WorldWideScience

Sample records for promising early results

  1. Promising pesticide results

    International Nuclear Information System (INIS)

    Wallace, Paula

    2012-01-01

    of DDT in soil. Given its 'sticky' quality, DDT is difficult to isolate and treat in the solid matrix of soil. “Our ViroFlow Technology has been designed to overcome both these problems by using a chemical, not bacterial, agent and by separating DDT from the structure of the soil matrix, thereby making it vulnerable to decomposition,” said Barros. As a result of these findings, Virotec is conducting a series of tests in conjunction with the NSW EPA and Department of Primary Industries to examine ways its solution can be applied to treating DDT in soil.

  2. High-dose, hyperfractionated, accelerated radiotherapy using a concurrent boost for the treatment of nonsmall cell lung cancer: unusual toxicity and promising early results

    International Nuclear Information System (INIS)

    King, Stephen C.; Acker, Jeffrey C.; Kussin, Peter S.; Marks, Lawrence B.; Weeks, Kenneth J.; Leopold, Kenneth A.

    1996-01-01

    Purpose: The treatment of nonsmall cell lung cancer (NSCLC) with conventional radiotherapy (RT) results in inadequate local tumor control and survival. We report results of a Phase II trial designed to treat patients with a significantly increased total dose administered in a reduced overall treatment time using a hyperfractionated, accelerated treatment schedule with a concurrent boost technique. Methods and Materials: A total of 49 patients with unresectable Stage IIIA/IIIB (38 patients) or medically inoperable Stage I/II (11 patients) NSCLC were prospectively enrolled in this protocol. Radiation therapy was administered twice daily, 5 days/week with > 6 h between each treatment. The primary tumor and adjacent enlarged lymph nodes were treated to a total dose of 73.6 Gy in 46 fractions of 1.6 Gy each. Using a concurrent boost technique, electively irradiated nodal regions were simultaneously treated with a dose of 1.25 Gy/fraction for the first 36 fractions to a total dose of 45 Gy. Results: Median survival for the entire group of 49 patients is 15.3 months. Actuarial survival at 2 years is 46%: 60% for 11 Stage I/II patients, 55% for 21 Stage IIIA patients, and 26% for 17 Stage IIIB patients. The actuarial rate of freedom from local progression at 2 years is 64% for the entire group of 49 patients: 62% for Stage I/II patients, 70% for Stage IIIA patients, and 55% for Stage IIIB patients. Patients who underwent serial bronchoscopic reevaluation (4 Stage I/II, 8 Stage IIIA, and 6 Stage IIIB) have an actuarial rate of local control of 71% at 2 years. The median total treatment time was 32 days. Nine of 49 patients (18%) experienced Grade III acute esophageal toxicity. The 2-year actuarial risk of Grade III or greater late toxicity is 30%. The 2-year actuarial rate of severe-late pulmonary and skin-subcutaneous toxicity is 20% and 15%, respectively. Conclusion: This treatment regimen administers a substantially higher biologically effective dose compared with

  3. Early Childhood Education: Its Historic Past and Promising Future.

    Science.gov (United States)

    Hewes, Dorothy W.

    As the end of the century nears, it is important to reflect upon the history of early childhood education and what the future holds. Centuries before the Christian era began, Plato wrote that the welfare of children from birth onward was a responsibility of the entire community. In 1628, the first written guidance for out-of-home education of…

  4. Metabolomics as a promising tool for early osteoarthritis diagnosis

    Directory of Open Access Journals (Sweden)

    E.B. de Sousa

    2017-09-01

    Full Text Available Osteoarthritis (OA is the main cause of disability worldwide, due to progressive articular cartilage loss and degeneration. According to recent research, OA is more than just a degenerative disease due to some metabolic components associated to its pathogenesis. However, no biomarker has been identified to detect this disease at early stages or to track its development. Metabolomics is an emerging field and has the potential to detect many metabolites in a single spectrum using high resolution nuclear magnetic resonance (NMR techniques or mass spectrometry (MS. NMR is a reproducible and reliable non-destructive analytical method. On the other hand, MS has a lower detection limit and is more destructive, but it is more sensitive. NMR and MS are useful for biological fluids, such as urine, blood plasma, serum, or synovial fluid, and have been used for metabolic profiling in dogs, mice, sheep, and humans. Thus, many metabolites have been listed as possibly associated to OA pathogenesis. The goal of this review is to provide an overview of the studies in animal models and humans, regarding the use of metabolomics as a tool for early osteoarthritis diagnosis. The concept of osteoarthritis as a metabolic disease and the importance of detecting a biomarker for its early diagnosis are highlighted. Then, some studies in plasma and synovial tissues are shown, and finally the application of metabolomics in the evaluation of synovial fluid is described.

  5. Soybean promising mutant lines super early maturity Q-298 and 4-Psj

    International Nuclear Information System (INIS)

    Arwin; Mulyana, H.I.; Tarmizi; Masrizal; Faozi, K.; Adie, M.

    2012-01-01

    One of the efforts to increase the national soybean (Glycine max L. Merr.) production is by growing super early maturity with high yielding varieties, so that the planting time can be shortened to fill out the cropping pattern of ''rice-rice-soybean''. Such varieties can be developed through mutation breeding method using γ ray irradiation. In this research the seeds of Tidar variety were irradiated by 200 Gy γ ray from 60 Co. Irradiated seeds were planted in the field and selections with emphasis on early maturing character were conducted in M 2 generation. Selected plants were purified to M 7 generation and selected pure mutant lines were subjected to preliminary and advanced yield trials. Based on these results 5 promising mutant lines were selected to continue in multi location yield trials. A set of lines for multi location yield trials consist of 14 lines included 5 mutant lines from this experiment, 5 lines from UNSUD, 3 national leading varieties, Argomulyo, Gorobogan, Burangrang, as national control varieties and Tidar as an original of mutant lines. Based on the result of multi location yield trials, 2 mutant lines, Q-298 dan 4-Psj, have significant high productivities compared to productivities of other lines and varieties. The growth duration of these lines were only 66 days and 68 days, respectively with average productivities were 2.41 tons / ha and 2.42 tons / ha, respectively. Index stability of Q-298 and 4-Psj mutant lines were 0.84 and 0.79, respectively, it means that the productivities of these two lines were stable in all tested locations. Based on the results, the Q-298 and 4-Psj mutant lines were proposed to be released as new varieties with the names of Gamasugen 1 and Gamasugen 2, respectively. (author)

  6. Promising Metabolite Profiles in the Plasma and CSF of Early Clinical Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Daniel Stoessel

    2018-03-01

    Full Text Available Parkinson's disease (PD shows high heterogeneity with regard to the underlying molecular pathogenesis involving multiple pathways and mechanisms. Diagnosis is still challenging and rests entirely on clinical features. Thus, there is an urgent need for robust diagnostic biofluid markers. Untargeted metabolomics allows establishing low-molecular compound biomarkers in a wide range of complex diseases by the measurement of various molecular classes in biofluids such as blood plasma, serum, and cerebrospinal fluid (CSF. Here, we applied untargeted high-resolution mass spectrometry to determine plasma and CSF metabolite profiles. We semiquantitatively determined small-molecule levels (≤1.5 kDa in the plasma and CSF from early PD patients (disease duration 0–4 years; n = 80 and 40, respectively, and sex- and age-matched controls (n = 76 and 38, respectively. We performed statistical analyses utilizing partial least square and random forest analysis with a 70/30 training and testing split approach, leading to the identification of 20 promising plasma and 14 CSF metabolites. These metabolites differentiated the test set with an AUC of 0.8 (plasma and 0.9 (CSF. Characteristics of the metabolites indicate perturbations in the glycerophospholipid, sphingolipid, and amino acid metabolism in PD, which underscores the high power of metabolomic approaches. Further studies will enable to develop a potential metabolite-based biomarker panel specific for PD.

  7. Targets and results of the Brazilian Biodiesel Incentive Program – Has it reached the Promised Land?

    International Nuclear Information System (INIS)

    Rathmann, Régis; Szklo, Alexandre; Schaeffer, Roberto

    2012-01-01

    Highlights: ► We test the assumptions that justified the Brazilian Biodiesel Production Program. ► The “Promised Land” has not been reached, particularly from a socioeconomic standpoint. ► The generation of jobs in the agricultural sector has been much lower than expected. -- Abstract: This study tests the assumptions that justified the establishment of the Brazilian Biodiesel Production Program (PNPB), to see whether this program has achieved its promised results. Given the connection between socioeconomic, political, technological and environmental issues, the study performs an analysis covering these different dimensions. From the socioeconomic standpoint, findings of the study show that the generation of jobs in the agricultural sector has been much lower than the expected 1.3-million-job creation figure. From the standpoint of reducing the outflow of foreign exchange because of potentially lower demand for imported diesel, the option for the methanol instead of ethanol production route has led to an increased net outflow, as the greater need to import methanol to produce biodiesel more than offsets the lesser need to import mineral diesel. Nevertheless, even though the “Promised Land” has not been reached, particularly from a socioeconomic standpoint, the premises of energy efficiency and the potential to mitigate GHG emissions appear to be on solid ground. In this respect, the input/output energy ratio of producing soy-based biodiesel and the GHG mitigation potential of pure biodiesel justify the continuing effort to improve the PNPB to achieve more promising results in relation to the other indicators.

  8. Use of sentinel-1 data for vessel detection in South African oceans: Early results

    CSIR Research Space (South Africa)

    Kleynhans, Waldo

    2015-08-01

    Full Text Available taking into consideration local incident angles. Early experimental results show promising vessel detection accuracy using the Sentinel-1 data but that polarization and incidence angle are important parameters to take into consideration when working...

  9. Radiotherapy Results of Early Uterine Cervix Cancer

    International Nuclear Information System (INIS)

    Choi, Doo Ho; Huh, Seung Jae

    1996-01-01

    Purpose : This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. Methods and Materials : Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months. and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy. Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. Results : Overall 5 year survival rate and relapse free survival rate were 72.3%, and 72.8% respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months. Late complication rate of bladder and rectum were 8.8%, 15% respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. Conclusion : These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients, To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed

  10. In-house coordination project for organ and tissue procurement: social responsibility and promising results.

    Science.gov (United States)

    Silva, Vanessa Silva E; Moura, Luciana Carvalho; Martins, Luciana Ribeiro; Santos, Roberta Cristina Cardoso Dos; Schirmer, Janine; Roza, Bartira de Aguiar

    2016-01-01

    to report the results of evaluation regarding changes in the number of potential donor referrals, actual donors, and conversion rates after the implementation of an in-house organ and tissue donation for transplantation coordination project. epidemiological study, both retrospective and transversal, was performed with organ donation data from the Secretariat of Health for the State and the in-house organ donation coordination project of a beneficent hospital. The data was compared using nonparametric statistical Mann-Whitney test, and the Student's t-test, considering a significance level of 5% (p <0.05). there were statistically significant differences (p < 0.05), before and after the implementation of the project on the number of potential donor notification/month (3.05 - 4.7 ), number of actual donor/month (0.78 to 1.60) and rate of conversion ( 24.7 to 34.8 %). The hospitals 1, 2, 7 and 8 had significant results in potential donor, actual donor or conversion rate. the presence of an in-house coordinator is promising and beneficial, the specialist is important to change the indicators of efficiency, which consequently reduces the waiting lists for organ transplants.

  11. Less promising results with sclerosing ethoxysclerol injections for midportion achilles tendinopathy: a retrospective study.

    Science.gov (United States)

    van Sterkenburg, Maayke N; de Jonge, Milko C; Sierevelt, Inger N; van Dijk, C Niek

    2010-11-01

    Local injections of the sclerosing substance polidocanol (Ethoxysclerol) have shown good clinical results in patients with chronic midportion Achilles tendinopathy. After training by the inventors of the technique, sclerosing Ethoxysclerol injections were applied on a group of patients in our center. Sclerosing Ethoxysclerol injections will yield good results in the majority of patients. Case series; Level of evidence, 4. In 113 patients (140 tendons) with Achilles tendinopathy, we identified 62 patients (70 tendons) showing neovascularization on color Doppler ultrasound. Fifty-three Achilles tendons (48 patients) were treated with sclerosing Ethoxysclerol injections, with intervals of 6 weeks and a maximum of 5 sessions. Treatment was completed when neovascularization or pain had disappeared, or when there was no positive treatment effect after 3 to 4 sessions. Forty-eight patients (20 women and 28 men) with a median age of 45 years, (range, 33-68 years) were treated. Median symptom duration was 23 months (range, 3-300 months). Fifty-three tendons were treated with a median of 3 sessions of Ethoxysclerol injections. Six weeks after the last injection, 35% of patients had no complaints, 9% had minimal symptoms, 42% were the same, and 14% had more complaints. Women were 3.8 times (95% confidence interval: 1.1-13.8) more likely to have unsatisfactory outcome than men. Pain correlated positively with neovessels on ultrasound (P < .01). At 2.7 to 5.1 year follow-up, 53% had received additional (surgical/conservative) treatment; 3 of these patients (7.5%) still had complaints of Achilles tendinopathy. In 6 patients, complaints that were still present 6 weeks after treatment had resolved spontaneously by final follow-up. Our study did not confirm the high beneficial value of sclerosing neovascularization in patients with midportion Achilles tendinopathy. Despite the retrospective design of our study, we consider it important to stress that injection of Ethoxysclerol may

  12. Prevention of caries with probiotic bacteria during early childhood. Promising but inconsistent findings

    DEFF Research Database (Denmark)

    Jørgensen, Mette Rose; pqd956, pqd956; Twetman, Svante

    2016-01-01

    PURPOSE: This review summarized the available literature on the prevention of childhood caries through biofilm engineering with probiotic bacteria in early childhood. METHODS: Three databases (PubMed, Cochrane Library and Trip) were searched through January, 2016 for randomized controlled trials...

  13. The potential of infant fMRI research and the study of early life stress as a promising exemplar

    Directory of Open Access Journals (Sweden)

    Alice M. Graham

    2015-04-01

    Full Text Available Functional magnetic resonance imaging (fMRI research with infants and toddlers has increased rapidly over the past decade, and provided a unique window into early brain development. In the current report, we review the state of the literature, which has established the feasibility and utility of task-based fMRI and resting state functional connectivity MRI (rs-fcMRI during early periods of brain maturation. These methodologies have been successfully applied beginning in the neonatal period to increase understanding of how the brain both responds to environmental stimuli, and becomes organized into large-scale functional systems that support complex behaviors. We discuss the methodological challenges posed by this promising area of research. We also highlight that despite these challenges, early work indicates a strong potential for these methods to influence multiple research domains. As an example, we focus on the study of early life stress and its influence on brain development and mental health outcomes. We illustrate the promise of these methodologies for building on, and making important contributions to, the existing literature in this field.

  14. Sputum-Based Molecular Biomarkers for the Early Detection of Lung Cancer: Limitations and Promise

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Connie E. [Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016 (United States); Tchou-Wong, Kam-Meng; Rom, William N., E-mail: william.rom@nyumc.org [Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016 (United States); Department of Environmental Medicine, New York University School of Medicine, 57 Old Forge Road, Tuxedo, NY 10987 (United States)

    2011-07-19

    Lung cancer is the leading cause of cancer deaths, with an overall survival of 15% at five years. Biomarkers that can sensitively and specifically detect lung cancer at early stage are crucial for improving this poor survival rate. Sputum has been the target for the discovery of non-invasive biomarkers for lung cancer because it contains airway epithelial cells, and molecular alterations identified in sputum are most likely to reflect tumor-associated changes or field cancerization caused by smoking in the lung. Sputum-based molecular biomarkers include morphology, allelic imbalance, promoter hypermethylation, gene mutations and, recently, differential miRNA expression. To improve the sensitivity and reproducibility of sputum-based biomarkers, we recommend standardization of processing protocols, bronchial epithelial cell enrichment, and identification of field cancerization biomarkers.

  15. Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer

    International Nuclear Information System (INIS)

    Whalley, D.; Caine, H.; McCloud, P.; Guo, L.; Kneebone, A.; Eade, T.

    2015-01-01

    To describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of bladder cancer. Twenty-eight patients with muscle-invasive carcinoma of the bladder were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with simultaneous integrated boost (SIB). Isotropic margins of .5 and 1 cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6 weeks post treatment. The median age was 83 years (range 58-92). Twenty patients had stage II or III disease, and eight were stage IV. Gross disease received 66 Gy in 30 fractions in 11 patients (ten with concurrent chemotherapy) or 55 Gy in 20 fractions for those of poorer performance status or with palliative intent. All patients completed radiation treatment as planned. Three patients ceased chemotherapy early due to toxicity. Six patients (21 %) had acute Grade ≥ 2 genitourinary (GU) toxicity and six (21 %) had acute Grade ≥ 2 gastrointestinal (GI) toxicity. Five patients (18 %) developed Grade ≥2 late GU toxicity and no ≥2 late GI toxicity was observed. Nineteen patients underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86 %), including all patients treated with chemoradiotherapy. Eight patients relapsed, four of which were local relapses. Of the patients with local recurrence, one underwent salvage cystectomy. For patients treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90 %/100 % for chemoradiotherapy versus 86 %/69 % for radiotherapy alone. IG- IMRT using daily soft tissue matching is a feasible in the treatment of bladder cancer, enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low toxicity

  16. Atlas-based functional radiosurgery: Early results

    Energy Technology Data Exchange (ETDEWEB)

    Stancanello, J.; Romanelli, P.; Pantelis, E.; Sebastiano, F.; Modugno, N. [Politecnico di Milano, Bioengineering Department and NEARlab, Milano, 20133 (Italy) and Siemens AG, Research and Clinical Collaborations, Erlangen, 91052 (Germany); Functional Neurosurgery Deptartment, Neuromed IRCCS, Pozzilli, 86077 (Italy); CyberKnife Center, Iatropolis, Athens, 15231 (Greece); Functional Neurosurgery Deptartment, Neuromed IRCCS, Pozzilli, 86077 (Italy)

    2009-02-15

    Functional disorders of the brain, such as dystonia and neuropathic pain, may respond poorly to medical therapy. Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and the centromedian nucleus of the thalamus (CMN) may alleviate dystonia and neuropathic pain, respectively. A noninvasive alternative to DBS is radiosurgical ablation [internal pallidotomy (IP) and medial thalamotomy (MT)]. The main technical limitation of radiosurgery is that targets are selected only on the basis of MRI anatomy, without electrophysiological confirmation. This means that, to be feasible, image-based targeting must be highly accurate and reproducible. Here, we report on the feasibility of an atlas-based approach to targeting for functional radiosurgery. In this method, masks of the GPi, CMN, and medio-dorsal nucleus were nonrigidly registered to patients' T1-weighted MRI (T1w-MRI) and superimposed on patients' T2-weighted MRI (T2w-MRI). Radiosurgical targets were identified on the T2w-MRI registered to the planning CT by an expert functional neurosurgeon. To assess its feasibility, two patients were treated with the CyberKnife using this method of targeting; a patient with dystonia received an IP (120 Gy prescribed to the 65% isodose) and a patient with neuropathic pain received a MT (120 Gy to the 77% isodose). Six months after treatment, T2w-MRIs and contrast-enhanced T1w-MRIs showed edematous regions around the lesions; target placements were reevaluated by DW-MRIs. At 12 months post-treatment steroids for radiation-induced edema and medications for dystonia and neuropathic pain were suppressed. Both patients experienced significant relief from pain and dystonia-related problems. Fifteen months after treatment edema had disappeared. Thus, this work shows promising feasibility of atlas-based functional radiosurgery to improve patient condition. Further investigations are indicated for optimizing treatment dose.

  17. Less promising results with sclerosing ethoxysclerol injections for midportion achilles tendinopathy: a retrospective study

    NARCIS (Netherlands)

    van Sterkenburg, Maayke N.; de Jonge, Milko C.; Sierevelt, Inger N.; van Dijk, C. Niek

    2010-01-01

    BACKGROUND: Local injections of the sclerosing substance polidocanol (Ethoxysclerol) have shown good clinical results in patients with chronic midportion Achilles tendinopathy. After training by the inventors of the technique, sclerosing Ethoxysclerol injections were applied on a group of patients

  18. Key Performance Indicators: From Promise to Payoff. The Productivity for Results Series No. 2

    Science.gov (United States)

    Casserly, Michael; Eugene, Michael

    2014-01-01

    This paper draws upon the expertise of two leading educators, Michael Casserly, director of the Council of the Great City Schools, and Michael Eugene, chief operating officer of the Orange County Public Schools in Florida. They outline a set of key performance indicators that some urban districts use to benchmark the results of their operating…

  19. Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

    Science.gov (United States)

    Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

    2017-08-01

    Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all Pcoaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

  20. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Science.gov (United States)

    Denis, Max; Mehrmohammadi, Mohammad; Song, Pengfei; Meixner, Duane D; Fazzio, Robert T; Pruthi, Sandhya; Whaley, Dana H; Chen, Shigao; Fatemi, Mostafa; Alizad, Azra

    2015-01-01

    To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  1. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Directory of Open Access Journals (Sweden)

    Max Denis

    Full Text Available To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE for classification of breast masses.CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s in comparison to benign masses (3.65 ± 1.36 m/s. Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC, the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC.CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  2. Pay For Success And Population Health: Early Results From Eleven Projects Reveal Challenges And Promise.

    Science.gov (United States)

    Lantz, Paula M; Rosenbaum, Sara; Ku, Leighton; Iovan, Samantha

    2016-11-01

    Pay for success (PFS) is a type of social impact investing that uses private capital to finance proven prevention programs that help a government reduce public expenditures or achieve greater value. We conducted an analysis of the first eleven PFS projects in the United States to investigate the potential of PFS as a strategy for financing and disseminating interventions aimed at improving population health and health equity. The PFS approach has significant potential for bringing private-sector resources to interventions regarding social determinants of health. Nonetheless, a number of challenges remain, including structuring PFS initiatives so that optimal prevention benefits can be achieved and ensuring that PFS interventions and evaluation designs are based on rigorous research principles. In addition, increased policy attention regarding key PFS payout issues is needed, including the "wrong pockets" problem and legal barriers to using federal Medicaid funds as an investor payout source. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Early Results from the Qweak Experiment

    Directory of Open Access Journals (Sweden)

    Androic D.

    2014-03-01

    Full Text Available A subset of results from the recently completed Jefferson Lab Qweak experiment are reported. This experiment, sensitive to physics beyond the Standard Model, exploits the small parity-violating asymmetry in elastic e→p$\\vec e{\\rm{p}}$ scattering to provide the first determination of the proton’s weak charge Qwp$Q_w^p$. The experiment employed a 180 μA longitudinally polarized 1.16 GeV electron beam on a 35 cm long liquid hydrogen target. Scattered electrons in the angular range 6° < θ < 12° corresponding to Q2 = 0.025 GeV2 were detected in eight Cerenkov detectors arrayed symmetrically around the beam axis. The goals of the experiment were to provide a measure of e→p$\\vec e{\\rm{p}}$ to 4.2% (combined statisstatistical and systematic error, which implies a measure of sin2(θw at the level of 0.3%, and to help constrain the vector weak quark charges C1u and C1d. The experimental method is described, with particular focus on the challenges associated with the world’s highest power LH2 target. The new constraints on C1u and C1d provided by the subset of the experiment’s data analyzed to date will also be shown, together with the extracted weak charge of the neutron.

  4. Early Calibration Results of CYGNSS Mission

    Science.gov (United States)

    Balasubramaniam, R.; Ruf, C. S.; McKague, D. S.; Clarizia, M. P.; Gleason, S.

    2017-12-01

    The first of its kind, GNSS-R complete orbital mission, CYGNSS was successfully launched on Dec 15 2016. The goal of this mission is to accurately forecast the intensification of tropical cyclones by modelling its inner core. The 8 micro observatories of CYGNSS carry a passive instrument called Delay Doppler Mapping Instrument (DDMI). The DDMIs form a 2D representation called the Delay-Doppler Map (DDM) of the forward scattered power signal. Each DDMI outputs 4 DDMs per second which are compressed and sent to the ground resulting in a total of 32 sea-surface measurements produced by the CYGNSS constellation per second. These are subsequently used in the Level-2 wind retrieval algorithm to extract wind speed information. In this paper, we perform calibration and validation of CYGNSS measurements for accurate extraction of wind speed information. The calibration stage involves identification and correction for dependence of the CYGNSS observables namely Normalised Bistatic Radar Cross Section and Leading Edge Slope of the Integrated Delay Waveform over instrument parameters, geometry etc. The validation stage involves training of the Geophysical Model Function over a multitude of ground truth sources during the Atlantic hurricane season and also refined validation of high wind speed data products.

  5. Early results from the Infrared Astronomical Satellite

    International Nuclear Information System (INIS)

    Neugebauer, G.; Beichman, C.A.; Soifer, B.T.

    1984-01-01

    For 10 months the Infrared Astronomical Satellite (IRAS) provided astronomers with what might be termed their first view of the infrared sky on a clear, dark night. Without IRAS, atmospheric absorption and the thermal emission from both the atmosphere and Earthbound telescopes make the task of the infrared astronomer comparable to what an optical astronomer would face if required to work only on cloudy afternoons. IRAS observations are serving astronomers in the same manner as the photographic plates of the Palomar Observatory Sky Survey; just as the optical survey has been used by all astronomers for over three decades, as a source of quantitative information about the sky and as a roadmap for future observations, the results of IRAS will be studied for years to come. IRAS has demonstrated the power of infrared astronomy from space. Already, from a brief look at a miniscule fraction of the data available, we have learned much about the solar system, about nearby stars, about the Galaxy as a whole and about distant extragalactic systems. Comets are much dustier than previously thought. Solid particles, presumably the remnants of the star-formation process, orbit around Vega and other stars and may provide the raw material for planetary systems. Emission from cool interstellar material has been traced throughout the Galaxy all the way to the galactic poles. Both the clumpiness and breadth of the distribution of this material were previously unsuspected. The far-infrared sky away from the galactic plane has been found to be dominate by spiral galaxies, some of which emit more than 50% and as much as 98% of their energy in the infrared - an exciting and surprising revelation. The IRAS mission is clearly the pathfinder for future mission that, to a large extent, will be devoted to the discoveries revealed by IRAS. 8 figures

  6. Promising results. Thailand.

    Science.gov (United States)

    Rojanapithayakorn, W

    1998-01-01

    This article describes the Thailand Ministry of Health's program for promotion of condom use. Since 1984, findings indicate that AIDS has been a leading public health problem that is spread through heterosexual intercourse. Since 1989, the government has conducted IEC programs to increase knowledge and change attitudes and practices for controlling HIV infections, AIDS, and other sexually transmitted diseases (STDs). A variety of institutions dispense condoms. Condom use was promoted over a 25-year period. The 100% condom program, implemented in 1989, has been successful in promotion of condoms among sex workers and clients. IEC to prevent AIDS has been operating since 1984. Messages focus on prevention of sexually transmitted HIV infections and correct use of condoms. Family planning programs over the past 30 years have supplied condoms free of charge. Condoms are available for sale through pharmacies and convenience stores. Health service facilities also supply condoms. The 100% condom program began as a pilot in Ratchaburi province. All owners of sex establishments cooperated. The program was initiated jointly by government officials and owners of sex establishments. Owners instructed sex workers about use of condoms in all sexual encounters. Penalties were imposed on owners for noncompliance. Condom use increased gradually and STDs declined. In 1991, the program was expanded nationwide. In 1992, condom quality control measures were instituted. Water soluble lubricants for condoms were added to prevent breakage and increase customer satisfaction. This program needs to be expanded to other sectors of the population.

  7. Percutaneous microwave ablation for early-stage non-small cell lung cancer (NSCLC) in the elderly: a promising outlook

    International Nuclear Information System (INIS)

    Acksteiner, Christian; Steinke, Karin

    2015-01-01

    Microwave ablation (MWA) is a relatively new minimally invasive treatment option for lung cancer with substantially lower morbidity and mortality than surgery. This retrospective study was performed to evaluate the safety, effectiveness and follow-up imaging of MWA in the elderly aged 75 years and above. Eleven percutaneous computed tomography (CT)-guided MWA of early-stage non-small cell lung cancer (NSCLC) were performed in 10 patients aged 75 years and older. All but one patient were treated with a high-powered MWA system delivering maximally 140 W. Follow-up with CT and fluorodeoxyglucose-positron emission tomography (FDG-PET) was carried out over a maximum period of 30 months and a median period of 12 months. There were no peri-procedural deaths or major complications. Seven patients were disease free at the time of manuscript submission. Three patients showed growth of the treated lesions, one patient aged 90 years deceased due to unknown cause after approximately 18 months. One patient presented with local progression and disseminated metastatic disease at 12 months; he is still alive. One patient showed increasing soft tissue at the ablation site 15 months post-treatment. Three consecutive core biopsies over 2 months failed to confirm tumour recurrence. MWA therapy is a promising option of treating early-stage NSCLC in the elderly with good treatment outcome and negligible morbidity. Determining successful treatment outcome may be challenging at times as local tissue increase and PET-CT positivity do not seem to necessarily correlate with recurrence of malignancy.

  8. What Triggers Early Retirement. Results from Swiss Pension Funds

    OpenAIRE

    Monika Bütler; Olivia Huguenin; Federica Teppa

    2004-01-01

    Early retirement is predominantly considered as the result of incentives set by social security and the tax system. But people seem to retire early even in the absence of such distortions as the Swiss example demonstrates. We look for determinants of early retirement, in particular the role of lifetime income and family status, using individual data from a selection of Swiss pension funds. Our findings suggest that affordability is a key determinant in retirement decisions: More affluent men,...

  9. Performance of gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?

    Energy Technology Data Exchange (ETDEWEB)

    Heijnen, Luc A.; Martens, Milou H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Lambregts, Doenja M.J.; Maas, Monique; Bakers, Frans C.H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Cappendijk, Vincent C. [Jeroen Bosch Ziekenhuis, Department of Radiology, ' s Hertogenbosch (Netherlands); Oliveira, Pedro [Instituto Portugues de Oncologia do Porto Francisco Gentil, Department of Radiology, Porto (Portugal); Lammering, Guido [Maastro Clinic, Radiation Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Riedl, Robert G. [Maastricht University Medical Center, Department of Pathology, Maastricht (Netherlands); Beets, Geerard L. [Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Beets-Tan, Regina G.H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2014-02-15

    A previous study showed promising results for gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort. Seventy-one rectal cancer patients were prospectively included, of whom 13 (group I) underwent a primary staging gadofosveset MRI (1.5-T) followed by surgery (± preoperative 5 x 5 Gy) and 58 (group II) underwent both primary staging and restaging gadofosveset MRI after a long course of chemoradiotherapy followed by surgery. Nodal status was scored as (y)cN0 or (y)cN+ by two independent readers (R1, R2) with different experience levels. Results were correlated with histology on a node-by-node basis. Sensitivity, specificity and area under the receiver operating characteristics curve (AUC) were 94 %, 79 % and 0.89 for the more experienced R1 and 50 %, 83 % and 0.74 for the non-experienced R2. R2's performance improved considerably after a learning curve, to an AUC of 0.83. Misinterpretations mainly occurred in nodes located in the superior mesorectum, nodes located in between vessels and nodes containing micrometastases. This prospective study confirms the good diagnostic performance of gadofosveset MRI for nodal (re)staging in rectal cancer. (orig.)

  10. GP50 as a promising early diagnostic antigen for Taenia multiceps infection in goats by indirect ELISA.

    Science.gov (United States)

    Huang, Xing; Xu, Jing; Wang, Yu; Guo, Cheng; Chen, Lin; Gu, Xiaobin; Lai, Weimin; Peng, Xuerong; Yang, Guangyou

    2016-12-01

    Coenurosis is caused by coenurus, the metacestode of Taenia multiceps, which mainly parasitizes the brain and spinal cord of cattle, sheep and goats. To date, no widely-approved methods are available to identify early coenurus infection. In this study, we identified a full-length cDNA that encodes GP50 (TmGP50) from the transcriptome of T. multiceps, and then cloned and expressed in E. coli. The native proteins in adult stage and coenurus were located via immunofluorescence assays, while the potential of recombinant TmGP50 protein (rTmGP50) for indirect ELISA-based serodiagnostics was assessed using native goat sera. In addition, we orally infected 20 goats with mature T. multiceps eggs. Praziquantel (10%) was given to 10 of the goats 45 days post-infection (p.i.). Blood samples were collected for 17 weeks p.i. from the 20 goats and anti-rTmGP50 antibodies were evaluated using the indirect ELISA established here. The TmGP50 contains an 897 bp open reading frame, in which signal sequence resides in 1 ~ 48 sites and mature polypeptide consists of 282 amino acid residues. Immunofluorescence staining showed that native TmGP50 was localized to the microthrix and parenchymatous zone of the adult parasite and coenurus, and the coenurus cystic wall. The indirect ELISA based on rTmGP50 exhibited a sensitivity of 95.0% and a specificity of 92.6% when detecting GP50 antibodies in sera of naturally infected goats and sheep. In goats experimentally infected with T. multiceps, anti-TmGP50 antibody was detectable from 2 to 17 weeks p.i. in the control group, while the antibody fell below the cut-off value about 3 weeks after praziquantel treatment. Our results indicate that recombinant TmGP50 is a suitable early diagnostic antigen for coenurus infection in goats.

  11. Planck early results. XIV. ERCSC validation and extreme radio sources

    DEFF Research Database (Denmark)

    Lähteenmäki, A.; Lavonen, N.; León-Tavares, J.

    2011-01-01

    Planck's all-sky surveys at 30-857 GHz provide an unprecedented opportunity to follow the radio spectra of a large sample of extragalactic sources to frequencies 2-20 times higher than allowed by past, large-area, ground-based surveys. We combine the results of the Planck Early Release Compact So...

  12. Early 13 TeV Results from the ATLAS Experiment

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    The ATLAS experiment has recorded almost 200 pb-1 of collision data at 13 TeV centre-of-mass energy. The seminar presents the status of the data taking, the commissioning of the event reconstruction, focusing on the key techniques that have allowed to quickly reach a good understanding of the basic physics objects, and early physics results.

  13. A belt charging system for the Vivitron - design, early results

    International Nuclear Information System (INIS)

    Helleboid, J.M.; Gaudiot, G.

    1990-10-01

    A specific belt charging system has been designed, built and assembled for the 35 MV Vivitron. 100 m long belt is used. Together with main features of the design, experimental studies, tests in a pilot machine and the results of the very early tests of the real system are reviewed

  14. Promising results of the first Conference of the Parties of the United Nations Framework Convention on Climate Charge (FCCC)

    International Nuclear Information System (INIS)

    Merkus, H.

    1995-01-01

    The first Conference of the Parties of the United Nations Framework Convention on Climate Change (FCCC), held from 28 March-7 April 1995 in Berlin, Germany, resulted in a positive outcome, despite gloomy prospects at the start of the conference. After two weeks of negotiations agreement was reached to start negotiating commitments after 2000. Also a decision was taken to set up a pilot phase for Joint Implementation. Furthermore, several institutional (a.o. FCCC secretariat will settle in Bonn) and organizational (a.o. budget) topics were solved. The challenge for negotiators now is to work out a concrete draft protocol for the conference in 1997 (Japan). In Berlin, Parties were prepared to compromise in the final (early morning) hours. The question remains whether the same willingness exists when definite choices have to be made on measures, targets and timetables

  15. Construction and early commissioning results of the AGS Booster

    International Nuclear Information System (INIS)

    Weng, W.T.; Ahrens, L.; Damm, R.; McNerney, A.J.

    1991-01-01

    The AGS Booster synchrotron has been designed to accelerate protons from 200 MeV to 1.5 GeV and heavy ions from several MeV per nucleon to several hundred MeV per nucleon for all the nuclei up to gold. The design requirements and measurements results of major accelerator components and systems are presented. The early commissioning results of the injection is also presented. 12 refs., 9 figs., 2 tabs

  16. A Conceptual Model for Youth-Led Programs as a Promising Approach to Early Childhood Care and Education

    Science.gov (United States)

    Ponguta, Liliana Angelica; Rasheed, Muneera Abdul; Reyes, Chin Regina; Yousafzai, Aisha Khizar

    2018-01-01

    The international community has set forth global targets that include calls for universal access to high-quality early childhood care and education (ECCE), as indicated in the United Nations' Sustainable Development Goals. One major impediment to achieving this target is the lack of a skilled workforce. In this paper, we argue the case for…

  17. Fuzzy promises

    DEFF Research Database (Denmark)

    Anker, Thomas Boysen; Kappel, Klemens; Eadie, Douglas

    2012-01-01

    as narrative material to communicate self-identity. Finally, (c) we propose that brands deliver fuzzy experiential promises through effectively motivating consumers to adopt and play a social role implicitly suggested and facilitated by the brand. A promise is an inherently ethical concept and the article...... concludes with an in-depth discussion of fuzzy brand promises as two-way ethical commitments that put requirements on both brands and consumers....

  18. Telomere Length in Preterm Infants: A Promising Biomarker of Early Adversity and Care in the Neonatal Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Livio Provenzi

    2017-10-01

    Full Text Available Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU, which is thought to grant at-risk newborns’ survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life. Recent advances in the behavioral epigenetic field are helping us to unveil the potential mechanisms through which early NICU-related stress may lead to negative developmental outcomes. From this perspective, telomere regulation might be a key programming mechanism. Telomeres are the terminal portion of chromosomes and are known to get shorter with age. Moreover, telomere length (TL is affected by the exposure to stress during early development. As such, TL might be an innovative biomarker of early adverse exposures in young infants and children. Unfortunately, there is paucity of studies investigating TL in populations of preterm infants and its association with known NICU-related stressors remains unexplored. In the present paper, the potential relevance of TL for research and clinical work with preterm infants will be underlined in the light of recent contributions linking progressive telomere shortening and early exposure to adverse experiences and stressful environments in humans. Finally, insights will be provided to guide clinically relevant translational research on TL in the field of VPT birth and NICU stay.

  19. Early detection and longitudinal monitoring of experimental primary and disseminated melanoma using [18F]ICF01006, a highly promising melanoma PET tracer

    International Nuclear Information System (INIS)

    Rbah-Vidal, Latifa; Vidal, Aurelien; Besse, Sophie; Audin, Laurent; Degoul, Francoise; Miot-Noirault, Elisabeth; Moins, Nicole; Auzeloux, Philippe; Chezal, Jean-Michel; Cachin, Florent; Bonnet, Mathilde; Askienazy, Serge; Dolle, Frederic

    2012-01-01

    Here, we report a new and rapid radiosynthesis of 18 F-N-[2-(diethylamino)ethyl]-6-fluoro-pyridine-3-carboxamide ([ 18 F]ICF01006), a molecule with a high specificity for melanotic tissue, and its evaluation in a murine model for early specific detection of pigmented primary and disseminated melanoma. [ 18 F]ICF01006 was synthesized using a new one-step bromine-for-fluorine nucleophilic heteroaromatic substitution. Melanoma models were induced by subcutaneous (primary tumour) or intravenous (lung colonies) injection of B16BL6 melanoma cells in C57BL/6J mice. The relevance and sensitivity of positron emission tomography (PET) imaging using [ 18 F]ICF01006 were evaluated at different stages of tumoural growth and compared to 18 F-fluorodeoxyglucose ([ 18 F]FDG). The fully automated radiosynthesis of [ 18 F]ICF01006 led to a radiochemical yield of 61 % and a radiochemical purity >99 % (specific activity 70-80 GBq/μmol; total synthesis time 42 min). Tumours were visualized before they were palpable as early as 1 h post-injection with [ 18 F]ICF01006 tumoural uptake of 1.64 ± 0.57, 3.40 ± 1.47 and 11.44 ± 2.67 percentage of injected dose per gram of tissue (%ID/g) at days 3, 5 and 14, respectively. [ 18 F]ICF01006 PET imaging also allowed detection of melanoma pulmonary colonies from day 9 after tumour cell inoculation, with a lung radiotracer accumulation correlated with melanoma invasion. At day 21, radioactivity uptake in lungs reached a value of 5.23 ± 2.08 %ID/g (versus 0.41 ± 0.90 %ID/g in control mice). In the two models, comparison with [ 18 F]FDG showed that both radiotracers were able to detect melanoma lesions, but [ 18 F]ICF01006 was superior in terms of contrast and specificity. Our promising results provide further preclinical data, reinforcing the excellent potential of [ 18 F]ICF01006 PET imaging for early specific diagnosis and follow-up of melanin-positive disseminated melanoma. (orig.)

  20. The results of radiation therapy for early glottic carcinoma

    International Nuclear Information System (INIS)

    Yamamoto, Michinori; Hada, Yoshihiro; Shirane, Makoto

    2000-01-01

    To analyze various parameters affect local control, we reviewed the results of radiotherapy for early glottic carcinoma. Between 1977 and 1997, 64 patients with untreated early glottic carcinoma and four patients with recurrent early glottic carcinoma were analyzed retrospectively. All tumors were classified as follows; T1 (n=56), T2 (n=12); well differentiated (n=33), moderately (n=25), poorly (n=1), unknown (n=9); very small tumor (VST) (n=46), small tumor (ST) (n=22). All patients were treated utilizing a cobalt-60 unit to a total dose that ranged from 56 Gy to 64 Gy (mean 60 Gy). The mean treatment time was 44 days (range 38-49). The local control rates at 2 years and 5 years for all patients were 85% and 78%, respectively. On univariate analysis, tumor size (p=0.0146) and recurrent or untreated tumor (p=0.0226) affected local control. On multivariate analysis, tumor size (p=0.0273) and recurrent or untreated tumor (p=0.0495) were also significant factors that affected local control. (author)

  1. Is 1H NMR metabolomics becoming the promising early biomarker for neonatal sepsis and for monitoring the antibiotic toxicity?

    Science.gov (United States)

    Noto, Antonio; Mussap, Michele; Fanos, Vassilios

    2014-06-01

    Metabolomics, the latest of omics disciplines, has been successfully used in various fields of basic research such as pharmacology and toxicology. Recently, this new science has gained an important role in the translational research of diagnostics. In this regard, the challenge for neonatologists and medical laboratories is to diagnose neonatal sepsis, a disease with high mortality and morbidity due to the difficulty in diagnosing it. Metabolomics, through its ability to identify perturbations caused by this condition, aims at recognizing metabolites that characterize neonatal sepsis with high specificity and sensitivity. The purpose of this review is to highlight the ability of metabolomics to find early biomarkers for this condition, as well as to predict the toxic effects caused by antibiotics.

  2. The Advanced Photon Source: Performance and results from early operation

    International Nuclear Information System (INIS)

    Moncton, D.E.

    1997-01-01

    The Advanced Photon Source at Argonne National Laboratory is now providing researchers with extreme-brilliance undulator radiation in the hard x-ray region of the spectrum. All technical facilities and components are operational and have met design specifications. Fourteen research teams, occupying 20 sectors on the APS experiment hall floor, are currently installing beamline instrumentation or actively taking data. An overview is presented for the first operational years of the Advanced Photon Source. Emphasis is on the performance of accelerators and insertion devices, as well as early scientific results and future plans

  3. Early Results from NICER Observations of Accreting Neutron Stars

    Science.gov (United States)

    Chakrabarty, Deepto; Ozel, Feryal; Arzoumanian, Zaven; Gendreau, Keith C.; Bult, Peter; Cackett, Ed; Chenevez, Jerome; Fabian, Andy; Guillot, Sebastien; Guver, Tolga; Homan, Jeroen; Keek, Laurens; Lamb, Frederick; Ludlam, Renee; Mahmoodifar, Simin; Markwardt, Craig B.; Miller, Jon M.; Psaltis, Dimitrios; Strohmayer, Tod E.; Wilson-Hodge, Colleen A.; Wolff, Michael T.

    2018-01-01

    The Neutron Star Interior Composition Explorer (NICER) offers significant new capabilities for the study of accreting neuton stars relative to previous X-ray missions including large effective area, low background, and greatly improved low-energy response. The NICER Burst and Accretion Working Group has designed a 2 Ms observation program to study a number of phenomena in accreting neutron stars including type-I X-ray bursts, superbursts, accretion-powered pulsations, quasi-periodic oscillations, and accretion disk reflection spectra. We present some early results from the first six months of the NICER mission.

  4. Cosmetic results of conservative treatment for early breast cancer

    International Nuclear Information System (INIS)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young

    2001-01-01

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary

  5. The Role of Telehealth to Assist In-Home tDCS: Opportunities, Promising Results and Acceptability

    Directory of Open Access Journals (Sweden)

    Brenton Hordacre

    2018-06-01

    Full Text Available Transcranial direct current stimulation (tDCS has shown great promise as a neuromodulatory intervention capable of improving behavioral outcomes in a range of neurological and psychiatric populations. Evidence indicates that the neuromodulatory effect of stimulation may be cumulative, with greater improvements in behavior observed following multiple treatment sessions. However, the requirement to attend clinical or research departments for multiple treatment sessions may present a barrier for many people, particularly those with greater disability or living remotely. The portability of tDCS suggests that in-home stimulation may become an avenue for further investigation. However, safe and effective use of tDCS by a participant within their home requires a form of monitoring. This review discusses how telehealth may provide real-time visual monitoring to ensure correct tDCS set-up and adherence to stimulation protocols, manage technical issues and monitor adverse events. The combination of telehealth to supplement in-home tDCS use has potential to transform the way tDCS is delivered.

  6. Early results from the Whisper instrument on Cluster: An overview

    DEFF Research Database (Denmark)

    Decreau, P.M.E.; Fergeau, P.; Krasnoselskikh, V.

    2001-01-01

    The Whisper instrument yields two data sets: (i) the electron density determined via the relaxation sounder, and (ii) the spectrum of natural plasma emissions in the frequency band 2-80 kHz. Both data sets allow for the three-dimensional exploration of the magnetosphere by the Cluster mission...... the drift velocity of density structures. Wave observations are also of crucial interest for studying small-scale structures, as demonstrated in an example in the fore-shock region. Early results from the Whisper instrument are very encouraging, and demonstrate that the four-point Cluster measurements...... largely overcomes the limited telemetry allocation. The natural emissions are usually related to the plasma frequency, as identified by the sounder, and the combination of an active sounding operation and a passive survey operation provides a time resolution for the total density determination of 2.2 s...

  7. Intention-based therapy for autism spectrum disorder: promising results of a wait-list control study in children.

    Science.gov (United States)

    Weiner, Robert H; Greene, Roger L

    2014-01-01

    Autism is a complex neurodevelopmental disability that usually manifests during the first three years of life and typically lasts throughout a person's lifetime. The purpose of this study is to investigate the efficacy of NeuroModulation Technique (NMT), a form of intention-based therapy, in improving functioning in children diagnosed with autism. A total of 18 children who met the study criteria were selected to participate. All children completed baseline measures. The children in the experimental group (n = 9) received two sessions a week of NMT for six weeks. Then, children in the wait-list control group (n = 9) received two sessions a week of NMT for six weeks. Primary efficacy outcome measures included the Pervasive Developmental Disorder Behavioral Inventory Autism Composite Index, the Aberrant Behavior Checklist-Community Total Score, and the Autism Treatment Evaluation Checklist Total Score. Our hypotheses were that children in both groups would show significant improvement over their respective baseline scores following NMT treatment, which would reflect an improvement in adaptive behaviors as well as a decrease in maladaptive behaviors. Statistical analysis indicates a significant improvement in both the experimental and wait-list control group on all primary outcome measures following NMT treatment. The wait-list control group demonstrated no significant improvement on test measures over baseline scores during the wait period. No adverse reactions were reported. These findings suggest that NMT is a promising intervention for autism that has the potential to produce a significant reduction in maladaptive behaviors and a significant increase in adaptive behaviors within a relatively short period of time. © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Early glottic carcinoma: results of treatment by radiotherapy

    International Nuclear Information System (INIS)

    Smee, R.; Williams, J.; Fisher, R.; Bridger, G.P.

    2000-01-01

    The purpose of the present paper was to review the results of treating early stages glottic, squamous cell carcinoma by radiotherapy in the Department of Radiation Oncology, Prince of Wales Hospital, Sydney. A retrospective review was carried out of all patients seen in the department from 1967 to 1994, inclusive. To be eligible, patients had to have newly diagnosed cancer and to have been treated with curative intent by radiotherapy alone. Three hundred and sixty-nine patients satisfied the eligibility requirements. The mean follow-up time was 12.2 years (maximum: 28 years). At 5 years the actuarial local control rate was 80% (84% for stage T 1 and 72% for T 2 ). The ultimate local control rate was 96%. The overall survival rates at 5 and 10 years were 73% and 52%, respectively. The risk of nodal recurrence was much higher after persisting disease or local recurrence. Our results confirm the high cure rates achieved with this modality of treatment and are comparable with those reported in the literature. Copyright (1999) Blackwell Science Pty. Ltd

  9. Esophagographic findings of early esophageal cancer : comparison with pathologic results

    International Nuclear Information System (INIS)

    Chung, Jae Joon; Kim, Choong Bai; Kim, Ho Guen; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik

    1998-01-01

    The purpose of this study is to investigate the esophagographic findings of early esophageal cancer (EEC), and to compare these with the pathologic results, and to thus determine the most useful method of esophagography for detection of EEC. We examined 18 patients (M:F=16:2) with pathologically proven EEC; 17 cases were squamous cell carcinoma and one was adenocarcinoma. Tumor size, shape and location were evaluated by esophagography and the findings were compared with the pathologic results. The tumors were 0.5 - 7 cm in size; all except two were smaller than 4 cm. Twelve were located in the middle esophagus, five cases in the lower esophagus and one case in the upper esophagus; in ten cases, the margin was ill-defined. Esophagography showed that eight cases were of the superficial depressed type, seven were the superficial elevated type, and three were the tumorous type. All 18 cases were detected by double contrast study, but mucosal relief study and barium filling study revealed only ten and eight cases, respectively; for the detection of EEC double contrast study was thus the most useful. EEC was commonly demonstrated in the middle esophagus with an ill-defined margin; it was of the superficial depressed or elevated type. For the detection of EEC, double contrast study was the most useful. (author). 14 refs., 1 tab., 5 figs

  10. Is story-based blended learning a promising avenue for skin and sexual health education? Results from the PAEDIMED project.

    Science.gov (United States)

    Apfelbacher, Christian J; Deimling, Erika; Wulfhorst, Britta; Adler, Frederic; Diepgen, Thomas L; Linder, Dennis; Blenk, Holger; Stosiek, Nikolaus; Reinmann, Gabi

    2010-03-01

    The PAEDIMED study group developed a learning and teaching scenario for school health education in the area of skin and sexual health in Italy, Romania and Germany, combining web-based and traditional learning ("blended learning"). A questionnaire-based needs assessment and context analysis were conducted, based on which an education scenario was designed. Particular emphasis was put on emotional and motivational aspects, using narrative components in the didactic concept. The design process occupied a central role in the project (design-based research). Evaluation was both formative and summative. Continuous feedback was obtained from relevant stakeholders. Following a prototypical implementation, the scenario was evaluated using questionnaires. The results revealed a high level of acceptance of the education scenario as well as an increase in students' knowledge concerning skin and sexual health. Evaluation also suggested that health education is highly influenced by cultural background and habits as well as diverse contextual and personal conditions.

  11. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Demet Pepele

    2014-03-01

    Full Text Available Aim: The goal in anterior cruciate ligament reconstruction (ACLR is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months. Patients%u2019 scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85% A (excellent and B (good group and 3 patients took place as C (adequate group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large numbers in order to determine improving clinical outcome, preventing degeneration and restoring the knee biomechanics better.

  12. Activities of the Bloomberg Philanthropies Global Road Safety Programme (formerly RS10) in Russia: promising results from a sub-national project.

    Science.gov (United States)

    Slyunkina, Ekaterina S; Kliavin, Vladimir E; Gritsenko, Elena A; Petruhin, Alexandr B; Zambon, Francesco; He, Huan; Hyder, Adnan A

    2013-12-01

    In Russia, the high Road Traffic Injuries (RTIs) rate has been attributed to two well-known risk factors - the low rates of seatbelt and child restraints use and speeding. Despite the importance of understanding both speeding and seatbelt use patterns for the purpose of direct interventions or monitoring road safety situation, no study has assessed the current status of speeding among all vehicles and seatbelt wearing rates among all vehicle occupants in Russia. We are aware that alcohol is a known risk factor for RTI in the country however the work focused on seat belts and speed. This research was conducted as part of the Bloomberg Philanthropies Global Road Safety Programme and focuses on observed speeding and seatbelt use in two Russian regions: Lipetskaya and Ivanovskaya Oblast. Data was collected through observational surveys on selected roads in the two interventions sites (Lipetskaya and Ivanovskaya Oblast) between October 2010 and March 2013. The percentage of seatbelt use by drivers and passengers and the percentage of speeding vehicles by speed limit and road types were calculated. Observational studies on speeding show signs that drivers are speeding less from the first survey held in July 2011 in Lipetskaya Oblast and March 2012 in Ivanovksya Oblast. Overall the observational studies showed a consistent reduction in the proportion of vehicles exceeding the speed limit: from 54.7% (2012) to 40.1% (2013) in Ivanovskaya Oblast and from 47.0% (2011) to 26.1% (2013) in Lipetskaya Oblast. Observational studies on seatbelt use demonstrate an increase in seatbelt wearing rates from the first survey held in October 2010 in Lipetskaya Oblast and April 2011 in Ivanovskaya Oblast. The overall prevalence of seatbelt use increased from 52.4% (2010) to 73.5% (2013) amongst all occupants in Lipetskaya Oblast and from 47.5% (2011) to 88.8% (2013) in Ivanovskaya Oblast. Preliminary results show some promising signs that speeding and seatbelt use are moving in the right

  13. Western gulf culture-density study-early results

    Science.gov (United States)

    Mohd S. Rahman; Michael G. Messina; Richard F. Fisher; Alan B. Wilson; Nick Chappell; Conner Fristoe; Larry Anderson

    2006-01-01

    The Western Gulf Culture-Density Study is a collaborative research effort between Texas A&M University and five forest products companies to examine the effects of early silvicultural treatment intensity and a wide range of both densities and soil types on performance of loblolly pine. The study tests 2 silvicultural intensities, 5 planting densities (200 to 1,200...

  14. Migration characteristics and early clinical results of the NANOS® short-stem hip arthroplasty.

    Science.gov (United States)

    Kaipel, Martin; Grabowiecki, Phillip; Sinz, Katrina; Farr, Sebastian; Sinz, Günter

    2015-05-01

    Femoral short stems promise essential advantages in total hip arthroplasty. Up to now, only short- and midterm clinical studies exist. Data on early stem migration that could predict later aseptic loosening at an early stage are rare. The purpose of this study was to assess migration patterns and clinical outcome 2 years after hip replacement by a metaphyseal anchored cementless short stem. Migration data and clinical results were prospectively assessed in 49 patients. Clinical outcome was measured using the Harris Hip Score (HHS). Migration analyses were performed using the computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) system. At 2 years after surgery, none of the implants needed revision, and HHS increased from 47.9 up to 98.1. Of 49 patients, 5 (10%) showed increased vertical stem migration (1.5 mm/2a) that might predict late aseptic loosening. Of 49 stems, 44 (90%) showed stable migration patterns indicating a beneficial long-term outcome. Results of this study confirm the excellent clinical data of previous works. Migration patterns strongly suggest that short-stem arthroplasty is not only an innovative but also a reliable strategy in total hip replacement.

  15. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Demet Pepele

    2014-01-01

    Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...

  16. Early laparoendoscopic rendezvous for acute biliary pancreatitis: preliminary results.

    Science.gov (United States)

    Borzellino, G; Lombardo, F; Minicozzi, A M; Donataccio, M; Cordiano, C

    2010-02-01

    Early restored patency of the papilla has been hypothesized to reduce complications and mortality of acute biliary pancreatitis. The aim of this study was to evaluate the role of urgent laparoscopic cholecystectomy with intraoperative cholangiography and rendezvous when necessary in acute biliary pancreatitis natural history. Patients observed in the early stage of an acute biliary pancreatitis were included in the study. Operative risk assessment based on American Society of Anesthesiologists (ASA) score allowed the performance of urgent laparoscopic cholecystectomy within 72 h from onset of symptoms in 55 patients and a delayed intervention during the same admission in 21 patients. Intraoperative cholangiography was performed in all cases, and clearance of common bile duct was performed by flushing when possible, or rendezvous when necessary. Evolution of pancreatitis was evaluated with clinical and radiological monitoring. Urgent laparoscopic cholecystectomy was performed in all cases without conversion. At intraoperative cholangiography common bile duct was free in 25 patients, a papillary spasm was observed in 9, and common bile duct stones in 21 patients. Patency of the papilla was restored by flushing in 13 patients, while a rendezvous was necessary in 17 patients. The rate of organ failure and pancreatic necrosis was 1.8%, overall mortality was 1.8%, and overall morbidity 21.8%. No infectious complications of peripancreatic collections were observed. Urgent laparoscopic cholecystectomy with selective intraoperative rendezvous may be considered as a treatment option in the early stage of acute biliary pancreatitis.

  17. Early results from NASA's SnowEx campaign

    Science.gov (United States)

    Kim, Edward; Gatebe, Charles; Hall, Dorothy; Misakonis, Amy; Elder, Kelly; Marshall, Hans Peter; Hiemstra, Chris; Brucker, Ludovic; Crawford, Chris; Kang, Do Hyuk; De Marco, Eugenia; Beckley, Matt; Entin, Jared

    2017-04-01

    SnowEx is a multi-year airborne snow campaign with the primary goal of addressing the question: How much water is stored in Earth's terrestrial snow-covered regions? Year 1 (2016-17) focuses on the distribution of snow-water equivalent (SWE) and the snow energy balance in a forested environment. The year 1 primary site is Grand Mesa and the secondary site is the Senator Beck Basin, both in western, Colorado, USA. Ten core sensors on four core aircraft will make observations using a broad suite of airborne sensors including active and passive microwave, and active and passive optical/infrared sensing techniques to determine the sensitivity and accuracy of these potential satellite remote sensing techniques, along with models, to measure snow under a range of forest conditions. SnowEx also includes an extensive range of ground truth measurements—in-situ samples, snow pits, ground based remote sensing measurements, and sophisticated new techniques. A detailed description of the data collected will be given and some early results will be presented. Seasonal snow cover is the largest single component of the cryosphere in areal extent (covering an average of 46M km2 of Earth's surface (31 % of land areas) each year). This seasonal snow has major societal impacts in the areas of water resources, natural hazards (floods and droughts), water security, and weather and climate. The only practical way to estimate the quantity of snow on a consistent global basis is through satellites. Yet, current space-based techniques underestimate storage of snow water equivalent (SWE) by as much as 50%, and model-based estimates can differ greatly vs. estimates based on remotely-sensed observations. At peak coverage, as much as half of snow-covered terrestrial areas involve forested areas, so quantifying the challenge represented by forests is important to plan any future snow mission. Single-sensor approaches may work for certain snow types and certain conditions, but not for others

  18. Planck early results. V. The Low Frequency Instrument data processing

    DEFF Research Database (Denmark)

    Poutanen, T.; Lähteenmäki, A.; León-Tavares, J.

    2011-01-01

    We describe the processing of data from the Low Frequency Instrument (LFI) used in production of the Planck Early Release Compact Source Catalogue (ERCSC). In particular, we discuss the steps involved in reducing the data from telemetry packets to cleaned, calibrated, time-ordered data (TOD) and ...... statistical uncertainties on LFI and Planck products are also produced. Main beams are estimated down to the ≈ -10dB level using Jupiter transits, which are also used for geometrical calibration of the focal plane. © ESO, 2011....

  19. Some early results from the ATS-6 radio beacon experiment

    International Nuclear Information System (INIS)

    Davies, K.; Fritz, R.B.; Grubb, R.N.; Jones, J.E.

    1975-01-01

    The multifrequency satellite radio beacon enables the measurement of the columnar electron content of the ionosphere and plasmasphere along the ray path and its spatial and temporal structure. Measurements include modulation phase, Faraday rotation, and amplitude. The characteristics of the beacon transmitter and its design are presented together with the design of the Boulder receiver and antennas and the calibration procedures. A shape factor F is defined which depends on the electron density and geomagnetic field distributions. It is found that F varies by about 30 percent from day to night. It is shown that the ratio of the plasmaspheric content to total content varies from about 0.08 during the day to about 0.35 at night. Other examples which are presented to illustrate the uses of the radio beacon include sunrise effects, solar flare enhancements of total content, and the ionospheric storms of early July 1974

  20. National and international forums to discuss the approach and the results of PROMISING : Discussion in the framework of the European research project PROMISING (Promotion of Measures for Vulnerable Road Users), Workpackage 7.

    NARCIS (Netherlands)

    Wittink, R. (ed.)

    2001-01-01

    The European PROMISING research project is aimed at the development and promotion of measures to improve both safety and mobility of vulnerable road users. Consideration was given to differences between European countries in the share of different transport modes. During the research work, an

  1. Planck early results. VI. The High Frequency Instrument data processing

    DEFF Research Database (Denmark)

    Colley, J.-M.; Bartlett, J.G.; Bucher, M.

    2011-01-01

    We describe the processing of the 336 billion raw data samples from the High Frequency Instrument (HFI) which we performed to produce six temperature maps from the first 295 days of Planck-HFI survey data. These maps provide an accurate rendition of the sky emission at 100, 143, 217, 353, 545...... and 857 GHz with an angular resolution ranging from 9.9 to 4.4′. The white noise level is around 1.5 μK degree or less in the 3 main CMB channels (100-217 GHz). The photometric accuracy is better than 2% at frequencies between 100 and 353 GHz and around 7% at the two highest frequencies. The maps created...... by the HFI Data Processing Centre reach our goals in terms of sensitivity, resolution, and photometric accuracy. They are already sufficiently accurate and well-characterised to allow scientific analyses which are presented in an accompanying series of early papers. At this stage, HFI data appears...

  2. Earthquake Early Warning in Japan - Result of recent two years -

    Science.gov (United States)

    Shimoyama, T.; Doi, K.; Kiyomoto, M.; Hoshiba, M.

    2009-12-01

    Japan Meteorological Agency(JMA) started to provide Earthquake Early Warning(EEW) to the general public in October 2007. It was followed by provision of EEW to a limited number of users who understand the technical limit of EEW and can utilize it for automatic control from August 2006. Earthquake Early Warning in Japan definitely means information of estimated amplitude and arrival time of a strong ground motion after fault rupture occurred. In other words, the EEW provided by JMA is defined as a forecast of a strong ground motion before the strong motion arrival. EEW of JMA is to enable advance countermeasures to disasters caused by strong ground motions with providing a warning message of anticipating strong ground motion before the S wave arrival. However, due to its very short available time period, there should need some measures and ideas to provide rapidly EEW and utilize it properly. - EEW is issued to general public when the maximum seismic intensity 5 lower (JMA scale) or greater is expected. - EEW message contains origin time, epicentral region name, and names of areas (unit is about 1/3 to 1/4 of one prefecture) where seismic intensity 4 or greater is expected. Expected arrival time is not included because it differs substantially even in one unit area. - EEW is to be broadcast through the broadcasting media(TV, radio and City Administrative Disaster Management Radio), and is delivered to cellular phones through cell broadcast system. For those who would like to know the more precise estimation and smaller earthquake information at their point of their properties, JMA allows designated private companies to provide forecast of strong ground motion, in which the estimation of a seismic intensity as well as arrival time of S-wave are contained, at arbitrary places under the JMA’s technical assurance. From October, 2007 to August, 2009, JMA issued 11 warnings to general public expecting seismic intensity “5 lower” or greater, including M=7.2 inland

  3. Planck early results. VIII. The all-sky early Sunyaev-Zeldovich cluster sample

    DEFF Research Database (Denmark)

    Poutanen, T.; Natoli, P.; Polenta, G.

    2011-01-01

    We present the first all-sky sample of galaxy clusters detected blindly by the Planck satellite through the Sunyaev-Zeldovich (SZ) effect from its six highest frequencies. This early SZ (ESZ) sample is comprised of 189 candidates, which have a high signal-to-noise ratio ranging from 6 to 29. Its ...

  4. Impact of a peer-counseling intervention on breastfeeding practices in different socioeconomic strata: results from the equity analysis of the PROMISE-EBF trial in Uganda.

    Science.gov (United States)

    Eide, Kristiane Tislevoll; Fadnes, Lars Thore; Engebretsen, Ingunn Marie Stadskleiv; Onarheim, Kristine Husøy; Wamani, Henry; Tumwine, James K; Norheim, Ole Frithjof

    2016-01-01

    Undernutrition is highly prevalent among infants in Uganda. Optimal infant feeding practices may improve nutritional status, health, and survival among children. Our study evaluates the socioeconomic distribution of exclusive breastfeeding (EBF) and growth outcomes among infants included in a trial, which promoted EBF by peer counselors in Uganda. Twenty-four clusters comprising one to two communities in Uganda were randomized into intervention and control arms, including 765 mother-infant pairs (PROMISE-EBF trial, 200608, ClinicalTrials.gov no. NCT00397150). Intervention clusters received the promotion of EBF by peer counselors in addition to standard care. Breastfeeding and growth outcomes were compared according to wealth quintiles and intervention/control arms. Socioeconomic inequality in breastfeeding and growth outcomes were measured using the concentration index 12 and 24 weeks postpartum. We used the decomposition of the concentration index to identify factors contributing to growth inequality at 24 weeks. EBF was significantly concentrated among the poorest in the intervention group at 24 weeks postpartum, concentration index -0.060. The control group showed a concentration of breastfeeding among the richest part of the population, although not statistically significant. Stunting, wasting, and underweight were similarly significantly concentrated among the poorest in the intervention group and the total population at 24 weeks, but showing non-significant concentrations for the control group. This study shows that EBF can be successfully promoted among the poor. In addition, socioeconomic inequality in growth outcomes starts early in infancy, but the breastfeeding intervention was not strong enough to counteract this influence.

  5. Early Science Results from the Williams College Eclipse Expedition

    Science.gov (United States)

    Pasachoff, Jay M.; Person, Michael J.; Dantowitz, Ron; Lockwood, Christian A.; Nagle-McNaughton, Tim; Meadors, Erin N.; Perez, Cielo C.; Marti, Connor J.; Yu, Ross; Rosseau, Brendan; Daly, Declan M.; Ide, Charles A.; Davis, Allen B.; Lu, Muzhou; Sliski, David; Seiradakis, John; Voulgaris, Aris; Rusin, Vojtech; Peñaloza-Murillo, Marcos A.; Roman, Michael; Seaton, Daniel B.; Steele, Amy; Lee, Duane M.; Freeman, Marcus J.

    2018-01-01

    We describe our first cut of data reduction on a wide variety of observations of the solar corona and of the effect of the penumbra and umbra on the terrestrial atmosphere, carried out from our eclipse site on the campus of Willamette University in Salem, Oregon. Our team of faculty, undergraduate students, graduate students, and other colleagues observed the eclipse, taking images and spectra with a variety of sensors and telescopes. Equipment included frame-transfer cameras observing at 3 Hz in 0.3 nm filters at the coronal green and red lines to measure the power spectrum of oscillations in coronal loops or elsewhere in the lower corona; 3 spectrographs; a variety of telescopes and telephotos for white-light imaging; a double Lyot system tuned at Fe XIV 530.3 nm (FWHM 0.4 nm) and Fe X 637.4 nm (FWHM 0.5 nm); and a weather station to record changes in the terrestrial atmosphere. We are comparing our observations with predictions based on the previous mapping of the photospheric magnetic field, and preparing wide-field complete coronal imaging incorporating NOAA/NASA GOES-16 SUVI and NRL/NASA/LASCO for the corona outside our own images (which extend, given the completely clear skies we had, at least 4 solar radii), and NASA SDO/AIA and NOAA/NASA GOES-16 SUVI for the solar disk. One of our early composites appeared as Astronomy Picture of the Day for September 27: https://apod.nasa.gov/apod/ap170927.htmlOur expedition was supported in large part by grants from the Committee for Research and Exploration of the National Geographic Society and from the Solar Terrestrial Program of the Atmospheric and Geospace Sciences Division of the National Science Foundation, with additional student support from the STP/AGS of NSF, the NASA Massachusetts Space Grant Consortium, the Sigma Xi honorary scientific society, the Clare Booth Luce Foundation studentship and the Freeman Foote Expeditionary Fund at Williams College, other Williams College funds, and U. Pennsylvania funds.

  6. Attitudes of the German general population toward early diagnosis of dementia--results of a representative telephone survey.

    Directory of Open Access Journals (Sweden)

    Tobias Luck

    Full Text Available BACKGROUND: Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer's dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. METHODS: A representative telephone survey of the German population aged 18+ years (n = 1,002 was conducted in 2011. RESULTS: The majority of respondents (69% would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP as the first source of professional help. More than half of the respondents (55% stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. CONCLUSIONS: Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs' potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved.

  7. Prototype Early Warning Fire Detection System: Test Series 4 Results

    National Research Council Canada - National Science Library

    Gottuk, Daniel

    2002-01-01

    .... The use of multiple sensors and the Probabilistic Neural Networks alarm algorithm in the EWFD system resulted in improved performance compared to only an ionization or photoelectric smoke detector...

  8. Early Results of Total Hip·Joint Replacement

    African Journals Online (AJOL)

    1974-09-28

    Sep 28, 1974 ... The majority (61%) of operations were done by the author, ... results of these conversion operations are considered .... Surgical and Postoperative Management .... slack. Dislocations are easily reduced by manipulation under.

  9. Early results after robot-assisted colorectal surgery

    DEFF Research Database (Denmark)

    Eriksen, Jens Ravn; Helvind, Neel Maria; Jakobsen, Henrik Loft

    2013-01-01

    Implementation of robotic technology in surgery is challenging in many ways. The aim of this study was to present the implementation process and results of the first two years of consecutive robot-assisted laparoscopic (RAL) colorectal procedures.......Implementation of robotic technology in surgery is challenging in many ways. The aim of this study was to present the implementation process and results of the first two years of consecutive robot-assisted laparoscopic (RAL) colorectal procedures....

  10. Early results of gate valve flow interruption blowdown tests

    International Nuclear Information System (INIS)

    DeWall, K.G.

    1988-01-01

    The preliminary results of the USNRC/INEL high-energy BWR line break flow interruption testing are presented. Two representative nuclear valve assemblies were cycled under design basis Reactor Water Cleanup pipe break conditions to provide input for the technical basis for resolving the Nuclear Regulatory Commission's Generic Issue 87. The effects of the blowdown hydraulic loadings on valve operability, especially valve closure stem forces, were studied. The blowdown tests showed that, given enough thrust, typical gate valves will close against the high flow resulting from a line break. The tests also showed that proper operator sizing depends on the correct identification of values for the sizing equation. Evidence exists that values used in the past may not be conservative for all valve applications. The tests showed that improper operator lock ring installation following test or maintenance can invalidate in-situ test results and prevent the valve from performing its design function. 2 refs., 12 figs., 2 tabs

  11. Designing an advanced available-to-promise mechanism compatible with the make-to-forecast production systems through integrating inventory allocation and job shop scheduling with due dates and weighted earliness/tardiness cost

    Directory of Open Access Journals (Sweden)

    Masoud Rabbani

    2016-06-01

    Full Text Available In the competitive business world, applying a reliable and powerful mechanism to support decision makers in manufacturing companies and helping them save time by considering varieties of effective factors is an inevitable issue. Advanced Available-to-Promise is a perfect tool to design and perform such a mechanism. In this study, this mechanism which is compatible with the Make-to-Forecast production systems is presented. The ability to distinguish between batch mode and real-time mode advanced available-to-promise is one of the unique superiorities of the proposed model. We also try to strengthen this mechanism by integrating the inventory allocation and job shop scheduling by considering due dates and weighted earliness/tardiness cost that leads to more precise decisions. A mixed integer programming (MIP model and a heuristic algorithm according to its disability to solve large size problems are presented. The designed experiments and the obtained results have proved the efficiency of the proposed heuristic method.

  12. Planck early results. XVI. The Planck view of nearby galaxies

    DEFF Research Database (Denmark)

    Lähteenmäki, A.; Poutanen, T.; Natoli, P.

    2011-01-01

    they have been observed. We here present the first results on the properties of nearby galaxies using these data. We match the ERCSC catalogue to IRAS-detected galaxies in the Imperial IRAS Faint Source Redshift Catalogue (IIFSCz), so that we can measure the spectral energy distributions (SEDs......) of these objects from 60 to 850μm. This produces a list of 1717 galaxies with reliable associations between Planck and IRAS, from which we select a subset of 468 for SED studies, namely those with strong detections in the three highest frequency Planck bands and no evidence of cirrus contamination. The SEDs...

  13. The Gravity Probe B experiment and early results

    Energy Technology Data Exchange (ETDEWEB)

    Conklin, John W [Stanford University (United States)], E-mail: johnwc@stanford.edu

    2008-11-01

    The NASA Gravity Probe B orbiting gyroscope test of General Relativity, launched from Vandenberg Air Force Base on 20 April, 2004 tests two consequences of Einstein's theory: 1) the predicted 6.6 arcs/yr geodetic effect due to the motion of the gyroscope through the curved space-time around the Earth; 2) the predicted 0.039 arcs/yr frame-dragging effect due to the rotating Earth. The mission required the development of many technologies that did not exist when experiment was conceived in 1960. Cryogenic gyroscopes with drift-rates 7 orders of magnitude better than the best inertial navigation gyroscopes, a < 1 marcs star tracking telescope, and other essential technologies were developed as a result of an intensive collaboration between Stanford physicists and engineers, NASA and industry. Gravity Probe B collected science data from August 27, 2004 through September 29, 2005. Analysis of the data began during the mission and is on-going. This paper describes the main features and challenges of the experiment and presents the preliminary results to date.

  14. The Gravity Probe B experiment and early results

    International Nuclear Information System (INIS)

    Conklin, John W

    2008-01-01

    The NASA Gravity Probe B orbiting gyroscope test of General Relativity, launched from Vandenberg Air Force Base on 20 April, 2004 tests two consequences of Einstein's theory: 1) the predicted 6.6 arcs/yr geodetic effect due to the motion of the gyroscope through the curved space-time around the Earth; 2) the predicted 0.039 arcs/yr frame-dragging effect due to the rotating Earth. The mission required the development of many technologies that did not exist when experiment was conceived in 1960. Cryogenic gyroscopes with drift-rates 7 orders of magnitude better than the best inertial navigation gyroscopes, a < 1 marcs star tracking telescope, and other essential technologies were developed as a result of an intensive collaboration between Stanford physicists and engineers, NASA and industry. Gravity Probe B collected science data from August 27, 2004 through September 29, 2005. Analysis of the data began during the mission and is on-going. This paper describes the main features and challenges of the experiment and presents the preliminary results to date.

  15. Early detection of breast cancer: results of a screening programme

    International Nuclear Information System (INIS)

    Beahrs, O.H.

    1980-01-01

    The results of a mammography screening programme launched by the American Cancer Society and the National Cancer Institute are discussed. Twenty-seven Breast Cancer Detection Demonstration Projects (BCDDP) screened 280,000 women annually for 5 years. During the first 2 screenings, 1810 cancers were detected. An increased rate of discovery in all age groups was achieved. The radiation risk of mammography is also discussed. The results of the BCDDP were evaluated by a review panel. Of the 1810 cancers detected, 45% had been detected by mammography alone, 47% by mammography and physical examination and only 7% by physical examination alone. 592 of the cancers were < 1 cm in diameter. Two-thirds of these lesions were considered to be in-situ carcinoma and one-third invasive cancer. In 66 instances, the tissue first presented was considered not to be cancerous; these cases were further studied clinically and pathologically. It is concluded that, in the experience of the BCDDP, mammography proved to be an excellent method of detection, but it does have a small theoretical risk. As a widely used approach to detection, mammography is probably not practical due to the number of experts necessary for image evaluation. (UK)

  16. Early Results and Spaceflight Implications of the SWAB Flight Experiment

    Science.gov (United States)

    Ott, C. Mark; Pierson, Duane L.

    2007-01-01

    Microbial monitoring of spacecraft environments provides key information in the assessment of infectious disease risk to the crew. Monitoring aboard the Mir space station and International Space Station (ISS) has provided a tremendous informational baseline to aid in determining the types and concentrations of microorganisms during a mission. Still, current microbial monitoring hardware utilizes culture-based methodology which may not detect many medically significant organisms, such as Legionella pneumophila. We hypothesize that evaluation of the ISS environment using non-culture-based technologies would reveal microorganisms not previously reported in spacecraft, allowing for a more complete health assessment. To achieve this goal, a spaceflight experiment, operationally designated as SWAB, was designed to evaluate the DNA from environmental samples collected from ISS and vehicles destined for ISS. Results from initial samples indicate that the sample collection and return procedures were successful. Analysis of these samples using denaturing gradient gel electrophoresis and targeted PCR primers for fungal contaminants is underway. The current results of SWAB and their implication for in-flight molecular analysis of environmental samples will be discussed.

  17. Early results from the Far Infrared Absolute Spectrophotometer (FIRAS)

    Science.gov (United States)

    Mather, J. C.; Cheng, E. S.; Shafer, R. A.; Eplee, R. E.; Isaacman, R. B.; Fixsen, D. J.; Read, S. M.; Meyer, S. S.; Weiss, R.; Wright, E. L.

    1991-01-01

    The Far Infrared Absolute Spectrophotometer (FIRAS) on the Cosmic Background Explorer (COBE) mapped 98 percent of the sky, 60 percent of it twice, before the liquid helium coolant was exhausted. The FIRAS covers the frequency region from 1 to 100/cm with a 7 deg angular resolution. The spectral resolution is 0.2/cm for frequencies less than 20/cm and 0.8/cm for higher frequencies. Preliminary results include: a limit on the deviations from a Planck curve of 1 percent of the peak brightness from 1 to 20/cm, a temperature of 2.735 +/- 0.06 K, a limit on the Comptonization parameter y of 0.001, on the chemical potential parameter mu of 0.01, a strong limit on the existence of a hot smooth intergalactic medium, and a confirmation that the dipole anisotropy spectrum is that of a Doppler shifted blackbody.

  18. Early results and future challenges of the Danish Fracture Database

    DEFF Research Database (Denmark)

    Gromov, Kirill; Brix, Michael; Kallemose, Thomas

    2014-01-01

    INTRODUCTION: The Danish Fracture Database (DFDB) was established in 2011 to establish nationwide prospective quality assessment of all fracture-related surgery. In this paper, we describe the DFDB's setup, present preliminary data from the first annual report and discuss its future potential...... are registered. Indication for reoperation is also recorded. The reoperation rate and the one-year mortality are the primary indicators of quality. RESULTS: Approximately 10,000 fracture-related surgical procedures were registered in the database at the time of presentation of the first annual DFDB report...... of osteosynthesis were the three most common indications for reoperation and accounted for 34%, 14% and 13%, respectively. CONCLUSION: The DFDB is an online database for registration of fracture-related surgery that allows for basic quality assessment of surgical fracture treatment and large-scale observational...

  19. Global inter-annual gravity changes from GRACE: Early results

    DEFF Research Database (Denmark)

    Andersen, Ole Baltazar; Hinderer, J.

    2005-01-01

    with an accuracy of 0.4 muGal corresponding to 9 mm water thickness on spatial scales longer than 1300 km. Four of the most widely used global hydrological models have been investigated for their spatial comparison with GRACE observations of inter-annual gravity field variations due to changes in continental water...... storage. The Global Land Data Assimilation System model has a spatial correlation coefficient with GRACE observations of 0.65 over the northern hemisphere. This demonstrates that the observed gravity field changes on these scales are largely related to changes in continental water storage.......Fifteen monthly gravity field solutions from the GRACE twin satellites launched more than two years ago have been studied to estimate gravity field changes between 2002 and 2003. The results demonstrate that GRACE is capable of capturing the changes in ground water on inter-annual scales...

  20. CMS Tracking Performance Results from Early LHC Operation

    CERN Document Server

    Khachatryan, Vardan; Tumasyan, Armen; Adam, Wolfgang; Bergauer, Thomas; Dragicevic, Marko; Erö, Janos; Fabjan, Christian; Friedl, Markus; Fruehwirth, Rudolf; Ghete, Vasile Mihai; Hammer, Josef; Haensel, Stephan; Hoch, Michael; Hörmann, Natascha; Hrubec, Josef; Jeitler, Manfred; Kasieczka, Gregor; Kiesenhofer, Wolfgang; Krammer, Manfred; Liko, Dietrich; Mikulec, Ivan; Pernicka, Manfred; Rohringer, Herbert; Schöfbeck, Robert; Strauss, Josef; Taurok, Anton; Teischinger, Florian; Waltenberger, Wolfgang; Walzel, Gerhard; Widl, Edmund; Wulz, Claudia-Elisabeth; Mossolov, Vladimir; Shumeiko, Nikolai; Suarez Gonzalez, Juan; Benucci, Leonardo; Ceard, Ludivine; De Wolf, Eddi A.; Janssen, Xavier; Maes, Thomas; Mucibello, Luca; Ochesanu, Silvia; Roland, Benoit; Rougny, Romain; Selvaggi, Michele; Van Haevermaet, Hans; Van Mechelen, Pierre; Van Remortel, Nick; Adler, Volker; Beauceron, Stephanie; Blyweert, Stijn; D'Hondt, Jorgen; Devroede, Olivier; Kalogeropoulos, Alexis; Maes, Joris; Maes, Michael; Tavernier, Stefaan; Van Doninck, Walter; Van Mulders, Petra; Villella, Ilaria; Chabert, Eric Christian; Charaf, Otman; Clerbaux, Barbara; De Lentdecker, Gilles; Dero, Vincent; Gay, Arnaud; Hammad, Gregory Habib; Marage, Pierre Edouard; Vander Velde, Catherine; Vanlaer, Pascal; Wickens, John; Costantini, Silvia; Grunewald, Martin; Klein, Benjamin; Marinov, Andrey; Ryckbosch, Dirk; Thyssen, Filip; Tytgat, Michael; Vanelderen, Lukas; Verwilligen, Piet; Walsh, Sinead; Zaganidis, Nicolas; Basegmez, Suzan; Bruno, Giacomo; Caudron, Julien; De Favereau De Jeneret, Jerome; Delaere, Christophe; Demin, Pavel; Favart, Denis; Giammanco, Andrea; Grégoire, Ghislain; Hollar, Jonathan; Lemaitre, Vincent; Militaru, Otilia; Ovyn, Severine; Pagano, Davide; Pin, Arnaud; Piotrzkowski, Krzysztof; Quertenmont, Loic; Schul, Nicolas; Beliy, Nikita; Caebergs, Thierry; Daubie, Evelyne; Alves, Gilvan; Pol, Maria Elena; Henrique Gomes E Souza, Moacyr; Carvalho, Wagner; Da Costa, Eliza Melo; De Jesus Damiao, Dilson; De Oliveira Martins, Carley; Fonseca De Souza, Sandro; Mundim, Luiz; Nogima, Helio; Oguri, Vitor; Santoro, Alberto; Silva Do Amaral, Sheila Mara; Sznajder, Andre; Torres Da Silva De Araujo, Felipe; De Almeida Dias, Flavia; Ferreira Dias, Marco Andre; Tomei, Thiago; De Moraes Gregores, Eduardo; Da Cunha Marinho, Franciole; Novaes, Sergio F.; Padula, Sandra; Darmenov, Nikolay; Dimitrov, Lubomir; Genchev, Vladimir; Iaydjiev, Plamen; Piperov, Stefan; Stoykova, Stefka; Sultanov, Georgi; Trayanov, Rumen; Vankov, Ivan; Dyulendarova, Milena; Hadjiiska, Roumyana; Kozhuharov, Venelin; Litov, Leander; Marinova, Evelina; Mateev, Matey; Pavlov, Borislav; Petkov, Peicho; Bian, Jian-Guo; Chen, Guo-Ming; Chen, He-Sheng; Jiang, Chun-Hua; Liang, Dong; Liang, Song; Wang, Jian; Wang, Jian; Wang, Xianyou; Wang, Zheng; Yang, Min; Zang, Jingjing; Zhang, Zhen; Ban, Yong; Guo, Shuang; Hu, Zhen; Mao, Yajun; Qian, Si-Jin; Teng, Haiyun; Zhu, Bo; Cabrera, Andrés; Carrillo Montoya, Camilo Andres; Gomez Moreno, Bernardo; Ocampo Rios, Alberto Andres; Osorio Oliveros, Andres Felipe; Sanabria, Juan Carlos; Godinovic, Nikola; Lelas, Damir; Lelas, Karlo; Plestina, Roko; Polic, Dunja; Puljak, Ivica; Antunovic, Zeljko; Dzelalija, Mile; Brigljevic, Vuko; Duric, Senka; Kadija, Kreso; Morovic, Srecko; Attikis, Alexandros; Fereos, Reginos; Galanti, Mario; Mousa, Jehad; Nicolaou, Charalambos; Ptochos, Fotios; Razis, Panos A.; Rykaczewski, Hans; Mahmoud, Mohammed; Hektor, Andi; Kadastik, Mario; Kannike, Kristjan; Müntel, Mait; Raidal, Martti; Rebane, Liis; Azzolini, Virginia; Eerola, Paula; Czellar, Sandor; Härkönen, Jaakko; Heikkinen, Mika Aatos; Karimäki, Veikko; Kinnunen, Ritva; Klem, Jukka; Kortelainen, Matti J.; Lampén, Tapio; Lassila-Perini, Kati; Lehti, Sami; Lindén, Tomas; Luukka, Panja-Riina; Mäenpää, Teppo; Sarkar, Subir; Tuominen, Eija; Tuominiemi, Jorma; Tuovinen, Esa; Ungaro, Donatella; Wendland, Lauri; Banzuzi, Kukka; Korpela, Arja; Tuuva, Tuure; Sillou, Daniel; Besancon, Marc; Dejardin, Marc; Denegri, Daniel; Descamps, Julien; Fabbro, Bernard; Faure, Jean-Louis; Ferri, Federico; Ganjour, Serguei; Gentit, François-Xavier; Givernaud, Alain; Gras, Philippe; Hamel de Monchenault, Gautier; Jarry, Patrick; Locci, Elizabeth; Malcles, Julie; Marionneau, Matthieu; Millischer, Laurent; Rander, John; Rosowsky, André; Rousseau, Delphine; Titov, Maksym; Verrecchia, Patrice; Baffioni, Stephanie; Bianchini, Lorenzo; Bluj, Michal; Broutin, Clementine; Busson, Philippe; Charlot, Claude; Dobrzynski, Ludwik; Elgammal, Sherif; Granier de Cassagnac, Raphael; Haguenauer, Maurice; Kalinowski, Artur; Miné, Philippe; Paganini, Pascal; Sabes, David; Sirois, Yves; Thiebaux, Christophe; Zabi, Alexandre; Agram, Jean-Laurent; Besson, Auguste; Bloch, Daniel; Bodin, David; Brom, Jean-Marie; Cardaci, Marco; Conte, Eric; Drouhin, Frédéric; Ferro, Cristina; Fontaine, Jean-Charles; Gelé, Denis; Goerlach, Ulrich; Greder, Sebastien; Juillot, Pierre; Karim, Mehdi; Le Bihan, Anne-Catherine; Mikami, Yoshinari; Speck, Joaquim; Van Hove, Pierre; Fassi, Farida; Mercier, Damien; Baty, Clement; Beaupere, Nicolas; Bedjidian, Marc; Bondu, Olivier; Boudoul, Gaelle; Boumediene, Djamel; Brun, Hugues; Chanon, Nicolas; Chierici, Roberto; Contardo, Didier; Depasse, Pierre; El Mamouni, Houmani; Fay, Jean; Gascon, Susan; Ille, Bernard; Kurca, Tibor; Le Grand, Thomas; Lethuillier, Morgan; Mirabito, Laurent; Perries, Stephane; Sordini, Viola; Tosi, Silvano; Tschudi, Yohann; Verdier, Patrice; Xiao, Hong; Roinishvili, Vladimir; Anagnostou, Georgios; Edelhoff, Matthias; Feld, Lutz; Heracleous, Natalie; Hindrichs, Otto; Jussen, Ruediger; Klein, Katja; Merz, Jennifer; Mohr, Niklas; Ostapchuk, Andrey; Perieanu, Adrian; Raupach, Frank; Sammet, Jan; Schael, Stefan; Sprenger, Daniel; Weber, Hendrik; Weber, Martin; Wittmer, Bruno; Actis, Oxana; Ata, Metin; Bender, Walter; Biallass, Philipp; Erdmann, Martin; Frangenheim, Jens; Hebbeker, Thomas; Hinzmann, Andreas; Hoepfner, Kerstin; Hof, Carsten; Kirsch, Matthias; Klimkovich, Tatsiana; Kreuzer, Peter; Lanske, Dankfried; Magass, Carsten; Merschmeyer, Markus; Meyer, Arnd; Papacz, Paul; Pieta, Holger; Reithler, Hans; Schmitz, Stefan Antonius; Sonnenschein, Lars; Sowa, Michael; Steggemann, Jan; Teyssier, Daniel; Zeidler, Clemens; Bontenackels, Michael; Davids, Martina; Duda, Markus; Flügge, Günter; Geenen, Heiko; Giffels, Manuel; Haj Ahmad, Wael; Heydhausen, Dirk; Kress, Thomas; Kuessel, Yvonne; Linn, Alexander; Nowack, Andreas; Perchalla, Lars; Pooth, Oliver; Sauerland, Philip; Stahl, Achim; Thomas, Maarten; Tornier, Daiske; Zoeller, Marc Henning; Aldaya Martin, Maria; Behrenhoff, Wolf; Behrens, Ulf; Bergholz, Matthias; Borras, Kerstin; Campbell, Alan; Castro, Elena; Dammann, Dirk; Eckerlin, Guenter; Flossdorf, Alexander; Flucke, Gero; Geiser, Achim; Hauk, Johannes; Jung, Hannes; Kasemann, Matthias; Katkov, Igor; Kleinwort, Claus; Kluge, Hannelies; Knutsson, Albert; Kuznetsova, Ekaterina; Lange, Wolfgang; Lohmann, Wolfgang; Mankel, Rainer; Marienfeld, Markus; Melzer-Pellmann, Isabell-Alissandra; Meyer, Andreas Bernhard; Mnich, Joachim; Mussgiller, Andreas; Olzem, Jan; Parenti, Andrea; Raspereza, Alexei; Schmidt, Ringo; Schoerner-Sadenius, Thomas; Sen, Niladri; Stein, Matthias; Tomaszewska, Justyna; Volyanskyy, Dmytro; Wissing, Christoph; Autermann, Christian; Bobrovskyi, Sergei; Draeger, Jula; Eckstein, Doris; Enderle, Holger; Gebbert, Ulla; Kaschube, Kolja; Kaussen, Gordon; Klanner, Robert; Mura, Benedikt; Naumann-Emme, Sebastian; Nowak, Friederike; Pietsch, Niklas; Sander, Christian; Schettler, Hannes; Schleper, Peter; Schröder, Matthias; Schum, Torben; Schwandt, Joern; Srivastava, Ajay Kumar; Stadie, Hartmut; Steinbrück, Georg; Thomsen, Jan; Wolf, Roger; Bauer, Julia; Buege, Volker; Cakir, Altan; Chwalek, Thorsten; Daeuwel, Daniel; De Boer, Wim; Dierlamm, Alexander; Dirkes, Guido; Feindt, Michael; Gruschke, Jasmin; Hackstein, Christoph; Hartmann, Frank; Heinrich, Michael; Held, Hauke; Hoffmann, Karl-Heinz; Honc, Simon; Kuhr, Thomas; Martschei, Daniel; Mueller, Steffen; Müller, Thomas; Niegel, Martin; Oberst, Oliver; Oehler, Andreas; Ott, Jochen; Peiffer, Thomas; Piparo, Danilo; Quast, Gunter; Rabbertz, Klaus; Ratnikov, Fedor; Renz, Manuel; Sabellek, Andreas; Saout, Christophe; Scheurer, Armin; Schieferdecker, Philipp; Schilling, Frank-Peter; Schott, Gregory; Simonis, Hans-Jürgen; Stober, Fred-Markus Helmut; Troendle, Daniel; Wagner-Kuhr, Jeannine; Zeise, Manuel; Zhukov, Valery; Ziebarth, Eva Barbara; Daskalakis, Georgios; Geralis, Theodoros; Kyriakis, Aristotelis; Loukas, Demetrios; Manolakos, Ioannis; Markou, Athanasios; Markou, Christos; Mavrommatis, Charalampos; Petrakou, Eleni; Gouskos, Loukas; Katsas, Panagiotis; Panagiotou, Apostolos; Evangelou, Ioannis; Kokkas, Panagiotis; Manthos, Nikolaos; Papadopoulos, Ioannis; Patras, Vaios; Triantis, Frixos A.; Aranyi, Attila; Bencze, Gyorgy; Boldizsar, Laszlo; Debreczeni, Gergely; Hajdu, Csaba; Horvath, Dezso; Kapusi, Anita; Krajczar, Krisztian; Laszlo, Andras; Sikler, Ferenc; Vesztergombi, Gyorgy; Beni, Noemi; Molnar, Jozsef; Palinkas, Jozsef; Szillasi, Zoltan; Veszpremi, Viktor; Raics, Peter; Trocsanyi, Zoltan Laszlo; Ujvari, Balazs; Bansal, Sunil; Beri, Suman Bala; Bhatnagar, Vipin; Jindal, Monika; Kaur, Manjit; Kohli, Jatinder Mohan; Mehta, Manuk Zubin; Nishu, Nishu; Saini, Lovedeep Kaur; Sharma, Archana; Sharma, Richa; Singh, Anil; Singh, Jas Bir; Singh, Supreet Pal; Ahuja, Sudha; Chauhan, Sushil; Choudhary, Brajesh C.; Gupta, Pooja; Jain, Sandhya; Jain, Shilpi; Kumar, Ashok; Ranjan, Kirti; Shivpuri, Ram Krishen; Choudhury, Rajani Kant; Dutta, Dipanwita; Kailas, Swaminathan; Kataria, Sushil Kumar; Mohanty, Ajit Kumar; Pant, Lalit Mohan; Shukla, Prashant; Suggisetti, Praveenkumar; Aziz, Tariq; Guchait, Monoranjan; Gurtu, Atul; Maity, Manas; Majumder, Devdatta; Majumder, Gobinda; Mazumdar, Kajari; Mohanty, Gagan Bihari; Saha, Anirban; Sudhakar, Katta; Wickramage, Nadeesha; Banerjee, Sudeshna; Dugad, Shashikant; Mondal, Naba Kumar; Arfaei, Hessamaddin; Bakhshiansohi, Hamed; Fahim, Ali; Hashemi, Majid; Jafari, Abideh; Mohammadi Najafabadi, Mojtaba; Paktinat Mehdiabadi, Saeid; Safarzadeh, Batool; Zeinali, Maryam; Abbrescia, Marcello; Barbone, Lucia; Colaleo, Anna; Creanza, Donato; De Filippis, Nicola; De Palma, Mauro; Dimitrov, Anton; Fedele, Francesca; Fiore, Luigi; Iaselli, Giuseppe; Lusito, Letizia; Maggi, Giorgio; Maggi, Marcello; Manna, Norman; Marangelli, Bartolomeo; My, Salvatore; Nuzzo, Salvatore; Pierro, Giuseppe Antonio; Pompili, Alexis; Pugliese, Gabriella; Romano, Francesco; Roselli, Giuseppe; Selvaggi, Giovanna; Silvestris, Lucia; Trentadue, Raffaello; Tupputi, Salvatore; Zito, Giuseppe; Abbiendi, Giovanni; Benvenuti, Alberto; Bonacorsi, Daniele; Braibant-Giacomelli, Sylvie; Capiluppi, Paolo; Castro, Andrea; Cavallo, Francesca Romana; Codispoti, Giuseppe; Cuffiani, Marco; Dallavalle, Gaetano-Marco; Fabbri, Fabrizio; Fanfani, Alessandra; Fasanella, Daniele; Giacomelli, Paolo; Giunta, Marina; Marcellini, Stefano; Masetti, Gianni; Montanari, Alessandro; Navarria, Francesco; Odorici, Fabrizio; Perrotta, Andrea; Rossi, Antonio; Rovelli, Tiziano; Siroli, Gianni; Albergo, Sebastiano; Cappello, Gigi; Chiorboli, Massimiliano; Costa, Salvatore; Tricomi, Alessia; Tuve, Cristina; Barbagli, Giuseppe; Broccolo, Giuseppe; Ciulli, Vitaliano; Civinini, Carlo; D'Alessandro, Raffaello; Focardi, Ettore; Frosali, Simone; Gallo, Elisabetta; Genta, Chiara; Lenzi, Piergiulio; Meschini, Marco; Paoletti, Simone; Sguazzoni, Giacomo; Tropiano, Antonio; Benussi, Luigi; Bianco, Stefano; Colafranceschi, Stefano; Fabbri, Franco; Piccolo, Davide; Fabbricatore, Pasquale; Musenich, Riccardo; Benaglia, Andrea; Cerati, Giuseppe Benedetto; De Guio, Federico; Di Matteo, Leonardo; Ghezzi, Alessio; Govoni, Pietro; Malberti, Martina; Malvezzi, Sandra; Martelli, Arabella; Massironi, Andrea; Menasce, Dario; Miccio, Vincenzo; Moroni, Luigi; Negri, Pietro; Paganoni, Marco; Pedrini, Daniele; Ragazzi, Stefano; Redaelli, Nicola; Sala, Silvano; Salerno, Roberto; Tabarelli de Fatis, Tommaso; Tancini, Valentina; Taroni, Silvia; Buontempo, Salvatore; Cimmino, Anna; De Cosa, Annapaola; De Gruttola, Michele; Fabozzi, Francesco; Iorio, Alberto Orso Maria; Lista, Luca; Noli, Pasquale; Paolucci, Pierluigi; Azzi, Patrizia; Bacchetta, Nicola; Bellan, Paolo; Bisello, Dario; Carlin, Roberto; Checchia, Paolo; Conti, Enrico; De Mattia, Marco; Dorigo, Tommaso; Dosselli, Umberto; Fanzago, Federica; Gasparini, Fabrizio; Gasparini, Ugo; Giubilato, Piero; Gresele, Ambra; Lacaprara, Stefano; Lazzizzera, Ignazio; Margoni, Martino; Mazzucato, Mirco; Meneguzzo, Anna Teresa; Perrozzi, Luca; Pozzobon, Nicola; Ronchese, Paolo; Simonetto, Franco; Torassa, Ezio; Tosi, Mia; Vanini, Sara; Zotto, Pierluigi; Zumerle, Gianni; Baesso, Paolo; Berzano, Umberto; Riccardi, Cristina; Torre, Paola; Vitulo, Paolo; Viviani, Claudio; Biasini, Maurizio; Bilei, Gian Mario; Caponeri, Benedetta; Fanò, Livio; Lariccia, Paolo; Lucaroni, Andrea; Mantovani, Giancarlo; Menichelli, Mauro; Nappi, Aniello; Santocchia, Attilio; Servoli, Leonello; Valdata, Marisa; Volpe, Roberta; Azzurri, Paolo; Bagliesi, Giuseppe; Bernardini, Jacopo; Boccali, Tommaso; Castaldi, Rino; D'Agnolo, Raffaele Tito; Dell'Orso, Roberto; Fiori, Francesco; Foà, Lorenzo; Giassi, Alessandro; Kraan, Aafke; Ligabue, Franco; Lomtadze, Teimuraz; Martini, Luca; Messineo, Alberto; Palla, Fabrizio; Palmonari, Francesco; Segneri, Gabriele; Serban, Alin Titus; Spagnolo, Paolo; Tenchini, Roberto; Tonelli, Guido; Venturi, Andrea; Verdini, Piero Giorgio; Barone, Luciano; Cavallari, Francesca; Del Re, Daniele; Di Marco, Emanuele; Diemoz, Marcella; Franci, Daniele; Grassi, Marco; Longo, Egidio; Organtini, Giovanni; Palma, Alessandro; Pandolfi, Francesco; Paramatti, Riccardo; Rahatlou, Shahram; Amapane, Nicola; Arcidiacono, Roberta; Argiro, Stefano; Arneodo, Michele; Biino, Cristina; Botta, Cristina; Cartiglia, Nicolo; Castello, Roberto; Costa, Marco; Demaria, Natale; Graziano, Alberto; Mariotti, Chiara; Marone, Matteo; Maselli, Silvia; Migliore, Ernesto; Mila, Giorgia; Monaco, Vincenzo; Musich, Marco; Obertino, Maria Margherita; Pastrone, Nadia; Pelliccioni, Mario; Romero, Alessandra; Ruspa, Marta; Sacchi, Roberto; Solano, Ada; Staiano, Amedeo; Trocino, Daniele; Vilela Pereira, Antonio; Ambroglini, Filippo; Belforte, Stefano; Cossutti, Fabio; Della Ricca, Giuseppe; Gobbo, Benigno; Montanino, Damiana; Penzo, Aldo; Kim, Hyunsoo; Chang, Sunghyun; Chung, Jin Hyuk; Kim, Dong Hee; Kim, Gui Nyun; Kim, Ji Eun; Kong, Dae Jung; Park, Hyangkyu; Son, Dohhee; Son, Dong-Chul; Kim, Jaeho; Kim, Jae Yool; Song, Sanghyeon; Choi, Suyong; Hong, Byung-Sik; Kim, Hyunchul; Kim, Ji Hyun; Kim, Tae Jeong; Lee, Kyong Sei; Moon, Dong Ho; Park, Sung Keun; Rhee, Han-Bum; Sim, Kwang Souk; Choi, Minkyoo; Kang, Seokon; Kim, Hyunyong; Park, Chawon; Park, Inkyu; Park, Sangnam; Choi, Young-Il; Choi, Young Kyu; Goh, Junghwan; Lee, Jongseok; Lee, Sungeun; Seo, Hyunkwan; Yu, Intae; Janulis, Mindaugas; Martisiute, Dalia; Petrov, Pavel; Sabonis, Tomas; Carrillo Moreno, Salvador; Salazar Ibarguen, Humberto Antonio; Casimiro Linares, Edgar; Morelos Pineda, Antonio; Reyes-Santos, Marco A.; Allfrey, Philip; Krofcheck, David; Tam, Jason; Butler, Philip H.; Signal, Tony; Williams, Jennifer C.; Ahmad, Muhammad; Ahmed, Ijaz; Asghar, Muhammad Irfan; Hoorani, Hafeez R.; Khan, Wajid Ali; Khurshid, Taimoor; Qazi, Shamona; Cwiok, Mikolaj; Dominik, Wojciech; Doroba, Krzysztof; Konecki, Marcin; Krolikowski, Jan; Frueboes, Tomasz; Gokieli, Ryszard; Górski, Maciej; Kazana, Malgorzata; Nawrocki, Krzysztof; Szleper, Michal; Wrochna, Grzegorz; Zalewski, Piotr; Almeida, Nuno; David Tinoco Mendes, Andre; Faccioli, Pietro; Ferreira Parracho, Pedro Guilherme; Gallinaro, Michele; Sá Martins, Pedro; Mini, Giuliano; Musella, Pasquale; Nayak, Aruna; Raposo, Luis; Ribeiro, Pedro Quinaz; Seixas, Joao; Silva, Pedro; Soares, David; Varela, Joao; Wöhri, Hermine Katharina; Belotelov, Ivan; Bunin, Pavel; Finger, Miroslav; Finger Jr., Michael; Golutvin, Igor; Kamenev, Alexey; Karjavin, Vladimir; Kozlov, Guennady; Lanev, Alexander; Moisenz, Petr; Palichik, Vladimir; Perelygin, Victor; Shmatov, Sergey; Smirnov, Vitaly; Volodko, Anton; Zarubin, Anatoli; Bondar, Nikolai; Golovtsov, Victor; Ivanov, Yury; Kim, Victor; Levchenko, Petr; Smirnov, Igor; Sulimov, Valentin; Uvarov, Lev; Vavilov, Sergey; Vorobyev, Alexey; Andreev, Yuri; Gninenko, Sergei; Golubev, Nikolai; Kirsanov, Mikhail; Krasnikov, Nikolai; Matveev, Viktor; Pashenkov, Anatoli; Toropin, Alexander; Troitsky, Sergey; Epshteyn, Vladimir; Gavrilov, Vladimir; Lychkovskaya, Natalia; Kaftanov, Vitali; Kossov, Mikhail; Krokhotin, Andrey; Kuleshov, Sergey; Oulianov, Alexei; Safronov, Grigory; Semenov, Sergey; Shreyber, Irina; Stolin, Viatcheslav; Vlasov, Evgueni; Zhokin, Alexander; Boos, Edouard; Dubinin, Mikhail; Dudko, Lev; Ershov, Alexander; Gribushin, Andrey; Kodolova, Olga; Lokhtin, Igor; Obraztsov, Stepan; Petrushanko, Sergey; Sarycheva, Ludmila; Savrin, Viktor; Snigirev, Alexander; Andreev, Vladimir; Dremin, Igor; Kirakosyan, Martin; Rusakov, Sergey V.; Vinogradov, Alexey; Azhgirey, Igor; Bitioukov, Sergei; Datsko, Kirill; Grishin, Viatcheslav; Kachanov, Vassili; Konstantinov, Dmitri; Krychkine, Victor; Petrov, Vladimir; Ryutin, Roman; Slabospitsky, Sergey; Sobol, Andrei; Sytine, Alexandre; Tourtchanovitch, Leonid; Troshin, Sergey; Tyurin, Nikolay; Uzunian, Andrey; Volkov, Alexey; Adzic, Petar; Djordjevic, Milos; Krpic, Dragomir; Maletic, Dimitrije; Milosevic, Jovan; Puzovic, Jovan; Aguilar-Benitez, Manuel; Alcaraz Maestre, Juan; Arce, Pedro; Battilana, Carlo; Calvo, Enrique; Cepeda, Maria; Cerrada, Marcos; Chamizo Llatas, Maria; Colino, Nicanor; De La Cruz, Begona; Diez Pardos, Carmen; Fernandez Bedoya, Cristina; Fernández Ramos, Juan Pablo; Ferrando, Antonio; Flix, Jose; Fouz, Maria Cruz; Garcia-Abia, Pablo; Gonzalez Lopez, Oscar; Goy Lopez, Silvia; Hernandez, Jose M.; Josa, Maria Isabel; Merino, Gonzalo; Puerta Pelayo, Jesus; Redondo, Ignacio; Romero, Luciano; Santaolalla, Javier; Willmott, Carlos; Albajar, Carmen; de Trocóniz, Jorge F; Cuevas, Javier; Fernandez Menendez, Javier; Gonzalez Caballero, Isidro; Lloret Iglesias, Lara; Vizan Garcia, Jesus Manuel; Cabrillo, Iban Jose; Calderon, Alicia; Chuang, Shan-Huei; Diaz Merino, Irma; Diez Gonzalez, Carlos; Duarte Campderros, Jordi; Fernandez, Marcos; Gomez, Gervasio; Gonzalez Sanchez, Javier; Gonzalez Suarez, Rebeca; Jorda, Clara; Lobelle Pardo, Patricia; Lopez Virto, Amparo; Marco, Jesus; Marco, Rafael; Martinez Rivero, Celso; Martinez Ruiz del Arbol, Pablo; Matorras, Francisco; Rodrigo, Teresa; Ruiz Jimeno, Alberto; Scodellaro, Luca; Sobron Sanudo, Mar; Vila, Ivan; Vilar Cortabitarte, Rocio; Abbaneo, Duccio; Auffray, Etiennette; Baillon, Paul; Ball, Austin; Barney, David; Beaudette, Florian; Bell, Alan James; Benedetti, Daniele; Bernet, Colin; Bialas, Wojciech; Bloch, Philippe; Bocci, Andrea; Bolognesi, Sara; Breuker, Horst; Brona, Grzegorz; Bunkowski, Karol; Camporesi, Tiziano; Cano, Eric; Cattai, Ariella; Cerminara, Gianluca; Christiansen, Tim; Coarasa Perez, Jose Antonio; Covarelli, Roberto; Curé, Benoît; Dahms, Torsten; De Roeck, Albert; Elliott-Peisert, Anna; Funk, Wolfgang; Gaddi, Andrea; Gennai, Simone; Gerwig, Hubert; Gigi, Dominique; Gill, Karl; Giordano, Domenico; Glege, Frank; Gomez-Reino Garrido, Robert; Gowdy, Stephen; Guiducci, Luigi; Hansen, Magnus; Hartl, Christian; Harvey, John; Hegner, Benedikt; Henderson, Conor; Hoffmann, Hans Falk; Honma, Alan; Innocente, Vincenzo; Janot, Patrick; Lecoq, Paul; Leonidopoulos, Christos; Lourenco, Carlos; Macpherson, Alick; Maki, Tuula; Malgeri, Luca; Mannelli, Marcello; Masetti, Lorenzo; Meijers, Frans; Mersi, Stefano; Meschi, Emilio; Moser, Roland; Mozer, Matthias Ulrich; Mulders, Martijn; Nesvold, Erik; Orsini, Luciano; Perez, Emmanuelle; Petrilli, Achille; Pfeiffer, Andreas; Pierini, Maurizio; Pimiä, Martti; Racz, Attila; Rolandi, Gigi; Rovelli, Chiara; Rovere, Marco; Sakulin, Hannes; Schäfer, Christoph; Schwick, Christoph; Segoni, Ilaria; Sharma, Archana; Siegrist, Patrice; Simon, Michal; Sphicas, Paraskevas; Spiga, Daniele; Spiropulu, Maria; Stöckli, Fabian; Stoye, Markus; Tropea, Paola; Tsirou, Andromachi; Veres, Gabor Istvan; Vichoudis, Paschalis; Voutilainen, Mikko; Zeuner, Wolfram Dietrich; Bertl, Willi; Deiters, Konrad; Erdmann, Wolfram; Gabathuler, Kurt; Horisberger, Roland; Ingram, Quentin; Kaestli, Hans-Christian; König, Stefan; Kotlinski, Danek; Langenegger, Urs; Meier, Frank; Renker, Dieter; Rohe, Tilman; Sibille, Jennifer; Starodumov, Andrei; Caminada, Lea; Chen, Zhiling; Cittolin, Sergio; Dissertori, Günther; Dittmar, Michael; Eugster, Jürg; Freudenreich, Klaus; Grab, Christoph; Hervé, Alain; Hintz, Wieland; Lecomte, Pierre; Lustermann, Werner; Marchica, Carmelo; Meridiani, Paolo; Milenovic, Predrag; Moortgat, Filip; Nardulli, Alessandro; Nef, Pascal; Nessi-Tedaldi, Francesca; Pape, Luc; Pauss, Felicitas; Punz, Thomas; Rizzi, Andrea; Ronga, Frederic Jean; Sala, Leonardo; Sanchez, Ann - Karin; Sawley, Marie-Christine; Schinzel, Dietrich; Stieger, Benjamin; Tauscher, Ludwig; Thea, Alessandro; Theofilatos, Konstantinos; Treille, Daniel; Weber, Matthias; Wehrli, Lukas; Weng, Joanna; Aguiló, Ernest; Amsler, Claude; Chiochia, Vincenzo; De Visscher, Simon; Favaro, Carlotta; Ivova Rikova, Mirena; Jaeger, Andreas; Millan Mejias, Barbara; Regenfus, Christian; Robmann, Peter; Rommerskirchen, Tanja; Schmidt, Alexander; Tsirigkas, Dimitrios; Wilke, Lotte; Chang, Yuan-Hann; Chen, Kuan-Hsin; Chen, Wan-Ting; Go, Apollo; Kuo, Chia-Ming; Li, Syue-Wei; Lin, Willis; Liu, Ming-Hsiung; Lu, Yun-Ju; Wu, Jing-Han; Yu, Shin-Shan; Bartalini, Paolo; Chang, Paoti; Chang, You-Hao; Chang, Yu-Wei; Chao, Yuan; Chen, Kai-Feng; Hou, George Wei-Shu; Hsiung, Yee; Kao, Kai-Yi; Lei, Yeong-Jyi; Lin, Sheng-Wen; Lu, Rong-Shyang; Shiu, Jing-Ge; Tzeng, Yeng-Ming; Ueno, Koji; Wang, Chin-chi; Wang, Minzu; Wei, Jui-Te; Adiguzel, Aytul; Ayhan, Aydin; Bakirci, Mustafa Numan; Cerci, Salim; Demir, Zahide; Dozen, Candan; Dumanoglu, Isa; Eskut, Eda; Girgis, Semiray; Gökbulut, Gül; Güler, Yalcin; Gurpinar, Emine; Hos, Ilknur; Kangal, Evrim Ersin; Karaman, Turker; Kayis Topaksu, Aysel; Nart, Alisah; Önengüt, Gülsen; Ozdemir, Kadri; Ozturk, Sertac; Polatöz, Ayse; Sahin, Ozge; Sengul, Ozden; Sogut, Kenan; Tali, Bayram; Topakli, Huseyin; Uzun, Dilber; Vergili, Latife Nukhet; Vergili, Mehmet; Zorbilmez, Caglar; Akin, Ilina Vasileva; Aliev, Takhmasib; Bilmis, Selcuk; Deniz, Muhammed; Gamsizkan, Halil; Guler, Ali Murat; Ocalan, Kadir; Ozpineci, Altug; Serin, Meltem; Sever, Ramazan; Surat, Ugur Emrah; Yildirim, Eda; Zeyrek, Mehmet; Deliomeroglu, Mehmet; Demir, Durmus; Gülmez, Erhan; Halu, Arda; Isildak, Bora; Kaya, Mithat; Kaya, Ozlem; Özbek, Melih; Ozkorucuklu, Suat; Sonmez, Nasuf; Levchuk, Leonid; Bell, Peter; Bostock, Francis; Brooke, James John; Cheng, Teh Lee; Cussans, David; Frazier, Robert; Goldstein, Joel; Hansen, Maria; Heath, Greg P.; Heath, Helen F.; Hill, Christopher; Huckvale, Benedickt; Jackson, James; Kreczko, Lukasz; Mackay, Catherine Kirsty; Metson, Simon; Newbold, Dave M.; Nirunpong, Kachanon; Smith, Vincent J.; Ward, Simon; Basso, Lorenzo; Bell, Ken W.; Belyaev, Alexander; Brew, Christopher; Brown, Robert M.; Camanzi, Barbara; Cockerill, David J.A.; Coughlan, John A.; Harder, Kristian; Harper, Sam; Kennedy, Bruce W.; Olaiya, Emmanuel; Petyt, David; Radburn-Smith, Benjamin Charles; Shepherd-Themistocleous, Claire; Tomalin, Ian R.; Womersley, William John; Worm, Steven; Bainbridge, Robert; Ball, Gordon; Ballin, Jamie; Beuselinck, Raymond; Buchmuller, Oliver; Colling, David; Cripps, Nicholas; Cutajar, Michael; Davies, Gavin; Della Negra, Michel; Foudas, Costas; Fulcher, Jonathan; Futyan, David; Guneratne Bryer, Arlo; Hall, Geoffrey; Hatherell, Zoe; Hays, Jonathan; Iles, Gregory; Karapostoli, Georgia; Lyons, Louis; Magnan, Anne-Marie; Marrouche, Jad; Nandi, Robin; Nash, Jordan; Nikitenko, Alexander; Papageorgiou, Anastasios; Pesaresi, Mark; Petridis, Konstantinos; Pioppi, Michele; Raymond, David Mark; Rompotis, Nikolaos; Rose, Andrew; Ryan, Matthew John; Seez, Christopher; Sharp, Peter; Sparrow, Alex; Tapper, Alexander; Tourneur, Stephane; Vazquez Acosta, Monica; Virdee, Tejinder; Wakefield, Stuart; Wardrope, David; Whyntie, Tom; Barrett, Matthew; Chadwick, Matthew; Cole, Joanne; Hobson, Peter R.; Khan, Akram; Kyberd, Paul; Leslie, Dawn; Reid, Ivan; Teodorescu, Liliana; Bose, Tulika; Carrera Jarrin, Edgar; Clough, Andrew; Fantasia, Cory; Heister, Arno; St. John, Jason; Lawson, Philip; Lazic, Dragoslav; Rohlf, James; Sulak, Lawrence; Andrea, Jeremy; Avetisyan, Aram; Bhattacharya, Saptaparna; Chou, John Paul; Cutts, David; Esen, Selda; Ferapontov, Alexey; Heintz, Ulrich; Jabeen, Shabnam; Kukartsev, Gennadiy; Landsberg, Greg; Narain, Meenakshi; Nguyen, Duong; Speer, Thomas; Tsang, Ka Vang; Borgia, Maria Assunta; Breedon, Richard; Calderon De La Barca Sanchez, Manuel; Cebra, Daniel; Chertok, Maxwell; Conway, John; Cox, Peter Timothy; Dolen, James; Erbacher, Robin; Friis, Evan; Ko, Winston; Kopecky, Alexandra; Lander, Richard; Liu, Haidong; Maruyama, Sho; Miceli, Tia; Nikolic, Milan; Pellett, Dave; Robles, Jorge; Schwarz, Thomas; Searle, Matthew; Smith, John; Squires, Michael; Tripathi, Mani; Vasquez Sierra, Ricardo; Veelken, Christian; Andreev, Valeri; Arisaka, Katsushi; Cline, David; Cousins, Robert; Deisher, Amanda; Erhan, Samim; Farrell, Chris; Felcini, Marta; Hauser, Jay; Ignatenko, Mikhail; Jarvis, Chad; Plager, Charles; Rakness, Gregory; Schlein, Peter; Tucker, Jordan; Valuev, Vyacheslav; Wallny, Rainer; Babb, John; Clare, Robert; Ellison, John Anthony; Gary, J William; Giordano, Ferdinando; Hanson, Gail; Jeng, Geng-Yuan; Kao, Shih-Chuan; Liu, Feng; Liu, Hongliang; Luthra, Arun; Nguyen, Harold; Pasztor, Gabriella; Satpathy, Asish; Shen, Benjamin C.; Stringer, Robert; Sturdy, Jared; Sumowidagdo, Suharyo; Wilken, Rachel; Wimpenny, Stephen; Andrews, Warren; Branson, James G.; Dusinberre, Elizabeth; Evans, David; Golf, Frank; Holzner, André; Kelley, Ryan; Lebourgeois, Matthew; Letts, James; Mangano, Boris; Muelmenstaedt, Johannes; Padhi, Sanjay; Palmer, Christopher; Petrucciani, Giovanni; Pi, Haifeng; Pieri, Marco; Ranieri, Riccardo; Sani, Matteo; Sharma, Vivek; Simon, Sean; Tu, Yanjun; Vartak, Adish; Würthwein, Frank; Yagil, Avraham; Barge, Derek; Bellan, Riccardo; Blume, Michael; Campagnari, Claudio; D'Alfonso, Mariarosaria; Danielson, Thomas; Garberson, Jeffrey; Incandela, Joe; Justus, Christopher; Kalavase, Puneeth; Koay, Sue Ann; Kovalskyi, Dmytro; Krutelyov, Vyacheslav; Lamb, James; Lowette, Steven; Pavlunin, Viktor; Rebassoo, Finn; Ribnik, Jacob; Richman, Jeffrey; Rossin, Roberto; Stuart, David; To, Wing; Vlimant, Jean-Roch; Witherell, Michael; Bornheim, Adolf; Bunn, Julian; Gataullin, Marat; Kcira, Dorian; Litvine, Vladimir; Ma, Yousi; Newman, Harvey B.; Rogan, Christopher; Shin, Kyoungha; Timciuc, Vladlen; Traczyk, Piotr; Veverka, Jan; Wilkinson, Richard; Yang, Yong; Zhu, Ren-Yuan; Akgun, Bora; Carroll, Ryan; Ferguson, Thomas; Jang, Dong Wook; Jun, Soon Yung; Liu, Yueh-Feng; Paulini, Manfred; Russ, James; Terentyev, Nikolay; Vogel, Helmut; Vorobiev, Igor; Cumalat, John Perry; Dinardo, Mauro Emanuele; Drell, Brian Robert; Edelmaier, Christopher; Ford, William T.; Heyburn, Bernadette; Luiggi Lopez, Eduardo; Nauenberg, Uriel; Smith, James; Stenson, Kevin; Ulmer, Keith; Wagner, Stephen Robert; Zang, Shi-Lei; Agostino, Lorenzo; Alexander, James; Blekman, Freya; Chatterjee, Avishek; Das, Souvik; Eggert, Nicholas; Fields, Laura Johanna; Gibbons, Lawrence Kent; Heltsley, Brian; Henriksson, Kristofer; Hopkins, Walter; Khukhunaishvili, Aleko; Kreis, Benjamin; Kuznetsov, Valentin; Nicolas Kaufman, Gala; Patterson, Juliet Ritchie; Puigh, Darren; Riley, Daniel; Ryd, Anders; Saelim, Michael; Shi, Xin; Sun, Werner; Teo, Wee Don; Thom, Julia; Thompson, Joshua; Vaughan, Jennifer; Weng, Yao; Wittich, Peter; Biselli, Angela; Cirino, Guy; Winn, Dave; Abdullin, Salavat; Albrow, Michael; Anderson, Jacob; Apollinari, Giorgio; Atac, Muzaffer; Bakken, Jon Alan; Banerjee, Sunanda; Bauerdick, Lothar A.T.; Beretvas, Andrew; Berryhill, Jeffrey; Bhat, Pushpalatha C.; Bloch, Ingo; Borcherding, Frederick; Burkett, Kevin; Butler, Joel Nathan; Chetluru, Vasundhara; Cheung, Harry; Chlebana, Frank; Cihangir, Selcuk; Demarteau, Marcel; Eartly, David P.; Elvira, Victor Daniel; Fisk, Ian; Freeman, Jim; Gao, Yanyan; Gottschalk, Erik; Green, Dan; Gutsche, Oliver; Hahn, Alan; Hanlon, Jim; Harris, Robert M.; Hirschauer, James; James, Eric; Jensen, Hans; Johnson, Marvin; Joshi, Umesh; Khatiwada, Rakshya; Kilminster, Benjamin; Klima, Boaz; Kousouris, Konstantinos; Kunori, Shuichi; Kwan, Simon; Limon, Peter; Lipton, Ron; Lykken, Joseph; Maeshima, Kaori; Marraffino, John Michael; Mason, David; McBride, Patricia; McCauley, Thomas; Miao, Ting; Mishra, Kalanand; Mrenna, Stephen; Musienko, Yuri; Newman-Holmes, Catherine; O'Dell, Vivian; Popescu, Sorina; Pordes, Ruth; Prokofyev, Oleg; Saoulidou, Niki; Sexton-Kennedy, Elizabeth; Sharma, Seema; Smith, Richard P.; Soha, Aron; Spalding, William J.; Spiegel, Leonard; Tan, Ping; Taylor, Lucas; Tkaczyk, Slawek; Uplegger, Lorenzo; Vaandering, Eric Wayne; Vidal, Richard; Whitmore, Juliana; Wu, Weimin; Yumiceva, Francisco; Yun, Jae Chul; Acosta, Darin; Avery, Paul; Bourilkov, Dimitri; Chen, Mingshui; Di Giovanni, Gian Piero; Dobur, Didar; Drozdetskiy, Alexey; Field, Richard D.; Fisher, Matthew; Fu, Yu; Furic, Ivan-Kresimir; Gartner, Joseph; Kim, Bockjoo; Klimenko, Sergey; Konigsberg, Jacobo; Korytov, Andrey; Kotov, Khristian; Kropivnitskaya, Anna; Kypreos, Theodore; Matchev, Konstantin; Mitselmakher, Guenakh; Muniz, Lana; Pakhotin, Yuriy; Piedra Gomez, Jonatan; Prescott, Craig; Remington, Ronald; Schmitt, Michael; Scurlock, Bobby; Sellers, Paul; Wang, Dayong; Yelton, John; Zakaria, Mohammed; Ceron, Cristobal; Gaultney, Vanessa; Kramer, Laird; Lebolo, Luis Miguel; Linn, Stephan; Markowitz, Pete; Martinez, German; Mesa, Dalgis; Rodriguez, Jorge Luis; Adams, Todd; Askew, Andrew; Chen, Jie; Diamond, Brendan; Gleyzer, Sergei V; Haas, Jeff; Hagopian, Sharon; Hagopian, Vasken; Jenkins, Merrill; Johnson, Kurtis F.; Prosper, Harrison; Sekmen, Sezen; Veeraraghavan, Venkatesh; Baarmand, Marc M.; Guragain, Samir; Hohlmann, Marcus; Kalakhety, Himali; Mermerkaya, Hamit; Ralich, Robert; Vodopiyanov, Igor; Adams, Mark Raymond; Anghel, Ioana Maria; Apanasevich, Leonard; Bazterra, Victor Eduardo; Betts, Russell Richard; Callner, Jeremy; Cavanaugh, Richard; Dragoiu, Cosmin; Garcia-Solis, Edmundo Javier; Gerber, Cecilia Elena; Hofman, David Jonathan; Khalatyan, Samvel; Lacroix, Florent; Shabalina, Elizaveta; Smoron, Agata; Strom, Derek; Varelas, Nikos; Akgun, Ugur; Albayrak, Elif Asli; Bilki, Burak; Cankocak, Kerem; Clarida, Warren; Duru, Firdevs; Lae, Chung Khim; McCliment, Edward; Merlo, Jean-Pierre; Mestvirishvili, Alexi; Moeller, Anthony; Nachtman, Jane; Newsom, Charles Ray; Norbeck, Edwin; Olson, Jonathan; Onel, Yasar; Ozok, Ferhat; Sen, Sercan; Wetzel, James; Yetkin, Taylan; Yi, Kai; Barnett, Bruce Arnold; Blumenfeld, Barry; Bonato, Alessio; Eskew, Christopher; Fehling, David; Giurgiu, Gavril; Gritsan, Andrei; Guo, Zijin; Hu, Guofan; Maksimovic, Petar; Rappoccio, Salvatore; Swartz, Morris; Tran, Nhan Viet; Whitbeck, Andrew; Baringer, Philip; Bean, Alice; Benelli, Gabriele; Grachov, Oleg; Murray, Michael; Radicci, Valeria; Sanders, Stephen; Wood, Jeffrey Scott; Zhukova, Victoria; Bandurin, Dmitry; Bolton, Tim; Chakaberia, Irakli; Ivanov, Andrew; Kaadze, Ketino; Maravin, Yurii; Shrestha, Shruti; Svintradze, Irakli; Wan, Zongru; Gronberg, Jeffrey; Lange, David; Wright, Douglas; Baden, Drew; Boutemeur, Madjid; Eno, Sarah Catherine; Ferencek, Dinko; Hadley, Nicholas John; Kellogg, Richard G.; Kirn, Malina; Lu, Ying; Mignerey, Alice; Rossato, Kenneth; Rumerio, Paolo; Santanastasio, Francesco; Skuja, Andris; Temple, Jeffrey; Tonjes, Marguerite; Tonwar, Suresh C.; Twedt, Elizabeth; Alver, Burak; Bauer, Gerry; Bendavid, Joshua; Busza, Wit; Butz, Erik; Cali, Ivan Amos; Chan, Matthew; D'Enterria, David; Everaerts, Pieter; Gomez Ceballos, Guillelmo; Goncharov, Maxim; Hahn, Kristan Allan; Harris, Philip; Kim, Yongsun; Klute, Markus; Lee, Yen-Jie; Li, Wei; Loizides, Constantinos; Luckey, Paul David; Ma, Teng; Nahn, Steve; Paus, Christoph; Roland, Christof; Roland, Gunther; Rudolph, Matthew; Stephans, George; Sumorok, Konstanty; Sung, Kevin; Wenger, Edward Allen; Wyslouch, Bolek; Xie, Si; Yang, Mingming; Yilmaz, Yetkin; Yoon, Sungho; Zanetti, Marco; Cole, Perrie; Cooper, Seth; Cushman, Priscilla; Dahmes, Bryan; De Benedetti, Abraham; Dudero, Phillip Russell; Franzoni, Giovanni; Haupt, Jason; Klapoetke, Kevin; Kubota, Yuichi; Mans, Jeremy; Rekovic, Vladimir; Rusack, Roger; Sasseville, Michael; Singovsky, Alexander; Cremaldi, Lucien Marcus; Godang, Romulus; Kroeger, Rob; Perera, Lalith; Rahmat, Rahmat; Sanders, David A; Sonnek, Peter; Summers, Don; Bloom, Kenneth; Bose, Suvadeep; Butt, Jamila; Claes, Daniel R.; Dominguez, Aaron; Eads, Michael; Keller, Jason; Kelly, Tony; Kravchenko, Ilya; Lazo-Flores, Jose; Lundstedt, Carl; Malbouisson, Helena; Malik, Sudhir; Snow, Gregory R.; Baur, Ulrich; Iashvili, Ia; Kharchilava, Avto; Kumar, Ashish; Smith, Kenneth; Zennamo, Joseph; Alverson, George; Barberis, Emanuela; Baumgartel, Darin; Boeriu, Oana; Chasco, Matthew; Reucroft, Steve; Swain, John; Wood, Darien; Zhang, Jinzhong; Anastassov, Anton; Kubik, Andrew; Ofierzynski, Radoslaw Adrian; Pozdnyakov, Andrey; Schmitt, Michael; Stoynev, Stoyan; Velasco, Mayda; Won, Steven; Antonelli, Louis; Berry, Douglas; Hildreth, Michael; Jessop, Colin; Karmgard, Daniel John; Kolb, Jeff; Kolberg, Ted; Lannon, Kevin; Lynch, Sean; Marinelli, Nancy; Morse, David Michael; Ruchti, Randy; Slaunwhite, Jason; Valls, Nil; Warchol, Jadwiga; Wayne, Mitchell; Ziegler, Jill; Bylsma, Ben; Durkin, Lloyd Stanley; Gu, Jianhui; Killewald, Phillip; Ling, Ta-Yung; Rodenburg, Marissa; Williams, Grayson; Adam, Nadia; Berry, Edmund; Elmer, Peter; Gerbaudo, Davide; Halyo, Valerie; Hunt, Adam; Jones, John; Laird, Edward; Lopes Pegna, David; Marlow, Daniel; Medvedeva, Tatiana; Mooney, Michael; Olsen, James; Piroué, Pierre; Stickland, David; Tully, Christopher; Werner, Jeremy Scott; Zuranski, Andrzej; Acosta, Jhon Gabriel; Huang, Xing Tao; Lopez, Angel; Mendez, Hector; Oliveros, Sandra; Ramirez Vargas, Juan Eduardo; Zatserklyaniy, Andriy; Alagoz, Enver; Barnes, Virgil E.; Bolla, Gino; Borrello, Laura; Bortoletto, Daniela; Everett, Adam; Garfinkel, Arthur F.; Gecse, Zoltan; Gutay, Laszlo; Jones, Matthew; Koybasi, Ozhan; Laasanen, Alvin T.; Leonardo, Nuno; Liu, Chang; Maroussov, Vassili; Merkel, Petra; Miller, David Harry; Neumeister, Norbert; Potamianos, Karolos; Shipsey, Ian; Silvers, David; Yoo, Hwi Dong; Zablocki, Jakub; Zheng, Yu; Jindal, Pratima; Parashar, Neeti; Cuplov, Vesna; Ecklund, Karl Matthew; Geurts, Frank J.M.; Liu, Jinghua H.; Morales, Jafet; Padley, Brian Paul; Redjimi, Radia; Roberts, Jay; Betchart, Burton; Bodek, Arie; Chung, Yeon Sei; de Barbaro, Pawel; Demina, Regina; Eshaq, Yossof; Flacher, Henning; Garcia-Bellido, Aran; Goldenzweig, Pablo; Gotra, Yury; Han, Jiyeon; Harel, Amnon; Miner, Daniel Carl; Orbaker, Douglas; Petrillo, Gianluca; Vishnevskiy, Dmitry; Zielinski, Marek; Bhatti, Anwar; Demortier, Luc; Goulianos, Konstantin; Hatakeyama, Kenichi; Lungu, Gheorghe; Mesropian, Christina; Yan, Ming; Atramentov, Oleksiy; Gershtein, Yuri; Gray, Richard; Halkiadakis, Eva; Hidas, Dean; Hits, Dmitry; Lath, Amitabh; Rose, Keith; Schnetzer, Steve; Somalwar, Sunil; Stone, Robert; Thomas, Scott; Cerizza, Giordano; Hollingsworth, Matthew; Spanier, Stefan; Yang, Zong-Chang; York, Andrew; Asaadi, Jonathan; Eusebi, Ricardo; Gilmore, Jason; Gurrola, Alfredo; Kamon, Teruki; Khotilovich, Vadim; Montalvo, Roy; Nguyen, Chi Nhan; Pivarski, James; Safonov, Alexei; Sengupta, Sinjini; Toback, David; Weinberger, Michael; Akchurin, Nural; Bardak, Cemile; Damgov, Jordan; Jeong, Chiyoung; Kovitanggoon, Kittikul; Lee, Sung Won; Mane, Poonam; Roh, Youn; Sill, Alan; Volobouev, Igor; Wigmans, Richard; Yazgan, Efe; Appelt, Eric; Brownson, Eric; Engh, Daniel; Florez, Carlos; Gabella, William; Johns, Willard; Kurt, Pelin; Maguire, Charles; Melo, Andrew; Sheldon, Paul; Velkovska, Julia; Arenton, Michael Wayne; Balazs, Michael; Boutle, Sarah; Buehler, Marc; Conetti, Sergio; Cox, Bradley; Hirosky, Robert; Ledovskoy, Alexander; Neu, Christopher; Yohay, Rachel; Gollapinni, Sowjanya; Gunthoti, Kranti; Harr, Robert; Karchin, Paul Edmund; Mattson, Mark; Milstène, Caroline; Sakharov, Alexandre; Anderson, Michael; Bachtis, Michail; Bellinger, James Nugent; Carlsmith, Duncan; Dasu, Sridhara; Dutta, Suchandra; Efron, Jonathan; Gray, Lindsey; Grogg, Kira Suzanne; Grothe, Monika; Herndon, Matthew; Klabbers, Pamela; Klukas, Jeffrey; Lanaro, Armando; Lazaridis, Christos; Leonard, Jessica; Lomidze, David; Loveless, Richard; Mohapatra, Ajit; Polese, Giovanni; Reeder, Don; Savin, Alexander; Smith, Wesley H.; Swanson, Joshua; Weinberg, Marc

    2010-01-01

    The first LHC pp collisions at centre-of-mass energies of 0.9 and 2.36 TeV were recorded by the CMS detector in December 2009. The trajectories of charged particles produced in the collisions were reconstructed using the all-silicon Tracker and their momenta were measured in the 3.8 T axial magnetic field. Results from the Tracker commissioning are presented including studies of timing, efficiency, signal-to-noise, resolution, and ionization energy. Reconstructed tracks are used to benchmark the performance in terms of track and vertex resolutions, reconstruction of decays, estimation of ionization energy loss, as well as identification of photon conversions, nuclear interactions, and heavy-flavour decays.

  1. Early Run 2 Hard QCD Results from the ATLAS Collaboration

    Directory of Open Access Journals (Sweden)

    Orlando Nicola

    2016-01-01

    Full Text Available We provide an overview of hard QCD results based on data collected with the ATLAS detector in proton-proton collision at √s = 13 TeV at the Large Hadron Collider. The production of high transverse momentum jets, photons and photon-pairs were studied; the inclusive jet cross section is found to agree well with the prediction of perturbative QCD calculations performed at next-to-leading accuracy. The production cross sections for W and Z bosons in their e and μ decays was measured; in general, agreement is found with the expectation of next-to-next-to leading order QCD calculations and interesting sensitivities to the proton structure functions are already observed. The top production cross sections were measured in different top decay channels and found to agree with the state of the art QCD predictions.

  2. Results of primary radiation therapy in early vocal cord cancers

    International Nuclear Information System (INIS)

    Mehta, S.A.; Sarkar, S.; Mehta, M.S.; Marfatia, P.T.; Choudhary, A.J.; Mehta, A.R.

    1991-01-01

    Results of 74 patients treated by primary radiation therapy with curative intent at the Tata Memorial Hospital between January 1980 and December 1984 are reported. Thirty three (44.6%) were classified as TlaNO, twenty five (33.8%) as TlbNO, ten (13.5%) as T2NO and six(8.1%) as TisNO. The 5-year actuarial survival was 92% and disease-free survival was 85%. Thirteen patients (17.5%) failed locally, seven (53.8%) of whom were salvaged by surgery. Radiation side-effects were minimal and there were no long term complications. Anterior commissure involvement did not affect the local recurrence rates. (author). 19 refs., 1 tabs

  3. LSNR Airborne LIDAR Mapping System Design and Early Results (Invited)

    Science.gov (United States)

    Shrestha, K.; Carter, W. E.; Slatton, K. C.

    2009-12-01

    Low signal-to-noise ratio (LSNR) detection techniques allow for implementation of airborne light detection and range (LIDAR) instrumentation aboard platforms with prohibitive power, size, and weight restrictions. The University of Florida has developed the Coastal Area Tactical-mapping System (CATS), a prototype LSNR LIDAR system capable of single photon laser ranging. CATS is designed to operate in a fixed-wing aircraft flying 600 m above ground level, producing 532 nm, 480 ps, 3 μJ output pulses at 8 kHz. To achieve continuous coverage of the terrain with 20 cm spatial resolution in a single pass, a 10x10 array of laser beamlets is scanned. A Risley prism scanner (two rotating V-coated optical wedges) allows the array of laser beamlets to be deflected in a variety of patterns, including conical, spiral, and lines at selected angles to the direction of flight. Backscattered laser photons are imaged onto a 100 channel (10x10 segmented-anode) photomultiplier tube (PMT) with a micro-channel plate (MCP) amplifier. Each channel of the PMT is connected to a multi-stop 2 GHz event timer. Here we report on tests in which ranges for known targets were accumulated for repeated laser shots and statistical analyses were applied to evaluate range accuracy, minimum separation distance, bathymetric mapping depth, and atmospheric scattering. Ground-based field test results have yielded 10 cm range accuracy and sub-meter feature identification at variable scan settings. These experiments also show that a secondary surface can be detected at a distance of 15 cm from the first. Range errors in secondary surface identification for six separate trials were within 7.5 cm, or within the timing resolution limit of the system. Operating at multi-photon sensitivity may have value for situations in which high ambient noise precludes single-photon sensitivity. Low reflectivity targets submerged in highly turbid waters can cause detection issues. CATS offers the capability to adjust the

  4. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    International Nuclear Information System (INIS)

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-01-01

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult

  5. Plant exploitation during the early Natufian in north-eastern Jordan: preliminary results from Shubayqa 1

    DEFF Research Database (Denmark)

    Otaegui, Amaia Arranz; Richter, Tobias

    -woody plant analyses from two in situ hearth structures, along with a summary of the available evidence at other contemporary early Natufian sites. In terms of past vegetation, the results show the presence of wetland species indicating a more forested and wet environment during the early Natufian, which...

  6. Induction chemotherapy followed by alternating chemo-radiotherapy in non-endemic undifferentiated carcinoma of the nasopharynx: optimal compliance and promising 4-year results.

    Science.gov (United States)

    Ponzanelli, Anna; Vigo, Viviana; Marcenaro, Michela; Bacigalupo, Almalina; Gatteschi, Beatrice; Ravetti, Jean-Luis; Corvò, Renzo; Benasso, Marco

    2008-08-01

    Concomitant chemo-radiotherapy is the standard treatment for advanced nasopharyngeal carcinoma (NPC). Induction chemotherapy may improve the results further by enhancing both loco-regional and distant control. Fifty patients with untreated, stage IV (UICC 1992) undifferentiated NPC were initially treated with three courses of epidoxorubicin, 90 mg/m(2), day 1 and cisplatin, 40 mg/m(2), days 1 and 2, every three weeks and then underwent three courses of cisplatin, 20 mg/m(2)/day, days 1-4 and fluorouracil, 200mg/m(2)/day, days 1-4 (weeks 1, 4, 7), alternated to three splits of radiation (week 2-3, 5-6, 8-9-10) up to 70 Gy. All patients but one received 3 cycles of induction chemotherapy. Toxicities from induction chemotherapy were grade III or IV mucositis (2%), grade III or IV nausea/vomiting (22%), grade III or IV hematological toxicity (6%). At the end of induction phase 12% of CRs, 84% of PRs were recorded. Toxicities from alternating chemo-radiotherapy were grade III or IV mucositis (30%), grade III or IV nausea/vomiting (8%), grade III or IV hematological toxicity (24%). Overall, 86% of CRs and 14% of PRs were observed. Four-year progression free survival and overall survival rates are 71% and 81%, respectively. In a small number of patients studied, no correlation between the level of EGFR overexpression and outcomes was detected. In locally advanced UNPC our combined program including induction chemotherapy followed by alternating chemo-radiotherapy is active and gives promising long-term outcomes with acceptable toxicity and optimal patients' compliance. This program merits to be tested in a phase III trial.

  7. Early Science Instruction and Academic Language Development Can Go Hand in Hand. The Promising Effects of a Low-Intensity Teacher-Focused Intervention

    NARCIS (Netherlands)

    Henrichs, Lotte F.; Leseman, Paul P.M.

    2014-01-01

    Early science instruction is important in order to lay a firm basis for learning scientific concepts and scientific thinking. In addition, young children enjoy science. However, science plays only a minor role in the kindergarten curriculum. It has been reported that teachers feel they need to

  8. A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators.

    Science.gov (United States)

    Angus, D C; Barnato, A E; Bell, D; Bellomo, R; Chong, C-R; Coats, T J; Davies, A; Delaney, A; Harrison, D A; Holdgate, A; Howe, B; Huang, D T; Iwashyna, T; Kellum, J A; Peake, S L; Pike, F; Reade, M C; Rowan, K M; Singer, M; Webb, S A R; Weissfeld, L A; Yealy, D M; Young, J D

    2015-09-01

    To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock. Using a search strategy of PubMed, EmBase and CENTRAL, we selected all relevant randomised clinical trials published from January 2000 to January 2015. We translated non-English papers and contacted authors as necessary. Our primary analysis generated a pooled odds ratio (OR) from a fixed-effect model. Sensitivity analyses explored the effect of including non-ED studies, adjusting for study quality, and conducting a random-effects model. Secondary outcomes included organ support and hospital and ICU length of stay. From 2395 initially eligible abstracts, five randomised clinical trials (n = 4735 patients) met all criteria and generally scored high for quality except for lack of blinding. There was no effect on the primary mortality outcome (EGDT: 23.2% [495/2134] versus control: 22.4% [582/2601]; pooled OR 1.01 [95% CI 0.88-1.16], P = 0.9, with heterogeneity [I(2) = 57%; P = 0.055]). The pooled estimate of 90-day mortality from the three recent multicentre studies (n = 4063) also showed no difference [pooled OR 0.99 (95% CI 0.86-1.15), P = 0.93] with no heterogeneity (I(2) = 0.0%; P = 0.97). EGDT increased vasopressor use (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and ICU admission [OR 2.19 (95% CI 1.82-2.65); P < 0.001]. Including six non-ED randomised trials increased heterogeneity (I(2) = 71%; P < 0.001) but did not change overall results [pooled OR 0.94 (95% CI 0.82 to 1.07); P = 0.33]. EGDT is not superior to usual care for ED patients with septic shock but is associated with increased utilisation of ICU resources.

  9. The deepwater Gulf of Mexico : promises delivered?

    International Nuclear Information System (INIS)

    Pickering, D.R.

    1999-01-01

    A summary review of deepwater Gulf of Mexico (GOM) oil production was presented for the years 1989 to 1998. Trends and prospects in deepwater GOM production and leasing were assessed. Promises and forecasts made in the early 1990s were compared with what actually happened since then. Forecasts in the early 1990s promised deeper, faster and cheaper developments in the deepwater Gulf. Results of the comparison showed that the prognosticators were correct on all three counts. Regarding the future of the Gulf, one can be justified in being optimistic in so far as more experience, robust economics, more and cheaper rigs can be taken as reliable indicators of optimism. In contrast, there are certain negatives to consider, such as low commodity prices, budget constraints, lease expirations, technical challenges and increased competition. . 12 figs

  10. Early Results of Chimney Technique for Type B Aortic Dissections Extending to the Aortic Arch

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chen [Affiliated Hospital of Nantong University, Department of General Surgery (China); Tang, Hanfei; Qiao, Tong; Liu, Changjian; Zhou, Min, E-mail: 813477618@qq.com [The Affiliated Hospital of Nanjing University Medical School, Department of Vascular Surgery, Nanjing Drum Tower Hospital (China)

    2016-01-15

    ObjectiveTo summarize our early experience gained from the chimney technique for type B aortic dissection (TBAD) extending to the aortic arch and to evaluate the aortic remodeling in the follow-up period.MethodsFrom September 2011 to July 2014, 27 consecutive TBAD patients without adequate proximal landing zones were retrograde analyzed. Chimney stent-grafts were deployed parallel to the main endografts to reserve flow to branch vessels while extending the landing zones. In the follow-up period, aortic remodeling was observed with computed tomography angiography.ResultsThe technical success rate was 100 %, and endografts were deployed in zone 0 (n = 3, 11.1 %), zone 1 (n = 18, 66.7 %), and zone 2 (n = 6, 22.2 %). Immediately, proximal endoleaks were detected in 5 patients (18.5 %). During a mean follow-up period of 17.6 months, computed tomography angiography showed all the aortic stent-grafts and chimney grafts to be patent. Favorable remodeling was observed at the level of maximum descending aorta and left subclavian artery with expansion of true lumen (from 18.4 ± 4.8 to 25 ± 0.86 mm, p < 0.001 and 27.1 ± 0.62 to 28.5 ± 0.37 mm, p < 0.001) and depressurization of false lumen (from 23.7 ± 2.7 to 8.7 ± 3.8 mm, p < 0.001, from 5.3 ± 1.2 to 2.1 ± 2.1 mm, p < 0.001). While at the level of maximum abdominal aorta, suboptimal remodeling of the total aorta (from 24.1 ± 0.4 to 23.6 ± 1.5 mm, p = 0.06) and true lumen (from 13.8 ± 0.6 to 14.5 ± 0.4 mm, p = 0.08) was observed.ConclusionBased on our limited experience, the chimney technique with thoracic endovascular repair is demonstrated to be promising for TBAD extending to the arch with favorable aortic remodeling.

  11. Early Science Instruction and Academic Language Development Can Go Hand in Hand. The Promising Effects of a Low-Intensity Teacher-Focused Intervention

    Science.gov (United States)

    Henrichs, Lotte F.; Leseman, Paul P. M.

    2014-11-01

    Early science instruction is important in order to lay a firm basis for learning scientific concepts and scientific thinking. In addition, young children enjoy science. However, science plays only a minor role in the kindergarten curriculum. It has been reported that teachers feel they need to prioritize language and literacy practices over science. In this paper, we investigate whether science lessons might be integrated with learning the language functional for school: academic language. The occurrence of scientific reasoning and sophisticated vocabulary in brief science lessons with 5-year-olds is evaluated. The aim of the study was twofold: first, to explore the nature of kindergarten science discourse without any researcher directions (pre-intervention observation). Second, in a randomized control trial, we evaluated the effect on science discourse of a brief teacher training session focused on academic language awareness. The science lessons focussed on air pressure and mirror reflection. Analyses showed that teachers from the intervention group increased their use of scientific reasoning and of domain-specific academic words in their science discourse, compared to the control group. For the use of general academic words and for lexical diversity, the effect was task-specific: these dependent measures only increased during the air pressure task. Implications of the study include the need to increase teachers' awareness of possibilities to combine early science instruction and academic language learning.

  12. The promise and problems of non-physician practitioners in general surgery education: Results of a multi-center, mixed-methods study of faculty.

    Science.gov (United States)

    Coverdill, James E; Shelton, Jeff Scott; Alseidi, Adnan; Borgstrom, David C; Dent, Daniel L; Dumire, Russell; Fryer, Jonathan; Hartranft, Thomas H; Holsten, Steven B; Nelson, M Timothy; Shabahang, Mohsen M; Sherman, Stanley R; Termuhlen, Paula M; Woods, Randy J; Mellinger, John D

    2018-02-01

    Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns. NPPs reduce faculty and resident workloads and teach residents. NPPs also reduce resident exposure to educationally valuable activities, and faculty sometimes round, make decisions, and operate with NPPs instead of residents. Interviews indicate that NPPs can overly reduce resident involvement in patient care, diminish resident responsibility and decision making, disrupt team dynamics, and compete for procedures. NPPs both enhance and hinder surgical education and highlight the need to more clearly articulate learning outcomes for residents and activities necessary to achieve those outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Early growth of promising rubber tree clones of Hevea brasiliensis (Willd. ex A. Juss. Müll. Arg. in an agroforestry system in Caquetá, Colombia

    Directory of Open Access Journals (Sweden)

    Armando Sterling Cuéllar

    2015-07-01

    Full Text Available This study aimed to evaluate the early growth of three rubber tree clones (Hevea brasiliensis (FX 4098, FDR 5788, and control IAN 873 in four planting systems with cupuasu (Theobroma grandiflorum and banana trees (Musa AAB at two localities in Caquetá (Colombian Amazonia. A completely randomized block design with three replications and split-plot arrangement, analyzed with a general linear mixed model, was used at each locality. Total height (AT, trunk circumference (CT, canopy area (AC and leaf area index (IAF were evaluated one and two years after establishment of rubber trees. Trunk circumference was the variable most correlated with different growth indices (r ≥ 0.94. Four growth indices were strongly influenced by temporal and clonal variation and by planting system (p < 0.01. The only significant differences between the two localities were for AC (p < 0.05. System x clone interaction was significant for IAF (p < 0.01. After two years, the highest growth indices were observed in rubber tree clone FX 4098 (AT = 4.43 m; CT = 13.00 cm, AC = 4.62 m2; LAI = 1.37, and in two of the three agroforestry systems (AT ≥ 4.08 m, CT ≥ 11.43 cm, AC ≥ 4.01 m2; IAF ≥ 1.54 compared with the control system (monoculture.

  14. The results of early physiotherapy on a child with incontinentia pigmenti with encephalocele

    Science.gov (United States)

    Kara, Ozgun Kaya; Mutlu, Akmer; Gunel, Mintaze Kerem

    2010-01-01

    This study aimed to exhibit the effects of early physiotherapy and discusses post-treatment results on a patient with incontinentia pigmenti (IP) with encephalocele. Physiotherapy evaluations of the child included cognitive, fine and gross motor development assessed with the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III), disability level with the gross motor function classification system, gross motor function with the gross motor function measurement (GMFM), and tonus evaluation with the Modified Ashworth Scale. The child was included in a physiotherapy and rehabilitation programme based on neurodevelopmental treatment three times a week. Although cognitive and motor development according to Bayley-III improved in the present case, motor and cognitive retardation became more apparent with growth. GMFM results indicated a large improvement from 5.88% to 47.73%. Presentation of this case shows the significance of early physiotherapy in this first study on physiotherapy for IP during the early rehabilitation process. PMID:22767665

  15. Elicited vs. voluntary promises

    NARCIS (Netherlands)

    Ismayilov, H.; Potters, Jan

    2017-01-01

    We set up an experiment with pre-play communication to study the impact of promise elicitation by trustors from trustees on trust and trustworthiness. When given the opportunity a majority of trustors solicits a promise from the trustee. This drives up the promise making rate by trustees to almost

  16. Early versus late enteral nutrition in intensive care units. Analysis of results

    Directory of Open Access Journals (Sweden)

    Sara Bermejo de las Heras

    2017-08-01

    Full Text Available Introduction: Malnutrition is particularly prevalent in Intensive Care Units (ICU and associated with poor clinical outcomes. Enteral nutrition (EN has multiple benefits in critically ill patients, particularly when started early at the ICU. A series of studies corroborate this fact; however, other studies present conflicting results. Objective: To assess the clinical results of ICU patients receiving EN, according to EN starting time (early versus late. Patients and method: Basic variables were recorded in all ICU patients who received NE along the study period, as well as time from ICU admission to the start of EN, ICU length of stay, characteristic gastrointestinal complications of EN (gastric residue, constipation, diarrhea, vomiting, regurgitation, abdominal distension and bronchoaspiration and mortality. Results: There was a significant association between early EN and mortality reduction. However, there were no differences in ICU length of stay according to EN starting time. The most frequent complications in the sample were high gastric residue (17.9%, abdominal distension (22.5% and constipation (42.2%. However, no significant differences were observed as a function of the EN starting time. Discussion: Our results, although discrepant at times, do not contradict with those of other studies. EN has shown to be effective as a therapeutic strategy. Therefore, it is recommended the early start of EN in the ICU.

  17. I-FABP as biomarker for the early diagnosis of acute mesenteric ischemia and resultant lung injury.

    Directory of Open Access Journals (Sweden)

    Rachel G Khadaroo

    Full Text Available Acute mesenteric ischemia (AMI is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury.

  18. Acceptable results of early closure of loop ileostomy to protect low rectal anastomosis

    DEFF Research Database (Denmark)

    Perdawid, Sharafaden Karim; Andersen, Ole Bjørn; Perdawood, Sharaf

    2011-01-01

    INTRODUCTION: This was a pilot project performed prior to full implementation of early loop ileostomy closure (within two weeks) following low anterior resection of the rectum in a group of patients selected according to previously recommended criteria for safe, early ileostomy closure. MATERIAL......, closure operation, the postoperative closure period and follow-up. RESULTS: Eleven patients were included (men, n = 4) with a median age of 58 years (range 47-79 years). Ileostomy closure was performed at a median of ten days (range 8-13 days) following rectum resection. The median hospital stay was 16...

  19. Dynamic gadolinium-enhanced subtraction MR imaging - a simple technique for the early diagnosis of Legg-Calve-Perthes disease: preliminary results

    International Nuclear Information System (INIS)

    Sebag, G.; Ducou Le Pointe, H.; Klein, I.; Maiza, D.; Mazda, K.; Bensahel, H.; Hassan, M.

    1997-01-01

    To determine whether the simple technique of dynamic gadolinium-enhanced subtraction MR imaging, which is available on standard MR units, can detect ischemia of the femoral head in children with early Legg-Calve-Perthes disease (LCP). Bone perfusion of eight hips in four patients (mean age 7.5 years) was studied using dynamic gadolinium-enhanced substraction MR imaging at the onset of proven LCP (with initial negative plain films). Enhancement of subtracted images was compared with that on standard MR images and with bone scintigraphy findings. Subtraction MR imaging depicted ischemia as a widespread absence of enhancement and was in good agreement with bone scintigraphy. The subtraction technique improved the sensitivity and the specificity of MR imaging in two children. Furthermore, subtraction MR imaging allowed recognition of the pattern of early reperfusion. Our preliminary results indicate that dynamic gadolinium-enhanced subtraction MRI is a simple and promising means of early recognition of ischemia in LCP. (orig.)

  20. Proteomic patterns analysis with multivariate calculations as a promising tool for prompt differentiation of early stage lung tissue with cancer and unchanged tissue material

    Directory of Open Access Journals (Sweden)

    Grodzki Tomasz

    2011-03-01

    Full Text Available Abstract Background Lung cancer diagnosis in tissue material with commonly used histological techniques is sometimes inconvenient and in a number of cases leads to ambiguous conclusions. Frequently advanced immunostaining techniques have to be employed, yet they are both time consuming and limited. In this study a proteomic approach is presented which may help provide unambiguous pathologic diagnosis of tissue material. Methods Lung tissue material found to be pathologically changed was prepared to isolate proteome with fast and non selective procedure. Isolated peptides and proteins in ranging from 3.5 to 20 kDa were analysed directly using high resolution mass spectrometer (MALDI-TOF/TOF with sinapic acid as a matrix. Recorded complex spectra of a single run were then analyzed with multivariate statistical analysis algorithms (principle component analysis, classification methods. In the applied protocol we focused on obtaining the spectra richest in protein signals constituting a pattern of change within the sample containing detailed information about its protein composition. Advanced statistical methods were to indicate differences between examined groups. Results Obtained results indicate changes in proteome profiles of changed tissues in comparison to physiologically unchanged material (control group which were reflected in the result of principle component analysis (PCA. Points representing spectra of control group were located in different areas of multidimensional space and were less diffused in comparison to cancer tissues. Three different classification algorithms showed recognition capability of 100% regarding classification of examined material into an appropriate group. Conclusion The application of the presented protocol and method enabled finding pathological changes in tissue material regardless of localization and size of abnormalities in the sample volume. Proteomic profile as a complex, rich in signals spectrum of proteins

  1. Early and long-term results of a valve-sparing operation for Marfan syndrome.

    Science.gov (United States)

    Birks, E J; Webb, C; Child, A; Radley-Smith, R; Yacoub, M H

    1999-11-09

    We have previously described the experience, rationale, and development of a valve preserving technique, but its role in patients with Marfan syndrome has not previously been defined. Here, we attempt to determine the early and long-term results, timing, and determinants of outcome of this operation in patients with Marfan syndrome. Since 1979, 82 patients (73.2% of all patients with Marfan syndrome undergoing resection of aneurysm of the ascending aorta) were operated on using this technique. Ages ranged from 2 to 69 years (mean, 33.9 years). In all, there were 4 early deaths (4.9%), 2 with acute dissection and 2 with chronic aneurysm operated on as emergencies. There were no early deaths in 67 patients operated on electively. Actuarial survival for patients operated for chronic aneurysm was 94.2%, 94.2%, and 94.2% at 1, 5, and 10 years, respectively; that for acute dissection was 72.7%, 63. 6%, and 63.6%; and that for chronic dissection was 100%, 85.7%, and 75.0%. The probability of needing reoperation was 5.7%, 17.3%, and 17.3% at 1, 5, and 10 years. There were no instances of infective endocarditis or thromboembolic complications except in 2 patients operated on early in the series who had cusp extension. At the end of the follow-up, trivial or no aortic regurgitation was demonstrated in 33.3%, mild in 45.6%, moderate in 21.1%, and severe in 0. Valve-sparing operations are feasible in most patients with Marfan syndrome; they are applicable to patients with both dissection and chronic aneurysm. The early and long-term results are encouraging. Results are better in the absence of dissection, and prophylactic operation is warranted in some cases.

  2. Early results from Magsat. [studies of near-earth magnetic fields

    Science.gov (United States)

    Langel, R. A.; Estes, R. H.; Mayhew, M. A.

    1981-01-01

    Papers presented at the May 27, 1981 meeting of the American Geophysical Union concerning early results from the Magsat satellite program, which was designed to study the near-earth magnetic fields originating in the core and lithosphere, are discussed. The satellite was launched on October 30, 1979 into a sun-synchronous (twilight) orbit, and re-entered the atmosphere on June 11, 1980. Instruments carried included a cesium vapor magnetometer to measure field magnitudes, a fluxgate magnetometer to measure field components and an optical system to measure fluxgate magnetometer orientation. Early results concerned spherical harmonic models, fields due to ionospheric and magnetospheric currents, the identification and interpretation of fields from lithospheric sources. The preliminary results confirm the possibility of separating the measured field into core, crustal and external components, and represent significant developments in analytical techniques in main-field modelling and the physics of the field sources.

  3. Simultaneous multislice echo planar imaging with blipped controlled aliasing in parallel imaging results in higher acceleration: a promising technique for accelerated diffusion tensor imaging of skeletal muscle

    OpenAIRE

    Filli, Lukas; Piccirelli, Marco; Kenkel, David; Guggenberger, Roman; Andreisek, Gustav; Beck, Thomas; Runge, Val M; Boss, Andreas

    2015-01-01

    PURPOSE The aim of this study was to investigate the feasibility of accelerated diffusion tensor imaging (DTI) of skeletal muscle using echo planar imaging (EPI) applying simultaneous multislice excitation with a blipped controlled aliasing in parallel imaging results in higher acceleration unaliasing technique. MATERIALS AND METHODS After federal ethics board approval, the lower leg muscles of 8 healthy volunteers (mean [SD] age, 29.4 [2.9] years) were examined in a clinical 3-T magnetic ...

  4. Artificial Intelligence Applications for Education: Promise, ...Promises.

    Science.gov (United States)

    Adams, Dennis M.; Hamm, Mary

    1988-01-01

    Surveys the current status of artificial intelligence (AI) technology. Discusses intelligent tutoring systems, robotics, and applications for educators. Likens the status of AI at present to that of aviation in the very early 1900s. States that educators need to be involved in future debates concerning AI. (CW)

  5. Keeping the Promise

    Science.gov (United States)

    Whissemore, Tabitha

    2016-01-01

    Since its launch in September 2015, Heads Up America has collected information on nearly 125 promise programs across the country, many of which were instituted long before President Barack Obama announced the America's College Promise (ACP) plan in 2015. At least 27 new free community college programs have launched in states, communities, and at…

  6. Disruption of the Sec24d gene results in early embryonic lethality in the mouse.

    Directory of Open Access Journals (Sweden)

    Andrea C Baines

    Full Text Available Transport of newly synthesized proteins from the endoplasmic reticulum (ER to the Golgi is mediated by the coat protein complex COPII. The inner coat of COPII is assembled from heterodimers of SEC23 and SEC24. Though mice with mutations in one of the four Sec24 paralogs, Sec24b, exhibit a neural tube closure defect, deficiency in humans or mice has not yet been described for any of the other Sec24 paralogs. We now report characterization of mice with targeted disruption of Sec24d. Early embryonic lethality is observed in mice completely deficient in SEC24D, while a hypomorphic Sec24d allele permits survival to mid-embryogenesis. Mice haploinsufficient for Sec24d exhibit no phenotypic abnormality. A BAC transgene containing Sec24d rescues the embryonic lethality observed in Sec24d-null mice. These results demonstrate an absolute requirement for SEC24D expression in early mammalian development that is not compensated by the other three Sec24 paralogs. The early embryonic lethality resulting from loss of SEC24D in mice contrasts with the previously reported mild skeletal phenotype of SEC24D deficiency in zebrafish and restricted neural tube phenotype of SEC24B deficiency in mice. Taken together, these observations suggest that the multiple Sec24 paralogs have developed distinct functions over the course of vertebrate evolution.

  7. Simultaneous Multislice Echo Planar Imaging With Blipped Controlled Aliasing in Parallel Imaging Results in Higher Acceleration: A Promising Technique for Accelerated Diffusion Tensor Imaging of Skeletal Muscle.

    Science.gov (United States)

    Filli, Lukas; Piccirelli, Marco; Kenkel, David; Guggenberger, Roman; Andreisek, Gustav; Beck, Thomas; Runge, Val M; Boss, Andreas

    2015-07-01

    The aim of this study was to investigate the feasibility of accelerated diffusion tensor imaging (DTI) of skeletal muscle using echo planar imaging (EPI) applying simultaneous multislice excitation with a blipped controlled aliasing in parallel imaging results in higher acceleration unaliasing technique. After federal ethics board approval, the lower leg muscles of 8 healthy volunteers (mean [SD] age, 29.4 [2.9] years) were examined in a clinical 3-T magnetic resonance scanner using a 15-channel knee coil. The EPI was performed at a b value of 500 s/mm2 without slice acceleration (conventional DTI) as well as with 2-fold and 3-fold acceleration. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in all 3 acquisitions. Fiber tracking performance was compared between the acquisitions regarding the number of tracks, average track length, and anatomical precision using multivariate analysis of variance and Mann-Whitney U tests. Acquisition time was 7:24 minutes for conventional DTI, 3:53 minutes for 2-fold acceleration, and 2:38 minutes for 3-fold acceleration. Overall FA and MD values ranged from 0.220 to 0.378 and 1.595 to 1.829 mm2/s, respectively. Two-fold acceleration yielded similar FA and MD values (P ≥ 0.901) and similar fiber tracking performance compared with conventional DTI. Three-fold acceleration resulted in comparable MD (P = 0.199) but higher FA values (P = 0.006) and significantly impaired fiber tracking in the soleus and tibialis anterior muscles (number of tracks, P DTI of skeletal muscle with similar image quality and quantification accuracy of diffusion parameters. This may increase the clinical applicability of muscle anisotropy measurements.

  8. Cosmetic results in early stage breast cancer patients with high-dose brachytherapy after conservative surgery

    International Nuclear Information System (INIS)

    Torres, Felipe; Pineda, Beatriz E

    2004-01-01

    Purpose: to reveal cosmetic results in patients at early stages of low risk breast cancer treated with partial accelerated radiotherapy using high dose rate brachytherapy. Methods and materials: from March 2001 to July 2003,14 stages l and ll breast cancer patients were treated at the Colombian national cancer institute in Bogota with conservative surgery and radiotherapy upon the tumor bed (partial accelerated radiotherapy), using interstitial implants with iridium 192 (high dose rate brachytherapy) with a dose of 32 Gys, over 4 days, at 8 fractions twice a day. Results: with an average follow up of 17.7 months, good cosmetic results were found among 71.4 % of patients and excellent results among 14.3% of patients, furthermore none of the patients neither local nor regional or distant relapses. Conclusion: among patients who suffer from breast cancer at early stages, it showed is possible to apply partial accelerated radiotherapy upon the tumor bed with high doses over 4 days with good to excellent cosmetic results

  9. Prospects of an alternative treatment against Trypanosoma cruzi based on abietic acid derivatives show promising results in Balb/c mouse model.

    Science.gov (United States)

    Olmo, F; Guardia, J J; Marin, C; Messouri, I; Rosales, M J; Urbanová, K; Chayboun, I; Chahboun, R; Alvarez-Manzaneda, E J; Sánchez-Moreno, M

    2015-01-07

    Chagas disease, caused by the protozoa parasite Trypanosoma cruzi, is an example of extended parasitaemia with unmet medical needs. Current treatments based on old-featured benznidazole (Bz) and nifurtimox are expensive and do not fulfil the criteria of effectiveness, and a lack of toxicity devoid to modern drugs. In this work, a group of abietic acid derivatives that are chemically stable and well characterised were introduced as candidates for the treatment of Chagas disease. In vitro and in vivo assays were performed in order to test the effectiveness of these compounds. Finally, those which showed the best activity underwent additional studies in order to elucidate the possible mechanism of action. In vitro results indicated that some compounds have low toxicity (i.e. >150 μM, against Vero cell) combined with high efficacy (i.e. <20 μM) against some forms of T. cruzi. Further in vivo studies on mice models confirmed the expectations of improvements in infected mice. In vivo tests on the acute phase gave parasitaemia inhibition values higher those of Bz, and a remarkable decrease in the reactivation of parasitaemia was found in the chronic phase after immunosuppression of the mice treated with one of the compounds. The morphological alterations found in treated parasites with our derivatives confirmed extensive damage; energetic metabolism disturbances were also registered by (1)H NMR. The demonstrated in vivo activity and low toxicity, together with the use of affordable starting products and the lack of synthetic complexity, put these abietic acid derivatives in a remarkable position toward the development of an anti-Chagasic agent. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Rapamycin and chloroquine: the in vitro and in vivo effects of autophagy-modifying drugs show promising results in valosin containing protein multisystem proteinopathy.

    Directory of Open Access Journals (Sweden)

    Angèle Nalbandian

    Full Text Available Mutations in the valosin containing protein (VCP gene cause hereditary Inclusion body myopathy (hIBM associated with Paget disease of bone (PDB, frontotemporal dementia (FTD, more recently termed multisystem proteinopathy (MSP. Affected individuals exhibit scapular winging and die from progressive muscle weakness, and cardiac and respiratory failure, typically in their 40s to 50s. Histologically, patients show the presence of rimmed vacuoles and TAR DNA-binding protein 43 (TDP-43-positive large ubiquitinated inclusion bodies in the muscles. We have generated a VCPR155H/+ mouse model which recapitulates the disease phenotype and impaired autophagy typically observed in patients with VCP disease. Autophagy-modifying agents, such as rapamycin and chloroquine, at pharmacological doses have previously shown to alter the autophagic flux. Herein, we report results of administration of rapamycin, a specific inhibitor of the mechanistic target of rapamycin (mTOR signaling pathway, and chloroquine, a lysosomal inhibitor which reverses autophagy by accumulating in lysosomes, responsible for blocking autophagy in 20-month old VCPR155H/+ mice. Rapamycin-treated mice demonstrated significant improvement in muscle performance, quadriceps histological analysis, and rescue of ubiquitin, and TDP-43 pathology and defective autophagy as indicated by decreased protein expression levels of LC3-I/II, p62/SQSTM1, optineurin and inhibiting the mTORC1 substrates. Conversely, chloroquine-treated VCPR155H/+ mice revealed progressive muscle weakness, cytoplasmic accumulation of TDP-43, ubiquitin-positive inclusion bodies and increased LC3-I/II, p62/SQSTM1, and optineurin expression levels. Our in vitro patient myoblasts studies treated with rapamycin demonstrated an overall improvement in the autophagy markers. Targeting the mTOR pathway ameliorates an increasing list of disorders, and these findings suggest that VCP disease and related neurodegenerative multisystem

  11. The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.

    Science.gov (United States)

    Benninger, Michael S; Derakhshan, Adeeb; Milstein, Claudio F

    2015-07-01

    Retrospective chart review. To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis. The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis. Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations. The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23). The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important. © The Author(s) 2015.

  12. Higgs couplings and supersymmetry in the light of early LHC results

    International Nuclear Information System (INIS)

    Stefaniak, Tim

    2014-07-01

    We present phenomenological studies investigating the implications of early results from the Large Hadron Collider (LHC) for models beyond the Standard Model (BSM), mostly focusing on Supersymmetry (SUSY). Our work covers different aspects in this wide field of research. We describe the development and basic concepts of the public computer codes HiggsBounds (version 4) and HiggsSignals. These confront the Higgs sector predictions of BSM models with results from LEP, Tevatron and LHC Higgs searches. While HiggsBounds tests the model against experimental null-results, HiggsSignals evaluates the model's chi-squared compatibility with the signal rate and mass measurements of the Higgs boson, that was discovered by the LHC in 2012. We then perform a systematic study of potential deviations in the Higgs couplings from their Standard Model (SM) prediction. No significant deviations are found. Future capabilities of Higgs coupling determination at the later LHC stages and at the International Linear Collider (ILC) are explored. We also study the implications of the Higgs discovery for the Minimal Supersymmetric Standard Model (MSSM), considering either the light or the heavy CP-even Higgs boson as the discovered state. We show that both interpretations are viable and discuss their phenomenology. Finally, we study the LHC signatures of resonant scalar lepton production, which may arise in SUSY models with R-parity violation (RPV). These are confronted with early LHC results, yielding constraints on the relevant RPV operators.

  13. Planck early results. XIII. Statistical properties of extragalactic radio sources in the Planck Early Release Compact Source Catalogue

    DEFF Research Database (Denmark)

    Lähteenmäki, A.; Poutanen, T.; Natoli, P.

    2011-01-01

    The data reported in Planck's Early Release Compact Source Catalogue (ERCSC) are exploited to measure the number counts (dN/dS) of extragalactic radio sources at 30, 44, 70, 100, 143 and 217 GHz. Due to the full-sky nature of the catalogue, this measurement extends to the rarest and brightest sou...

  14. Oceans Melting Greenland: Early Results from NASA's Ocean-Ice Mission in Greenland

    DEFF Research Database (Denmark)

    Fenty, Ian; Willis, Josh K.; Khazendar, Ala

    2016-01-01

    the continental shelf, and about the extent to which the ocean interacts with glaciers. Early results from NASA's five-year Oceans Melting Greenland (OMG) mission, based on extensive hydrographic and bathymetric surveys, suggest that many glaciers terminate in deep water and are hence vulnerable to increased...... melting due to ocean-ice interaction. OMG will track ocean conditions and ice loss at glaciers around Greenland through the year 2020, providing critical information about ocean-driven Greenland ice mass loss in a warming climate....

  15. Promise Zones for Applicants

    Data.gov (United States)

    Department of Housing and Urban Development — This tool assists applicants to HUD's Promise Zone initiative prepare data to submit with their application by allowing applicants to draw the exact location of the...

  16. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik

    2011-01-01

    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the ...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  17. Early cessation of pressure garment therapy results in scar contraction and thickening.

    Directory of Open Access Journals (Sweden)

    Danielle M DeBruler

    Full Text Available Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1-2 years, though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released; scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements.

  18. Early cessation of pressure garment therapy results in scar contraction and thickening.

    Science.gov (United States)

    DeBruler, Danielle M; Zbinden, Jacob C; Baumann, Molly E; Blackstone, Britani N; Malara, Megan M; Bailey, J Kevin; Supp, Dorothy M; Powell, Heather M

    2018-01-01

    Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1-2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements.

  19. Early Period Results and Clinical Characteristics of Upper Gastrointestinal Endoscopy in Sivrihisar State Hospital

    Directory of Open Access Journals (Sweden)

    Ozgur Turk

    2014-12-01

    Full Text Available Aim: Our aim was to identify the characteristics of the patient that performed upper gastrointestinal endoscopy in a new established endoscopy unit of a state hospital. We want to present the spectrum of gastrointestinal diseases in our hospitals region. Material and Method: We analyzed patients upper endoscopy results according to age, sex, complaints, clinical characteristics, type of anesthesia, and the necessity of biopsy. We reviewed 256 patients data between 2013 December-2014 July. All endoscopies were performed by same surgeon. Results: The highest complaint was epigastric pain (n=112, 43, 8%. Other complaints were followed as dyspepsia (n=84, 32.8%, heartburn (n=42, 16.4%, nausea (n=4, 1.6%, vomiting (n=2, 0.8%, dysphagia (n=6, 2.3%. We determined 218 gastritis (85.2%, 64 hiatal hernia (25%, 120 esophagitis (46.9%, 76 duodenitis (29.7%, 4 gastric ulcer (1.6%, 18 duodenal ulcers (7%, 20 bile reflux (7.8%, 26 Gastro esophageal reflux disease (GERD in patients (10.2%. 10 patients reported as normal (3.9%. Biopsy was performed in 186 of the patients. Discussion: Endoscopy can become an early diagnostic examination by increasing the availability of endoscopy. Also alarm symptoms should not be ignored and endoscopy should perform immediately in symptomatic patients. As an early result of upper gastrointestinal endoscopies that performed in this study; gastritis, esophagitis, duodenitis and hiatal hernia are common gastrointestinal diseases in our region.

  20. GLOBULAR CLUSTER POPULATIONS: FIRST RESULTS FROM S{sup 4}G EARLY-TYPE GALAXIES

    Energy Technology Data Exchange (ETDEWEB)

    Zaritsky, Dennis [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Aravena, Manuel [Núcleo de Astronomía, Facultad de Ingeniería, Universidad Diego Portales, Avenida Ejército 441, Santiago (Chile); Athanassoula, E.; Bosma, Albert [Aix Marseille Université, CNRS, LAM (Laboratoire d' Astrophysique de Marseille) UMR 7326, F-13388 Marseille (France); Comerón, Sébastien; Laine, Jarkko; Laurikainen, Eija; Salo, Heikki [Astronomy Division, Department of Physics, P.O. Box 3000, FI-90014 University of Oulu (Finland); Elmegreen, Bruce G. [IBM T. J. Watson Research Center, 1101 Kitchawan Road, Yorktown Heights, NY 10598 (United States); Erroz-Ferrer, Santiago; Knapen, Johan H. [Instituto de Astrofísica de Canarias, Vía Lácteas, E-38205 La Laguna (Spain); Gadotti, Dimitri A.; Muñoz-Mateos, Juan Carlos [European Southern Observatory, Casilla 19001, Santiago 19 (Chile); Hinz, Joannah L. [MMT Observatory, P.O. Box 210065, Tucson, AZ 85721 (United States); Ho, Luis C. [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China); Holwerda, Benne [Leiden Observatory, University of Leiden, Niels Bohrweg 4, NL-2333 Leiden (Netherlands); Sheth, Kartik, E-mail: dennis.zaritsky@gmail.com [National Radio Astronomy Observatory/NAASC, 520 Edgemont Road, Charlottesville, VA 22903 (United States)

    2015-02-01

    Using 3.6 μm images of 97 early-type galaxies, we develop and verify methodology to measure globular cluster populations from the S{sup 4}G survey images. We find that (1) the ratio, T {sub N}, of the number of clusters, N {sub CL}, to parent galaxy stellar mass, M {sub *}, rises weakly with M {sub *} for early-type galaxies with M {sub *} > 10{sup 10} M {sub ☉} when we calculate galaxy masses using a universal stellar initial mass function (IMF) but that the dependence of T {sub N} on M {sub *} is removed entirely once we correct for the recently uncovered systematic variation of IMF with M {sub *}; and (2) for M {sub *} < 10{sup 10} M {sub ☉}, there is no trend between N {sub CL} and M {sub *}, the scatter in T {sub N} is significantly larger (approaching two orders of magnitude), and there is evidence to support a previous, independent suggestion of two families of galaxies. The behavior of N {sub CL} in the lower-mass systems is more difficult to measure because these systems are inherently cluster-poor, but our results may add to previous evidence that large variations in cluster formation and destruction efficiencies are to be found among low-mass galaxies. The average fraction of stellar mass in clusters is ∼0.0014 for M {sub *} > 10{sup 10} M {sub ☉} and can be as large as ∼0.02 for less massive galaxies. These are the first results from the S{sup 4}G sample of galaxies and will be enhanced by the sample of early-type galaxies now being added to S{sup 4}G and complemented by the study of later-type galaxies within S{sup 4}G.

  1. Early results of patellofemoral inlay resurfacing arthroplasty using the HemiCap Wave prosthesis.

    Science.gov (United States)

    Patel, Akash; Haider, Zakir; Anand, Amarjit; Spicer, Dominic

    2017-01-01

    Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre. From 2010 to 2013, 16 consecutive patients underwent patellofemoral resurfacing procedures using HemiCap Wave (Arthrosurface Inc., Franklin, Massachusetts, USA) for anterior knee pain with confirmed radiologically and/or arthroscopically isolated severe patellofemoral arthrosis. Standardized surgical technique, as recommended by the implant manufacturer, was followed. Outcome measures included range of movement, functional knee scores (Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Short Form-36 (SF-36)), radiographic disease progression, revision rates and complications. Eight men and eight women underwent patellofemoral HemiCap Wave resurfacing, with an average age of 63 years (range: 46-83). Average follow-up was 24.1 months (6-34). Overall, post-operative scores were excellent. There was a statistically significant improvement in the post-operative OKS, KOOS and SF-36 scores ( p patellofemoral resurfacing prosthesis has excellent early results in terms of functional outcomes, radiological outcomes and low complication rates. At the very least, early results show that the HemiCap Wave is comparable to more established onlay prostheses. The HemiCap Wave thus provides a safe and effective surgical option in the treatment of isolated patellofemoral osteoarthritis in selected patients.

  2. Early results of an in vivo trial of ESS in thyroid cancer

    Science.gov (United States)

    Rosen, Jennifer E.; Goukassian, Ilona D.; A'Amar, Ousama M.; Bigio, Irving J.; Lee, Stephanie L.

    2012-02-01

    Introduction: Thyroid cancer is the most common endocrine malignancy. The current gold standard for diagnosis, fine-needle aspiration (FNA) biopsy, yields 10-25% of indeterminate cytology results, leading to patients undergoing thyroidectomy for diagnosis. We assessed the technical potential of a miniaturized in vivo ESS (elastic light scattering spectroscopy) probe, built into an FNA needle assembly, to differentiate benign from malignant thyroid nodules. Methods: Under IRB approval, 15 patients in the endocrine clinic undergoing FNAB of a thyroid nodule had collection of ESS data using our novel miniaturized FNA probe. Using final surgical pathology as our gold standard, data post processing and visual inspection was completed. Results: 225 spectra were grouped and analyzed (120 benign, 30 malignant and 75 from indeterminate cytology). ESS probes demonstrated excellent reproducibility in use. Initial analysis of these preliminary data is promising, indicating distinction of spectral ESS features between malignant and benign conditions. Conclusion(s): An in vivo trial of an invasive miniaturized integrated ESS biopsy probe is acceptable to patients, and collection of ESS data is feasible and reliable. With development of a disease-specific algorithm, ESS could potentially be used as an in-situ real time intra-operative diagnostic tool or as a minimally invasive adjunct to conventional FNA cytology.

  3. Results of a clinical trial comparing conservative and modified radical mastectomy for early breast cancer

    International Nuclear Information System (INIS)

    Du Xianghui; Wang Yuezhen; Wu Lie; Zhu Yuan; Yang Hongjian; Zou Dehong

    2005-01-01

    Objective: The influence of conservative mastectomy plus postoperative radiation (CM + RT) in local control, distant failure, cosmetic and psychological outcome for early stage breast cancer was evaluated comparing with modified radical mastectomy. Methods: Between January 1998 and December 2003, 68 early stage breast cancer patients underwent CM + RT. During the save period, 76 similar patients were treated by modified radical mastectomy (MRM + RT). The cosmetic results evaluated as 'excellent', 'fair' or 'poor' using specific guide lines together with their psychological changes. Sex life and marital stability were also recorded. All patients were female with median age of 44.5 years (range, 28-62 years). Guidelines for patient selection reported by National Breast Cancer Cooperative Group was adhered to. In general, CM consisted of wide local excision with the breast conserved and postoperative radiotherapy to the entire breast with tangential fields followed by a boost to the tumor bed. All patients also received adjuvant chemotherapy with CAF. Patients with positive ER or PR assay results received tamoxifen for 5 years. In the 76 MRM + RT patients, the post operative radiotherapy and chemotherapy were given as clinically indicated. Results: There was no failure locally in all. In CM + RT group, the cause of failure was bone metastasis in 1 and mutiple metastasis in 2. In the MRM + RT group, the cause of failure was bone metastasis in 2, brain metastasis in 1 and mutiple metastases in 1. The cosmetic scores were 91.2% excellent, 5.6% fair and 2.9% poor. Conclusions: Breast preservation by conservative mastectomy is preferable to mastectomy in appropriately selected patients as it provides equivalent survival but giving good cosmetic results. (authors)

  4. Arthroscopic coracoid transfer in the treatment of recurrent shoulder instability: a systematic review of early results.

    Science.gov (United States)

    Butt, Usman; Charalambous, Charalambos P

    2013-04-01

    Systematic review of the literature to characterize safety profile and complication rates associated with arthroscopic coracoid transfer procedures. We conducted a combined search of Medline, EMBASE, and the CINAHL databases from 1985 to November 2012. Articles were selected and data extracted according to standard criteria. Only 3 studies met the inclusion criteria, and these originated from the pioneers of this technique. These studies described the results of 172 arthroscopic coracoid transfer procedures with an overall complication rate of 19.8% ± 5.6%. Conversion to open surgery was necessary in 6/172 (3.5%) patients. Repeated surgery was described in 5/172 (2.9% ± 2.5%) cases, all for screw removal. The overall rate of recurrent instability was 3/172 cases (1.7% ± 2%). Hardware-related complications occurred in 4/172 patients (2.3% ± 2.3%). Coracoid grafts failed to unite in 14/172 patients (8.1% ± 4.1%); graft osteolysis was seen in 7/172 patients (4.1% ± 2.6%). The coracoid graft fractured in 2/172 cases (1.2% ± 1.6%); one of these occurred intraoperatively and one occurred early postoperatively. There was one transient nerve palsy (0.6% ± 1.1%). Results of arthroscopic coracoid transfer surgery for anterior shoulder instability are sparse, with the available studies originating from the pioneers of this technique. Early results suggest that arthroscopic coracoid transfer is a technically feasible procedure that is able to restore shoulder stability. However, this technique seems to be associated with a high complication rate and a steep learning curve. Results from the wider orthopaedic shoulder arthroscopic community are awaited. Extensive cadaveric training and experience with the open technique is recommended before performing the arthroscopic procedure. Systematic review of Level IV studies. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Early embryonic chromosome instability results in stable mosaic pattern in human tissues.

    Directory of Open Access Journals (Sweden)

    Hasmik Mkrtchyan

    Full Text Available The discovery of copy number variations (CNV in the human genome opened new perspectives on the study of the genetic causes of inherited disorders and the aetiology of common diseases. Here, a single-cell-level investigation of CNV in different human tissues led us to uncover the phenomenon of mitotically derived genomic mosaicism, which is stable in different cell types of one individual. The CNV mosaic ratios were different between the 10 individuals studied. However, they were stable in the T lymphocytes, immortalized B lymphoblastoid cells, and skin fibroblasts analyzed in each individual. Because these cell types have a common origin in the connective tissues, we suggest that mitotic changes in CNV regions may happen early during embryonic development and occur only once, after which the stable mosaic ratio is maintained throughout the differentiated tissues. This concept is further supported by a unique study of immortalized B lymphoblastoid cell lines obtained with 20 year difference from two subjects. We provide the first evidence of somatic mosaicism for CNV, with stable variation ratios in different cell types of one individual leading to the hypothesis of early embryonic chromosome instability resulting in stable mosaic pattern in human tissues. This concept has the potential to open new perspectives in personalized genetic diagnostics and can explain genetic phenomena like diminished penetrance in autosomal dominant diseases. We propose that further genomic studies should focus on the single-cell level, to better understand the aetiology of aging and diseases mediated by somatic mutations.

  6. Intraoperative Ir-192 implantation for early breast cancer. Techniques and results

    International Nuclear Information System (INIS)

    Mansfield, C.M.

    1990-01-01

    Patients with early breast cancer (T1-2 N0-1) can be treated by lumpectomy and irradiation with a local control and survival equal to more radical surgery. Between 1982 and 1988, 323 patients with early breast cancer were treated, when possible, with Ir-192 implants at the time of lumpectomy to a local dose of 2000 cGy in 40-50 hours. Ten to 14 days later, the whole breast was treated to 4500 cGy at 180 per fraction in 5 weeks. The 6-year actuarial survival for stages I and II disease was 98% and 91%, respectively, and the recurrence-free survival was 96% and 98%, respectively. When these 323 patients were evaluated by T status, a local control of 97% was the same for T1 and T2 lesions. The cosmetic results were good to excellent in 95% of the patients. This approach has improved our ability to accurately place the boost dose in the breast

  7. Promising More Information

    Science.gov (United States)

    2003-01-01

    When NASA needed a real-time, online database system capable of tracking documentation changes in its propulsion test facilities, engineers at Stennis Space Center joined with ECT International, of Brookfield, Wisconsin, to create a solution. Through NASA's Dual-Use Program, ECT developed Exdata, a software program that works within the company's existing Promise software. Exdata not only satisfied NASA s requirements, but also expanded ECT s commercial product line. Promise, ECT s primary product, is an intelligent software program with specialized functions for designing and documenting electrical control systems. An addon to AutoCAD software, Promis e generates control system schematics, panel layouts, bills of material, wire lists, and terminal plans. The drawing functions include symbol libraries, macros, and automatic line breaking. Primary Promise customers include manufacturing companies, utilities, and other organizations with complex processes to control.

  8. Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.

    Science.gov (United States)

    Gamba, Amando; Tasca, Giordano; Giannico, Floriana; Lobiati, Elisabetta; Skouse, Douglas; Galanti, Andrea; Martino, Antonello Stefano; Triggiani, Michele

    2015-04-01

    The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results. Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist. The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively. Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Posttreatment biopsy results following interstitial brachytherapy in early-stage prostate cancer

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Hoak, David C.; Grimm, Peter D.; Ragde, Haakon; Cavanagh, William; Blasko, John C.

    1997-01-01

    Purpose: To assess pathologic control rates for prostatic carcinoma as determined by postimplant prostate biopsy in a large series of consecutive patients who have received permanent interstitial brachytherapy using a contemporary transrectal ultrasound-directed, transperineal, computer generated, volume technique. Methods and Materials: Four hundred and two patients received permanent 125 I or 103 Pd interstitial brachytherapy as primary treatment for early stage prostatic carcinoma at the Northwest Tumor Institute between January 1988 and January 1994. Of these, 201 have consented to biopsy 12 or more months postimplant with a median follow-up of 40 months (range: 12-83 months). None had received homonal manipulation. A total of 361 biopsies was performed on 201 patients with a range of one to six annual biopsies per patient (91 received multiple, serial biopsies). Of the 161 patients more than 12 months postimplant who have not been biopsied, most have been unwilling or unable to submit to biopsy. Only six patients with biochemical progression have not been biopsied. There was no difference in the presenting characteristics or implant parameters between those patients biopsied and those that were not. One hundred and forty-three received 125 I (71%) prescribed to a MPD of 160 Gy with a median activity of 35.5 mCi, and 58 (29%) received 103 Pd prescribed to a MPD of 115 Gy with a median activity of 123 mCi. Multiple biopsies were performed under transrectal ultrasound guidance, and all specimens were classified as either negative, indeterminate, or positive. Results: At the time of last biopsy, 161 (80%) have achieved negative pathology, 34 (17%) remain indeterminate, and 6 (3%) have been positive. Only 2 of the 186 patients with a PSA < 4.0 ng/ml at the time of biopsy were positive. Among those 33 indeterminate patients with a subsequent biopsy, 28 have converted to negative, 2 to positive, and 3 remain unchanged to date. Conclusions: These data demonstrate at

  10. Results of early thyroidectomy for medullary thyroid carcinoma in children with multiple endocrine neoplasia type 2.

    Science.gov (United States)

    Telander, R L; Zimmerman, D; van Heerden, J A; Sizemore, G W

    1986-12-01

    Children with multiple endocrine neoplasia type 2 (MEN2) often develop medullary carcinoma of the thyroid (MCT) or its precursor, C-cell hyperplasia. Survival results are improved if malignancy is diagnosed early from the results of plasma immunoreactive calcitonin (iCT) measurement. The effect of early detection and thyroidectomy in children with MEN2 syndrome was determined by reviewing the experience between 1975 and 1985. Seventeen children with MEN2 who were 12 years old or younger underwent a total thyroidectomy for MCT or C-cell hyperplasia. iCT was measured in all patients preoperatively and postoperatively. Of the 17 children, 14 (82%) had MEN2a and 3 (18%) had MEN2b. There were 14 (82%) female and three (18%) male patients; their mean age was 6.97 years (range 1.5 to 12 years). In all patients, the diagnosis of MCT was made from initial elevated levels of iCT after stimulation with pentagastrin. Three patients had clinical evidence of disease preoperatively. All patients underwent a total thyroidectomy and lymph nodes were removed from the central zone; a neck dissection was performed in the three with clinically obvious disease. MCT with C-cell hyperplasia was found in 11 children and C-cell hyperplasia alone in six. Of the 11 with carcinoma, eight had bilateral disease and three unilateral. Six children had bilateral C-cell hyperplasia. All 17 children were alive and feeling well at the time of this report; however, three had evidence of metastatic disease according to iCT measurements. None of the children had recurrent nerve injuries; one had evidence of hypoparathyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. [Personalized cell therapy for early postoperative bullous keratopathy (experimental proof and clinical results)].

    Science.gov (United States)

    Kasparov, A A; Kasparova, Evg A; Fadeeva, L L; Subbot, A M; Borodina, N V; Kasparova, E A; Kobzova, M V; Musaeva, G M; Pavliuk, A S

    2013-01-01

    The article presents the results of a long-term research on development and clinical application of personalized cell therapy (PCT) for treatment of early postoperative (manifesting within the first 3 months after surgery) bullous keratopathy (BK). The method of intracameral PCT implies in vitro incubation of the patient's blood sample with poly(A:U) stimulator, separation of the serum with activated leukocytes, and injection of the final cell preparation into the anterior chamber. The fundamental part of the research was aimed at a detailed description of the cell preparation and investigation of its possible mechanisms of action. Cytokine and growth factor level in the cell preparation suggested that its high clinical efficacy might be due to its ability to improve regeneration of damaged corneal endothelium. The clinical study was conducted on a group of 52 patients with early BK. A significant effect (smoothing of the Descement's membrane folds, complete resorption of corneal edema, improvement of corneal transparency, reduction of corneal thickness and increase of visual acuity by 0.49 +/- 0.27) was achieved in 44.2% of patients, while partial effect was seen in 21.1% of patients. There was no clinical effect in 34.6% of patients. In those patients who developed significant or partial clinical effect after the PCT, many endotheliocytes appeared to have multiple nuclei (2 and more). In some patients polyploid nuclei persisted for 3-5 years after the treatment. Polyploidy results from incomplete mitosis which might be due to regenerative processes in the endothelium stimulated by the PCT. Obviously, high efficacy and relative simplicity of the method should promote its further clinical introduction.

  12. [Early results after varicose vein surgery--a multicenter patient inquiry].

    Science.gov (United States)

    Hermanns, H-J

    2008-08-01

    Beside varicose vein surgery, endovenous procedures (endovenous laser therapy, VNUS and foam sclerotherapy) are now therapeutic options with the following advantages: low invasiveness, only out-patient operations, quick resumption of general activities. Whether or not classical vein surgery today still fulfills patient demands was analysed by a study group of German vascular surgeons (ANG) as a multicentre patient questioning. The questionnaire was subdivided into eight main complexes with 24 questions about the early results of stripping operations (from start of preparation until suture removal) and the patients answers were analysed. Answers with points (1-6) and free answers were possible. Between 1.1.2005 and 31.3.2005 18 centres for vascular surgery collected 1708 questionnaires from patients after stripping operations. The complex "preparation and information about the operation" was scored with 1.33 to 1.39. The "general organisation" of the vascular centre was scored between 1.22 and 1.30. "Pain after operation" was rated at 1.98 (immediately), 2.26 (first day) and 2.12 (third day after operation). Reasons for other problems after surgery were haematoma (3.09), problems with the compression dressing (1.67), circulatory collapse (1.51), headache (1.33), nausea (1.25). The total score for all centres was 1.47. The early results after varicose vein surgery are good up to very good. The patients' reconvalescence time is short and there is a quick resumption of general activities. The invasiveness of vein surgery seems to be overestimated. Comparative studies to evaluate the new methods are necessary. Benchmarking projects like this study are essential parts of current quality control systems.

  13. The difficulties of Indonesian fourth graders in learning fractions: An early exploration of TIMSS 2015 results

    Science.gov (United States)

    Wijaya, Ariyadi

    2017-08-01

    The present study investigates Indonesian fourth-graders low performance in dealing with fractions in TIMSS 2015. Furthermore, the present study also explores possible reasons for this low performance. The data for this study was drawn from TIMSS 2015 data which included test results and responses to Teacher Questionnaire. Descriptive statistics was used to analyze the data. Indonesian textbooks were also analyzed to portrait a broader scope of possible reasons for students' low performance. The analysis of TIMSS test result reveals that Indonesian students, in comparison to students from other countries, had low understanding of the basic concepts of fractions. From the Teacher Questionnaire it was found that a possible reason for this low understanding was the Indonesian curriculum for third grade which gave low emphasis on the basic concepts of fractions and introduced operations of fractions rather early. Furthermore, the result of textbook analysis shows that Indonesian textbooks restricted only to one definition of fractions, i.e. fractions as parts of wholes. This finding might also explain Indonesian fourth graders' low understanding of fractions.

  14. Early results of studies on the levels of depleted uranium excreted by Balkan residents

    International Nuclear Information System (INIS)

    Priest, N.D.; Thirlwell, M.

    2002-01-01

    Urine samples collected from residents of Bosnia and Herzegovina and Kosovo were analysed to determine their natural and depleted uranium content using MC-ICP-MS. All may have been exposed to depleted uranium released as a consequence of the deployment of armour-piercing rounds by the US Air Force. A 236 U tracer was employed to determine chemical recovery. Early results suggest that the levels of natural and depleted uranium excretion by the subjects, which ranged in age from 1 to 71 years, ranged from 2.8 - 58.2 ng d -1 and 1.3 - 46.3 ng d -1 , respectively. The results suggest accumulated body burdens of depleted uranium ranging from close to zero to 46 μg. All the body burdens predicted are lower than published values for the uranium content of the body (90μg) and health effects are not predicted. Further studies are underway to check the provenance of the results. (author)

  15. Radiotherapy in early-stage Dupuytren's contracture. Long-term results after 13 years

    International Nuclear Information System (INIS)

    Betz, Nicolas; Ott, Oliver J.; Sauer, Rolf; Fietkau, Rainer; Adamietz, Boris; Keilholz, Ludwig

    2010-01-01

    Background and Purpose: In early-stage Dupuytren's contracture, radiotherapy is applied to prevent disease progression. Long-term outcome and late toxicity of the treatment were evaluated in a retrospective analysis. Patients and Methods: Between 12/1982 and 02/2006, 135 patients (208 hands) were irradiated with orthovoltage (120 kV; 20 mA; 4-mm Al filter), in two courses with five daily fractions of 3.0 Gy to a total dose of 30 Gy; separated by a 6- to 8-week interval. The extent of disease was described according to a modified classification of Tubiana et al. Long-term outcome was analyzed at last follow-up between 02/2008 and 05/2008 with a median follow-up of 13 years (range, 2-25 years). Late treatment toxicity and objective reduction of symptoms as change in stage and numbers of nodules and cords were evaluated and used as evidence to assess treatment response. Results: According to the individual stages, 123 cases (59%) remained stable, 20 (10%) improved, and 65 (31%) progressed. In stage N 87% and in stage N/I 70% remained stable or even regressed. In more advanced stages, the rate of disease progression increased to 62% (stage I) or 86% (stage II). 66% of the patients showed a long-term relief of symptoms (i.e., burning sensations, itching and scratching, pressure and tension). Radiotherapy did not increase the complication rate after surgery in case of disease progression and only minor late toxicity (skin atrophy, dry desquamation) could be observed in 32% of the patients. There was no evidence for a second malignancy induced by radiotherapy. Conclusion: After a mean follow-up of 13 years radiotherapy is effective in prevention of disease progression and improves patients' symptoms in early-stage Dupuytren's contracture (stage N, N/I). In case of disease progression after radiotherapy, a ''salvage'' operation is still feasible. (orig.)

  16. Early mobilisation versus plaster immobilisation of simple elbow dislocations: Results of the FuncSiE multicentre randomised clinical trial

    NARCIS (Netherlands)

    G.I.T. Iordens (Gijs); E.M.M. van Lieshout (Esther); N.W.L. Schep (Niels); J. de Haan (Jeroen); W.E. Tuinebreijer (Wim); D. Eygendaal (Denise); E.F. van Beeck (Ed); P. Patka (Peter); M.H.J. Verhofstad (Michiel); D. den Hartog (Dennis); R.S. Breederveld (Roelf S.); M.W.G.A. Bronkhorst (Maarten); M.R. de Vries (Mark); B.J. Dwars (Boudewijn); R. Haverlag (Robert); S.A.G. Meylaerts (Sven); J.W. Mulder (Jan-Willem); K.J. Ponsen (Kees-jan); W.H. Roerdink (Herbert); G.R. Roukema (Gert); I.B. Schipper (Inger); M.A. Schouten (Michel); J.B. Sintenie (Jan Bernard); S. Sivro (Senail); J.G.H. van den Brand (Johan); F.M. van der Linden (Frits); H.G.W.M. Meulen (Hub); E.J.M.M. Verleisdonk (Egbert); J.P.A.M. Vroemen (Jos); M. Waleboer (Marco); W.J. Willems (Jaap)

    2017-01-01

    textabstractBackground/aim To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery. Methods From August 2009 to September 2012, 100 adult patients with a

  17. Early life environmental and pharmacological stressors result in persistent dysregulations of the serotonergic system

    Directory of Open Access Journals (Sweden)

    Peiyan eWong

    2015-04-01

    Full Text Available Dysregulations in the brain serotonergic system and exposure to environmental stressors have been implicated in the development of major depressive disorder. Here, we investigate the interactions between the stress and serotonergic systems by characterizing the behavioral and biochemical effects of chronic stress applied during early-life or adulthood in wild type (WT mice and mice with deficient tryptophan hydroxylase 2 (TPH2 function. We showed that chronic mild stress applied in adulthood did not affect the behaviors and serotonin levels of WT and TPH2 knock-in (KI mice. Whereas, maternal separation (MS stress increased anxiety- and depressive-like behaviors of WT mice, with no detectable behavioral changes in TPH2 KI mice. Biochemically, we found that MS WT mice had reduced brain serotonin levels, which was attributed to increased expression of monoamine oxidase A (MAO A. The increased MAO A expression was detected in MS WT mice at 4 weeks old and adulthood. No change in TPH2 expression was detected. To determine whether a pharmacological stressor, dexamethasone (Dex, will result in similar biochemical results obtained from MS, we used an in vitro system, SH-SY5Y cells, and found that Dex treatment resulted in increased MAO A expression levels. We then treated WT mice with Dex for 5 days, either during postnatal days 7-11 or adulthood. Both groups of Dex treated WT mice had reduced basal corticosterone and glucocorticoid receptors expression levels. However, only Dex treatment during PND7-11 resulted in reduced serotonin levels and increased MAO A expression. Just as with MS WT mice, TPH2 expression in PND7-11 Dex-treated WT mice was unaffected. Taken together, our findings suggest that both environmental and pharmacological stressors affect the expression of MAO A, and not TPH2, when applied during the critical postnatal period. This leads to long-lasting perturbations in the serotonergic system, and results in anxiety- and depressive

  18. Neuronal redox imbalance results in altered energy homeostasis and early postnatal lethality.

    Science.gov (United States)

    Maity-Kumar, Gandhari; Thal, Dietmar R; Baumann, Bernd; Scharffetter-Kochanek, Karin; Wirth, Thomas

    2015-07-01

    Redox imbalance is believed to contribute to the development and progression of several neurodegenerative disorders. Our aim was to develop an animal model that exhibits neuron-specific oxidative stress in the CNS to study the consequences and eventually find clues regarding the pathomechanisms of oxidative insults in neuronal homeostasis. We therefore generated a novel neuron-specific superoxide dismutase 2 (SOD2)-deficient mouse by deleting exon 3 of the SOD2 gene using CamKIIα promoter-driven Cre expression. These neuron-specific SOD2 knockout (SOD2(nko)) mice, although born at normal frequencies, died at the age of 4 weeks with critical growth retardation, severe energy failure, and several neurologic phenotypes. In addition, SOD2(nko) mice exhibited severe neuronal alterations such as reactive astrogliosis, neuronal cell cycle inhibition, and induction of apoptosis. JNK activation and stabilization of p53, as a result of reactive oxygen species accumulation, are most likely the inducers of neuronal apoptosis in SOD2(nko) mice. It is remarkable that hypothalamic regulation of glucose metabolism was affected, which in turn induced necrotic brain lesions in SOD2(nko) mice. Taken together, our findings suggest that exclusive deficiency of SOD2 in neurons results in an impaired central regulation of energy homeostasis that leads to persistent hypoglycemia, hypoglycemia-related neuropathology, and an early lethality of the mutant mice. © FASEB.

  19. FRACTURES OF THE FIFTH METATARSAL RESULTS OF THE EARLY OPERATIVE TREATMENT OF ACUTE DISPLACED FRACTURES

    Directory of Open Access Journals (Sweden)

    Slaviša Mihaljević

    2004-04-01

    Full Text Available Background. Fracture of the proximal 5th metatarsal bone (MTB reach almost 2% of all fractures of the foot. Conservative treatment is method of choice in almost all cases. Selected cases can benefit from acute surgery especially if the proximal fragment is severe displaced or the excessive articular step off is present.Materials and methods. In a 4 year period 14 patients were operated due to the acute fracture of proximal 5th MTB. All patients were treated in less than 2 weeks after the injury. 10 patients had base avulsion fracture in zone I and 4 had Jones fracture in zone II with dislocation of fragments? 5 mm, articular step off of 2 mm and 30% of articulation surface. We used tension bend wire in 9 cases (64%, partially threaded cancellous screw in 4 cases (28% and bone sutures in 1 case (7%. Postoperatively all patients used crutches with nonweight bearing for 4 weeks and afterwards partial weight bearing till the end of the treatment. All patients were practicing active exercises for ankle, foot and toes. The results were evaluated according to the Maryland Foot Score (MFS at least 20 months after injury.Results. 13 patients (93% were included in follow up. 12 patients were evaluated as excellent and only one as a good. All 13 patients have no or slight pain with no change in ADL or work ability. 9 patients (69% reached full functional result and 4 (31% patients had slight limitation during distance walk. Patients reached full weight bearing in average 7 weeks (5–13.Conclusions. Early operative treatment of selected cases allows fast return to preoperative activity without long term functional sequel. Both operative procedures, screw fixation and tension wire, yielded comparable and excellent end result.

  20. Early life exposure to allergen and ozone results in altered development in adolescent rhesus macaque lungs

    International Nuclear Information System (INIS)

    Herring, M.J.; Putney, L.F.; St George, J.A.; Avdalovic, M.V.; Schelegle, E.S.; Miller, L.A.; Hyde, D.M.

    2015-01-01

    In rhesus macaques, previous studies have shown that episodic exposure to allergen alone or combined with ozone inhalation during the first 6 months of life results in a condition with many of the hallmarks of asthma. This exposure regimen results in altered development of the distal airways and parenchyma (Avdalovic et al., 2012). We hypothesized that the observed alterations in the lung parenchyma would be permanent following a long-term recovery in filtered air (FA) housing. Forty-eight infant rhesus macaques (30 days old) sensitized to house dust mite (HDM) were treated with two week cycles of FA, house dust mite allergen (HDMA), ozone (O 3 ) or HDMA/ozone (HDMA + O 3 ) for five months. At the end of the five months, six animals from each group were necropsied. The other six animals in each group were allowed to recover in FA for 30 more months at which time they were necropsied. Design-based stereology was used to estimate volumes of lung components, number of alveoli, size of alveoli, distribution of alveolar volumes, interalveolar capillary density. After 30 months of recovery, monkeys exposed to HDMA, in either group, had significantly more alveoli than filtered air. These alveoli also had higher capillary densities as compared with FA controls. These results indicate that early life exposure to HDMA alone or HDMA + O 3 alters the development process in the lung alveoli. - Highlights: • Abnormal lung development after postnatal exposure to ozone and allergen • This remodeling is shown as smaller, more numerous alveoli and narrower airways. • Allergen appears to have more of an effect than ozone during recovery. • These animals also have continued airway hyperresponsiveness (Moore et al. 2014)

  1. Management strategies, early results, benefits, and risk factors of laparoscopic repair of perforated peptic ulcer.

    Science.gov (United States)

    Lunevicius, Raimundas; Morkevicius, Matas

    2005-10-01

    The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal was to emphasize the benefits of this operation, and the fourth goal was to clarify the possible risk factors associated with laparoscopic repair of the duodenal ulcer. The Medline/Pubmed database was used. Review was done after evaluation of 96 retrieved full-text articles. Thirteen prospective and twelve retrospective studies were selected, grouped, and summarized. The spectrum of the retrospective studies' results are as follows: median overall morbidity rate 10.5 %, median conversion rate 7%, median hospital stay 7 days, and median postoperative mortality rate 0%. The following is the spectrum of results of the prospective studies: median overall morbidity rate was slightly less (6%); the median conversion rate was higher (15%); the median hospital stay was shorter (5 days) and the postoperative mortality was higher (3%). The risk factors identified were the same. Shock, delayed presentation (> 24 hours), confounding medical condition, age > 70 years, poor laparoscopic expertise, ASA III-IV, and Boey score should be considered preoperative laparoscopic repair risk factors. Each of these factors independently should qualify as a criterion for open repair due to higher intraoperative risks as well as postoperative morbidity. Inadequate ulcer localization, large perforation size (defined by some as > 6 mm diameter, and by others as > 10 mm), and ulcers with friable edges are also considered as conversion risk factors.

  2. Early life exposure to allergen and ozone results in altered development in adolescent rhesus macaque lungs

    Energy Technology Data Exchange (ETDEWEB)

    Herring, M.J.; Putney, L.F.; St George, J.A. [California National Primate Research Center, Davis, CA (United States); Avdalovic, M.V. [Department of Internal Medicine, Division of Pulmonary and Critical Care, University of California, Davis, CA (United States); Schelegle, E.S.; Miller, L.A. [California National Primate Research Center, Davis, CA (United States); Hyde, D.M., E-mail: dmhyde@ucdavis.edu [California National Primate Research Center, Davis, CA (United States)

    2015-02-15

    In rhesus macaques, previous studies have shown that episodic exposure to allergen alone or combined with ozone inhalation during the first 6 months of life results in a condition with many of the hallmarks of asthma. This exposure regimen results in altered development of the distal airways and parenchyma (Avdalovic et al., 2012). We hypothesized that the observed alterations in the lung parenchyma would be permanent following a long-term recovery in filtered air (FA) housing. Forty-eight infant rhesus macaques (30 days old) sensitized to house dust mite (HDM) were treated with two week cycles of FA, house dust mite allergen (HDMA), ozone (O{sub 3}) or HDMA/ozone (HDMA + O{sub 3}) for five months. At the end of the five months, six animals from each group were necropsied. The other six animals in each group were allowed to recover in FA for 30 more months at which time they were necropsied. Design-based stereology was used to estimate volumes of lung components, number of alveoli, size of alveoli, distribution of alveolar volumes, interalveolar capillary density. After 30 months of recovery, monkeys exposed to HDMA, in either group, had significantly more alveoli than filtered air. These alveoli also had higher capillary densities as compared with FA controls. These results indicate that early life exposure to HDMA alone or HDMA + O{sub 3} alters the development process in the lung alveoli. - Highlights: • Abnormal lung development after postnatal exposure to ozone and allergen • This remodeling is shown as smaller, more numerous alveoli and narrower airways. • Allergen appears to have more of an effect than ozone during recovery. • These animals also have continued airway hyperresponsiveness (Moore et al. 2014)

  3. Differential population synthesis of early-type galaxies. III. Synthesis results

    International Nuclear Information System (INIS)

    Pickles, A.J.

    1985-01-01

    Synthesis results are presented for 12 elliptical and five lenticular galaxies which cover nearly a 6 mag range of absolute magnitude in the Fornax cluster (V = 1430 km s -1 ). The results of age, metallicity, and mass-to-light ratio (M/L) determinations are presented differentially as functions of galactic luminosity and morphology. Bright elliptical galaxies are well represented by main-sequence turnoff colors of (V-R)/sub c/roughly-equal0.37 and B-Vroughly-equal0.70, in good agreement with O'Connell's results for bright Virgo ellipticals. The relatively young main-sequence turnoff ages, of 6-10 Gyr for ellipticals of all luminosities, indicate that substantial star formation activity occurred in these galaxies for a period of 6dagger10 Gyr after the epoch of globular cluster formation. There is strong evidence for small amounts of current star formation in at least the brightest ellipticals of all luminosities, indicate that substantial star formation in at least the brightest ellipticals, variation in the amount of which may account for significant dispersion in the cluster U-V versus V color-magnitude relation. A metallicity gradient in [Fe/H] of at least 0.16 dex per absolute magnitude is derived, with the brightest ellipticals being 2 to 3 times more metal-rich than solar. The mean metallicities and turnoff ages of the faintest ellipticals are probably dependent on environment. Distance-independent upper limits to galaxy M/L ratios derived from the syntheses conform well with M/L ratios derived from velocity dispersion measurements and give no evidence for unseen mass in the nuclei of early type galaxies of any luminosity

  4. The Revival of Memory: Gardens and Avenues of Remembrance. Early Results of a Research in Abruzzo

    Directory of Open Access Journals (Sweden)

    Aldo Giorgio Pezzi

    2014-06-01

    Full Text Available The forthcoming centenary of the Great War (1914-1918 can be considered an important occasion to focus attention on the subject of memorials for the fallen in the War. Immediately after the War, this topic was considered so relevant that in each municipality of Italy, Gardens and Avenues of Remembrance were realized and soon became places of memory, characterized by strong values of identity, history and landscape. In these places, usually correspondent to the number of fallen in that neighbourhood and located in urban or peripheral areas, nature and anthropic elements coexisted. For their importance, from 1926 these places have been included among the National Monuments. After the Second World War, avenues and gardens, as well as toponyms, were gradually forgotten and, in many cases, radically transformed. Due to a form of damnatio memoriae, which locations considered symbols of past governments have had to pay, these places have been changed, radically transforming also their authentic significance. A century on, it is important to start a programme for protection and enhancement of this historic heritage (classification at a regional and national scale, measurements, archival research, definition of guide lines for conservation. The essay also describes the early results of the classification of Gardens and Avenues of Remembrance in Abruzzo.

  5. Results of surgical treatment versus chemoradiation therapy in oropharyngeal early tumors

    Directory of Open Access Journals (Sweden)

    Chedid, Helma Maria

    2009-03-01

    Full Text Available Introduction: The epidermoid carcinoma of the upper aerodigestive tract is diagnosed in approximately 40% of the cases of advanced clinical stages. Objective: To evaluate the disease-free interval in patients with clinical stages I and II epidermoid carcinoma who were submitted to surgery or chemoradiation. Method: Retrospective study of the records of 139 patients treated for oropharyngeal epidermoid carcinoma submitted to treatment with curative intent. Among those patients, 38 were classified with early tumors clinical stages I and II. Twenty-seven (71.1% underwent surgical treatment whereas eleven (28.9% were treated with chemoradiation. The mean age was 56.4 years; 31 cases (81.6% were in men and seven (18.4% were in women. Results: Among the eleven patients who were submitted to chemoradiation, 72.7% obtained locoregional control of the disease and their disease-free survival was of 42%. Among the 27 patients operated, 19 remained in Clinical Stages I and II in the histological report and six underwent postoperative radiation therapy. The disease-free interval for two years was of 70%. Conclusion: The patients submitted to the surgery had a better disease-free interval as compared to those submitted to chemoradiation treatment.

  6. Comparison of Early-period Results of Nasal Splint and Merocel Nasal Packs in Septoplasty

    Science.gov (United States)

    Bingöl, Fatih; Budak, Ali; Şimşek, Eda; Kılıç, Korhan; Bingöl, Buket Özel

    2017-01-01

    Objective Several types of nasal packs are used postoperatively in septoplasty. In this study, we compared two commonly used nasal packing materials, the intranasal septal splint with airway and Merocel tampon, in terms of pain, bleeding, nasal obstruction, eating difficulties, discomfort in sleep, and pain and bleeding during removal of packing in the early period. Methods The study group included 60 patients undergoing septoplasty. Patients were divided into two groups (n=30 in each group). An intranasal splint with airway was used for the patients in the first group after septoplasty, while Merocel nasal packing was used for the second group. Patients were investigated in terms of seven different factors - pain, bleeding while the tampon was in place, nasal obstruction, eating difficulties, night sleep, pain during removal of the nasal packing, and bleeding after removal of packing. Results There was no statistically significant difference between the groups in terms of pain 24 hours after operation (p=0.05), while visual analog scale (VAS) scores for nasal obstruction, night sleep, eating difficulties, and pain during packing removal were lower in the nasal splint group with a statistically significant difference (p<0.05). There was no statistically significant difference between the groups in terms of postoperative bleeding (p=0.23). Significantly less bleeding occurred during removal of the packing in the nasal splint group (p<0.05). Conclusion Our study indicates that the nasal splint was more comfortable and effective in terms of causing lesser bleeding and pain during removal of packing. PMID:29392071

  7. Ocriplasmin for treatment of stage 2 macular holes: early clinical results.

    Science.gov (United States)

    Miller, John B; Kim, Leo A; Wu, David M; Vavvas, Demetrios G; Eliott, Dean; Husain, Deeba

    2014-01-01

    To review clinical and structural outcomes of ocriplasmin for treatment of stage 2 macular holes. A retrospective review of the first patients with stage 2 macular holes to be treated with ocriplasmin at Massachusetts Eye and Ear Infirmary. All patients were imaged with spectral-domain optical coherence tomography (SD-OCT). Eight patients with stage 2 macular holes received a single injection of 125 μg of ocriplasmin. One patient (12.5%) demonstrated macular hole closure. The posterior hyaloid separated from the macula in six eyes (75%). All seven holes that remained open showed enlargement in hole diameters (narrowest, apical, and basal) at 1 week and 1 month. All seven were successfully closed with surgery. Ellipsoid zone disruptions were observed by OCT in four eyes (50%) and persisted throughout follow-up (more than 6 months on average). In early clinical results, the authors found a lower macular hole closure rate with ocriplasmin than previously reported. Enlargement was observed in all holes that failed to close with ocriplasmin. The authors found ellipsoid zone disruptions that persisted through 6 months of follow-up after ocriplasmin injection. Further work is needed to investigate the cause for these ellipsoid zone changes. Copyright 2014, SLACK Incorporated.

  8. Classroom-based narrative and vocabulary instruction: results of an early-stage, nonrandomized comparison study.

    Science.gov (United States)

    Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B

    2014-07-01

    This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

  9. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    International Nuclear Information System (INIS)

    Pellerin, O.; Barral, F. G.; Lions, C.; Novelli, L.; Beregi, J. P.; Sapoval, M.

    2008-01-01

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 ± 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.

  10. SPECTROSCOPIC ANALYSIS OF METAL-POOR STARS FROM LAMOST: EARLY RESULTS

    International Nuclear Information System (INIS)

    Li, Hai-Ning; Zhao, Gang; Wang, Liang; Wang, Wei; Yuan, Hailong; Christlieb, Norbert; Zhang, Yong; Hou, Yonghui

    2015-01-01

    We report on early results from a pilot program searching for metal-poor stars with LAMOST and follow-up high-resolution observation acquired with the MIKE spectrograph attached to the Magellan II telescope. We performed detailed abundance analysis for eight objects with iron abundances [Fe/H] < -2.0, including five extremely metal-poor (EMP; [Fe/H] < -3.0) stars with two having [Fe/H] < -3.5. Among these objects, three are newly discovered EMP stars, one of which is confirmed for the first time with high-resolution spectral observations. Three program stars are regarded as carbon-enhanced metal-poor (CEMP) stars, including two stars with no enhancement in their neutron-capture elements, which thus possibly belong to the class of CEMP-no stars; one of these objects also exhibits significant enhancement in nitrogen, and is thus a potential carbon and nitrogen-enhanced metal-poor star. The [X/Fe] ratios of the sample stars generally agree with those reported in the literature for other metal-poor stars in the same [Fe/H] range. We also compared the abundance patterns of individual program stars with the average abundance pattern of metal-poor stars and find only one chemically peculiar object with abundances of at least two elements (other than C and N) showing deviations larger than 0.5 dex. The distribution of [Sr/Ba] versus [Ba/H] agrees that an additional nucleosynthesis mechanism is needed aside from a single r-process. Two program stars with extremely low abundances of Sr and Ba support the prospect that both main and weak r-processes may have operated during the early phase of Galactic chemical evolution. The distribution of [C/N] shows that there are two groups of carbon-normal giants with different degrees of mixing. However, it is difficult to explain the observed behavior of the [C/N] of the nitrogen-enhanced unevolved stars based on current data

  11. Stem cell therapy in spinal cord injury: Hollow promise or promising science?

    Directory of Open Access Journals (Sweden)

    Aimee Goel

    2016-01-01

    Full Text Available Spinal cord injury (SCI remains one of the most physically, psychologically and socially debilitating conditions worldwide. While rehabilitation measures may help limit disability to some extent, there is no effective primary treatment yet available. The efficacy of stem cells as a primary therapeutic option in spinal cord injury is currently an area under much scrutiny and debate. Several laboratory and some primary clinical studies into the use of bone marrow mesenchymal stem cells or embryonic stem cell-derived oligodentrocyte precursor cells have shown some promising results in terms of remyelination and regeneration of damaged spinal nerve tracts. More recently,laboratory and early clinical experiments into the use of Olfactory Ensheathing Cells, a type of glial cell derived from olfactory bulb and mucosa have provided some phenomenal preliminary evidence as to their neuroregenerative and neural bridging capacity. This report compares and evaluates some current research into selected forms of embryonic and mesenchymal stem cell therapy as well as olfactory ensheathing cell therapy in SCI, and also highlights some legal and ethical issues surrounding their use. While early results shows promise, more rigorous large scaleclinical trials are needed to shed light on the safety, efficacy and long term viability of stem cell and cellular transplant techniques in SCI.

  12. Results of the Software Process Improvement Efforts of the Early Adopters in NAVAIR 4.0

    National Research Council Canada - National Science Library

    Saint-Amand, David C; Hodgins, Bradley

    2007-01-01

    .... The process improvement efforts described in this paper began in the 1990s and early 2000s. Their process improvement tool sets included the Capability Maturity Model, the Capability Maturity Model (CMM...

  13. Transcription and replication result in distinct epigenetic marks following repression of early gene expression

    OpenAIRE

    Kallestad, Les; Woods, Emily; Christensen, Kendra; Gefroh, Amanda; Balakrishnan, Lata; Milavetz, Barry

    2013-01-01

    Simian Virus 40 (SV40) early transcription is repressed when the product of early transcription, T-antigen, binds to its cognate regulatory sequence, Site I, in the promoter of the SV40 minichromosome. Because SV40 minichromosomes undergo replication and transcription potentially repression could occur during active transcription or during DNA replication. Since repression is frequently epigenetically marked by the introduction of specific forms of methylated histone H3, we characterized th...

  14. Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

    International Nuclear Information System (INIS)

    Beal, Kathryn; McCormick, Beryl; Zelefsky, Michael J.; Borgen, Patrick; Fey, Jane; Goldberg, Jessica; Sacchini, Virgilio

    2007-01-01

    Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size ≤2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterally to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm 3 (range, 20-97 cm 3 ). Patients with ≤47 cm 3 of treated tissue had better cosmetic outcomes than did the women who had >47 cm 3 of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary

  15. Results of the spine-to-rib-cage distraction in the treatment of early onset scoliosis

    Directory of Open Access Journals (Sweden)

    Teli Marco

    2010-01-01

    Full Text Available Background: Growing rod systems have been used in the last 30 years for the treatment of early onset scoliosis (EOS with variable success rates. We report the results of treatment of EOS with a newly developed hybrid rod distraction system applied to the rib cage and spine with a nonfusion technique in a prospective multicenter clinical trial. Materials and Methods: A total of 22 patients affected by progressive EOS resistant to cast and/or brace treatment were enrolled from 2004 to 2005 after informed consent into a trial of surgical treatment with a single spine-to-rib growing rod instrumentation growing spine profiler (GSP. Curves> 60° Cobb in the frontal plane or bending < 50% were addressed with staged anterior annulotomy and fusion and posterior implantation of a GSP rod. Less severe and rigid curves were treated with posterior implantation of GSP only. The elongation of GSP was planned according to spinal growth. Patients were kept in a brace between elongations. Results: A total of 20 patients were available to follow-up with complete data. The mean follow up is 4.1 years. Mean age at time of initial surgery was 5 years (3-8. Nine patients had staged antero-posterior surgeries, 11 posterior only surgeries. Mean spinal growth was 1.9 cm (1.5-2.3 or 0.5 cm per year. Mean coronal Cobb′s angle correction was from 56° to 45°. Major complications affected 40% of patients and included rod failure in 6/20 and crankshaft in 5/20 (all in the anteroposterior surgery group. Conclusion: Treatment of EOS with spine-to-rib growing rod in the present form provides similar correction and complication rates to those published in the series considering traditional single or dual growing rod systems. Based on this, the authors recommend revision of the GSP design and a new clinical trial to test safety and efficacy.

  16. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results.

    Science.gov (United States)

    Sabir, Mohammad; Alam, Mohammad Nazish

    2015-06-01

    The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved.

  17. Extensively coated revision stems in proximally deficient femur: Early results in 15 patients

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2008-01-01

    Full Text Available Background: Hip replacement following failed internal fixation (dynamic hip screw for intertrochanteric fractures or previous hip arthroplasty presents a major surgical challenge. Proximal fitting revision stems do not achieve adequate fixation. Distal fixation with long-stemmed extensively coated cementless implants (like the Solution™ system affords a suitable solution. We present our early results of 15 patients treated with extensively coated cementless revision stems. Materials and Methods: Fifteen patients with severely compromised proximal femora following either failed hip arthroplasty or failed internal fixation (dynamic hip screw fixation for intertrochanteric fractures were operated by the senior author over a two-year period. Eight patients had aseptic loosening of their femoral stems following cemented hip replacements, with severe thinning of their proximal cortices and impending stress fractures. Seven had secondary hip arthritis following failure of long implants for comminuted intertrochanteric or subtrochanteric femoral fractures. All patients were treated by removal of implant (cemented stems/DHS implants and insertion of long-stemmed extensively coated cementless revision (′ Solution™; DePuy, Warsaw (IN, US′ stems along with press-fit acetabular component (Duraloc Cup, DePuy, Warsaw (IN, US. All eight hip revisions needed extended trochanteric osteotomies. Results: All patients were primarily kept in bed on physiotherapy for six weeks and then gradually progressed to weight-bearing walking over the next six to eight weeks. The Harris Hip Scores and patient satisfaction were used for final evaluation. We achieved good results in the short term studied. In our first three patients (all following failed cemented total hip replacements, we resorted to cerclage wiring to hold osteotomised segments (done to facilitate stem removal. The subsequent 12 proceeded without the need for cerclage wiring. One patient had a

  18. Uncertainty and sensitivity analysis of early exposure results with the MACCS Reactor Accident Consequence Model

    International Nuclear Information System (INIS)

    Helton, J.C.; Johnson, J.D.; McKay, M.D.; Shiver, A.W.; Sprung, J.L.

    1995-01-01

    Uncertainty and sensitivity analysis techniques based on Latin hypercube sampling, partial correlation analysis and stepwise regression analysis are used in an investigation with the MACCS model of the early health effects associated with a severe accident at a nuclear power station. The primary purpose of this study is to provide guidance on the variables to be considered in future review work to reduce the uncertainty in the important variables used in the calculation of reactor accident consequences. The effects of 34 imprecisely known input variables on the following reactor accident consequences are studied: number of early fatalities, number of cases of prodromal vomiting, population dose within 10 mi of the reactor, population dose within 1000 mi of the reactor, individual early fatality probability within 1 mi of the reactor, and maximum early fatality distance. When the predicted variables are considered collectively, the following input variables were found to be the dominant contributors to uncertainty: scaling factor for horizontal dispersion, dry deposition velocity, inhalation protection factor for nonevacuees, groundshine shielding factor for nonevacuees, early fatality hazard function alpha value for bone marrow exposure, and scaling factor for vertical dispersion

  19. Promising change, delivering continuity

    DEFF Research Database (Denmark)

    Lund, Jens Friis; Sungusia, Eliezeri; Mabele, Mathew Bukhi

    2017-01-01

    REDD+ is an ambition to reduce carbon emissions from deforestation and forest degradation in the Global South. This ambition has generated unprecedented commitment of political support and financial funds for the forest-development sector. Many academics and people-centered advocacy organizations...... have conceptualized REDD+ as an example of ‘‘green grabbing” and have voiced fears of a potential global rush for land and trees. In this paper we argue that, in practice and up until now, REDD+ resembles longstanding dynamics of the development and conservation industry, where the promise of change...... becomes a discursive commodity that is constantly reproduced and used to generate value and appropriate financial resources. We thus argue for a re-conceptualization of REDD+ as a conservation fad within the broader political economy of development and conservation. We derive this argument from a study...

  20. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.

    Science.gov (United States)

    Creswell, Jacob; Codlin, Andrew J; Andre, Emmanuel; Micek, Mark A; Bedru, Ahmed; Carter, E Jane; Yadav, Rajendra-Prasad; Mosneaga, Andrei; Rai, Bishwa; Banu, Sayera; Brouwer, Miranda; Blok, Lucie; Sahu, Suvanand; Ditiu, Lucica

    2014-01-02

    The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the

  1. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    Directory of Open Access Journals (Sweden)

    Toischer Karl

    2009-09-01

    failure: 3; stroke: 1; cancer: 1; unknown reasons: 3. NYHA-classification significantly improved after CABG with CE from 2.2 ± 0.9 preoperative to 1.7 ± 0.9 postoperative. CCS also changed from 2.4 ± 1.0 to 1.5 ± 0.8 Conclusion Early results of coronary endarterectomy are acceptable with respect to mortality, NYHA & CCS. This technique offers a valuable surgical option for patients with endstage coronary artery disease in whom complete revascularization otherwise can not be obtained. Careful patient selection will be necessary to assure the long-term benefit of this procedure.

  2. Early results of surgical intervention for elbow deformity in cerebral palsy based on degree of contracture.

    Science.gov (United States)

    Carlson, Michelle G; Hearns, Krystle A; Inkellis, Elizabeth; Leach, Michelle E

    2012-08-01

    Elbow flexion posture, caused by spasticity of the muscles on the anterior surface of the elbow, is the most common elbow deformity seen in patients with cerebral palsy. This study retrospectively evaluated early results of 2 surgical interventions for elbow flexion deformities based on degree of contracture. We hypothesized that by guiding surgical treatment to degree of preoperative contracture, elbow extension and flexion posture angle at ambulation could be improved while preserving maximum flexion. Eighty-six patients (90 elbows) were treated for elbow spasticity due to cerebral palsy. Seventy-one patients (74 elbows) were available for follow-up. Fifty-seven patients with fixed elbow contractures less than 45° were surgically treated with a partial elbow muscle lengthening, which included partial lengthening of the biceps and brachialis and proximal release of the brachioradialis. Fourteen patients (17 elbows) with fixed elbow contractures ≥ 45° had a more extensive full elbow release, with biceps z-lengthening, partial brachialis myotomy, and brachioradialis proximal release. Age at surgery averaged 10 years (range, 3-20 y) for partial lengthening and 14 years (range, 5-20 y) for full elbow release. Follow-up averaged 22 months (range, 7-144 mo) for partial lengthening and 18 months (range, 6-51 mo) for full elbow release. Both groups achieved meaningful improvement in flexion posture angle at ambulation, active and passive extension, and total range of motion. Elbow flexion posture angle at ambulation improved by 57° and active extension increased 17° in the partial lengthening group, with a 4° loss of active flexion. In the full elbow release group, elbow flexion posture angle at ambulation improved 51° and active extension improved 38°, with a loss of 19° of active flexion. Surgical treatment of spastic elbow flexion in cerebral palsy can improve deformity. We obtained excellent results by guiding the surgical intervention by the amount of

  3. Only fixation for cervical spondylosis: Report of early results with a preliminary experience with 6 cases

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2013-01-01

    Full Text Available Aim: The author reports early post-operative outcome and preliminary experience with an alternative form of treatment of cervical degenerative or spondylotic disease leading to spinal canal stenosis that involves fixation-arthrodesis of the affected spinal segment using one or two (double insurance transarticular screws for each joint. Materials and Methods: During the period of months from March 2013 to July 2013, six patients having cervical spondylotic cord compression were treated with transarticular method of screw fixation of the involved segments. The operation involved section of the spinous process at its base, opening up of the facet joint, denuding of articular cartilage, placement of intraarticular cavity bone graft chips and insertion of either a single or two transarticular screws at each level. The fixation was done in four levels in four patients and at two levels in two patients. Japanese Orthopedic Association score, visual analog scale (neck pain and Odom′s criteria were used to monitor the clinical status of the patients before and after the surgery and at follow-up. Results: Immediate post-operative and a relatively short-term post-operative outcome was remarkably gratifying. During the average period of follow-up of 6 months (range: 3-8 months; there was varying degree of recovery of symptoms. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened after treatment. During the period of follow-up, all patients showed remarkable and progressive recovery in symptoms. Conclusions: Vertical instability and telescoping, listhesis or overriding of the facets on physical activity seems to be the defining phenomenon in pathogenesis of cervical spondylotic disease. The clinical outcome in our patients suggest that only fixation of the spinal segment can be a rationale form of treatment. Transarticular method of treatment is a simple, safe and

  4. ECOLOGICAL RESEARCH IN THE LARGE-SCALE BIOSPHERE–ATMOSPHERE EXPERIMENT IN AMAZONIA: EARLY RESULTS.

    Science.gov (United States)

    M. Keller; A. Alencar; G. P. Asner; B. Braswell; M. Bustamente; E. Davidson; T. Feldpausch; E. Fern ndes; M. Goulden; P. Kabat; B. Kruijt; F. Luizao; S. Miller; D. Markewitz; A. D. Nobre; C. A. Nobre; N. Priante Filho; H. Rocha; P. Silva Dias; C von Randow; G. L. Vourlitis

    2004-01-01

    The Large-scale Biosphere–Atmosphere Experiment in Amazonia (LBA) is a multinational, interdisciplinary research program led by Brazil. Ecological studies in LBA focus on how tropical forest conversion, regrowth, and selective logging influence carbon storage, nutrient dynamics, trace gas fluxes, and the prospect for sustainable land use in the Amazon region. Early...

  5. Early Rehabilitation of Great Terror in 1939–1941: Intentions and Results

    Directory of Open Access Journals (Sweden)

    Геннадий Аркадьевич Бордюгов

    2013-12-01

    Full Text Available The article analyzes the early attempts of the Stalin regime to investigate the cases of «breaking the socialist law» in 1937–1938. On the basis of the documents of central and local archives, the author examines the methods of this process, its scope, participants as well as the reasons for its abandoning.

  6. Management of Very Early-onset Fetal Growth Restriction: Results from 92 Consecutive Cases.

    Science.gov (United States)

    Hoellen, Friederike; Beckmann, Annika; Banz-Jansen, Constanze; Weichert, Jan; Rody, Achim; Bohlmann, Michael K

    2016-01-01

    To evaluate management of early-onset intrauterine growth restriction (IUGR) and to define outcome according to obstetric setting. During an 11-year period (2000-2011), data of patients presenting with IUGR and preterm delivery of less than 30 weeks of gestation at a tertiary perinatal center were retrospectively reviewed. A total of 92 pregnancies were investigated. Delivery was indicated for fetal reasons in 38 out of 92 patients. Sixteen children of our cohort died within one year post partum, out of which eight had suffered from severe early-onset IUGR causing iatrogenic preterm delivery. Concerning the fetal outcome, gestational age at delivery and antenatal exposure to corticosteroids were found to be crucial. In some cases, respiratory distress syndrome prophylaxis and a "wait and see" approach to management in favor of a prolongation of the pregnancy might be favorable. Randomized prospective trials in early-onset IUGR with threatened preterm deliveries are needed in order to define guidelines for an individually tailored management of early-onset preterm infants. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  7. Tennessee Promise: A Response to Organizational Change

    Science.gov (United States)

    Littlepage, Ben; Clark, Teresa; Wilson, Randal; Stout, Logan

    2018-01-01

    Community colleges in Tennessee, either directly or indirectly, experienced unprecedented change as a result of Tennessee Promise. The present study explored how student support service administrators at three community colleges responded to organizational change as a result of the Tennessee Promise legislation. Investigators selected community…

  8. Early removal of odontoma resulting in spontaneous eruption of the impacted teeth

    Directory of Open Access Journals (Sweden)

    Achmad Harijadi

    2010-06-01

    Full Text Available Background: Compound odontomas in the anterior maxilla during mixed dentition frequently cause obstruction to the eruption pathway of permanent upper anterior teeth. Removal of the odontomas may or may not lead to spontaneous eruption of the impacted teeth depending on the age when the surgery is performed, the size of the lesion, and the stage of tooth development of the involved teeth. Purpose: This paper attempts to emphasize the importance of early removal of compound odontoma to enable spontaneous eruption of the affected teeth. Case: A case of odontoma in the anterior maxilla causing failure of eruption and delayed root formation of upper right permanent lateral incisor and canine in a 10-year-old male patient is presented. Case management: The odontoma was surgically removed under general anesthesia and histology result confirmed the diagnosis of compound odontoma. A three-year post surgical follow up showed spontaneous eruption as well as continued root formation of the two affected teeth. Conclusion: Removal of odontoma may lead to spontaneous eruption of the affected teeth if their root development are not completed.Latar belakang: Compound odontoma pada daerah anterior maksila pada masa geligi pergantian sering menyebabkan hambatan erupsi pada gigi permanen penggantinya. Kemungkinan terjadinya erupsi spontan gigi permanen yang impaksi setelah pengambilan odontoma tergantung dari: umur penderita pada saat dilakukan operasi, ukuran lesi odontoma dan tahapan perkembangan gigi permanen yang terlibat. Tujuan: Laporan kasus ini ingin menekankan pentingnya pengambilan compound odontoma sedini mungkin untuk memberi kesempatan tumbuhnya gigi permanen yang terlibat dan erupsi secara spontan. Kasus: Ditampilkan sebuah kasus compound odontoma pada regio maksila anterior menyebabkan gagalnya erupsi dan terlambatnya pembentukan akar gigi insisif kedua dan kaninus permanent rahang atas kanan pada penderita anak laki-laki berumur 10 tahun

  9. Analysis of aberrant methylation on promoter sequences of tumor suppressor genes and total DNA in sputum samples: a promising tool for early detection of COPD and lung cancer in smokers

    Directory of Open Access Journals (Sweden)

    Guzmán Leda

    2012-07-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is a disorder associated to cigarette smoke and lung cancer (LC. Since epigenetic changes in oncogenes and tumor suppressor genes (TSGs are clearly important in the development of LC. In this study, we hypothesize that tobacco smokers are susceptible for methylation in the promoter region of TSGs in airway epithelial cells when compared with non-smoker subjects. The purpose of this study was to investigate the usefulness of detection of genes promoter methylation in sputum specimens, as a complementary tool to identify LC biomarkers among smokers with early COPD. Methods We determined the amount of DNA in induced sputum from patients with COPD (n = 23, LC (n = 26, as well as in healthy subjects (CTR (n = 33, using a commercial kit for DNA purification, followed by absorbance measurement at 260 nm. The frequency of CDKN2A, CDH1 and MGMT promoter methylation in the same groups was determined by methylation-specific polymerase chain reaction (MSP. The Fisher’s exact test was employed to compare frequency of results between different groups. Results DNA concentration was 7.4 and 5.8 times higher in LC and COPD compared to the (CTR (p  Conclusions We provide evidence that aberrant methylation of TSGs in samples of induced sputum is a useful tool for early diagnostic of lung diseases (LC and COPD in smoker subjects. Virtual slides The abstract MUST finish with the following text: Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1127865005664160

  10. Early results of metal on metal articulation total hip arthroplasty in young patients.

    Science.gov (United States)

    Mohamad, J A; Kwan, M K; Merican, A M; Abbas, A A; Kamari, Z H; Hisa, M K; Ismail, Z; Idrus, R M

    2004-12-01

    We report our early experience of 20 cases of metal on metal articulation total hip arthroplasty in 19 young patients. Avascular necrosis of the femoral head (63%) was the commonest diagnosis for patients undergoing this procedure, followed by osteoarthritis (21%). In general, most of the patients were young and physically active with an average age of 43.1 years (range, 25 to 58 years). The average follow-up period was 18 months (range, 7 to 46 months). The mean total Harris Hip Score preoperatively and at final follow-up was 31 points and 89 points respectively. The mean total Pain Score improved from an average of 11.5 to 41.1 points at final follow-up. Sixteen (84%) of the patients had a good to excellent hip score. There was one dislocation, which stabilized after reduction and conservative management. One case of early infection underwent a two-staged revision.

  11. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    Science.gov (United States)

    Hals, F. A.

    1981-03-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  12. Radiation pneumonitis: a complication resulting from combined radiation and chemotherapy for early breast cancer

    International Nuclear Information System (INIS)

    Gez, E.; Sulkes, A.; Isacson, R.; Catane, R.; Weshler, Z.

    1985-01-01

    Described is a patient with early breast carcinoma who developed clinical radiation pneumonitis during primary radiation therapy and concomitant chemotherapy that included prednisone. This syndrome developed three days following abrupt steroid withdrawal. Retrieval of steroids brought complete resolution of the clinical and radiological findings. Although this syndrome is rare, it is recommended that steroid therapy in a patient previously irradiated to the chest be avoided

  13. Early Post Traumatic Seizures in Military Personnel Result in Long Term Disability

    Science.gov (United States)

    2013-10-01

    activity will be determined. EEG will be displayed in the ICU and monitored by specially trained nurses to detect electrographic seizures. Automated...Cerebral Metabolic Crisis After TBI Influences Outcome Despite Adequate Hemodynamic Resuscitation.. Neurocrit Care. 2012 Aug;17(1):49-57. 5. Irimia...McArthur DL, Etchepare M, Vespa PM. Early cerebral metabolic crisis after TBI influences outcome despite adequate hemodynamic resuscitation

  14. Assessment of renal perfusion with contrast-enhanced ultrasound: Preliminary results in early diabetic nephropathies.

    Science.gov (United States)

    Dong, Yi; Wang, Wen-Ping; Lin, Pan; Fan, Peili; Mao, Feng

    2016-01-01

    We performed a prospective study to evaluate the value of contrast-enhanced ultrasound (CEUS) in quantitative evaluation of renal cortex perfusion in patients suspected of early diabetic nephropathies (DN), with the estimated GFR (MDRD equation) as the gold standard. The study protocol was approved by the hospital review board; each patient gave written informed consent. Our study included 46 cases (21 males and 25 females, mean age 55.6 ± 4.14 years) of clinical confirmed early DN patients. After intravenous bolus injection of 1 ml sulfur hexafluoride microbubbles of ultrasound contrast agent, real time CEUS of renal cortex was performed successively using a 2-5 MHz convex probe. Time-intensity curves (TICs) and quantitative indexes were created with Qlab software. Receiver operating characteristic (ROC) curves were used to predict the diagnostic criteria of CEUS quantitative indexes, and their diagnostic efficiencies were compared with resistance index (RI) and peak systolic velocity (PSV) of renal segmental arteries by chi square test. Our control group included forty-five healthy volunteers. Difference was considered statistically significant with P  0.05). CEUS might be helpful to improve early diagnosis of DN by quantitative analyses. AUC and DPI might be valuable quantitative indexes.

  15. Results from a pediatric surgical centre justify early intervention in disorders of sex development.

    Science.gov (United States)

    Crawford, Jennifer M; Warne, Garry; Grover, Sonia; Southwell, Bridget R; Hutson, John M

    2009-02-01

    Controversy persists surrounding early management of disorders of sex development. We assessed genital appearance, gender identity, and quality of life in prepubertal children who have had early surgical intervention. Children treated for disorders of sex development who were 5 to 10 years of age were eligible (n = 54). Children were scored (modified Creighton scale) for anatomical and cosmetic outcome, and both patients and parents completed PedsQL quality-of-life and gender identity questionnaires, with ethics approval. Of 54 patients, 41 presented for review. Treatment began at 13.2 (1.8-250.1) months (median; range) and were reviewed at 7.5 +/- 2.1 (mean +/- SD) years of age. Nineteen were raised as girls and 22 as boys. Girls had good (85%) or satisfactory (15%) anatomical/cosmetic outcome, whereas 52% boys had good, 38% satisfactory, and 10% poor cosmetic outcomes. On gender identity questionnaire, boys scored 3.9 +/- 0.4 (mean +/- SD) and girls 3.6 +/- 0.5; 1 of 19 boys and 3 of 19 girls had lower scores, suggesting risk of gender identity disorder. Quality-of-life scores were 80+ for physical and 65 to 80 for psychosocial scores. Early intervention is generally associated with positive outcomes for patients and parents. Girls had better anatomical outcomes than boys, and gender dysphoria risks were low in both sexes.

  16. The Mars Science Laboratory Mission: Early Results from Gale Crater Landing Site

    Science.gov (United States)

    Flatow, I.; Grotzinger, J. P.; Blake, D.; Crisp, J. A.; Edgett, K. S.; Gellert, R.; Gomez-Elvira, J.; Hassler, D. M.; Mahaffy, P. R.; Malin, M. C.; Meyer, M. A.; Mitrofanov, I.; Vasavada, A. R.; Wiens, R. C.

    2012-12-01

    The Mars Science Laboratory rover, Curiosity, landed at Gale Crater on August 5th (PDT) and initiated an investigation of modern and ancient environments. The 155-km diameter Gale Crater was chosen as Curiosity's field site based on several attributes: the interior Mount Sharp preserves a succession of flat-lying strata extending almost 5 km above the elevation of the landing site; the lower few hundred meters of the mound show a progression with relative age from clay-bearing to sulfate-bearing strata, separated by an unconformity from overlying likely anhydrous strata; the landing ellipse is characterized by a mixture of alluvial fan and high thermal inertia/high albedo stratified deposits; and a number of stratigraphically/geomorphically distinct fluvial features. Gale's regional context and strong evidence for a progression through multiple potentially habitable environments, represented by a stratigraphic record of extraordinary extent, ensure preservation of a rich record of the environmental history of early Mars. Curiosity has an expected lifetime of at least one Mars year (~23 months), and drive capability of at least 20 km. The MSL science payload was specifically assembled to assess habitability and includes a gas chromatograph-mass spectrometer and gas analyzer that will search for organic carbon in rocks, regolith fines, and the atmosphere (SAM); an x-ray diffractometer that will determine mineralogical diversity (CheMin); focusable cameras that can image landscapes and rock/regolith textures in natural color (MAHLI, Mastcam); an alpha-particle x-ray spectrometer for in situ determination of rock and soil chemistry (APXS); a laser-induced breakdown spectrometer to remotely sense the chemical composition of rocks and minerals (ChemCam); an active/passive neutron spectrometer designed to search for water in rocks/regolith (DAN); a weather station to measure modern-day environmental variables (REMS); and a sensor designed for continuous monitoring of

  17. Lipid raft disarrangement as a result of neuropathological progresses: a novel strategy for early diagnosis?

    Science.gov (United States)

    Marin, R; Rojo, J A; Fabelo, N; Fernandez, C E; Diaz, M

    2013-08-15

    Lipid rafts are the preferential site of numerous membrane signaling proteins which are involved in neuronal functioning and survival. These proteins are organized in multiprotein complexes, or signalosomes, in close contact with lipid classes particularly represented in lipid rafts (i.e. cholesterol, sphingolipids and saturated fatty acids), which may contribute to physiological responses leading to neuroprotection. Increasing evidence indicates that alteration of lipid composition in raft structures as a consequence of neuropathologies, such as Alzheimer's disease (AD) and Parkinson's disease (PD), causes a dramatic increase in lipid raft order. These phenomena may correlate with perturbation of signalosome activities, likely contributing to neurodegenerative progression. Interestingly, significant disruption of stable raft microenvironments has been already observed in the first stages of either AD or PD, suggesting that these alterations may represent early events in the neuropathological development. In this regard, the search for biochemical markers, such as specific metabolic products altered in the brain at the first steps of the disease, presently represents an important challenge for early diagnostic strategies. Alterations of these biomarkers may be reflected in either plasma or cerebrospinal fluid, thus representing a potential strategy to predict an accurate diagnosis. We propose that pathologically-linked lipid raft markers may be interesting candidates to be explored at this level, although it has not been studied so far to what extent alteration of different signalosome components may be reflected in peripheral fluids. In this mini-review, we will discuss on relevant aspects of lipid rafts that contribute to the modulation of neuropathological events related to AD and PD. An interesting hypothesis is that anomalies on raft biomarkers measured at peripheral fluids might mirror the lipid raft pathology observed in early stages of AD and PD. Copyright

  18. Early industrial stage of modernization pre-revolutionary Russia: sources, tendencies and results

    Directory of Open Access Journals (Sweden)

    Татьяна Михайловна Братченко

    2010-03-01

    Full Text Available In the article the sources, occurrence and development of industrialization of pre-revolutionary Russia at its early stage are analyzed. The authors have shown the basic tendencies and directions of these processes. In the article the set of the reasons of industrialization of Russia is opened, among which not internal conditions, and external factors were basic. Is shown also, that the earli-industrial modernization in the liberal - conservative form has put a society in the extremely unstable, «transitive» condition, that was fraught with social shocks.

  19. The Role of Indocyanine Green for Robotic Partial Nephrectomy: Early Results, Limitations and Future Directions

    Directory of Open Access Journals (Sweden)

    Zachary Klaassen

    2014-07-01

    Full Text Available The surgical management of small renal masses has continued to evolve, particularly with the advent of the robotic partial nephrectomy (RPN. Recent studies at high volume institutions utilizing near infrared imaging with indocyanine green (ICG fluorescent dye to delineate renal tumor anatomy has generated interest among robotic surgeons for improving warm ischemia times and positive margin rate for RPN. To date, early studies suggest positive margin rate using ICG is comparable to traditional RPN, however this technology improves visualization of the renal vasculature allowing selective clamping or zero ischemia. The precise combination of fluorescent compound, dose, and optimal tumor anatomy for ICG RPN has yet to be elucidated.

  20. Realizing the promises of marine biotechnology

    NARCIS (Netherlands)

    Luiten, EEM; Akkerman, [No Value; Koulman, A; Kamermans, P; Reith, H; Barbosa, MJ; Sipkema, D; Wijffels, RH

    High-quality research in the field of marine biotechnology is one of the key-factors for successful innovation in exploiting the vast diversity of marine life. However, fascinating scientific research with promising results and claims on promising potential applications (e.g. for pharmaceuticals,

  1. Realizing the promises of marine biotechnology

    NARCIS (Netherlands)

    Luiten, E.E.M.; Akkerman, I.; Koulman, A.; Kamermans, P.; Reith, H.; Barbosa, M.J.; Sipkema, D.; Wijffels, R.H.

    2003-01-01

    High-quality research in the field of marine biotechnology is one of the key-factors for successful innovation in exploiting the vast diversity of marine life. However, fascinating scientific research with promising results and claims on promising potential applications (e.g. for pharmaceuticals,

  2. Profile Modifications Resulting from Early High-harmonic Fast Wave heating in NSTX

    International Nuclear Information System (INIS)

    Mendard, J.E.; LeBlanc, Wilson J.R.; Sabbagh, S.A.; Stutman, D.; Swain, D.W.

    2001-01-01

    Experiments have been performed in the National Spherical Torus Experiment (NSTX) to inject high harmonic fast wave (HHFW) power early during the plasma current ramp-up in an attempt to reduce the current penetration rate to raise the central safety factor during the flattop phase of the discharge. To date, up to 2 MW of HHFW power has been coupled to deuterium plasmas as early as t = 50 ms using the slowest interstrap phasing of k|| approximately equals 14 m(superscript)-1 (nf = 24). Antenna-plasma gap scans have been performed and find that for small gaps (5-8 cm), electron heating is observed with relatively small density rises and modest reductions in current penetration rate. For somewhat larger gaps (10-12 cm), weak electron heating is observed but with a spontaneous density rise at the plasma edge similar to that observed in NSTX H-modes. In the larger gap configuration, EFIT code reconstructions (without MSE [motional Stark effect]) find that resistive flux consumption is reduced as much as 30%, the internal inductance is maintained below 0.6 at 1 MA into the flattop, q(0) is increased significantly, and the MHD stability character of the discharges is strongly modified

  3. CMS Results of Grid-related activities using the early deployed LCG Implementations

    CERN Document Server

    Coviello, Tommaso; De Filippis, Nicola; Donvito, Giacinto; Maggi, Giorgio; Pierro, A; Bonacorsi, Daniele; Capiluppi, Paolo; Fanfani, Alessandra; Grandi, Claudio; Maroney, Owen; Nebrensky, H; Donno, Flavia; Jank, Werner; Sciabà, Andrea; Sinanis, Nick; Colling, David; Tallini, Hugh; MacEvoy, Barry C; Wang, Shaowen; Kaiser, Joseph; Osman, Asif; Charlot, Claude; Semenjouk, I; Biasotto, Massimo; Fantinel, Sergio; Corvo, Marco; Fanzago, Federica; Mazzucato, Mirco; Verlato, Marco; Go, Apollo; Khan Chia Ming; Andreozzi, S; Cavalli, A; Ciaschini, V; Ghiselli, A; Italiano, A; Spataro, F; Vistoli, C; Tortone, G

    2004-01-01

    The CMS Experiment is defining its Computing Model and is experimenting and testing the new distributed features offered by many Grid Projects. This report describes use by CMS of the early-deployed systems of LCG (LCG-0 and LCG-1). Most of the used features here discussed came from the EU implemented middleware, even if some of the tested capabilities were in common with the US developed middleware. This report describes the simulation of about 2 million of CMS detector events, which were generated as part of the official CMS Data Challenge 04 (Pre-Challenge-Production). The simulations were done on a CMS-dedicated testbed (CMS-LCG-0), where an ad-hoc modified version of the LCG-0 middleware was deployed and where the CMS Experiment had a complete control, and on the official early LCG delivered system (with the LCG-1 version). Modifications to the CMS simulation tools for events produc tion where studied and achieved, together with necessary adaptations of the middleware services. Bilateral feedback (betwee...

  4. Results of a prospective randomized controlled trial of early ambulation for patients with lower extremity autografts.

    Science.gov (United States)

    Lorello, David John; Peck, Michael; Albrecht, Marlene; Richey, Karen J; Pressman, Melissa A

    2014-01-01

    It is common practice to keep those patients with lower extremity autografts immobile until post-operative day (POD) 5. There is however inherent risks associated with even short periods of immobility. As of now there are no randomized controlled trials looking at early ambulation of patients with lower extremity autografts in the burn community.The objective of this study was to show that patients who begin ambulation within 24 hours of lower extremity autografting will have no increased risk of graft failure than those patients who remain immobile until POD 5. Thirty-one subjects who received autografts to the lower extremity were randomized after surgery into either the early ambulation group (EAG;17 subjects) or the standard treatment group (STG;14 subjects). Those subjects randomized to the EAG began ambulating with physical therapy on POD 1. Subjects in the STG maintained bed rest until POD 5. There was no difference in the number of patients with graft loss in either the EAG or STG on POD 5, and during any of the follow-up visits. No subjects required regrafting. There was a significant difference in the mean minutes of ambulation, with the EAG ambulating longer than the STG (EAG 23.4 minutes [SD 12.03], STG 14.1 [SD 9.00], P=.0235) on POD 5. Burn patients with lower extremity autografts can safely ambulate on POD 1 without fear of graft failure compared with those patients that remain on bed rest for 5 days.

  5. Early effects of water inflow into a deposition hole. Laboratory tests results

    International Nuclear Information System (INIS)

    Sanden, Torbjoern; Boergesson, Lennart

    2010-12-01

    During the installation of buffer and canister in a deposition hole a number of different problems can arise. The problems are mainly connected to water flow from fractures in the rock into the deposition hole. At some conditions it probably will be necessary to protect the installed buffer blocks with a special sheet made of rubber or plastic. This report deals with two processes that can occur and are possible to strongly influence the buffer during installation: 1. Erosion. Erosion of bentonite from the deposition hole up to the voids in the tunnel backfill. This process will continue until a tunnel plug have been built and the voids in the backfill are filled with water. 2. Heave. Early wetting of the pellets filling may cause a heave of the buffer blocks that will decrease the density of the buffer. An erosion model has been suggested /Sanden et al. 2008b/ which makes it possible to estimate the amount of eroded material for a certain water flow rate during a certain time. In order to verify the model and investigate how the buffer in a deposition hole behaves when exposed to a water flow, a number of different tests have been performed: - Test type 1. Simulation of water flow out from a deposition hole. The deposition hole was made of steel and had a radial scale of 1:4 and a height of 0.6 meter. The pellets slot was scaled 1:1. After filling the deposition hole with buffer blocks and pellets, a constant water flow was applied in a point at the bottom. The discharged water at the top was collected and the amount of eroded material determined. The displacement of the blocks and pellets surfaces was also measured during the test. - Test type 2. The influence of test length on the erosion rate was investigated by performing tests with Plexiglas tubes of different lengths (0.4 and 4 meter). The tubes were positioned vertically, filled with pellets and a point inflow was applied in the bottom. The discharged water was collected at the top and the amount of eroded

  6. Early effects of water inflow into a deposition hole. Laboratory tests results

    Energy Technology Data Exchange (ETDEWEB)

    Sanden, Torbjoern; Boergesson, Lennart (Clay Technology AB, Lund (Sweden))

    2010-12-15

    During the installation of buffer and canister in a deposition hole a number of different problems can arise. The problems are mainly connected to water flow from fractures in the rock into the deposition hole. At some conditions it probably will be necessary to protect the installed buffer blocks with a special sheet made of rubber or plastic. This report deals with two processes that can occur and are possible to strongly influence the buffer during installation: 1. Erosion. Erosion of bentonite from the deposition hole up to the voids in the tunnel backfill. This process will continue until a tunnel plug have been built and the voids in the backfill are filled with water. 2. Heave. Early wetting of the pellets filling may cause a heave of the buffer blocks that will decrease the density of the buffer. An erosion model has been suggested /Sanden et al. 2008b/ which makes it possible to estimate the amount of eroded material for a certain water flow rate during a certain time. In order to verify the model and investigate how the buffer in a deposition hole behaves when exposed to a water flow, a number of different tests have been performed: - Test type 1. Simulation of water flow out from a deposition hole. The deposition hole was made of steel and had a radial scale of 1:4 and a height of 0.6 meter. The pellets slot was scaled 1:1. After filling the deposition hole with buffer blocks and pellets, a constant water flow was applied in a point at the bottom. The discharged water at the top was collected and the amount of eroded material determined. The displacement of the blocks and pellets surfaces was also measured during the test. - Test type 2. The influence of test length on the erosion rate was investigated by performing tests with Plexiglas tubes of different lengths (0.4 and 4 meter). The tubes were positioned vertically, filled with pellets and a point inflow was applied in the bottom. The discharged water was collected at the top and the amount of eroded

  7. Early Results of the PETTICOAT Technique for the Management of Acute Type A Aortic Dissection.

    Science.gov (United States)

    Kotha, Vamshi Krishna; Pozeg, Zlatko I; Herget, Eric J; Moon, Michael C; Appoo, Jehangir J

    2017-08-01

    Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia. In Type B dissection, the PETTICOAT (Provisional Extension To Induce Complete Attachment) technique, which entails stent graft coverage of the primary intimal tear followed by bare metal stent placement distally, may improve true lumen caliber and promote false lumen thrombosis without increasing the risk of spinal cord ischemia, as intercostal branches remain perfused through the bare metal stents. The technique of hybrid arch with surgical creation of a Dacron landing zone covering a stent graft in the proximal descending aorta and bare metal stents in the thoraco-abdominal aorta is a promising concept in the treatment of ATAAD.

  8. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  9. Results of a survey of the treatment policy for early stage tongue and oral floor cancer

    International Nuclear Information System (INIS)

    Asakura, Kohji; Kataura, Akikatsu; Hareyama, Masato

    1998-01-01

    To realize the treatment policy for early stage oral cancer, a survey of 102 institutes in Japan was performed by questionnaire. A majority of the otolaryngologists preferred surgery for the treatment of T1N0 and T2N0 cases of oral cancer. The preferred method of treatment for the T1N0 cases was simple tumor resection and that for the T2N0 cases was extended tumor resection with plastic surgery, elective neck dissection and combined radio-and/or chemotherapy. A majority of the radiologists preferred brachytherapy for T1N0 and non-invasive T2N0 cases. For invasive cases of T2N0 oral cancer, radiologists preferred either surgical treatment or the combination of brachytherapy and external irradiation. (author)

  10. Planck early results. XV. Spectral energy distributions and radio continuum spectra of northern extragalactic radio sources

    DEFF Research Database (Denmark)

    Aatrokoski, J.; Lähteenmäki, A.; Lavonen, N.

    2011-01-01

    Spectral energy distributions (SEDs) and radio continuum spectra are presented for a northern sample of 104 extragalactic radio sources, based on the Planck Early Release Compact Source Catalogue (ERCSC) and simultaneous multifrequency data. The nine Planck frequencies, from 30 to 857 GHz......, are complemented by a set of simultaneous observations ranging from radio to gamma-rays. This is the first extensive frequency coverage in the radio and millimetre domains for an essentially complete sample of extragalactic radio sources, and it shows how the individual shocks, each in their own phase...... of development, shape the radio spectra as they move in the relativistic jet. The SEDs presented in this paper were fitted with second and third degree polynomials to estimate the frequencies of the synchrotron and inverse Compton (IC) peaks, and the spectral indices of low and high frequency radio data...

  11. Results of high energy x-ray therapy of gastric carcinoma, 3. Early gastric carcinoma (Tl carcinoma)

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, S; Asakawa, H; Otawa, H; Matsumoto, K [Miyagi Seijinbyo Center (Japan)

    1981-11-01

    A total of 25 cases with early gastric carcinoma, of which 10 cases were followed by gastrectomy, were given a combined radiotherapy with 5-Fu, Ft 207 or MFC at Miyagi Seijinbyo Center. Histologic examinations of biopsy specimens revealed the disappearance of cancer cells in five (42%) of 12 cases and those of serial specimens of the resected stomach showed the complete disappearance of cancer cells in three (27%) of 11 lesions (10 cases). Five year survival rate in 15 non-resected cases was only 30%. From these results, it was suggested that a combined radiotherapy of early gastric carcinoma should not be chosen as a curative treatment procedure but it might be valuable, if early carcinoma was thought to be inoperable because of other medical reasons.

  12. Result

    African Journals Online (AJOL)

    Tsinuel

    BACKGROUND: Neonatal deaths in general, early neonatal deaths in particular now represent two- third of infant deaths and one-third of under-five deaths worldwide. Therefore, improving newborn survival is a major priority in child health today. Negotiation of improved neonatal health care practice into the community ...

  13. Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results.

    Science.gov (United States)

    Kotoula, Aggeliki; Gardikis, Stefanos; Tsalkidis, Aggelos; Mantadakis, Elpis; Zissimopoulos, Athanassios; Kambouri, Katerina; Deftereos, Savvas; Tripsianis, Gregorios; Manolas, Konstantinos; Chatzimichael, Athanassios; Vaos, George

    2009-01-01

    In order to establish the most reliable marker for distinguishing urinary tract infections (UTI) with and without renal parenchymal involvement (RPI), we recorded the clinical features and admission leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum procalcitonin (PCT) in 57 children (including 43 girls) aged 2-108 months admitted with a first episode of UTI. RPI was evaluated by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy within 7 days of admission. To establish cut-off points for ESR, CRP, and PCT, we used receiver operating characteristics curves and compared the area under the curve for ESR, CRP, and PCT. Twenty-seven children were diagnosed as having RPI based on positive renal scintigraphy. A body temperature of >38 degrees C, a history of diarrhea, and poor oral intake were more common in patients with RPI. ESR, CRP, and PCT, but not leukocyte count, were significantly higher in patients with RPI (P UTI than ESR and CRP. Using a cut-off value of 0.85 ng/ml, PCT had the best performance, with sensitivity, specificity, and positive and negative predictive values of 89%, 97%, 96%, and 91% respectively. Serum PCT is a better marker than ESR, CRP, and leukocyte count for the early prediction of RPI in children with a first episode of UTI.

  14. Disease management of early childhood caries: results of a pilot quality improvement project.

    Science.gov (United States)

    Ng, Man Wai; Torresyap, Gay; White, Alex; Melvin, Patrice; Graham, Dionne; Kane, Daniel; Scoville, Richard; Ohiomoba, Henry

    2012-08-01

    The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). We tested a disease management (DM) approach in children younger than age 60 months with ECC. After 30 months, for the 403 and 234 DM patients at Children's Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.

  15. Planck Early Results. XV. Spectral Energy Distributions and Radio Continuum Spectra of Northern Extragalactic Radio Sources

    Science.gov (United States)

    Aatrokoski, J.; Ade, P. A. R.; Aghanim, N.; Aller, H. D.; Aller, M. F.; Angelakis, E.; Amaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; hide

    2011-01-01

    Spectral energy distributions (SEDs) and radio continuum spectra are presented for a northern sample of 104 extragalactic radio sources. based on the Planck Early Release Compact Source Catalogue (ERCSC) and simultaneous multi frequency data. The nine Planck frequencies, from 30 to 857 GHz, are complemented by a set of simultaneous observations ranging from radio to gamma-rays. This is the first extensive frequency coverage in the radio and millimetre domains for an essentially complete sample of extragalactic radio sources, and it shows how the individual shocks, each in their own phase of development, shape the radio spectra as they move in the relativistic jet. The SEDs presented in this paper were fitted with second and third degree polynomials to estimate the frequencies of the synchrotron and inverse Compton (IC) peaks, and the spectral indices of low and high frequency radio data, including the Planck ERCSC data, were calculated. SED modelling methods are discussed, with an emphasis on proper. physical modelling of the synchrotron bump using multiple components. Planck ERCSC data also suggest that the original accelerated electron energy spectrum could be much harder than commonly thought, with power-law index around 1.5 instead of the canonical 2.5. The implications of this are discussed for the acceleration mechanisms effective in blazar shock. Furthermore in many cases the Planck data indicate that gamma-ray emission must originate in the same shocks that produce the radio emission.

  16. Results and survival after photodynamic therapy in early-stage esophageal carcinoma

    Science.gov (United States)

    Spinelli, Pasquale; Mancini, Andrea; dal Fante, Marco; Meroni, Emmanuele; Jasinskas, Algirdas

    1996-01-01

    From January 1985 to December 1994, 23 early stage carcinomas of the esophagus were treated by photodynamic therapy in 21 patients. The stage of the tumors was assessed by esophagoscopy with multiple biopsies, CT scan and, from June 1991, also by endoscopic ultrasonography: 7 lesions were classified as carcinoma in situ (Tis) and 16 as invasive (T1). The photosensitizers used for PDT were hematoporphyrin derivative 3 mg/kg in 4 patients and dihematoporphyrin ether 2 mg/kg in 17. Light irradiation was performed using an Argon-dye laser system at a wavelength of 630 nm with an average energy of 50 J/cm2 and 70 J/cm2 for the treatment of Tis and T1, respectively. A complete response was achieved in 17/23 (74%) tumors, 15/21 (71%) patients. In the follow-up period from 6 to 78 months (median 36 months) 3 recurrences occurred 6, 12, and 14 months after PDT, respectively. Seven patients died due to concomitant diseases, not related to tumor progression. The actuarial survival rate was 95%, 75% and 37% at 1, 3, and 5 years, respectively. Complications included 1 case of sunburn and 2 cases of esophageal stenosis at the treatment site, that gradually responded to endoscopic bougienage.

  17. The Promises of Biology and the Biology of Promises

    DEFF Research Database (Denmark)

    Lee, Jieun

    2015-01-01

    commitments with differently imagined futures. I argue that promises are constitutive of the stem cell biology, rather than being derivative of it. Since the biological concept of stem cells is predicated on the future that they promise, the biological life of stem cells is inextricably intertwined...... patients’ bodies in anticipation of materializing the promises of stem cell biology, they are produced as a new form of biovaluable. The promises of biology move beyond the closed circuit of scientific knowledge production, and proliferate in the speculative marketplaces of promises. Part II looks at how...... of technologized biology and biological time can appear promising with the backdrop of the imagined intransigence of social, political, and economic order in the Korean society....

  18. [Promising networks, fruitful inquiry].

    Science.gov (United States)

    Frenk, Silvestre

    2014-01-01

    This supplement of the Revista Médica del Instituto Mexicano del Seguro Social includes 10 original contributions, and also six current themes, all of them related to childhood obesity. It is the result of an institutional program that it has been identified as Redes de Investigación Institucional, and it has been promoted and developed by the Coordinación de Investigación of the Instituto Mexicano del Seguro Social.

  19. Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Murray, Anna; Bennett, Claire E; Perry, John R B; Weedon, Michael N; Jacobs, Patricia A; Morris, Danielle H; Orr, Nicholas; Schoemaker, Minouk J; Jones, Michael; Ashworth, Alan; Swerdlow, Anthony J

    2011-01-01

    Women become infertile approximately 10 years before menopause, and as more women delay childbirth into their 30s, the number of women who experience infertility is likely to increase. Tests that predict the timing of menopause would allow women to make informed reproductive decisions. Current predictors are only effective just prior to menopause, and there are no long-range indicators. Age at menopause and early menopause (EM) are highly heritable, suggesting a genetic aetiology. Recent genome-wide scans have identified four loci associated with variation in the age of normal menopause (40-60 years). We aimed to determine whether theses loci are also risk factors for EM. We tested the four menopause-associated genetic variants in a cohort of approximately 2000 women with menopause≤45 years from the Breakthrough Generations Study (BGS). All four variants significantly increased the odds of having EM. Comparing the 4.5% of individuals with the lowest number of risk alleles (two or three) with the 3.0% with the highest number (eight risk alleles), the odds ratio was 4.1 (95% CI 2.4-7.1, P=4.0×10(-7)). In combination, the four variants discriminated EM cases with a receiver operator characteristic area under the curve of 0.6. Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM in an independent cohort from the BGS. The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.

  20. [Results of applying a paediatric early warning score system as a healthcare quality improvement plan].

    Science.gov (United States)

    Rivero-Martín, M J; Prieto-Martínez, S; García-Solano, M; Montilla-Pérez, M; Tena-Martín, E; Ballesteros-García, M M

    2016-06-01

    The aims of this study were to introduce a paediatric early warning score (PEWS) into our daily clinical practice, as well as to evaluate its ability to detect clinical deterioration in children admitted, and to train nursing staff to communicate the information and response effectively. An analysis was performed on the implementation of PEWS in the electronic health records of children (0-15 years) in our paediatric ward from February 2014 to September 2014. The maximum score was 6. Nursing staff reviewed scores >2, and if >3 medical and nursing staff reviewed it. Monitoring indicators: % of admissions with scoring; % of complete data capture; % of scores >3; % of scores >3 reviewed by medical staff, % of changes in treatment due to the warning system, and number of patients who needed Paediatric Intensive Care Unit (PICU) admission, or died without an increased warning score. The data were collected from all patients (931) admitted. The scale was measured 7,917 times, with 78.8% of them with complete data capture. Very few (1.9%) showed scores >3, and 14% of them with changes in clinical management (intensifying treatment or new diagnostic tests). One patient (scored 2) required PICU admission. There were no deaths. Parents or nursing staff concern was registered in 80% of cases. PEWS are useful to provide a standardised assessment of clinical status in the inpatient setting, using a unique scale and implementing data capture. Because of the lack of severe complications requiring PICU admission and deaths, we will have to use other data to evaluate these scales. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  1. Cast iron promises.

    Science.gov (United States)

    Hawker, Andrew

    2007-01-01

    During the Victorian era, a fiercely competitive industry emerged to build and operate Britain's railways. Many of the design and construction skills required were still fairly rudimentary, and were typically developed through practical experience. The resulting mix of entrepreneurship and new technology reshaped the landscape, but often in ways which proved hazardous for passengers. Minor accidents were commonplace, and a number of major failures occurred, one such being the collapse of the Tay Bridge, in 1879. Events in the ten years prior to this disaster still have some resonance today. Ambitions to exploit new technology are not always matched by foresight in the planning, financing or management of projects. Contracts may be based on wrong assumptions, and prove difficult to enforce. Once a project has gathered momentum, those working on it may fear that any attempt to draw attention to risks or defects will be seen as disloyal. When work is completed, it cannot be assumed that formal inspections will reveal potential flaws, or that those using the technology will appreciate the need to follow the procedures laid down for them. Some possible parallels with recent experiences in NHS computing are noted.

  2. Early Results of a Modular Cementless Tibial Component for Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Raj Sinha, MD, PhD

    2014-10-01

    Full Text Available Cementless components in TKA have been used for almost 3 decades, despite mixed success rates. However, biologic fixation remains attractive, especially for younger patients, because of the potential of unlimited durability. This paper is the first to report results on a modular tibial base plate using trabecular metal as a fixation surface. Twenty-four primary TKAs were evaluated clinical and radiographically at mean 1.9 year followup. Excellent clinical results were obtained. There was no significant subsidence or change in orientation of any component. One component was probably loose radiographically but was insufficiently symptomatic to warrant revision. Five components showed nonprogressive radiolucent lines. One reoperation was performed for stiffness, at which time the components were well fixed. Thus, it would appear that excellent bony fixation can be achieved with a modular cementless tibial component with excellent short-term clinical results.

  3. Planck early results. IV. First assessment of the High Frequency Instrument in-flight performance

    DEFF Research Database (Denmark)

    Bartlett, J.G.; Bréelle, E.; Bucher, M.

    2011-01-01

    heat load on the sub-Kelvin stage. Temporal variation and the inhomogeneous distribution of the flux results in thermal fluctuations that are a probable source of low frequency noise. The removal of systematic effects in the time ordered data provides a signal with an average noise equivalent power...

  4. Gradual remapping results in early retinotopic and late spatiotopic inhibition of return.

    NARCIS (Netherlands)

    Mathôt, S.; Theeuwes, J.

    2010-01-01

    Here we report that immediately following the execution of an eye movement, oculomotor inhibition of return resides in retinotopic (eye-centered) coordinates. At longer postsaccadic intervals, inhibition resides in spatiotopic (world-centered) coordinates. These results are explained in terms of

  5. Competitive Employment for Youth with Autism Spectrum Disorders: Early Results from a Randomized Clinical Trial

    Science.gov (United States)

    Wehman, Paul H.; Schall, Carol M.; McDonough, Jennifer; Kregel, John; Brooke, Valerie; Molinelli, Alissa; Ham, Whitney; Graham, Carolyn W.; Riehle, J. Erin; Collins, Holly T.; Thiss, Weston

    2014-01-01

    For most youth with autism spectrum disorders (ASD), employment upon graduation from high school or college is elusive. Employment rates are reported in many studies to be very low despite many years of intensive special education services. This paper presented the preliminary results of a randomized clinical trial of Project SEARCH plus ASD…

  6. Nras Overexpression Results in Granulocytosis, T-Cell Expansion and Early Lethality in Mice

    DEFF Research Database (Denmark)

    Lassen, Louise Berkhoudt; Gonzalez, Borja Ballarin; Schmitz, Alexander

    2012-01-01

    NRAS is a proto-oncogene involved in numerous myeloid malignancies. Here, we report on a mouse line bearing a single retroviral long terminal repeat inserted into Nras. This genetic modification resulted in an increased level of wild type Nras mRNA giving the possibility of studying the function ...... the increment in immature myeloid cells detected in these mice. The short latency period indicates that Nras overexpression alone is sufficient to cause dose-dependent granulocytosis and T-cell expansion....

  7. Exploring the uncertainties of early detection results: model-based interpretation of mayo lung project

    Directory of Open Access Journals (Sweden)

    Berman Barbara

    2011-03-01

    Full Text Available Abstract Background The Mayo Lung Project (MLP, a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer mortality. Whether this result necessarily indicates a lack of mortality benefit for screening remains controversial. A number of hypotheses have been proposed to explain the observed outcome, including over-diagnosis, screening sensitivity, and population heterogeneity (initial difference in lung cancer risks between the two trial arms. This study is intended to provide model-based testing for some of these important arguments. Method Using a micro-simulation model, the MISCAN-lung model, we explore the possible influence of screening sensitivity, systematic error, over-diagnosis and population heterogeneity. Results Calibrating screening sensitivity, systematic error, or over-diagnosis does not noticeably improve the fit of the model, whereas calibrating population heterogeneity helps the model predict lung cancer incidence better. Conclusions Our conclusion is that the hypothesized imperfection in screening sensitivity, systematic error, and over-diagnosis do not in themselves explain the observed trial results. Model fit improvement achieved by accounting for population heterogeneity suggests a higher risk of cancer incidence in the intervention group as compared with the control group.

  8. [Early results of proximal femoral fractures treated with FENIX modular hemiarthroplasty].

    Science.gov (United States)

    Görski, Radosław; Górecki, Andrzej; Olszewski, Paweł; Biedrzycki, Jerzy; Skowronek, Paweł

    2010-01-01

    The article discusses preliminary clinical results in patients with proximal femoral fractures treated with hemiarthroplasty using a FENIX implant. The study group comprised 41 subjects aged 69 to 97 (median age 82.3 year). The follow-up study provided data on 26 subjects (63.4%), among which 15 attended the check-up, 5 subjects refused to visit at the Department and 6 subjects were reported as deceased. Median follow-up period amounted to 6.8 month (1 to 22 months). General hospitalization-related complications occurred in 8 patients (19.5%). During hospitalization no deaths occurred, in the deceased group 3 patients died within 12 months after surgery, while another 3 died after the twelve-month postoperative period (median of 13.3%). According to Merle d'Aubigne-Postel score favorable long-term results were observed in 9 patients (59.9%), 13 patients regained the level of motor function similar to the functional ability prior to fracture. The need to postpone the surgery due to general health status and impaired pre-operative motor function are significant negative prognostic factors. The results obtained were compared with previous efficacy studies on femoral fracture treatment using an Austin-Moore implant. Functional ability and self-reliance was higher in the FENIX group. FENIX arthroplasty effectively helps patients regain self-reliance and motor function thanks to its modular characteristics and anatmoical construction.

  9. Do promises matter? An exploration of the role of promises in psychological contract breach.

    Science.gov (United States)

    Montes, Samantha D; Zweig, David

    2009-09-01

    Promises are positioned centrally in the study of psychological contract breach and are argued to distinguish psychological contracts from related constructs, such as employee expectations. However, because the effects of promises and delivered inducements are confounded in most research, the role of promises in perceptions of, and reactions to, breach remains unclear. If promises are not an important determinant of employee perceptions, emotions, and behavioral intentions, this would suggest that the psychological contract breach construct might lack utility. To assess the unique role of promises, the authors manipulated promises and delivered inducements separately in hypothetical scenarios in Studies 1 (558 undergraduates) and 2 (441 employees), and they measured them separately (longitudinally) in Study 3 (383 employees). The authors' results indicate that breach perceptions do not represent a discrepancy between what employees believe they were promised and were given. In fact, breach perceptions can exist in the absence of promises. Further, promises play a negligible role in predicting feelings of violation and behavioral intentions. Contrary to the extant literature, the authors' findings suggest that promises may matter little; employees are concerned primarily with what the organization delivers.

  10. Medium dose rate brachytherapy for patients with cervical carcinoma; early result of a prospective study

    Directory of Open Access Journals (Sweden)

    Amouzegar Hashemi F

    2009-03-01

    Full Text Available "nBackground: Treatment of cervical carcinoma is routinely performed with Low Dose Rate (LDR brachytherapy, but Brachytherapy in our department is done with Medium Dose Rate (MDR due to the technical characteristics of the machine available here. Thus we decided to evaluate the results of this treatment in our department in a prospective study. "nMethods: Between March 2006 and July 2008, 140 patients with histologic diagnosis of cervical carcinoma referred to Tehran Cancer Institute; were treated with external beam radiotherapy (44-64 Gy to whole pelvis and MDR brachytherapy (8-30 Gy to Point A with a dose rate of 2.2±0.3 Gy/h. "nResults: 121 patients were followed up for a median time of 18 months (range: 9-39 m. There were 11%(6/54 local recurrence for surgery and adjuvant radiotherapy group; 25%(16/65 for radical radiotherapy group, and 19%(23/121 for all patients. Rectal and bladder complications incidence for all patients were 10%(12/121 and 13%(16/121 respectively. High grade complication was shown only in one patient in radical radiotherapy group. In this study 3-years disease free survival and overall survival were 73% and 92% respectively, and disease stage (p=0.007 and overall treatment time (p=0.05 were the significant factors affecting disease free survival. "nConclusions: Results of this series suggest that the use of external beam radiotherapy and MDR brachytherapy with about 20% dose reduction in comparison with LDR can be an acceptable technique with regard to local control and complications.

  11. A Prospective Study of Early Loaded Single Implant-Retained Mandibular Overdentures: Preliminary One-Year Results

    Directory of Open Access Journals (Sweden)

    Ali M. El-Sheikh

    2012-01-01

    Full Text Available Purpose. To investigate the predictability of simplifying mandibular overdenture treatment using one-stage surgery and early prosthetic loading of a single implant. Materials and Methods. Twenty edentulous patients with problematic existing mandibular dentures were treated. A single implant with a chemically modified surface (SLActive, Straumann AG, Basel, Switzerland was placed into the mandibular midline. The patients were recalled at 3, 6 and 12 months. Clinical assessments and marginal bone loss using standardized radiographs were recorded. All complications, failures and maintenance were noted. Visual analog-scale questionnaires were used to record patient satisfaction in five categories. ANOVA was used to determine differences between means of marginal bone loss and different categories of patient staisfaction (=0.05. Results. The 20 early loaded implants were all surviving at the 12-month recall. All implants showed less than 1 mm of marginal bone loss by the end of the 1-year with a significant increase during the follow-up period. Few prosthetic problems were reported. Patient satisfaction was high with a significant increase in all comfort and functional parameters. Conclusions. These preliminary 1-year results indicate that early loading of a single chemically modified surface implant used to retain a mucosa-borne mandibular overdenture is a safe, reliable, and cost-effective treatment.

  12. Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Mizandari, Malkhaz [Tbilisi State Medical University, Department of Radiology (Georgia); Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk; Xi Feng [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Ao Guokun [The 309 Hospital of Chinese PLA, Department of Radiology (China); Kyriakides, Charis [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Dickinson, Robert [Imperial College London, Department of Bioengineering (United Kingdom); Nicholls, Joanna; Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom)

    2013-06-15

    Purpose. Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods. Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results. Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. Conclusions. In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.

  13. Planck early results. XXIV. Dust in the diffuse interstellar medium and the Galactic halo

    DEFF Research Database (Denmark)

    Poutanen, T.; Natoli, P.; Polenta, G.

    2011-01-01

    by this correlation analysis. Its spectral properties are consistent with, compared to the local ISM values, significantly hotter dust (T ~ 20 K), lower submm dust opacity normalized per H-atom, and a relative abundance of very small grains to large grains about four times higher. These results are compatible......This paper presents the first results from a comparison of Planck dust maps at 353, 545 and 857GHz, along with IRAS data at 3000 (100 μm) and 5000GHz (60 μm), with Green Bank Telescope 21-cm observations of Hi in 14 fields covering more than 800deg2 at high Galactic latitude. The main goal...... of this study is to estimate the far-infrared to sub-millimeter (submm) emissivity of dust in the diffuse local interstellar medium (ISM) and in the intermediate-velocity (IVC) and high-velocity clouds (HVC) of the Galactic halo. Galactic dust emission for fields with average Hi column density lower than 2...

  14. Early and delayed results of radiotherapy and multimodality therapy of spinal hemangiomas

    International Nuclear Information System (INIS)

    Morozov, A.I.; Neretin, V.Ya.; Korshunov, A.I.; Nikolaeva, S.N.; Balkanov, A.S.; Marchenko, V.A.

    1988-01-01

    The authors described the results of therapy of 74 spinal hemangioma patients. The patients were divided into 2 groups: 1 - radiotherapy only; 2 - radiotherapy following surgical intervention for enhanced symptoms of spinal compression. γ-beam therapy was given 5 times a week at a single dose of 0.8-1.2 Gy. An integral dose delivered to the cervical spine was 26-32 Gy, to the thoracic spine 28-30 Gy, to the lumber spine - 30-34 Gy. Field sizes varied from 3x4 to 3x12 cm depending on lesion spreading. Therapy also included traction on a special platform bed. An analysis of delayed therapeutic results (from 3 to 13 yrs.) has shown that clinical convalescence with regained working capacity in the 1st group (40 patients) was observed in 21 patients, in the 2nd group (34 patients) - in 5 patients only. Partial functional restoration was observed in both groups (19 patients in each group). The therapy applied was ineffective in 10 patients of the 2nd group

  15. A novel specialized suture and inserting device for the resuspension of ptotic facial tissues: early results.

    Science.gov (United States)

    Bisaccia, Emil; Kadry, Razan; Saap, Liliana; Rogachefsky, Arlene; Scarborough, Dwight

    2009-04-01

    In the past decade, the popularity of minimally invasive procedures for facial rejuvenation has increased. To describe a new specialized suture, and its associated technique, used to elevate sagging tissues of the face and neck. A detailed description of the technique and the results obtained in 20 patients in whom we have used this novel approach. Attention was given to appropriate patient selection. The primary focus was on the correction of the jowl, jawline, and neck subunits. It involves the percutaneous introduction of a novel 3-0 polypropylene suture that has 10 absorbable hollow cones along its axis that are equally interspersed with knots. Once the absorbable cones are resorbed into the surrounding tissues, the non-absorbable suture component can be removed without compromising the aesthetic outcome. All patients demonstrated improvement in these areas, with minimal complications. One patient required resuspension using the open technique. (Excessive ptotic tissue was later excised for an optimal cosmetic result.) The suture and technique described in this article provide a major contribution to the correction of ptosis of facial tissues. When done in conjunction with other procedures, such as neck and jowl microliposuction, this technique has proven to be a useful addition to facial rejuvenation.

  16. Hearing taboo words can result in early talker effects in word recognition for female listeners.

    Science.gov (United States)

    Tuft, Samantha E; MᶜLennan, Conor T; Krestar, Maura L

    2018-02-01

    Previous spoken word recognition research using the long-term repetition-priming paradigm found performance costs for stimuli mismatching in talker identity. That is, when words were repeated across the two blocks, and the identity of the talker changed reaction times (RTs) were slower than when the repeated words were spoken by the same talker. Such performance costs, or talker effects, followed a time course, occurring only when processing was relatively slow. More recent research suggests that increased explicit and implicit attention towards the talkers can result in talker effects even during relatively fast processing. The purpose of the current study was to examine whether word meaning would influence the pattern of talker effects in an easy lexical decision task and, if so, whether results would differ depending on whether the presentation of neutral and taboo words was mixed or blocked. Regardless of presentation, participants responded to taboo words faster than neutral words. Furthermore, talker effects for the female talker emerged when participants heard both taboo and neutral words (consistent with an attention-based hypothesis), but not for participants that heard only taboo or only neutral words (consistent with the time-course hypothesis). These findings have important implications for theoretical models of spoken word recognition.

  17. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A

    2015-01-01

    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... a total of 77 pregnancies. Of the 72 women 40 were referred to fertility treatment. First and second trimester miscarriage rates were 21.6% and 2.7%, respectively. A total of 53 children were born of which 41 were delivered after gestational week 34. CONCLUSION: This unselected national single center...... of 120 unselected consecutive VRTs were assessed. To obtain complete follow-up about fertility treatment, pregnancy and obstetric outcome the women filled out an electronic questionnaire. Median follow-up: 55.7 months. RESULTS: 85.8% of the patients had stage IB1 disease, 68.3% squamous cell carcinomas...

  18. Some early results of the keV plasma experiment on GEOS-1

    International Nuclear Information System (INIS)

    Borg, H.; Holmgren, L.-A.; Hultqvist, B.; Cambou, F.; Reme, H.

    1978-01-01

    Some preliminary new results are presented of the keV plasma experiment on GEOS-1. Electrons and ions have been observed to stream along the magnetic field lines in the dayside magnetosphere from the ionospheric side of the satellite towards the equatorial plane during magnetic storms, with streaming velocities corresponding to a kinetic energy of the order of a keV. The opposite streaming velocity has also been seen, but primarily in the ions only and with a smaller flux ratio for the two opposite directions along the field lines. The transition between the two opposite streaming directions, as seen by the satellite, has been found to occur even in a fraction of a second. In magnetic storm conditions azimuthal asymmetries in ion fluxes corresponding to electric field intensities of several tens of millivolts per meter have been observed. (Auth.)

  19. Human amyloidogenic light chain proteins result in cardiac dysfunction, cell death, and early mortality in zebrafish.

    Science.gov (United States)

    Mishra, Shikha; Guan, Jian; Plovie, Eva; Seldin, David C; Connors, Lawreen H; Merlini, Giampaolo; Falk, Rodney H; MacRae, Calum A; Liao, Ronglih

    2013-07-01

    Systemic amyloid light-chain (AL) amyloidosis is associated with rapidly progressive and fatal cardiomyopathy resulting from the direct cardiotoxic effects of circulating AL light chain (AL-LC) proteins and the indirect effects of AL fibril tissue infiltration. Cardiac amyloidosis is resistant to standard heart failure therapies, and, to date, there are limited treatment options for these patients. The mechanisms underlying the development of cardiac amyloidosis and AL-LC cardiotoxicity are largely unknown, and their study has been limited by the lack of a suitable in vivo model system. Here, we establish an in vivo zebrafish model of human AL-LC-induced cardiotoxicity. AL-LC isolated from AL cardiomyopathy patients or control nonamyloidogenic LC protein isolated from multiple myeloma patients (Con-LC) was directly injected into the circulation of zebrafish at 48 h postfertilization. AL-LC injection resulted in impaired cardiac function, pericardial edema, and increased cell death relative to Con-LC, culminating in compromised survival with 100% mortality within 2 wk, independent of AL fibril deposition. Prior work has implicated noncanonical p38 MAPK activation in the pathogenesis of AL-LC-induced cardiotoxicity, and p38 MAPK inhibition via SB-203580 rescued AL-LC-induced cardiac dysfunction and cell death and attenuated mortality in zebrafish. This in vivo zebrafish model of AL-LC cardiotoxicity demonstrates that antagonism of p38 MAPK within the AL-LC cardiotoxic signaling response may serve to improve cardiac function and mortality in AL cardiomyopathy. Furthermore, this in vivo model system will allow for further study of the molecular underpinnings of AL cardiotoxicity and identification of novel therapeutic strategies.

  20. Early and mid-term results of lung transplantation with donors 60 years and older.

    Science.gov (United States)

    López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

    2015-01-01

    There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India.

    Science.gov (United States)

    Gadgil, Anita; Sauvaget, Catherine; Roy, Nobhojit; Muwonge, Richard; Kantharia, Surita; Chakrabarty, Anuradha; Bantwal, Kanchan; Haldar, Indrani; Sankaranarayanan, Rengaswamy

    2017-02-01

    Indian women with breast cancer are usually diagnosed in advanced stages leading to poor survival. Improving breast awareness and increasing access to early diagnosis and adequate treatment has been advocated for breast cancer control. We implemented a program to increase awareness on breast cancer and access to its early detection in an occupational health care scheme in Mumbai, India. Breast awareness brochures were mailed annually between June 2013 and June 2016 to a cohort of 22,500 eligible women aged 30-69 years old receiving universal health care from an occupational health care scheme comprising of primary health centres and a referral secondary care hospital in Mumbai. Women with suspected breast cancers were provided with diagnostic investigations and treatment. Socio-demographic information and tumour characteristics were compared between the breast awareness pre-intervention period (Jan 2005-May 2013) and the breast awareness intervention period after four rounds of mailers (June 2013-June 2016). The proportion of women with early tumours and axillary lymph node negative cancers increased from 74% to 81% and 46% to 53% respectively, between the two periods. While the proportion of patients receiving breast conserving surgery increased from 39% to 51%, the proportion receiving chemotherapy decreased from 84% to 56%. Interim results following efforts to improve breast awareness and access to care in a cohort of women in an occupational health care scheme indicate early detection and more conservative treatment of breast cancers. Creating awareness and improving access to care may result in cancer down-staging. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Patient-centered feedback on the results of personality testing increases early engagement in residential substance use disorder treatment: a pilot randomized controlled trial.

    Science.gov (United States)

    Blonigen, Daniel M; Timko, Christine; Jacob, Theodore; Moos, Rudolf H

    2015-03-14

    Patient-centered models of assessment have shown considerable promise for increasing patients' readiness for mental health treatment in general, but have not been used to facilitate patients' engagement in substance use disorder (SUD) treatment. We developed a brief patient-centered intervention using assessment and feedback of personality data and examined its acceptability and efficacy to increase early engagement in residential SUD treatment. Thirty patients entering a 90-day residential SUD treatment program were randomly assigned to a feedback (n = 17) or control (n = 13; assessment-only) condition. Normal-range personality was assessed with the NEO Personality Inventory-Revised (NEO PI-R). Patients were re-interviewed one month after treatment entry to obtain information on their satisfaction with the intervention, as well as their adjustment to the residential milieu. Electronic medical records were reviewed to obtain information on patients' length of stay in the program and discharge status. Univariate ANOVAs and chi-square tests were conducted to examine group differences on outcomes. Patients' ratings indicated strong satisfaction with the feedback intervention and expectations that it would have a positive impact on their treatment experiences. Among patients who had not previously been treated in the residential program, the feedback intervention was associated with more positive relationships with other residents in treatment and a stronger alliance with the treatment program one month after treatment entry. The feedback intervention was also associated with a longer length of stay in treatment, although this effect did not reach statistical significance. The findings highlight the clinical utility of providing SUD patients with patient-centered feedback based on the results of personality testing, and provide preliminary support for the acceptability and efficacy of this intervention to facilitate early engagement in residential SUD treatment.

  3. The Results and Prognostic Factors of Postoperative Radiation Therapy in the Early Stages of Endometrial Cancer

    International Nuclear Information System (INIS)

    Lee, Kyung Ja

    2008-01-01

    To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial

  4. Adenocarcinoma of the esophagogastric junction. Neoadjuvant radiochemotherapy and radical surgery. Early results and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Leibl, Bernhard J. [Klinikum Coburg (Germany). Dept. of Surgery; Coburg Cancer Center, Coburg (Germany); Vitz, Stephanie; Schaefer, Wolfgang; Alfrink, Martin; Grabenbauer, Gerhard G. [DiCura Coburg, Coburg (Germany). Dept. of Radiation Oncology; Coburg Cancer Center, Coburg (Germany); Geschwendtner, Andreas [Klinikum Coburg (Germany). Dept. of Pathology; Coburg Cancer Center, Coburg (Germany)

    2011-04-15

    Purpose: To retrospectively evaluate treatment results and toxicity following a combined approach consisting of neoadjuvant radiochemotherapy and radical surgery in advanced adenocarcinoma of the esophagus and gastroesophageal junction. Patients and Methods: Between 2005 and 2009, a total of 41 consecutive patients with newly diagnosed nonmetastatic adenocarcinoma of the esophagus and the esophagogastric junction were evaluated, of whom 23 received neoadjuvant radiochemo-therapy (RCT). A total dose of 50.4 Gy with 2 cycles of simultaneous cisplatin/5-fluorouracil (FU) or Taxol/FU-chemotherapy were applied. A radical transthoracic subtotal esophageal and proximal gastric resection through a right thoracoabdominal laparotomy with intrathoracic anastomosis was performed 6-8 weeks following RCT. This was combined with a two-field lymphadenectomy of mediastinal and abdominal lymph nodes. Standard histopathological evaluation included the application of regression grading according to Werner and Hoefler. Toxicity was recorded on the basis of CTC criteria; survival curves were calculated according to Kaplan-Meier. V10, V15, and V20 data were correlated with pulmonary toxicity. Results: Overall survival for all 23 patients was 61% at 3 years. Of the original 23 patients, 18 (78%) patients proceeded to radical surgery. Reasons for no surgery included advanced age of 79, 82, and 86 years (n = 3), severe comorbidity (n = 1), and progression during radiochemotherapy (n = 1). Surgical morbidity (grade 3-4) and mortality rates were 35% and 6%, respectively. Resurgery was necessary in 3 cases (18%). Clear resection margins were achieved in 17 of 18 patients (94%). Twelve of 18 (67%) patients initially diagnosed with T3 tumors and 3 of 3 patients with T4 tumors experienced downstaging. The ypN0 rate was 12 of 18 patients (67%). Out of a total of 18 patients, regression grading revealed < 10% viable cells in 8 (44%) including 3 cases (17%) with complete regression, 10-50% viable

  5. Biodegradable fixation of mandibular fractures in children: stability and early results.

    Science.gov (United States)

    Yerit, Kaan C; Hainich, Sibylle; Enislidis, Georg; Turhani, Dritan; Klug, Clemens; Wittwer, Gert; Ockher, Michael; Undt, Gerhard; Kermer, Christian; Watzinger, Franz; Ewers, Rolf

    2005-07-01

    The aim of this study was to assess the safety and efficiency of biodegradable self-reinforced (SR-PLDLA) bone plates and screws in open reduction and internal fixation of mandible fractures in children. Thirteen patients (5 female, 8 male; mean age 12 years, range 5-16 years) were operated on various fractures of the mandible (2 symphyseal, 6 parasymphyseal, 4 body, 3 angle, 1 ramus, 2 condylar fractures). The mean follow-up time was 26.4 months (range 10.9-43.4 months). Intermaxillary fixation was applied in cases with concomitant condylar fractures up to 3 weeks. Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operations was not endangered. Adverse tissue reactions to the implants, malocclusion, and growth restrictions did not occur during the observation period. Pediatric patients benefit from the advantages of resorbable materials, especially from faster mobilization and the avoidance of secondary removal operations. Based on these preliminary results, self-reinforced fixation devices are safe and efficient in the treatment of pediatric mandible fractures. However, further clinical investigations are necessary to evaluate the long-term reliability.

  6. Early results with a monorail-stent-balloon device for endovascular treatment of renal artery stenosis

    International Nuclear Information System (INIS)

    Mueller-Huelsbeck, S.; Jahnke, T.; Grimm, J.; Behm, C.; Hilbert, C.; Frahm, C.; Biederer, J.; Brossmann, J.; Heller, M.

    2002-01-01

    Objective: To evaluate the technical feasibility of a new monorail-stent-balloon device for treatment of renal artery stenosis (RAS). Patients and Methods: During a study period of 18 months, 38 patients with proven RAS in 41 cases (hypertension n = 36, renal insufficiency n = 13) and indication for stenting (calicified ostial lesions n = 35, insufficient PTA n = 4, dissection n = 2) were enrolled into this prospective evaluation. Pre-mounted stents (Rx-Herculink TM 5 mm = 13, 6 mm = 34, 7 mm = 1) were implanted a transfermoral (n = 35) or transbrachial approach (n = 6). Mean grade and lengths of stenosis measured were 88% ±10 and 9 mm ±5. Results: Renal stent implantation was technically successful in all cases (100%). In 7 cases a second stent had to be implanted to cover the entire lesion. The transstenotic pressure drop decreased from 88 mmHg ± 10 before to 1 mmHg ± 1.8 after the procedure. Remaining stenosis measured 0.7% ±4.2. Serum creatine levels decreased from 1.9 mm/dl to 1.5 mg/dl (n.s.), blood pressure decreased from 178/94 mmHg to 148/79 mmHg (p [de

  7. Early results of sarcomeric gene screening from the Egyptian National BA-HCM Program.

    Science.gov (United States)

    Kassem, Heba Sh; Azer, Remon S; Saber-Ayad, Maha; Ayad, Maha S; Moharem-Elgamal, Sarah; Magdy, Gehan; Elguindy, Ahmed; Cecchi, Franco; Olivotto, Iacopo; Yacoub, Magdi H

    2013-02-01

    The present study comprised sarcomeric genotyping of the three most commonly involved sarcomeric genes: MYBPC3, MYH7, and TNNT2 in 192 unrelated Egyptian hypertrophic cardiomyopathy (HCM) index patients. Mutations were detected in 40 % of cases. Presence of positive family history was significantly (p=0.002) associated with a higher genetic positive yield (49/78, 62.8 %). The majority of the detected mutations in the three sarcomeric genes were novel (40/62, 65 %) and mostly private (47/62, 77 %). Single nucleotide substitution was the most frequently detected mutation type (51/62, 82 %). Over three quarters of these substitutions (21/27, 78 %) involved CpG dinucleotide sites and resulted from C>T or G>A transition in the three analyzed genes, highlighting the significance of CpG high mutability within the sarcomeric genes examined. This study could aid in global comparative studies in different ethnic populations and constitutes an important step in the evolution of the integrated clinical, translational, and basic science HCM program.

  8. Planck early results. XXIV. Dust in the diffuse interstellar medium and the Galactic halo

    Science.gov (United States)

    Planck Collaboration; Abergel, A.; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Blagrave, K.; Bock, J. J.; Bonaldi, A.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bucher, M.; Burigana, C.; Cabella, P.; Cantalupo, C. M.; Cardoso, J.-F.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chiang, L.-Y.; Chiang, C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Frailis, M.; Franceschi, E.; Galeotta, S.; Ganga, K.; Giard, M.; Giardino, G.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Hansen, F. K.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Jaffe, A. H.; Joncas, G.; Jones, A.; Jones, W. C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leonardi, R.; Leroy, C.; Linden-Vørnle, M.; Lockman, F. J.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; MacTavish, C. J.; Maffei, B.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Marshall, D. J.; Martin, P.; Martínez-González, E.; Masi, S.; Matarrese, S.; Matthai, F.; Mazzotta, P.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; O'Dwyer, I. J.; Osborne, S.; Pajot, F.; Paladini, R.; Pasian, F.; Patanchon, G.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Pinheiro Gonçalves, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Reinecke, M.; Renault, C.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Sandri, M.; Santos, D.; Savini, G.; Scott, D.; Seiffert, M. D.; Shellard, P.; Smoot, G. F.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Umana, G.; Valenziano, L.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    This paper presents the first results from a comparison of Planck dust maps at 353, 545 and 857GHz, along with IRAS data at 3000 (100 μm) and 5000GHz (60 μm), with Green Bank Telescope 21-cm observations of Hi in 14 fields covering more than 800 deg2 at high Galactic latitude. The main goal of this study is to estimate the far-infrared to sub-millimeter (submm) emissivity of dust in the diffuse local interstellar medium (ISM) and in the intermediate-velocity (IVC) and high-velocity clouds (HVC) of the Galactic halo. Galactic dust emission for fields with average Hi column density lower than 2 × 1020 cm-2 is well correlated with 21-cm emission because in such diffuse areas the hydrogen is predominantly in the neutral atomic phase. The residual emission in these fields, once the Hi-correlated emission is removed, is consistent with the expected statistical properties of the cosmic infrared background fluctuations. The brighter fields in our sample, with an average Hi column density greater than 2 × 1020 cm-2, show significant excess dust emission compared to the Hi column density. Regions of excess lie in organized structures that suggest the presence of hydrogen in molecular form, though they are not always correlated with CO emission. In the higher Hi column density fields the excess emission at 857 GHz is about 40% of that coming from the Hi, but over all the high latitude fields surveyed the molecular mass faction is about 10%. Dust emission from IVCs is detected with high significance by this correlation analysis. Its spectral properties are consistent with, compared to the local ISM values, significantly hotter dust (T ~ 20K), lower submm dust opacity normalized per H-atom, and a relative abundance of very small grains to large grains about four times higher. These results are compatible with expectations for clouds that are part of the Galactic fountain in which there is dust shattering and fragmentation. Correlated dust emission in HVCs is not detected

  9. Endoscopic management of traumatic posterior urethral stricture: early results and followup.

    Science.gov (United States)

    Goel, M C; Kumar, M; Kapoor, R

    1997-01-01

    We assessed the outcome of core through internal urethrotomy for traumatic posterior urethral stricture, and reviewed the followup results of these patients. During the last 4 years 13 patients with a stricture up to 2 cm. long underwent core through internal urethrotomy with C-arm fluoroscopy guidance and an orientation in 2 planes. Retrograde urethrotomy was performed and an 18F Foley catheter was left indwelling for 4 weeks, after which urethrotomy was repeated. All patients were advised to perform clean intermittent self-catheterization for urethral calibration and dilation. Outcome was defined as class 1-3 patients who required 2 or fewer urethrotomies with clean intermittent self-catheterization discontinued after the primary procedure, class 2-5 who required 2 or fewer urethrotomies with clean intermittent self-catheterization and class 3-5 who required 3 or more urethrotomies. Of the 13 patients 8 (61%) did well after a mean followup of 17.7 months. The 3 patients with a class 1 outcome did well, while 2 of 5 with a class 2 outcome required repeat urethrotomy during followup. Of the 5 patients (39%) with a class 3 outcome in whom core through internal urethrotomy failed 3 required open surgery and 2 were lost to followup. Recurrence rate was 69% at 3 months and 25% at 12 months after the initial procedure. No patient was incontinent at last followup. Two patients had significant hematuria postoperatively, which resolved with conservative treatment. Endoscopic treatment should be considered the first line procedure for all post-traumatic posterior urethral strictures. The morbidity of open surgery can be avoided in 61% of patients. Hospital stay, loss of work, morbidity and related complications are also markedly decreased with endoscopic therapy.

  10. Expanding indications for valve-sparing aortic root reconstruction: early and midterm results.

    Science.gov (United States)

    Valo, Johanna; Jokinen, Janne J; Kaarne, Markku; Ihlberg, Leo

    2013-02-01

    Valve-sparing aortic root reconstruction (VSRR) is an accepted method to treat patients with aortic root dilation. The role of the VSRR is less well defined for patients with bicuspid aortic valve, severe aortic valve insufficiency, congenital heart defects, and type A aortic dissection. We studied the clinical outcome of patients who underwent VSRR for expanded indications. Seventy-eight patients underwent VSRR between the 2005 and 2012. Seventy-two patients (92%) underwent reimplantation and 6 patients (8%) were operated on with the remodeling technique. The mean age was 51 ± 12 years (range 24 to 73). For 71 patients (91%), the operation was elective, and for 7 (9%; all with type A aortic dissection), on an emergency basis. Preoperatively, the degree of aortic insufficiency was graded as 2+ or greater for 27 patients (35%). Connective tissue disorder (Marfan or Loeys-Dietz), bicuspid aortic valve, or congenital heart disease was present in 15 (19%), 15 (19%), and 7 patients (9%), respectively. Concomitant aortic valve leaflet repair was performed for 39 patients (50%). The mean follow-up time was 2.4 ± 1.7 years (range, 0.1 to 7.0). Thirty-day mortality was zero. The rate of postoperative complications was low: stroke 3%, renal failure 3%, prosthesis infection 1%, and low cardiac output syndrome 1%. Survival was 100% at 1 year and 97% at 5 years. Freedom from recurrent aortic valve insufficiency (≥2+) during the follow-up was 94%. The midterm results of VSRR in terms of survival, freedom from recurrent aortic valve insufficiency, and the need for reoperation are excellent, even for high-risk patients. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Early cow's milk consumption among Brazilian children: results of a national survey.

    Science.gov (United States)

    Bortolini, Gisele Ane; Vitolo, Márcia Regina; Gubert, Muriel Bauermann; Santos, Leonor Maria Pacheco

    2013-01-01

    to assess the intake, frequency, and type of milk consumed by Brazilian children younger than 60 months of age. this was a cross-sectional study, which used secondary data from the National Demographic and Health Survey of 2006-2007. Data from 4,817 children under the age of 60 months were used. All analyses were performed with expanded samples. The dietetic survey assessed the previous day's consumption, and estimates were made through univariate analysis, presented as a percentage. on the day prior to the survey, breast milk was consumed by 91% of the children younger than six months of age, by 61.5% of the children aged 6 to 12 months, and by 34.8% of the children aged 13 to 24 months. Among the children who had received other types of milk, cow's milk was consumed by 62.4% of the children younger than six months, by 74.6% of the children aged 6 to 12 months, and by approximately 80% of the children older than 12 months. Infant formulas were consumed by 23% of the children younger than six months of age, by 9.8% of the children aged 6 to 12 months, and by less than 1% of the older children. Soy milk consumption varied from 14.6% to 20% among the investigated ages. Non-breast milk consumption before the age of six months was more frequent in children living in the Northeastern and Southern regions. the results of the present study demonstrated that most children received cow's milk prematurely as a substitute for breast milk, highlighting the importance of the development of public policies to promote, protect, and support breastfeeding in all regions of Brazil, aiming at reversing the observed scenario. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Development and preliminary results of an in vivo Raman probe for early lung cancer detection

    Science.gov (United States)

    Short, Michael A.; Lam, Stephen; McWilliams, Annette; Zhao, Jianhua; Lui, Harvey; Zeng, Haishan

    2008-02-01

    Our previous results from Raman spectroscopy studies on ex vivo lung tissue showed the technique had great potential to differentiate between samples with different pathologies. In this work, a fast dispersive-type near-infrared (NIR) Raman spectroscopy system was developed to collect real-time, noninvasive, in vivo human lung spectra. The 785 nm excitation, and the collection of tissue emission were accomplished by using a reusable fiber optic catheter which passed down the instrument channel of a bronchoscope. Filters in two stages blocked laser emission other than 785 nm from reaching the tissue surface, and reduced fiber fluorescence and elastically scattered excitation light from being passed to the spectrometer. The spectrometer itself consisted of one of two holographic gratings with usable frequency ranges of: 700 to 2000 cm -1 and 1500 to 3400 cm -1. The dispersed light was detected by a cooled CCD array consisting of 400 by 1340 pixels. To increase the resolution of the system, while maximizing the throughput, a second fiber bundle, consisting of 54×100 μm diameter fibers connected the catheter to the spectrometer. The fibers in this second bundle were spread out to form a parabolic arc which replaced the conventional entrance slit. This geometry corrected for image aberrations, permitting complete CCD vertical binning, thereby yielding up to a 20-fold improvement in signal-to-noise ratio. The estimated spectral resolution of the system was 9 cm -1 for both gratings. So far we have measured spectra from 20 patients and have seen clear differences between spectra from tumor and normal tissue.

  13. Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience

    International Nuclear Information System (INIS)

    Neuerburg, Joerg M.; Guenther, Rolf W.; Vorwerk, Dierk; Dondelinger, Robert F.; Jaeger, Horst; Lackner, Klaus J.; Schild, Hans H.; Plant, Graham R.; Joffre, Francis G.; Schneider, Pierre A.; Janssen, Johan H. A.

    1997-01-01

    Purpose. To evaluate clinically a new, retrievable vena caval filter in a multicenter study. Methods. The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis. Results. An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n=2) or a manipulation error (n=1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication. Conclusion. Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion

  14. Early perioperative results and surgical recurrence after strictureplasty and miniresection for complicated Crohn's disease.

    Science.gov (United States)

    Sampietro, G M; Cristaldi, M; Porretta, T; Montecamozzo, G; Danelli, P; Taschieri, A M

    2000-01-01

    recurrence rate results support the efficacy and safety of SP and MR surgery in the treatment of complicated CD. Copyright 2000 S. Karger AG, Basel

  15. Tolerance and early outcome results of postprostatectomy three-dimensional conformal radiotherapy

    International Nuclear Information System (INIS)

    Zelefsky, Michael J.; Aschkenasy, Eric; Kelsen, Suzanne; Leibel, Steven A.

    1997-01-01

    Purpose: Three-dimensional conformal radiotherapy (3D-CRT) has been associated with a reduction in acute and late toxicity among patients treated for localized prostatic cancer. The purpose of this study is to assess the acute and late toxicity of 3D-CRT delivered to patients in the postprostatectomy setting and to analyze which factors predict for durable biochemical control in this group of patients. Methods and Materials: Between 1988 and 1994, 42 patients were treated after prostatectomy with three-dimensional conformal radiotherapy. The median time from prostatectomy to radiotherapy was 11 months. Indications for treatment included a rising serum PSA level in 28 patients (65%) and positive surgical margins without a rising PSA level in 14 (35%). Twenty-five patients (60%) had pathologic stage T3 disease, and 32 (74%) had tumor at or close to the surgical margins. The median dose was 64.8 Gy, and the median follow-up time was 2 years. Results: 3D-CRT in the postprostatectomy setting was well tolerated. Three patients (7%) experienced Grade II acute genitourinary toxicity and nine patients (21%) experienced Grade II acute gastrointestinal toxicity during treatment. No patient experienced Grade III or higher acute morbidity. The 2-year actuarial risk for Grade II late genitourinary and gastrointestinal late complications were 5 and 9%, respectively. In patients with existing incontinence, the incidence of worsening stress incontinence 6 months after treatment was 17%, which resolved within 12 months to its preradiotherapy level in four of six cases (66%). The overall 2-year postirradiation PSA relapse-free survival rate was 53%. The 2-year PSA relapse-free survival was 66% for patients with undetectable PSA levels in the immediate postoperative period compared to 26% for those with detectable levels of PSA after surgery (p 1.0 ng/ml (p 1 ng/ml (p < 0.002) was the most important covariate predicting for a rising PSA after radiotherapy. Conclusions: After

  16. Early Cretaceous paleomagnetic results from Marie Byrd Land, West Antarctica: Implications for the Weddellia collage of crustal blocks

    Science.gov (United States)

    Divenere, Vic; Kent, Dennis V.; Dalziel, Ian W. D.

    1995-05-01

    A new approximately 117 Ma paleomagnetic pole has been defined from the study of volcanic and plutonic rocks from the eastern portion Marie Byrd Land (MBL). The new pole (185.6 deg E/56.8 deg S, A(sub 95) = 8.7 deg) implies that the eastern portion of MBL was an integral part of Weddellia, which included the ancestral Antarctic Peninsula, Thurston Island, and Ellsworth-Whitmore Mountains blocks of West Antarctica. This pole is generally similar to a approximately 125 Ma pole from Thurston Island. Both poles call for major clockwise rotation and poleward motion of eastern MBL and Thurston Island between the Early Cretaceous (125-117 Ma) and the mid-Cretaceous (110-100 Ma). We propose that in the Early Cretaceous, eastern MBL and the Eastern Province of New Zealand were part of a continuous active Pacific margin of Gondwana, connecting with the Antarctic Peninsula, and distinct from western MBL, the Western Province of New Zealand, and North Victoria Land. These western terranes are thought to have accreted to Gondwana in the Devonian. Eastern MBL and the Eastern Province of New Zealand amalgamated with western MBL and the Western Province of New Zealand by the mid-Cretaceous. Major Early Cretaceous motions of the Weddellia blocks postdate the estimated initiation of seafloor spreading in the Weddell Sea and therefore may be the result of plate reorganization during the Cretaceous Quiet Zone.

  17. The dementia and disability project in Thai elderly: rational, design, methodology and early results

    Directory of Open Access Journals (Sweden)

    Senanarong Vorapun

    2013-01-01

    Full Text Available Abstract Background A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods The Dementia and Disability Project in Thai Elderly (DDP aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95 years. 689(34.9% are men and 1284(65.1% are women. Mean body weight was 58.36(SD=11.20 kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003. The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952 had highest level gait disorders. 39

  18. Robustness of an uncertainty and sensitivity analysis of early exposure results with the MACCS reactor accident consequence model

    International Nuclear Information System (INIS)

    Helton, J.C.; Johnson, J.D.; McKay, M.D.; Shiver, A.W.; Sprung, J.L.

    1995-01-01

    Uncertainty and sensitivity analysis techniques based on Latin hypercube sampling, partial correlation analysis and stepwise regression analysis were used in an investigation with the MACCS model of the early health effects associated with a severe accident at a nuclear power station. The following results were obtained in tests to check the robustness of the analysis techniques: two independent Latin hypercube samples produced similar uncertainty and sensitivity analysis results; setting important variables to best-estimate values produced substantial reductions in uncertainty, while setting the less important variables to best-estimate values had little effect on uncertainty; similar sensitivity analysis results were obtained when the original uniform and loguniform distributions assigned to the 34 imprecisely known input variables were changed to left-triangular distributions and then to right-triangular distributions; and analyses with rank-transformed and logarithmically-transformed data produced similar results and substantially outperformed analyses with raw (i.e., untransformed) data

  19. Early Child Care and Adolescent Functioning at the End of High School: Results from the NICHD Study of Early Child Care and Youth Development

    Science.gov (United States)

    Vandell, Deborah Lowe; Burchinal, Margaret; Pierce, Kim M.

    2016-01-01

    Relations between early child care and adolescent functioning at the end of high school (EOHS; M age = 18.3 years) were examined in a prospective longitudinal study of 1,214 children. Controlling for extensive measures of family background, early child care was associated with academic standing and behavioral adjustment at the EOHS. More…

  20. Bulletin Survey - Early Results

    CERN Multimedia

    2002-01-01

    There was a good response to our questionnaire on the Bulletin (around 450 so far). Many thanks to all of you - your views are invaluable to us. Pending publication of the full figures, which will give latecomers time to take part in the survey, here we give here answers some of your most frequent comments. Thank you for the many warm tributes and messages of encouragement we received. We also received criticisms about the way information is handled in the Bulletin and on its circulation. In today's issue we reply to these two points. Why is the Bulletin politically correct ? Many respondents reproach the Bulletin for a lack of objectivity and for being too politically correct to the point of being a propaganda organ. It is true that the Bulletin is not a newspaper, but rather a bulletin of communication (like SLAC's Beam Line). What is the difference ? A newspaper is objectively independent of the subjects it reports on, and when its reporters write stories they dig around for information from all parties...

  1. Political Reputations and Campaign Promises

    OpenAIRE

    Aragones, Enriqueta; Palfrey, Thomas R.; Postlewaite, Andrew

    2006-01-01

    We analyze conditions under which candidates' reputations may affect voters' beliefs over what policy will be implemented by the winning candidate of an election. We develop a model of repeated elections with complete information in which candidates are purely ideological. We analyze an equilibrium in which voters' strategies involve a credible threat to punish candidates who renege on their campaign promises and in which all campaign promises are believed by voters and honored by candidates....

  2. Effect of Early Intensive Care on Recovery From Whiplash-Associated Disorders: Results of a Population-Based Cohort Study.

    Science.gov (United States)

    Skillgate, Eva; Côté, Pierre; Cassidy, J David; Boyle, Eleanor; Carroll, Linda; Holm, Lena W

    2016-05-01

    To determine whether the results from previous research suggesting that early intensive health care delays recovery from whiplash-associated disorders (WADs) were confounded by expectations of recovery and whether the association between early health care intensity and time to recovery varies across patterns of health care. Population-based inception cohort. All adults (≥18y) injured in motor vehicle collisions who received treatment from a regulated health professional or reported their injuries to the single provincially administered motor vehicle insurer. Participants with WAD (N=5204). Self-report visits to physicians, chiropractors, physiotherapists, massage therapists, and other professionals during the first 42 days postcollision were used to define health care intensity. Not applicable. Self-perceived recovery. Individuals with high utilization health care had slower recovery independent of expectation of recovery and other confounders. Compared with individuals who reported low utilization of physician services, recovery was slower for those with high health care utilization, regardless of the type of profession. For instance, those with high physician (hazard rate ratio [HRR]=.56; 95% confidence interval [CI], .42-.75), physician and high physiotherapy utilization (HRR=.68; 95% CI, .61-.77), physician and high chiropractor utilization (HRR=.74; 95% CI, .64-.85), and physician and high massage therapy utilization (HRR=.78; 95% CI, .68-.90) had significantly slower recovery. Our study adds to the existing evidence that early intensive care is associated with slower recovery from WAD, independent of expectation of recovery. The results have policy implications and suggest that the optimal management of WADs focuses on reassurance and education instead of intensive care. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. A Multi-Institutional Study of Feasibility, Implementation, and Early Clinical Results With Noninvasive Breast Brachytherapy for Tumor Bed Boost

    International Nuclear Information System (INIS)

    Hamid, Subarna; Rocchio, Kathy; Arthur, Douglas; Vera, Robyn; Sha, Sandra; Jolly, Michele; Cavanaugh, Sean; Wooten, Eric; Benda, Rashmi; Greenfield, Brad; Prestidge, Bradley; Ackerman, Scot; Kuske, Robert; Quiet, Coral; Snyder, Margaret; Wazer, David E.

    2012-01-01

    Purpose: To evaluate the feasibility, implementation, and early results of noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT). Methods and Materials: NIBB is a commercially available (AccuBoost, Billerica, MA) mammography-based, brachytherapy system in which the treatment applicators are centered on the planning target volume (PTV) to direct 192 Ir emissions along orthogonal axes. A privacy-encrypted online data registry collected information from 8 independent academic and community-based institutions. Data were from 146 consecutive women with early-stage breast cancer after lumpectomy and WBRT receiving boost with NIBB between July 2007 and March 2010. Toxicity and cosmesis were graded according to the Common Toxicity Criteria (v. 3.0) and the Harvard scale. Median follow-up was 6 months (1–39 months). Results: Grade 1–2 skin toxicity was observed in 64%, 48%, and 21% during the acute (1–3 weeks), intermediate (4–26 weeks), and late-intermediate (>26 weeks) periods. There was no Grade 4 toxicity. At 6 months, for the entire cohort, cosmesis was excellent/good in 62%/38%. The subset receiving NIBB before WBRT had cosmetic scores of 32% and 63%, whereas during WBRT, 58% and 37% were rated as excellent and good, respectively. Breast compression was scored as “uncomfortable” in 12%, 29%, and 59% when NIBB was delivered before, during, or after WBRT. For each patient, the fraction-to-fraction variability in PTV was low. Skin flash was associated with a higher proportion of excellent cosmesis (58% vs. 42%) relative to having the applicator all within breast tissue. Conclusions: These data indicate that NIBB is feasible and can be consistently implemented in a broad array of practice settings. Preliminary evaluation suggests that NIBB is associated with acceptably mild normal tissue toxicity and favorable early cosmesis. The application of NIBB before WBRT may be associated with better patient tolerance at

  4. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    International Nuclear Information System (INIS)

    Nichols, Elizabeth; Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia; Tkaczuk, Katherine; Cohen, Randi J.; Citron, Wendla; Morgan, Michelle; Staats, Paul; Feigenberg, Steven; Regine, William F.

    2017-01-01

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 ( 21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  5. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Elizabeth, E-mail: Enichols1@umm.edu [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia [Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Tkaczuk, Katherine [Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Cohen, Randi J.; Citron, Wendla; Morgan, Michelle [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Staats, Paul [Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Feigenberg, Steven; Regine, William F. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)

    2017-03-15

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  6. Clinical outcome and cosmetic results of conservative surgery plus radiation therapy in early stage breast cancer patients

    International Nuclear Information System (INIS)

    Jin Yening; Wang Yajie; Zhang Xiaoqing; Meng Yan; Li Rongqing; Shi Junyi

    2005-01-01

    Objective: To evaluate the clinical outcome and cosmetic results in early stage breast cancer patients treated with conservative surgery plus radiation therapy. Methods: From May 1995 to December 2002, 109 such patients were so treated. The post-operative radiotherapy consisted of whole-breast 6 MV linear accelerator irradiation with two tangential half-fields to a total dose of 45-52 Gy (mean 48.6 Gy), followed by a boost irradiation to the tumor bed. Among them, 79 patients received 10-12 Gy (DB) boost by interstitial implantation brachytherapy ( 192 Ir HDR, Nucletron), with single plane implantation for T1 and double plane implantation for T2 tumor. Thirty patients received 15 Gy boost by electron beam. Adjuvant/concurrent chemotherapy (CMF or CEF) and hormonotherapy were also used according to the patients' clinical characteristics. The cosmetic results were scored by both the doctor and the patients. Results: The overall actuarial 5-year survival was 93.8%, with local recurrence of 6.5%. No radiation-induced ulcer was observed in the breast except for acute inflammation at skin pinholes in 5 patients treated by interstitial implant brachytherapy. Among the 75 patients who had had breast examination, cosmetic result scored as good by patient and doctor were 81% and 87%, respectively. The good rate assessed by doctor in brachytherapy boost group and electron beam boost group were 81.2% (39/48) and 85.2% (23/27), There was no significant difference between these two boost techniques (P>0.05). Conclusions: Tumor bed boost irradiation by either brachytherapy or electron beam technique can provide satisfactory local control in early breast cancer treated with conservative surgery plus radiotherapy without increasing the side effects. There is no significant difference in cosmetic result between these two boost techniques. (authors)

  7. Protocolised Management In Sepsis (ProMISe): a multicentre randomised controlled trial of the clinical effectiveness and cost-effectiveness of early, goal-directed, protocolised resuscitation for emerging septic shock.

    Science.gov (United States)

    Mouncey, Paul R; Osborn, Tiffany M; Power, G Sarah; Harrison, David A; Sadique, M Zia; Grieve, Richard D; Jahan, Rahi; Tan, Jermaine C K; Harvey, Sheila E; Bell, Derek; Bion, Julian F; Coats, Timothy J; Singer, Mervyn; Young, J Duncan; Rowan, Kathryn M

    2015-11-01

    Early goal-directed therapy (EGDT) is recommended in international guidance for the resuscitation of patients presenting with early septic shock. However, adoption has been limited and uncertainty remains over its clinical effectiveness and cost-effectiveness. The primary objective was to estimate the effect of EGDT compared with usual resuscitation on mortality at 90 days following randomisation and on incremental cost-effectiveness at 1 year. The secondary objectives were to compare EGDT with usual resuscitation for requirement for, and duration of, critical care unit organ support; length of stay in the emergency department (ED), critical care unit and acute hospital; health-related quality of life, resource use and costs at 90 days and at 1 year; all-cause mortality at 28 days, at acute hospital discharge and at 1 year; and estimated lifetime incremental cost-effectiveness. A pragmatic, open, multicentre, parallel-group randomised controlled trial with an integrated economic evaluation. Fifty-six NHS hospitals in England. A total of 1260 patients who presented at EDs with septic shock. EGDT (n = 630) or usual resuscitation (n = 630). Patients were randomly allocated 1 : 1. All-cause mortality at 90 days after randomisation and incremental net benefit (at £20,000 per quality-adjusted life-year) at 1 year. Following withdrawals, data on 1243 (EGDT, n = 623; usual resuscitation, n = 620) patients were included in the analysis. By 90 days, 184 (29.5%) in the EGDT and 181 (29.2%) patients in the usual-resuscitation group had died [p = 0.90; absolute risk reduction -0.3%, 95% confidence interval (CI) -5.4 to 4.7; relative risk 1.01, 95% CI 0.85 to 1.20]. Treatment intensity was greater for the EGDT group, indicated by the increased use of intravenous fluids, vasoactive drugs and red blood cell transfusions. Increased treatment intensity was reflected by significantly higher Sequential Organ Failure Assessment scores and more advanced

  8. Accelerated Hypofractionated Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Long-Term Results

    International Nuclear Information System (INIS)

    Soliman, Hany; Cheung, Patrick; Yeung, Latifa; Poon, Ian; Balogh, Judith; Barbera, Lisa; Spayne, Jacqueline; Danjoux, Cyril; Dahele, Max; Ung, Yee

    2011-01-01

    Purpose: To retrospectively review the results of a single-institution series of accelerated hypofractionated radiotherapy for early-stage non-small-cell lung cancer (NSCLC) in patients who are medically inoperable or who refuse surgery. Methods and Materials: Peripherally located T1 to T3 N0 M0 tumors were treated with 48 to 60 Gy in 12 to 15 fractions between 1996 and 2007. No elective nodal irradiation was delivered. Patient, tumor, and treatment information was abstracted from the medical records. Results: A total of 124 tumors were treated in 118 patients (56 male and 62 female). Median age at diagnosis was 76.3 years (range, 49-90 years). In all, 113 patients (95.8%) were not surgical candidates because of medical comorbidities. The 2- and 5-year overall survival (OS) rates were 51.0% and 23.3%, respectively, and the 2- and 5-year cause-specific survival (CSS) rates were 67.6% and 59.8%, respectively. The 2- and 5-year actuarial local control (LC) rates were 76.2% and 70.1%, respectively. Univariate analysis revealed that tumor size less than 3cm compared with greater than 3 cm resulted in significantly improved OS (40.0% vs. 5.0% at 5 years; p = 0.0002), CSS (69.7% vs. 45.1% at 5 years; p = 0.0461), and a trend toward better LC (82.5% vs. 66.9% at 2 years, 76.6% vs. 60.8% at 5 years; p = 0.0685). Treatment was well tolerated and there were no treatment delays because of acute toxicity. Conclusions: Accelerated hypofractionated radiotherapy with 48 to 60 Gy using fractions of 4 Gy per day provides very good results for small tumors in medically inoperable patients with early-stage NSCLC.

  9. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Ping, E-mail: ping.jiang@uksh.de [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Baumann, René [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Dunst, Juergen [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, University of Copenhagen, Copenhagen (Denmark); Geenen, Matthias [Department of Reconstructive Surgery, Lubinus Clinic Kiel, Kiel (Germany); Siebert, Frank-André [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Niehoff, Peter [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, Community Clinic Köln, Köln (Germany); Department of Radiation Oncology, University Witten/Herdecke, Witten (Germany); Bertolini, Julia; Druecke, Daniel [Department of Reconstructive Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany)

    2016-03-01

    Purpose: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. Methods and Materials: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection. Results: The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. Conclusions: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.

  10. results

    Directory of Open Access Journals (Sweden)

    Salabura Piotr

    2017-01-01

    Full Text Available HADES experiment at GSI is the only high precision experiment probing nuclear matter in the beam energy range of a few AGeV. Pion, proton and ion beams are used to study rare dielectron and strangeness probes to diagnose properties of strongly interacting matter in this energy regime. Selected results from p + A and A + A collisions are presented and discussed.

  11. The effects of patient and physician characteristics on early outpatient satisfaction with substance dependence care: results of the SUBUSQOL study

    Directory of Open Access Journals (Sweden)

    Bourion-Bédès S

    2017-05-01

    Full Text Available Stéphanie Bourion-Bédès,1–3 Raymund Schwan,2 Paolo Di Patrizio,2 Guillaume Vlamynck,2 Sarah Viennet,2 Maxime Schvartz,2 Anne Gaunard,2 Alex Bédès,4 Isabelle Clerc-Urmès,5 Cédric Baumann3,5 1Regional Medical and Psychological Service (SMPR, 2CSAPA (Healthcare Center of Accompaniment and Prevention in Addictology, University Hospital of Nancy, 3EA4360 APEMAC, University of Lorraine, Nancy, 4ANPAA 15-CSAPA (Healthcare Center of Accompaniment and Prevention in Addictology, Saint-Flour, Cantal, 5Platform of Clinical Research Facility PARC, Unit MDS, University Hospital of Nancy, Nancy, France Background: Although patient perceptions of health care have increasingly been explored in the literature, little is known about care satisfaction among individuals with substance dependence. This exploratory study assessed the relationships between patient and physician characteristics and early outpatient satisfaction with care for alcohol and opioid dependence. Methods: Satisfaction was assessed using a multidimensional, self-administered and validated questionnaire during the early care process among a prospective outpatient cohort. In addition to measuring satisfaction and obtaining sociodemographic and clinical data, this study collected data on the self-reported health status and physician characteristics at inclusion. Cross-sectional analysis with multiple linear regression was performed to identify the variables associated with satisfaction level. Results: A total of 249 outpatients were included, and 63.8% completed the satisfaction questionnaire. Patients without a history of previous care for substance dependence were more satisfied with the appointment-making process (β=7.2; P=0.029 and with the doctor consultation (β=10.3; P=0.003 than those who had received care previously. Neither sociodemographic characteristics nor self-reported health status was associated with outpatient satisfaction. Conclusion: The factors that affect patients

  12. Feasibility and Acceptability of an Early Childhood Obesity Prevention Intervention: Results from the Healthy Homes, Healthy Families Pilot Study

    Directory of Open Access Journals (Sweden)

    Akilah Dulin Keita

    2014-01-01

    Full Text Available Background. This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children’s health behaviors. Methods. We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up. Results. 39 (78% parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, P=0.001 and ounces of fruit juice decreased at follow-up (11.9 ounces at 4 months compared to 16.0 ounces at baseline, P=0.036. Sedentary behaviors also improved. Children significantly decreased time spent watching TV on weekdays (P<0.01 and also reduced weekend TV time. In addition, the number of homes with TV sets in the child’s bedroom also decreased (P<0.0013. Conclusions. The findings indicate that a home-based early childhood obesity prevention intervention is feasible, acceptable and demonstrates short-term effects on dietary and sedentary behaviors of low-income racially/ethnically diverse children.

  13. Postoperative versus definitive chemoradiation in early-stage anal cancer. Results of a matched-pair analysis

    Energy Technology Data Exchange (ETDEWEB)

    Berger, B.; Menzel, M.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Breucha, G. [Kreiskrankenhaus Hechingen, Tuebingen Univ. (Germany). Dept. of Surgery

    2012-07-15

    Background and purpose: The goal of the present study was to comparatively assess the results of definitive chemoradiation (CRT) with or without previous macroscopically complete resection in patients with early-stage node-negative (T1-2 N0) anal carcinoma. Patients and methods: A total of 20 patients with T1-2 N0 anal carcinoma who received radiotherapy (RT) with or without chemotherapy following incidental R0/1 tumor resection (S/CRT group) were selected. These were matched to 20 comparable patients who underwent definitive chemoradiation without previous surgery (CRT group). Major objectives of this analysis were treatment outcomes in terms of locoregional tumor control (LRC), overall survival (OS), colostomy-free survival, and toxicity. Results: Patients treated postoperatively received significantly lower RT doses (median 54.0 Gy vs. 59.7 Gy; p < 0.001) and less frequently concomitant chemotherapy than those treated definitely. The 5-year LRC and 5-year OS rates were 97.5% and 90.0%, respectively, without significant differences between the S/CRT and the CRT groups. The distribution of acute and late toxicities was comparable, and the 5-year colostomy-free survival was 95% in both groups. Conclusion: This matched-pair comparison of incidental R0/1 resection plus dose-reduced CRT with standard definitive CRT of early-stage anal cancer shows similar treatment results. Thus, dose-reduced RT with or without chemotherapy may be considered in R0/1 resected patients with T1-2 N0 anal carcinoma. (orig.)

  14. Early risk of recurrent stroke in patients with symptomatic carotid near-occlusion: Results from CAOS, a multicenter registry study.

    Science.gov (United States)

    García-Pastor, Andrés; Gil-Núñez, Antonio; Ramírez-Moreno, José María; González-Nafría, Noelia; Tejada, Javier; Moniche, Francisco; Portilla-Cuenca, Juan Carlos; Martínez-Sánchez, Patricia; Fuentes, Blanca; Gamero-García, Miguel Ángel; Alonso de Leciñana, María; Cánovas-Verge, David; Aladro, Yolanda; Parkhutik, Vera; Lago-Martín, Aida; de Arce-Borda, Ana María; Usero-Ruíz, María; Delgado-Mederos, Raquel; Pampliega, Ana; Ximenez-Carrillo, Álvaro; Bártulos-Iglesias, Mónica; Castro-Reyes, Enrique

    2017-10-01

    Background The risk of recurrent stroke among patients with symptomatic carotid near-occlusion is not well established, and management of the condition remains controversial. Symptomatic carotid near-occlusion with full collapse has been identified as a strong predictor of early recurrence. We aimed to analyze the 90-day risk of recurrent ipsilateral ischemic stroke in medically treated patients with symptomatic carotid near-occlusion. Methods We performed a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed symptomatic carotid near-occlusion were included. The primary endpoint was ipsilateral ischemic stroke or transient ischemic attack (TIA) within 90 days after the presenting event. For this analysis, patients who underwent revascularization within 90 days after stroke were excluded. Results The study population comprised 141 patients from 17 Spanish centers; 83 patients were treated medically. Primary endpoint occurred in eight patients, resulting in a cumulative rate of 10.6% (95% CI, 3.7-17.5). Previous history of stroke or transient ischemic attack was identified as an independent predictor for recurrence in the multivariate Cox regression analysis (HR, 4.37 [95% CI, 1.05-18.18]; p = 0.043), while the presence of full collapse was not associated with an increased risk (HR, 0.81 [95% CI, 0.17-3.92]; p = 0.793). The risk of recurrence was also not affected by the presence of significant stenosis or occlusion of the contralateral carotid artery, or by the collateral circulation. Conclusions Patients with symptomatic carotid near-occlusion seem to have an increased risk of early ipsilateral recurrent stroke. Our results contrast with the low risk of symptomatic carotid near-occlusion reported to date. Full collapse did not increase the risk of recurrent stroke in our study.

  15. Brief report: Assessing youth well-being in global emergency settings: Early results from the Emergency Developmental Assets Profile.

    Science.gov (United States)

    Scales, Peter C; Roehlkepartain, Eugene C; Wallace, Teresa; Inselman, Ashley; Stephenson, Paul; Rodriguez, Michael

    2015-12-01

    The 13-item Emergency Developmental Assets Profile measures the well-being of children and youth in emergency settings such as refugee camps and armed conflict zones, assessing whether young people are experiencing adequate positive relationships and opportunities, and developing positive values, skills, and self-perceptions, despite being in crisis circumstances. The instrument was found to have acceptable and nearly identical internal consistency reliability in 22 administrations in non-emergency samples in 15 countries (.75), and in 4 samples of youth ages 10-18 (n = 1550) in the emergency settings (war refugees and typhoon victims, .74) that are the measure's focus, and evidence of convergent validity. Confirmatory Factor Analysis showed acceptable model fit among those youth in emergency settings. Measures of model fit showed that the Em-DAP has configural and metric invariance across all emergency contexts and scalar invariance across some. The Em-DAP is a promising brief cross-cultural tool for assessing the developmental quality of life as reported by samples of youth in a current humanitarian crisis situation. The results can help to inform international relief program decisions about services and activities to be provided for children, youth, and families in emergency settings. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  16. Mastering JavaScript promises

    CERN Document Server

    Hussain, Muzzamil

    2015-01-01

    This book is for all the software and web engineers wanting to apply the promises paradigm to their next project and get the best outcome from it. This book also acts as a reference for the engineers who are already using promises in their projects and want to improve their current knowledge to reach the next level. To get the most benefit from this book, you should know basic programming concepts, have a familiarity with JavaScript, and a good understanding of HTML.

  17. A Multi-Institutional Study of Feasibility, Implementation, and Early Clinical Results With Noninvasive Breast Brachytherapy for Tumor Bed Boost

    Energy Technology Data Exchange (ETDEWEB)

    Hamid, Subarna, E-mail: shamid@tuftsmedicalcenter.org [Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States); Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States); Rocchio, Kathy [Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States); Arthur, Douglas; Vera, Robyn [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Sha, Sandra; Jolly, Michele [Central Florida Cancer Institute, Davenport, FL (United States); Cavanaugh, Sean; Wooten, Eric [Atlanta Oncology Associates, Hawkinsville, GA (United States); Benda, Rashmi; Greenfield, Brad [Department of Radiation Oncology, Boca Raton Community Hospital, Boca Raton, FL (United States); Prestidge, Bradley [Texas Cancer Clinic, San Antonio, TX (United States); Ackerman, Scot [First Coast Oncology, Jacksonville, FL (United States); Kuske, Robert; Quiet, Coral; Snyder, Margaret [Arizona Breast Cancer Specialists, Phoenix, AZ (United States); Wazer, David E. [Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States); Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States)

    2012-08-01

    Purpose: To evaluate the feasibility, implementation, and early results of noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT). Methods and Materials: NIBB is a commercially available (AccuBoost, Billerica, MA) mammography-based, brachytherapy system in which the treatment applicators are centered on the planning target volume (PTV) to direct {sup 192}Ir emissions along orthogonal axes. A privacy-encrypted online data registry collected information from 8 independent academic and community-based institutions. Data were from 146 consecutive women with early-stage breast cancer after lumpectomy and WBRT receiving boost with NIBB between July 2007 and March 2010. Toxicity and cosmesis were graded according to the Common Toxicity Criteria (v. 3.0) and the Harvard scale. Median follow-up was 6 months (1-39 months). Results: Grade 1-2 skin toxicity was observed in 64%, 48%, and 21% during the acute (1-3 weeks), intermediate (4-26 weeks), and late-intermediate (>26 weeks) periods. There was no Grade 4 toxicity. At 6 months, for the entire cohort, cosmesis was excellent/good in 62%/38%. The subset receiving NIBB before WBRT had cosmetic scores of 32% and 63%, whereas during WBRT, 58% and 37% were rated as excellent and good, respectively. Breast compression was scored as 'uncomfortable' in 12%, 29%, and 59% when NIBB was delivered before, during, or after WBRT. For each patient, the fraction-to-fraction variability in PTV was low. Skin flash was associated with a higher proportion of excellent cosmesis (58% vs. 42%) relative to having the applicator all within breast tissue. Conclusions: These data indicate that NIBB is feasible and can be consistently implemented in a broad array of practice settings. Preliminary evaluation suggests that NIBB is associated with acceptably mild normal tissue toxicity and favorable early cosmesis. The application of NIBB before WBRT may be associated with better patient tolerance

  18. Early and Late Results of the Nuss Procedure in Surgical Treatment of Pectus Excavatum in Different Age Groups.

    Science.gov (United States)

    Pawlak, Krystian; Gąsiorowski, Łukasz; Gabryel, Piotr; Gałęcki, Bartłomiej; Zieliński, Paweł; Dyszkiewicz, Wojciech

    2016-11-01

    The aim of this study was a comparison of early and late results in surgical treatment of funnel chest using the Nuss method in patients in various age groups to find the optimal age to perform the corrective procedure. Six hundred eighty patients operated on from June 2002 to October 2012 were included in the retrospective analysis. Patients were divided into 3 different age groups: group A = 156 patients from 7 to 14 years, group B = 328 patients aged 15 to 20 years, and group C = 196 patients older than 20 years of age. The mean follow-up was 33 months. Early non-life-threatening complications developed in 238 (35.0%) patients and frequency increased with age (group A, 24.3%; group B, 37.8%; group C, 38.8%; p = 0.0063). Good and very good corrective effects were achieved in 97.7 % of the entire patient population. Recurrence of the deformity was observed more often in younger patients (group A, 3.2 %) than in the other patients (group B, 1.2%; group C, 1.5%), although the difference between the studied groups was not significant (p = 0.3251). Good cosmetic results obtained with the use of the Nuss operation were not related to the age of the patients. The high incidence of minor complications in older patients seems to be an acceptable cost of a good cosmetic outcome and stable correction. Surgical morbidity is lowest in younger patients; however, the frequency of the recurrence of deformation is higher than in other groups. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Comparison of Early Results and Complications between Multi-and Single-Port Sleeve Gastrectomy: A Randomized Clinical Study

    Directory of Open Access Journals (Sweden)

    Seyed Vahid Hosseini

    2017-05-01

    Full Text Available Background: In recent years, laparoscopic sleeve gastrectomy (LSG has become more acceptable for obese patients. Single-port sleeve gastrectomy (SPSG is more popular since each abdominal incision carries the risk of bleeding, hernia, and internal organ injury as well as exponentially affecting cosmesis. This cross-sectional study aimed at comparing multi-port sleeve gastrectomy (MPSG and SPSG in terms of their early results and complications. Methods: Out of129 obese patients candidated for LSG, 102 patients were assigned to 2 groups of SPSG and MPSG. Complications and demographic data such as body mass index (BMI, age, gender, operation time, and hospital stay were measured. All surgeries were carried out between2013 and 2015 in Shiraz, Iran. Data analysis was performed using SPSS, version 16 for Windows (SPSS Inc., Chicago, IL. The continuous and categorical variables were compared using the Student t-test and the Chi-square test or the Fisher exact test, respectively. Results: The patients’ data from both groups were similar in terms of age, intraoperative and postoperative bleeding volume, and length of hospital stay. Mean BMI was 42.8±0.7 in the SPSG group and 45.3±1.2 in the MPSG group. Duration of surgery was significantly lower in the SPSG group (P<0.001. Only 1 patient from the SPSG group and 5 patients from the MPSG group had bleeding as an early complication. Conclusion: The differences in each complication between the groups were not statistically significant. SPSG seems to be safe and is the same as MPSG in terms of major postoperative complications. Trial Registration Number: IRCT201512229936N12

  20. Capturing Early Changes in the Marine Bacterial Community as a Result of Crude Oil Pollution in a Mesocosm Experiment.

    Science.gov (United States)

    Krolicka, Adriana; Boccadoro, Catherine; Nilsen, Mari Mæland; Baussant, Thierry

    2017-12-27

    The results of marine bacterial community succession from a short-term study of seawater incubations at 4°C to North Sea crude oil are presented herein. Oil was used alone (O) or in combination with a dispersant (OD). Marine bacterial communities resulting from these incubations were characterized by a fingerprinting analysis and pyrosequencing of the 16S rRNA gene with the aim of 1) revealing differences in bacterial communities between the control, O treatment, and OD treatment and 2) identifying the operational taxonomic units (OTUs) of early responders in order to define the bacterial gene markers of oil pollution for in situ monitoring.After an incubation for 1 d, the distribution of the individual ribotypes of bacterial communities in control and oil-treated (O and OD) tanks differed. Differences related to the structures of bacterial communities were observed at later stages of the incubation. Among the early responders identified (Pseudoalteromonas, Sulfitobacter, Vibrio, Pseudomonas, Glaciecola, Neptunomonas, Methylophaga, and Pseudofulvibacter), genera that utilize a disintegrated biomass or hydrocarbons as well as biosurfactant producers were detected. None of these genera included obligate hydrocarbonoclastic bacteria (OHCB). After an incubation for 1 d, the abundances of Glaciecola and Pseudofulvibacter were approximately 30-fold higher in the OD and O tanks than in the control tank. OTUs assigned to the Glaciecola genus were represented more in the OD tank, while those of Pseudofulvibacter were represented more in the O tank. We also found that 2 to 3% of the structural community shift originated from the bacterial community in the oil itself, with Polaribacter being a dominant bacterium.

  1. Status and promise of fuel cell technology

    Energy Technology Data Exchange (ETDEWEB)

    Williams, M.C. [National Energy Technology Lab., Pittsburgh, PA (United States). Dept. of Energy

    2001-09-01

    The niche or early entry market penetration by ONSI and its phosphoric acid fuel cell technology has proven that fuel cells are reliable and suitable for premium power and other opportunity fuel niche market applications. Now, new fuel cell technologies - solid oxide fuel cells, molten carbonate fuel cells, and polymer electrolyte fuel cells - are being developed for near-term distributed generation shortly after 2003. Some of the evolving fuel cell systems are incorporating gas turbines in hybrid configurations. The combination of the gas turbine with the fuel cell promises to lower system costs and increase efficiency to enhance market penetration. Market estimates indicate that significant early entry markets exist to sustain the initially high cost of some distributed generation technologies. However, distributed generation technologies must have low introductory first cost, low installation cost, and high system reliability to be viable options in competitive commercial and industrial markets. In the long-term, solid state fuel cell technology with stack costs under $100/kilowatt (kW) promises deeper and wider market penetration in a range of applications including a residential, auxillary power, and the mature distributed generation markets. The solid state energy conversion alliance (SECA) with its vision for fuel cells in 2010 was recently formed to commercialize solid state fuel cells and realize the full potential of the fuel cell technology. Ultimately, the SECA concept could lead to megawatt-size fuel-cell systems for commercial and industrial applications and Vision 21 fuel cell turbine hybrid energy plants in 2015. (orig.)

  2. Promising Compilation to ARMv8 POP

    OpenAIRE

    Podkopaev, Anton; Lahav, Ori; Vafeiadis, Viktor

    2017-01-01

    We prove the correctness of compilation of relaxed memory accesses and release-acquire fences from the "promising" semantics of [Kang et al. POPL'17] to the ARMv8 POP machine of [Flur et al. POPL'16]. The proof is highly non-trivial because both the ARMv8 POP and the promising semantics provide some extremely weak consistency guarantees for normal memory accesses; however, they do so in rather different ways. Our proof of compilation correctness to ARMv8 POP strengthens the results of the Kan...

  3. Is the Prediction of Adolescent Outcomes from Early Child Care Moderated by Later Maternal Sensitivity? Results from the NICHD Study of Early Child Care and Youth Development

    Science.gov (United States)

    Burchinal, Margaret R.; Lowe Vandell, Deborah; Belsky, Jay

    2014-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during…

  4. "Big Bang" as a result result of the curvature-driven first-order phase transition in the early cold Universe

    Science.gov (United States)

    Pashitskii, E. A.; Pentegov, V. I.

    We suggest that the "Big Bang" may be a result of the first-order phase transition driven by changing scalar curvature of the 4D space-time in the expanding cold Universe, filled with nonlinear scalar field φ and neutral matter with equation of state p = vɛ (where p and ɛ are pressure and energy density of matter). We consider a Lagrangian for scalar field in curved space-time with nonlinearity φ, which along with the quadratic term -ΣR|φ|2 (where Σ is interaction constant and R is scalar curvature) contains a term ΣR(φ +φ+) linear in φ. Due to this term the condition for the extrema of the potential energy of the scalar field is given by a cubic equation. Provided v > 1/3 the scalar curvature R = [κ(3v-1)ɛ - 4Γ (where κ and Γ are Einstein's gravitational and cosmological constants) decreases along with decreasing " in the process of the Universe's expansion, and at some critical value Rc < 0 a first-order phase transition occurs, driven by an "external field" parameter proportional to R. Given certain conditions the critical radius of the early Universe at the point of the first-order phase transition may reach arbitrary large values, so this scenario of unrestricted "inflation" of the Universe may be called "hyperinflation". Beyond the point of phase transition the system is rolling down into the potential minimum releasing the potential energy of scalar field with subsequent powerful heating of the Universe playing the role of "Big Bang".

  5. Early results of Latitude primary total elbow replacement with a minimum follow-up of 2 years.

    Science.gov (United States)

    Mehta, Saurabh S; Watts, Adam C; Talwalkar, Sumedh C; Birch, Ann; Nuttall, David; Trail, Ian A

    2017-10-01

    The aim of this study was to present outcomes of primary Latitude total elbow replacement (TER) with a minimum follow-up of 2 years. A retrospective cohort study was undertaken with prospective outcome data collection for the latest outcome. Included were 63 consecutive primary Latitude TERs in 58 patients performed during a period of 5 years at a specialist orthopedic hospital. The mean age of the patients was 62 years (33-85 years). Five primary TERs (4 patients) were lost to follow-up. The primary diagnosis was rheumatoid arthritis in 49, osteoarthritis in 8, and trauma in 6 elbows. The mean flexion-extension arc was 75° preoperatively and 97° postoperatively. Mean postoperative Elbex pain score was 19/100, and function score was 37/100. Mean postoperative scores were 42/100 for the Quick Disabilities of the Arm, Shoulder, and Hand and 38/50 for the elbow-specific American Shoulder and Elbow Surgeons assessment. Four patients died of unrelated causes, and 8 of 63 underwent further surgical intervention, including explantation and conversion from unlinked to linked implant. On radiographic review of 41 surviving TERs, aseptic radiologic loosening was observed of the humeral component in 4 elbows and of the ulnar component in 9. Seven elbows had no radial component, and of the remaining 34 elbows, 16 (47%) had signs of loosening of the radial implant. Complications included 1 heterotopic ossification, 1 olecranon fracture, and 3 further procedures for ulnar nerve entrapment. The results indicate that the early outcome of Latitude TER is comparable to that of other prostheses. There is concern about early radiologic loosening of the radial component. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  6. Results From Medium Deep Near-UV Imaging With The HST/WFC3 Early Release Science Data

    Science.gov (United States)

    Cohen, Seth H.; Ryan, R. E., Jr.; Hathi, N. P.; Straughn, A. N.; Yan, H.; Rutkowski, M. J.; Windhorst, R. A.; McCarthy, P. J.; O'Connell, R. W.; Koekemoer, A. M.; SOC, WFC3

    2011-01-01

    As part of the WFC3 Early Release Science observations, a portion of the GOODS-S field was observed with both the UVIS and IR Channels of the WFC3. The full data set of 100 orbits covers 50 square arcminutes on the sky at 0.09 arcseconds per pixel with ten broad bands covering 0.2-1.7 microns. The field was observed in F225W, F275W, and F336W to 10 sigma point source flux limits of 26.0, 26.1, and 25.7 AB-mag, respectively. In this poster, we will emphasize the results enabled by these UV observations of faint galaxies. We demonstrate that these UV observations are extremely useful, even for galaxies of intermediate redshifts (zdropout galaxies, AGN, etc. In particular, optical and near-IR studies only measure the rest-frame UV properties of the highest redshift galaxies, and for comparison these UV observations are needed to properly study galaxy evolution near the peak of the global star formation rate density. In fact, deeper UV observations, below the atmospheric cutoff, and with space-based resolution, are need to properly study galaxies at the faint-end of the luminosity function at z 1. This paper is based on Early Release Science observations made by the WFC3 Scientific Oversight Committee. We are grateful to the Director of the Space Telescope Science Institute for awarding Director's Discretionary time for this program. Support for program #11359 was provided by NASA through a grant from the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555.

  7. Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey.

    Science.gov (United States)

    Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

    2016-01-01

    Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

  8. Refining the Early and Middle Eocene Geomagnetic Polarity Time Scale: new results from ODP Leg 208 (Walvis Ridge)

    Science.gov (United States)

    Westerhold, T.; Roehl, U.; Frederichs, T.; Bohaty, S. M.; Florindo, F.; Zachos, J. C.; Raffi, I.; Agnini, C.

    2015-12-01

    Astronomical calibration of the Geomagnetic Polarity Time Scale (GPTS) for the Eocene (34-56 Ma) has advanced tremendously in recent years. Combining a cyclostratigraphic approach based on the recognition of the stable 405-kyr eccentricity cycle of Earth's orbit with high-resolution bio- and magnetostratigraphy from deep-sea sedimentary records (ODP Legs 171B, 189 and 207; IODP Exp. 320/321) resulted in a new calibration of the middle-to-late Eocene GPTS spanning Chrons C12r to C19n (30.9-41.3 Ma). A fully astronomically calibrated GPTS for the Eocene was established recently by integrating cyclo-bio-magnetostratigraphy from ODP Sites 702 and 1263 records spanning the middle Eocene with Site 1258 records covering the early Eocene. Comparison of this deep sea-derived GPTS with GTS2012 and GPTS calibration points from terrestrial successions show overall consistent results, but there are still major offsets for the duration of Chrons C20r, C22r and C23n.2n. Because of the relatively large uncertainty of the calibration point, a radioisotopic dated ash layer in DSDP 516F, at C21n.75 (46.24±0.5 Ma) the duration of C20r in GPTS2012 (2.292 myr) is uncertain. Offsets in durations of C22r and C23n.2n between GPTS2012 and the new astronomical GPTS (~400-kyr longer C22r; ~400-kyr shorter C23n.2n) could be due to uncertainties in the interpretation of Site 1258 magnetostratigraphic data. Here we present new results toward establishing a more accurate and complete bio-, magneto- and chemostratigraphy for South Atlantic Leg 208 sites encompassing magnetochrons C13 to C24 (33 to 56 Ma). Our study aims to integrate paleomagnetic records from multiple drilled sites with physical property data, stable isotope data and XRF core scanning data to construct an astronomically calibrated framework for refining GPTS age estimates. This effort will complete the Early-to-Middle Eocene GPTS and allow evaluation of the relative position of calcareous nannofossil events to magnetostratigraphy.

  9. Measurement of volume change in cementitious materials at early ages - Review of testing protocols and interpretation of results

    DEFF Research Database (Denmark)

    Sant, Gaurav; Lura, Pietro; Weiss, Jason

    2006-01-01

    Early-age cracking in concrete bridge decks, pavements, and superstructure elements has served as the impetus for substantial research on early-age shrinkage in cementitious materials. Much of this research has indicated how mixture proportions, constituent materials, and construction operations...

  10. Early Childhood Program Participation, Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-101

    Science.gov (United States)

    Corcoran, Lisa; Steinley, Katrina

    2017-01-01

    This report presents findings from the Early Childhood Program Participation Survey of the National Household Education Surveys Program of 2016 (NHES:2016). The Early Childhood Program Participation Survey collected data on children's participation in relative care, nonrelative care, and center-based care arrangements. It also collected…

  11. Interocular suppression in strabismic amblyopia results in an attenuated and delayed hemodynamic response function in early visual cortex.

    Science.gov (United States)

    Farivar, Reza; Thompson, Benjamin; Mansouri, Behzad; Hess, Robert F

    2011-12-20

    Factors such as strabismus or anisometropia during infancy can disrupt normal visual development and result in amblyopia, characterized by reduced visual function in an otherwise healthy eye and often associated with persistent suppression of inputs from the amblyopic eye by those from the dominant eye. It has become evident from fMRI studies that the cortical response to stimulation of the amblyopic eye is also affected. We were interested to compare the hemodynamic response function (HRF) of early visual cortex to amblyopic vs. dominant eye stimulation. In the first experiment, we found that stimulation of the amblyopic eye resulted in a signal that was both attenuated and delayed in its time to peak. We postulated that this delay may be due to suppressive effects of the dominant eye and, in our second experiment, measured the cortical response of amblyopic eye stimulation under two conditions--where the dominant eye was open and seeing a static pattern (high suppression) or where the dominant eye was patched and closed (low suppression). We found that the HRF in response to amblyopic eye stimulation depended on whether the dominant eye was open. This effect was manifested as both a delayed HRF under the suppressed condition and an amplitude reduction.

  12. Nuclear energy: obstacles and promises

    International Nuclear Information System (INIS)

    Bacher, P.

    2003-01-01

    Nuclear energy has distinctive merits (sustainable resources, low costs, no greenhouse gases) but its development must overcome serious hurdles (fear of accidents, radio-phobia, waste management). The large unit size of present-day reactors is compatible only with large electrical grids, and involves a high capital cost. Taking into account these different factors, the paper outlines how nuclear energy may contribute to the reduction of greenhouse gases, and which are the most promising developments. (author)

  13. The promise of cyborg intelligence.

    Science.gov (United States)

    Brown, Michael F; Brown, Alexander A

    2017-03-01

    Yu et al. (2016) demonstrated that algorithms designed to find efficient routes in standard mazes can be integrated with the natural processes controlling rat navigation and spatial choices, and they pointed out the promise of such "cyborg intelligence" for biorobotic applications. Here, we briefly describe Yu et al.'s work, explore its relevance to the study of comparative cognition, and indicate how work involving cyborg intelligence would benefit from interdisciplinary collaboration between behavioral scientists and engineers.

  14. Freedom: A Promise of Possibility.

    Science.gov (United States)

    Bunkers, Sandra Schmidt

    2015-10-01

    The idea of freedom as a promise of possibility is explored in this column. The core concepts from a research study on considering tomorrow (Bunkers, 1998) coupled with humanbecoming community change processes (Parse, 2003) are used to illuminate this notion. The importance of intentionality in human freedom is discussed from both a human science and a natural science perspective. © The Author(s) 2015.

  15. Early Results of Three-Year Monitoring of Red Wood Ants’ Behavioral Changes and Their Possible Correlation with Earthquake Events

    Science.gov (United States)

    Berberich, Gabriele; Berberich, Martin; Grumpe, Arne; Wöhler, Christian; Schreiber, Ulrich

    2013-01-01

    Simple Summary For three years (2009–2012), two red wood ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), have been monitored 24/7 by high-resolution cameras. Early results show that ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants’ behavior hours before the earthquake: the nocturnal rest phase and daily activity are suppressed, and standard daily routine does not resume until the next day. At present, an automated image evaluation routine is being applied to the video streams. Based on this automated approach, a statistical analysis of the ant behavior will be carried out. Abstract Short-term earthquake predictions with an advance warning of several hours or days are currently not possible due to both incomplete understanding of the complex tectonic processes and inadequate observations. Abnormal animal behaviors before earthquakes have been reported previously, but create problems in monitoring and reliability. The situation is different with red wood ants (RWA; Formica rufa-group (Hymenoptera: Formicidae)). They have stationary mounds on tectonically active, gas-bearing fault systems. These faults may be potential earthquake areas. For three years (2009–2012), two red wood ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), have been monitored 24/7 by high-resolution cameras with both a color and an infrared sensor. Early results show that ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants’ behavior hours before the earthquake: the nocturnal rest phase and daily activity are suppressed, and standard daily routine does not resume until the next day. At present, an automated image evaluation routine is being applied to the more than 45,000 hours of video streams. Based on this automated approach, a statistical analysis of

  16. Factors associated with a bad functional prognosis in early inflammatory back pain: results from the DESIR cohort.

    Science.gov (United States)

    Lukas, C; Dougados, M; Combe, B

    2016-01-01

    Spondyloarthritis (SpA) is a heterogeneous disease with hardly predictable potential courses. We aimed at determining prognostic factors of bad functional outcome at 2 years in patients with early inflammatory back pain (IBP). Data from patients included in the French multicentre devenir des spondylarthropathies indifférenciées récentes (DESIR) cohort, that is, suffering from IBP starting before 50 years of age and lasting for 3-36 months, were used. A bad functional outcome at 24 months was defined as an increase in bath ankylosing spondylitis functional index (BASFI), or BASFI at 2 years higher than the 75th centile in the cohort. Demographic, clinical, biological and radiological data collected at inclusion were compared in patients with bad functional outcome versus others, by χ(2) test, then by a multivariate logistic regression model with stepwise selection of relevant factors. 513 patients (54.4% females, 72.2% fulfilling ASAS criteria) were assessed. Of those, 130 (25.3%) fulfilled the aforementioned criteria of a bad functional outcome (BASFI increase ≥4 units or ≥36 at 2 years). Multivariate analysis revealed that not fulfilling ASAS criteria, female sex, age >33 years, lower educational level, active smoking status and high disease activity according to bath ankylosing spondylitis disease activity index (BASDAI) at baseline were independently associated with a bad functional outcome at 24 months. Sensitivity analyses restricted to patients fulfilling ASAS criteria for SpA resulted in similar results. We observed, in a large prospective cohort of patients with early IBP, formerly described bad prognostic factors, especially a low educational level, an older age and a high disease activity at onset, and revealed that active smoking status and female sex were also independently associated with a poor outcome. Fulfilment of ASAS criteria, on the other hand, was predictive of a better outcome, most likely due to the more consensual

  17. Autologous transplantation of bone marrow mononuclear stem cells by mini-thoracotomy in dilated cardiomyopathy: technique and early results

    Directory of Open Access Journals (Sweden)

    Renato Abdala Karam Kalil

    Full Text Available CONTEXT AND OBJECTIVES: There are few studies concerning bone marrow mononuclear cell (BMMC transplantation in cases of nonischemic dilated cardiomyopathy. This study describes a novel technique of BMMC transplantation and the results up to one year after the procedure. DESIGN AND SETTING: This was a case series to evaluate the safety and viability of the procedure, at Instituto de Cardiologia do Rio Grande do Sul. METHODS: Nine patients with symptomatic dilated cardiomyopathy, functional class III/IV and left ventricular ejection fraction (LVEF < 35% received BMMC (9.6 ± 2.6 x 107 cells at 20 sites in the ventricular wall, by means of thoracotomy of length 5 cm in the fifth left intercostal space. Echocardiograms and nuclear magnetic resonance (NMR were performed. RESULTS: There were no major complications. The functional class results for the first six patients (preoperatively and at two, four, eight and twelve-month follow-ups, respectively were: [IV-2, III-4] to [I-5, II-1] to [I-3, II-3] to [I-2, II-3] and [I-2, II-3]. Echocardiograms showed LVEF: 25.9 ± 8.2; 32.9 ± 10.4; 29.4 ± 7.2; 25.1 ± 7.9; 25.4 ± 6.8% (p = 0.023; and % left ventricular (LV fiber shortening: 12.6 ± 4.4; 16.4 ± 5.4; 14.3 ± 3.7; 12.1 ± 4.0; 12.2 ± 3.4% (p = 0.021. LV performance variation seen on NMR was non-significant. CONCLUSION: Intramyocardial transplantation of BMMC in dilated cardiomyopathy cases is feasible and safe. There were early improvements in symptoms and LV performance. Medium-term evaluation revealed regression of LV function, although maintaining improved functional class.

  18. Toxicity and cosmetic result of partial breast high-dose-rate interstitial brachytherapy for conservatively operated early breast cancer

    International Nuclear Information System (INIS)

    Xiu Xia; Tripuraneni Prabhakar; Giap Huan; Lin Ray; Chu Colin

    2007-01-01

    Objective: Objective To study the method, side effects and cosmetic outcome of high- dose-rate (HDR) accelerated partial breast interstitial irradiation (APBI) alone in early stage breast cancer' after conservative surgery. Methods: From February 2002 to June 2003,47 breast cancer lesions from 46 patients suffering from stage I/II breast cancer were treated with HDR 192 Ir APBI after conservative surgery. All patients were over 40 year-old, with T1-2N0-1 (≤3 lymph nodes positive), surgical margin > 1-2 mm, but those having lobular or inflammatory breast cancer were excluded. HDR brachytherapy with 34 Gy, 10 fractions/5 days was used after surgery, toxic reaction and cosmetic outcome were observed in one month, 6 and 12 months respectively. Results: Follow up of 1846 months, 34 months was carried out for the whole group. During the treatment, acute reactions including: erythema, edema, tenderness and infection, all under I-II grade, none of III-IV grade were observed in 21 patients(46%); late toxicity reactions: skin fibrosis, breast tenderness, fat necrosis, and telangiectasia, totally 20 patients (43%) were observed: 2 patients in III grade but one patient received 6 cycle chemotherapy. The result of cosmetic outcome evaluation was excellent or good, at 6 months 95% and 12 months 98%, respectively, but there was no recurfence. Conclusions: Excellent and favorable cosmetic results are noted after APBI by interstitial alone. Acute and late reactions are few. Long term observation is necessary for the rate of' local control. (authors)

  19. Low prevalence of work disability in early inflammatory arthritis (EIA) and early rheumatoid arthritis at enrollment into a multi-site registry: results from the catch cohort.

    Science.gov (United States)

    Mussen, Lauren; Boyd, Tristan; Bykerk, Vivian; de Leon, Faye; Li, Lihua; Boire, Gilles; Hitchon, Carol; Haraoui, Boulos; Thorne, J Carter; Pope, Janet

    2013-02-01

    We determined the prevalence of work disability in early rheumatoid arthritis (ERA) and undifferentiated early inflammatory arthritis (EIA) patients at first enrollment into the Canadian Early Arthritis Cohort (CATCH) who met the 2010 ACR criteria versus those not meeting criteria, to determine the impact of meeting new criteria on work disability status. Data at first visit into the cohort were analyzed. Descriptive statistics and logistic regression analyses were performed to investigate the association of other variables in our database with work disability. 1,487 patients were enrolled in the CATCH study, a multi-site observational, prospective cohort of patients with EIA. 934 patients were excluded (505 based on missing criteria for ACR 2010 classification, as anti-CCP was absent, and 429 were not working for other reasons). Of the 553 patients included, 71 % were female with mean disease duration of 6.4 months. 524 (94.8 %) were employed while 29 (5.2 %) reported work disability at first visit. There were no differences between those meeting 2010 ACR criteria versus those who did not. Baseline characteristics associated with work disability were male gender, age, education, income, HAQ, and positive RF status. The mean HAQ score in work disabled patients was 1.4 versus 0.9 in those who were working (p 50 years; p = 0.3), lower education (p = 0.3) or RF positivity (p = 0.6). We found rates of work disability to be low at entry into this EIA cohort compared to previous studies. There may be potential for intervention in ERA to prevent the development of work disability.

  20. Novel percutaneous suture-mediated patent foramen ovale closure technique. Early results of the NobleStitch EL Italian Registry.

    Science.gov (United States)

    Gaspardone, Achille; De Marco, Federico; Sgueglia, Gregory A; De Santis, Antonella; Iamele, Maria; D'Ascoli, Emanuela; Tusa, Maurizio; Corciu, Anca; Mullen, Michael; Nobles, Anthony; Carminati, Mario; Bedogni, Francesco

    2018-04-03

    To assess the efficacy of a novel percutaneous "device-less" suture mediated patent foramen ovale (PFO) closure system. Between June 2016 and October 2017, a prospective registry aimed at assessing the safety and efficacy of the NobleStitch EL (HeartStitch, Fountain Valley, CA) suture-based PFO closure system was carried out at 12 sites in Italy. Among 200 consecutive evaluated patients, 192 were considered suitable for suture-mediated PFO closure (44±13 years, 114 women). Suture of the septum with the NobleStitch EL system was carried out successfully in 186 (96%) patients. Median fluoroscopy time was 16.1 (13.0-22.5) minutes and contrast volume 200 (150-270) ml. At 206±130 days follow-up, microbubbles transthoracic echocardiography with Valsalva maneuver revealed no RLS (grade 0) in 139 (75%) patients and RLS grade ≤1 in 166 (89%) patients. Significant RLS was present in 20 (11%) patients (grade 2 and 3 in 11 and 9 patients, respectively). There were no device-related complications. The early results of this first Italian Registry indicates that the suture mediated "deviceless" closure of PFO is feasible in the majority of septal anatomies, provides an effective closure of PFO comparable to traditional devices with an excellent safety profile at medium term follow-up.

  1. Early stimulation results in children with Retinopathy of Prematurity in Sancti Spíritus. 2007-2012.

    Directory of Open Access Journals (Sweden)

    Miriam Rodríguez Rodríguez

    2014-06-01

    Full Text Available A descriptive retrospective study with a longitudinal projection was made, since January 2007 until December 2010, in Retinopathy of prematurity and early stimulation consultations inside of Low vision´s department in Camilo Cienfuegos´ Hospital, with the objective to describe the result of laser treatment for retinopathy of prematurity, in order to avoid blindness in children who developed this illness. The data base used was the one of the provincial program of retinopathy. The population of the study was conformed by 36 children who developed retinopathy in the studied period, 11 children were taken as a sample, the one that received laser treatment because they have suffer stage III of the illness. Males prevailed, coming from five different municipalities of the province, must of them were rehabilitated with glasses for their residual ametropia after the treatment was employed. All of these made possible an adequate visual development and an economical saving of 58800 pesos for all the cases who didn´t develop a visual disability because of Retinopathy from the prematurity, and did not register in the Blind and low visual children´s School.

  2. Intersphincteric proctectomy with end-colostomy for anorectal Crohn's disease results in early and severe proximal colonic recurrence.

    Science.gov (United States)

    de Buck van Overstraeten, Anthony; Wolthuis, Albert M; Vermeire, Séverine; Van Assche, Gert; Rutgeerts, Paul; Penninckx, Freddy; D'Hoore, André

    2013-07-01

    Perianal Crohn's disease (CD) represents a more aggressive phenotype of inflammatory bowel disease and often coincides with proctocolitis. This study aims to assess the outcome of patients undergoing proctectomy with end-colostomy. A retrospective outcome analysis of 10 consecutive patients who underwent intersphincteric proctectomy with end-colostomy between February 2007 and May 2011 was performed. All patients suffered from refractory distal and perianal CD. The proximal colon was normal at endoscopy. All data were extracted from a prospectively maintained database. The main outcome parameter was disease recurrence and need for completion colectomy. Severe and early endoscopic recurrence in the proximal colon occurred in 9/10 patients at a median time interval of 9.5 months (range: 1.9-23.6 months). Despite protracted medical treatment, completion colectomy was necessary in 5 patients. One patient, who underwent a second segmental colectomy with a new end-colostomy, showed again endoscopic recurrence and is currently treated with anti-TNF agents. Intersphincteric proctectomy with colostomy seems to be an ineffective surgery for perianal CD with coexisting proctitis and results in a high risk of recurrence of the disease in the remaining colon. Therefore, despite a normal appearance of the proximal colon, a proctocolectomy with end-ileostomy seems to be the surgical approach of choice in these patients. Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  3. Early Results of Three-Year Monitoring of Red Wood Ants’ Behavioral Changes and Their Possible Correlation with Earthquake Events

    Directory of Open Access Journals (Sweden)

    Gabriele Berberich

    2013-02-01

    Full Text Available Short-term earthquake predictions with an advance warning of several hours or days are currently not possible due to both incomplete understanding of the complex tectonic processes and inadequate observations. Abnormal animal behaviors before earthquakes have been reported previously, but create problems in monitoring and reliability. The situation is different with red wood ants (RWA; Formica rufa-group (Hymenoptera: Formicidae. They have stationary mounds on tectonically active, gas-bearing fault systems. These faults may be potential earthquake areas. For three years (2009–2012, two red wood ant mounds (Formica rufa-group, located at the seismically active Neuwied Basin (Eifel, Germany, have been monitored 24/7 by high-resolution cameras with both a color and an infrared sensor. Early results show that ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants’ behavior hours before the earthquake: the nocturnal rest phase and daily activity are suppressed, and standard daily routine does not resume until the next day. At present, an automated image evaluation routine is being applied to the more than 45,000 hours of video streams. Based on this automated approach, a statistical analysis of the ants’ behavior will be carried out. In addition, other parameters (climate, geotectonic and biological, which may influence behavior, will be included in the analysis.

  4. Long-term results of patients with clinical stage C prostate cancer treated by photontherapy and early orchiectomy

    International Nuclear Information System (INIS)

    Wiegel, T.; Tepel, J.; Schmidt, R.; Klosterhalfen, H.; Arps, H.; Berger, P.; Franke, H.D.

    1996-01-01

    Background: To evaluate the value of radiotherapy and immediate hormonal therapy in the treatment of stage C prostate cancer. Patients and Method: From 1977 to 1986, 169 patients with clinically stage C prostate cancer underwent irradiation with curative intent following early orchiectomy. Sixty-four patients had a transurethral resection, 22 patients a prostatectomy and 83 patients had only a biopsy. In 38 patients a grade Ia/b tumor was found, in 78 patients a grade IIa/b tumor and in 43 patients a grade IIIa/b tumor using the German grade of malignancy. Treatment fields included the prostate, the seminal vesicles and the locoregional lymphatics. Until 1979 the dose was 60 Gy for the tumor encompassing isodose and from then on 65 Gy with a single dose of 2 Gy. Results: With a median follow-up of 98 months, the overall survival rate for 8 and 10 years was 51% and 37% and the cause-specific survival rate was 84% and 77%, respectively. Thirty-two patients (19%) developed distant metastases. Patients with local tumor control (n=148) had a significantly better overall survival rate of 45% for 10 years compared to patients with clinical local progression of disease (n=21) of 22% (p [de

  5. Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

    Science.gov (United States)

    Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

    2016-02-01

    In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Sea surface temperature measurements by the along-track scanning radiometer on the ERS 1 satellite: Early results

    Science.gov (United States)

    Mutlow, C. T.; ZáVody, A. M.; Barton, I. J.; Llewellyn-Jones, D. T.

    1994-11-01

    The along-track scanning radiometer (ATSR) was launched in July 1991 on the European Space Agency's first remote sensing satellite, ERS 1. An initial analysis of ATSR data demonstrates that the sea surface temperature (SST) can be measured from space with very high accuracy. Comparison of simultaneous measurements of SST made from ATSR and from a ship-borne radiometer show that they agree to within 0.3°C. To assess data consistency, a complementary analysis of SST data from ATSR was also carried out. The ATSR global SST field was compared on a daily basis with daily SST analysis of the United Kingdom Meteorological Office (UKMO). The ATSR global field is consistently within 1.0°C of the UKMO analysis. Also, to demonstrate the benefits of along-track scanning SST determination, the ATSR SST data were compared with high-quality bulk temperature observations from drifting buoys. The likely causes of the differences between ATSR and the bulk temperature data are briefly discussed. These results provide early confidence in the quantitative benefit of ATSR's two-angle view of the Earth and its high radiometric performance and show a significant advance on the data obtained from other spaceborne sensors. It should be noted that these measurements were made at a time when the atmosphere was severely contaminated with volcanic aerosol particles, which degrade infrared measurements of the Earth's surface made from space.

  7. Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ayman K.M. Hassan

    2015-03-01

    Conclusion: Our results indicate that AFCD2 is a simple and effective alternative to MC for hemostasis following PCI. Early sheath removal 2 h post PCI is feasible, safe, and improves the patient’s comfort.

  8. Computerized detection of vertebral compression fractures on lateral chest radiographs: Preliminary results with a tool for early detection of osteoporosis

    International Nuclear Information System (INIS)

    Kasai, Satoshi; Li Feng; Shiraishi, Junji; Li Qiang; Doi, Kunio

    2006-01-01

    Vertebral fracture (or vertebral deformity) is a very common outcome of osteoporosis, which is one of the major public health concerns in the world. Early detection of vertebral fractures is important because timely pharmacologic intervention can reduce the risk of subsequent additional fractures. Chest radiographs are used routinely for detection of lung and heart diseases, and vertebral fractures can be visible on lateral chest radiographs. However, investigators noted that about 50% of vertebral fractures visible on lateral chest radiographs were underdiagnosed or under-reported, even when the fractures were severe. Therefore, our goal was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation and thus allow the early diagnosis of osteoporosis. The cases used in this study were 20 patients with severe vertebral fractures and 118 patients without fractures, as confirmed by the consensus of two radiologists. Radiologists identified the locations of fractured vertebrae, and they provided morphometric data on the vertebral shape for evaluation of the accuracy of detecting vertebral end plates by computer. In our computerized method, a curved search area, which included a number of vertebral end plates, was first extracted automatically, and was straightened so that vertebral end plates became oriented horizontally. Edge candidates were enhanced by use of a horizontal line-enhancement filter in the straightened image, and a multiple thresholding technique, followed by feature analysis, was used for identification of the vertebral end plates. The height of each vertebra was determined from locations of identified vertebral end plates, and fractured vertebrae were detected by comparison of the measured vertebral height with the expected height. The sensitivity of our computerized method for detection of fracture cases was 95% (19/20), with 1.03 (139/135) false

  9. Early assisted discharge with generic community nursing for chronic obstructive pulmonary disease exacerbations: Results of a randomised controlled trial

    NARCIS (Netherlands)

    C.M.A. Utens (Cecile); L.M.A. Goossens (Lucas); F.W.J.M. Smeenk (Frank); M.P.M.H. Rutten-van Mölken (Maureen); M. van Vliet (Monique); M.W. Braken (Maria); L. van Eijsden (Loes); O.C.P. Schayck (Onno)

    2012-01-01

    textabstractObjectives: To determine the effectiveness of early assisted discharge for chronic obstructive pulmonary disease (COPD) exacerbations, with home care provided by generic community nurses, compared with usual hospital care. Design: Prospective, randomised controlled and multicentre trial

  10. Is the Prediction of Adolescent Outcomes From Early Child Care Moderated by Later Maternal Sensitivity? Results From the NICHD Study of Early Child Care and Youth Development

    Science.gov (United States)

    Burchinal, Margaret R.; Vandell, Deborah Lowe; Belsky, Jay

    2016-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during adolescence accentuated the association between child care quality and adolescent academic-cognitive skills at age 15 years when maternal sensitivity during adolescence was high. This interaction was obtained in analyses with maternal sensitivity as both a categorical and continuous variable. Relations between early child care hours and adolescent behavioral outcomes also were moderated by maternal sensitivity, with longer child care hours predicting more impulsivity and externalizing at age 15 when maternal sensitivity during middle childhood, scored as a categorical variable, was low to moderate and when maternal sensitivity during adolescence, scored as a continuous variable, was lower. These findings suggest that some child care effects are moderated by subsequent parenting and that this moderation may take both linear and nonlinear forms. PMID:23937381

  11. Gene therapy, early promises, subsequent problems, and recent breakthroughs.

    Science.gov (United States)

    Razi Soofiyani, Saeideh; Baradaran, Behzad; Lotfipour, Farzaneh; Kazemi, Tohid; Mohammadnejad, Leila

    2013-01-01

    Gene therapy is one of the most attractive fields in medicine. The concept of gene delivery to tissues for clinical applications has been discussed around half a century, but scientist's ability to manipulate genetic material via recombinant DNA technology made this purpose to reality. Various approaches, such as viral and non-viral vectors and physical methods, have been developed to make gene delivery safer and more efficient. While gene therapy initially conceived as a way to treat life-threatening disorders (inborn errors, cancers) refractory to conventional treatment, to date gene therapy is considered for many non-life-threatening conditions including those adversely influence on a patient's quality of life. Gene therapy has made significant progress, including tangible success, although much slower than was initially predicted. Although, gene therapies still at a fairly primitive stage, it is firmly science based. There is justifiable hope that with enhanced pathobiological understanding and biotechnological improvements, gene therapy will be a standard part of clinical practice within 20 years.

  12. Gene Therapy, Early Promises, Subsequent Problems, and Recent Breakthroughs

    Directory of Open Access Journals (Sweden)

    Saeideh Razi Soofiyani

    2013-08-01

    Full Text Available Gene therapy is one of the most attractive fields in medicine. The concept of gene delivery to tissues for clinical applications has been discussed around half a century, but scientist’s ability to manipulate genetic material via recombinant DNA technology made this purpose to reality. Various approaches, such as viral and non-viral vectors and physical methods, have been developed to make gene delivery safer and more efficient. While gene therapy initially conceived as a way to treat life-threatening disorders (inborn errors, cancers refractory to conventional treatment, to date gene therapy is considered for many non–life-threatening conditions including those adversely influence on a patient’s quality of life. Gene therapy has made significant progress, including tangible success, although much slower than was initially predicted. Although, gene therapies still at a fairly primitive stage, it is firmly science based. There is justifiable hope that with enhanced pathobiological understanding and biotechnological improvements, gene therapy will be a standard part of clinical practice within 20 years.

  13. Early results of pediatric appendicitis after adoption of diagnosis-related group-based payment system in South Korea

    Directory of Open Access Journals (Sweden)

    Moon SB

    2015-11-01

    Full Text Available Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National School of Medicine, Kangwon National University, Chuncheon, South KoreaPurpose: As an alternative to the existing fee-for-service (FFS system, a diagnosis-related group (DRG-based payment system has been suggested. The aim of this study was to investigate the early results of pediatric appendicitis treatment under the DRG system, focusing on health care expenditure and quality of health care services.Patients and methods: The medical records of 60 patients, 30 patients before (FFS group, and 30 patients after adoption of the DRG system (DRG, were reviewed retrospectively.Results: Mean hospital stay was shortened, but the complication and readmission rates did not worsen in the DRG. Overall health care expenditure and self-payment decreased from Korean Won (KRW 2,499,935 and KRW 985,540, respectively, in the FFS group to KRW 2,386,552 and KRW 492,920, respectively, in the DRG. The insurer’s payment increased from KRW 1,514,395 in the FFS group to KRW 1,893,632 in the DRG. For patients in the DRG, calculation by the DRG system yielded greater overall expenditure (KRW 2,020,209 vs KRW 2,386,552 but lower self-payment (KRW 577,803 vs KRW 492,920 than calculation by the FFS system.Conclusion: The DRG system worked well in pediatric patients with acute appendicitis in terms of cost-effectiveness over the short term. The gradual burden on the national health insurance fund should be taken into consideration.Keywords: appendicitis, child, fee-for-service plans, diagnosis-related groups, quality of health care, health care expenditures

  14. Chitin fulfilling a biomaterials promise

    CERN Document Server

    Khor, Eugene

    2001-01-01

    The second edition of Chitin underscores the important factors for standardizing chitin processing and characterization. It captures the essential interplay between chitin's assets and limitations as a biomaterial, placing the past promises of chitin in perspective, addressing its present realities and offering insight into what is required to realize chitin's destiny (including its derivative, chitosan) as a biomaterial of the twenty-first century. This book is an ideal guide for both industrialists and researchers with a vested interest in commercializing chitin.An upd

  15. Early and late results of graft replacement for dissecting aneurysm of thoracoabdominal aorta in patients with Marfan syndrome.

    Science.gov (United States)

    Omura, Atsushi; Tanaka, Akiko; Miyahara, Shunsuke; Sakamoto, Toshihito; Nomura, Yoshikatsu; Inoue, Takeshi; Oka, Takanori; Minami, Hitoshi; Okada, Kenji; Okita, Yutaka

    2012-09-01

    When treating dissecting aneurysm of the thoracoabdominal aorta surgically in patients with Marfan syndrome, we have usually performed graft replacement- including the entire thoracoabdominal aorta and reconstruction of all visceral branches, even if dilatation is mild in some segments-to avoid further aortic operations in the follow-up period. From October 1999 through July 2011, 20 consecutive patients with Marfan syndrome underwent repair of dissecting aneurysm of the thoracoabdominal aorta (median age, 45 years; range, 19-65 years). All patients underwent surgical intervention with cerebrospinal fluid (CSF) drainage and distal aortic and selective organ perfusion. Deep hypothermia was used in 13 patients for spinal cord protection. No in-hospital mortality was observed. One patient had temporary spinal cord ischemia but was fully recovered by discharge. Other complications included exploration for bleeding (n=1), prolonged ventilation (n=1), and graft infection (n=1). At a mean follow-up of 54 months (range, 9-129 months), 1 patient had died of interstitial pneumonia at 38 months postoperatively. Survival at 8% years was 91.2±9.0%. Two patients required additional aortic procedures (total arch replacement and aortic valve-sparing surgery). Actuarial rate of freedom from aortic operations at 8 years was 83.9%±10.5%, but no patient needed required repeated thoracotomy for an aortic procedure. Neither false nor patch aneurysms were observed using computed tomography (CT) during follow-up surveillance. Graft replacement for dissecting aneurysm of the thoracoabdominal aorta in Marfan syndrome offers good early and long-term results. We believe total aortic replacement including the entire thoracoabdominal aorta and reconstruction of all visceral arteries should be recommended for selected patients with Marfan syndrome. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Serwadda David

    2011-03-01

    Full Text Available Abstract Background Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders. Methods This quasi-experimental trial is conducted in two districts in Eastern Uganda. The supply side component includes health worker refresher training and additions of minimal drugs and supplies, whereas the demand side component involves vouchers given to pregnant women for motorcycle transport and the payment to service providers for antenatal, delivery, and postnatal care. The trial is ongoing, but early analysis from routine health information systems on the number of services used is presented. Results Motorcyclists in the community organized themselves to accept vouchers in exchange for transport for antenatal care, deliveries and postnatal care, and have become actively involved in ensuring that women obtain care. Increases in antenatal, delivery, and postnatal care were demonstrated, with the number of safe deliveries in the intervention area immediately jumping from Conclusions Transport and service vouchers appear to be a viable strategy for rapidly increasing maternal care. MakCHS can design strategies together with stakeholders using a learning-by-doing approach to take advantage of community resources.

  17. Elevated Early Callose Deposition Results in Complete Penetration Resistance to Powdery Mildew in Arabidopsis1[C][W][OA

    Science.gov (United States)

    Ellinger, Dorothea; Naumann, Marcel; Falter, Christian; Zwikowics, Claudia; Jamrow, Torsten; Manisseri, Chithra; Somerville, Shauna C.; Voigt, Christian A.

    2013-01-01

    A common response by plants to fungal attack is deposition of callose, a (1,3)-β-glucan polymer, in the form of cell wall thickenings called papillae, at site of wall penetration. While it has been generally believed that the papillae provide a structural barrier to slow fungal penetration, this idea has been challenged in recent studies of Arabidopsis (Arabidopsis thaliana), where fungal resistance was found to be independent of callose deposition. To the contrary, we show that callose can strongly support penetration resistance when deposited in elevated amounts at early time points of infection. We generated transgenic Arabidopsis lines that express POWDERY MILDEW RESISTANT4 (PMR4), which encodes a stress-induced callose synthase, under the control of the constitutive 35S promoter. In these lines, we detected callose synthase activity that was four times higher than that in wild-type plants 6 h post inoculation with the virulent powdery mildew Golovinomyces cichoracearum. The callose synthase activity was correlated with enlarged callose deposits and the focal accumulation of green fluorescent protein-tagged PMR4 at sites of attempted fungal penetration. We observed similar results from infection studies with the nonadapted powdery mildew Blumeria graminis f. sp. hordei. Haustoria formation was prevented in resistant transgenic lines during both types of powdery mildew infection, and neither the salicylic acid-dependent nor jasmonate-dependent pathways were induced. We present a schematic model that highlights the differences in callose deposition between the resistant transgenic lines and the susceptible wild-type plants during compatible and incompatible interactions between Arabidopsis and powdery mildew. PMID:23335625

  18. Results of breast conserving therapy for early breast cancer and the role of mammographic follow-up

    International Nuclear Information System (INIS)

    Grosse, Antje; Schreer, Ingrid; Frischbier, Hans-Joachim; Maass, Heinrich; Loening, Thomas; Bahnsen, Jens

    1997-01-01

    Purpose: The following article is a review of 23 years of breast-conserving therapy in our hospital. This study was performed to assess and improve the follow-up care of women with early breast cancer and to evaluate whether or not biannual mammogram is useful. Methods and Materials: Between 1972 and December 1995, 3072 women with pathological size pT1 and pT2 breast cancer were treated with conservative surgery and radiation therapy. Eighty-five patients developed a recurrence in the treated breast as the first site of failure, 12 of which had positive axillary nodes. In the following patient study, those with an noninvasive recurrence were excluded. A retrospective assessment of the entire mammographic course was made, starting with the mammogram at the time of original diagnosis to the mammogram of the recurrence. Results: In our study group the probability for local failure ranged from 1 to 2% per year. At 5 and 10 years the actuarial rates were 5 and 10%. The median time to recurrence was 41 months (range 8-161). Twenty-six (31%) recurrences were detected by mammography alone, 10 (12%) by clinical examination only, and 35 (41%) by both methods. For the patients with an ipsilateral recurrence, the overall actuarial 5- and 10-year survival after treatment was 87 and 70%, respectively. The 5-year actuarial rate of survival from salvage mastectomy was 61%. Conclusion: Considering the high percentage of recurrences detectable by mammography and the possibility of detection within a short-term interval, we think biannual mammographic follow-up is appropriate for the first years following breast-conserving therapy

  19. Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia

    Directory of Open Access Journals (Sweden)

    Kim Houlind

    2013-12-01

    Full Text Available Background: Patients with critical lower limb ischemia without patent pedal arteries cannot be treated by the conventional arterial reconstruction. Venous arterialization has been suggested to improve limb salvage in this subgroup of patients but has not gained wide acceptance. We report our early experience after implementing deep and superficial venous arterialization of the lower limb. Materials and methods: Ten patients with critical ischemia and without crural or pedal arteries available for conventional bypass surgery or angioplasty were treated with distal venous arterialization. Inflow was from the most distal unobstructed segment. Run-off was the dorsal pedal venous arch (n=5, the dorsal pedal venous arch and a concomitant vein of the posterior tibial artery (n=3, or the dorsal pedal venous arch and a concomitant vein of the common plantar artery (n=2 depending on the location of the ischemic lesion. Venous valves were destroyed using antegrade valvulotomes, guide wires, knob needles, or retrograde valvulotomes via an extra incision. Results: Seven of the operated limbs were amputated after 23 (1–256 days (median [range]. The main reasons for amputation were lack of healing of either the original wound, of incisional wounds on the foot, or persisting pain at rest. In three cases, the bypass was open at the time of amputation. Two patients experienced complete wound healing after 231 and 342 days, respectively. By the end of follow-up, the last patient was ambulating with slow wound healing but without pain 309 days after surgery. Conclusion: Venous arterialization may be used as a treatment of otherwise unsalveable limbs. The success rate is, however, limited. Technical optimization of the technique is warranted.

  20. Early Detection of Alzheimer's Disease Based on the Patient's Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method.

    Science.gov (United States)

    Heymann, Petra; Gienger, Regine; Hett, Andreas; Müller, Stephan; Laske, Christoph; Robens, Sibylle; Ostermann, Thomas; Elbing, Ulrich

    2018-01-01

    Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

  1. Melanoma Vaccines: Mixed Past, Promising Future

    Science.gov (United States)

    Ozao-Choy, Junko; Lee, Delphine J.; Faries, Mark B.

    2014-01-01

    Synopsis Cancer vaccines were one of the earliest forms of immunotherapy to be investigated. Past attempts to vaccinate against cancer, including melanoma, have mixed results, revealing the complexity of what was thought to be a simple concept. However, several recent successes and the combination of improved knowledge of tumor immunology and the advent of new immunomodulators make vaccination a promising strategy for the future. PMID:25245965

  2. Results of level-ii oncoplasty in breast cancer patients: an early experience from a tertiary care hospital in pakistan

    International Nuclear Information System (INIS)

    Qureshi, S.; Ghazanfar, S.; Quraishy, S.; Iqbal, S.

    2014-01-01

    Objective: To assess the oncologic and cosmetic outcomes for breast cancer patients who underwent breast conservation therapy using Level II oncoplasty techniques. Methods: The prospective, non-randomised and descriptive study was conducted at the Department of Surgery, Unit IV of Civil Hospital, Karachi, from December 2009 to November 2011 in which 21 consecutive women with breast carcinoma who underwent wide local excision with remodeling mammoplasty were enrolled. All patients were reviewed by the surgeon and medical oncologist every 3 months for the first year. A grading system of 5-1 (excellent to poor) was employed and those with 3 or more were considered to have acceptable results. Results: The mean patient age was 45.38+-10.09 years (range: 26-70); 11 (52.3%) were premenopausal and 10 (47.7%) were postmenopausal; and 5 (27.8%) had family history of breast cancer. The mean size of the tumour determined by histology was 59.9+-3.18 mm (range: 25-150). Eight (30%) patients received preoperative chemotherapy to downsize the tumour. Three (14.2%) patients received preoperative radiotherapy. Mean operative time was 1.59+-0.52 hours (range: 1-2.5 hours). Mean volume of breast tissue excised from the breast containing the tumour was 545.27+-412.06 cm3 (range: 43.70-1456). Assessment of excision margins showed no tumour at the margins of 19 (90.4%) patients. Two (9.5%) patients had close but negative margins. The mean hospital stay was 7.10+-3.30 days (range: 4-15). There were early complications in 4 (19%) patients. One (4.76%) patient had late complications. Two (9.5%) patients developed tumour recurrence; both had an ipsilateral tumour recurrence. None of the patients developed metastases and one died of cardiac problem. Twenty (95.2%) patients had an acceptable post-surgical cosmetic result. Conclusion: Level II oncoplasty was a safe option in breast conservation allowing large sized and difficult-location tumour excision with good cosmetic outcome in the study

  3. Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

    Science.gov (United States)

    Siegrist, Johannes; Wahrendorf, Morten; von dem Knesebeck, Olaf; Jürges, Hendrik; Börsch-Supan, Axel

    2007-02-01

    Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

  4. Surgical Results of Laparoscopic Loop Duodenojejunal Bypass with Sleeve Gastrectomy (LDJB-SG in Obese Asians (BMI ≥ 27.5 kg/m2 with Type 2 Diabetes Mellitus (T2DM: A New Promising Bariatric and Metabolic Surgery

    Directory of Open Access Journals (Sweden)

    Voraboot Taweerutchana, M.D. F.R.C.S.T.

    2018-03-01

    Full Text Available Objective: To demonstrate surgical outcomes, safety and complications in obese Asians (BMI > 27.5 kg/m2 who underwent LDJB-SG in our center. Methods: We retrospectively reviewed ninety-one patients who underwent LDJB-SG from October 2011 to March 2014. One-year surgical outcomes regarding the efficacy of weight loss, safety as well as complications of this procedure were demonstrated. Remission of T2DM and co-morbidities resolution after one year were also analyzed. Results: The median duration of T2DM was 60 months and the median operative time was 140 min. Interestingly, the mean/median preoperative BMI, HbA1C and FPG levels dropped significantly from 30.7 kg/m2 , 8.9%, and 139.0 mg% to 23.7 kg/m2 , 6.2%, and 95.0 mg% respectively at 1 year after operation (p<0.001. Furthermore, 61.5% of patients who had completed 1 year follow-up showed complete diabetic remission and 92.3% experienced glycemic control (HbA1c<7% without any medication. The postoperative complications were intra-abdominal bleeding (4.4%, leakage (1.1%, stricture (3.3% and port site hernia (2.2%. Conclusion: LDJB-SG is a safe and feasible bariatric and metabolic surgery, which has demonstrated excellent outcomes in terms of weight reduction, co-morbidities resolution as well as glycemic control in short-term follow-up.

  5. SU-F-T-195: Systematic Constraining of Contralateral Parotid Gland Led to Improved Dosimetric Outcomes for Multi-Field Optimization with Scanning Beam Proton Therapy: Promising Results From a Pilot Study in Patients with Base of Tongue Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Wu, R; Liu, A; Poenisch, F; Palmer, M; Gillin, M; Zhu, X [Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX (United States); Crowford, C; Georges, R; Amin, M [Department of Medical Dosimetry, MD Anderson Cancer Ctr, Houston, TX (United States); Sio, T; Gunn, B; Frank, S [Radiation Oncology Department MD Anderson Cancer Ctr, Houston, TX (United States)

    2016-06-15

    Purpose: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning. Methods: Twenty-four (24) consecutive patients previously treated for base of tongue carcinoma were retrospectively selected. The doses were 70Gy, 63Gy and 57Gy (SIB in 33 fractions) for high-, intermediate-, and standard-risk clinical target volumes (CTV), respectively; the treatment included bilateral neck. Scanning beams using MFO with standardized bilateral anterior oblique and PA fields were applied. New plans where then developed and optimized by employing additional contralateral parotid constraints at multiple defined dose levels. Using a step-wise iterative process, the volume-based constraints at each level were then further reduced until known target coverages were compromised. The newly developed plans were then compared to the original clinically approved plans using paired student t-testing. Results: All 24 newly optimized treatment plans maintained initial plan quality as compared to the approved plans, and the 98% prescription dose coverage to the CTV’s were not compromised. Representative DVH comparison is shown in FIGURE 1. The contralateral parotid doses were reduced at all levels of interest when systematic constraints were applied to V10, V20, V30 and V40Gy (All P<0.0001; TABLE 1). Overall, the mean contralateral parotid doses were reduced by 2.26 Gy on average, a ∼13% relative improvement. Conclusion: Applying systematic and volume-based contralateral parotid constraints for IMPT planning significantly reduced the dose at all dosimetric

  6. Co-occurring development of early childhood communication and motor skills: results from a population-based longitudinal study.

    Science.gov (United States)

    Wang, M V; Lekhal, R; Aarø, L E; Schjølberg, S

    2014-01-01

    Communicative and motor development is frequently found to be associated. In the current study we investigate to what extent communication and motor skills at 1½ years predict skills in the same domains at 3 years of age. This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Heath. Data stem from 62,944 children and their mothers. Mothers completed questionnaires on their child's communication and motor skills at ages 1½ and 3. Associations between communication and motor skills were estimated in a cross-lagged model with latent variables. Early communication skills were correlated with early motor skills (0.72). Stability was high (0.81) across time points for motor skills and somewhat lower (0.40) for communication skills. Early motor skills predicted later communication skills (0.38) whereas early communication skills negatively predicted later motor skills (-0.14). Our findings provide support for the hypothesis that these two difficulties are not symptoms of separate disorders, but might rather be different manifestations of a common underlying neurodevelopmental weakness. However, there also seem to be specific developmental pathways for each domain. Besides theoretical interest, more knowledge about the relationship between these early skills might shed light upon early intervention strategies and preventive efforts commonly used with children with problems in these areas. Our findings suggest that the relationship between language and motor skills is not likely to be simple and directional but rather to be complex and multifaceted. © 2012 John Wiley & Sons Ltd.

  7. Long-term results of patients with clinical stage C prostate cancer treated by photontherapy and early orchiectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wiegel, T. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy]|[Dept. of Radiotherapy, Univ. Hospital Benjamin Franklin, Freie Univ. Berlin (Germany); Tepel, J. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy; Schmidt, R. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy; Klosterhalfen, H. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Urology; Arps, H. [General Hospital Fulda (Germany). Inst. of Pathology; Berger, P. [Univ. Hospital Eppendorf, Hamburg (Germany). Inst. of Medical Statistics; Franke, H.D. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy

    1996-11-01

    Background: To evaluate the value of radiotherapy and immediate hormonal therapy in the treatment of stage C prostate cancer. Patients and Method: From 1977 to 1986, 169 patients with clinically stage C prostate cancer underwent irradiation with curative intent following early orchiectomy. Sixty-four patients had a transurethral resection, 22 patients a prostatectomy and 83 patients had only a biopsy. In 38 patients a grade Ia/b tumor was found, in 78 patients a grade IIa/b tumor and in 43 patients a grade IIIa/b tumor using the German grade of malignancy. Treatment fields included the prostate, the seminal vesicles and the locoregional lymphatics. Until 1979 the dose was 60 Gy for the tumor encompassing isodose and from then on 65 Gy with a single dose of 2 Gy. Results: With a median follow-up of 98 months, the overall survival rate for 8 and 10 years was 51% and 37% and the cause-specific survival rate was 84% and 77%, respectively. Thirty-two patients (19%) developed distant metastases. Patients with local tumor control (n=148) had a significantly better overall survival rate of 45% for 10 years compared to patients with clinical local progression of disease (n=21) of 22% (p<0.05). Multivariate analysis showed the grade of malignancy and local control as independent factors for overall survival and cause-specific survival (p<0.05). Twenty-three patients (14%) had at least one late side effect for the rectum or the bladder, in almost all cases grade I or II. Five patients (3%) showed severe late side effects RTOG grade III (n=2) or IV (n=3). One patient had a colostomy, in 2 patients a severe haemorrhagic cystitis was seen. Conclusions: Radiotherapy with photons and early orchiectomy for patients with stage C prostate cancer achieves high local control rates and a 30% to 40% 10-year survival rate with a low incidence of late side effects. The value of the radiotherapy of the locoregional lymphatics remains controversial. (orig.) [Deutsch] Zwischen 1977 und 1986

  8. MFTF-progress and promise

    International Nuclear Information System (INIS)

    Thomassen, K.I.

    1980-01-01

    The Mirror Fusion Test Facility (MFTF) has been in construction at Lawrence Livermore National Laboratory (LLNL) for 3 years, and most of the major subsystems are nearing completion. Recently, the scope of this project was expanded to meet new objectives, principally to reach plasma conditions corresponding to energy break-even. To fulfill this promise, the single-cell minimum-B mirror configuration will be replaced with a tandem mirror configuration (MFTF-B). The facility must accordingly be expanded to accomodate the new geometry. This paper briefly discusses the status of the major MFTF subsystems and describes how most of the technological objectives of MFTF will be demonstrated before we install the additional systems necessary to make the tandem. It also summarizes the major features of the expanded facility

  9. The promising opportunity of dismantlement

    International Nuclear Information System (INIS)

    Anon.

    2009-01-01

    Civil engineering, mechanics and waste conditioning companies are thriving around the market of nuclear facilities dismantlement which is promised to a huge development in the coming decade. This paper presents a map of the opportunities of the dismantlement market throughout Europe (research and power reactors, fuel fabrication plants, spent fuel reprocessing plants) and a cost estimation of a given dismantling work with respect to the different steps of the work. In France a small core of about twenty companies is involved in nuclear dismantlement but the French market is also looking towards foreign specialists of this activity. The British market is also targeted by the French companies but for all the actors the technological or commercial advance gained today will be determining for the future markets. (J.S.)

  10. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients. One-year results from a randomised controlled trial.

    Science.gov (United States)

    Merli, Mauro; Merli, Aldo; Bernardelli, Francesco; Lombardini, Francesco; Esposito, Marco

    2008-01-01

    To compare immediate versus early (6 weeks) non-occlusal loading of dental implants placed flapless in partially edentulous patients 1 year after loading. Sixty patients were randomised: 30 to the immediately loaded group and 30 to the early loaded group. In order to be immediately loaded, implants were inserted with a minimum torque of > or = 40Ncm. Implants were fully occlusally loaded after 6 months. Outcome measures were prosthesis and implant failures, and biological and biomechanical complications. Five implants in five patients randomised to the immediately loaded group did not reach the required primary implant stability. Three of these implants (two prostheses) were not immediately loaded. Two patients who were randomised to the early loaded group were immediately loaded erroneously. Implants in five patients of the early loaded group were conventionally loaded. No patient dropped out and there were no failures. Two complications occurred in the early and one in the immediately loaded group (no statistically significant difference), but were solved. The use of a flapless technique for placing dental implants in conjunction with non-occlusal immediate or early loading in selected patients can provide excellent clinical results. No differences were observed when comparing implants that were loaded immediately or early. Therefore, when a high primary implant stability is obtained, it might be preferable to load the implants immediately rather than waiting for a few weeks.

  11. Adherence to a treat-to-target strategy in early rheumatoid arthritis : results of the DREAM remission induction cohort

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; Moens, Hein J. Bernelot; Hoekstra, Monique; Posthumus, Marcel D.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    2012-01-01

    Introduction: Clinical trials have demonstrated that treatment-to-target (T2T) is effective in achieving remission in early rheumatoid arthritis (RA). However, the concept of T2T has not been fully implemented yet and the question is whether a T2T strategy is feasible in daily clinical practice. The

  12. The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study

    NARCIS (Netherlands)

    I.P.M. Derks (Ivonne P. M.); A. Koster (Annemarie); M.T. Schram (Miranda); C.D. Stehouwer (Coen); P.C. Dagnelie (Pieter); D.A.I. Groffen (Danielle A. I.); H. Bosma (Hans)

    2017-01-01

    markdownabstractBackground: Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and

  13. Changes in gait characteristics of women with early and established medial knee osteoarthritis : Results from a 2-years longitudinal study

    NARCIS (Netherlands)

    Mahmoudian, Armaghan; van Dieёn, Jaap H.; Baert, Isabel A.C.; Bruijn, Sjoerd M.; Faber, Gert S.; Luyten, Frank P.; Verschueren, Sabine M.P.

    2017-01-01

    Background Despite the large number of cross-sectional studies on gait in subjects with knee osteoarthritis, there are scarcely any longitudinal studies on gait changes in knee osteoarthritis. Methods Gait analysis was performed on 25 women with early and 18 with established medial knee

  14. Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort.

    Science.gov (United States)

    Kronisch, Caroline; McLernon, David J; Dale, James; Paterson, Caron; Ralston, Stuart H; Reid, David M; Tierney, Ann; Harvie, John; McKay, Neil; Wilson, Hilary E; Munro, Robin; Saunders, Sarah; Richmond, Ruth; Baxter, Derek; McMahon, Mike; Kumar, Vinod; McLaren, John; Siebert, Stefan; McInnes, Iain B; Porter, Duncan; Macfarlane, Gary J; Basu, Neil

    2016-07-01

    To identify baseline prognostic indicators of disability at 1 year within a contemporary early inflammatory arthritis inception cohort and then develop a clinically useful tool to support early patient education and decision-making. The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis. SERA data were analyzed to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at 1 year. Clinical and psychosocial baseline exposures were entered into a forward stepwise logistic regression model. The model was externally validated using newly accrued SERA data and subsequently converted into a prediction tool. Of the 578 participants (64.5% female), 36.7% (n = 212) reported functional disability at 1 year. Functional disability was independently predicted by baseline disability (odds ratio [OR] 2.67 [95% confidence interval (95% CI) 1.98, 3.59]), depression (OR 2.52 [95% CI 1.18, 5.37]), anxiety (OR 2.37 [95% CI 1.33, 4.21]), being in paid employment with absenteeism during the last week (OR 1.19 [95% CI 0.63, 2.23]), not being in paid employment (OR 2.36 [95% CI 1.38, 4.03]), and being overweight (OR 1.61 [95% CI 1.04, 2.50]). External validation (using 113 newly acquired patients) evidenced good discriminative performance with a C statistic of 0.74, and the calibration slope showed no evidence of model overfit (P = 0.31). In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at 1 year appear to be dominated by psychosocial rather than more traditional clinical measures. This indicates the potential benefit of early access to nonpharmacologic interventions targeting key psychosocial factors, such as mental health and work disability. © 2016, American College of Rheumatology.

  15. Estimation of the {beta}+ dose to the embryo resulting from {sup 18}F-FDG administration during early pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P.; Trebossen, R.; Maroy, R. [CEA, DSV, I2BM, SHFJ, LIME, Orsay (France); Champion, C. [Univ Paul Verlaine Metz, Inst Phys, Lab Phys Mol et Collis, Metz (France); Hindie, E. [Univ Paris 07, IUH, Ecole Doctorale B2T, Paris (France); Hindie, E. [Hop St Louis, AP-HP, Nucl Med Serv, F-75475 Paris 10 (France)

    2008-07-01

    Although {sup 18}F-FDG examinations are widely used, data are lacking on the dose to human embryo tissues in cases of exposure in early pregnancy. Although the photon component can easily be estimated from available data on the pharmacokinetics of {sup 18}F-FDG in female organs and from phantom measurements (considering the uterus as the target organ), the intensity of embryo tissue uptake, which is essential for deriving the {beta}+ dose, is not known. We report the case of a patient who underwent {sup 18}F-FDG PET/CT for tumor surveillance and who was later found to have been pregnant at the time of the examination(embryo age, 8 wk). Methods: The patient received 320 MBq of {sup 18}F-FDG. Imaging started with an unenhanced CT scan 1 h after the injection, followed by PET acquisition. PET images were used to compute the total number of {beta}+ emissions in embryo tissues per unit of injected activity, from standardized uptake value (SUV) measurements corrected for partial-volume effects. A Monte Carlo track structure code was then used to derive the {beta}+ self-dose and the {beta}+ cross-dose from amniotic fluid. The photon and CT doses were added to obtain the final dose received by the embryo. Results: The mean SUV in embryo tissues was 2.7, after correction for the partial-volume effect. The mean corrected SUV of amniotic fluid was 1.1. Monte Carlo simulation showed that the {beta}+ dose to the embryo (self-dose plus cross-dose from amniotic fluid) was 1.8 E-2 mGy per MBq of injected {sup 18}F-FDG. Based on MIRD data for the photon dose to the uterus, the estimated photon dose to the embryo was 1.5 E-2 mGy/MBq. Thus, the specific {sup 18}F-FDG dose to the embryo was 3.3 E-2 mGy/MBq (10.6 mGy in this patient). The CT scan added a further 8.3 mGy. Conclusion: The dose to the embryo is 3.3 E-2 mGy/MBq of {sup 18}F-FDG. The {beta}+ dose contributes 55% of the total dose. This value is higher than previous estimates in late nonhuman-primate pregnancies. (authors)

  16. Promising results in treating lymphoma in young people

    Science.gov (United States)

    Patients with a type of cancer known as primary mediastinal B-cell lymphoma who received infusions of chemotherapy, but who did not have radiation therapy to an area of the thorax known as the mediastinum, had excellent outcomes, according to clinical tri

  17. Stem cells show promising results for lymphoedema treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Quaade, Marlene Louise; Sheikh, Søren Paludan

    2015-01-01

    Abstract Lymphoedema is a debilitating condition, manifesting in excess lymphatic fluid and swelling of subcutaneous tissues. Lymphoedema is as of yet still an incurable condition and current treatment modalities are not satisfactory. The capacity of mesenchymal stem cells to promote angiogenesis......, secrete growth factors, regulate the inflammatory process, and differentiate into multiple cell types make them a potential ideal therapy for lymphoedema. Adipose tissue is the richest and most accessible source of mesenchymal stem cells and they can be harvested, isolated, and used for therapy...... in a single stage procedure as an autologous treatment. The aim of this paper was to review all studies using mesenchymal stem cells for lymphoedema treatment with a special focus on the potential use of adipose-derived stem cells. A systematic search was performed and five preclinical and two clinical...

  18. Application of regional physically-based landslide early warning model: tuning of the input parameters and validation of the results

    Science.gov (United States)

    D'Ambrosio, Michele; Tofani, Veronica; Rossi, Guglielmo; Salvatici, Teresa; Tacconi Stefanelli, Carlo; Rosi, Ascanio; Benedetta Masi, Elena; Pazzi, Veronica; Vannocci, Pietro; Catani, Filippo; Casagli, Nicola

    2017-04-01

    runs in real-time by assimilating weather data and uses Monte Carlo simulation techniques to manage the geotechnical and hydrological input parameters. In this context, an assessment of the factors controlling the geotechnical and hydrological features is crucial in order to understand the occurrence of slope instability mechanisms and to provide reliable forecasting of the hydrogeological hazard occurrence, especially in relation to weather events. In particular, the model and the soil characterization were applied in back analysis, in order to assess the reliability of the model through validation of the results with landslide events that occurred during the period. The validation was performed on four past events of intense rainfall that have affected Valle d'Aosta region between 2008 and 2010 years triggering fast shallows landslides. The simulations show substantial improvement of the reliability of the results compared to the use of literature parameters. A statistical analysis of the HIRESSS outputs in terms of failure probability has been carried out in order to define reliable alert levels for regional landslide early warning systems.

  19. Early results of valve-sparing ascending aortic replacement in type A aortic dissection and aortic insufficiency

    Directory of Open Access Journals (Sweden)

    М. Л. Гордеев

    2016-08-01

    Full Text Available Aim: The study was designed to investigate predictors of effective valve-sparing ascending aortic replacement in patients with Stanford type A aortic dissection combined with aortic insufficiency and to analyze efficacy and safety of this kind of surgery.Methods: From January 2010 to December 2015, 49 patients with Stanford type A aortic dissection combined with aortic insufficiency underwent ascending aortic replacement. All patients were divided into 3 groups: valve-sparing procedures (group 1, n = 11, combined aortic valve and supracoronary ascending aortic replacement (group 2, n = 12, and Bentall procedure (group 3, n = 26. We assessed the initial status of patients, incidence of complications and efficacy of valve-sparing ascending aortic replacement.Results: The hospital mortality rate was 8.2% (4/49 patients. The amount of surgical correction correlated with the initial diameter of the aorta at the level of the sinuses of Valsalva. During the hospital period, none of patients from group 1 developed aortic insufficiency exceeding Grade 2 and the vast majority of patients had trivial aortic regurgitation. The parameters of cardiopulmonary bypass, cross-clamp time and circulatory arrest time did not correlate with the initial size of the ascending aorta and aortic valve blood flow impairment, neither did they influence significantly the incidence and severity of neurological complications. The baseline size of the ascending aorta and degree of aortic regurgitation did not impact the course of the early hospital period.Conclusions: Supracoronary ascending aortic replacement combined with aortic valve repair in ascending aortic dissection and aortic regurgitation is effective and safe. The initial size of the ascending aorta and aortic arch do not influence immediate results. The diameter of the aorta at the level of the sinuses of Valsalva and the condition of aortic valve leaflets could be considered as the limiting factors. Further long

  20. [Efficiency of early diagnosis and prevention of chronic obstructive pulmonary disease in industrial workers (prospective observation results)].

    Science.gov (United States)

    Bobrov, S V; Shpagina, L A; Kuznetsova, G V; Burganova, M R

    2011-01-01

    Examination of workers engaged into major industrial enterprises of Novosibirsk demonstrated high prevalence of bronchial obstruction in individuals contacting industrial aerosol. The workers with long length of service proved high level of tobacco addiction and marked psychologic dependence on smoking. Based on the data obtained, the authors specified a program for early diagnosis and prevention of occupational bronchitis among the workers of major industrial enterprises.

  1. Food irradiation - Problems and promises

    International Nuclear Information System (INIS)

    Hickman, J.R.

    1974-01-01

    It has been stated that food irradiation represents the most significant discovery in food processing since Nicholas Appert invented canning in 1810. Certainly it is a process with great future potential; it is attractive because it works without heating the product, it is effective within sealed containers as well as for bulk usage, and it does not leave chemical residues on the treated food. Of course, no one process can be expected to solve all problems relating to preservation of food. Ionizing radiation can be used effectively to solve many of these problems, but the process is no panacea to cure the world's food problems. Unfortunately, early ill-founded claims about irradiation led to expectations which have proved beyond the reasonable capabilities of the process. Nevertheless, the number of foods that have been successfully treated, and the broad range of effects that can be achieved by radiation processing is impressive. (author)

  2. Post-treatment biopsy results following permanent transrectal ultrasound-guided interstitial brachytherapy in early stage prostate cancer

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Blasko, John C.; Grimm, Peter D.; Hoak, David C.; Cavanagh, Bill; Ragde, Haakon

    1995-01-01

    with further follow-up as the majority of 'indeterminate' biopsies seem to convert to negative over time. Although this series represents a selected group of favorable patients, the results surpass those published in the teletherapy literature and support the use of modern interstitial brachytherapy techniques for selected patients with early stage disease

  3. Preliminary numerical simulations of the 27 February 2010 Chile tsunami: first results and hints in a tsunami early warning perspective

    Science.gov (United States)

    Tinti, S.; Tonini, R.; Armigliato, A.; Zaniboni, F.; Pagnoni, G.; Gallazzi, Sara; Bressan, Lidia

    2010-05-01

    The tsunamigenic earthquake (M 8.8) that occurred offshore central Chile on 27 February 2010 can be classified as a typical subduction-zone earthquake. The effects of the ensuing tsunami have been devastating along the Chile coasts, and especially between the cities of Valparaiso and Talcahuano, and in the Juan Fernandez islands. The tsunami propagated across the entire Pacific Ocean, hitting with variable intensity almost all the coasts facing the basin. While the far-field propagation was quite well tracked almost in real-time by the warning centres and reasonably well reproduced by the forecast models, the toll of lives and the severity of the damage caused by the tsunami in the near-field occurred with no local alert nor warning and sadly confirms that the protection of the communities placed close to the tsunami sources is still an unresolved problem in the tsunami early warning field. The purpose of this study is two-fold. On one side we perform numerical simulations of the tsunami starting from different earthquake models which we built on the basis of the preliminary seismic parameters (location, magnitude and focal mechanism) made available by the seismological agencies immediately after the event, or retrieved from more detailed and refined studies published online in the following days and weeks. The comparison with the available records of both offshore DART buoys and coastal tide-gauges is used to put some preliminary constraints on the best-fitting fault model. The numerical simulations are performed by means of the finite-difference code UBO-TSUFD, developed and maintained by the Tsunami Research Team of the University of Bologna, Italy, which can solve both the linear and non-linear versions of the shallow-water equations on nested grids. The second purpose of this study is to use the conclusions drawn in the previous part in a tsunami early warning perspective. In the framework of the EU-funded project DEWS (Distant Early Warning System), we will

  4. LANDSAT-4 Science Characterization Early Results. Volume 4: Applications. [agriculture, soils land use, geology, hydrology, wetlands, water quality, biomass identification, and snow mapping

    Science.gov (United States)

    Barker, J. L. (Editor)

    1985-01-01

    The excellent quality of TM data allows researchers to proceed directly with applications analyses, without spending a significant amount of time applying various corrections to the data. The early results derived of TM data are discussed for the following applications: agriculture, land cover/land use, soils, geology, hydrology, wetlands biomass, water quality, and snow.

  5. Documenting the conversion from traditional to Studio Physics formats at the Colorado School of Mines: Process and early results

    Science.gov (United States)

    Kohl, Patrick B.; Kuo, H. Vincent; Ruskell, Todd G.

    2008-10-01

    The Colorado School of Mines (CSM) has taught its first-semester introductory physics course using a hybrid lecture/Studio Physics format for several years. Over the past year we have converted the second semester of our calculus-based introductory physics course (Physics II) to a Studio Physics format, starting from a traditional lecture-based format. In this paper, we document the early stages of this conversion in order to better understand which features succeed and which do not, and in order to develop a model for switching to Studio that keeps the time and resource investment manageable. We describe the recent history of the Physics II course and of Studio at Mines, discuss the PER-based improvements that we are implementing, and characterize our progress via several metrics, including pre/post Conceptual Survey of Electricity and Magnetism (CSEM) scores, Colorado Learning About Science Survey scores (CLASS), solicited student comments, failure rates, and exam scores.

  6. Brief Report: HIV Drug Resistance in Adults Failing Early Antiretroviral Treatment: Results From the HIV Prevention Trials Network 052 Trial.

    Science.gov (United States)

    Fogel, Jessica M; Hudelson, Sarah E; Ou, San-San; Hart, Stephen; Wallis, Carole; Morgado, Mariza G; Saravanan, Shanmugam; Tripathy, Srikanth; Hovind, Laura; Piwowar-Manning, Estelle; Sabin, Devin; McCauley, Marybeth; Gamble, Theresa; Zhang, Xinyi C; Eron, Joseph J; Gallant, Joel E; Kumwenda, Johnstone; Makhema, Joseph; Kumarasamy, Nagalingeswaran; Chariyalertsak, Suwat; Hakim, James; Badal-Faesen, Sharlaa; Akelo, Victor; Hosseinipour, Mina C; Santos, Breno R; Godbole, Sheela V; Pilotto, Jose H; Grinsztejn, Beatriz; Panchia, Ravindre; Mayer, Kenneth H; Chen, Ying Q; Cohen, Myron S; Eshleman, Susan H

    2016-07-01

    Early initiation of antiretroviral treatment (ART) reduces HIV transmission and has health benefits. HIV drug resistance can limit treatment options and compromise use of ART for HIV prevention. We evaluated drug resistance in 85 participants in the HIV Prevention Trials Network 052 trial who started ART at CD4 counts of 350-550 cells per cubic millimeter and failed ART by May 2011; 8.2% had baseline resistance and 35.3% had resistance at ART failure. High baseline viral load and less education were associated with emergence of resistance at ART failure. Resistance at ART failure was observed in 7 of 8 (87.5%) participants who started ART at lower CD4 cell counts.

  7. Nuclear energy: Promise and problems

    International Nuclear Information System (INIS)

    Richter, B.

    2005-01-01

    Nuclear energy is having a renaissance driven by both old fashioned supply and demand, and environmental concerns. Oil and gas prices have exploded and show no signs of returning to the levels of only a few years ago. Coal is not in short supply, but the pollution it generates has severe economic and health consequences. Concern about greenhouse gases and global warming has caused the environmental movement to begin a reassessment of the role of nuclear in the world's energy portfolio. The full potential of nuclear energy will be achieved only if governments and the public are satisfied that it is safe, that the radioactive waste can be safely disposed of, and that the risk of the proliferation of nuclear weapons is low. The first criterion has been met with designs that are inherently safer than current LWRs, primarily through design simplification, reducing the number of critical components, and advanced control and monitoring technologies. Operating safety has to be assured through good practices and a rigorous, independent inspection process. The second criterion, waste disposal, is a problem where the science and technology (S and T) communities have the primary role in a solution. Many believe that it is solved in principle, but there has as yet been no solution in practice. I will report on where I think we have gotten and what needs to be done. The third criterion, proliferation resistance, is one that the S and T communities cannot solve on their own. The best that S and T can do is to make proliferation difficult, and to make sure that any attempts are discovered early. The rest can be handled only by enforceable international agreements. Safeguards technology needs more attention. (author)

  8. Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications.

    Science.gov (United States)

    Riboh, Jonathan C; Saltzman, Bryan M; Yanke, Adam B; Cole, Brian J

    2016-09-01

    Amniotic membrane (AM)-derived products have been successfully used in ophthalmology, plastic surgery, and wound care, but little is known about their potential applications in orthopaedic sports medicine. To provide an updated review of the basic science and preclinical and clinical data supporting the use of AM-derived products and to review their current applications in sports medicine. Systematic review. A systematic search of the literature was conducted using the Medline, EMBASE, and Cochrane databases. The search term amniotic membrane was used alone and in conjunction with stem cell, orthopaedic, tissue engineering, scaffold, and sports medicine. The search identified 6870 articles, 80 of which, after screening of the titles and abstracts, were considered relevant to this study. Fifty-five articles described the anatomy, basic science, and nonorthopaedic applications of AM-derived products. Twenty-five articles described preclinical and clinical trials of AM-derived products for orthopaedic sports medicine. Because the level of evidence obtained from this search was not adequate for systematic review or meta-analysis, a current concepts review on the anatomy, physiology, and clinical uses of AM-derived products is presented. Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint. The current body of evidence in sports medicine is heavily biased toward in vitro and animal studies, with little to no human clinical data. Nonetheless, 14 companies or distributors offer commercial AM products. The preparation and formulation of these products alter their biological and mechanical properties, and a thorough understanding of these

  9. Quantifying Neonatal Sucking Performance: Promise of New Methods.

    Science.gov (United States)

    Capilouto, Gilson J; Cunningham, Tommy J; Mullineaux, David R; Tamilia, Eleonora; Papadelis, Christos; Giannone, Peter J

    2017-04-01

    Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neonatal sucking performance that hold significant clinical and research promise. We present early results from an ongoing study investigating neonatal sucking as a marker of risk for adverse neurodevelopmental outcomes. We include quantitative measures of sucking performance to better understand how movement variability evolves during skill acquisition. Results showed the coefficient of variation of suck duration was significantly different between preterm neonates at high risk for developmental concerns (HRPT) and preterm neonates at low risk for developmental concerns (LRPT). For HRPT, results indicated the coefficient of variation of suck smoothness increased from initial feeding to discharge and remained significantly greater than healthy full-term newborns (FT) at discharge. There was no significant difference in our measures between FT and LRPT at discharge. Our findings highlight the need to include neonatal sucking assessment as part of routine clinical care in order to capture the relative risk of adverse neurodevelopmental outcomes at discharge. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Planning benchmark study for SBRT of early stage NSCLC. Results of the DEGRO Working Group Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Moustakis, Christos [University Muenster, Department of Radiation Oncology, Muenster (Germany); German CyberKnife Center, Soest (Germany); Blanck, Oliver [UKSH Universitaetsklinikum Schleswig Holstein, Department of Radiation Oncology, Kiel (Germany); Saphir Radiosurgery Center, Guestrow and Frankfurt, Frankfurt (Germany); Ebrahimi Tazehmahalleh, Fatemeh [University Muenster, Department of Radiation Oncology, Muenster (Germany); City Hospital Dessau, Dessau (Germany); Chan, Mark ka heng [UKSH Universitaetsklinikum Schleswig Holstein, Department of Radiation Oncology, Kiel (Germany); Ernst, Iris; Haverkamp, Uwe; Eich, Hans Theodor [University Muenster, Department of Radiation Oncology, Muenster (Germany); German CyberKnife Center, Soest (Germany); Krieger, Thomas [University of Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Duma, Marciana-Nona; Oechsner, Markus [Technical University of Munich, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Ganswindt, Ute; Heinz, Christian [Ludwig-Maximilians-University, Department of Radiation Oncology, Munich (Germany); Alheit, Horst; Blank, Hilbert [Radiationtherapy Distler, Bautzen (Germany); Nestle, Ursula; Wiehle, Rolf [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); Kornhuber, Christine; Ostheimer, Christian [University Halle, Department of Radiation Oncology, Halle (Germany); Petersen, Cordula [University Hospital Hamburg-Eppendorf, Hamburg (Germany); Pollul, Gerhard [University Mainz, Department of Radiation Oncology, Mainz (Germany); Baus, Wolfgang; Altenstein, Georg [University Hospital of Cologne, Cologne (Germany); Beckers, Eric; Jurianz, Katrin [Gamma Knife Center Krefeld, Krefeld (Germany); Sterzing, Florian [University Hospital Heidelberg, Heidelberg (Germany); Kretschmer, Matthias [Radiologische Allianz Hamburg, Hamburg (Germany); Seegenschmiedt, Heinrich; Maass, Torsten [Radiationtherapy and Cyberknife Center Hamburg, Hamburg (Germany); Droege, Stefan [Lung Clinic Hemer, Hemer (Germany); Wolf, Ulrich [University Leipzig, Department of Radiation Oncology, Leipzig (Germany); Schoeffler, Juergen [Radiationtherapy Department Boeblingen, Boeblingen (Germany); Guckenberger, Matthias [University Zurich, Department of Radiation Oncology, Zurich (Switzerland)

    2017-10-15

    The aim was to evaluate stereotactic body radiation therapy (SBRT) treatment planning variability for early stage nonsmall cell lung cancer (NSCLC) with respect to the published guidelines of the Stereotactic Radiotherapy Working Group of the German Society for Radiation Oncology (DEGRO). Planning computed tomography (CT) scan and the structure sets (planning target volume, PTV; organs at risk, OARs) of 3 patients with early stage NSCLC were sent to 22 radiotherapy departments with SBRT experience: each department was asked to prepare a treatment plan according to the DEGRO guidelines. The prescription dose was 3 fractions of 15 Gy to the 65% isodose. In all, 87 plans were generated: 36 used intensity-modulated arc therapy (IMAT), 21 used three-dimensional conformal radiation therapy (3DCRT), 6 used static field intensity-modulated radiation therapy (SF-IMRT), 9 used helical radiotherapy and 15 used robotic radiosurgery. PTV dose coverage and simultaneously kept OARs doses were within the clinical limits published in the DEGRO guidelines. However, mean PTV dose (mean 58.0 Gy, range 52.8-66.4 Gy) and dose conformity indices (mean 0.75, range 0.60-1.00) varied between institutions and techniques (p ≤ 0.02). OARs doses varied substantially between institutions, but appeared to be technique independent (p = 0.21). All studied treatment techniques are well suited for SBRT of early stage NSCLC according to the DEGRO guidelines. Homogenization of SBRT practice in Germany is possible through the guidelines; however, detailed treatment plan characteristics varied between techniques and institutions and further homogenization is warranted in future studies and recommendations. Optimized treatment planning should always follow the ALARA (as low as reasonably achievable) principle. (orig.) [German] Ziel war die Untersuchung der Variabilitaet der Bestrahlungsplanung der stereotaktischen Strahlentherapie (SBRT) fuer das nicht-kleinzellige Bronchialkarzinom (NSCLC) im

  11. Increased platelet activation in early symptomatic versus asymptomatic carotid stenosis and relationship with microembolic status: Results from the Platelets And Carotid Stenosis (PACS) Study.

    LENUS (Irish Health Repository)

    Kinsella, Ja

    2013-04-26

    BACKGROUND: Cerebral microembolic signals (MES) may predict increased stroke risk in carotid stenosis. However, the relationship between platelet counts or platelet activation status and MES in symptomatic versus asymptomatic carotid stenosis has not been comprehensively assessed. SETTING: University teaching hospitals. METHODS: This prospective, pilot observational study assessed platelet counts and platelet activation status, and the relationship between platelet activation and MES in asymptomatic versus early (≤4 weeks after TIA\\/stroke) and late phase (≥3 months) symptomatic moderate or severe (≥50%) carotid stenosis patients. Full blood count measurements were performed, and whole blood flow cytometry was used to quantify platelet surface activation marker expression (CD62P and CD63) and circulating leucocyte-platelet complexes. Bilateral simultaneous transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed for 1 hour to classify patients as MES-positive or MES-negative. RESULTS: Data from 31 asymptomatic patients were compared with 46 symptomatic patients in the early phase, and 35 of these patients followed up to the late phase after symptom onset. The median platelet count (211 vs. 200 x 10(9) \\/L; p=0.03) and the median% lymphocyte-platelet complexes were higher in early symptomatic than asymptomatic patients (2.8 vs. 2.4%, p=0.001). The% lymphocyte-platelet complexes was higher in early symptomatic than asymptomatic patients with ≥70% carotid stenosis (p=0.0005), and in symptomatic patients recruited within 7 days of symptom onset (p=0.028). Complete TCD data were available in 25 asymptomatic and 31 early phase symptomatic, and 27 late phase symptomatic patients. 12% of asymptomatic versus 32% of early phase symptomatic (p=0.02) and 19% of late phase symptomatic patients (p=0.2) were MES-positive. Early symptomatic MES-negative patients had a higher% lymphocyte-platelet complexes than asymptomatic MES

  12. HIV pre-exposure prophylaxis and early antiretroviral treatment among female sex workers in South Africa: Results from a prospective observational demonstration project.

    Directory of Open Access Journals (Sweden)

    Robyn Eakle

    2017-11-01

    . There were no seroconversions on PrEP and 7 virological failures on early ART among women remaining in the study. Reported adherence to PrEP varied over time between 70% and 85%, whereas over 90% of participants reported taking pills daily while on early ART. Data on provider-side costs were also collected and analysed. The total cost of service delivery was approximately US$126 for PrEP and US$406 for early ART per person-year. The main limitations of this study include the lack of a control group, which was not included due to ethical considerations; clinical study requirements imposed when PrEP was not approved through the regulatory system, which could have affected uptake; and the timing of the implementation of a national sex worker HIV programme, which could have also affected uptake and retention.PrEP and early ART services can be implemented within FSW routine services in high prevalence, urban settings. We observed good uptake for both PrEP and early ART; however, retention rates for PrEP were low. Retention rates for early ART were similar to retention rates for the current standard of care. While the cost of the interventions was higher than previously published, there is potential for cost reduction at scale. The TAPS Demonstration Project results provided the basis for the first government PrEP and early ART guidelines and the rollout of the national sex worker HIV programme in South Africa.

  13. Improved survival of baby boomer women with early-stage uterine cancer: A Surveillance, Epidemiology and End Results (SEER) Study.

    Science.gov (United States)

    Elshaikh, Mohamed A; Ruterbusch, Julie; Cote, Michele L; Cattaneo, Richard; Munkarah, Adnan R

    2013-11-01

    To study the prognostic impact of baby boomer (BB) generation on survival end-points of patients with early-stage endometrial carcinoma (EC). Data were obtained from the SEER registry between 1988-2009. Inclusion criteria included women who underwent hysterectomy for stage I-II EC. Patients were divided into two birth cohorts: BB (women born between 1946 and 1964) and pre-boomers (PB) (born between 1926 and 1945). A total of 30,956 patients were analyzed. Considering that women in the PB group were older than those of the BB generation, the statistical analysis was limited to women 50-59 years of age at the time of diagnosis (n=11,473). Baby boomers had a significantly higher percentage of endometrioid histology (pgeneration compared to the PB generation (p=0.0003) with a trend for improved uterine cancer-specific survival (p=0.0752). On multivariate analysis, birth cohort (BB vs. PB) was not a significant predictor of survival end-points. Factors predictive of survival included: tumor grade, FIGO stage, African-American race, and increased number of dissected LN. Our study suggests that the survival of BB women between 50-60 years of age is better compared to women in the PB generation. As more BB patients are diagnosed with EC, further research is warranted.

  14. Effectiveness of systematic chromoendoscopy for diagnosis of early cancer and gastric premalignant lesions. Results of two consecutive screening campaigns in Colombia

    International Nuclear Information System (INIS)

    Emura, Fabian; Mejia, Juan; Mejia, Marcela; Osorio, Camilo

    2010-01-01

    Gastric cancer is the most common malignancy in South America and East Asia. In addition to the high mortality, in Colombia a great disvantage is the lack of data regarding premalignant lesions and early cancer. Aim: To evaluate the usefulness of systematic chromoendoscopy in the prevalence of early cancer and gastric premalignant lesions. A total of 950 were invited to participate, 800 fulfilled the inclusion criteria and finally 650 were analyzed. Results: None of participants had normal gastric mucosa. Mild antrum gastritis was found in 21.8% (142/650), meanwhile moderate or severe antrum gastritis in 77.4% (508/650). Atrophy and metaplasia was found in 14.5% (94/650) and 15.5% (101/650) respectively. H Pilory infection was found in 7.3%, 79.3% 75.5% 57.4% y 0% of subjects with mild, moderate and severe, atrophy, metaplasia and dysplasia respectively. Gastric premalignant lesion was found in 30% (195/650). Two subjects were diagnosed as early gastric cancer and treated by endoscopic submucosal dissection (ESD) with curability as final result. Conclusions: By systematic chromoendoscopy this series has demonstrated that 1/325 healthy volunteers had early gastric cancer and that 1/33 had a premalignant lesion explaining in part the high prevalence of gastric cancer in the region. Bases on this series, gastric cancer is diagnosable and curable among healthy volunteers in Colombia.

  15. Impact of early life adversity on reward processing in young adults: EEG-fMRI results from a prospective study over 25 years.

    Directory of Open Access Journals (Sweden)

    Regina Boecker

    Full Text Available Several lines of evidence have implicated the mesolimbic dopamine reward pathway in altered brain function resulting from exposure to early adversity. The present study examined the impact of early life adversity on different stages of neuronal reward processing later in life and their association with a related behavioral phenotype, i.e. attention deficit/hyperactivity disorder (ADHD. 162 healthy young adults (mean age = 24.4 years; 58% female from an epidemiological cohort study followed since birth participated in a simultaneous EEG-fMRI study using a monetary incentive delay task. Early life adversity according to an early family adversity index (EFA and lifetime ADHD symptoms were assessed using standardized parent interviews conducted at the offspring's age of 3 months and between 2 and 15 years, respectively. fMRI region-of-interest analysis revealed a significant effect of EFA during reward anticipation in reward-related areas (i.e. ventral striatum, putamen, thalamus, indicating decreased activation when EFA increased. EEG analysis demonstrated a similar effect for the contingent negative variation (CNV, with the CNV decreasing with the level of EFA. In contrast, during reward delivery, activation of the bilateral insula, right pallidum and bilateral putamen increased with EFA. There was a significant association of lifetime ADHD symptoms with lower activation in the left ventral striatum during reward anticipation and higher activation in the right insula during reward delivery. The present findings indicate a differential long-term impact of early life adversity on reward processing, implicating hyporesponsiveness during reward anticipation and hyperresponsiveness when receiving a reward. Moreover, a similar activation pattern related to lifetime ADHD suggests that the impact of early life stress on ADHD may possibly be mediated by a dysfunctional reward pathway.

  16. Underexploited tropical plants with promising economic value

    Energy Technology Data Exchange (ETDEWEB)

    1975-01-01

    The apparent advantages of staple plants over the minor tropical plants often result only from the disproportionate research attention they have been given. A world-wide inquiry resulted in a list of 400 promising but neglected species. The 36 most important species are described in compact monographs and concern cereals (Echinochloa turnerana, grain amaranths, quinua and Zosterea mazina), roots and tubers (Arrachacha, cocoyams and taro), vegetables (chaya, hearts of palms, wax gourd, winged bean), fruits (durian, mangosteen, naranjilla, pejibaye, pummelo, soursop, uvilla), oilseeds (babassu palm, buffalo gourd, Caryocar species, Hessenia polycarpa and jojoba), forage (Acacia albida, Brosimum alicastrum Cassia sturtii, saltbushes and tamarugo) and other crops (buriti palm, Calathea lutea, candelilla, guar, guayule, Paspalum vaginatum, ramie and Spirulina).

  17. Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study.

    Science.gov (United States)

    Ekirapa-Kiracho, Elizabeth; Waiswa, Peter; Rahman, M Hafizur; Makumbi, Fred; Kiwanuka, Noah; Okui, Olico; Rutebemberwa, Elizeus; Bua, John; Mutebi, Aloysius; Nalwadda, Gorette; Serwadda, David; Pariyo, George W; Peters, David H

    2011-03-09

    Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS) can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders. This quasi-experimental trial is conducted in two districts in Eastern Uganda. The supply side component includes health worker refresher training and additions of minimal drugs and supplies, whereas the demand side component involves vouchers given to pregnant women for motorcycle transport and the payment to service providers for antenatal, delivery, and postnatal care. The trial is ongoing, but early analysis from routine health information systems on the number of services used is presented. Motorcyclists in the community organized themselves to accept vouchers in exchange for transport for antenatal care, deliveries and postnatal care, and have become actively involved in ensuring that women obtain care. Increases in antenatal, delivery, and postnatal care were demonstrated, with the number of safe deliveries in the intervention area immediately jumping from Voucher revenues have been used to obtain needed supplies to improve quality and to pay health workers, ensuring their availability at a time when workloads are increasing. Transport and service vouchers appear to be a viable strategy for rapidly increasing maternal care. MakCHS can design strategies together with stakeholders using a learning-by-doing approach to take advantage of

  18. Peri-operative morbidity and early results of a randomised trial comparing TVT and TVT-O.

    Science.gov (United States)

    Meschia, Michele; Bertozzi, Rosanna; Pifarotti, Paola; Baccichet, Roberto; Bernasconi, Francesco; Guercio, Elso; Magatti, Fabio; Minini, Gianfranco

    2007-11-01

    The aim of this study was to compare the morbidity and short-term efficacy of retro-pubic (TVT) and inside-out trans-obturator (TVT-O) sub-urethral sling in the treatment of stress urinary incontinence. This was a prospective multi-centre randomised trial; 231 women with primary stress urinary incontinence were randomised to TVT (114) or TVT-O (117). The International Consultation on Incontinence-Short Form (ICIQ-SF), Women Irritative Prostate Symptoms Score (W-IPSS) and Patient Global Impression of Severity (PGI-S) questionnaires were used to evaluate the impact of incontinence and voiding dysfunction on QoL and to measure the patient's perception of incontinence severity. The primary and secondary outcome measures were rates of success and complications. The SPSS software was used for data analysis. The TVT-O procedure was associated with significantly shorter operation time and with a more extensive use of general anaesthesia when compared with TVT. There were 5 (4%) bladder perforations in the TVT group compared with none in the TVT-O group. Rates of early post-operative urinary retention and voiding difficulty were similar for both groups and no difference was found in the average hospital stay. Six patients (5%) in the TVT-O group complained of thigh pain in the post-operative course. The median follow-up time was 6 months. Two hundred eighteen patients were available for the analysis of outcomes. Subjective and objective cure rates were 92% and 92% in the TVT group and 87% and 89% in the TVT-O group. The ICIQ-SF questionnaire symptoms score showed a highly statistical decrease in both groups, the W-IPSS on the contrary was unchanged. Our data show that both procedures were equally effective in the short-term for the treatment of stress urinary incontinence with a highly significant improvement in incontinence-related QoL.

  19. Solar power's rise and promise

    OpenAIRE

    Pernia, Ernesto M.; Generoso, Maria Janela M.

    2015-01-01

    Time was when solar energy was facilely dismissed as impractical, inefficient, and pricey. In recent years, however, innovations in technology, regulation, and financing have resulted in remarkable efficiency improvements and price reductions, thereby reversing the skepticism about this renewable energy (RE) source. In this paper, we explore how this has happened, to what extent photovoltaic solar technology has been accepted around the world, and what might be its potential for inclusive gre...

  20. Association Between Early Caffeine Citrate Administration and Risk of Acute Kidney Injury in Preterm Neonates: Results From the AWAKEN Study.

    Science.gov (United States)

    Harer, Matthew W; Askenazi, David J; Boohaker, Louis J; Carmody, J Bryan; Griffin, Russell L; Guillet, Ronnie; Selewski, David T; Swanson, Jonathan R; Charlton, Jennifer R

    2018-04-02

    caffeine remained associated with reduced odds of developing AKI (adjusted odds ratio, 0.20; 95% CI, 0.11-0.34), indicating that for every 4.3 neonates exposed to caffeine one case of AKI was prevented. Among neonates with early AKI, those receiving caffeine were less likely to develop stage 2 or 3 AKI (adjusted odds ratio, 0.20; 95% CI, 0.12-0.34). Caffeine administration in preterm neonates is associated with reduced incidence and severity of AKI. Further studies should focus on the timing and dosage of caffeine to optimize the prevention of AKI.

  1. Study of treatment results and early complications of tube drainage versus capitonnage after the unroofing and aspiration of hydatid cysts

    Directory of Open Access Journals (Sweden)

    Mostafa Mehrabi Bahar

    2014-10-01

    Conclusion: This study demonstrated that capitonnage versus the tube drainage method may result in a shorter hospital stay, decreased time to return to work, and low rate of morbidity and complications.

  2. Aggressive combination therapy with intraarticular glucocorticoid injections and conventional DMARDs in early rheumatoid arthritis Two Year Clinical and Radiographic Results From The CIMESTRA Study

    DEFF Research Database (Denmark)

    Hetland, Merete; Stengaard-Pedersen, Kristian; Junker, Peter

    2008-01-01

    of the 2nd year of the randomized, controlled double-blind CIMESTRA study. METHODS: 160 patients with early RA (any swollen joint in combination with step-up treatment with either methotrexate and placebo...... years, and the radiographic erosive progression was minimal. Addition of cyclosporine during the first 76 weeks resulted in significantly better ACR20 and ACR50 responses, but did not have any additional effect on remission rate and radiographic outcome.......OBJECTIVE: To investigate whether clinical and radiographic disease control can be achieved and maintained in patients with early, active rheumatoid arthritis (RA) during the 2nd year of aggressive treatment with conventional DMARD and intraarticular corticosteroid. This paper presents the results...

  3. A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients.

    Science.gov (United States)

    Myers, Ronald E; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C; Waldman, Scott A

    2016-10-03

    We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption. We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results. Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using the new prognostic test. Multivariable analyses showed that physicians in academic medical centers were significantly more receptive to molecular test use than those in non-academic settings. Forty-one percent of respondents were ready to act on abnormal molecular test results. Physicians who viewed current staging methods as inaccurate and were confident in their capacity to incorporate molecular testing in practice were more likely to say they would act on abnormal test results. Physician receptivity to molecular diagnostic testing for early-stage colon cancer patients is likely to be influenced by practice setting and perceptions related to delivering quality care to patients. ClinicalTrials.gov Identifier: NCT01972737.

  4. Halopentacenes: Promising Candidates for Organic Semiconductors

    International Nuclear Information System (INIS)

    Gong-He, Du; Zhao-Yu, Ren; Ji-Ming, Zheng; Ping, Guo

    2009-01-01

    We introduce polar substituents such as F, Cl, Br into pentacene to enhance the dissolubility in common organic solvents while retaining the high charge-carrier mobilities of pentacene. Geometric structures, dipole moments, frontier molecule orbits, ionization potentials and electron affinities, as well as reorganization energies of those molecules, and of pentacene for comparison, are successively calculated by density functional theory. The results indicate that halopentacenes have rather small reorganization energies (< 0.2 eV), and when the substituents are in position 2 or positions 2 and 9, they are polarity molecules. Thus we conjecture that they can easily be dissolved in common organic solvents, and are promising candidates for organic semiconductors. (condensed matter: electronicstructure, electrical, magnetic, and opticalproperties)

  5. Neuroimaging in psychiatric pharmacogenetics research: the promise and pitfalls.

    Science.gov (United States)

    Falcone, Mary; Smith, Ryan M; Chenoweth, Meghan J; Bhattacharjee, Abesh Kumar; Kelsoe, John R; Tyndale, Rachel F; Lerman, Caryn

    2013-11-01

    The integration of research on neuroimaging and pharmacogenetics holds promise for improving treatment for neuropsychiatric conditions. Neuroimaging may provide a more sensitive early measure of treatment response in genetically defined patient groups, and could facilitate development of novel therapies based on an improved understanding of pathogenic mechanisms underlying pharmacogenetic associations. This review summarizes progress in efforts to incorporate neuroimaging into genetics and treatment research on major psychiatric disorders, such as schizophrenia, major depressive disorder, bipolar disorder, attention-deficit/hyperactivity disorder, and addiction. Methodological challenges include: performing genetic analyses in small study populations used in imaging studies; inclusion of patients with psychiatric comorbidities; and the extensive variability across studies in neuroimaging protocols, neurobehavioral task probes, and analytic strategies. Moreover, few studies use pharmacogenetic designs that permit testing of genotype × drug effects. As a result of these limitations, few findings have been fully replicated. Future studies that pre-screen participants for genetic variants selected a priori based on drug metabolism and targets have the greatest potential to advance the science and practice of psychiatric treatment.

  6. Visualizing Chemistry: The Progess and Promise of Advanced Chemical Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Committee on Revealing Chemistry Through Advanced Chemical Imaging

    2006-09-01

    The field of chemical imaging can provide detailed structural, functional, and applicable information about chemistry and chemical engineering phenomena that have enormous impacts on medicine, materials, and technology. In recognizing the potential for more research development in the field of chemical imaging, the National Academies was asked by the National Science Foundation, Department of Energy, U.S. Army, and National Cancer Institute to complete a study that would review the current state of molecular imaging technology, point to promising future developments and their applications, and suggest a research and educational agenda to enable breakthrough improvements in the ability to image molecular processes simultaneously in multiple physical dimensions as well as time. The study resulted in a consensus report that provides guidance for a focused research and development program in chemical imaging and identifies research needs and possible applications of imaging technologies that can provide the breakthrough knowledge in chemistry, materials science, biology, and engineering for which we should strive. Public release of this report is expected in early October.

  7. Evaluation of Early Performance Results for Massachusetts Homes in the National Grid Pilot Deep Energy Retrofit Program

    Energy Technology Data Exchange (ETDEWEB)

    Gates, C. [Building Science Corporation, Somerville, MA (United States); Neuhauser, K. [Building Science Corporation, Somerville, MA (United States)

    2013-11-01

    This research project evaluates post-retrofit performance measurements, energy use data and construction costs for 13 projects that participated in the National Grid Deep Energy Retrofit Pilot program. The projects implemented a package of measures defined by performance targets for building enclosure components and building enclosure air tightness. Nearly all of the homes reached a post-retrofit air tightness result of 1.5 ACH 50. Homes that used the chainsaw retrofit technique along with roof insulation, and wall insulation applied to the exterior had the best air tightness results and the lowest heating and cooling source energy use. Analysis of measure costs and project objectives yielded a categorization of costs relative to energy performance objectives. On average about 1/2 of the energy-related measure costs correspond primarily to energy-related objectives, and 20% of energy-related measure costs relate primarily to non-energy objectives.

  8. Evaluation of Early Performance Results for Massachusetts Homes in the National Grid Pilot Deep Energy Retrofit Program

    Energy Technology Data Exchange (ETDEWEB)

    Neuhauser, K. [Building Science Corporation, Somerville, MA (United States); Gates, C. [Building Science Corporation, Somerville, MA (United States)

    2013-11-01

    This research project evaluates post-retrofit performance measurements, energy use data and construction costs for 13 projects that participated in the National Grid Deep Energy Retrofit Pilot program. The projects implemented a package of measures defined by performance targets for building enclosure components and building enclosure air tightness. Nearly all of the homes reached a post-retrofit air tightness result of 1.5 ACH 50. Homes that used the chainsaw retrofit technique along with roof insulation, and wall insulation applied to the exterior had the best air tightness results and the lowest heating and cooling source energy use. Analysis of measure costs and project objectives yielded a categorization of costs relative to energy performance objectives. On average about ½ of the energy-related measure costs correspond primarily to energy-related objectives, and 20% of energy-related measure costs relate primarily to non-energy objectives.

  9. Prenatal and early postnatal intoxication by inorganic mercury resulting from the maternal use of mercury containing soap.

    Science.gov (United States)

    Lauwerys, R; Bonnier, C; Evrard, P; Gennart, J P; Bernard, A

    1987-05-01

    A case of slight renal tubular dysfunction associated with cataract and anaemia was diagnosed in a 3-month-old black boy in whom high levels of mercury were found in blood and urine. Several arguments suggest that the renal, ocular and haematological defects may have resulted from exposure to mercury during foetal life and the 1-month lactation period due to the extensive use of inorganic mercury containing cosmetics by the mother.

  10. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Doros, Attila [Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)

    2013-07-11

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  11. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    International Nuclear Information System (INIS)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-01-01

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies

  12. Effects of 60 Hz electromagnetic fields on early growth in three plant species and a replication of previous results

    Energy Technology Data Exchange (ETDEWEB)

    Davis, M.S. [Univ. of Sunderland (United Kingdom). Ecology Centre

    1996-05-01

    In an attempt to replicate the findings of Smith et al., seeds of Raphanus sativus L. (radish), Sinapsis alba L. (mustard), and Hordeum vulgare L. (barley) were grown for between 9 and 21 days in continuous electromagnetic fields (EMFs) at ion-cyclotron resonance conditions for stimulation of Ca{sup 2+} (B{sub H} = 78.3 {micro}T, B{sub HAC} = 40 {micro}T peak-peak at 60 Hz, B{sub v} = 0). On harvesting, radish showed results similar to those of Smith et al. Dry stem weight and plant height were both significantly greater (Mann-Whitney tests, Ps < 0.05) in EMF-exposed plants than in control plants in each EMF experiment. Wet root weight was significantly greater in EMF-exposed plants in two out of three experiments, as were dry leaf weight, dry whole weight, and stem diameter. Dry root weight, wet leaf weight, and wet whole weight were significantly greater in EMF-exposed plants in one of three experiments. All significant differences indicated an increase in weight or size in the EMF-exposed plants. In each of the sham experiments, no differences between exposed and control plants were evident. Mustard plants failed to respond to the EMFs in any of the plant parameters measured. In one experiment, barley similarly failed to respond; but in another showed significantly greater wet root weight and significantly smaller stem diameter and dry seed weight at the end of the experiment in exposed plants compared to control plants. Although these results give no clue about the underlying bioelectromagnetic mechanism, they demonstrate that, at least for one EMF-sensitive biosystem, results can be independently replicated in another laboratory. Such replication is crucial in establishing the validity of bioelectromagnetic science.

  13. Early malnutrition results in long-lasting impairments in pattern-separation for overlapping novel object and novel location memories and reduced hippocampal neurogenesis.

    Science.gov (United States)

    Pérez-García, Georgina; Guzmán-Quevedo, Omar; Da Silva Aragão, Raquel; Bolaños-Jiménez, Francisco

    2016-02-17

    Numerous epidemiological studies indicate that malnutrition during in utero development and/or childhood induces long-lasting learning disabilities and enhanced susceptibility to develop psychiatric disorders. However, animal studies aimed to address this question have yielded inconsistent results due to the use of learning tasks involving negative or positive reinforces that interfere with the enduring changes in emotional reactivity and motivation produced by in utero and neonatal malnutrition. Consequently, the mechanisms underlying the learning deficits associated with malnutrition in early life remain unknown. Here we implemented a behavioural paradigm based on the combination of the novel object recognition and the novel object location tasks to define the impact of early protein-restriction on the behavioural, cellular and molecular basis of memory processing. Adult rats born to dams fed a low-protein diet during pregnancy and lactation, exhibited impaired encoding and consolidation of memory resulting from impaired pattern separation. This learning deficit was associated with reduced production of newly born hippocampal neurons and down regulation of BDNF gene expression. These data sustain the existence of a causal relationship between early malnutrition and impaired learning in adulthood and show that decreased adult neurogenesis is associated to the cognitive deficits induced by childhood exposure to poor nutrition.

  14. Percutaneous intraductal radiofrequency ablation for clearance of occluded metal stent in malignant biliary obstruction: feasibility and early results.

    Science.gov (United States)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-02-01

    The major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter. Nine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal-external biliary drainage. All nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50-488) days and a median stent patency of 102.5 (range 50-321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation. In this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  15. Oral Effects and Early Implant Survival Results After Imatinib Discontinuation Therapy for Chronic Myelogenous Leukemia: A Case Report.

    Science.gov (United States)

    Dixon, Douglas R; Yassin, Alaa

    2017-08-01

    Little is known regarding the success, failure, or complication rates of advanced implant procedures in patients after discontinuation therapy of long-term medications for the treatment of chronic myelogenous leukemia (CML). This case report presents initial results of a case involving implant placement in the mandible and maxilla as well as reduction of palatal oral pigmentation in a patient discontinuing long-term tyrosine kinase inhibitor (TKI) therapy for CML. A 57-year-old male was referred to the Department of Periodontics, University of Washington, Seattle, Washington, for an assessment of edentulous areas (tooth sites #3 and #14) and failing tooth #19. Previous medical treatment included oral administration (>10 years) of TKI for the treatment of CML. Systemic complications arising from long-term TKI therapy were treated with discontinuation of this medication. Concurrently, after multispecialty dental and medical consultation, extraction of tooth #19 with immediate implant placement and bilateral sinus augmentation with simultaneous implant placement were successfully performed during three separate surgical appointments. Additionally, marked reduction of oral palatal pigmentation was observed during the surgical and restorative phases after TKI discontinuation. Patients with a history of long-term TKIs for CML are at risk for developing complications that result in discontinuation of therapy. Long-term benefits of therapy may allow these patients to enjoy remission with an extended and improved quality of life. Patients undergoing discontinuation therapy may seek dental care. Therefore, dental providers need to understand these systemic interactions and, with multispecialty consultation, may help effectively treat these individuals.

  16. Placement of hemoparin-coated stents in the iliac arteries: Early experience and midterm results in 28 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kalmar, Peter I., E-mail: peter.kalmar@medunigraz.at; Portugaller, Rupert H., E-mail: rupert.portugaller@medunigraz.at; Schedlbauer, Peter, E-mail: peter.schedlbauer@klinikum-graz.at; Bohlsen, Dennis, E-mail: dennis.bohlsen@medunigraz.at; Deutschmann, Hannes A., E-mail: hannes.deutschmann@medunigraz.at

    2014-07-15

    Purpose: Aim was to determine immediate results and mid-term outcome of the hemoparin-coated (HC) stainless-steel stent (camouflage coating) in the treatment of occlusive lesions of the iliac arteries. Materials and methods: Twenty-eight patients were prospectively treated with the use of a HC stent between January 2007 and March 2010. Clinical examination and color-doppler ultrasound were performed at 1, 3, 6 and 12 months, CT angiography (CTA) or MR angiography (MRA) at 12 months. Indication for treatment was a high-grade stenosis of the common iliac and/or external iliac artery. Results: Successful placement was achieved in all patients. Significant decrease in translesional pressure gradient (>10 mmHg) was measured in 27 patients (96%). In one patient, proximal dissection occurred without flow limitation. A minor complication (small access site hematoma) occurred in one patient (4%). Two patients (7%) were lost to follow-up. After 12 months, stent patency in CTA, MRA and ultrasound was 100%. 20 patients (77%) experienced an initial improvement of at least one clinical stage. In one patient (4%), mild intimal hyperplasia without significant stenosis was observed. In three patients (12%), proximal or distal stenosis occurred. A non-significant increase of mean ankle-brachial index (ABI) after treatment was measured (0.85 ± 0.27 vs. 0.75 ± 0.22, respectively; p = 0.328). Conclusions: The use of HC stents in patients with iliac artery occlusive disease may lead to a lower rate of intimal hyperplasia and thus to increased patency rates even in heavily calcified vessels. However, large-scale prospective trials have to be performed to evaluate the long-term patency rates of the HC coated stents.

  17. Unstable Expression of Commonly Used Reference Genes in Rat Pancreatic Islets Early after Isolation Affects Results of Gene Expression Studies.

    Directory of Open Access Journals (Sweden)

    Lucie Kosinová

    Full Text Available The use of RT-qPCR provides a powerful tool for gene expression studies; however, the proper interpretation of the obtained data is crucially dependent on accurate normalization based on stable reference genes. Recently, strong evidence has been shown indicating that the expression of many commonly used reference genes may vary significantly due to diverse experimental conditions. The isolation of pancreatic islets is a complicated procedure which creates severe mechanical and metabolic stress leading possibly to cellular damage and alteration of gene expression. Despite of this, freshly isolated islets frequently serve as a control in various gene expression and intervention studies. The aim of our study was to determine expression of 16 candidate reference genes and one gene of interest (F3 in isolated rat pancreatic islets during short-term cultivation in order to find a suitable endogenous control for gene expression studies. We compared the expression stability of the most commonly used reference genes and evaluated the reliability of relative and absolute quantification using RT-qPCR during 0-120 hrs after isolation. In freshly isolated islets, the expression of all tested genes was markedly depressed and it increased several times throughout the first 48 hrs of cultivation. We observed significant variability among samples at 0 and 24 hrs but substantial stabilization from 48 hrs onwards. During the first 48 hrs, relative quantification failed to reflect the real changes in respective mRNA concentrations while in the interval 48-120 hrs, the relative expression generally paralleled the results determined by absolute quantification. Thus, our data call into question the suitability of relative quantification for gene expression analysis in pancreatic islets during the first 48 hrs of cultivation, as the results may be significantly affected by unstable expression of reference genes. However, this method could provide reliable information

  18. Placement of hemoparin-coated stents in the iliac arteries: Early experience and midterm results in 28 patients

    International Nuclear Information System (INIS)

    Kalmar, Peter I.; Portugaller, Rupert H.; Schedlbauer, Peter; Bohlsen, Dennis; Deutschmann, Hannes A.

    2014-01-01

    Purpose: Aim was to determine immediate results and mid-term outcome of the hemoparin-coated (HC) stainless-steel stent (camouflage coating) in the treatment of occlusive lesions of the iliac arteries. Materials and methods: Twenty-eight patients were prospectively treated with the use of a HC stent between January 2007 and March 2010. Clinical examination and color-doppler ultrasound were performed at 1, 3, 6 and 12 months, CT angiography (CTA) or MR angiography (MRA) at 12 months. Indication for treatment was a high-grade stenosis of the common iliac and/or external iliac artery. Results: Successful placement was achieved in all patients. Significant decrease in translesional pressure gradient (>10 mmHg) was measured in 27 patients (96%). In one patient, proximal dissection occurred without flow limitation. A minor complication (small access site hematoma) occurred in one patient (4%). Two patients (7%) were lost to follow-up. After 12 months, stent patency in CTA, MRA and ultrasound was 100%. 20 patients (77%) experienced an initial improvement of at least one clinical stage. In one patient (4%), mild intimal hyperplasia without significant stenosis was observed. In three patients (12%), proximal or distal stenosis occurred. A non-significant increase of mean ankle-brachial index (ABI) after treatment was measured (0.85 ± 0.27 vs. 0.75 ± 0.22, respectively; p = 0.328). Conclusions: The use of HC stents in patients with iliac artery occlusive disease may lead to a lower rate of intimal hyperplasia and thus to increased patency rates even in heavily calcified vessels. However, large-scale prospective trials have to be performed to evaluate the long-term patency rates of the HC coated stents

  19. The Early Result of Whole Pelvic Radiotherapy and Stereotactic Body Radiotherapy Boost for High Risk Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Yu-Wei eLin

    2014-10-01

    Full Text Available PurposeThe rationale for hypofractionated radiotherapy in the treatment of prostate cancer is based on the modern understanding of radiobiology and advances in stereotactic body radiotherapy (SBRT techniques. Whole-pelvis irradiation combined with SBRT boost for high-risk prostate cancer might escalate biologically effective dose without increasing toxicity. Here, we report our 4-year results of SBRT boost for high-risk localized prostate cancer.Methods and MaterialsFrom October 2009 to August 2012, 41 patients of newly diagnosed, high-risk or very high-risk (NCCN definition localized prostate cancer patients were treated with whole-pelvis irradiation and SBRT boost. The whole pelvis dose was 45Gy (25 fractions of 1.8Gy. The SBRT boost dose was 21 Gy (three fractions of 7 Gy. Ninety percent of these patients received hormone therapy. The toxicities of gastrointestinal (GI and genitourinary (GU tracts were scored by Common Toxicity Criteria Adverse Effect (CTCAE v3.0. Biochemical failure was defined by Phoenix definition.ResultsMedian follow-up was 42 months. Mean PSA before treatment was 44.18 ng/ml. Mean PSA level at 3, 6, 12, 18, and 24 months was 0.94, 0.44, 0.13, 0.12, and 0.05 ng/ml, respectively. The estimated 4-year biochemical failure-free survival was 91.9%. Three biochemical failures were observed. GI and GU tract toxicities were minimal. No grade 3 acute GU or GI toxicity was noted. During radiation therapy, 27% of the patient had grade 2 acute GU toxicity and 12% had grade 2 acute GI toxicity. At 3 months, most toxicity scores had returned to baseline. At the last follow up, there was no grade 3 late GU or GI toxicity.ConclusionsWhole-pelvis irradiation combined with SBRT boost for high-risk localized prostate cancer is feasible with minimal toxicity and encouraging biochemical failure-free survival. Continued accrual and follow-up would be necessary to confirm the biochemical control rate and the toxicity profiles.

  20. Physical and biological predictors of radiation-induced whole lung injury: early results of a prospective study

    International Nuclear Information System (INIS)

    Marks, L.B.; Munley, M.; Bentel, G.; Hollis, D.; Zhou, S.; Jirtle, R.; Kong, F.M.; Scarfone, C.; Antoine, P.; Chew, M.; Tapson, V.; Spencer, D.; Jaszczak, R.; Coleman, E.; Anscher, M.

    1996-01-01

    Purpose: To develop methods of predicting the pulmonary consequences of thoracic irradiation (RT) by prospectively studying changes in pulmonary function following RT. Methods: 105 patients receiving incidental partial lung irradiation during treatment of tumors in/around the thorax (lung-70, breast-18, lymphoma-4, misc-3) had whole lung function assessed (symptoms and pulmonary function tests [PFTs: FEV1-forced expiratory volume 1 sec; DLCO-diffusion capacity]) before and repeatedly 6-48 months following RT. All had computed tomography-based 3-dimensional (3D) dose calculations with lung density heterogeneity corrections for dose-volume histogram (DVH) and NTCP (normal tissue complication probability) calculations. Functional DVHs (DVfH) based on SPECT (single photon emission computed tomography) lung perfusion scans, and serial transforming growth factor-beta (TGF-β) levels were available in 50 and 30 patients, respectively. The incidence and severity of changes in whole lung function were correlated with clinical, physical and biological factors outlined in the results. Exploratory statistical analyses were preformed using chi-square, logistic regression, and multiple linear regression. Mean pt age=57, range 21-87; sex: 63 F, 42 M; 29 had chemotherapy (CT) before/with RT; Follow-up 6-48 months (mean 15, median 12). Results RT-induced symptoms developed in 26 patients (7-grade I-no intervention; 16 grade II-steroids; 3 grade III-oxygen and steroids). A mixed model based on pre-RT DLCO and CT-based NTCP was strongly predictive for the development of symptoms (p 30 Gy. In patients with 'good' pre-RT PFTs, there may be a relationship between the % reduction in PFT and % lung volume receiving >30 Gy (figure). Conclusion: Whole lung injury (symptoms or PFT changes) appears to be related to a variety of physical, biological and clinical factors. The data suggest that no one variable is likely to be an adequate predictor and that multi-faceted predictive models will be

  1. Early and mid-term results in the endovascular treatment of popliteal aneurysms with the multilayer flow modulator.

    Science.gov (United States)

    Ucci, Alessandro; Curci, Ruggiero; Azzarone, Matteo; Bianchini Massoni, Claudio; Bozzani, Antonio; Marcato, Carla; Marone, Enrico Maria; Perini, Paolo; Tecchio, Tiziano; Freyrie, Antonio; Argenteri, Angelo

    2018-01-01

    Background The endovascular approach became an alternative to open surgical treatment of popliteal artery aneurysm over the last few years. Heparin-bonded stent-grafts have been employed for endovascular popliteal artery aneurysm repair, showing good and stable results. Only few reports about the use of multilayer flow modulator are available in literature, providing small patient series and short follow-up. The aim of this study is to report the outcomes of patients with popliteal artery aneurysm treated with the multilayer flow modulator in three Italian centres. Methods We retrospectively analysed a series of both symptomatic and asymptomatic patients with popliteal artery aneurysm treated with the multilayer flow modulator from 2009 to 2015. Follow-up was undertaken with clinical and contrast-enhanced ultrasound examinations at 1, 6 and 12 months, and yearly thereafter. Computed tomography angiography was performed in selected cases. Primary endpoints were aneurysm sac thrombosis; freedom from sac enlargement and primary, primary-assisted and secondary patency during follow-up. Secondary endpoints were technical success, collateral vessels patency, limb salvage and aneurysm-related complications. Results Twenty-three consecutive patients (19 males, age 72 ± 11) with 25 popliteal artery aneurysms (mean diameter 23 mm ± 1, 3 symptomatic patients) were treated with 40 multilayer flow modulators during the period of the study. Median follow-up was 22.6 ± 16.7 months. Complete aneurysm thrombosis occurred in 92.9% of cases (23/25 cases) at 18 months. Freedom from sac enlargement was 100% (25/25 cases) with 17 cases of aneurysm sac shrinkage (68%). At 1, 6, 12 and 24 months, estimated primary patency was 95.7%, 87.3%, 77% and 70.1%, respectively. At the same intervals, primary-assisted patency was 95.7%, 91.3%, 86% and 86%, respectively, and secondary patency was 100%, 95.7%, 90.3% and 90.3%, respectively. Technical success was 100%. The collateral

  2. Study of treatment results and early complications of tube drainage versus capitonnage after the unroofing and aspiration of hydatid cysts.

    Science.gov (United States)

    Mehrabi Bahar, Mostafa; Jabbari Nooghabi, Azadeh; Hamid, Alireza; Amouzeshi, Ahmad; Jangjoo, Ali

    2014-10-01

    There is controversy concerning the management of the remaining cavity after the evacuation of a cyst in patients who have undergone surgical operation for liver hydatidosis. This study compares the results of capitonnage and tube drainage of the remaining cavity. In this retrospective study, participants were selected from two groups of patients with a liver hydatid cyst who underwent capitonnage or tube drainage from 2004 to 2012. The patients were followed for 6-24 months. The data of age, sex, involved liver lobe, size of the cyst, complications, drain duration, and hospital stay were analyzed. Participants included 155 patients consisting of 96 (61.94%) females and 59 (38.06%) males. Most cysts were in the right lobe, and the most common diameter of the cysts was greater than 10 cm. Capitonnage was performed on 90 (58.06%) patients and the tube drainage procedure was performed on the remaining 65 (41.94%) patients. In the tube drainage group and the capitonnage group, the operative times were 2.21 ± 0.65 hours and 2.53 ± 0.35 hours, respectively; the hospital stays were 5.695 ± 3.37 days and 4.43 ± 2.96 days, respectively; the drain duration was 9.2 ± 1.7 days and 2.1 ± 0.4 days, respectively; and the time to return to work was 14.7 ± 2.3 days and 8.3 ± 10.4 days, respectively. All variables were statistically significant, except for the operative time. Cavity infection and biliary fistula were identified in three patients and six patients, respectively, in the tube drainage group and identified in two patients and three patients, respectively, in the capitonnage group. This difference was not statistically significant. This study demonstrated that capitonnage versus the tube drainage method may result in a shorter hospital stay, decreased time to return to work, and low rate of morbidity and complications. Copyright © 2014. Published by Elsevier B.V.

  3. Poor results of drilling in early stages of juxta-articular osteonecrosis in 12 joints affected by Gaucher disease

    Science.gov (United States)

    Lebel, Ehud; Phillips, Mici; Zimran, Ari; Itzchaki, Menachem

    2009-01-01

    Background and purpose Gaucher disease is heterogeneous. One of the most devastating complications is bone involvement, ranging from mild osteopenia to osteonecrosis, but no markers have been discovered to predict onset and/or progression. We describe our experience in a large referral center using drilling for juxta-articular osteonecrosis in young patients with Gaucher disease. Patients and methods We retrospectively reviewed medical data from all patients who were recommended to undergo drilling for osteonecrosis of juxta-articular bone of the femoral head, the humeral head, or upper tibia for acute osteonecrosis at a pre-collapse stage. Results 11 patients (mean age 34 years) underwent drilling of 12 joints with juxta-articular osteonecrosis; 3 (mean age 51 years) refused intervention. 9 joints that were drilled showed advancing joint degeneration within 0.5 to 4 years. 3 joints have undergone replacement. Of the 3 joints that did not undergo drilling, 2 have undergone replacement and 1 has collapsed with osteoarthritis. Interpretation We found equally poor outcome with and without drilling. Effective intervention can only be achieved by improving our understanding of bone physiology and pathophysiology in Gaucher disease. PMID:19404804

  4. Early Expansion of the Intracranial CSF Volume After Palliative Whole-Brain Radiotherapy: Results of a Longitudinal CT Segmentation Analysis

    International Nuclear Information System (INIS)

    Sanghera, Paul; Gardner, Sandra L.; Scora, Daryl; Davey, Phillip

    2010-01-01

    Purpose: To assess cerebral atrophy after radiotherapy, we measured intracranial cerebrospinal fluid volume (ICSFV) over time after whole-brain radiotherapy (WBRT) and compared it with published normal-population data. Methods and Materials: We identified 9 patients receiving a single course of WBRT (30 Gy in 10 fractions over 2 weeks) for ipsilateral brain metastases with at least 3 years of computed tomography follow-up. Segmentation analysis was confined to the tumor-free hemi-cranium. The technique was semiautomated by use of thresholds based on scanned image intensity. The ICSFV percentage (ratio of ICSFV to brain volume) was used for modeling purposes. Published normal-population ICSFV percentages as a function of age were used as a control. A repeated-measures model with cross-sectional (between individuals) and longitudinal (within individuals) quadratic components was fitted to the collected data. The influence of clinical factors including the use of subependymal plate shielding was studied. Results: The median imaging follow-up was 6.25 years. There was an immediate increase (p < 0.0001) in ICSFV percentage, which decelerated over time. The clinical factors studied had no significant effect on the model. Conclusions: WBRT immediately accelerates the rate of brain atrophy. This longitudinal study in patients with brain metastases provides a baseline against which the potential benefits of more localized radiotherapeutic techniques such as radiosurgery may be compared.

  5. Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study

    International Nuclear Information System (INIS)

    Meijer, O.W.M.; Wolbers, J.G.; Baayen, J.C.; Slotman, B.J.

    2000-01-01

    Purpose: To prospectively assess the local control and toxicity rate in acoustic neuroma patients treated with linear accelerator-based radiosurgery and fractionated stereotactic radiation therapy. Methods and Materials: We evaluated 37 consecutive patients treated with stereotactic radiation therapy for acoustic neuroma. All patients had progressive tumors, progressive symptoms, or both. Mean tumor diameter was 2.3 cm (range 0.8-3.3) on magnetic resonance (MR) scan. Dentate patients were given a dose of 5 x 4 Gy or 5 x 5 Gy and edentate patients were given a dose of 1 x 10 Gy or 1 x 12.50 Gy prescribed to the 80% isodose. All patients were treated with a single isocenter. Results: With a mean follow-up period of 25 months (range 12-61), the actuarial local control rate at 5 years was 91% (only 1 patient failed). The actuarial rate of hearing preservation at 5 years was 66% in previously-hearing patients. The actuarial rate of freedom from trigeminal nerve toxicity was 97% at 5 years. No patient developed facial nerve toxicity or other complications. Conclusion: In this unselected series, fractionated stereotactic radiation therapy and linear accelerator-based radiosurgery give excellent local control in acoustic neuroma. It combines a high rate of preservation of hearing with a very low rate of other toxicity, although follow-up is relatively short

  6. Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: results of a two-year open-label extension trial

    Directory of Open Access Journals (Sweden)

    Subha V. Raman

    2017-02-01

    Full Text Available Abstract Background Cardiomyopathy is a leading cause of morbidity and mortality in boys with Duchenne muscular dystrophy (DMD. We recently showed in a 12-month double-blind randomized controlled trial that adding eplerenone to background medical therapy was cardioprotective in this population. The objective of this study was to evaluate the safety and efficacy of longer-term eplerenone therapy in boys with DMD. Results Eleven subjects (phase 1 baseline median [range] age: 13 [7 – 25] years from the original 12-month trial at a single participating center were enrolled. Importantly, those who entered the extension study who had been on eplerenone previously were significantly older than those who had originally been on placebo (median age 10.5 vs. 18.0 years, p = 0.045. During an additional 24-month open-label extension study, all boys received eplerenone 25 mg orally once daily to treat preclinical DMD cardiomyopathy, defined as evident myocardial damage by late gadolinium enhancement cardiac magnetic resonance (LGE with preserved ejection fraction (EF. The threshold for potassium level, the primary safety measure, was not exceeded in any non-hemolyzed blood sample. Over 24 months, left ventricular (LV systolic strain, a more sensitive marker whose more negative values indicate greater contractility significantly improved (median change -4.4%, IQR -5.8 to -0.9% in younger subjects whereas older subjects’ strain remained stable without significant worsening or improvement (median change 0.2%, IQR -1.1 to 4.3%. EF and extent of myocardial damage by LGE remained stable in both groups over 2 years. Conclusions Eplerenone offers effective and safe cardioprotection for boys with DMD, particularly when started at a younger age. Eplerenone is a useful clinical therapeutic option, particularly if treatment is initiated earlier in life when cardiac damage is minimal. Trial registration http://ClinicalTrials.gov identifier NCT01521546

  7. Lung tumor tracking during stereotactic radiotherapy treatment with the CyberKnife: Marker placement and early results

    International Nuclear Information System (INIS)

    Nuyttens, J.J.; Prevost, J.B.; Praag, J.; Hoogeman, M.; Levendag, P.C.; Klaveren, R.J. van; Pattynama, P.M.T.

    2006-01-01

    Lung tumor tracking during stereotactic radiotherapy with the CyberKnife requires the insertion of markers in or close to the tumor. To reduce the risk of pneumothorax, three methods of marker placement were used: 1) intravascular coil placement, 2) percutaneous intrathoracal, and 3) percutaneous extrathoracal placement. We investigated the toxicity of marker placement and the tumor response of the lung tumor tracking treatment. Markers were placed in 20 patients with 22 tumors: 13 patients received a curative treatment, seven a palliative. The median Charlson Comorbidity Score was 4 (range: 1-8). Platinum fiducials and intravascular embolisation coils were used as markers. In total, 78 markers were placed: 34 intrathoracal, 23 intravascular and 21 extrathoracal. The PTV equaled the GTV + 5 mm. A median dose of 45 Gy (range: 30-60 Gy, in 3 fractions) was prescribed to the 70-85% isodose. The response was evaluated with a CTscan performed 6-8 weeks after the last treatment and routinely thereafter. The median follow-up was 4 months (range: 2-11). No severe toxicity due to the marker placement was seen. Pneumothorax was not seen. The local control was 100%. Four tumors in four patients showed a complete response, 15 tumors in 14 patients a partial response, and three tumors in two patients with metastatic disease had stable disease. No severe toxicity of marker placement was seen due to the appropriate choice of one of the three methods. CyberKnife tumor tracking with markers is feasible and resulted in excellent tumor response. Longer follow-up is needed to validate the local control

  8. Early- and Mid-term Results of the Chimney Technique in the Repair of Aortic Arch Pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Junjie; Jiao, Yuanyong, E-mail: wishlucky@163.com, E-mail: johemail@163.com; Zhang, Xiwei; Jiang, Jun; Yang, Hongyu; Ma, Hao [First Affiliated Hospital of Nanjing Medical University, Division of Vascular Surgery, Department of General Surgery (China)

    2016-11-15

    PurposeTo examine the safety, feasibility, and mid-term efficacy of the chimney technique for aortic arch pathologies.MethodsFrom February 2011 to December 2014, a total of 35 patients (30 men; mean age 54.3 ± 14.1 years) with aortic arch pathologies underwent thoracic endovascular aortic repair combined with chimney stents. The indication was a proximal landing zone <1.5 cm. Follow-up was performed at 3, 6, and 12 months and then yearly thereafter.ResultsA total of 36 chimney stents were deployed (innominate artery, n = 1; left common carotid artery, n = 9; right subclavian artery, n = 1; left subclavian artery, n = 25). The technical success rate was 94.3 % (33/35). Immediate type Ia endoleaks (ELIa) were observed in two patients (8.6 %, 2/35). Twenty-five patients were successfully followed-up for a median period of 29.3 months (range, 6–48 months). One patient died due to aortic dissection aneurysm rupture at 36 months (mortality rate of 4 %, 1/25). Three late ELIa were observed and no reinterventions were performed. The overall incidence of ELIa was 20 % (5/25). During follow-up, the patency rate for chimney stents was 92 % (23/25).ConclusionOur limited experience demonstrates that the chimney technique is a viable and relatively safe treatment for patients with challenging thoracic aortic pathologies at least in the mid-term follow-up period.

  9. In situ replacement of infected vascular prosthesis with fresh arterial homograft: Early and long-term results in 18 patients

    Directory of Open Access Journals (Sweden)

    Pejkić Siniša

    2013-01-01

    Full Text Available Introduction. Graft infection is rightly considered one of the severest complications of vascular reconstruction. Treatment is non­standardized and associated with high mortality and morbidity rates. The choice of therapeutic modality depends upon variety of factors. One increasingly used option is in situ replacement of the infected prosthesis with the arterial allograft. Objective. The aim of this prospective nonrandomized study was to evaluate the effectiveness and durability of fresh arterial allograft as in situ substitute for the infected vascular prosthesis. Methods. During period of 2002-2005, 18 patients with the synthetic vascular graft infection underwent partial or complete prosthesis removal and secondary in situ reconstruction using the fresh arterial allograft, preserved under hypothermic conditions in buffered saline solution with an addition of antibiotics. Results. In 14 male and 4 female patients, meanaged 62 years, 8 aortic and 10 peripheral arterial infected prostheses were partially or completely replaced with the allograft. Operative mortality was 27.8% and amputation rate was 22.2%. Systemic sepsis at initial presentation and highly virulent nature of causative microorganisms were identified as significant negative prognostic factors (χ² test, p<0.05. During the long­term follow­up (mean 47 months, allograft aneurysm developed in three patients, requiring allograft explantation, followed in two cases by tertiary prosthetic reconstruction. Conclusion. Substitution of the infected prosthesis with the arterial allograft could be successful if used selectively - for less virulent and localized infections of extracavitary grafts. Close follow­up is mandatory for timely diagnosis of late homograft lesions and its eventual replacement with more durable prosthetic material.

  10. A computer-aided audit system for respiratory therapy consult evaluations: description of a method and early results.

    Science.gov (United States)

    Kester, Lucy; Stoller, James K

    2013-05-01

    Use of respiratory therapist (RT)-guided protocols enhances allocation of respiratory care. In the context that optimal protocol use requires a system for auditing respiratory care plans to assure adherence to protocols and expertise of the RTs generating the care plan, a live audit system has been in longstanding use in our Respiratory Therapy Consult Service. Growth in the number of RT positions and the need to audit more frequently has prompted development of a new, computer-aided audit system. The number and results of audits using the old and new systems were compared (for the periods May 30, 2009 through May 30, 2011 and January 1, 2012 through May 30, 2012, respectively). In contrast to the original, live system requiring a patient visit by the auditor, the new system involves completion of a respiratory therapy care plan using patient information in the electronic medical record, both by the RT generating the care plan and the auditor. Completing audits in the new system also uses an electronic respiratory therapy management system. The degrees of concordance between the audited RT's care plans and the "gold standard" care plans using the old and new audit systems were similar. Use of the new system was associated with an almost doubling of the rate of audits (ie, 11 per month vs 6.1 per month). The new, computer-aided audit system increased capacity to audit more RTs performing RT-guided consults while preserving accuracy as an audit tool. Ensuring that RTs adhere to the audit process remains the challenge for the new system, and is the rate-limiting step.

  11. Cisplatin and radiation in the treatment of tumors of the central nervous system: Pharmacological considerations and results of early studies

    International Nuclear Information System (INIS)

    Stewart, D.J.; Molepo, J.M.; Eapen, L.; Montpetit, V.A.J.; Goel, R.; Wong, P.T.T.; Popovic, P.; Taylor, K.D.; Raaphorst, G.P.

    1994-01-01

    The purpose of this study was to review the human central nervous system pharmacology of cisplatin, factors that affect cisplatin uptake in tumors, and use alone and with radiation for the treatment of primary brain tumors. The authors review their own prior published and unpublished experience and data published by other groups on the above issues. Cisplatin is one of the most active chemotherapy drugs available for the treatment of solid tumors. It is synergistic with several other agents, including radiation. While it attains only low concentrations in the normal central nervous system, concentrations and plasma-tissue transfer constants for human intracerebral tumors are comparable to those in extracerebral tumors. Tumor type appears to be a more important determinant of platinum concentration than is tumor location, and gliomas do achieve lower concentrations than do other intracerebral or extracerebral tumors. Several other factors have also been identified that correlate with concentrations of cisplatin achieved in human tumors. While cisplatin alone and in combination with other drugs does have some degree of efficacy against primary brain tumors, combining it with cranial irradiation has generally not resulted in any substantial improvement in outcome to date, although some individual studies have been somewhat encouraging. New approaches are currently under investigation. Human pharmacology studies provide a rationale for use of cisplatin in the treatment of human brain tumors, and human and in vitro studies suggest some manipulations that might potentially further augment tumor platinum concentrations. While clinical studies suggest that cisplatin combinations may be of some value vs. human primary brain tumors and brain metastases, and while in vitro studies suggest that cisplatin potentiates radiation efficacy, no combination of cisplatin plus radiation yet tested has appeared to be superior to radiation alone. 123 refs., 5 tabs

  12. Early- and Mid-term Results of the Chimney Technique in the Repair of Aortic Arch Pathologies

    International Nuclear Information System (INIS)

    Zou, Junjie; Jiao, Yuanyong; Zhang, Xiwei; Jiang, Jun; Yang, Hongyu; Ma, Hao

    2016-01-01

    PurposeTo examine the safety, feasibility, and mid-term efficacy of the chimney technique for aortic arch pathologies.MethodsFrom February 2011 to December 2014, a total of 35 patients (30 men; mean age 54.3 ± 14.1 years) with aortic arch pathologies underwent thoracic endovascular aortic repair combined with chimney stents. The indication was a proximal landing zone <1.5 cm. Follow-up was performed at 3, 6, and 12 months and then yearly thereafter.ResultsA total of 36 chimney stents were deployed (innominate artery, n = 1; left common carotid artery, n = 9; right subclavian artery, n = 1; left subclavian artery, n = 25). The technical success rate was 94.3 % (33/35). Immediate type Ia endoleaks (ELIa) were observed in two patients (8.6 %, 2/35). Twenty-five patients were successfully followed-up for a median period of 29.3 months (range, 6–48 months). One patient died due to aortic dissection aneurysm rupture at 36 months (mortality rate of 4 %, 1/25). Three late ELIa were observed and no reinterventions were performed. The overall incidence of ELIa was 20 % (5/25). During follow-up, the patency rate for chimney stents was 92 % (23/25).ConclusionOur limited experience demonstrates that the chimney technique is a viable and relatively safe treatment for patients with challenging thoracic aortic pathologies at least in the mid-term follow-up period.

  13. Impacts of a water stress followed by an early frost event on beech (Fagus sylvatica L.) susceptibility to Scolytine ambrosia beetles - Research strategy and first results

    Science.gov (United States)

    La Spina, Sylvie; de Cannière, Charles; Molenberg, Jean-Marc; Vincke, Caroline; Deman, Déborah; Grégoire, Jean-Claude

    2010-05-01

    Climate change tends to induce more frequent abiotic and biotic extreme events, having large impacts on tree vitality. Weakened trees are then more susceptible to secondary insect outbreaks, as it happened in Belgium in the early 2000s: after an early frost event, secondary Scolytine ambrosia beetles attacks were observed on beech trees. In this study, we test if a combination of stress, i.e. a soil water deficit preceding an early frost, could render trees more attractive to beetles. An experimental study was set in autumn 2008. Two parcels of a beech forest were covered with plastic tents to induce a water stress by rain interception. The parcels were surrounded by 2-meters depth trenches to avoid water supply by streaming. Soil water content and different indicators of tree water use (sap flow, predawn leaf water potential, tree radial growth) were followed. In autumn 2010, artificial frost injuries will be inflicted to trees using dry ice. Trees attractivity for Scolytine insects, and the success of insect colonization will then be studied. The poster will focus on experiment setting and first results (impacts of soil water deficit on trees).

  14. Effect of food on early drug exposure from extended-release stimulants: results from the Concerta, Adderall XR Food Evaluation (CAFE) Study.

    Science.gov (United States)

    Auiler, J F; Liu, K; Lynch, J M; Gelotte, C K

    2002-01-01

    Stimulant therapy is the mainstay of treatment for children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Once-daily, extended-release oral formulations offer long acting control of symptoms by modifying drug delivery and absorption. In particular, consistency in early drug exposure is important for symptom control during school or work hours. Because these once-daily formulations are usually taken in the morning, the timing of the doses with breakfast is important. This study compared the effect of a high-fat breakfast on early drug exposure from a morning dose of two extended-release stimulant formulations: the osmotic-controlled OROS tablet of methylphenidate HCI (CONCERTA) and the capsule containing extended-release beads of mixed amphetamine salts (ADDERALL XR). The study had a single-dose, open-label, randomised, four-treatment, crossover design in which healthy subjects received either 36 mg CONCERTA or 20 mg ADDERALL XR in the morning after an overnight fast or a high-fat breakfast. Serial blood samples were collected over 28h to determine plasma concentrations of methylphenidate and amphetamine. The food effect on early drug exposure and the pharmacokinetic profiles up to 8 h after dosing of the two extended-release stimulants were directly compared using partial area (AUC(p4h), AUC(p6h) and AUC(p8h)) fed/fasted ratios. Amphetamine concentrations were markedly lower when the subjects had eaten breakfast, resulting in lower early drug exposures (p food, for patients with ADHD.

  15. Early ART Results in Greater Immune Reconstitution Benefits in HIV-Infected Infants: Working with Data Missingness in a Longitudinal Dataset.

    Directory of Open Access Journals (Sweden)

    Livio Azzoni

    Full Text Available Early initiation of anti-retroviral treatment (ART decreases mortality as compared to deferred treatment, but whether it preserves immune cells from early loss or promotes their recovery remains undefined. Determination of complex immunological endpoints in infants is often marred by missing data due to missed visits and/or inadequate sampling. Specialized methods are required to address missingness and facilitate data analysis.We characterized the changes in cellular and humoral immune parameters over the first year of life in 66 HIV-infected infants (0-1 year of age enrolled in the CHER study starting therapy within 12 weeks of birth (n = 42 or upon disease progression (n = 24. A convenience cohort of 23 uninfected infants aged 0-6 months born to mothers with HIV-1 infection was used as controls. Flow cytometry and ELISA were used to evaluate changes in natural killer (NK cells, plasmacytoid dendritic cells (pDC, and CD4+ or CD8+ T-cell frequencies. Data missingness was assessed using Little's test. Complete datasets for analysis were created using Multiple Imputation (MI or Bayesian modeling and multivariate analysis was conducted on the imputed datasets.HIV-1-infected infants had greater frequency of CD4+ T cells with naïve phenotype, as well as higher serum IL-7 levels than HIV exposed/uninfected infants. The elevated data missingness was completely at random, allowing the use of both MI and Bayesian modeling. Both methods indicate that early ART initiation results in higher CD4+ T cell frequency, lower expression of CD95 in CD8+ T cell, and preservation of naïve T cell subsets. In contrast, innate immune effectors appeared to be similar independently of the timing of ART initiation.Early ART initiation in infants with perinatal HIV infection reduces immune activation and preserves an early expansion of naïve T-cells with undiminished innate cell numbers, giving greater immune reconstitution than achieved with deferred ART. Both

  16. Financial Technology: The Promise of Blockchain

    OpenAIRE

    Demary, Markus; Demary, Vera

    2017-01-01

    Digitization affects all sectors of the economy. A new and possibly disruptive digital technology is the blockchain, a decentralized ledger, which seems to offer great promise for many financial and business applications.

  17. Predictive value of early {sup 18}F-FDG PET/CT studies for treatment response evaluation to ipilimumab in metastatic melanoma: preliminary results of an ongoing study

    Energy Technology Data Exchange (ETDEWEB)

    Sachpekidis, Christos; Pan, Leyun; Dimitrakopoulou-Strauss, Antonia [German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Larribere, Lionel [German Cancer Research Center, Clinical Cooperation Unit Dermato-Oncology, Heidelberg (Germany); Haberkorn, Uwe [German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); University of Heidelberg, Division of Nuclear Medicine, Heidelberg (Germany); Hassel, Jessica C. [University Hospital Heidelberg, Skin Cancer Center, Department of Dermatology, Heidelberg (Germany); National Center for Tumor Diseases Heidelberg, Heidelberg (Germany)

    2014-10-31

    Ipilimumab is a newly approved immunotherapeutic agent that has been shown to provide a survival benefit in patients with metastatic melanoma. {sup 18}F-FDG PET/CT has demonstrated very satisfying results in detecting melanoma metastases in general. Using {sup 18}F-FDG PET/CT we monitored patients with metastatic melanoma undergoing ipilimumab therapy during the course of treatment. The aim of our study was to evaluate the role of {sup 18}F-FDG PET/CT performed after two cycles of ipilimumab in predicting the final response to therapy. In 22 patients suffering from unresectable metastatic melanoma, scheduled for ipilimumab treatment PET/CT scanning was performed before the start of treatment (baseline scan), after two cycles of treatment (early response) and at the end of treatment after four cycles (late response). Evaluation of the patient response to treatment on PET was based on the European Organization for Research and Treatment of Cancer 1999 criteria. Progression-free survival (PFS) and overall survival (OS) data are presented. After the end of treatment, 15 patients were characterized as having progressive metabolic disease (PMD) and five as having stable metabolic disease (SMD), and two patients showed a partial metabolic response (PMR). Early PET/CT performed after two ipilimumab cycles predicted treatment response in 13 of the 15 PMD patients, in five of the five SMD patients and in neither of the two PMR patients. Both patients with PMR showed pseudoprogression after the second cycle and were therefore wrongly classified. According to the patients' clinical outcome, patients with late PMD had a median PFS of 3.6 months (mean 5.6 months), while patients with late SMD had a median PFS of 9.8 months (mean 9.0 months). In comparison, patients with early PMD had a median PFS of 2.7 months (mean 5.5 months) and patients with early SMD had a median PFS of 6.3 months (mean 7.5 months). The difference in PFS between the two groups was statistically

  18. Hyperthermia: Clinical promise and current challenges

    International Nuclear Information System (INIS)

    Kapp, D.S.

    1987-01-01

    Local-regional hyperthermia (HT) when used in conjunction with radiation therapy (XRT), has been shown in numerous clinical trials to result in considerable improvement in response rates and local tumor control rates when compared with treatment by XRT alone. Although considerable progress has been made in understanding the biological basis for hyperthermia induced cytotoxicity and radiosensitization, additional research remains in establishing the optimal treatment schedules for the clinical utilization of HT-XRT. The number of HT treatments; the sequencing of HT and XRT; the frequency of administration of HT; and the ideal temperature-time parameters all remain to be better defined for the clinical setting. The role of tumor blood flow on the thermal distributions also warrants further investigation. In addition, considerable effort is needed to improve hyperthermia equipment in order to provide more uniform therapeutic temperature distributions (temperatures ≥42.5%C). Better heating equipment is particularly needed for the treatment of deep seeted tumors. Pertinent clinical literature will be presented summarizing the clinical promise of hyperthermia and the above mentioned clinical challenges

  19. Uterine transplantation: a promising surrogate to surrogacy?

    Science.gov (United States)

    Grynberg, Michael; Ayoubi, Jean-Marc; Bulletti, Carlo; Frydman, Rene; Fanchin, Renato

    2011-03-01

    Infertility due to the inability of the uterus to carry a pregnancy ranks among the most unresolved issues in reproductive medicine. It affects millions of women worldwide who have congenital or acquired uterine affections, often requiring hysterectomy, and potentially represents a considerable fraction of the general infertile population. Patients suffering from severe uterine infertility are currently compelled to go through gestational surrogacy or adoption; both approaches, unfortunately, deprive them of the maternal experience of pregnancy and birth. Uterine transplantation represents an outstanding, yet complex, perspective to alleviating definitive uterine infertility. In the past decades, a number of scientific experiments conducted both in animals and women, focusing on uterine transplantation, have led to promising results. Collectively, these findings undoubtedly constitute a sound basis to clinically apply uterine transplantation in the near future. This paper is, however, an overview not only of the extent and limitations of accumulated scientific knowledge on uterine transplantation, but also its ethical implications, in an effort to define the actual place of such an approach among the therapeutic arsenal for alleviating infertility. © 2011 New York Academy of Sciences.

  20. Medical big data: promise and challenges

    Directory of Open Access Journals (Sweden)

    Choong Ho Lee

    2017-03-01

    Full Text Available The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

  1. Medical big data: promise and challenges.

    Science.gov (United States)

    Lee, Choong Ho; Yoon, Hyung-Jin

    2017-03-01

    The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

  2. Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)

    Science.gov (United States)

    Galatzer-Levy, Isaac R.; Ankri, Yael; Freedman, Sara; Israeli-Shalev, Yossi; Roitman, Pablo; Gilad, Moran; Shalev, Arieh Y.

    2013-01-01

    Context Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis. Objectives To describe discrete symptom trajectories and examine their relevance for preventive interventions. Design Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data. Setting Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Participants Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months. Approach We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample. Main Outcome Measure Latent trajectories of PTSD symptoms; effects of CBT on these trajectories. Results Three trajectories were identified: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes. Conclusions The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder

  3. Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push-back method: preliminary results.

    Science.gov (United States)

    Kitagawa, Taiji; Kohara, Hiroshi; Sohmura, Taiji; Takahashi, Junzo; Tachimura, Takashi; Wada, Takeshi; Kogo, Mikihiko

    2004-09-01

    This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

  4. Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort

    Directory of Open Access Journals (Sweden)

    Mark D Huffman

    2015-01-01

    Full Text Available Background & objectives: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease. Methods: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 µg were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women from the New Delhi Birth Cohort (2006-2009. Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations. Results: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI th > 30 kg/m [2] . Mean systolic blood pressure (SBP was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm. A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex. Interpretation & conclusions: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.

  5. Health-related quality of life and chronic obstructive pulmonary disease in early stages - longitudinal results from the population-based KORA cohort in a working age population.

    Science.gov (United States)

    Wacker, Margarethe E; Hunger, Matthias; Karrasch, Stefan; Heinrich, Joachim; Peters, Annette; Schulz, Holger; Holle, Rolf

    2014-08-09

    It is widely recognized that health-related quality of life (HRQL) is impaired in patients with Chronic Obstructive Pulmonary Disease (COPD), but there is a lack of research on longitudinal associations of COPD and HRQL. This study examined the effects of COPD in early stages of disease on HRQL over ten years in a working-age general population setting in Southern Germany while considering the influence of common comorbidities. In the population-based KORA F4 study (2006-08) 1,321 participants aged 41-61 years performed spirometry and reported information on HRQL (measured by the generic SF-12) and comorbidities. For the same participants, HRQL information was available seven years before and three years after the lung function test from the previous S4 (1999-2001) and the F4L follow-up study (2010). Using linear mixed models, the physical and mental component summary scores (PCS-12 / MCS-12) of the SF-12 were compared over time between COPD groups. 7.8% of participants were classified as having COPD (according to the LLN definition and the Global Lungs Initiative), 59.4% of them in grade 1. Regression models showed a negative cross-sectional association of COPD grade 2+ with PCS-12 which persisted when comorbidities were considered. Adjusted mean PCS-12 scores for the COPD grade 2+ group were reduced (-3.5 (p=0.008) in F4, -3.3 (p=0.014) in S4 and -4.7 (p=0.003) in F4L) compared to the group without airflow limitation. The size of the COPD effect in grade 2+ was similar to the effect of myocardial infarction and cancer. Over ten years, a small decline in PCS-12 was observed in all groups. This decline was larger in participants with COPD grade 2+, but insignificant. Regarding MCS-12, no significant cross-sectional or longitudinal associations with COPD were found. Despite small HRQL differences between COPD patients in early disease stages and controls and small changes over ten years, our results indicate that it is important to prevent subjects with airflow

  6. Early Cretaceous paleomagnetic and geochronologic results from the Tethyan Himalaya: Insights into the Neotethyan paleogeography and the India–Asia collision

    Science.gov (United States)

    Ma, Yiming; Yang, Tianshui; Bian, Weiwei; Jin, Jingjie; Zhang, Shihong; Wu, Huaichun; Li, Haiyan

    2016-01-01

    To better understand the Neotethyan paleogeography, a paleomagnetic and geochronological study has been performed on the Early Cretaceous Sangxiu Formation lava flows, which were dated from ~135.1 Ma to ~124.4 Ma, in the Tethyan Himalaya. The tilt-corrected site-mean characteristic remanent magnetization (ChRM) direction for 26 sites is Ds = 296.1°, Is = −65.7°, ks = 51.7, α95 = 4.0°, corresponding to a paleopole at 5.9°S, 308.0°E with A95 = 6.1°. Positive fold and reversal tests prove that the ChRM directions are prefolding primary magnetizations. These results, together with reliable Cretaceous-Paleocene paleomagnetic data observed from the Tethyan Himalaya and the Lhasa terrane, as well as the paleolatitude evolution indicated by the apparent polar wander paths (APWPs) of India, reveal that the Tethyan Himalaya was a part of Greater India during the Early Cretaceous (135.1–124.4 Ma) when the Neotethyan Ocean was up to ~6900 km, it rifted from India sometime after ~130 Ma, and that the India-Asia collision should be a dual-collision process including the first Tethyan Himalaya-Lhasa terrane collision at ~54.9 Ma and the final India-Tethyan Himalaya collision at ~36.7 Ma. PMID:26883692

  7. Early Cretaceous paleomagnetic and geochronologic results from the Tethyan Himalaya: Insights into the Neotethyan paleogeography and the India-Asia collision.

    Science.gov (United States)

    Ma, Yiming; Yang, Tianshui; Bian, Weiwei; Jin, Jingjie; Zhang, Shihong; Wu, Huaichun; Li, Haiyan

    2016-02-17

    To better understand the Neotethyan paleogeography, a paleomagnetic and geochronological study has been performed on the Early Cretaceous Sangxiu Formation lava flows, which were dated from ~135.1 Ma to ~124.4 Ma, in the Tethyan Himalaya. The tilt-corrected site-mean characteristic remanent magnetization (ChRM) direction for 26 sites is Ds = 296.1°, Is = -65.7°, ks = 51.7, α95 = 4.0°, corresponding to a paleopole at 5.9°S, 308.0°E with A95 = 6.1°. Positive fold and reversal tests prove that the ChRM directions are prefolding primary magnetizations. These results, together with reliable Cretaceous-Paleocene paleomagnetic data observed from the Tethyan Himalaya and the Lhasa terrane, as well as the paleolatitude evolution indicated by the apparent polar wander paths (APWPs) of India, reveal that the Tethyan Himalaya was a part of Greater India during the Early Cretaceous (135.1-124.4 Ma) when the Neotethyan Ocean was up to ~6900 km, it rifted from India sometime after ~130 Ma, and that the India-Asia collision should be a dual-collision process including the first Tethyan Himalaya-Lhasa terrane collision at ~54.9 Ma and the final India-Tethyan Himalaya collision at ~36.7 Ma.

  8. GETTING READY: RESULTS OF A RANDOMIZED TRIAL OF A RELATIONSHIP-FOCUSED INTERVENTION ON THE PARENT–INFANT RELATIONSHIP IN RURAL EARLY HEAD START

    Science.gov (United States)

    KNOCHE, LISA L.; SHERIDAN, SUSAN M.; CLARKE, BRANDY L.; EDWARDS, CAROLYN POPE; MARVIN, CHRISTINE A.; CLINE, KEELY D.; KUPZYK, KEVIN A.

    2014-01-01

    The purpose of this study is to investigate the effects of a relational intervention (the Getting Ready intervention) on parenting behaviors supporting the parent–infant relationship for families enrolled in Early Head Start home-based programming. Two-hundred thirty-four parents and their children participated in the randomized study, with 42% of parents reporting education of less than a high-school diploma. Brief, semistructured parent–child interaction tasks were videotaped every 4 months over a16-month intervention period. Observational codes of parent–infant relationship behaviors included quality of three parental behaviors: warmth and sensitivity, support for learning, and encouragement of autonomy; two appropriateness indicators: support for learning and guidance/directives; and one amount indicator: constructive behaviors. Parents who participated in the Getting Ready intervention demonstrated higher quality interactions with their children that included enhanced quality of warmth and sensitivity, and support for their children’s autonomy than did parents in the control group. They also were more likely to use appropriate directives with their children and more likely to demonstrate appropriate supports for their young children’s learning. Results indicate an added value of the Getting Ready intervention for Early Head Start home-based programming for families of infants and toddlers. PMID:24644374

  9. Can baseline ultrasound results help to predict failure to achieve DAS28 remission after 1 year of tight control treatment in early RA patients?

    Science.gov (United States)

    Ten Cate, D F; Jacobs, J W G; Swen, W A A; Hazes, J M W; de Jager, M H; Basoski, N M; Haagsma, C J; Luime, J J; Gerards, A H

    2018-01-30

    At present, there are no prognostic parameters unequivocally predicting treatment failure in early rheumatoid arthritis (RA) patients. We investigated whether baseline ultrasonography (US) findings of joints, when added to baseline clinical, laboratory, and radiographical data, could improve prediction of failure to achieve Disease Activity Score assessing 28 joints (DAS28) remission (baseline. Clinical, laboratory, and radiographical parameters were recorded. Primary analysis was the prediction by logistic regression of the absence of DAS28 remission 12 months after diagnosis and start of therapy. Of 194 patients included, 174 were used for the analysis, with complete data available for 159. In a multivariate model with baseline DAS28 (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.2), the presence of rheumatoid factor (OR 2.3, 95% CI 1.1-5.1), and type of monitoring strategy (OR 0.2, 95% CI 0.05-0.85), the addition of baseline US results for joints (OR 0.96, 95% CI 0.89-1.04) did not significantly improve the prediction of failure to achieve DAS28 remission (likelihood ratio test, 1.04; p = 0.31). In an early RA population, adding baseline ultrasonography of the hands, wrists, and feet to commonly available baseline characteristics did not improve prediction of failure to achieve DAS28 remission at 12 months. Clinicaltrials.gov, NCT01752309 . Registered on 19 December 2012.

  10. [Feasibility and results of at-home follow-up after early postpartum discharge from maternity units in Bobo-Dioulasso, Burkina Faso].

    Science.gov (United States)

    Ouattara, S; Some, D A; Toure, B; Ouattara, Z A; Dembele, A; Bambara, M; Dao, B

    2014-01-01

    to describe the feasibility and results of at-home follow-up of mothers and newborns discharged early from the maternity ward after normal childbirth. This prospective descriptive study took place during a one month period (April 1-30, 2011) in five maternity units in Bobo-Dioulasso, the second largest city in Burkina Faso. Mothers with normal vaginal deliveries and no complications at the sixth hour postpartum were included in the study with their newborns after informed oral consent. The discharge took place between 12 and 48 hours after delivery. The follow-up took place by telephone, home visits, and emergency hospital visits in cases of complications. A postnatal hospital visit was systematically planned for day 7. The study included 630 mothers and their babies. There were 1567 phone calls made: 27 women could not be reached by telephone after discharge, and 140 home visits took place, either at the mother's request or because of the failure to reach her by telephone. Complications were observed in 55 mothers and 135 babies. Postnatal follow-up at home is required for mothers and their newborns discharged early from the maternity ward after normal childbirth in view of the possibility of complications. This ensures continuity of care to improve survival of mothers and babies. As cell phones become more and more available, they may play an important role as a tool for such follow up.

  11. The path to fulfilling the promise

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, J. [Canadian Nuclear Association, Ottawa, ON (Canada)

    2014-07-01

    'Full text:'Countries work together to develop effective governance and regulation. Canada has made big investments in these areas and it carries a premium for us. The rapid build-out of nuclear technology around the Pacific Rim holds vast promise for our populations in better climate, better air, affordable and reliable electricity, and longer lives. The biggest risk is not another accident: rather, it is the risk of failing to fulfill that promise to our people. Every country that wants the benefits of nuclear must also want to be sure that those benefits are realized and sustained by good governance and regulation. Canada has the people, laws, organizations, public institutions, and relationships that can help our partners fulfill the whole and lasting promise of nuclear technology. (author)

  12. Early breast cancer

    International Nuclear Information System (INIS)

    Dongen, J.A. van

    1989-01-01

    The therapy of early breast cancer has been changing during the last decennium. It requires a multi-disciplinary approach and in each of these disciplines improvements have been implemented. The result is that treatment schedules can now be adapted to specific subgroups. In this review early breast cancer is defined as operable disease, using the criteria set out by Haagensen. Emphasis is given to describing the new developments in prognostic criteria, since these form the basis for creating subgroups for specific treatment schedules. Distinction is made between the factors relating to growth rate and those relating to metastatic potential. Data on screening promises a beneficial effect of the implementation of screening in national health care programs. Important shifts are seen in treatment schedules; the place of postoperative radiotherapy after classic ablative treatment is being challenged, whereas it plays a major role in the new breast conserving therapy schedules. The data mentioned in the review suggest that a large proportion of 'operable' cases can be treated with breast conservation but details in the technique of breast conserving therapy are still under investigation. They form a major part of the coming prospective studies in breast cancer. Improvements in reconstruction techniques, creating better cosmetic results, make reconstruction more competitive with breast conserving therapy. The use of chemotherapy and endocrine manipulation in early breast cancer has now been clearly confirmed by the overview technique by the Peto-group, thanks to all efforts of individual trialists together. (orig.)

  13. The promise of innovation: Nuclear energy horizons

    International Nuclear Information System (INIS)

    Mourogov, V.

    2003-01-01

    The 21st century promises the most open, competitive, and globalized markets in human history, as well as the most rapid pace of technological change ever. For nuclear energy, as any other, that presents challenges. Though the atom now supplies a good share of world electricity, its share of total energy is relatively small, anywhere from four to six per cent depending on how it is calculated. And, while energy is most needed in the developing world, four of every five nuclear plants are in industrialized countries. Critical problems that need to be overcome are well known - high capital costs for new plants, and concerns over proliferation risks and safety, (including safety of waste disposal) stand high among them. The IAEA and other programmes are confronting these problems through ambitious initiatives involving both industrialized and developing countries. They include the collaborative efforts known as the Generation-IV International Forum (GIF) and the IAEA International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO). They use ideas, results and the best experiences from today's research and development tools and advanced types of nuclear energy systems to meet tomorrow's challenges. Though the market often decides the fate of new initiatives, the market is not always right for the common good. Governments, and the people that influence them, play an indispensable role in shaping progress in energy fields for rich and poor countries alike. They shoulder the main responsibilities for fundamental science, basic research, and long-term investments. For energy in particular, government investment and support will prove instrumental in the pace of innovation toward long-term options that are ready to replace limited fossil fuel supplies, and respond to the growing premium put on clean energy alternatives. Yet governments cannot go it alone. The challenges are too diverse and complex, and public concerns - about proliferation or safety - go beyond

  14. The epigenetic promise for prostate cancer diagnosis.

    Science.gov (United States)

    Van Neste, Leander; Herman, James G; Otto, Gaëtan; Bigley, Joseph W; Epstein, Jonathan I; Van Criekinge, Wim

    2012-08-01

    Prostate cancer is the most common cancer diagnosis in men and a leading cause of death. Improvements in disease management would have a significant impact and could be facilitated by the development of biomarkers, whether for diagnostic, prognostic, or predictive purposes. The blood-based prostate biomarker PSA has been part of clinical practice for over two decades, although it is surrounded by controversy. While debates of usefulness are ongoing, alternatives should be explored. Particularly with recent recommendations against routine PSA-testing, the time is ripe to explore promising biomarkers to yield a more efficient and accurate screening for detection and management of prostate cancer. Epigenetic changes, more specifically DNA methylation, are amongst the most common alterations in human cancer. These changes are associated with transcriptional silencing of genes, leading to an altered cellular biology. One gene in particular, GSTP1, has been widely studied in prostate cancer. Therefore a meta-analysis has been conducted to examine the role of this and other genes and the potential contribution to prostate cancer management and screening refinement. More than 30 independent, peer reviewed studies have reported a consistently high sensitivity and specificity of GSTP1 hypermethylation in prostatectomy or biopsy tissue. The meta-analysis combined and compared these results. GSTP1 methylation detection can serve an important role in prostate cancer managment. The meta-analysis clearly confirmed a link between tissue DNA hypermethylation of this and other genes and prostate cancer. Detection of DNA methylation in genes, including GSTP1, could serve an important role in clinical practice. Copyright © 2011 Wiley Periodicals, Inc.

  15. The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study

    Directory of Open Access Journals (Sweden)

    Reeder FD

    2017-02-01

    Full Text Available Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2 1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample. Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%, parental mental illness (19%, bullying (18%, absence of a parent (13%, and ‘other’ trauma (24% – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with

  16. A first city-wide early defibrillation project in a German city: 5-year results of the Bochum against sudden cardiac arrest study

    Directory of Open Access Journals (Sweden)

    Hanefeld Christoph

    2010-06-01

    Full Text Available Abstract Background Immediate defibrillation is the decisive determinant of prognosis in patients suffering from cardiac/circulatory arrest caused by ventricular fibrillation (VF. Therefore, various national and international associations recommend that first responders use defibrillators as soon as possible and also recommend public access to early defibrillation programmes. Here we report the results of the first city-wide early defibrillation project in a large German urban area. Methods There were 155 automated external defibrillators (AEDs put into operation in the Bochum municipal area, and 6,294 people took part in cardiopulmonary resuscitation (CPR and AED training. Free, accessible AEDs were installed in places with large volumes of people. Additionally, emergency forces were progressively equipped with AEDs. Results Twelve AED administrations prior to the arrival of an emergency physician were recorded and analysed over a period of 5 years (08/2004-08/2009. Rhythm analysis via AED demonstrated VF in seven cases, non-malignant dysrhythmias in four cases and asystole in one case. Two of the seven patients with VF were successfully defibrillated and survived cardiac/circulatory arrest without any neurological sequelae. Eight of the 12 AED applications were performed by laymen. The mean time between switching the unit on and applying the electrodes to the patient was 39 seconds (SD +/-20 sec. On average, another 20 seconds elapsed before the AED recommendation of "shock delivery" was displayed, and a total of 96 seconds elapsed before shock administration (± 56 sec. Conclusion Consistent with other reports, our findings show that the organisation of a city-wide initiative by a project office combining public access and first-responder defibrillation programmes can be safe, feasible and successful. Our experiences confirm that strategic planning of AED placement is a prerequisite for successful, cost-effective resuscitation.

  17. Early diagnosis and early intervention in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Mijna eHadders-Algra

    2014-09-01

    Full Text Available This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP. CP describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to disturbances that occurred in the fetal or infant brain. Therefore the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions, but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuro-imaging techniques and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group best prediction is achieved with the combination of neuro-imaging and the assessment of general movements, in the latter group best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high risk infants without CP. In these infants early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is

  18. Promising design options for the encapsulated nuclear heat source reactor

    Energy Technology Data Exchange (ETDEWEB)

    Conway, L.; Carelli, M.D.; Dzodzo, M. [Westinghouse Science and Technology, Pittsburgh, PA (United States); Hossain, Q.; Brown, N.W. [Lawrence Livermore National Lab., CA (United States); Wade, D.C.; Sienick, J.J. [Argonne National Lab., IL (United States); Greenspan, E.; Kastenberg, W.E.; Saphier, D. [University of California Dept of Nuclear Engineering, Berkeley, CA (United States)

    2001-07-01

    Promising design options for the Encapsulated Nuclear Heat Source (ENHS) liquid-metal cooled fast reactor were identified during the first year of the DOE NERI program sponsored feasibility study. Many opportunities for incorporation of innovations in design and fabrication were identified. Three of the innovations are hereby described: a novel IHX (intermediate heat exchanger) made of a relatively small number of rectangular channels, an ENHS module design featuring 100% natural circulation, and a novel conceptual design of core support and fuelling. As a result of the first year study the ENHS concept appears more practical and more promising than perceived at the outset of this study. (authors)

  19. Promising design options for the encapsulated nuclear heat source reactor

    International Nuclear Information System (INIS)

    Conway, L.; Carelli, M.D.; Dzodzo, M.; Hossain, Q.; Brown, N.W.; Wade, D.C.; Sienick, J.J.; Greenspan, E.; Kastenberg, W.E.; Saphier, D.

    2001-01-01

    Promising design options for the Encapsulated Nuclear Heat Source (ENHS) liquid-metal cooled fast reactor were identified during the first year of the DOE NERI program sponsored feasibility study. Many opportunities for incorporation of innovations in design and fabrication were identified. Three of the innovations are hereby described: a novel IHX (intermediate heat exchanger) made of a relatively small number of rectangular channels, an ENHS module design featuring 100% natural circulation, and a novel conceptual design of core support and fuelling. As a result of the first year study the ENHS concept appears more practical and more promising than perceived at the outset of this study. (authors)

  20. The Promise of Zoomable User Interfaces

    Science.gov (United States)

    Bederson, Benjamin B.

    2011-01-01

    Zoomable user interfaces (ZUIs) have received a significant amount of attention in the 18 years since they were introduced. They have enjoyed some success, and elements of ZUIs are widely used in computers today, although the grand vision of a zoomable desktop has not materialised. This paper describes the premise and promise of ZUIs along with…

  1. Promising carbons for supercapacitors derived from fungi

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Hui; Wang, Xiaolei; Yang, Fan; Yang, Xiurong [State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022 (China)

    2011-06-24

    Activated carbons with promising performance in capacitors are produced from fungi via a hydrothermal assistant pyrolysis approach. This study introduces a facile strategy to discover carbonaceous materials and triggers interest in exploring fungi for material science applications. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  2. Seaweed: Promising plant of the millennium

    Digital Repository Service at National Institute of Oceanography (India)

    Dhargalkar, V.K.; Pereira, N.

    Seaweeds, one of the important marine living resources could be termed as the futuristically promising plants. These plants have been a source of food, feed and medicine in the orient as well as in the west, since ancient times. Although, seaweeds...

  3. Complexity of Propositional Proofs Under a Promise

    Czech Academy of Sciences Publication Activity Database

    Dershowitz, N.; Tzameret, Iddo

    2010-01-01

    Roč. 11, č. 3 (2010), s. 1-29 ISSN 1529-3785 Institutional research plan: CEZ:AV0Z10190503 Keywords : theory * promise problems * propositional proof complexity * random 3CNF * resolution Subject RIV: BA - General Mathematics Impact factor: 1.391, year: 2010 http://dl.acm.org/ citation .cfm?doid=1740582.1740586

  4. Complexity of Propositional Proofs Under a Promise

    Czech Academy of Sciences Publication Activity Database

    Dershowitz, N.; Tzameret, Iddo

    2010-01-01

    Roč. 11, č. 3 (2010), s. 1-29 ISSN 1529-3785 Institutional research plan: CEZ:AV0Z10190503 Keywords : theory * promise problems * propositional proof complexity * random 3CNF * resolution Subject RIV: BA - General Mathematics Impact factor: 1.391, year: 2010 http://dl.acm.org/citation.cfm?doid=1740582.1740586

  5. 76 FR 13152 - Promise Neighborhoods Program

    Science.gov (United States)

    2011-03-10

    ... comprehensive education reforms that are linked to improved educational outcomes for children and youth in... parents or family members who report talking with their child about the importance of college and career... DEPARTMENT OF EDUCATION RIN 1855-ZA07 Promise Neighborhoods Program Catalog of Federal Domestic...

  6. Congestion Service Facilities Location Problem with Promise of Response Time

    Directory of Open Access Journals (Sweden)

    Dandan Hu

    2013-01-01

    Full Text Available In many services, promise of specific response time is advertised as a commitment by the service providers for the customer satisfaction. Congestion on service facilities could delay the delivery of the services and hurts the overall satisfaction. In this paper, congestion service facilities location problem with promise of response time is studied, and a mixed integer nonlinear programming model is presented with budget constrained. The facilities are modeled as M/M/c queues. The decision variables of the model are the locations of the service facilities and the number of servers at each facility. The objective function is to maximize the demands served within specific response time promised by the service provider. To solve this problem, we propose an algorithm that combines greedy and genetic algorithms. In order to verify the proposed algorithm, a lot of computational experiments are tested. And the results demonstrate that response time has a significant impact on location decision.

  7. Why do promises affect trustworthiness, or do they?

    NARCIS (Netherlands)

    Ismayilov, Huseyn; Potters, Jan

    2016-01-01

    We set out to test whether the effect of promises on trustworthiness derives from the fact that they are made (internal consistency) or that they are received (social obligation). The results of an experimental trust game appeared at first to support the former mechanism. Even when trustee messages

  8. Quadrantectomy and Nipple Saving Mastectomy in Treatment of Early Breast Cancer: Feasibility and Aesthetic Results of Adjunctive Latissmus Dorsi Breast Reconstruction

    International Nuclear Information System (INIS)

    Bassiouny, M.; El-Marakby, H.H.; Saber, N.; Zayed, S.B.; Shokry, A.

    2005-01-01

    Breast conserving surgery has been a recognised method of treatment of early breast cancer. The treatment methods include quadrantectomy or skin sparing mastectomy combined with ipsilateral axillary nodal dissection followed by radiotherapy. In the current study we evaluate the feasibility and oncologic safety of the quadrantectomy and SSM operations with preservation of the nipple and areola, and the cosmetic results of immediate reconstruction by using the latissmus dorsi flap. Materials and Methods: A breast conservative surgery (quadrantectomy or nipple sparing mastectomy) was carried out in a group of 55 patients with invasive breast cancer treated at the Department of Surgical Oncology, NCl, between January 2001 and April 2004. The selection criteria included those patients who presented with TI or T2 breast cancer and were located at least 2 cm from the nipple as the centre for the nipple areola complex. The age of the patients ranged from 32 years to 65 years. The follow up period ranged from 2 to 33 months with an average of 21 months. Pathological assessment of the specimens showed a negative safety margin in all cases. Most of our cases were invasive duct carcinoma grade 1-2 (42) (75%). The complications of the flap reconstruction included one major sloughing of the Iatissmus dorsi flap, 4 partial flap sloughing, 4 sloughing of the nipple and fat necrosis in 6 patients. The donor site healed normally in all of our cases except for one patient who suffered from a hypertrophic scar which settled down during the follow up period. The aesthetic assessment of the patients, showed an excellent to good results in the majority of cases (42) (75%) while in 6 (12%) results were fair and in 7 (13%) results were poor. Breast conservative surgery with quadrantectomy or skin sparing technique with preservation of the nipple and areola combined with immediate LD flap reconstruction is a valid procedure for treatment of early breast cancer. Immediate reconstruction by

  9. Preliminary Results of a Phase 1 Dose-Escalation Trial for Early-Stage Breast Cancer Using 5-Fraction Stereotactic Body Radiation Therapy for Partial-Breast Irradiation

    International Nuclear Information System (INIS)

    Rahimi, Asal; Thomas, Kimberly; Spangler, Ann; Rao, Roshni; Leitch, Marilyn; Wooldridge, Rachel; Rivers, Aeisha; Seiler, Stephen; Albuquerque, Kevin; Stevenson, Stella; Goudreau, Sally; Garwood, Dan; Haley, Barbara; Euhus, David; Heinzerling, John; Ding, Chuxiong; Gao, Ang; Ahn, Chul; Timmerman, Robert

    2017-01-01

    Purpose: To evaluate the tolerability of a dose-escalated 5-fraction stereotactic body radiation therapy for partial-breast irradiation (S-PBI) in treating early-stage breast cancer after partial mastectomy; the primary objective was to escalate dose utilizing a robotic stereotactic radiation system treating the lumpectomy cavity without exceeding the maximum tolerated dose. Methods and Materials: Eligible patients included those with ductal carcinoma in situ or invasive nonlobular epithelial histologies and stage 0, I, or II, with tumor size <3 cm. Patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Starting dose was 30 Gy in 5 fractions and was escalated by 2.5 Gy total for each cohort to 40 Gy. Results: In all, 75 patients were enrolled, with a median age of 62 years. Median follow-up for 5 cohorts was 49.9, 42.5, 25.7, 20.3, and 13.5 months, respectively. Only 3 grade 3 toxicities were experienced. There was 1 dose-limiting toxicity in the overall cohort. Ten patients experienced palpable fat necrosis (4 of which were symptomatic). Physicians scored cosmesis as excellent or good in 95.9%, 100%, 96.7%, and 100% at baseline and 6, 12, and 24 months after S-PBI, whereas patients scored the same periods as 86.5%, 97.1%, 95.1%, and 95.3%, respectively. The disagreement rates between MDs and patients during those periods were 9.4%, 2.9%, 1.6%, and 4.7%, respectively. There have been no recurrences or distant metastases. Conclusion: Dose was escalated to the target dose of 40 Gy in 5 fractions, with the occurrence of only 1 dose-limiting toxicity. Patients felt cosmetic results improved within the first year after surgery and stereotactic body radiation therapy. Our results show minimal toxicity with excellent cosmesis; however, further follow-up is warranted in future studies. This study is the first to show the safety, tolerability, feasibility, and cosmesis results of a 5-fraction dose-escalated S-PBI treatment for

  10. Preliminary Results of a Phase 1 Dose-Escalation Trial for Early-Stage Breast Cancer Using 5-Fraction Stereotactic Body Radiation Therapy for Partial-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Rahimi, Asal, E-mail: asal.rahimi@utsouthwestern.edu [University of Texas Southwestern Medical Center, Dallas, Texas (United States); Thomas, Kimberly; Spangler, Ann [University of Texas Southwestern Medical Center, Dallas, Texas (United States); Rao, Roshni; Leitch, Marilyn; Wooldridge, Rachel; Rivers, Aeisha [Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Seiler, Stephen [Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Albuquerque, Kevin; Stevenson, Stella [University of Texas Southwestern Medical Center, Dallas, Texas (United States); Goudreau, Sally [Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Garwood, Dan [University of Texas Southwestern Medical Center, Dallas, Texas (United States); Haley, Barbara [Department of Medical Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Euhus, David [Department of Surgery, Johns Hopkins University, Baltimore, Maryland (United States); Heinzerling, John [Department of Radiation Oncology, Levine Cancer Institute, Charlotte, North Carolina (United States); Ding, Chuxiong [University of Texas Southwestern Medical Center, Dallas, Texas (United States); Gao, Ang; Ahn, Chul [Department of Statistics, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Timmerman, Robert [University of Texas Southwestern Medical Center, Dallas, Texas (United States)

    2017-05-01

    Purpose: To evaluate the tolerability of a dose-escalated 5-fraction stereotactic body radiation therapy for partial-breast irradiation (S-PBI) in treating early-stage breast cancer after partial mastectomy; the primary objective was to escalate dose utilizing a robotic stereotactic radiation system treating the lumpectomy cavity without exceeding the maximum tolerated dose. Methods and Materials: Eligible patients included those with ductal carcinoma in situ or invasive nonlobular epithelial histologies and stage 0, I, or II, with tumor size <3 cm. Patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Starting dose was 30 Gy in 5 fractions and was escalated by 2.5 Gy total for each cohort to 40 Gy. Results: In all, 75 patients were enrolled, with a median age of 62 years. Median follow-up for 5 cohorts was 49.9, 42.5, 25.7, 20.3, and 13.5 months, respectively. Only 3 grade 3 toxicities were experienced. There was 1 dose-limiting toxicity in the overall cohort. Ten patients experienced palpable fat necrosis (4 of which were symptomatic). Physicians scored cosmesis as excellent or good in 95.9%, 100%, 96.7%, and 100% at baseline and 6, 12, and 24 months after S-PBI, whereas patients scored the same periods as 86.5%, 97.1%, 95.1%, and 95.3%, respectively. The disagreement rates between MDs and patients during those periods were 9.4%, 2.9%, 1.6%, and 4.7%, respectively. There have been no recurrences or distant metastases. Conclusion: Dose was escalated to the target dose of 40 Gy in 5 fractions, with the occurrence of only 1 dose-limiting toxicity. Patients felt cosmetic results improved within the first year after surgery and stereotactic body radiation therapy. Our results show minimal toxicity with excellent cosmesis; however, further follow-up is warranted in future studies. This study is the first to show the safety, tolerability, feasibility, and cosmesis results of a 5-fraction dose-escalated S-PBI treatment for

  11. Comparative study of Contour Transtar and STARR procedure for the treatment of obstructed defecation syndrome (ODS)--feasibility, morbidity and early functional results.

    Science.gov (United States)

    Isbert, C; Reibetanz, J; Jayne, D G; Kim, M; Germer, C-T; Boenicke, L

    2010-09-01

    Stapled transanal rectal resection (STARR) is a promising new treatment for obstructed defecation syndrome (ODS). It may be performed using either a double-stapling technique (PPH-STARR) or with the new Contour Transtar (CT) device. The aim of this study was to evaluate the two techniques with respect to morbidity and functional outcomes. Patients presenting with ODS were evaluated using standardized clinical and radiological investigations and prospectively entered into a database. A total of 150 Patients were treated with either PPH-STARR (n = 68) or CT (n = 82) and further evaluated at 12 month postoperatively. The mean size of the resected specimen was 27 cm(2) (SD +/-4.86 cm(2)) in the PPH-STARR group and 46 cm(2) (SD +/-10.6 cm(2)) in the CT group [P < 0.001]. Morbidity was 7.3% (n = 5) in the PPH-STARR group and 7.5% (n = 6) in the CT group. The most common complication was minor postoperative bleeding in both groups (PPH-STARR: n = 2, 2.9%; CT: n = 2, 2.4%) Overall there were no septic complications and no surgical re-interventions. There was a tendency for more postoperative pain following CT (n = 3, 3.6%) as compared with PPH-STARR (n = 1, 1.4%). Constipation Scores (CCS) were 15.50 +/- 5.71 in the PPH-STARR group and 15.70 +/- 5.84 in the CT group preoperatively and decreased significantly to 8.25 (SD +/-1.45) and 8.01 (SD +/-2.31) 12-months after surgery. Values did not differ significantly between the two groups. Contour Transtar is as safe and effective as PPH-STARR and provides a true circumferential resection of rectal intussusception. This may benefit selected patients and result in improved long-term durability of the technique.

  12. India: Past achievements and future promises

    International Nuclear Information System (INIS)

    Sethna, H.N.

    1972-01-01

    Generation of nuclear power has been one of the major objectives of the atomic energy programme in India. One of the early tasks was to establish a firm technological base for the various activities involved in the development of atomic energy. A national research centre then called the Atomic Energy Establishment Trombay and now renamed as Bhabha Atomic Research Centre (BARC) was created at Trombay near Bombay, and a wide range of R and D activities were initiated, ranging from basic studies in nuclear and solid state physics to investigations in metallurgy, engineering, health physics and nuclear medicine. Viewed especially against the Indian background, the Centre's contributions have been substantial. In addition to building up expertise to take up work in connection with the development, design, and construction of power reactors, it was essential to introduce the manufacturing know how-into industry for the fabrication of all the sophisticated components for these reactors. It was also necessary to establish processes for the fabrication and reprocessing of nuclear fuel and the production of fuel materials and other special materials such as zircaloy and heavy water. Endeavour to be self-sufficient in all aspects of nuclear technology is particularly important for a developing country, so that introduction of a fairly large nuclear power programme does not result in too unfavourable a balance of payment situation

  13. The analysis results of EEWS(Earthquake Early Warning System) about Iksan(Ml4.3) and Ulsan(Ml5.0) earthquakes in Korea

    Science.gov (United States)

    Park, J. H.; Chi, H. C.; Lim, I. S.; Seong, Y. J.; Pak, J.

    2016-12-01

    EEW(Earthquake Early Warning) service to the public has been officially operated by KMA (Korea Meteorological Administration) from 2015 in Korea. For the KMA's official EEW service, KIGAM has adopted ElarmS from UC Berkeley BSL and modified local magnitude relation, 1-D travel time curves and association procedures with real time waveforms from about 160 seismic stations of KMA and KIGAM. We have checked the performance of EEWS(Earthquake Early Warning System) reviewing two moderate size earthquakes: one is Iksan Eq.(Ml4.3) inside of networks and the other is Ulsan Eq.(Ml5.0) happened at the southern east sea of Korea outside of networks. The first trigger time at NPR station of the Iksan Eq. took 2.3 sec and BUY and JEO2 stations were associated to produce the first event version in 10.07 sec from the origin time respectively. Because the epicentral distance of JEO2 station is about 30 km and the estimated travel time is 6.2 sec, the delay time including transmission and processing is estimated as 3.87 sec with assumption that P wave velocity is 5 km/sec and the focal depth is 8 km. The first magnitude was M4.9 which was a little bigger than Ml4.3 by KIGAM. After adding 3 more triggers of stations (CHO, KMSA, PORA), the estimated magnitude became to M4.6 and the final was settled down to M4.3 with 10 stations. In the case of Ulsan the first trigger time took 11.04 sec and the first alert time with 3 stations in 14.8 sec from the origin time (OT) respectively. The first magnitude was M5.2, however, the difference between the first EEW epicenter and the manual final result was about 63 km due to the poor azimuth coverage outside of seismic network. After 16.2 sec from OT the fourth station YSB was used to update the location near to the manual results within 6 km with magnitude 5.0 and location and magnitude were stable with more stations. Ulsan Eq. was the first case announced to the public by EEWS and the process and result were successful, however, we have to

  14. Early Nonresponse in the Antipsychotic Treatment of Acute Mania : A Criterion for Reconsidering Treatment? Results From an Individual Patient Data Meta-Analysis

    NARCIS (Netherlands)

    Welten, Carlijn C M; Koeter, Maarten W J; Wohlfarth, Tamar D; Storosum, Jitschak G; van den Brink, Wim; Gispen-de Wied, Christine C; Leufkens, Hubert G M; Denys, Damiaan A J P

    OBJECTIVE: To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse. DATA SOURCES: Short-term efficacy studies assessing antipsychotics that were submitted to the

  15. The prognostic significance of early treatment response in pediatric relapsed acute myeloid leukemia : results of the international study Relapsed AML 2001/01

    NARCIS (Netherlands)

    Creutzig, Ursula; Zimmermann, Martin; Dworzak, Michael N.; Gibson, Brenda; Tamminga, Rienk; Abrahamsson, Jonas; Ha, Shau-Yin; Hasle, Henrik; Maschan, Alexey; Bertrand, Yves; Leverger, Guy; von Neuhoff, Christine; Razzouk, Bassem; Rizzari, Carmelo; Smisek, Petr; Smith, Owen P.; Stark, Batia; Reinhardt, Dirk; Kaspers, Gertjan L.

    2014-01-01

    The prognostic significance of early response to treatment has not been reported in relapsed pediatric acute myeloid leukemia. In order to identify an early and easily applicable prognostic factor allowing subsequent treatment modifications, we assessed leukemic blast counts in the bone marrow by

  16. Service Users perspectives in PROMISE and research.

    Science.gov (United States)

    Rae, Sarah

    2017-09-01

    Since its inception in 2013, PROMISE (PROactive Management of Integrated Services and Environments) has been supporting service users and staff at the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) on a journey to reduce reliance on force. The author's own personal experiences led to the founding of PROMISE and illustrates how individual experiences can influence a patient to lead change. Coproduction is actively embedded in PROMISE. Patients have been meaningfully involved because they are innovators and problem solvers who bring an alternative viewpoint by the very nature of their condition. A patient is more than just a person who needs to be 'fixed' they are individuals with untapped skills and added insight. There have been 2 separate Patient Advisory Groups (PAGs) since the project was first established. The first Patient Advisory Group was recruited to work with the PROMISE researchers on a study which used a participatory qualitative approach. Drawing on their lived experience and different perspectives the PAG was instrumental in shaping the qualitative study, including the research questions. Their active involvement helped to ensure that that the study was sensitively designed, methodologically robust and ethically sound. The 2 nd PAG was formed in 2016 to give the project an overall steer. Patients in this group contributed to the work on the 'No' Audit and reviewed several CPFT policies such as the Seclusion and Segregation policy which has impacted on frontline practice. They also made a significant contribution to the study design for a funding application that was submitted by the PROMISE team to the National Institute for Health Research (NIHR). Both PAGs were supported by funding from East of England Collaboration for Leadership in Applied Health Research and Care (CLAHRC EoE) and were influential in different ways. An evaluation of the 2 nd PAG which was conducted in June 2017 showed very high satisfaction levels. The free text

  17. Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mamgani, Abrahim, E-mail: a.almamgani@nki.nl [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Kwa, Stefan L.S.; Tans, Lisa; Moring, Michael; Fransen, Dennie; Mehilal, Robert; Verduijn, Gerda M. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Baatenburg de Jong, Rob J. [Department of Otolaryngology and Head and Neck Surgery – Erasmus MC, University Medical Center Rotterdam, Rotterdam (Netherlands); Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands)

    2015-10-01

    subsequently improved to normal levels. Long-term follow-up is needed to consolidate these promising results.

  18. Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial.

    Science.gov (United States)

    van Barneveld, Kevin W Y; Smeets, Boudewijn J J; Heesakkers, Fanny F B M; Bosmans, Joanna W A M; Luyer, Misha D; Wasowicz, Dareczka; Bakker, Jaap A; Roos, Arnout N; Rutten, Harm J T; Bouvy, Nicole D; Boelens, Petra G

    2016-06-01

    To investigate direct postoperative outcome and plasma amino acid concentrations in a study comparing early enteral nutrition versus early parenteral nutrition after major rectal surgery. Previously, it was shown that a low plasma glutamine concentration represents poor prognosis in ICU patients. A preplanned substudy of a previous prospective, randomized, open-label, single-centre study, comparing early enteral nutrition versus early parenteral nutrition in patients at high risk of postoperative ileus after surgery for locally advanced or locally recurrent rectal cancer. Early enteral nutrition reduced postoperative ileus, anastomotic leakage, and hospital stay. Tertiary referral centre for locally advanced and recurrent rectal cancer. A total of 123 patients with locally advanced or recurrent rectal carcinoma requiring major rectal surgery. Patients were randomized (ALEA web-based external randomization) preoperatively into two groups: early enteral nutrition (early enteral nutrition, intervention) by nasojejunal tube (n = 61) or early parenteral nutrition (early parenteral nutrition, control) by jugular vein catheter (n = 62). Eight hours after the surgical procedure artificial nutrition was started in hemodynamically stable patients, stimulating oral intake in both groups. Blood samples were collected to measure plasma glutamine, citrulline, and arginine concentrations using a validated ultra performance liquid chromatography-tandem mass spectrometric method. Baseline concentrations were comparable for both groups. Directly after rectal surgery, a decrease in plasma amino acids was observed. Plasma glutamine concentrations were higher in the parenteral group than in the enteral group on postoperative day 1 (p = 0.027) and day 5 (p = 0.008). Arginine concentrations were also significantly increased in the parenteral group at day 1 (p < 0.001) and day 5 (p = 0.001). Lower plasma glutamine and arginine concentrations were measured in the enteral group, whereas a

  19. Clinical predictors of in-hospital death and early surgery for infective endocarditis: results of CArdiac Disease REgistration (CADRE), a nation-wide survey in Japan.

    Science.gov (United States)

    Ohara, Takahiro; Nakatani, Satoshi; Kokubo, Yoshihiro; Yamamoto, Haruko; Mitsutake, Kotaro; Hanai, Sotaro

    2013-09-10

    The benefit of early surgery for IE is yet to be determined in non-Western countries. We conducted this study to evaluate the role of early surgery in infective endocarditis (IE) in Japan. IE admissions in Japan were prospectively registered using a nation-wide WEB-based registration system (CArdiac Disease REgistration, CADRE). The impact of early surgery on in-hospital mortality was assessed in native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). Risk factors for in-hospital death were assessed by multiple logistic regression analysis. The propensity score for early surgery was calculated to adjust the impact of early surgery. From September 2006 to May 2009, 348 NVE and 81 PVE were registered. In NVE, early surgery was preferable in every quartile stratified with the propensity score and the summary odds ratio (OR) and 95% confidence interval (CI) was 0.12 (0.05-0.31). The predictors of in-hospital death were Staphylococcus aureus infection (OR 3.5, 95% CI 1.26-9.7), heart failure (OR 6.74, 95% CI 2.43-18.7) and early surgery (OR 0.07, 95% CI 0.03-0.2). In PVE, the predictors of in-hospital death were age (OR 1.09, 95% CI 1.01-1.18), S. aureus infection (OR 5.8, 95% CI 1.4-24.01) and heart failure (OR 7.44, 95% CI 1.81-30.67), whereas early surgery was not (OR 0.51, 95% CI 0.12-2.16). Early surgery for NVE is associated with improved survival in a wide range of clinical subgroups in Japan. In PVE a survival benefit of early surgery is not clear. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Volumetric modulated arc therapy with flattening filter free beams for isolated abdominal/pelvic lymph nodes: report of dosimetric and early clinical results in oligometastatic patients

    Directory of Open Access Journals (Sweden)

    Alongi Filippo

    2012-12-01

    Full Text Available Abstract Background SBRT is a safe and efficient strategy to locally control multiple metastatic sites. While research in the physics domain for Flattening Filter Free Beams (FFF beams is increasing, there are few clinical data of FFF beams in clinical practice. Here we reported dosimentric and early clinical data of SBRT and FFF delivery in isolated lymph node oligometastatic patients. Methods Between October 2010 and March 2012, 34 patients were treated with SBRT for oligometastatic lymph node metastasis on a Varian TrueBeamTM treatment machine using Volumetric Modulated Arc Therapy (RapidArc. We retrospectively evaluated a total of 25 patients for isolated lymph node metastases in abdomen and/or pelvis treated with SBRT and FFF (28 treatments. Acute toxicity was recorded. Local control evaluation was scored by means of CT scan and/or PET scan. Results All dosimetric results are in line with what published for the same type of stereotactic abdominal lymph node metastases treatments and fractionation, using RapidArc. All 25 FFF SBRT patients completed the treatment. Acute gastrointestinal toxicity was minimal: one patient showed Grade 1 gastrointestinal toxicity. Three other patients presented Grade 2 toxicity. No Grade 3 or higher was recorded. All toxicities were recovered within one week. The preliminary clinical results at the median follow up of 195 days are: complete response in 12 cases, partial response in 11, stable disease in 5, with an overall response rate of 82%; no local progression was recorded. Conclusions Data of dosimetrical findings and acute toxicity are excellent for patients treated with SBRT with VMAT using FFF beams. Preliminary clinical results showed a high rate of local control in irradiated lesion. Further data and longer follow up are needed to assess late toxicity and definitive clinical outcomes.

  1. Preliminary Results of a New Auxiliary Mechatronic Near-Field Radar System to 3D Mammography for Early Detection of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Ashkan Ghanbarzadeh Dagheyan

    2018-01-01

    Full Text Available Accurate and early detection of breast cancer is of high importance, as it is directly associated with the patients’ overall well-being during treatment and their chances of survival. Uncertainties in current breast imaging methods can potentially cause two main problems: (1 missing newly formed or small tumors; and (2 false alarms, which could be a source of stress for patients. A recent study at the Massachusetts General Hospital (MGH indicates that using Digital Breast Tomosynthesis (DBT can reduce the number of false alarms, when compared to conventional mammography. Despite the image quality enhancement DBT provides, the accurate detection of cancerous masses is still limited by low radiological contrast (about 1% between the fibro-glandular tissue and affected tissue at X-ray frequencies. In a lower frequency region, at microwave frequencies, the contrast is comparatively higher (about 10% between the aforementioned tissues; yet, microwave imaging suffers from low spatial resolution. This work reviews conventional X-ray breast imaging and describes the preliminary results of a novel near-field radar imaging mechatronic system (NRIMS that can be fused with the DBT, in a co-registered fashion, to combine the advantages of both modalities. The NRIMS consists of two antipodal Vivaldi antennas, an XY positioner, and an ethanol container, all of which are particularly designed based on the DBT physical specifications. In this paper, the independent performance of the NRIMS is assessed by (1 imaging a bearing ball immersed in sunflower oil and (2 computing the heat Specific Absorption Rate (SAR due to the electromagnetic power transmitted into the breast. The preliminary results demonstrate that the system is capable of generating images of the ball. Furthermore, the SAR results show that the system complies with the standards set for human trials. As a result, a configuration based on this design might be suitable for use in realistic clinical

  2. Perpendicular recording: the promise and the problems

    International Nuclear Information System (INIS)

    Wood, Roger; Sonobe, Yoshiaki; Jin Zhen; Wilson, Bruce

    2001-01-01

    Perpendicular recording has long been advocated as a means of achieving the highest areal densities. In particular, in the context of the 'superparamagnetic limit', perpendicular recording with a soft underlayer promises several key advantages. These advantages include a higher coercivity, thicker media that should permit smaller diameter grains and higher signal-to-noise ratio. Also, the sharper edge-writing will facilitate recording at very high track densities (lower bit aspect ratio). Recent demonstrations of the technology have shown densities comparable with the highest densities reported for longitudinal recording. This paper further examines the promise that perpendicular recording will deliver an increase in areal density two to eight times higher than that achievable with longitudinal recording. There are a number of outstanding issues but the key challenge is to create a low-noise medium with a coercivity that is high and is much larger than the remanent magnetization

  3. Promising Products for Printing and Publishing Market

    Directory of Open Access Journals (Sweden)

    Renata Činčikaitė

    2011-04-01

    Full Text Available The article surveys printing and publishing market and its strong and weak aspects. The concept of a new product is described as well as its lifetime and the necessity of its introduction to the market. The enterprise X operating on the market is analyzed, its strong and weak characteristics are presented. The segmentation of the company consumers is performed. On the basis of the performed analysis the potential promising company products are defined.Article in Lithuanian

  4. Chemoradiation for Advanced Head and Neck Cancer: Potential for Improving Results to Match Those of Current Treatment Modalities for Early-Stage Tumors-Long-Term Results of Hyperfractionated Chemoradiation With Carbogen Breathing and Anemia Correction With Erythropoietin

    International Nuclear Information System (INIS)

    Villar, Alfonso; Martinez, Jose Carlos; Serdio, Jose Luis de

    2008-01-01

    Purpose: To attempt to improve results of chemoradiation for head and neck cancer. Methods and Materials: From March 1996 to April 2007, 98 patients with head and neck cancer (15 Stage III and 83 Stage IV) were treated with a twice-daily hyperfractionated schedule. Eleven patients presented with N0, 11 with N1, 13 with N2A, 17 with N2B, 24 with N2C, and 22 with N3. Each fraction of treatment consisted of 5 mg/m 2 of carboplatin plus 115 cGy with carbogen breathing. Treatment was given 5 days per week up to total doses of 350 mg/m 2 of carboplatin plus 8050 cGy in 7 weeks. Anemia was corrected with erythropoietin. Results: Ninety-six patients tolerated the treatment as scheduled. All patients tolerated the planned radiation dose. Local toxicity remained at the level expected with irradiation alone. Chemotherapy toxicity was moderate. Ninety-seven complete responses were achieved. After 11 years of follow-up (median, 81 months), actuarial locoregional control, cause-specific survival, overall survival, and nodal control rates at 5 and 10 years were, respectively, 83% and 83%, 68% and 68%, 57% and 55%, and 100% and 100%. Median follow-up of disease-free survivors was 80 months. No significant differences in survival were observed between the different subsites or between the pretreatment node status groups (N0 vs. N+, N0 vs. N1, N0 vs. N2A, N0 vs. N2B, N0 vs. N2C, and N0 vs. N3). Conclusions: Improving results of chemoradiation for advanced head and neck cancer up to the level obtained with current treatments for early-stage tumors is a potentially reachable goal

  5. Health, job characteristics, skills, and social and financial factors in relation to early retirement--results from a longitudinal study in the Netherlands.

    Science.gov (United States)

    de Wind, Astrid; Geuskens, Goedele A; Ybema, Jan Fekke; Blatter, Birgitte M; Burdorf, Alex; Bongers, Paulien M; van der Beek, Allard J

    2014-03-01

    This study aimed to investigate the relative contribution of health, job characteristics, skills and knowledge, and social and financial factors to the transition from work to (non-disability) early retirement. Employees aged 59-63 years (N=2317) were selected from the Study on Transitions in Employment, Ability and Motivation in the Netherlands (STREAM). Individual characteristics, health, job characteristics, skills and knowledge, and social and financial factors were measured using a questionnaire at baseline. Information on early retirement was derived from the one-year follow-up questionnaire. Logistic regression analyses were used to identify predictors of early retirement. Population Attributable Fractions (PAF) were calculated. Older age [odds ratio (OR) 1.79], poor physical health (OR 1.78), a positive attitude of the partner with respect to early retirement (OR 3.85), and the financial possibility to stop working before the age of 65 (OR 10.2) predicted the transition to early retirement, whereas employees that reported high appreciation at work (OR 0.58) and higher focus on development of skills and knowledge (OR 0.54) were less likely to retire early. PAF were 0.75 for the financial possibility to stop working, 0.43 for a positive attitude of the partner with respect to early retirement, 0.27 for low appreciation at work, 0.23 for a low focus on development, and 0.21 for poor health. The financial possibility to stop working before the age of 65 importantly contributes to early retirement. In the context of rapidly diminishing financial opportunities to retire early in the Netherlands, the prolongation of working life might be promoted by workplace health promotion and disability management, and work-related interventions focusing on appreciation and the learning environment.

  6. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    International Nuclear Information System (INIS)

    Fitzek, Markus M.; Linggood, Rita M.; Adams, Judy; Munzenrider, John E.

    2006-01-01

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory

  7. Endoscopic-assisted linea alba reconstruction plus mesh augmentation (ELAR plus for treatment of umbilical and/or epigastric hernias and rectus abdominis diastasis – Early results

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2016-05-01

    Full Text Available IntroductionSymptomatic umbilical and/or epigastric hernias are often seen concomitantly with rectus abdominis diastasis (RAD, and suture repair of such defects has a high recurrence rate. In the literature there are reports of both endoscopic and open techniques for repair of symptomatic umbilical and/or epigastric hernias in association with RAD. This paper now reports on the early results of a hybrid technique used for reconstruction of the linea alba and mesh augmentation (ELAR plus.Material and methodsBetween 15 June 2015 and 31 January 2016, 40 patients with symptomatic umbilical and /or epigastric hernia and concomitant RAD underwent reconstruction of the linea alba using a hybrid technique involving a small umbilical incision and the use of video endoscopic equipment. The patients comprised 29 men and 11 women with a mean age of 53.6 years and mean BMI of 32.6. The mean operating time was 120 minutes. The mesh had a mean longitudinal extension of 18.6 cm and transverse extension of 9.1 cm. ResultsThirty-day follow-up results are available for all patients. Thirty-seven out of 40 patients (92.5 % experienced no postoperative complication. Two cases of discrete impaired umbilical wound healing and one seroma were successfully managed with conservative treatment. On 30-day follow-up, three out of 40 patients (7.5 % complained of intermittent pain on exertion, and two out of 40 patients (5 % still took painkillers when required.ConclusionEndoscopic-assisted linea alba reconstruction plus mesh augmentation (ELAR plus is a novel minimally invasive procedure for repair of symptomatic umbilical and/or epigastric hernias with concomitant RAD. Reconstruction of the linea alba via a minimally invasive access route is able to restore the normal anatomy of the abdominal wall.

  8. Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer.

    Science.gov (United States)

    Cante, Domenico; Petrucci, Edoardo; Sciacero, Piera; Piva, Cristina; Ferrario, Silvia; Bagnera, Silvia; Patania, Sebastiano; Mondini, Guido; Pasquino, Massimo; Casanova Borca, Valeria; Vellani, Giorgio; La Porta, Maria Rosa; Franco, Pierfrancesco

    2017-09-01

    Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2.25 Gy daily) with an additional boost dose of 0.25 Gy delivered concomitantly to the lumpectomy cavity, for an additional dose of 5 Gy. Median follow-up period was 117 months. At 10-year, overall, cancer-specific, disease-free survival and local control were 92.2% (95% CI 88.7-93.4%), 99.2% (95% CI 96.7-99.7%), 95.5% (95% CI 91.2-97.2%) and 97.3% (95% CI 94.5-98.9%), respectively. Only eight patients recurred. Four in-breast recurrences, two axillary node relapses and two metastatic localizations were observed. Fourteen patients died during the observation period due to other causes while breast cancer-related deaths were eight. At last follow-up, ≥G2 fibrosis and telangiectasia were seen in 7% and 5% of patients. No major lung and heart toxicities were observed. Cosmetic results were excellent/good in 87.8% of patients and fair/poor in 12.2%. Hypofractionated WBRT with concomitant boost to the lumpectomy cavity after BCS in EBC led to consistent clinical results at 10 years. Hence, it can be considered a valid treatment option in this setting.

  9. RILEM technical committee 195-DTD recommendation for test methods for AD and TD of early age concrete Round Robin documentation report : program, test results and statistical evaluation

    CERN Document Server

    Bjøntegaard, Øyvind; Krauss, Matias; Budelmann, Harald

    2015-01-01

    This report presents the Round-Robin (RR) program and test results including a statistical evaluation of the RILEM TC195-DTD committee named “Recommendation for test methods for autogenous deformation (AD) and thermal dilation (TD) of early age concrete”. The task of the committee was to investigate the linear test set-up for AD and TD measurements (Dilation Rigs) in the period from setting to the end of the hardening phase some weeks after. These are the stress-inducing deformations in a hardening concrete structure subjected to restraint conditions. The main task was to carry out an RR program on testing of AD of one concrete at 20 °C isothermal conditions in Dilation Rigs. The concrete part materials were distributed to 10 laboratories (Canada, Denmark, France, Germany, Japan, The Netherlands, Norway, Sweden and USA), and in total 30 tests on AD were carried out. Some supporting tests were also performed, as well as a smaller RR on cement paste. The committee has worked out a test procedure recommenda...

  10. Phonological Awareness and Rapid Automatized Naming Predicting Early Development in Reading and Spelling: Results from a Cross-Linguistic Longitudinal Study

    Science.gov (United States)

    Furnes, Bjarte; Samuelsson, Stefan

    2010-01-01

    In this study, the relationship between latent constructs of phonological awareness (PA) and rapid automatized naming (RAN) were investigated and related to later measures of reading and spelling in children learning to read in different alphabetic writing systems (i.e., Norwegian/Swedish vs. English). 750 U.S./Australian children and 230 Scandinavian children were followed longitudinally between kindergarten and 2nd grade. PA and RAN were measured in kindergarten and Grade 1, while word recognition, phonological decoding, and spelling were measured in kindergarten, Grade 1, and Grade 2. In general, high stability was observed for the various reading and spelling measures, such that little additional variance was left open for PA and RAN. However, results demonstrated that RAN was more related to reading than spelling across orthographies, with the opposite pattern shown for PA. In addition, tests of measurement invariance show that the factor loadings of each observed indicator on the latent PA factor was the same across U.S./Australia and Scandinavia. Similar findings were obtained for RAN. In general, tests of structural invariance show that models of early literacy development are highly transferable across languages. PMID:21359098

  11. Early avascular necrosis of the femoral head: relationship of the findings of preoperative MRI and the long-term results of core decompression

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dal Soo; Jeong, Gun Young [Taejeon Eulji Hospital, Taejeon (Korea, Republic of); Kwon, Soon Tae [Chungnam National Univ. College of Medicine, Taejeon (Korea, Republic of)] [and others

    1997-10-01

    To evaluate potential correlation between the extent and site of avascular necrosis (AVN), as determined by preoperative magnetic resonance (MR) imaging, and the development of femoral head collapse. Using clinical, radiographic and MR imaging criteria, twenty hips in 15 patients were selected for core decompression. Preoperative MR results were classified into three categories: group A, less than 15% involvement of the weight-bearing portion of the femoral head; group B, 15%-30% involvement; group C, more than 30% involvement, according to ARCO staging. We also established three groups according to site of involvement of the femoral head namely medial, middle and lateral. Of 20 cases, three were stage Ia; two, Ib; four, Ic; three, 2a; two, 2b; and 6, 2c. Ten cases of Ia, Ib, 2a or 2b showed no femoral head collapse during follow-up of at least 24 months, while ten cases of Ic or 2c showed femoral head collapse. The prognosis of core decompression in patients with early AVN is related to the area of lesion in the femoral head.

  12. Early avascular necrosis of the femoral head: relationship of the findings of preoperative MRI and the long-term results of core decompression

    International Nuclear Information System (INIS)

    Park, Dal Soo; Jeong, Gun Young; Kwon, Soon Tae

    1997-01-01

    To evaluate potential correlation between the extent and site of avascular necrosis (AVN), as determined by preoperative magnetic resonance (MR) imaging, and the development of femoral head collapse. Using clinical, radiographic and MR imaging criteria, twenty hips in 15 patients were selected for core decompression. Preoperative MR results were classified into three categories: group A, less than 15% involvement of the weight-bearing portion of the femoral head; group B, 15%-30% involvement; group C, more than 30% involvement, according to ARCO staging. We also established three groups according to site of involvement of the femoral head namely medial, middle and lateral. Of 20 cases, three were stage Ia; two, Ib; four, Ic; three, 2a; two, 2b; and 6, 2c. Ten cases of Ia, Ib, 2a or 2b showed no femoral head collapse during follow-up of at least 24 months, while ten cases of Ic or 2c showed femoral head collapse. The prognosis of core decompression in patients with early AVN is related to the area of lesion in the femoral head

  13. Aggressive combination therapy with intra-articular glucocorticoid injections and conventional disease-modifying anti-rheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from the CIMESTRA study

    DEFF Research Database (Denmark)

    Hetland, M.L.; Stengaard-Pedersen, K.; Junker, P.

    2008-01-01

    -articular corticosteroid. This paper presents the results of the second year of the randomised, controlled double-blind CIMESTRA (Ciclosporine, Methotrexate, Steroid in RA) study. METHODS: 160 patients with early RA (duration

  14. Randomized trial on external radiation therapy alone versus external radiation therapy followed by brachytherapy in early stage nasopharyngeal carcinoma with a long term result

    International Nuclear Information System (INIS)

    Gao Li; Yuan Zhiyong; Xu Guozhen; Li Suyan; Xiao Guangli; Cai Weiming

    2004-01-01

    Objective: To compare local control and toxicity in patients treated with external beam radiotherapy followed by intracavitary brachytherapy (BT) versus external beam radiotherapy alone (RT) for locally early stage nasopharyngeal carcinoma (NPC). Methods: From 1990 to 1997, 126 NPC patients staged T1 and T2 by 1992 Fuzhou Staging System (oropharynx, carotid sheath and soft tissue around cervical vertebral involvement excluded) were randomized into RT alone and RT followed BT groups. The two groups were comparable in age, gender, stage and pathology. The median follow-up was 112 months. T1 patients were randomized before the treatment into RT alone group of 66-70 Gy and RT plus BT with the dose of 56 Gy plus 10-16 Gy BT boost to the nasopharynx. For T2 patients, if MRI or CT showed no residual lesion in parapharyngeal space after 50 Gy, they were randomized into RT alone (median dose: 72 Gy) or RT of 66 Gy followed by 8-24 Gy BT boost (1-3 fractions over 1-3 weeks). Results: In RT group, 8 patients (13.1%) failed in primary site during the follow-up period, 7 (11%) in BT group. The 5-year local control rates was 86% for RT group and 88% for BT group (P=0.47). The 5-year overall survival rates were 83% and 84% (P=0.84), respectively. Ten patients (18%) in RT group (4 of grade I, 6 of grade II) and 7 patients (11%) in BT group (4 of grade I, 3 of grade II, P=0.31) developed radiation induced encephalopathy. The incidence of trismus was much lower in BT group than in RT group (26% versus 10%, P=0.02). No soft palate perforation or sphenoid necrosis were observed. Conclusion: Compared to conventional external beam radiotherapy, planned irradiation plus intracavitary brachytherapy not only can achieve similar local control and survival rates for locally early stage nasopharyngeal carcinoma, but also decrease irradiation dose and the trismus incidence. (authors)

  15. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease

    International Nuclear Information System (INIS)

    Cellai, Enrico; Frata, Paolo; Magrini, Stefano M.; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Bonetti, Bartolomea; Vitali, Elisabetta; De Stefani, Agostina; Buglione, Michela; Biti, Gianpaolo

    2005-01-01

    was equal to 23%, with second tumor deaths being more frequent than larynx cancer deaths (67 of 831 vs. 46/831). Conclusion: The results of this study support the opinion, suggested by some international guidelines, that radiotherapy is standard treatment for T1 glottic cancer. Better results are obtained in patients with less extended disease and with 4-6 MV photon beams. The use of doses in excess of 65 Gy and of field sizes of 36-49 cm 2 is probably the best technical choice available. Late damage is infrequent, but careful follow-up is warranted to detect early not only relapses (because conservative salvage surgery is feasible), but also second malignant tumors, which constitute the main cause of death in these patients and are potentially curable

  16. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-05-01

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

  17. Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lahmer, G.; Lotter, M.; Kreppner, S.; Fietkau, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-08-15

    Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects. Patients and methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.6 Gy/h, 24 h per day) corresponding to a total dose of 60 Gy. Dose volume adaptation was performed with the aim of optimal coverage of the whole prostate (V{sub 100} > 95 %) simultaneously respecting the protocol-based dose volume constraints for the urethra (D{sub 0.1} {sub cc} < 130 %) and the rectum (D{sub 2} {sub cc} < 50-60 %) taking into account the previous radiation therapy. Local relapse after radiotherapy (external beam irradiation, brachytherapy with J-125 seeds or combination) was confirmed mostly via choline-PET and increased PSA levels. The primary endpoint was treatment-related late toxicities - particularly proctitis, anal incontinence, cystitis, urinary incontinence, urinary frequency/urgency, and urinary retention according to the Common Toxicity Criteria. The secondary endpoint was PSA-recurrence-free survival. Results: We registered urinary toxicities only. Grade 2 and grade 3 toxicities were observed in up to 11.1 % (2/18) and 16.7 % (3/18) of patients, respectively. The most frequent late-event grade 3 toxicity was urinary retention in 17 % (3/18) of patients. No late gastrointestinal side effects occurred. The biochemical PSA-recurrence-free survival probability at 3 years was 57.1 %. The overall survival at 3 years was 88.9 %; 22 % (4/18) of patients developed metastases. The median follow-up time for all patients after salvage BT was 21 months (range, 8-77 months). Conclusion: Salvage PDR

  18. Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: Results from a nationally representative sample☆

    OpenAIRE

    Brown, Monique J.; Masho, Saba W.; Perera, Robert A.; Mezuk, Briana; Cohen, Steven A.

    2015-01-01

    Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the associatio...

  19. Early Workplace Communication and Problem Solving to Prevent Back Disability: Results of a Randomized Controlled Trial Among High-Risk Workers and Their Supervisors.

    Science.gov (United States)

    Linton, Steven J; Boersma, Katja; Traczyk, Michal; Shaw, William; Nicholas, Michael

    2016-06-01

    Purpose There is a clear need for interventions that successfully prevent the development of disability due to back pain. We hypothesized that an intervention aimed at both the worker and the workplace could be effective. Hence, we tested the effects of a new early intervention, based on the misdirected problem solving model, aimed at both workers at risk of long-term impairments and their workplace. Methods Supervisors of volunteers with back pain, no red flags, and a high score on a screen (Örebro Musculoskeletal Screening Questionnaire) were randomized to either an evidence based treatment as usual (TAU) or to a worker and workplace package (WWP). The WWP intervention included communication and problem solving skills for the patient and their immediate supervisor. The key outcome variables of work absence due to pain, health-care utilization, perceived health, and pain intensity were collected before, after and at a 6 month follow up. Results The WWP showed significantly larger improvements relative to the TAU for work absence due to pain, perceived health, and health-care utilization. Both groups improved on pain ratings but there was no significant difference between the groups. The WWP not only had significantly fewer participants utilizing health care and work absence due to pain, but the number of health care visits and days absent were also significantly lower than the TAU. Conclusions The WWP with problem solving and communication skills resulted in fewer days off work, fewer health care visits and better perceived health. This supports the misdirected problem solving model and indicates that screening combined with an active intervention to enhance skills is quite successful and likely cost-effective. Future research should replicate and extend these findings with health-economic analyses.

  20. Early results of a simple distraction dynamic external fixator in management of comminuted intra-articular fractures of base of middle phalanx.

    Science.gov (United States)

    Mansha, Muhammad; Miranda, Sanjay

    2013-12-01

    Treatment for comminuted fracture dislocations of the proximal interphalangeal joint (pilon injuries) remains a challenge. We present our short term results of twelve pilon fracture dislocations treated by closed reduction and application of a distraction dynamic external fixator. The aim of the study was to assess the clinical outcomes and compare them to the original description by Hynes and Giddins. A cohort of 12 consecutive patients with pilon fracture of the proximal interphalangeal joint (comminuted fracture of the base of middle phalanx, longitudinally unstable with joint subluxation), were treated with this method over the study period. Data was collected by an independent observer at last follow-up appointment in the clinic. The outcome measures recorded were; level of residual pain, arc of motion, X-ray appearance, return to work and satisfaction with the procedure. The study group comprises of 7 male and 5 female patients at a mean age of 38.1 years (range 21-70 years). The average range of movement achieved was 13-87° at a mean follow-up of 16.4 weeks (Range 12-42 weeks). Early return to work, good pain relief and high level of patient satisfaction were achieved. No serious complication was noted during this period. We used the construct with slight modification of the original description and we feel this modification may help to reduce the pin site infection. We found the results reproducible and based on our experience we recommend this technique to treat these complex intra-articular fractures of base of middle phalanx.

  1. Bicalutamide ('Casodex') 150 mg as adjuvant to radiotherapy in patients with localised or locally advanced prostate cancer: Results from the randomised Early Prostate Cancer Programme

    Energy Technology Data Exchange (ETDEWEB)

    Tyrrell, Chris J [Derriford Hospital, Plymouth (United Kingdom); Payne, Heather [Middlesex Hospital, London (United Kingdom); See, William A [Medical College of Wisconsin, Milwaukee, WI (United States); McLeod, David G [Walter Reed Army Medical Center, Washington, DC (United States); Wirth, Manfred P [Department of Urology, Technical University of Dresden (Germany); Iversen, Peter [Department of Urology, Rigshospitalet, Copenhagen (Denmark); Armstrong, Jon [AstraZeneca, Macclesfield (United Kingdom); Morris, Clive [AstraZeneca, Macclesfield (United Kingdom)

    2005-07-01

    Background and purpose: The ongoing Early Prostate Cancer (EPC) programme is assessing bicalutamide ('Casodex') 150 mg, either alone or as adjuvant to treatment of curative intent, in patients with localised or locally advanced prostate cancer (n=8113). This paper presents an exploratory analysis of the subgroup of the EPC programme who received radiotherapy with curative intent (n=1370) in order to determine the efficacy (in terms of progression-free survival [PFS]) and tolerability of bicalutamide 150 mg in this setting. Patients and methods: 1370 patients with T1-4, M0, any N prostate cancer received bicalutamide 150 mg or placebo adjuvant to radiotherapy of curative intent. This analysis was undertaken at median 5.3 years' follow-up. Results: In patients with locally advanced disease (n=305), bicalutamide adjuvant to radiotherapy significantly increased PFS by 53% (event-time ratio 1.53; 95% confidence intervals [CI] 1.16, 2.02) compared with placebo and reduced the risk of disease progression by 42% (hazard ratio [HR] 0.58; 95% CI 0.41, 0.84; P=0.00348). In these patients, objective progression was experienced by 33.5% of those randomised to bicalutamide versus 48.6% for those randomised to placebo. The between-group difference in patients with localised disease (n=1065) failed to reach statistical significance (HR 0.80; 95% CI 0.62, 1.03; P=0.088). The most common adverse events were breast pain (74.8%) and gynaecomastia (66.6%), which were mild to moderate in >90% of cases. Conclusions: Bicalutamide 150 mg/day given as adjuvant to radiotherapy significantly improved PFS in patients with locally advanced prostate cancer. For patients with localised disease, the results at this stage from the radiotherapy subgroup and the overall EPC programme suggest that adjuvant hormonal therapy is currently not appropriate. There were no unexpected tolerability findings.

  2. Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp

    Science.gov (United States)

    Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K.; Madidi, Ngonidzashe; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M.; Thirumurthy, Harsha

    2015-01-01

    Background: Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. Methods: Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant. Results: The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices. Conclusions: EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization. PMID:26017658

  3. Partial breast irradiation as sole therapy for low risk breast carcinoma: Early toxicity, cosmesis and quality of life results of a MammoSite brachytherapy phase II study

    International Nuclear Information System (INIS)

    Belkacemi, Yazid; Chauvet, Marie-Pierre; Giard, Sylvia; Villette, Sylviane; Lacornerie, Thomas; Bonodeau, Francois; Baranzelli, Marie-Christine; Bonneterre, Jacques; Lartigau, Eric

    2009-01-01

    Purpose: The MammoSite is a device that was developed with the goal of making breast-conserving surgery (BCT) more widely available. Our objective was to evaluate the MammoSite device performances after an open cavity placement procedure and quality of life in highly selected patients with early-stage breast cancer. Methods and materials: From March 2003 to March 2005, 43 patients with T1 breast cancer were enrolled in a phase II study. The median age was 72 years. Twenty-five (58%) patients were treated with high-dose rate brachytherapy using the MammoSite applicator to deliver 34 Gy in 10 fractions. The main disqualifying factor was pathologic sentinel node involvement (10/43; 23%). There were no device malfunctions, migration or rupture of the balloon. Results: After a median follow-up of 13 months, there were no local recurrences and one contralateral lobular carcinoma. Seventeen (68%), 13 (52%), 8 (32%), 5 (20%) and 2 (8%) patients had erythema, seroma, inflammation, hematoma and sever infection, respectively. Only 2 patients developed telangiectasia. At 1 year the rate of 'good to excellent' cosmetic results was 84%. Significant changes in QoL were observed for emotional and social well-being between 3 and 12 months. At 24 months, only emotional well-being subscore changes were statistically significant (p = 0.015). Conclusions: Our data in patients older than 60 years support the previously published data. Histologic features were the main disqualifying criteria. With higher skin spacing levels we observed very low incidence of telangiectasia. QoL evaluation indicates that baseline scores were satisfactory. Changes concerned emotional and social well-being

  4. Fuel and fission product behaviour in early phases of a severe accident. Part II: Interpretation of the experimental results of the PHEBUS FPT2 test

    Energy Technology Data Exchange (ETDEWEB)

    Dubourg, R. [Institut de Radioprotection et de Sûreté Nucléaire, B.P. 3, 13115 Saint Paul-lez-Durance Cedex (France); Barrachin, M., E-mail: marc.barrachin@irsn.fr [Institut de Radioprotection et de Sûreté Nucléaire, B.P. 3, 13115 Saint Paul-lez-Durance Cedex (France); Ducher, R. [Institut de Radioprotection et de Sûreté Nucléaire, B.P. 3, 13115 Saint Paul-lez-Durance Cedex (France); Gavillet, D. [Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland); De Bremaecker, A. [Institute for Nuclear Materials Sciences, SCK-CEN, Boeretang 200, B-2400 Mol (Belgium)

    2014-10-15

    One objective of the FPT2 test of the PHEBUS FP Program was to study the degradation of an irradiated UO{sub 2} fuel bundle and the fission product behaviour under conditions of low steam flow. The results of the post-irradiation examinations (PIE) at the upper levels (823 mm and 900 mm) of the test section previously reported are interpreted in the present paper. Solid state interactions between fuel and cladding have been compared with the characteristics of interaction identified in the previous separate-effect tests. Corium resulting from the interaction between fuel and cladding was formed. The uranium concentration in the corium is compared to analytical tests and a scenario for the corium formation is proposed. The analysis showed that, despite the rather low fuel burn up, the conditions of temperature and oxygen potential reached during the starvation phase are able to give an early very significant release fraction of caesium. A significant part (but not all) of the molybdenum was segregated at grain boundaries and trapped in metallic inclusions from which they were totally removed in the final part of the experiment. During the steam starvation phase, the conditions of oxygen potential were favourable for the formation of simple Ba and BaO chemical forms but the temperature was too low to provoke their volatility. This is one important difference with out-of-pile experiments such as VERCORS for which only a combination of high temperature and low oxygen potential induced a significant barium release. Finally another significant difference with analytical out-of-pile experiments comes from the formation of foamy zones due to the fission gas presence in FPT2-type experiments which give an additional possibility for the formation of stable fission product compounds.

  5. Biting back: BiTE antibodies as a promising therapy for acute myeloid leukemia.

    Science.gov (United States)

    Walter, Roland B

    2014-06-01

    The experience with gemtuzumab ozogamicin has highlighted both the potential value and limitations of antibodies in acute myeloid leukemia (AML). Recently, bispecific T-cell engager (BiTE) antibodies have emerged as a means to harness polyclonal cytotoxic T-cells and cause highly efficient lysis of targeted tumor cells. Promising early results have been obtained with the CD19-directed BiTE antibody, blinatumomab, in patients with acute lymphoblastic leukemia. A first candidate for AML is the CD33/CD3 molecule, AMG 330, for which several recent preclinical studies demonstrated high potency and efficacy in destroying CD33(+) human AML cells. Many questions remain to be addressed, but BiTE antibodies may offer an exciting new tool in a disease for which the outcomes in many patients remain unsatisfactory.

  6. [Absorbable coronary stents. New promising technology].

    Science.gov (United States)

    Erbel, Raimund; Böse, Dirk; Haude, Michael; Kordish, Igor; Churzidze, Sofia; Malyar, Nasser; Konorza, Thomas; Sack, Stefan

    2007-06-01

    Coronary stent implantation started in Germany 20 years ago. In the beginning, the progress was very slow and accelerated 10 years later. Meanwhile, coronary stent implantation is a standard procedure in interventional cardiology. From the beginning of permanent stent implantation, research started to provide temporary stenting of coronary arteries, first with catheter-based systems, later with stent-alone technology. Stents were produced from polymers or metal. The first polymer stent implantation failed except the Igaki-Tamai stent in Japan. Newly developed absorbable polymer stents seem to be very promising, as intravascular ultrasound (IVUS) and optical coherence tomography have demonstrated. Temporary metal stents were developed based on iron and magnesium. Currently, the iron stent is tested in peripheral arteries. The absorbable magnesium stent (Biotronik, Berlin, Germany) was tested in peripheral arteries below the knee and meanwhile in the multicenter international PROGRESS-AMS (Clinical Performance and Angiographic Results of Coronary Stenting with Absorbable Metal Stents) study. The first magnesium stent implantation was performed on July 30, 2004 after extended experimental testing in Essen. The magnesium stent behaved like a bare-metal stent with low recoil of 5-7%. The stent struts were absorbed when tested with IVUS. Stent struts were not visible by fluoroscopy or computed tomography (CT) as well as magnetic resonance imaging (MRI). That means, that the magnesium stent is invisible and therefore CT and MRI can be used for imaging of interventions. Only using micro-CT the stent struts were visible. The absorption process could be demonstrated in a patient 18 days after implantation due to suspected acute coronary syndrome, which was excluded. IVUS showed a nice open lumen. Stent struts were no longer visible, but replaced by tissue indicating the previous stent location. Coronary angiography after 4 months showed an ischemia-driven target lesion

  7. Does environmental archaeology need an ethical promise?

    DEFF Research Database (Denmark)

    Riede, Felix; Andersen, Per; Price, Neil

    2016-01-01

    formalized ethical codes or promises that not only guide the dissemination of data but oblige scientists to relate to fundamentally political issues. This article couples a survey of the recent environmental ethics literature with two case studies of how past natural hazards have affected vulnerable...... societies in Europe?s prehistory. We ask whether cases of past calamities and their societal effects should play a greater role in public debates and whether archaeologists working with past environmental hazards should be more outspoken in their ethical considerations. We offer no firm answers, but suggest...... that archaeologists engage with debates in human?environment relations at this interface between politics, public affairs and science....

  8. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease

    International Nuclear Information System (INIS)

    Frata, Paolo; Cellai, Enrico; Magrini, Stefano M.; Bonetti, Bartolomea; Vitali, Elisabetta; Tonoli, Sandro; Buglione, Michela; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Biti, Gianpaolo

    2005-01-01

    Purpose: To retrospectively evaluate local control rates, late damage incidence, functional results, and second-tumor occurrence according to the different patient, tumor, and treatment features in a large bi-institutional series of T2 glottic cancer. Methods and Materials: A total of 256 T2 glottic cancer cases treated consecutively with radical intent at the Florence University Radiation Oncology Department (FLO) and at the Radiation Oncology Department of University of Brescia, Istituto del Radio 'O. Alberti' (BS) were studied. Cumulative probability of local control (LC), disease-specific survival (DSS), and overall survival (OS) rates were calculated and compared in the different clinical and therapeutic subgroups by both univariate and multivariate analysis. Types of relapse and their surgical salvage were evaluated, along with the functional results of treatment. Late-damage incidence and second-tumor cumulative probability (STP) were also calculated. Results: In the entire series, 3-year, 5-year, and 10-year OS rates were, respectively, 73%, 59%, and 37%. Corresponding values for cumulative LC probability were 73%, 73%, and 70% and for DSS, 89%, 86%, and 85%, taking into account surgical salvage of relapsed cases. Seventy-three percent of the patients were cured with function preserved. Main determinants of a worse LC at univariate analysis were larger tumor extent and impaired cord mobility. At multivariate analysis, the same factors retained statistical significance. Twenty-year STP was 23%, with second-tumor deaths less frequent than larynx cancer deaths (20 of 256 vs. 30 of 256). Incidence of late damage was higher in the first decade of accrual (22%) than in the last decade (10%, p = 0.03); the same was true for severe late damage (9% vs. 1.8%). Conclusion: Present-day radical radiotherapy can be considered a standard treatment for T2 glottic cancer. Better results are obtained in patients with less extended disease. Late damage is relatively

  9. Nanomedicine: Perspective and promises with ligand-directed molecular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pan Dipanjan [Department of Medicine, Washington University Medical School, St. Louis, MO (United States)], E-mail: dipanjan@wustl.edu; Lanza, Gregory M.; Wickline, Samuel A. [Department of Medicine, Washington University Medical School, St. Louis, MO (United States); Caruthers, Shelton D. [Department of Medicine, Washington University Medical School, St. Louis, MO (United States); Philips Healthcare, Andover, MA (United States)], E-mail: scaruthers@cmrl.wustl.edu

    2009-05-15

    Molecular imaging and targeted drug delivery play an important role toward personalized medicine, which is the future of patient management. Of late, nanoparticle-based molecular imaging has emerged as an interdisciplinary area, which shows promises to understand the components, processes, dynamics and therapies of a disease at a molecular level. The unprecedented potential of nanoplatforms for early detection, diagnosis and personalized treatment of diseases, have found application in every biomedical imaging modality. Biological and biophysical barriers are overcome by the integration of targeting ligands, imaging agents and therapeutics into the nanoplatform which allow for theranostic applications. In this article, we have discussed the opportunities and potential of targeted molecular imaging with various modalities putting a particular emphasis on perfluorocarbon nanoemulsion-based platform technology.

  10. Expedited remedial action -- A promising opportunity at your doorstep

    Energy Technology Data Exchange (ETDEWEB)

    Newman, E.R.

    1996-12-31

    The Expedited Remedial Action Program or ERAP carries great promise and is limited to no more than 30 sites, there are a number of slots now available, and the legislature will soon be considering a reauthorization of the full state Superfund program, which expires in June 1998, to reportedly be based to a great extent on the ERAP model. The ERAP provides for: (1) The early identification of fair and equitable shares of liability, including an orphan share, where appropriate, to be paid by the state; (2) The elimination of all joint and several liability; (3) Cleanup levels and remedies based on the foreseeable planned use of the site; (4) Site specific risk assessments based on the latest risk assessment protocols; (5) Use of an arbitrator to quickly resolve all significant liability and technical disputes; and (6) Broad and timely releases from future liability upon completion of cleanup.