test dumping, and 10/sup 5/ Ci/year in the case of full-scale dumping. The conditions required for the dumping sea area are that the bottom water flow and upwelling amount are limited, and that the sea bottom is flat. The horizontal dispersion coefficient of 10/sup 7/ cm/sup 2//sec and the vertical dispersion coefficient of 2 x 10/sup 2/ cm/sup 2//sec are assumed. It is assumed that the radionuclides in the disposed package would leached out as soon as it reaches the sea bottom, and would not show any physicochemical behavior. Typycal radionuclides are classified into 5 groups in terms of their half lives, and their estimated concentrations at 1 km depth are tabulated. The maximum level of individual dose and the magnitude of population dose were assessed on the fishermen working in the dumping sea area, and the adults, children and infants who were expected to receive higher dose on account of the larger intake of fish products than average. The dose level given with the dose assessment model and various panamentors under the dumping conditions is much lower than natural radiation and the permissible level recommended by ICRP.

  3. Advanced thermal-hydraulic and neutronic codes: current and future applications. Summary and conclusions

    International Nuclear Information System (INIS)

    2001-05-01

    An OECD Workshop on Advanced Thermal-Hydraulic and Neutronic Codes Applications was held from 10 to 13 April 2000, in Barcelona, Spain, sponsored by the Committee on the Safety of Nuclear Installations (CSNI) of the OECD Nuclear Energy Agency (NEA). It was organised in collaboration with the Spanish Nuclear Safety Council (CSN) and hosted by CSN and the Polytechnic University of Catalonia (UPC) in collaboration with the Spanish Electricity Association (UNESA). The objectives of the Workshop were to review the developments since the previous CSNI Workshop held in Annapolis [NEA/CSNI/ R(97)4; NUREG/CP-0159], to analyse the present status of maturity and remnant needs of thermal-hydraulic (TH) and neutronic system codes and methods, and finally to evaluate the role of these tools in the evolving regulatory environment. The Technical Sessions and Discussion Sessions covered the following topics: - Regulatory requirements for Best-Estimate (BE) code assessment; - Application of TH and neutronic codes for current safety issues; - Uncertainty analysis; - Needs for integral plant transient and accident analysis; - Simulators and fast running codes; - Advances in next generation TH and neutronic codes; - Future trends in physical modeling; - Long term plans for development of advanced codes. The focus of the Workshop was on system codes. An incursion was made, however, in the new field of applying Computational Fluid Dynamic (CFD) codes to nuclear safety analysis. As a general conclusion, the Barcelona Workshop can be considered representative of the progress towards the targets marked at Annapolis almost four years ago. The Annapolis Workshop had identified areas where further development and specific improvements were needed, among them: multi-field models, transport of interfacial area, 2D and 3D thermal-hydraulics, 3-D neutronics consistent with level of details of thermal-hydraulics. Recommendations issued at Annapolis included: developing small pilot/test codes for

  4. LEAping to conclusions: A computational reanalysis of late embryogenesis abundant proteins and their possible roles

    Directory of Open Access Journals (Sweden)

    Wise Michael J

    2003-10-01

    Full Text Available Abstract Background The late embryogenesis abundant (LEA proteins cover a number of loosely related groups of proteins, originally found in plants but now being found in non-plant species. Their precise function is unknown, though considerable evidence suggests that LEA proteins are involved in desiccation resistance. Using a number of statistically-based bioinformatics tools the classification of a large set of LEA proteins, covering all Groups, is reexamined together with some previous findings. Searches based on peptide composition return proteins with similar composition to different LEA Groups; keyword clustering is then applied to reveal keywords and phrases suggestive of the Groups' properties. Results Previous research has suggested that glycine is characteristic of LEA proteins, but it is only highly over-represented in Groups 1 and 2, while alanine, thought characteristic of Group 2, is over-represented in Group 3, 4 and 6 but under-represented in Groups 1 and 2. However, for LEA Groups 1 2 and 3 it is shown that glutamine is very significantly over-represented, while cysteine, phenylalanine, isoleucine, leucine and tryptophan are significantly under-represented. There is also evidence that the Group 4 LEA proteins are more appropriately redistributed to Group 2 and Group 3. Similarly, Group 5 is better found among the Group 3 LEA proteins. Conclusions There is evidence that Group 2 and Group 3 LEA proteins, though distinct, might be related. This relationship is also evident in the overlapping sets of keywords for the two Groups, emphasising alpha-helical structure and, at a larger scale, filaments, all of which fits well with experimental evidence that proteins from both Groups are natively unstructured, but become structured under stress conditions. The keywords support localisation of LEA proteins both in the nucleus and associated with the cytoskeleton, and a mode of action similar to chaperones, perhaps the cold shock chaperones

  5. Summary of the workshop robustness of electrical systems - Conclusions and recommendations

    International Nuclear Information System (INIS)

    2015-01-01

    The workshop included an opening session, seven sessions with participant presentations followed by short discussions, and a facilitated discussion session. The contributions presented were devoted to discussions of national post-Fukushima regulatory programme developments, methods to determine allowable coping time for electric power recovery, electric power system simulation methods development and benchmarking efforts, analysis of component capability, and approaches to facilitate electric power system recovery from extended loss of AC power. The following conclusions and recommendations are made based on workshop presentations, discussions during particular sessions, and facilitated discussions: - Based upon the panel discussions at the end of the workshop, a majority of the participants suggested the need for continuing efforts after the ROBELSYS workshop and particularly the importance of launching a more permanent international working group on modeling tools and methods related to nuclear power plant electrical power system studies. The working group would be modelled on WGRISK. (It is recognized that creating such a permanent working group would require a multi-year commitment of CSNI and the participants). - It will be very beneficial to continue international information sharing of the following items, eventually leading to development of suitable international electrical standards: System and component requirements for addressing beyond design basis external events; Recommended practice for incorporating diversity in the onsite electrical power system; Recommended practice for relaxing electric power protection features used in emergency situations (assuring margin against spurious electrical shutdowns); Recommended practice for qualification requirements for existing systems and portable components used to cope with AC station blackout. - There is a need for further development and improvements in the analysis and simulation of the following

  6. Study on the Prevalence of Hypertension in Dental Out-patient Population

    Directory of Open Access Journals (Sweden)

    Shobha Basavaraj Sikkerimath

    2010-01-01

    Conclusion: As significant numbers of patients with HTN are visiting dental institutions, routine blood pressure measurement for all dental patients is required. Presence of high blood pressure justifies medical examination in dental patients, to prevent complications during dental treatment. Many subjects examined were unaware of their high blood pressure levels: caution is required prior to performing dental procedures.

  7. [The presence of a companion in the primary care consultation].

    Science.gov (United States)

    Turabián, J L; Pérez Franco, B

    2015-01-01

    The presence of an adult accompanying the patient in the consulting room is a significant fact that deserves the attention of the physician. Some types of companions and their presence in the consultation have been described and may improve communication, patient management, and participatory decision making, achieving greater patient satisfaction. Consultations with companion are generally longer, and patients accompanied are often elderly, women, less educated, and with poorer physical and mental health. But it is not known exactly what is the significance of a consultation with a companion. It may be a semiological fact to keep in mind for the family diagnosis, or it may be the risks of their presence, the influence of medication, or the importance of the doctors themselves that are the cause of the presence of a companion. Different communication skills must be achieved during the interview with the companion in the consultation, rather than with the patient alone. Copyright © 2014. Publicado por Elsevier España, S.L.U.

  8. Conclusion: probable and possible futures. MRI with ultra high magnetic field

    International Nuclear Information System (INIS)

    Le Bihan, D.

    2009-01-01

    MR neuroimaging does not interfere with brain function. Because it is safe, it can be used to study the brains of both patients and healthy volunteers. The tasks performed by neurons depend largely on their precise location, and high-field magnets have the potential to provide a 5- to 10-fold increase in spatio-temporal resolution. This should allow brain function to be studied on a scale of only a few thousand neurons, possibly at the intermediate scale of the 'neural code'. NeuroSpin, a new CEA research center, is dedicated to neuro-MRI at high magnetic field strengths. As a forum for dialogue between those developing and those using these instruments, it brings together researchers and engineers, technicians and medical doctors. NeuroSpin is one of the few institutions in Europe, if not the world, where these experts can come together in one place to design, construct and use machines equipped with ultra-strong magnets. The strongest 'routine' MR device currently operates at 3 Tesla (60 000 times the earth's magnetic field), whereas a first French system operating at 7 Tesla (140 000 times the earth's field) is now available for human studies, and another system operating at 11.7 Tesla (world record) should be delivered in 2011. Preclinical studies are also being conducted with magnets operating at 7 Tesla and, soon, 17.6 Tesla. (author)

  9. CpG island methylator phenotype in adenocarcinomas from the digestive tract: Methods, conclusions, and controversies

    Science.gov (United States)

    Sánchez-Vega, Francisco; Gotea, Valer; Chen, Yun-Ching; Elnitski, Laura

    2017-01-01

    Over the last two decades, cancer-related alterations in DNA methylation that regulate transcription have been reported for a variety of tumors of the gastrointestinal tract. Due to its relevance for translational research, great emphasis has been placed on the analysis and molecular characterization of the CpG island methylator phenotype (CIMP), defined as widespread hypermethylation of CpG islands in clinically distinct subsets of cancer patients. Here, we present an overview of previous work in this field and also explore some open questions using cross-platform data for esophageal, gastric, and colorectal adenocarcinomas from The Cancer Genome Atlas. We provide a data-driven, pan-gastrointestinal stratification of individual samples based on CIMP status and we investigate correlations with oncogenic alterations, including somatic mutations and epigenetic silencing of tumor suppressor genes. Besides known events in CIMP such as BRAF V600E mutation, CDKN2A silencing or MLH1 inactivation, we discuss the potential role of emerging actors such as Wnt pathway deregulation through truncating mutations in RNF43 and epigenetic silencing of WIF1. Our results highlight the existence of molecular similarities that are superimposed over a larger backbone of tissue-specific features and can be exploited to reduce heterogeneity of response in clinical trials. PMID:28344746

  10. Chester 2, Summary and Way Forward, Plenary Session Outputs, Summary Presentation and Conclusions

    International Nuclear Information System (INIS)

    2012-01-01

    The workshop ended with a summary session. The Workshop Chair and Technical Reporter summarised the main findings, and provided the opportunity for further discussion and comment. There was a discussion on the way forward, including reporting, future meetings and other means of networking. Participants provided feedback on the workshop to assist with the planning and conduct of future events. The main conclusions arising from the workshop were as follows: - Licensees are generally positive about engaging with regulators to raise awareness about and support improvements in LMfS/SC. - More active and visible senior regulatory leadership increases the effectiveness of LMfS/SC interventions. Examples of practical actions that senior regulatory leaders can take include raising LMfS/SC matters at senior levels within licensee organisations and feeding back results of discussions to regulatory staff so that priorities and expectations are aligned. - A common 'language', and trust between regulators and licensees are fundamental factors for effective oversight of LMfS/SC. - The message from the previous workshop in 2007 on the importance of integrating LMfS/SC into normal regulatory business was reinforced. - A combination of integrated and targeted LMfS/SC interventions is considered to be effective to take account of the advantages and disadvantages of both approaches. - In line with the conclusions from the previous workshop, influence is preferred to 'enforcement'. Where enforcement action is required, this is likely to be associated with tangible manifestations of LMfS/SC safety culture issues, such as license condition violations. - A fundamental principle of regulatory oversight of LMfS/SC is to encourage licensees to understand and take ownership of issues and solutions. Strategies include: Discussion of regulatory perceptions to test for shared regulator/licensee understanding, - Working together with licensees to develop guidance and understanding (e.g., through

  11. Administrative Databases Can Yield False Conclusions-An Example of Obesity in Total Joint Arthroplasty.

    Science.gov (United States)

    George, Jaiben; Newman, Jared M; Ramanathan, Deepak; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K

    2017-09-01

    Research using large administrative databases has substantially increased in recent years. Accuracy with which comorbidities are represented in these databases has been questioned. The purpose of this study was to evaluate the extent of errors in obesity coding and its impact on arthroplasty research. Eighteen thousand thirty primary total knee arthroplasties (TKAs) and 10,475 total hip arthroplasties (THAs) performed at a single healthcare system from 2004-2014 were included. Patients were classified as obese or nonobese using 2 methods: (1) body mass index (BMI) ≥30 kg/m 2 and (2) international classification of disease, 9th edition codes. Length of stay, operative time, and 90-day complications were collected. Effect of obesity on various outcomes was analyzed separately for both BMI- and coding-based obesity. From 2004 to 2014, the prevalence of BMI-based obesity increased from 54% to 63% and 40% to 45% in TKA and THA, respectively. The prevalence of coding-based obesity increased from 15% to 28% and 8% to 17% in TKA and THA, respectively. Coding overestimated the growth of obesity in TKA and THA by 5.6 and 8.4 times, respectively. When obesity was defined by coding, obesity was falsely shown to be a significant risk factor for deep vein thrombosis (TKA), pulmonary embolism (THA), and longer hospital stay (TKA and THA). The growth in obesity observed in administrative databases may be an artifact because of improvements in coding over the years. Obesity defined by coding can overestimate the actual effect of obesity on complications after arthroplasty. Therefore, studies using large databases should be interpreted with caution, especially when variables prone to coding errors are involved. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Severe accident management (SAM), operator training and instrumentation capabilities - Summary and conclusions

    International Nuclear Information System (INIS)

    2002-01-01

    The Workshop on Operator Training for Severe Accident Management (SAM) and Instrumentation Capabilities During Severe Accidents was organised in collaboration with Electricite de France (Service Etudes et Projets Thermiques et Nucleaires). There were 34 participants, representing thirteen OECD Member countries, the Russian Federation and the OECD/NEA. Almost half the participants represented utilities. The second largest group was regulatory authorities and their technical support organisations. Basically, the Workshop was a follow-up to the 1997 Second Specialist Meeting on Operator Aids for Severe Accident Management (SAMOA-2) [Reports NEA/CSNI/R(97)10 and 27] and to the 1992 Specialist Meeting on Instrumentation to Manage Severe Accidents [Reports NEA/CSNI/R(92)11 and (93)3]. It was aimed at sharing and comparing progress made and experience gained from these two meetings, emphasizing practical lessons learnt during training or incidents as well as feedback from instrumentation capability assessment. The objectives of the Workshop were therefore: - to exchange information on recent and current activities in the area of operator training for SAM, and lessons learnt during the management of real incidents ('operator' is defined hear as all personnel involved in SAM); - to compare capabilities and use of instrumentation available during severe accidents; - to monitor progress made; - to identify and discuss differences between approaches relevant to reactor safety; - and to make recommendations to the Working Group on the Analysis and Management of Accidents and the CSNI (GAMA). The Workshop was organised into five sessions: - 1: Introduction; - 2: Tools and Methods; - 3: Training Programmes and Experience; - 4: SAM Organisation Efficiency; - 5: Instrumentation Capabilities. It was concluded by a Panel and General Discussion. This report presents the summary and conclusions: the meeting confirmed that only limited information is needed for making required decisions

  13. The Successful Conclusion of the Deep Space 1 Mission: Important Results without a Flashy Title

    Science.gov (United States)

    Rayman, Marc D.

    2002-01-01

    direct scientific return, the comet encounter is of engineering value to other missions planning comet encounters. With the successful conclusion of its extended mission, DS1 undertook a hyperextended mission. This phase of its flight was dedicated to final testing of the advanced technologies on board. With the mission at more than three times its planned lifetime, this offered an excellent opportunity to obtain unplanned data on the effects of long-term operation in space. All nine of the hardware technologies were used during the hyperextended mission, with a focus on the ion propulsion system. Following this period of extremely aggressive testing, with no further technology or science objectives, the mission was terminated on December 18, 2001, with the powering off of the spacecraft s transmitter, although the receiver was left on. By the end of its mission, DS1 had returned a wealth of important science data and engineering data for future missions. It did so following the shortest time from pre-phase A through launch of any NASA interplanetary mission in the modern era and the lowest cost of any NASA interplanetary mission ever conducted (measured in same year dollars, including the launch cost). This paper will describe the encounter with comet Borrelly, the hyperextended mission, and summarize the overall results of the Deep Space 1 project.

  14. Synthesis of the Constructing Memory Conference. Conclusions from the Constructing Memory Conference

    International Nuclear Information System (INIS)

    2015-01-01

    'Constructing Memory: An International Conference and Debate on the Preservation of Records, Knowledge and Memory of Radioactive Waste across Generations' was met with a great deal of enthusiasm by participants. The wealth of new topics, the presence of both specialists and of interested stakeholders, and the structure of the conference that allowed both scholarly presentations and group discussions, were particularly appreciated. Academics found that it laid the basis for new academic research. One participant expressed his appreciation in this way: 'It gave me food for thought not only on the issue of nuclear waste information but also on other preservation issues'. Overall, the conference upheld the findings of the RK and M initiative's Phase I and its main work directions. Namely, it confirmed the RK and M overarching findings that: There is no single mechanism or technique that would achieve, alone, the preservation of RK and M over centuries and millennia. An RK and M preservation method is needed whose components offer a variety of RK and M transmission mechanisms that are integrated with one another or that complement one another with a view to maximising information accessibility, understandability and survivability over the timescales considered. The RK and M initiative is thus well advised to continue working on a systemic approach for RK and M preservation and to map its various components and highlight their internal synergies. At a higher level, the RK and M also found confirmation that: There should be no intention to forgo, at any time, records, knowledge and memory (RK and M) of the repository and of the waste it contains. Enabling future members of society to make informed decisions is part of responsible, ethically sound and sustainable radioactive waste management. During the conference's long-term session, its Rapporteur, Fabrice Boissier (Andra), emphasised the idea that the medium term should last as long as

  15. MRI of ovarian torsion: Correlation of imaging features with the presence of perifollicular hemorrhage and ovarian viability

    Energy Technology Data Exchange (ETDEWEB)

    Petkovska, Iva, E-mail: dr.iva.petkovska@gmail.com [Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ (United States); Duke, Eugene; Martin, Diego R.; Irani, Zeenia [Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ (United States); Geffre, Christopher P. [Department of Pathology, University of Arizona College of Public Health, Tucson, AZ (United States); Cragun, Janiel M. [Department of Obstetrics & Gynecology, University of Arizona College of Medicine, Tucson, AZ (United States); Costello, James R.; Arif-Tiwari, Hina; Czeyda-Pommersheim, Ferenc; Udayasankar, Unni [Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ (United States); Kalb, Bobby, E-mail: bkalb@radiology.arizona.edu [Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ (United States)

    2016-11-15

    Purpose: The purpose of our study is to test for: (a) correlation between the presence of a perifollicular T2-hypointense rim on MRI with the presence of perifollicular hemorrhage on histology; and (b) correlation between this finding and diminished ovarian viability after intra-operative detorsion. Methods and materials: Our IRB-approved, retrospective study evaluated 780 patients between August 2012 and February 2016 with ovarian torsion as a diagnostic consideration on the emergency department note. Patients were included if they had preoperative MRI and intraoperatively confirmed case of ovarian torsion. MRIs were retrospectively reviewed for presence of perifollicular T2 hypointense rim in the torsed ovary. Two arms of analysis were performed: (a) assessment of perifollicular hemorrhage on histological exam; and (b) assessment of ovarian viability after intra-operative detorsion. Sensitivity, specificity, positive predictive value, and negative predictive value of MRI for predicting ovarian viability in the setting of torsion was performed. κ test assessed level of agreement between readers. Results: 24 patients included in one of the two arms; 20 in viability analysis and 12 in perifollicular hemorrhage analysis (8 in both). The presence of T2-hypointense rim on MRI demonstrated 88.9% sensitivity and 66.7% specificity for the diagnosis of perifollicular hemorrhage on histology, and 91.7% sensitivity and 100% specificity for predicting intraoperative viability. Conclusion: The presence of a perifollicular T2 hypointense rim on MRI in the setting of ovarian torsion correlates with perifollicular hemorrhage on histopathologic exam, and may also be a useful predictor of ovarian viability in patients presenting with ovarian torsion.

  16. Central poststroke pain: somatosensory abnormalities and the presence of associated myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    de Oliveira Rogério Adas

    2012-09-01

    Full Text Available Abstract Background Central post-stroke pain (CPSP is a neuropathic pain syndrome associated with somatosensory abnormalities due to central nervous system lesion following a cerebrovascular insult. Post-stroke pain (PSP refers to a broader range of clinical conditions leading to pain after stroke, but not restricted to CPSP, including other types of pain such as myofascial pain syndrome (MPS, painful shoulder, lumbar and dorsal pain, complex regional pain syndrome, and spasticity-related pain. Despite its recognition as part of the general PSP diagnostic possibilities, the prevalence of MPS has never been characterized in patients with CPSP patients. We performed a cross-sectional standardized clinical and radiological evaluation of patients with definite CPSP in order to assess the presence of other non-neuropathic pain syndromes, and in particular, the role of myofascial pain syndrome in these patients. Methods CPSP patients underwent a standardized sensory and motor neurological evaluation, and were classified according to stroke mechanism, neurological deficits, presence and profile of MPS. The Visual Analogic Scale (VAS, McGill Pain Questionnaire (MPQ, and Beck Depression Scale (BDS were filled out by all participants. Results Forty CPSP patients were included. Thirty-six (90.0% had one single ischemic stroke. Pain presented during the first three months after stroke in 75.0%. Median pain intensity was 10 (5 to 10. There was no difference in pain intensity among the different lesion site groups. Neuropathic pain was continuous-ongoing in 34 (85.0% patients and intermittent in the remainder. Burning was the most common descriptor (70%. Main aggravating factors were contact to cold (62.5%. Thermo-sensory abnormalities were universal. MPS was diagnosed in 27 (67.5% patients and was more common in the supratentorial extra-thalamic group (P Conclusions The presence of MPS is not an exception after stroke and may present in association with CPSP

  17. Determinants of physician empathy during medical education: hypothetical conclusions from an exploratory qualitative survey of practicing physicians

    Science.gov (United States)

    2014-01-01

    Background Empathy is an outcome-relevant physician characteristic and thus a crucial component of high-quality communication in health care. However, the factors that promote and inhibit the development of empathy during medical education have not been extensively researched. Also, currently there is no explicit research on the perspective of practicing physicians on the subject. Therefore the aim of our study was to explore physicians’ views of the positive and negative influences on the development of empathy during their medical education, as well as in their everyday work as physicians. Method We administered a written Qualitative Short Survey to 63 physicians in seven specialties. They were able to respond anonymously. Our open-ended question was: “What educational content in the course of your studies and/or your specialist training had a positive or negative effect on your empathy?” We analyzed the data using thematic content analysis following Mayring’s approach. Results Forty-two physicians took part in our survey. All together, they mentioned 68 specific factors (37 positive, 29 negative, 2 neutral) from which six themes emerged: 1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Physicians’ active self-development through reflective practice helps the development of empathy. 5. Interactions with colleagues can both promote and inhibit empathy through their role modeling of empathic and non-empathic behavior. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development. Conclusions Our results provide an overview of what might influence the development of clinical empathy, as well as hypothetical conclusions about how to promote it. Reflective practice seems to be lacking in current medical curricula and could be incorporated. Raising physicians

  18. Determinants of Small Business Presence in Japanese and UK Manufacturing

    OpenAIRE

    土井, 教之; Cowling, Mark

    1995-01-01

    The present paper has attempted to examine determinants of small business(SMEs) presence in Japanese and UK manufacturing industries, using a cross-industry model. The results suggest that market structure elements have a definite influence on SMEs' share. This conclusion is consistent with the findings observed in the US and other European countries. The main results here are the following; (1) Concentration is negatively related to SMEs' share. (2) Capital intensity and requirements have a ...

  19. Presence of Helicobacter pylori in betel chewers and non betel chewers with and without oral cancers

    Science.gov (United States)

    Fernando, Neluka; Jayakumar, Gnanapragasam; Perera, Naomal; Amarasingha, Indranee; Meedin, Fahra; Holton, John

    2009-01-01

    which two were also culture positive (Only thirty samples were cultured). The presence of H. pylori in betel chewers (with or without cancer) compared to non-betel chewers was statistically significant. (Chi-square test p < 0.05) The use of tobacco and areca nut in betel chewers was significant with the presence of H. pylori (p < 0.05). Conclusion There is a significant higher proportion of H. pylori in betel chewers compared to non-betel chewers but not between oral cancer patients compared to patients without oral cancer. Hence Betel chewing may predispose to colonisation with H. pylori in the digestive tract through swallowing the quid or during betel chewing. PMID:19772630

  20. Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence

    Directory of Open Access Journals (Sweden)

    Rafael T. da Costa

    2018-02-01

    Full Text Available Objective: To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET sessions. Methods: The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants’ sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants. Results: Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment. Conclusion: All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.

  1. 43 CFR 4.452-8 - Findings and conclusions; decision by administrative law judge; submission to Board for decision.

    Science.gov (United States)

    2010-10-01

    ... after the time allowed for presenting proposed findings and conclusions, the administrative law judge... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Findings and conclusions; decision by... Findings and conclusions; decision by administrative law judge; submission to Board for decision. (a) At...

  2. Emergency nurses' current practices and understanding of family presence during CPR.

    LENUS (Irish Health Repository)

    Madden, Eilis

    2012-02-03

    PURPOSE: To examine emergency nurses\\' current practices and understanding of family presence during CPR in the emergency department, Cork University Hospital, Republic of Ireland. METHOD: A quantitative descriptive design was used in the study. A questionnaire developed by ENA was distributed to emergency nurses working in a level I trauma emergency department at Cork University Hospital. The total sample number was 90, including all emergency nurses with at least 6 months\\' emergency nursing experience. RESULTS: Emergency nurses often took families to the bedside during resuscitation efforts (58.9%) or would do so if the opportunity arose (17.8%). A high percentage (74.4%) of respondents would prefer a written policy allowing the option of family presence during CPR. The most significant barrier to family witnessed resuscitation (FWR) was conflicts occurring within the emergency team. The most significant facilitator to FWR was a greater understanding of health care professionals on the benefits of FWR to patients and families, indicating the need for educational development. CONCLUSION: The findings of the study and previously published studies indicate the need for development of written polices and guidelines on the practice to meet the needs of patients, families, and staff by providing consistent, safe, and caring practices for all involved in the resuscitation process. Recommendations of the study include the development of a written policy and an educational programme on the safe implementation and practices of FWR.

  3. Presence, Mourning, and Beauty: Elements of Analytic Process.

    Science.gov (United States)

    Markman, Henry C

    2017-12-01

    Analyst and patient occasionally arrive at moments of heightened meaning and aliveness. These moments can be transformative and lead to psychic change in the patient. They give life and arouse hope, and feel "real" in a new way, though often entailing emotional turbulence. Specific internal work must be done by the analyst to allow for and foster these experiences. This involves a kind of mourning process in the analyst that allows for "presence" and "availability" as described by Gabriel Marcel, and for the "at-one-ment" described by Bion. These transforming moments can be viewed in an aesthetic realm, along the lines of Keats's "Beauty is truth, truth beauty." This embodies the analytic value of emotional truth. These moments are shared and their emergence is an intersubjective creation. Clinical illustrations show how the internal work of mourning by the analyst through directed introspection allows for presence and availability, and then for shared moments of beauty with the patient.

  4. Enhancing the online presence of a dental practice.

    Science.gov (United States)

    McLeod, Neil S

    2012-04-01

    This article describes methods for enhancing the online presence of a dental practice to gain market share and facilitate communication with current and prospective patients. Topics discussed include creation of a website that will help patients easily locate the practice. The importance of back links and embedded keywords is stressed. A method for identifying competitors' online marketing strategies also is presented, along with discussions of patient reviews and pay-per-click advertising options. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  5. Evaluation of the effect of presence of blood in the stomach on endoscopic diagnostic tests for Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    S Mittal

    2011-01-01

    Full Text Available Introduction: Presence of blood in the stomach has been thought to affect the performance of diagnostic tests used in detecting Helicobacter pylori (H. pylori in the stomach. This study evaluated the effect of blood on the efficacy of rapid urease test (RUT and microscopic appearance of the biopsy after staining with Giemsa stain. Materials and Methods: Patients with bleeding oesophageal varices who met the inclusion criteria were tested for H. pylori by RUT and microscopic examination of the biopsy. A repeat endoscopy, RUT and histology were done one month following initial presentation. The performance of the diagnostic tests was evaluated with and without the presence of intraluminal blood. A combined result of the two tests, RUT and histology, carried out in presence or absence of blood for the diagnosis of H. pylori, when considered together was considered as the gold standard. Results: Thirty six patients included in the study were in the ages ranging between 15-60 years (mean age = 44.14 years ±2.1. The combination of tests at both visits showed 20/36 (55.6% patients were positive for H. pylori. The decrease in H. pylori positivity in the presence of blood was significant for RUT (8.3% vs. 38.9%; P=0.005 and combined test (19.4% vs. 47.2%; P=0.02 but the decrease in positivity for histology (11.1% vs 30.6% was not significant (P=0.08. In the presence of blood, the sensitivity of RUT, histology and combined tests were 15%, 20% and 35%, respectively. In the absence of blood, the sensitivity of RUT, histology and combination of tests was 70%, 55% and 85%, respectively. Conclusion: Blood in the stomach significantly decreased the sensitivity of RUT, histology and the combination of both. Negative results of these tests in acute upper gastro intestinal (GI bleeding should therefore be interpreted carefully.

  6. Rethinking presence: a grounded theory of nurses and teleconsultation.

    Science.gov (United States)

    Barrett, David

    2017-10-01

    To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses. Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses. The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches. Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding). Theoretical saturation occurred after 17 interviews. The core category identified from the data was 'nursing presence' Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors - enablers, constraints and compensation. Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care. Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care. © 2016 John Wiley & Sons Ltd.

  7. A cross-sectional study to assess the incompatible dietary behavior of patients suffering from skin diseases: A pilot study

    Directory of Open Access Journals (Sweden)

    Meghana Kulkarni

    2016-04-01

    Conclusion: Scores for consumption of incompatible diet and dietary habits were found to be higher in acne and psoriasis patients compared to controls. Patients with fungal infections had higher scores for the presence of incompatible dietary habits but similar scores for the consumption of incompatible diet, whereas both scores in patients of vitiligo were similar to controls.

  8. Conclusion Dokter en digter

    African Journals Online (AJOL)

    1994-08-17

    Aug 17, 1994 ... Effects of srmvastatin and cholestyramine in familial and non-familial hypercholesterolaemia. .... in 1993, total and tobacco advertising expenditure, brand ..... luxury market, and through funding of accessories such as ...

  9. Prospects and conclusion

    International Nuclear Information System (INIS)

    1994-01-01

    The present issue of 'Les Cahiers de COGEMAGAZINE', dedicated to role played by Cogema in the nuclear fuel cycling, ends with a short account on perspectives and concluding considerations. In the world nuclear fuel industry the most active zones appear to be France, Japan, China, Taiwan and Korea. A real expansion is to be expected in UO 2 market for PWRs. Also rapid development will be recorded by the production of MOF (mixed oxide fuels) especially due to the inception of British reprocessing plant at Thorp and the increase of number of MOF-fuelled reactors. The most significant lines of progress related to the new fuels are estimated to be: high burn-up (by increasing the resistance to fission gas pressure and irradiation), improvement of response to power excursions, fuel matrices of stronger retention, increase in the plutonium content of MOF, 100% MOF-fuelled reactors, optimizing the utilization of consumable poisons (for PWR) and very high burn-up and very long service lifetimes (for Breeders). In a nuclear environment, now in a rather low expansion rate, the French nuclear fuel industry enjoys the benefit of: an important national market, industrial experimented teams able to tackle all the steps from design to realization of a diversity of nuclear fuel types, fabrication facilities combining suppleness to clients' demands with requirements for high quality, a highly-rated worldwide position, and important capabilities of technological further development. An annex is added showing the percentage involvement of COGEMA and FRAMATOME in the fields of UO 2 -PuO 2 fuel production for PWR, fuels for Breeder, WER and experimental reactors and transport. Also participation of other European companies like PECHINEY, BELGONUCLEAIRE and SIEMENS is indicated

  10. Conclusions and recommendations

    International Nuclear Information System (INIS)

    Moore, A.

    1996-01-01

    This Air Concerted Action successfully developed a standard methodology to help integrate non-food crop production in rural areas with niche energy markets. The project developed and used a common methodology for comparing the costs of different energy crop production and conversion options across the six participating nations. The partners tested the methodology and ran examples in each of the two heat and one liquid biofuel niche markets. The examples demonstrated that at the current crop yields and with the current conversion technology, the delivered heat and liquid fuel from biomass were not competitive with that from fossil fuels, even in the three niche markets. It was confirmed, however, that biomass was important non only as a potential ''clean'' alternative fuel, but as an alternative crop for farmers which could additionally boost employment in rural communities. Following the inclusion of grants, subsidies and co-firing options, the partners tested the extended methodology and then ran another series of examples in the selected niche markets. (Author)

  11. Conclusion. Chapter 4

    International Nuclear Information System (INIS)

    1999-01-01

    Beginning 1992, January 1 Semipalatinsk test site was transforming into large research scientific center. The National Nuclear Center (NNC) was formed on the base of site's research enterprises. The principal problems of NNC are as follows: liquidation of nuclear tests consequences; liquidation of technological infrastructure for preparation and conducting of nuclear tests, creation of technology for radioactive wastes store; implementation of atomic energy development conception in Kazakhstan, etc. Program of site conversion constantly is expanding. In this chapter measures by rehabilitation of injured population are revealed. Taking into account radioecological situation, dose loadings, demographic indexes, sick rate and mortality of population on territories exposed to site's influence Government of Kazakhstan adopted Decree on declaration of these lands of zone of ecological catastrophe. Measures on improvement of radioecological situation are reduce to following ones: determination of irradiation doses received by population during testing period; study of existing radiation contamination; study of all possible sources for dose increasing and taking into account other ones; information of population about radioecological situation and about all consequences of nuclear tests. In 1992 Supreme Soviet of Republic of Kazakhstan worked out and adopted law On social defence of citizens suffered from consequences of nuclear tests on Semipalatinsk test site. It was distinguished four zones of radiation risk. The first zone is zone of extreme risk. It is part of territory subjected to radiation contamination with dose of influence on population above 100 rem during of total period of tests conducting. To this zone belong following inhabited settlements: Budene, Dolon', Cheremushki, Mostik, Sarzhal, Isa, Sarpan, Karakoryk, Zagotskot-2. Second zone is zone of maximal radiation risk. To this zone belong inhabited settlements of following districts: Abaj, Abraly, Beskargaj and Zana-Semej. Population of these districts have been exposed to ionizing radiation influence in doses from 35 up to 100 rem. Third zone is zone of increased risk. To this zone belong inhabited settlements of following districts of Semipalatinsk region: Chybartau, Novo-Shul'ba, Borodulikha, Charsk, Zharmy, Ayaguz. Effective equivalent doses for population during all these years made up from 7 to 35 rem. Forth zone is zone of minimal radiation risk. To this zone the inhabited settlements of Makanchi, Urdzhary, Taskesken, Kokpekty, Aksuat districts belongs. Effective equivalent doses of population irradiation made up from 0.1 to 7 rem. Measures on compensation payment for caused harm to suffered peoples health in result of nuclear weapon test have been carried out with taking into consideration of living duration in different zones

  12. Conclusion: The balanced company

    DEFF Research Database (Denmark)

    Scheuer, John Damm; Jensen, Inger

    2013-01-01

    This concluding chapter brings together the various research findings of the book "The balanced company - organizing for the 21st Century" and develops a general overview of their implications for our understanding of the balancing processes unfolding in companies and organizations....

  13. Conclusions [Chapter 15

    Science.gov (United States)

    Joanne J. Ho; David L. Peterson; Natalie J. Little

    2018-01-01

    The Intermountain Adaptation Partnership (IAP) provided significant contributions to assist climate change response in national forests and national parks of the region. The effort synthesized the best available scientific information to assess climate change vulnerability, develop adaptation options, and catalyze a collaboration of land management agencies and...

  14. Conclusions [Chapter 13

    Science.gov (United States)

    S. Karen Dante-Wood; Linh Hoang

    2018-01-01

    The Northern Rockies Adaptation Partnership (NRAP) provided significant contributions to assist climate change response in national forests and national parks of the Northern Rockies region. The effort synthesized the best available scientific information to assess climate change vulnerability, develop adaptation options, and catalyze a collaboration of land management...

  15. Instead of a Conclusion

    DEFF Research Database (Denmark)

    Dosenrode, Søren

    2009-01-01

    The findings of the book are summarised and commented upon. The concept of 'martyrdom' and the reluctance in the use of violence are discussed......The findings of the book are summarised and commented upon. The concept of 'martyrdom' and the reluctance in the use of violence are discussed...

  16. Geomagnetic field: Conclusions

    Digital Repository Service at National Institute of Oceanography (India)

    Gorodnitsky, A; Subrahmanyam, A

    stream_size 1 stream_content_type text/plain stream_name Mem_Geol_Soc_India_1998_39_38.pdf.txt stream_source_info Mem_Geol_Soc_India_1998_39_38.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  17. Chernobyl - consequences and conclusions

    International Nuclear Information System (INIS)

    1986-10-01

    The Chernobyl accident has taught mankind very plainly that nuclear energy bears a deadly potential and thus is to be ranked as a key problem of future decisions in the sector of power engineering. Decisions to be taken in future have to be seen in the context of the ecological, economic, and social needs. The statements given reflect the FEST's opinion on nuclear energy and the biological, economic, political, and ethical implications. (DG) [de

  18. Conclusions and Further Readings.

    Science.gov (United States)

    Lucas, John A.

    1979-01-01

    The components of a complete and effective marketing plan for higher education institutions are summarized. It is suggested that a marketing plan embrace all elements of the total marketing concept, and include curriculum evaluation, a retention program, and a scheme for evaluating the strategy's effectiveness. A bibliography is included.…

  19. Summary and conclusions

    Digital Repository Service at National Institute of Oceanography (India)

    Rao, D.G; Murthy, K.S; Neprochnov, Y.P; Subrahmanyam, C.

    stream_size 4 stream_content_type text/plain stream_name Mem_Geol_Soc_India_1998_39_233.pdf.txt stream_source_info Mem_Geol_Soc_India_1998_39_233.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  20. Chernobyl - facts and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Schlaefer, H

    1986-07-01

    The article summarizes and comments on the activities started in the FRG after the Chernobyl MCA, and tries to assess whether the legal provisions currently applicable, or emergency plans available, are apt to efficiently cope with such an emergency situation. The author discusses the Soviet Union's initial efforts towards minimizing the disastrous significance of events, the lack of preparedness of German authorities and provisions, the non-availability of persons responsible during weekends and night hours, the confounding mess of measured data and units published by the information media and authorities, and the lack of a suitable information scheme and infrastructure supported both by the Land governments and the Federal Government. (HSCH).

  1. Summary and conclusions

    International Nuclear Information System (INIS)

    2000-01-01

    The international workshop on 'Nuclear Power Plant Life Management in a Changing Business World' was held in Washington, DC, on 26-27 June 2000. This workshop was attended by more than 50 experts from 12 countries and three international organisations. The workshop included a series of presentations to a plenary session of all participants. A spectrum of experiences in plant life extension activities as well as experiences in operating a nuclear power plant (NPP) in a 'free-market' electricity environment were presented: The workshop also included three working groups in which major issues facing PLIM activities for NPPs were identified and discussed. The three working groups covered technology, regulation and business. The following sections of this report consist of summaries of the discussions that took place in each of the three working groups. (author)

  2. Different Teams, Same Conclusions?

    DEFF Research Database (Denmark)

    Fuller, Thomas E; Haider, Haula F; Kikidis, Dimitris

    2017-01-01

    Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the asses......Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations...... for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year......, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across...

  3. Conclusions and prospects

    International Nuclear Information System (INIS)

    2005-01-01

    This article presents general problems of countries Tajikistan, Uzbekistan, Kyrgyzstan-leakage of dangerous matters and industry pollutions, transboundary pollutions of environment, the problems of tailing pits, climate change, public health

  4. Conclusion du titre II

    OpenAIRE

    Nguyen, Minh Hang

    2013-01-01

    La qualification de la conciliation et de la médiation judiciaires en contrats de pourparlers judiciaires emporte d’importantes conséquences. 216. Consécration d’une nouvelle famille de contrats : les contrats de pourparlers judiciaires - Elle consacre tout d’abord une nouvelle famille de contrats : les contrats de pourparlers judiciaires. Ce faisant, elle apporte une pierre supplémentaire à l’édifice des figures hybrides qui mêlent le conventionnel et le judiciaire. 217. Les contrats de pour...

  5. The Cramster Conclusion

    Science.gov (United States)

    Grams, Michael

    2011-01-01

    In a recent "TPT" article, I wrote about a website called "Cramster" (www.cramster.com), which provides students with solutions to homework problems from many textbooks in math and science. I proposed the following question: Could giving students the answers to their assigned homework problems be an effective way of teaching them physics? This…

  6. Proposals, conclusions and recommendations

    OpenAIRE

    2014-01-01

    MISE EN PLACE OU CONSOLIDATION DES OUTILS DE GESTION Des modèles de simulation Les connaissances scientifiques doivent être mieux intégrées et plus accessibles aux décideurs. L’une des options possibles serait d’utiliser des modèles permettant de simuler des scénarios afin d’aider les décideurs dans leurs choix stratégiques. Trois types de modèles nous semblent particulièrement souhaitables : un modèle hydraulique simulant les écoulements et permettant notamment de faire des études d’impact d...

  7. Normal myocardial perfusion imaging in the presence of significant coronary artery stenosis

    International Nuclear Information System (INIS)

    Tian Yueqin; He Zuoxiang; Fang Wei; Yang Minfu; Shen Rui

    2007-01-01

    Objective: The aim of this study was to investigate the factors which might result in normal myocardial perfusion imaging in the presence of significant coronary artery stenosis. Methods: One hundred and thirty-three patients [mean age of (59±10) years, 98 men, 35 women] who underwent coronary angiography and myocardial perfusion SPECT were retrospectively analyzed. Results: Forty-six (35%) patients performed adequate bicycle exercise testing and achieved more than 85% of their predicted maximal heart rates; while 87 (65%) patients did not. Eighty-four (63%) patients had single coronary stenosis, 31(23%) two-vessel and 17(13%) three-vessel diseases. The difference in stenosis severity among the vessels in 13 (76%) cases with three-vessel diseases was not more than 20%. There were totally 202 coronary artery stenosis: 93 (46%) in left anterior descending coronary artery (LAD), 52 (26%) left circumflex coronary artery (LCX), 52(26% ) right coronary artery (RCA) and 5 (2%) left main coronary artery (LM) disease. Eighty-six(43%) vessels had 50%-70% stenosis, 100 (49%) >70%-90% and 16(8% )more than 90%. Conclusion: Normal myocardial perfusion imaging with significant coronary artery stenosis can probably due to inadequate exercise, single vessel disease and mild to moderate stenotic lesion. (authors)

  8. Community of inquiry: Social presence revisited

    NARCIS (Netherlands)

    Kreijns, Karel; Van Acker, Frederik; Vermeulen, Marjan; Van Buuren, Hans

    2018-01-01

    Social presence is a construct that has attracted the attention of many educational scholars involved in online collaborative learning settings wherein all the dialogue is happening through text-based asynchronous and synchronous communication channels. The social presence of the learning group

  9. creating social presence in large classes

    African Journals Online (AJOL)

    Social presence refers to the ability of students to project themselves as 'real people' in an online learning community. While it is difficult to create social presence in large classes, educational technologies can enhance the social dimension of online learning if educators relinquish the use of technology as an instrument of ...

  10. Implication of the presence of a variant hepatic artery during the Whipple procedure

    Directory of Open Access Journals (Sweden)

    Mercedes Rubio-Manzanares-Dorado

    2015-07-01

    Full Text Available Introduction: The anatomical variants of the hepatic artery may have important implications for pancreatic cancer surgery. The aim of our study is to compare the outcome following a pancreatoduodenectomy (PD in patients with or without a variant hepatic artery arising from superior mesenteric artery. Material and methods: We reviewed 151 patients with periampullary tumoral pathology. All patients underwent oncological PD between January 2005 and February 2012. Our series was divided into two groups: Group A: Patients with a hepatic artery arising from superior mesenteric artery; and Group B: Patients without a hepatic artery arising from superior mesenteric artery. We expressed the results as mean ± standard deviation for continuous variables and percentages for qualitative variables. Statistical tests were considered significant if p < 0.05. Results: We identified 11 patients with a hepatic artery arising from superior mesenteric artery (7.3%. The most frequent variant was an aberrant right hepatic artery (n = 7, following by the accessory right hepatic artery (n = 2 and the common hepatic artery trunk arising from the superior mesenteric artery (n = 2. In 73% of cases the diagnosis of the variant was intraoperative. R0 resection was performed in all patients with a hepatic artery arising from superior mesenteric artery. There were no significant differences in the tumor resection margins and the incidence of postoperative complications. Conclusion: Oncological PD is feasible by the presence of a hepatic artery arising from superior mesenteric artery. The complexity of having it does not seem to influence in tumor resection margins, complications and survival.

  11. Factors influencing presence in virtual worlds.

    Science.gov (United States)

    Chow, Meyrick C M

    2012-01-01

    Virtual worlds are showing potential as an effective platform for a variety of activities, including learning. The concept of presence (the sensation of "being there" in a mediated environment) has received substantial attention from the virtual reality community, and the effectiveness of virtual worlds has often been linked to the feelings of presence reported by their users. The present study examined the effects of attitude and perceived ease of use on sense of presence in Second Life, which is one of the most known and used virtual worlds. Based on data from a survey of 206 nursing students, hypotheses are empirically tested. Findings suggest that users' attitude toward using Second Life and their perceived ease of use of it have a positive effect on their sense of presence in the virtual environment. This study advances our understanding of factors influencing presence in virtual worlds.

  12. The Association between Serum Resistin Level and Presence or Severity of Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Roozbeh Mortazavi

    2017-03-01

    Full Text Available Background: Obesity is a well-known principal risk factor for metabolic disorders and cardiovascular diseases. Resistin is one of adipocyte-derived molecules, which plays important roles in inflammation as well as in endocrine and cardiovascular systems. Objectives: The present study aimed to determine the association between serum resistin level and presence/severity of Coronary Heart Disease (CHD. Patients and Methods: This cross-sectional study was conducted on 155 individuals referred for coronary angiography. Information about the patients’ age, gender, and cardiovascular risk factors was recorded. Their weight, height, and waist and hip circumferences were measured, as well. Each coronary angiogram was reported for two scoring methods (number of vessel diseases (usual method and Gensini scoring system by one cardiologist who was not aware of the participants’ serum resistin levels. Then, the relationship between serum resistin level and presence/severity of CHD was evaluated. Results: The results revealed no significant associations between the mean serum resistin level and the presence of CHD by both methods of evaluation of the coronary angiograms after adjustment for all conventional risk factors for CHD. In addition, no significant association was detected between serum resistin level and the severity of CHD based on the usual method of reporting the coronary angiograms (number of vessel diseases (P = 0.332. Yet, serum resistin level was positively correlated to body mass index and waist and hip circumferences and negatively related to height and fasting blood sugar level. Moreover, no linear correlation was found between serum resistin level and Gensini score (P = 0.35. Finally, hip circumference (P = 0.002 and height (P = 0.018 were determined as the predictors of serum resistin level. Conclusions: This cross-sectional study showed no significant associations between serum resistin level and presence/severity of CHD.

  13. 16 CFR 5.63 - Evidence; transcript; in camera orders; proposed findings of fact and conclusions of law.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Evidence; transcript; in camera orders; proposed findings of fact and conclusions of law. 5.63 Section 5.63 Commercial Practices FEDERAL TRADE... findings of fact and conclusions of law. Sections 3.43, 3.44, 3.45, and 3.46 of the Commission's Rules of...

  14. Prevalence of Mycoplasma genitalium, Mycoplasma hominis and Chlamydia trachomatis among Danish patients requesting abortion

    DEFF Research Database (Denmark)

    Baczynska, Agata; Hvid, Malene; Lamy, P

    2008-01-01

    . There was no correlation between the presence of genital infection with C. trachomatis and genital mycoplasmas and no correlation between the presence of antibodies to these bacteria. In conclusion, in Danish patients it is not necessary to test for M. genitalium before abortion since less than 1% were found positive....... The prevalence of genital C. trachomatis infections was high among the abortion-seeking patients....

  15. Correlation between severity of ultrasonographic nonalcoholic fatty liver disease and cardiometabolic risk among Filipino wellness patients

    Directory of Open Access Journals (Sweden)

    Lucky R. Cuenza

    2017-06-01

    Conclusion: Ultrasound-based grading of the severity of NAFLD is associated with abnormalities in the metabolic profile of patients. The FRS is correlated with increasing severity of NAFLD based on ultrasound. These findings suggest that the presence of NAFLD may be a marker for the presence of increased cardiovascular risk and may help identify patients who may benefit from more aggressive therapies to prevent development of adverse cardiovascular events.

  16. Presence and the utility of audio spatialization

    DEFF Research Database (Denmark)

    Bormann, Karsten

    2005-01-01

    The primary concern of this paper is whether the utility of audio spatialization, as opposed to the fidelity of audio spatialization, impacts presence. An experiment is reported that investigates the presence-performance relationship by decoupling spatial audio fidelity (realism) from task...... performance by varying the spatial fidelity of the audio independently of its relevance to performance on the search task that subjects were to perform. This was achieved by having conditions in which subjects searched for a music-playing radio (an active sound source) and having conditions in which...... supplied only nonattenuated audio was detrimental to performance. Even so, this group of subjects consistently had the largest increase in presence scores over the baseline experiment. Further, the Witmer and Singer (1998) presence questionnaire was more sensitive to whether the audio source was active...

  17. Presence within a mixed reality environment.

    Science.gov (United States)

    van Schaik, Paul; Turnbull, Triece; van Wersch, Anna; Drummond, Sarah

    2004-10-01

    Mixed reality environments represent a new approach to creating technology-mediated experiences. However, there is a lack of empirical research investigating users' actual experience. The aim of the current exploratory, non-experimental study was to establish levels of and identify factors associated with presence, within the framework of Schubert et al.'s model of presence. Using questionnaire and interview methods, the experience of the final performance of the Desert Rain mixed reality environment was investigated. Levels of general and spatial presence were relatively high, but levels of involvement and realness were not. Overall, intrinsic motivation, confidence and intention to re-visit Desert Rain were high. However, age was negatively associated with both spatial presence and confidence to play. Furthermore, various problems in navigating the environment were identified. Results are discussed in terms of Schubert's model and other theoretical perspectives. Implications for system design are presented.

  18. Treating the thyroid in the presence of Graves' ophthalmopathy

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J

    2012-01-01

    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  19. Can vitamin d suppress endothelial cells apoptosis in multiple sclerosis patients?

    Directory of Open Access Journals (Sweden)

    Leila Dehghani

    2013-01-01

    Conclusion: Withregard to increment in EC apoptosis rate, which treated by the sera from MS patients and decrement in apoptosis rate by the presence of vitamin D in culture media, it could be proposed that vitamin D pre-treatment can be used for MS patients, due to its beneficial effects on protecting EC apoptosis.

  20. Bladder stones in catheterized spinal cord-injured patients in Nigeria

    African Journals Online (AJOL)

    2011-04-26

    Apr 26, 2011 ... Conclusions: This study shows that a large number of SCI patients have an indwelling urethral catheter and suggests that ultrasound scan for the presence of stone should be schedule in a catheterized SCI patient if catheter encrustation or a positive urine culture of P. mirabilis is noted. Key words: Bladder ...

  1. Prevalence and predictors of low voltage zones in the left atrium in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Huo, Yan; Gaspar, Thomas; Pohl, Matthias

    2017-01-01

    of LVZ. Conclusion: In a large cohort of patients undergoing ablation for AF, the prevalence of LVZ was higher and LVZ areas larger in patients with persistent as compared with paroxysmal AF. The most frequent localization of LVZ was anterior wall, septum and posterior wall. Presence of LVZ...

  2. Influenza immunization rates in children and teenagers in Polish cities: conclusions from the 2009/2010 season.

    Science.gov (United States)

    Kuchar, Ernest; Nitsch-Osuch, Aneta; Zycinska, Katarzyna; Miskiewicz, Katarzyna; Szenborn, Leszek; Wardyn, Kazimierz

    2013-01-01

    The aim of this study was to determine influenza vaccine coverage among children aged 0-18 years in inner city practices in Poland in the 2009/2010 season and factors that might have influenced low vaccination coverage. A retrospective review of 11,735 vaccination charts of children aged 0-18 from seven randomly selected general practices in the capital city of Warsaw and one large practice in the city of Wroclaw was performed. We calculated the numbers of children who were vaccinated in the 2009/2010 season and analyzed the age distribution of vaccinated children. We also reviewed the vaccination history in patients who were vaccinated against influenza including: previous influenza vaccinations, modification (widening) of standard immunization scheme, and a proportion of children who completed the recommended two-dose schedule of vaccination. In the calculations, 95% confidence intervals were used. Out of the total of 11,735 children surveyed, 362 (3.1%, CI: 2.8-3.4%) were vaccinated against influenza in the 2009/2010 season. For 115 of these 362 (31.8%, CI: 27.0-36.6%) children it was their first vaccination against influenza. The mean age of a vaccinated child was 6.0 ± 4.3 years. Children aged 2-5 were most commonly vaccinated (153/362, 42.3%, CI: 37.2-47.4%), while infants (aged 6-12 months) were vaccinated rarely (15/362, 4.4%, CI: 2.2-6.2%). In the group of children younger than 8 years (86/362 children) who were vaccinated for the first time in their life only 29/86 (33.7%, CI: 23.7-43.7%) completed the recommended two-dose schedule. In conclusion, the importance of vaccinating children against influenza is hugely understated in Poland. General physicians should actively recommend annual influenza immunization of children. Recommendations of National Immunization Program concerning influenza vaccine should be clearer, simpler, and easier to implement.

  3. The correlation between the presence of exostoses and temporomandibular joint dysfunction - doi:10.5020/18061230.2008.p174

    Directory of Open Access Journals (Sweden)

    Ana Karolina Nunes Furtado

    2012-01-01

    Full Text Available Objective: To evaluate the association between exostosis and / or torus along with the variables: sex, age, ethnic aspects, anatomic site and temporomandibular joint dysfunction (TMD. Methods: This was a retrospective and serial case study. The sample consisted of 75 patients, of both genders, aged between the 1st and 10th life decades, sorted from the Center of Oral facial Pain of Pernambuco Dentistry School at the State University of Pernambuco (CDO-FOP-UPE. The data were obtained by means of patients’ interview, complemented by analyses of clinical records, besides intraoral examination for the identification, description and classification of the exostosis and/or palatal and/or mandibular torus. The descriptive statistical analyses was accomplished considering anthropometric and demographic data of the patients, applying Pearson’s chi-square test and Fisher’s exact test (p>5. Results: The torus was present in 20.0% of the cases, of which 60.0% were palatal torus. The majority of the cases occurred in male patients (25.0%, brown in color (24.3% and at the 5th decade of life (23.1%, with no association between its presence and the sex, age or race. It was observed that the displacement of the disc with reduction was the type of intra-capsular TMD most related to these alterations. Conclusion: In the studied sample, the presence of torus was registered in 20.0% of the studied subjects, although there was no statistically significant association between the presence of exostosis and the analyzed variables – sex, race and age. The displacement of the disc with reduction was the temporomandibular joint dysfunction most associated to the presence of torus.

  4. We've looked at care from both sides now: the effects of alternative evaluation strategies on study conclusions.

    Science.gov (United States)

    Kane, Robert L; Kane, Rosalie A

    2009-01-01

    This study uses two studies about the role of managed-care programs in serving Medicaid long-term care clients in Florida to illustrate how different research designs can reach divergent conclusions. Two reports from different groups using essentially the same database to assess the impact of managed care on a group of older Medicaid clients served by a Nursing Home Diversion Program reached different conclusions. The report from Florida's Office of Program Policy Analysis and Government Accountability concluded that the Diversion program saved money, whereas the report from the Florida Policy Exchange Center on Aging at the University of South Florida reached basically the opposite conclusion. Both agreed that the capitation rate was too high. How the policy questions are framed and analyzed can affect the conclusions reached. A variety of factors can influence the apparent effects of programmatic interventions. Evaluations must take relevant confounding variables into account.

  5. Misrepresentation of neuroscience data might give rise to misleading conclusions in the media: the case of attention deficit hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    Francois Gonon

    Full Text Available BACKGROUND: There is often a huge gap between neurobiological facts and firm conclusions stated by the media. Data misrepresentation in the conclusions and summaries of neuroscience articles might contribute to this gap. METHODOLOGY/PRINCIPAL FINDINGS: Using the case of attention deficit hyperactivity disorder (ADHD, we identified three types of misrepresentation. The first relies on prominent inconsistencies between results and claimed conclusions and was observed in two scientific reports dealing with ADHD. Only one out of the 61 media articles echoing both scientific reports adequately described the results and, thus questioned the claimed conclusion. The second type of misrepresentation consists in putting a firm conclusion in the summary while raw data that strongly limit the claim are only given in the results section. To quantify this misrepresentation we analyzed the summaries of all articles asserting that polymorphisms of the gene coding for the D4 dopaminergic receptor are associated with ADHD. Only 25 summaries out of 159 also mentioned that this association confers a small risk. This misrepresentation is also observed in most media articles reporting on ADHD and the D4 gene. The third misrepresentation consists in extrapolating basic and pre-clinical findings to new therapeutic prospects in inappropriate ways. Indeed, analysis of all ADHD-related studies in mice showed that 23% of the conclusions were overstated. The frequency of this overstatement was positively related with the impact factor of the journal. CONCLUSION/SIGNIFICANCE: Data misrepresentations are frequent in the scientific literature dealing with ADHD and may contribute to the appearance of misleading conclusions in the media. In synergy with citation distortions and publication biases they influence social representations and bias the scientific evidence in favor of the view that ADHD is primarily caused by biological factors. We discuss the social consequences and

  6. PRESENÇA DE LEVEDURAS DO GÊNERO CANDIDA NA SALIVA DE PACIENTES COM DIFERENTES FATORES PREDISPONENTES E DE INDIVÍDUOS CONTROLE PRESENCE OF CANDIDA GENUS YEASTS IN THE SALIVA OF PATIENTS WITH DIFFERENT PREDISPOSING FACTORS AND OF CONTROL INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Antonio Olavo Cardoso JORGE

    1997-10-01

    Full Text Available Os microrganismos do gênero Candida são, em geral, comensais da cavidade bucal, mas, em determinados indivíduos e em situações específicas, podem transformar-se na forma parasitária, produzindo candidoses bucais. O objetivo deste trabalho foi analisar a presença das espécies do gênero Candida na saliva de indivíduos controle, comparando com pacientes que apresentavam diferentes fatores predisponentes. Foram avaliados 493 pacientes, divididos em 7 grupos: prótese total, prótese parcial removível, periodontite crônica de adulto, respiração bucal, aparelho ortodôntico fixo, aparelho ortodôntico removível e aparelho extrabucal. O grupo controle consistiu de 570 indivíduos que não apresentavam nenhum desses fatores, divididos em 2 grupos: infantil e adulto. Foram realizados o isolamento e a identificação das espécies do gênero Candida. Os resultados mostraram maior porcentagem de pacientes positivos para Candida nos grupos com fatores predisponentes em relação aos controles. Houve predominância de isolamento de C. albicans em todos os grupos, porém, os pacientes com fatores predisponentes apresentaram diversidade maior de espéciesCandida genus microorganisms are common to the normal oral flora, but in certain individuals and in specific situations they can produce oral candidosis. The aim of this study was to analyze the presence of Candida species in the saliva of control individuals and compare the results with those from patients with different predisposing factors. Four-hundred and ninety-three patients were divided in 7 groups: full denture wearers, removable partial denture wearers, patients with adult chronic periodontitis, mouthbreathers, fixed orthodontic appliance wearers, removable orthodontic appliance wearers, or facebow wearers. The control group consisted of 570 individuals who did not present any of these factors, divided in 2 groups: child and adult. Isolation and identification of Candida species were

  7. Social influence on 5-year survival in a longitudinal chemotherapy ward co-presence network.

    Science.gov (United States)

    Lienert, Jeffrey; Marcum, Christopher Steven; Finney, John; Reed-Tsochas, Felix; Koehly, Laura

    2017-09-01

    Chemotherapy is often administered in openly designed hospital wards, where the possibility of patient-patient social influence on health exists. Previous research found that social relationships influence cancer patient's health; however, we have yet to understand social influence among patients receiving chemotherapy in the hospital. We investigate the influence of co-presence in a chemotherapy ward. We use data on 4,691 cancer patients undergoing chemotherapy in Oxfordshire, United Kingdom who average 59.8 years of age, and 44% are Male. We construct a network of patients where edges exist when patients are co-present in the ward, weighted by both patients' time in the ward. Social influence is based on total weighted co-presence with focal patients' immediate neighbors, considering neighbors' 5-year mortality. Generalized estimating equations evaluated the effect of neighbors' 5-year mortality on focal patient's 5-year mortality. Each 1,000-unit increase in weighted co-presence with a patient who dies within 5 years increases a patient's mortality odds by 42% ( β = 0.357, CI:0.204,0.510). Each 1,000-unit increase in co-presence with a patient surviving 5 years reduces a patient's odds of dying by 30% ( β = -0.344, CI:-0.538,0.149). Our results suggest that social influence occurs in chemotherapy wards, and thus may need to be considered in chemotherapy delivery.

  8. Misrepresentation of neuroscience data might give rise to misleading conclusions in the media: the case of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Gonon, Francois; Bezard, Erwan; Boraud, Thomas

    2011-01-31

    There is often a huge gap between neurobiological facts and firm conclusions stated by the media. Data misrepresentation in the conclusions and summaries of neuroscience articles might contribute to this gap. Using the case of attention deficit hyperactivity disorder (ADHD), we identified three types of misrepresentation. The first relies on prominent inconsistencies between results and claimed conclusions and was observed in two scientific reports dealing with ADHD. Only one out of the 61 media articles echoing both scientific reports adequately described the results and, thus questioned the claimed conclusion. The second type of misrepresentation consists in putting a firm conclusion in the summary while raw data that strongly limit the claim are only given in the results section. To quantify this misrepresentation we analyzed the summaries of all articles asserting that polymorphisms of the gene coding for the D4 dopaminergic receptor are associated with ADHD. Only 25 summaries out of 159 also mentioned that this association confers a small risk. This misrepresentation is also observed in most media articles reporting on ADHD and the D4 gene. The third misrepresentation consists in extrapolating basic and pre-clinical findings to new therapeutic prospects in inappropriate ways. Indeed, analysis of all ADHD-related studies in mice showed that 23% of the conclusions were overstated. The frequency of this overstatement was positively related with the impact factor of the journal. Data misrepresentations are frequent in the scientific literature dealing with ADHD and may contribute to the appearance of misleading conclusions in the media. In synergy with citation distortions and publication biases they influence social representations and bias the scientific evidence in favor of the view that ADHD is primarily caused by biological factors. We discuss the social consequences and the causes of data misrepresentations and suggest a few corrective actions.

  9. Value of conventional cytology in the presence of macroscopic lesions of the anal canal

    Directory of Open Access Journals (Sweden)

    Lêda Pereira de Barcellos

    2014-01-01

    Full Text Available Objectives: To verify the value of conventional cytology for the diagnosis of macroscopic le- sions of the anal canal and to describe the limitations of the samples. Method: We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination. Results: Of the total, 91.6% of samples were classified as adequate. Cellular elements repre- sentative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion: The study demonstrates the feasibility of using conventional anal cytology in outpatients. Resumo: Objetivo: verificar o valor da citologia convencional no diagnóstico de lesões macroscópicas do canal anal e descrever as limitações das amostras obtidas. Método: avaliamos 395 exames citológicos convencionais obtidos por escovado do canal anal de pacientes predominantemente do sexo masculino, soropositivos para HIV, e com- paramos com a presença de lesões macroscópicas do canal anal constatadas ao exame proctológico. Resultado: o percentual de amostras adequadas foi de 91,6%, e os elementos celulares re- presentativos da zona de transformação anal foram observados em 63,5% das amostras. Encontramos sensibilidade de 80% e 31% na presença ou ausência desta celularidade, res- pectivamente. Conclusão: O estudo demonstra a possibilidade de utilização da citologia anal convencional no rastreio de lesões macroscópicas do canal anal em pacientes ambulatoriais. Keywords: HPV Prevention of anal neoplasia Conventional cytology, Palavras-chave: HPV Prevenção de neoplasia anal Citologia convencional

  10. Oral Hygiene and Oral Flora Evaluation in Psychiatric Patients in ...

    African Journals Online (AJOL)

    Conclusions: The oral hygiene of most patients was insufficient. The presence of Gram‑negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.

  11. Detection of Trypanosoma cruzi antibodies in multitransfused patients in Colombia

    Directory of Open Access Journals (Sweden)

    Mauricio Beltrán

    2017-09-01

    Conclusions: The results of this study showed a low frequency of T. cruzi infection in multitransfused patients, suggesting that the risk of transfusion infection in Colombia is low. Known risk factors for transfusion-related infection were not associated with the presence of anti-T. cruzi antibodies.

  12. Teaching and Learning Immersion and Presence

    DEFF Research Database (Denmark)

    Herbelin, Bruno; Ciger, Jan

    2008-01-01

    It is known since Socrates that people learn better by experiencing a problem by themselves and by finding a (the) solution(s) by their own. It is however not always possible to offer such freedom to students when teaching the concepts of immersion and presence in virtual environments due......-presence, and observe the inherent problems liked to  communication, field of view, or latency issues. The test performed shows that such experimentation have positive pedagogical impacts, both from the learning and students motivation perspectives....

  13. Connections and lingering presence as cocreated art.

    Science.gov (United States)

    Dempsey, Leona F

    2008-10-01

    Parse described nursing practice as a performing art where the nurse is like a dancer. Just as in any dance performance, unplanned events may occur. When a nurse is artistically living, unique and meaningful performances might emerge from unplanned events. In this practice column, the author describes how shifting experiences surfaced with unforeseen connections and lingering presence during her study of feeling confined. In her study she was in true presence with men living in prison, who were diagnosed with severe mental illness. The humanbecoming school of thought was the nursing perspective guiding the research study.

  14. Designing for Active Place Presence at Home

    DEFF Research Database (Denmark)

    Ylirisku, Salu; Jylhä, Antti; Lehtiö, Anu

    2016-01-01

    Technological support for augmenting the relationship that people establish with remote places has been studied fairly little as the primary focus in telepresence studies is the connection between people. This paper addresses the design challenge for supporting ‘active place presence’ at home...... to be considered when designing for active place presence at home........ A prototype, Hole in Space, was created to explore the design challenge. A longitudinal study of how an urban couple appropriated the prototype was conducted over the duration of seven months. The paper elaborates on how the Web-mediated design influenced place presence and outlines several aspects that need...

  15. Can presence of oral Fordyce's granules serve as a marker for hyperlipidemia?

    Science.gov (United States)

    Gaballah, Kamis Y.; Rahimi, Iman

    2014-01-01

    Background: Hyperlipidemia is a well-documented risk factor for coronary heart disease and a great wealth of clinical trials have shown that early detection of hyperlipidemia and prescribing drugs that lower elevated lipid levels reduce serious cardiovascular events, such as myocardial infarction, heart failure and stroke. Fordyce granules (FGs) are sebaceous glands without hair follicles, most often located under the epithelium of the cheek and the vermilion border of lip. The incidence of FGs is typically high and their presence is usually regarded as a normal variation of the oral mucosa. The aim of this study was to investigate the pattern of anatomical distribution and density of FGs and also to explore any potential relationship between the detection of FGs and the state of hyperlipidemia. Materials and Methods: A cross-sectional, prospective study was designed. The participants were divided into two groups; first group consisted of individuals with FGs and the second group included those with no FGs detected. All participants were fasting 9-12 h before they were subjected to a comprehensive oral examination and their blood was sampled and tested for complete lipid profile. The presence of FGs was scored based on the number of the granules and their anatomical distribution. Chi-square test was used and P < 0.05 was considered as significant. Results: A total of 350 patients were recruited for this study, nearly 90% (n = 314) elicit detectable FGs. The FGs were mainly located on the buccal mucosa with or without labial involvement and their density tend to reduce with age and also with smoking. Individuals with elevated lipid profile tend to have the highest score of the FGs. Conclusion: According to this report, the presence of high numbers of FGs in people with high risk factors for cardiovascular disease should not be neglected. PMID:25426145

  16. Can presence of oral Fordyce′s granules serve as a marker for hyperlipidemia?

    Directory of Open Access Journals (Sweden)

    Kamis Y Gaballah

    2014-01-01

    Full Text Available Background: Hyperlipidemia is a well-documented risk factor for coronary heart disease and a great wealth of clinical trials have shown that early detection of hyperlipidemia and prescribing drugs that lower elevated lipid levels reduce serious cardiovascular events, such as myocardial infarction, heart failure and stroke. Fordyce granules (FGs are sebaceous glands without hair follicles, most often located under the epithelium of the cheek and the vermilion border of lip. The incidence of FGs is typically high and their presence is usually regarded as a normal variation of the oral mucosa. The aim of this study was to investigate the pattern of anatomical distribution and density of FGs and also to explore any potential relationship between the detection of FGs and the state of hyperlipidemia. Materials and Methods: A cross-sectional, prospective study was designed. The participants were divided into two groups; first group consisted of individuals with FGs and the second group included those with no FGs detected. All participants were fasting 9-12 h before they were subjected to a comprehensive oral examination and their blood was sampled and tested for complete lipid profile. The presence of FGs was scored based on the number of the granules and their anatomical distribution. Chi-square test was used and P < 0.05 was considered as significant. Results: A total of 350 patients were recruited for this study, nearly 90% (n = 314 elicit detectable FGs. The FGs were mainly located on the buccal mucosa with or without labial involvement and their density tend to reduce with age and also with smoking. Individuals with elevated lipid profile tend to have the highest score of the FGs. Conclusion: According to this report, the presence of high numbers of FGs in people with high risk factors for cardiovascular disease should not be neglected.

  17. Evaluation of an IPCC climate report. An analysis of conclusions on the possible regional consequences of climate change

    International Nuclear Information System (INIS)

    2010-01-01

    This report contains the results of a study of the reliability of the regional chapters (H9-16) of the contribution of Working Group II to the Fourth Climate Report of the IPCC (the sub report on consequences, adaptation and vulnerability). Moreover an assessment was made of the possible consequences of errors for the conclusions in the high level summaries of that report. The Netherlands Environmental Assessment Agency did not detect any errors that may undermine the main conclusions of the scientific UN Climate Panel IPCC of 2007 on the possible future consequences of climate change. However, some of the substantiations of the conclusions lack clarity. To prevent lack of clarity and inaccuracies the IPCC needs to invest more in quality checks. [nl

  18. Alternative global goodness metrics and sensitivity analysis: heuristics to check the robustness of conclusions from studies comparing virtual screening methods.

    Science.gov (United States)

    Sheridan, Robert P

    2008-02-01

    We introduce two ways of testing the robustness of conclusions from studies comparing virtual screening methods: alternative "global goodness" metrics and sensitivity analysis. While the robustness tests cannot eliminate all biases in virtual screening comparisons, they are useful as a "reality check" for any given study. To illustrate this, we apply them to a set of enrichments published in McGaughey et al. (J. Chem. Inf. Model. 2007, 47, 1504-1519) where 11 target protein/ligand combinations are tested on 2D and 3D similarity methods, plus docking. The major conclusions in that paper, for instance, that ligand-based methods are better than docking methods, hold up. However, some minor conclusions, such as Glide being the best docking method, do not.

  19. The relationship between the presence of lower urinary tract symptoms and waist circumference

    Directory of Open Access Journals (Sweden)

    Oliveira MC

    2016-07-01

    Full Text Available Maria Clara Eugênia de Oliveira, Larissa Ramalho Dantas Varella, Priscylla Helouyse melo Angelo, Maria Thereza Albuquerque Barbosa Cabral Micussi Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil Purpose: The aim of the study is to evaluate the pressure of the pelvic floor muscles (PFM according to waist circumference (WC and correlate the presence of urinary tract symptoms (UTS with WC. Patients and methods: The study was observational and cross-sectional. One-hundred and sixty-four females between 45 and 65 years of age were evaluated. The sample was divided into two groups, according to WC: Group ≤80 (G≤80 was composed of females in whom WC was up to 80 cm; and Group >80 (G>80 was composed of females with WC above 80 cm. The subjects were assessed in terms of sociodemographic data, pre-existing conditions, urogynecological and obstetric history, and the presence of lower UTS (LUTS, as well as physical examination, measurement of WC, height, and weight. The PFM assessment was made by perineometry. To compare the mean between groups, the independent samples t-test was applied, and to correlate the WC with perineometry and LUTS, the Pearson’s correlation test was used. Results: The final sample was composed of 156 patients. The average age of participants was 55.21 (±24.5 years in G≤80 and 57.23 (±6.12 years in G>80. There were significant differences regarding the presence of LUTS between the groups (P<0.05; as to the perineometry, there was a significant difference (P=0.03 between the groups: 38.68±13.63 cmH2O for G≤80 and 30.11±11.20 cmH2O for G>80. There was a correlation between the presence of urinary urgency (r=0.7; P=0.00, nocturia (r=0.7; P=0.00, and urinary incontinence (r=0.9; P=0.00 with WC. Conclusion: Females with larger abdominal diameter have a higher prevalence of LUTS such as urinary incontinence, nocturia, and urinary urgency, as well as a lower PFM

  20. Preoperative parental information and parents' presence at induction of anaesthesia.

    Science.gov (United States)

    Astuto, M; Rosano, G; Rizzo, G; Disma, N; Raciti, L; Sciuto, O

    2006-06-01

    Preoperative preparation of paediatric patients and their environment in order to prevent anxiety is an important issue in paediatric anaesthesia. Anxiety in paediatric patients may lead to immediate negative postoperative responses. When a child undergoes surgery, information about the child's anaesthesia must be provided to parents who are responsible for making informed choices about healthcare on their child's behalf. A combination of written, pictorial, and verbal information would improve the process of informed consent. The issue of parental presence during induction of anaesthesia has been a controversial topic for many years. Potential benefits from parental presence at induction include reducing or avoiding the fear and anxiety that might occur in both the child and its parents, reducing the need for preoperative sedatives, and improving the child's compliance even if other studies showed no effects on the anxiety and satisfaction level. The presence of other figures such as clowns in the operating room, together with one of the child's parents, is an effective intervention for managing child and parent anxiety during the preoperative period.

  1. Presence and HRCT quantification of bronchiectasis in coal workers

    Energy Technology Data Exchange (ETDEWEB)

    Altin, R.; Savranlar, A.; Kart, L.; Mahmutyazicioglu, K.; Ozdemir, H.; Akdag, B.; Gundogdu, S. [Zonguldak Karalmas University, Zonguldak (Turkey). Dept. of Pulmonary Medicine

    2004-11-01

    The purpose of this study was to evaluate the presence of bronchiectasis in coal workers with or without coal worker pneumoconiosis (CWT) and to assess the extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high resolution computed tomography (HRCT). The patient group consisted of 78 patients (43 CWP; 35 non-CWP). Pneumoconiosis profusions of CWP workers were between p0/1 and p2/2 according to ILO 1980 chest X-ray classification. HRCT examinations of all subjects were evaluated for the presence, extent, dilatation and thickness of bronchiectasis. The diagnosis of bronchiectasis was put on 19 of 43 CWP (44.1 %) and 7 of 35 non-CWP workers (20.0 %). There were statistically significant differences between bronchiectasis positive and negative coal workers with CWP concerning age and exposure duration (P = 0.012 and 0.009, respectively). Then, multiple logistic regression analysis was performed to define exact risk factors. Exposure duration was only found to be related with presence of bronchiectasis ((odds ratio) OR = 1.494, 95 % confidence interval 1.168-1.912). The data from the present study shows that bronchiectasis is frequent and severe in CWP workers than without. Bronchiectasis is influenced by coal dust exposure. Thus, coal dust protection measures must be controlled efficiently to prevent bronchiectasis in coal workers.

  2. DECONSTRUCTION OF THE METAPHYSICS OF PRESENCE IN PHENOMENOLOGY AND STRUCTURALISM

    Directory of Open Access Journals (Sweden)

    A. A. Polivoda

    2017-06-01

    Full Text Available Purpose of the work is a description of critical position of J. Derrida on metaphysics of presence in phenomenological and structuralist discourses. As a philosophical strategy, deconstruction tries to destroy a violent hierarchy of terms, in which one term dominates the other according to its ontological or rational sense. Methodology of research is based on J. Derrida’s strategy of deconstruction, which tries to undermine the basic principles of knowledge and Western philosophy existence, for example, the opposition between nature and culture. In terms of J. Derrida, to deconstruct Western philosophy means to explore the tensions and contradictions in text, which should clarify false reliability of accepted hierarchies. The originality of the work lies in the identification of metaphysic of presence problem in structuralist and phenomenological discourses through the deconstruction project. Deconstruction should show instability of logocentrism, which focuses on repression of writing in terms of thought, truth, reason or logic. Conclusions: J. Derrida’s deconstruction appeared as an attempt to overthrow metaphysics and get focused on the concept of writing, which scope is limited by discourse. Deconstruction of metaphysics of presence is a continuous request of legitimacy of the existing logocentrism, and search of its weaknesses, aporias and contradictions, which make impossible the tradition, centered around mind.

  3. Modulating presence and impulsiveness by external stimulation of the brain

    Directory of Open Access Journals (Sweden)

    Baumgartner Thomas

    2008-08-01

    Full Text Available Abstract Background "The feeling of being there" is one possible way to describe the phenomenon of feeling present in a virtual environment and to act as if this environment is real. One brain area, which is hypothesized to be critically involved in modulating this feeling (also called presence is the dorso-lateral prefrontal cortex (dlPFC, an area also associated with the control of impulsive behavior. Methods In our experiment we applied transcranial direct current stimulation (tDCS to the right dlPFC in order to modulate the experience of presence while watching a virtual roller coaster ride. During the ride we also registered electro-dermal activity. Subjects also performed a test measuring impulsiveness and answered a questionnaire about their presence feeling while they were exposed to the virtual roller coaster scenario. Results Application of cathodal tDCS to the right dlPFC while subjects were exposed to a virtual roller coaster scenario modulates the electrodermal response to the virtual reality stimulus. In addition, measures reflecting impulsiveness were also modulated by application of cathodal tDCS to the right dlPFC. Conclusion Modulating the activation with the right dlPFC results in substantial changes in responses of the vegetative nervous system and changed impulsiveness. The effects can be explained by theories discussing the top-down influence of the right dlPFC on the "impulsive system".

  4. Performing Presence in the Pop Art Lab

    DEFF Research Database (Denmark)

    Strand, Dixi Louise

    2011-01-01

    they come together to create an event of presence. The paper relates how this object of study is approached, and produced, through a series of methods. Methods such as participant observation, interviews, reading of blogs and web texts are understood as mediations. The paper traces how these mediations...

  5. Stay the Course: Managing Online Presence

    Science.gov (United States)

    Fredrick, Kathy

    2009-01-01

    How can a school librarian share instruction and information with students and colleagues in the virtual world? Library Web pages make resources available 24/7. New tools available to schools can also give new options in making a Web presence known. This article suggests a plan for school librarians on how they can manage their libraries' online…

  6. 31 CFR 91.3 - Recording presence.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Recording presence. 91.3 Section 91.3 Money and Finance: Treasury Regulations Relating to Money and Finance REGULATIONS GOVERNING CONDUCT IN... exists, and at such other times as may be necessary for the orderly conduct of the Government's business...

  7. 31 CFR 407.3 - Recording presence.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Recording presence. 407.3 Section 407.3 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE... business of the Treasury Department. The property shall also be closed to the public when, in the opinion...

  8. Sampling season affects conclusions on soil arthropod community structure responses to metal pollution in Mediterranean urban soils

    NARCIS (Netherlands)

    Santorufo, L.; van Gestel, C.A.M.; Maisto, G.

    2014-01-01

    This study aimed to assess if the period of sampling affected conclusions on the responses of arthropod community structure to metal pollution in urban soils in the Mediterranean area. Higher temperature and lower precipitation were detected in autumn than in spring. In both samplings, the most

  9. It Is Incorrect To Say "The Test Is Reliable": Bad Language Habits Can Contribute to Incorrect or Meaningless Research Conclusions.

    Science.gov (United States)

    Thompson, Bruce

    Researchers too frequently consider the reliability of the scores they analyze, and this may lead to incorrect conclusions. Practice in this regard may be negatively influenced by telegraphic habits of speech implying that tests possess reliability and other measurement characteristics. Styles of speaking in journal articles, in textbooks, and in…

  10. Cortical thickness difference across the central sulcus visualized in the presence of vasogenic edema

    International Nuclear Information System (INIS)

    Togao, Osamu; Yoshiura, Takashi; Mihara, Futoshi; Noguchi, Tomoyuki; Hiwatashi, Akio; Yamashita, Koji; Yoshitake, Tadamasa; Honda, Hiroshi

    2008-01-01

    Purpose: To confirm the cortical thickness difference across the central sulcus (CS) visualized in the presence of vasogenic edema on MRI. Materials and methods: T2-weighted images of 70 cerebral hemispheres showing vasogenic edema infiltrating into subcortical white matter around the CS were studied retrospectively. Two neuroradiologists measured the cortical thickness of the anterior and posterior banks of the CS, precentral sulci (PrCS), and postcentral sulci (PoCS). Additionally, we compared the cortical thickness of the anterior and posterior banks of each sulcus visually using a grading scale. Results: On T2-weighted images, the cerebral cortex was highlighted by a high signal-intensity vasogenic edema in the adjacent white matter, and its thickness was readily measurable. The unique cortical thickness difference between the anterior and posterior banks of the CS were confirmed with measurements of 2.67 and 1.48 mm (p < 0.0001). The cortical measurements across other cerebral sulci were 2.04 and 1.95 mm (NS) for the PrCS, and 1.67 and 1.77 mm (NS) for the PoCS. The cortical thickness ratios were 1.86 for the CS, 1.05 for the PrCS, and 0.96 for the PoCS. On visual evaluation, the anterior bank of the CS was thicker than the posterior bank in 93% (65/70). For the PrCS and PoCS, the thickness of the anterior and posterior banks appeared to be equal in over 70% of the patients. Conclusion: A prominent cortical thickness difference across the CS in the presence of vasogenic edema was confirmed. This finding is considered to facilitate the identification of the CS in patients with brain tumors

  11. Cortical thickness difference across the central sulcus visualized in the presence of vasogenic edema

    Energy Technology Data Exchange (ETDEWEB)

    Togao, Osamu [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582 (Japan)], E-mail: togao@dr.hosp.kyushu-u.ac.jp; Yoshiura, Takashi; Mihara, Futoshi; Noguchi, Tomoyuki; Hiwatashi, Akio; Yamashita, Koji; Yoshitake, Tadamasa; Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582 (Japan)

    2008-05-15

    Purpose: To confirm the cortical thickness difference across the central sulcus (CS) visualized in the presence of vasogenic edema on MRI. Materials and methods: T2-weighted images of 70 cerebral hemispheres showing vasogenic edema infiltrating into subcortical white matter around the CS were studied retrospectively. Two neuroradiologists measured the cortical thickness of the anterior and posterior banks of the CS, precentral sulci (PrCS), and postcentral sulci (PoCS). Additionally, we compared the cortical thickness of the anterior and posterior banks of each sulcus visually using a grading scale. Results: On T2-weighted images, the cerebral cortex was highlighted by a high signal-intensity vasogenic edema in the adjacent white matter, and its thickness was readily measurable. The unique cortical thickness difference between the anterior and posterior banks of the CS were confirmed with measurements of 2.67 and 1.48 mm (p < 0.0001). The cortical measurements across other cerebral sulci were 2.04 and 1.95 mm (NS) for the PrCS, and 1.67 and 1.77 mm (NS) for the PoCS. The cortical thickness ratios were 1.86 for the CS, 1.05 for the PrCS, and 0.96 for the PoCS. On visual evaluation, the anterior bank of the CS was thicker than the posterior bank in 93% (65/70). For the PrCS and PoCS, the thickness of the anterior and posterior banks appeared to be equal in over 70% of the patients. Conclusion: A prominent cortical thickness difference across the CS in the presence of vasogenic edema was confirmed. This finding is considered to facilitate the identification of the CS in patients with brain tumors.

  12. Should colloid boluses be prioritized over crystalloid boluses for the management of dengue shock syndrome in the presence of ascites and pleural effusions?

    Directory of Open Access Journals (Sweden)

    Weerasinghe Mindu

    2011-02-01

    Full Text Available Abstract Background Although the WHO guideline for the management of dengue fever considers the presence of ascites or pleural effusions in the diagnosis of DSS, it does not emphasize the importance of their presence when selecting fluids for resuscitation. Case presentation We highlight three patients with DSS who received boluses of crystalloids on priority basis as recommended by WHO guidelines during resuscitation. All three patients had varying degrees of third space fluid loss (ascites and pleural effusions at the time of development of DSS. Ascites and pleural effusions were detected in all 3 patients at the time of shock irrespective of whether iv fluids were given or not. All three patients had documented liver involvement at the time of shock evidenced by elevation of AST (4800 iu/L, 5000 iu/L and 1960 iu/L. One patient who had profound shock died 6 hours after admission with evidence of acute pulmonary oedema in the convalescence phase. All of them needed CPAP ventilator support and potent diuretics. Conclusions We therefore feel that resuscitation of patients with DSS who already have third space fluid accumulation with crystalloid boluses on priority basis may contribute to recovery phase pulmonary oedema.

  13. Apparent diffusion coefficient of renal parenchyma and color Doppler ultrasound of intrarenal arteries in patients with cirrhosis related renal dysfunction

    Directory of Open Access Journals (Sweden)

    Mohamed M Hefeda

    2014-12-01

    Conclusion: Liver cirrhosis, even in the presence of refractory ascites, did not affect the ADC value of renal parenchyma, however ADC value is affected in renal parenchyma of patients with hepato-renal syndrome. Duplex-Doppler ultrasound of intrarenal arteries enables the early detection of renal hemodynamic disturbances in patients with liver cirrhosis.

  14. Can pleural adenosine deaminase (ADA) levels in pleural tuberculosis predict the presence of pulmonary tuberculosis? A CT analysis

    International Nuclear Information System (INIS)

    Koh, Myung Je; Lee, In Jae; Kim, Joo-Hee

    2016-01-01

    Aim: To assess the relationship between imaging features of pulmonary tuberculosis at computed tomography (CT) and adenosine deaminase (ADA) values via pleural fluid analysis in patients with pleural tuberculosis. Materials and methods: This retrospective study enrolled 60 patients who underwent fluid analysis for ADA and chest CT and were diagnosed with tuberculosis by culture or polymerase chain reaction of pleural fluid and sputum. The presence of centrilobular nodules, consolidation, cavitation, and mediastinal lymphadenopathy at CT were evaluated. The relationship between ADA values and the pattern of pulmonary involvement of tuberculosis was analysed. Results: Pulmonary involvement was seen in 42 of the 60 patients. A centrilobular nodular pattern was seen in 37 and consolidation in 22. In 17 patients, both findings were identified. A centrilobular nodular pattern was more common than consolidation or cavitary lesions. When ADA values were high, pulmonary involvement was more frequent (p=0.002). Comparing low and high ADA groups using an obtained cut-off value of 80 IU/l, the high group had more frequent pulmonary involvement (p<0.001). Conclusion: Patients with tuberculous pleurisy who had high ADA values had a higher probability of manifesting pulmonary tuberculosis. High ADA values may help predict contagious pleuroparenchymal tuberculosis. The most common pulmonary involvement of tuberculous pleurisy showed a centrilobular nodular pattern. - Highlights: • To know the relationship of ADA values and pulmonary involvement pattern of pleural tuberculosis. • To help exact diagnosis of pleuroparenchymal tuberculosis in clinical setting. • The imaging findings of pleuroparenchymal tuberculosis.

  15. Crude incidence in two-phase designs in the presence of competing risks

    Directory of Open Access Journals (Sweden)

    Paola Rebora

    2016-01-01

    Full Text Available Abstract Background In many studies, some information might not be available for the whole cohort, some covariates, or even the outcome, might be ascertained in selected subsamples. These studies are part of a broad category termed two-phase studies. Common examples include the nested case-control and the case-cohort designs. For two-phase studies, appropriate weighted survival estimates have been derived; however, no estimator of cumulative incidence accounting for competing events has been proposed. This is relevant in the presence of multiple types of events, where estimation of event type specific quantities are needed for evaluating outcome. Methods We develop a non parametric estimator of the cumulative incidence function of events accounting for possible competing events. It handles a general sampling design by weights derived from the sampling probabilities. The variance is derived from the influence function of the subdistribution hazard. Results The proposed method shows good performance in simulations. It is applied to estimate the crude incidence of relapse in childhood acute lymphoblastic leukemia in groups defined by a genotype not available for everyone in a cohort of nearly 2000 patients, where death due to toxicity acted as a competing event. In a second example the aim was to estimate engagement in care of a cohort of HIV patients in resource limited setting, where for some patients the outcome itself was missing due to lost to follow-up. A sampling based approach was used to identify outcome in a subsample of lost patients and to obtain a valid estimate of connection to care. Conclusions A valid estimator for cumulative incidence of events accounting for competing risks under a general sampling design from an infinite target population is derived.

  16. Presence of Gout is Associated With Increased Prevalence and Severity of Knee Osteoarthritis

    Science.gov (United States)

    Howard, Rennie G.; Samuels, Jonathan; Gyftopoulos, Soterios; Krasnokutsky, Svetlana; Leung, Joseph; Swearingen, Christopher J.; Pillinger, Michael H.

    2015-01-01

    Background Gout and osteoarthritis (OA) are the most prevalent arthritides, but their relationship is neither well established nor well understood. Objectives We assessed whether a diagnosis of gout or asymptomatic hyperuricemia (AH) is associated with increased prevalence/severity of knee OA. Methods 119 male patients ages 55–85 were sequentially enrolled from the primary care clinics of an urban VA hospital, assessed and categorized into 3 groups: gout (ACR Classification Criteria), AH ([serum urate] ≥ 6.8 mg/dL, no gout), and control ([serum urate] gout). 25 patients from each group subsequently underwent formal assessment of knee OA presence and severity (ACR Clinical/Radiographic Criteria, Kellgren-Lawrence (KL) grade). Musculoskeletal ultrasound was used to detect monosodium urate (MSU) deposition at the knees and 1st metatarsophalangeal (MTP) joints. Results 68.0% of gout, 52.0% of AH, and 28.0% of age-matched control subjects had knee OA (gout vs. control, P=0.017). Odds ratio for knee OA in gout vs. controls was 5.46 prior to, and 3.80 after adjusting for BMI. Gout subjects also had higher KL grades than controls (P=0.001). Subjects with sonographically-detected MSU crystal deposition on cartilage were more likely to have OA than those without (60.0 vs 27.5%, P=0.037), with crystal deposition at the 1st MTP joints correlating most closely with OA knee involvement. Conclusion Knee OA was more prevalent in gout patients vs. controls, and intermediate in AH. Knee OA was more severe in gout patients vs. controls. PMID:25710856

  17. Intragroup emotions: physiological linkage and social presence

    Directory of Open Access Journals (Sweden)

    Simo eJärvelä

    2016-02-01

    Full Text Available We investigated how technologically mediating two different components of emotion – communicative expression and physiological state – to group members affects physiological linkage and self-reported feelings in a small group during video viewing. In different conditions the availability of second screen text chat (communicative expression and visualization of group level physiological heart rates and their dyadic linkage (physiology was varied. Within this four person group two participants formed a physically co-located dyad and the other two were individually situated in two separate rooms. We found that text chat always increased heart rate synchrony but HR visualization only with non-co-located dyads. We also found that physiological linkage was strongly connected to self-reported social presence. The results encourage further exploration of the possibilities of sharing group member’s physiological components of emotion by technological means to enhance mediated communication and strengthen social presence.

  18. Distraction as a measure of presence

    DEFF Research Database (Denmark)

    Nordahl, Rolf; Korsgaard, Dannie

    2010-01-01

    ) to determine presence as immersion (Lombard and Ditton in At the heart of it all: the concept of presence, Department of Broadcasting, Telecommunications and Mass Media, Temple University, 1997) at selectable events (approximated real-time). Two experiments were conducted to investigate its applicability......To assess and improve the user experience in entertainment products, developers need results of evaluation methods, which in detail measure the relationship between the mediated content and the resulting media experience. This paper proposes a method applying adjustable distraction (AD...... in computer games and movies with respectively visual and tactile AD. The first experiment examined whether the experienced intensity in a survival-shooter game, measured through questionnaires, was proportional to results from the AD method. The intrusiveness of the AD method was also addressed...

  19. Vitrification in the presence of salts

    International Nuclear Information System (INIS)

    Marra, J.C.; Andrews, M.K.; Schumacher, R.F.

    1994-01-01

    Glass is an advantageous material for the immobilization of nuclear wastes because of the simplicity of processing and its unique ability to accept a wide variety of waste elements into its network structure. Unfortunately, some anionic species which are present in the nuclear waste streams have only limited solubility in oxide glasses. This can result in either vitrification concerns or it can affect the integrity, of the final vitrified waste form. The presence of immiscible salts can also corrode metals and refractories in the vitrification unit as well as degrade components in the off-gas system. The presence of a molten salt layer on the melt may alter the batch melting rate and increase operational safety concerns. These safety concerns relate to the interaction of the molten salt and the melter cooling fluids. Some preliminary data from ongoing experimental efforts examining the solubility of molten salts in glasses and the interaction of salts with melter component materials is included

  20. Intragroup Emotions: Physiological Linkage and Social Presence.

    Science.gov (United States)

    Järvelä, Simo; Kätsyri, Jari; Ravaja, Niklas; Chanel, Guillaume; Henttonen, Pentti

    2016-01-01

    We investigated how technologically mediating two different components of emotion-communicative expression and physiological state-to group members affects physiological linkage and self-reported feelings in a small group during video viewing. In different conditions the availability of second screen text chat (communicative expression) and visualization of group level physiological heart rates and their dyadic linkage (physiology) was varied. Within this four person group two participants formed a physically co-located dyad and the other two were individually situated in two separate rooms. We found that text chat always increased heart rate synchrony but HR visualization only with non-co-located dyads. We also found that physiological linkage was strongly connected to self-reported social presence. The results encourage further exploration of the possibilities of sharing group member's physiological components of emotion by technological means to enhance mediated communication and strengthen social presence.