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Sample records for proven treatment protocols

  1. Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic

    DEFF Research Database (Denmark)

    Most, Sebastian W; Højgaard, Birgitte; Teilmann, Grete Katrine

    2015-01-01

    BACKGROUND: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol. METHODS: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th......, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time. CONCLUSIONS: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time...... percentile for sex and age were eligible for inclusion. At baseline patients' height, weight, and tanner stages were measured, as well as parents' socioeconomic status (SES) and family structure. Parental weight and height were self-reported. An individualised treatment plan including numerous advices...

  2. Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

    Science.gov (United States)

    This issue paper, developed for EPA's Engineering Forum, identifies and summarizes experiences with proven aboveground treatment alternatives for arsenic in groundwater, and provides information on their relative effectiveness and cost.

  3. Extraction protocols for orthodontic treatment: A retrospective study

    Directory of Open Access Journals (Sweden)

    Vaishnevi N Thirunavukkarasu

    2016-01-01

    Full Text Available Background and Objectives: Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics. Materials and Methods: One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance. Results: The descriptive statistics of the study revealed a total of 40 (29% patients in protocol 1, 43 (31.2% in protocol 2, 18 (13% in protocol 3, 16 (11.6% in protocol 5, and 12 (8.7% in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals. Conclusion: Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors.

  4. Establishing treatment protocols for clinical mastitis.

    Science.gov (United States)

    Roberson, Jerry R

    2003-03-01

    Each farm has a unique mix of mastitis pathogens and management procedures that have evolved over time. The herd veterinarian should work with the manager/owner to systematically develop treatment protocols that meet the needs and management of the farm. To establish a mastitis treatment protocol, it is necessary to develop a system to routinely identify clinical mastitis cases, develop a herd-specific severity level assessment system, manage the clinical mastitis cases based on severity level and culture result (when available), avoid antibiotic residues, and monitor the success of the system and alter the protocol as necessary.

  5. The Protocol of Choice for Treatment of Snake Bite

    Directory of Open Access Journals (Sweden)

    Afshin Mohammad Alizadeh

    2016-01-01

    Full Text Available The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF, and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89% were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS. Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values.

  6. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study.

    Science.gov (United States)

    Quanbeck, Andrew R; Gustafson, David H; Marsch, Lisa A; McTavish, Fiona; Brown, Randall T; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E; Atwood, Amy K; McDowell, Helene

    2014-05-29

    Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods - pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance - with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of

  7. Three-stage treatment protocol for recalcitrant distal femoral nonunion.

    Science.gov (United States)

    Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien

    2017-04-01

    In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated. Osseous union with angular deformity lengthening was 5.88 cm (range 3.5-12 cm). Excellent or good outcomes were obtained in 9 patients. Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

  8. Hybrid protocols plus natural treatments for inflammatory conditions.

    Science.gov (United States)

    1998-01-01

    Hybrid protocols combine one, two, or three pharmaceutical drugs with several nutritional or immune-based therapies. These protocols are not limited solely to FDA-approved drugs or strictly to alternative therapies. The rationale for using a hybrid protocol is to find an effective antiviral regimen that also restores immune function. The goal is to obtain the benefits of protease inhibitors without viral resistance and side effects which include problems with fat metabolism and cholesterol levels. Natural treatments for inflammatory conditions are also described. Options include licorice root, ginger root, and slippery elm.

  9. The costs and cost-effectiveness of an integrated sepsis treatment protocol.

    Science.gov (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

    2008-04-01

    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

  10. Accelerated treatment protocols: full arch treatment with interim and definitive prostheses.

    Science.gov (United States)

    Drago, Carl

    2012-01-01

    With the advent of titanium, root form implants and osseointegration, dental treatment has undergone a metamorphosis in recent years. These new techniques enable dentists to provide anchorage for various kinds of prostheses that improve masticatory function, esthetics, and comfort for patients. Implant treatment protocols have been improved relative to implant macro- and micro-geometries, surgical and prosthetic components, and treatment times. Over the past 20 years, immediate occlusal function (also known as loading) has been established as a predictable treatment modality, provided certain specific criteria are met. In many cases, edentulous patients, crippled by the loss of their teeth, can undergo outpatient surgical and prosthetic procedures and return to a masticatory function that is near normal--sometimes after only one day of surgical and prosthetic treatment. This treatment option is also available for patients with advanced, generalized periodontal disease. Computer-assisted design/Computer-assisted manufacturing (CAD/CAM) has transformed how dental prostheses are made, offering improved accuracy, longevity, and biocompatibility; along with reduced labor costs and fewer complications than casting technologies. This article reviews the principles associated with immediate occlusal loading and illustrates one specific accelerated prosthodontic treatment protocol used to treat edentulous and partially edentulous patients with interim and definitive prostheses.

  11. From Provenance Standards and Tools to Queries and Actionable Provenance

    Science.gov (United States)

    Ludaescher, B.

    2017-12-01

    The W3C PROV standard provides a minimal core for sharing retrospective provenance information for scientific workflows and scripts. PROV extensions such as DataONE's ProvONE model are necessary for linking runtime observables in retrospective provenance records with conceptual-level prospective provenance information, i.e., workflow (or dataflow) graphs. Runtime provenance recorders, such as DataONE's RunManager for R, or noWorkflow for Python capture retrospective provenance automatically. YesWorkflow (YW) is a toolkit that allows researchers to declare high-level prospective provenance models of scripts via simple inline comments (YW-annotations), revealing the computational modules and dataflow dependencies in the script. By combining and linking both forms of provenance, important queries and use cases can be supported that neither provenance model can afford on its own. We present existing and emerging provenance tools developed for the DataONE and SKOPE (Synthesizing Knowledge of Past Environments) projects. We show how the different tools can be used individually and in combination to model, capture, share, query, and visualize provenance information. We also present challenges and opportunities for making provenance information more immediately actionable for the researchers who create it in the first place. We argue that such a shift towards "provenance-for-self" is necessary to accelerate the creation, sharing, and use of provenance in support of transparent, reproducible computational and data science.

  12. [Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer].

    Science.gov (United States)

    2018-04-01

    Colorectal cancer is one of the most common malignant tumors in China. In 2012 one million thirty six thousand cases of colorectal cancer were diagnosed all over the world, two hundred fifty three thousand cases were diagnosed in China (accounted for 18.6%). China has the largest number of new cases of colorectal cancer in the world. Colorectal cancer has becoming a serious threat of Chinese residents' health. In 2010, the National Ministry of Health organized colorectal cancer expertise of the Chinese Medical Association to write the "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (2010edition), and publish it publicly. In recent years, the National Health and Family Planning Commission has organized experts to revised the protocol 2 times: the first time in 2015, the second time in 2017. The revised part of "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (2017 edition) involves new progress in the field of imaging examination, pathological evaluation, surgery, chemotherpy and radiotherapy. The 2017 edition of the protocol not only referred to the contents of the international guidelines, but also combined with the specific national conditions and clinical practice in China, and also included many evidence-based clinical data in China recently. The 2017 edition of the protocol would further promote the standardization of diagnosis and treatment of colorectal cancer in China, improve the survival and prognosis of patients, and benefit millions of patients with colorectal cancer and their families.

  13. Proton Beam Therapy for Hepatocellular Carcinoma: A Comparison of Three Treatment Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Mizumoto, Masashi; Okumura, Toshiyuki; Hashimoto, Takayuki [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Fukuda, Kuniaki [Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Oshiro, Yoshiko; Fukumitsu, Nobuyoshi [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Abei, Masato [Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Kawaguchi, Atsushi [Biostatistics Center, Kurume University, Fukuoka (Japan); Hayashi, Yasutaka; Ookawa, Ayako; Hashii, Haruko; Kanemoto, Ayae [Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Moritake, Takashi [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Tohno, Eriko [Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Tsuboi, Koji [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Sakae, Takeji [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Sakurai, Hideyuki, E-mail: hsakurai@pmrc.tsukuba.ac.jp [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan)

    2011-11-15

    Background: Our previous results for treatment of hepatocellular carcinoma (HCC) with proton beam therapy revealed excellent local control with low toxicity. Three protocols were used to avoid late complications such as gastrointestinal ulceration and bile duct stenosis. In this study, we examined the efficacy of these protocols. Methods and Materials: The subjects were 266 patients (273 HCCs) treated by proton beam therapy at University of Tsukuba between January 2001 and December 2007. Three treatment protocols (A, 66 GyE in 10 fractions; B, 72.6 GyE in 22 fractions; and C, 77 GyE in 35 fractions) were used, depending on the tumor location. Results: Of the 266 patients, 104, 95, and 60 patients were treated with protocols A, B, and C, respectively. Seven patients with double lesions underwent two different protocols. The overall survival rates after 1, 3 and 5 years were 87%, 61%, and 48%, respectively (median survival, 4.2 years). Multivariate analysis showed that better liver function, small clinical target volume, and no prior treatment (outside the irradiated field) were associated with good survival. The local control rates after 1, 3, and 5 years were 98%, 87%, and 81%, respectively. Multivariate analysis did not identify any factors associated with good local control. Conclusions: This study showed that proton beam therapy achieved good local control for HCC using each of three treatment protocols. This suggests that selection of treatment schedules based on tumor location may be used to reduce the risk of late toxicity and maintain good treatment efficacy.

  14. Aggregation by Provenance Types: A Technique for Summarising Provenance Graphs

    Directory of Open Access Journals (Sweden)

    Luc Moreau

    2015-04-01

    Full Text Available As users become confronted with a deluge of provenance data, dedicated techniques are required to make sense of this kind of information. We present Aggregation by Provenance Types, a provenance graph analysis that is capable of generating provenance graph summaries. It proceeds by converting provenance paths up to some length k to attributes, referred to as provenance types, and by grouping nodes that have the same provenance types. The summary also includes numeric values representing the frequency of nodes and edges in the original graph. A quantitative evaluation and a complexity analysis show that this technique is tractable; with small values of k, it can produce useful summaries and can help detect outliers. We illustrate how the generated summaries can further be used for conformance checking and visualization.

  15. Efficacy of 2 finishing protocols in the quality of orthodontic treatment outcome.

    Science.gov (United States)

    Stock, Gregory J; McNamara, James A; Baccetti, Tiziano

    2011-11-01

    The objectives of this prospective clinical study were to evaluate the quality of treatment outcomes achieved with a complex orthodontic finishing protocol involving serpentine wires and a tooth positioner, and to compare it with the outcomes of a standard finishing protocol involving archwire bends used to detail the occlusion near the end of active treatment. The complex finishing protocol sample consisted of 34 consecutively treated patients; 1 week before debonding, their molar bands were removed, and serpentine wires were placed; this was followed by active wear of a tooth positioner for up to 1 month after debonding. The standard finishing protocol group consisted of 34 patients; their dental arches were detailed with archwire bends and vertical elastics. The objective grading system of the American Board of Orthodontics was used to quantify the quality of the finish at each time point. The Wilcoxon signed rank test was used to compare changes in the complex finishing protocol; the Mann-Whitney U test was used to compare changes between groups. The complex finishing protocol group experienced a clinically significant improvement in objective grading system scores after treatment with the positioner. Mild improvement in posterior space closure was noted after molar band removal, but no improvement in the occlusion was observed after placement of the serpentine wires. Patients managed with the complex finishing protocol also had a lower objective grading system score (14.7) at the end of active treatment than did patients undergoing the standard finishing protocol (23.0). Tooth positioners caused a clinically significant improvement in interocclusal contacts, interproximal contacts, and net objective grading system score; mild improvement in posterior band space was noted after molar band removal 1 week before debond. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  16. Irradiation sensibility of different provenances of Jatropha curcas L. seeds

    International Nuclear Information System (INIS)

    Yang Qing; Xu Congheng; Peng Daiping; Duan Zhubiao; Han Lei; Sun Qixiang; Peng Zhenhua

    2007-01-01

    The irradiation sensibility of 10 provenances of Jatropha curcas L. seeds to 60 Co γ-rays was studied. The results showed that the relationship between relative germination rate of the seeds and the doses of irradiation was negative correlation, and the difference of relative germination rate among different doses treatment was significant at 5% probability level or highly significant at 1% probability level. For seeds of different provenances, the correlation coefficient of linear regression was from -0.89--0.96, and the medial lethal doses (LD 50) of 10 provinces was from 127 Gy to 184 Gy. According to the LD 50, we could divided 10 provinces of J. curcas L. into sensitive provenance, transitional provenances and obtuse provenances. The provenances of Yuanjiang , Yunan (184 Gy) belonged to sensitive provenance; the provenances of Zhenfeng, Guizhou (127 Gy) and the provenances of Yuedong, Hainan (141 Gy) belonged to obtuse provenance; other 7 provenances belonged to transitional provenances. The results provided important experiment basis for germ plasma resources innovation of J. curcas L. (authors)

  17. Adult Rhabdomyosarcoma Survival Improved With Treatment on Multimodality Protocols

    International Nuclear Information System (INIS)

    Gerber, Naamit Kurshan; Wexler, Leonard H.; Singer, Samuel; Alektiar, Kaled M.; Keohan, Mary Louise; Shi, Weiji; Zhang, Zhigang; Wolden, Suzanne

    2013-01-01

    Purpose: Rhabdomyosarcoma (RMS) is a pediatric sarcoma rarely occurring in adults. For unknown reasons, adults with RMS have worse outcomes than do children. Methods and Materials: We analyzed data from all patients who presented to Memorial Sloan-Kettering Cancer Center between 1990 and 2011 with RMS diagnosed at age 16 or older. One hundred forty-eight patients met the study criteria. Ten were excluded for lack of adequate data. Results: The median age was 28 years. The histologic diagnoses were as follows: embryonal 54%, alveolar 33%, pleomorphic 12%, and not otherwise specified 2%. The tumor site was unfavorable in 67% of patients. Thirty-three patients (24%) were at low risk, 61 (44%) at intermediate risk, and 44 (32%) at high risk. Forty-six percent were treated on or according to a prospective RMS protocol. The 5-year rate of overall survival (OS) was 45% for patients with nonmetastatic disease. The failure rates at 5 years for patients with nonmetastatic disease were 34% for local failure and 42% for distant failure. Among patients with nonmetastatic disease (n=94), significant factors associated with OS were histologic diagnosis, site, risk group, age, and protocol treatment. On multivariate analysis, risk group and protocol treatment were significant after adjustment for age. The 5-year OS was 54% for protocol patients versus 36% for nonprotocol patients. Conclusions: Survival in adult patients with nonmetastatic disease was significantly improved for those treated on RMS protocols, most of which are now open to adults

  18. Adult Rhabdomyosarcoma Survival Improved With Treatment on Multimodality Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, Naamit Kurshan [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wexler, Leonard H. [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Singer, Samuel [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Alektiar, Kaled M. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Keohan, Mary Louise [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Shi, Weiji; Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wolden, Suzanne, E-mail: woldens@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-05-01

    Purpose: Rhabdomyosarcoma (RMS) is a pediatric sarcoma rarely occurring in adults. For unknown reasons, adults with RMS have worse outcomes than do children. Methods and Materials: We analyzed data from all patients who presented to Memorial Sloan-Kettering Cancer Center between 1990 and 2011 with RMS diagnosed at age 16 or older. One hundred forty-eight patients met the study criteria. Ten were excluded for lack of adequate data. Results: The median age was 28 years. The histologic diagnoses were as follows: embryonal 54%, alveolar 33%, pleomorphic 12%, and not otherwise specified 2%. The tumor site was unfavorable in 67% of patients. Thirty-three patients (24%) were at low risk, 61 (44%) at intermediate risk, and 44 (32%) at high risk. Forty-six percent were treated on or according to a prospective RMS protocol. The 5-year rate of overall survival (OS) was 45% for patients with nonmetastatic disease. The failure rates at 5 years for patients with nonmetastatic disease were 34% for local failure and 42% for distant failure. Among patients with nonmetastatic disease (n=94), significant factors associated with OS were histologic diagnosis, site, risk group, age, and protocol treatment. On multivariate analysis, risk group and protocol treatment were significant after adjustment for age. The 5-year OS was 54% for protocol patients versus 36% for nonprotocol patients. Conclusions: Survival in adult patients with nonmetastatic disease was significantly improved for those treated on RMS protocols, most of which are now open to adults.

  19. Interoperability Using Lightweight Metadata Standards: Service & Data Casting, OpenSearch, OPM Provenance, and Shared SciFlo Workflows

    Science.gov (United States)

    Wilson, B. D.; Manipon, G.; Hua, H.; Fetzer, E.

    2011-12-01

    Under several NASA grants, we are generating multi-sensor merged atmospheric datasets to enable the detection of instrument biases and studies of climate trends over decades of data. For example, under a NASA MEASURES grant we are producing a water vapor climatology from the A-Train instruments, stratified by the Cloudsat cloud classification for each geophysical scene. The generation and proper use of such multi-sensor climate data records (CDR's) requires a high level of openness, transparency, and traceability. To make the datasets self-documenting and provide access to full metadata and traceability, we have implemented a set of capabilities and services using known, interoperable protocols. These protocols include OpenSearch, OPeNDAP, Open Provenance Model, service & data casting technologies using Atom feeds, and REST-callable analysis workflows implemented as SciFlo (XML) documents. We advocate that our approach can serve as a blueprint for how to openly "document and serve" complex, multi-sensor CDR's with full traceability. The capabilities and services provided include: - Discovery of the collections by keyword search, exposed using OpenSearch protocol; - Space/time query across the CDR's granules and all of the input datasets via OpenSearch; - User-level configuration of the production workflows so that scientists can select additional physical variables from the A-Train to add to the next iteration of the merged datasets; - Efficient data merging using on-the-fly OPeNDAP variable slicing & spatial subsetting of data out of input netCDF and HDF files (without moving the entire files); - Self-documenting CDR's published in a highly usable netCDF4 format with groups used to organize the variables, CF-style attributes for each variable, numeric array compression, & links to OPM provenance; - Recording of processing provenance and data lineage into a query-able provenance trail in Open Provenance Model (OPM) format, auto-captured by the workflow engine

  20. Effectiveness of a transdiagnostic internet-based protocol for the treatment of emotional disorders versus treatment as usual in specialized care: study protocol for a randomized controlled trial.

    Science.gov (United States)

    González-Robles, Alberto; García-Palacios, Azucena; Baños, Rosa; Riera, Antonio; Llorca, Ginés; Traver, Francisco; Haro, Gonzalo; Palop, Vicente; Lera, Guillem; Romeu, José Enrique; Botella, Cristina

    2015-10-31

    Emotional disorders (depression and anxiety disorders) are highly prevalent mental health problems. Although evidence showing the effectiveness of disorder-specific treatments exists, high comorbidity rates among emotional disorders limit the utility of these protocols. This has led some researchers to focus their interest on transdiagnostic interventions, a treatment perspective that might be more widely effective across these disorders. Also, the current way of delivering treatments makes it difficult provide assistance to all of the population in need. The use of the Internet in the delivery of evidence-based treatments may help to disseminate treatments among the population. In this study, we aim to test the effectiveness of EmotionRegulation, a new transdiagnostic Internet-based protocol for unipolar mood disorders, five anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder and anxiety disorder not otherwise specified), and obsessive-compulsive disorder in comparison to treatment as usual as provided in Spanish public specialized mental health care. We will also study its potential impact on basic temperament dimensions (neuroticism/behavioral inhibition and extraversion/behavioral activation). Expectations and opinions of patients about this protocol will also be studied. The study is a randomized controlled trial. 200 participants recruited in specialized care will be allocated to one of two treatment conditions: a) EmotionRegulation or b) treatment as usual. Primary outcome measures will be the BAI and the BDI-II. Secondary outcomes will include a specific measure of the principal disorder, and measures of neuroticism/behavioral inhibition and extraversion/behavioral activation. Patients will be assessed at baseline, post-treatment, and 3- and 12-month follow-ups. Intention to treat and per protocol analyses will be performed. Although the effectiveness of face-to-face transdiagnostic protocols has been

  1. Flow-Based Provenance

    Directory of Open Access Journals (Sweden)

    Sabah Al-Fedaghi

    2017-02-01

    Full Text Available Aim/Purpose: With information almost effortlessly created and spontaneously available, current progress in Information and Communication Technology (ICT has led to the complication that information must be scrutinized for trustworthiness and provenance. Information systems must become provenance-aware to be satisfactory in accountability, reproducibility, and trustworthiness of data. Background:\tMultiple models for abstract representation of provenance have been proposed to describe entities, people, and activities involved in producing a piece of data, including the Open Provenance Model (OPM and the World Wide Web Consortium. These models lack certain concepts necessary for specifying workflows and encoding the provenance of data products used and generated. Methodology: Without loss of generality, the focus of this paper is on OPM depiction of provenance in terms of a directed graph. We have redrawn several case studies in the framework of our proposed model in order to compare and evaluate it against OPM for representing these cases. Contribution: This paper offers an alternative flow-based diagrammatic language that can form a foundation for modeling of provenance. The model described here provides an (abstract machine-like representation of provenance. Findings: The results suggest a viable alternative in the area of diagrammatic representation for provenance applications. Future Research: Future work will seek to achieve more accurate comparisons with current models in the field.

  2. A correctness proof of the bakery protocol in $ mu $CRL

    NARCIS (Netherlands)

    J.F. Groote (Jan Friso); H.P. Korver

    1994-01-01

    textabstractA specification of a bakery protocol is given in $mu$CRL. We provide a simple correctness criterion for the protocol. Then the protocol is proven correct using a proof system that has been developed for $mu$CRL. The proof primarily consists of algebraic manipulations based on

  3. A Correctness Proof of the Bakery Protocol in μCRL

    NARCIS (Netherlands)

    Groote, J.F.; Korver, H.

    1992-01-01

    A specification of the bakery protocol is given in μCRL. We provide a simple correctness criterion for the protocol. Then the protocol is proven correct using a proof system that has been developed for μCRL. The proof primarily consists of algebraic manipulations based on specifications of

  4. Evaluation of cardiopulmonary and inflammatory markers in dogs with heartworm infection during treatment with the 2014 American Heartworm Society recommended treatment protocol

    Directory of Open Access Journals (Sweden)

    Won-Kyoung Yoon

    2017-11-01

    Full Text Available Abstract Background Heartworm disease in dogs is a life-threatening parasitic disease. Although adulticide treatment with melarsomine has been proven to be the most effective, complications associated with adulticide treatment are major concerns for clinicians. Methods This study evaluated the change in levels of D-dimer, interleukin-6, C-reactive protein and cardiac troponin I in 12 dogs with different severities of heartworm infection treated by the American Heartworm Society (AHS recommended protocol during the treatment period. The serum levels of several markers were measured on the day of diagnosis (T-60, before the initiation of melarsomine therapy (T0, 1 day after the first injection (T1, 1 week after the first injection (T7, 1 month after the first injection (T30, 1 day after the second injection (T31, 1 day after the third injection (T32, 1 week after the third injection (T39, 1 month after the third injection (T62, 2 months after the third injection (T92, 3 months after the third injection (T122, and 6 months after the third injection (T182. Results The serum levels of these markers were significantly different at the test time point after melarsomine treatment and also differed significantly according to the stage of heartworm disease in the dogs. Conclusion This study found that monitoring of inflammatory and hemostatic markers in dogs with heartworm disease being treated with melarsomine might be beneficial in predicting the clinical outcomes and complications associated with melarsomine treatment.

  5. Evaluation of image-guidance protocols in the treatment of head and neck cancers

    International Nuclear Information System (INIS)

    Zeidan, Omar A.; Langen, Katja M.; Meeks, Sanford L.; Manon, Rafael R.; Wagner, Thomas H.; Willoughby, Twyla R.; Jenkins, D. Wayne; Kupelian, Patrick A.

    2007-01-01

    Purpose: The aim of this study was to assess the residual setup error of different image-guidance (IG) protocols in the alignment of patients with head and neck cancer. The protocols differ in the percentage of treatment fractions that are associated with image guidance. Using data from patients who were treated with daily IG, the residual setup errors for several different protocols are retrospectively calculated. Methods and Materials: Alignment data from 24 patients (802 fractions) treated with daily IG on a helical tomotherapy unit were analyzed. The difference between the daily setup correction and the setup correction that would have been made according to a specific protocol was used to calculate the residual setup errors for each protocol. Results: The different protocols are generally effective in reducing systematic setup errors. Random setup errors are generally not reduced for fractions that are not image guided. As a consequence, if every other treatment is image guided, still about 11% of all treatments (IG and not IG) are subject to three-dimensional setup errors of at least 5 mm. This frequency increases to about 29% if setup errors >3 mm are scored. For various protocols that require 15% to 31% of the treatments to be image guided, from 50% to 60% and from 26% to 31% of all fractions are subject to setup errors >3 mm and >5 mm, respectively. Conclusion: Residual setup errors reduce with increasing frequency of IG during the course of external-beam radiotherapy for head-and-neck cancer patients. The inability to reduce random setup errors for fractions that are not image guided results in notable residual setup errors

  6. Diverging Drought Resistance of Scots Pine Provenances Revealed by Infrared Thermography

    Directory of Open Access Journals (Sweden)

    Hannes Seidel

    2016-08-01

    Full Text Available With recent climate changes, Scots pine (Pinus sylvestris L. forests have been affected by die-off events. Assisted migration of adapted provenances mitigates drought impacts and promotes forest regeneration. Although suitable provenances are difficult to identify by traditional ecophysiological techniques, which are time consuming and invasive, plant water status can be easily assessed by infrared thermography. Thus, we examined the stress responses of 2-year-old potted Scots pine seedlings from six provenances (Bulgaria, France, Germany, Italy, Poland, and Spain based on two thermal indices (crop water stress index and stomatal conductance index. Both indices were derived from infrared images during a six-week drought/control treatment in a greenhouse in the summer of 2013. The pines were monitored during the stress and subsequent recovery period. After controlling for fluctuating environmental conditions, soil moisture or treatment-specific water supply was the most important driver of drought stress. The stress magnitude and response to soil water deficit depended on provenance. Under moderate drought conditions, pines from western and eastern Mediterranean provenances (Bulgaria, France, and Spain expressed lower stress levels than those from both continental provenances (Germany and Poland. In pines from the Spanish and Bulgarian provenances, the stress level differences were significantly lower than in continental pines. Moreover, pines from continental provenances were less resilient (showed less recovery after the stress period than Mediterranean pines. Under extreme drought, all provenances were equally stressed with almost no significant differences in their thermal indices. Provenance-specific differences in drought resistance, which are associated with factors such as summer precipitation at the origin of Scots pine seedlings, may offer promising tracks of adaptation to future drought risks.

  7. Password-only authenticated three-party key exchange proven secure against insider dictionary attacks.

    Science.gov (United States)

    Nam, Junghyun; Choo, Kim-Kwang Raymond; Paik, Juryon; Won, Dongho

    2014-01-01

    While a number of protocols for password-only authenticated key exchange (PAKE) in the 3-party setting have been proposed, it still remains a challenging task to prove the security of a 3-party PAKE protocol against insider dictionary attacks. To the best of our knowledge, there is no 3-party PAKE protocol that carries a formal proof, or even definition, of security against insider dictionary attacks. In this paper, we present the first 3-party PAKE protocol proven secure against both online and offline dictionary attacks as well as insider and outsider dictionary attacks. Our construct can be viewed as a protocol compiler that transforms any 2-party PAKE protocol into a 3-party PAKE protocol with 2 additional rounds of communication. We also present a simple and intuitive approach of formally modelling dictionary attacks in the password-only 3-party setting, which significantly reduces the complexity of proving the security of 3-party PAKE protocols against dictionary attacks. In addition, we investigate the security of the well-known 3-party PAKE protocol, called GPAKE, due to Abdalla et al. (2005, 2006), and demonstrate that the security of GPAKE against online dictionary attacks depends heavily on the composition of its two building blocks, namely a 2-party PAKE protocol and a 3-party key distribution protocol.

  8. Lahore general hospital protocol for treatment of neovascular glaucoma caused by retinal disease

    International Nuclear Information System (INIS)

    Khaqan, H.A.; Haider, S.A.

    2013-01-01

    To evaluate efficacy of LGH (Lahore General Hospital) protocol for treatment of neovascular glaucoma caused by retinal diseases. Material and Methods: This case series was performed on 9 consecutive eyes of nine patients with uncontrolled neovascular glaucoma at Department of Ophthalmology, Unit II, Lahore General Hospital/PGMI, Lahore. All nine patients completed six months follow up. Among them 6 patients were having PDR (proliferative diabetic retinopathy) and 3 patients having CRVO (central retinal vein occlusion). LGH protocol for treatment of neovascular glaucoma was: To give intravitreal injection of avastin and then PRP (Pan Retinal Photocoagulation) or Trabeculectomy with MMC (Mitomycin C), if PRP and intravitreal avastin fails to control the intra ocular-pressure (IOP). Results: Three patients had IOP control after intravitreal injection of avastin and PRP, 5 patients had uncontrolled IOP after intravitreal avastin and two sessions of PRP, so they under went trabeculectomy with MMC. One patient had uncontrolled IOP despite of full treatment protocol. All other 8 patients IOP remained stable for six months. Conclusion: Significant decrease in intraocular pressure was achieved after observing LGH protocol for treatment of NVG (Neovascular Glaucoma) caused by retinal diseases. (author)

  9. Using research literature to develop a perceptual retraining treatment protocol.

    Science.gov (United States)

    Neistadt, M E

    1994-01-01

    Treatment protocols derived from research literature can help therapists provide more rigorous treatment and more systematic assessment of client progress. This study applied research findings about the influence of task, subject, and feedback parameters on adult performance with block designs to an occupational therapy treatment protocol for parquetry block assembly--an activity occupational therapists use to remediate constructional deficits. Task parameter research suggests that parquetry tasks can be graded according to the features of the design cards, with cards having all block boundaries drawn in being easier than those with some block boundaries omitted. Subject parameter findings suggest that clients' lesions and initial constructional competence can influence their approaches to parquetry tasks. Feedback parameter research suggests that a combination of perceptual and planning cues is most effective for parquetry tasks. Methods to help clients transfer constructional skills from parquetry to functional tasks are also discussed.

  10. Treatment Protocol for High Velocity/High Energy Gunshot Injuries to the Face

    Science.gov (United States)

    Peled, Micha; Leiser, Yoav; Emodi, Omri; Krausz, Amir

    2011-01-01

    Major causes of facial combat injuries include blasts, high-velocity/high-energy missiles, and low-velocity missiles. High-velocity bullets fired from assault rifles encompass special ballistic properties, creating a transient cavitation space with a small entrance wound and a much larger exit wound. There is no dispute regarding the fact that primary emergency treatment of ballistic injuries to the face commences in accordance with the current advanced trauma life support (ATLS) recommendations; the main areas in which disputes do exist concern the question of the timing, sequence, and modes of surgical treatment. The aim of the present study is to present the treatment outcome of high-velocity/high-energy gunshot injuries to the face, using a protocol based on the experience of a single level I trauma center. A group of 23 injured combat soldiers who sustained bullet and shrapnel injuries to the maxillofacial region during a 3-week regional military conflict were evaluated in this study. Nine patients met the inclusion criteria (high-velocity/high-energy injuries) and were included in the study. According to our protocol, upon arrival patients underwent endotracheal intubation and were hemodynamically stabilized in the shock-trauma unit and underwent total-body computed tomography with 3-D reconstruction of the head and neck and computed tomography angiography. All patients underwent maxillofacial surgery upon the day of arrival according to the protocol we present. In view of our treatment outcomes, results, and low complication rates, we conclude that strict adherence to a well-founded and structured treatment protocol based on clinical experience is mandatory in providing efficient, appropriate, and successful treatment to a relatively large group of patients who sustain various degrees of maxillofacial injuries during a short period of time. PMID:23449809

  11. Comparison between two treatment protocols with recombinant Human Erythropoietin (rHuEpo in the treatment of late anemia in neonates with Rh-Isoimmunization

    Directory of Open Access Journals (Sweden)

    A.A. Zuppa

    2012-08-01

    Full Text Available Objectve. The Rh-hemolytic disease can lead to a late anemia by hemolytic and hyporigenerative mechanism. We compared the effectiveness of rHuEPO in two care protocols that differ for doses of rHuEPO administrated and for timing of administration. Methods. A cohort of 14 neonates was investigated. The neonates were treated with two different protocols. Protocol A: a dose of 200 U/kg/day of rHuEpo administered subcutaneously starting from the end of the second week of life; Protocol B: a dose of 400 U/kg/day of rHuEpo administered subcutaneously starting from the end of the first week of life. Results. The hematocrit values in the protocol A group decreased during treatment (32,5% vs 25,2%, whereas the hematocrit value in protocol B group remained almost stable (38,7% vs 42,8%. The mean numbers of platelets remained stable in both groups while neutrophils increased in protocol A group and decreased in protocol B (p<0,05. Reticulocyte count increased during treatment in both groups, although only in protocol B group it was statistically significative (p<0,05. Conclusions. Our results suggest a similar efficacy between the two treatment protocols. Increasing doses of rHuEPO do not seem enhancing their effectiveness and the incidence of side effects.

  12. Early signaling, referral, and treatment of adolescent chronic pain: a study protocol

    Directory of Open Access Journals (Sweden)

    Voerman Jessica S

    2012-06-01

    Full Text Available Abstract Background Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study. Methods and design The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition. Discussion If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based. Trial registration Dutch Trial Register NTR1926

  13. New protocol of clomiphene citrate treatment in women with hypothalamic amenorrhea.

    Science.gov (United States)

    Borges, Lavinia Estrela; Morgante, Giuseppe; Musacchio, Maria Concetta; Petraglia, Felice; De Leo, Vincenzo

    2007-06-01

    To determine if a new protocol of administration of clomiphene citrate (CC) is effective in menstrual cycle recovery in women with hypothalamic secondary amenorrhea. This was an open-label study. Patients comprised a group of eight women with secondary amenorrhea. Interventions. An oral preparation containing CC (50 mg/day) was administered for 5 days followed by a double dose (100 mg/day) for another 5 days, initiated on day 3 after estrogen/progestogen-induced withdrawal bleeding. If ovulation and vaginal bleeding occurred, treatment continued in the two next months with 100 mg/day from day 3 to day 7 day of the cycle. Cycle control was evaluated at each visit, when patients recorded bleeding patterns and tablet intake. Data on the intensity and duration of bleeding were collected. Six patients responded to the first cycle of CC administration, resuming normal menstrual cycles. The other two patients failed to menstruate after the first 10 days of treatment with CC and repeated the same protocol. After the second administration, these two women also had normal menstrual bleeding. The present data show that this new protocol of CC treatment may be useful to restore normal menstrual cycles in young women with hypothalamic amenorrhea.

  14. Single-Rooted Extraction Sockets: Classification and Treatment Protocol.

    Science.gov (United States)

    El Chaar, Edgar; Oshman, Sarah; Fallah Abed, Pooria

    2016-09-01

    Clinicians have many treatment techniques from which to choose when extracting a failing tooth and replacing it with an implant-supported restoration and when successful management of an extraction socket during the course of tooth replacement is necessary to achieve predictable and esthetic outcomes. This article presents a straightforward, yet thorough, classification for extraction sockets of single-rooted teeth and provides guidance to clinicians in the selection of appropriate and predictable treatment. The presented classification of extraction sockets for single-rooted teeth focuses on the topography of the extraction socket, while the protocol for treatment of each socket type factors in the shape of the remaining bone, the biotype, and the location of the socket whether it be in the mandible or maxilla. This system is based on the biologic foundations of wound healing and can help guide clinicians to successful treatment outcomes.

  15. Security of modified Ping-Pong protocol in noisy and lossy channel

    OpenAIRE

    Han, Yun-Guang; Yin, Zhen-Qiang; Li, Hong-Wei; Chen, Wei; Wang, Shuang; Guo, Guang-Can; Han, Zheng-Fu

    2014-01-01

    The “Ping-Pong” (PP) protocol is a two-way quantum key protocol based on entanglement. In this protocol, Bob prepares one maximally entangled pair of qubits, and sends one qubit to Alice. Then, Alice performs some necessary operations on this qubit and sends it back to Bob. Although this protocol was proposed in 2002, its security in the noisy and lossy channel has not been proven. In this report, we add a simple and experimentally feasible modification to the original PP protocol, and prove ...

  16. Improving treatment times for patients with in-hospital stroke using a standardized protocol.

    Science.gov (United States)

    Koge, Junpei; Matsumoto, Shoji; Nakahara, Ichiro; Ishii, Akira; Hatano, Taketo; Sadamasa, Nobutake; Kai, Yasutoshi; Ando, Mitsushige; Saka, Makoto; Chihara, Hideo; Takita, Wataru; Tokunaga, Keisuke; Kamata, Takahiko; Nishi, Hidehisa; Hashimoto, Tetsuya; Tsujimoto, Atsushi; Kira, Jun-Ichi; Nagata, Izumi

    2017-10-15

    Previous reports have shown significant delays in treatment of in-hospital stroke (IHS). We developed and implemented our IHS alert protocol in April 2014. We aimed to determine the influence of implementation of our IHS alert protocol. Our implementation processes comprise the following four main steps: IHS protocol development, workshops for hospital staff to learn about the protocol, preparation of standardized IHS treatment kits, and obtaining feedback in a monthly hospital staff conference. We retrospectively compared protocol metrics and clinical outcomes of patients with IHS treated with intravenous thrombolysis and/or endovascular therapy between before (January 2008-March 2014) and after implementation (April 2014-December 2016). Fifty-five patients were included (pre, 25; post, 30). After the implementation, significant reductions occurred in the median time from stroke recognition to evaluation by a neurologist (30 vs. 13.5min, pvs. 26.5min, pvs. 16min, p=0.02). The median time from first neuroimaging to endovascular therapy had a tendency to decrease (75 vs. 53min, p=0.08). There were no differences in the favorable outcomes (modified Rankin scale score of 0-2) at discharge or the incidence of symptomatic intracranial hemorrhage between the two periods. Our IHS alert protocol implementation saved time in treating patients with IHS without compromising safety. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Optimizing stormwater treatment practices a handbook of assessment and maintenance

    CERN Document Server

    Erickson, Andrew J; Gulliver, John S

    2013-01-01

    Optimizing Stormwater Treatment Practices: A Handbook of Assessment and Maintenance provides the information necessary for developing and operating an effective maintenance program for stormwater treatment. The book offers instructions on how to measure the level of performance of stormwater treatment practices directly and bases proposed maintenance schedules on actual performance and historical maintenance efforts and costs. The inspection methods, which are proven in the field and have been implemented successfully, are necessary as regulatory agencies are demanding evaluations of the performance of stormwater treatment practices. The authors have developed a three-tiered approach that offers readers a standard protocol for how to determine the effectiveness of stormwater treatment practices currently in place. This book also: Provides a standard protocol for how to determine the effectiveness of stormwater treatment practices Assists readers with identifying which assessment techniques to use for stormwa...

  18. Empowering Provenance in Data Integration

    Science.gov (United States)

    Kondylakis, Haridimos; Doerr, Martin; Plexousakis, Dimitris

    The provenance of data has recently been recognized as central to the trust one places in data. This paper presents a novel framework in order to empower provenance in a mediator based data integration system. We use a simple mapping language for mapping schema constructs, between an ontology and relational sources, capable to carry provenance information. This language extends the traditional data exchange setting by translating our mapping specifications into source-to-target tuple generating dependencies (s-t tgds). Then we define formally the provenance information we want to retrieve i.e. annotation, source and tuple provenance. We provide three algorithms to retrieve provenance information using information stored on the mappings and the sources. We show the feasibility of our solution and the advantages of our framework.

  19. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40

    Science.gov (United States)

    Boone, Margaret; Brown, Nancy J.; Moon, Mary A.; Schuman, Deborah J.; Thomas, Josephine; Wright, Denise L.

    2004-01-01

    This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts…

  20. Efficacy of a sedo-analgesia protocol in pre-hospital trauma treatment

    Directory of Open Access Journals (Sweden)

    Savino Occhionorelli

    2013-06-01

    Full Text Available Pre-hospital trauma treatment is an important situation in which pain should be appropriately assessed and treated, but there is a great lack of studies about it. Literature has widely pointed out that the underanalgesia problem is spread to all groups of patients. The objective of the study is to verify the efficacy of a sedation-analgesia protocol based on the use of NSAIDs, Fentanyl and Midazolam, for prehospital treatment of trauma patients. The protocol was tested in three Emergency Medical Services for a four month period, in which 30 patients were included in the study. Results evidenced a good management of both pain and anxiety in the majority of patients treated, with the achievement of analgesia target in 80% of the patients and sedation target in 100% of the patients.

  1. Logical provenance in data-oriented workflows?

    KAUST Repository

    Ikeda, R.

    2013-04-01

    We consider the problem of defining, generating, and tracing provenance in data-oriented workflows, in which input data sets are processed by a graph of transformations to produce output results. We first give a new general definition of provenance for general transformations, introducing the notions of correctness, precision, and minimality. We then determine when properties such as correctness and minimality carry over from the individual transformations\\' provenance to the workflow provenance. We describe a simple logical-provenance specification language consisting of attribute mappings and filters. We provide an algorithm for provenance tracing in workflows where logical provenance for each transformation is specified using our language. We consider logical provenance in the relational setting, observing that for a class of Select-Project-Join (SPJ) transformations, logical provenance specifications encode minimal provenance. We have built a prototype system supporting the features and algorithms presented in the paper, and we report a few preliminary experimental results. © 2013 IEEE.

  2. Special Section: The third provenance challenge on using the open provenance model for interoperability

    NARCIS (Netherlands)

    Simmhan, Y; Groth, P.T.; Moreau, L

    2011-01-01

    The third provenance challenge was organized to evaluate the efficacy of the Open Provenance Model (OPM) in representing and sharing provenance with the goal of improving the specification. A data loading scientific workflow that ingests data files into a relational database for the Pan-STARRS sky

  3. Our Approach to Toxic Epidermal Necrolysis and Review of Current Treatment Alternatives

    Directory of Open Access Journals (Sweden)

    Fatih Uygur

    2008-09-01

    Full Text Available Toxic epidermal necrolysis (TEN is a clinical entity which has a 30 to 40 % mortality rate, with necrolysis affecting the entire epidermis. Antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants are offender drugs in TEN etiology. A standard treatment protocol with proven efficacy is still lacking. In this study, current treatment practice and our treatment strategy for TEN is discussed and eight patients treated in our clinic between the years 2001 and 2008 are reviewed.

  4. PROTOCOL OF TREATMENT IN LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    Alisson Guimbala dos Santos Araujo

    2013-09-01

    Full Text Available Low back pain can be considered as one of the main factors that lead to decreased functional capacity of the human being. Being a frequent dysfunction in people, causing a decrease in quality of life, productivity and functional disability and is associated with important social and economic impact. Therefore the objective of the research was to assess the treatment protocols in low back pain. The study is characterized by being a literature of scientific articles, based on data published in PubMed, SciELO, BIREME and Cochrane from 2000 to 2012. We found eight scientific articles that addressed physical therapy methods in the treatment of low back pain, including a literature review. Related Articles show variation from one to 55 patients in groups, with a total of 185 patients studied. It was concluded then that it hasn’t met a specific treatment that is placed as the most effective for this pathology, although all include electrotherapy, manual therapy, exercise and RPG they show significant results in pain relief, quality of life thereby increasing functionality.

  5. EFFECTS OF COLD STRATIFICATION AND GA3 ON GERMINATION OF ARBUTUS UNEDO SEEDS OF THREE PROVENANCES.

    Science.gov (United States)

    Pipinis, Elias; Stampoulidis, Athanasios; Milios, Elias; Kitikidou, Kyriaki; Radoglou, Kalliopi

    2017-01-01

    Arbutus unedo is a valuable Mediterranean shrub as an ornamental plant as well as fruit tree. Fresh fruits of A. unedo are a good source of antioxidants, of vitamins C, E and carotenoids and also are characterized by the high content of mineral elements. The effects of gibberellic acid (GA 3 ) and cold stratification (CS) on seed germination performance were investigated in A. unedo seeds collected from three provenances in the Northern part of Greece. Seeds of each provenance were soaked in solutions of GA 3 (500, 1000 or 2000 ppm) for 24 h and subsequently were subjected to CS at 3 - 5°C for 0, 1, 2, and 3 months. Non-stratified seeds of the three A. unedo provenances which were not treated with GA 3 solutions exhibited very low germination. However, seed germination was significantly improved after a one-month period of CS. Similarly, the non-stratified seeds of all three provenances became non-dormant after the treatment with 2000 ppm GA 3 and they germinated at high percentages. However, in untreated seeds with GA3, after a one-month CS period the seeds of the Pieria provenance exhibited higher germination percentage than that of Rodopi provenance seeds. Furthermore, in non-stratified seeds, the Pieria provenance seeds treated with GA3 germinated at higher percentages and more rapidly than those of the other two provenances. The results indicated that untreated seeds exhibited very low germination at 20/25°C. However, in all three provenances seed germinability was significantly improved by a one-month period of CS or treatment of seeds with 2000 ppm GA3. Furthermore, there was a considerable variability among seed provenances in response to the treatments which were applied.

  6. Security of modified Ping-Pong protocol in noisy and lossy channel.

    Science.gov (United States)

    Han, Yun-Guang; Yin, Zhen-Qiang; Li, Hong-Wei; Chen, Wei; Wang, Shuang; Guo, Guang-Can; Han, Zheng-Fu

    2014-05-12

    The "Ping-Pong" (PP) protocol is a two-way quantum key protocol based on entanglement. In this protocol, Bob prepares one maximally entangled pair of qubits, and sends one qubit to Alice. Then, Alice performs some necessary operations on this qubit and sends it back to Bob. Although this protocol was proposed in 2002, its security in the noisy and lossy channel has not been proven. In this report, we add a simple and experimentally feasible modification to the original PP protocol, and prove the security of this modified PP protocol against collective attacks when the noisy and lossy channel is taken into account. Simulation results show that our protocol is practical.

  7. File Level Provenance Tracking in CMS

    CERN Document Server

    Jones, C D; Paterno, M; Sexton-Kennedy, L; Tanenbaum, W; Riley, D S

    2009-01-01

    The CMS off-line framework stores provenance information within CMS's standard ROOT event data files. The provenance information is used to track how each data product was constructed, including what other data products were read to do the construction. We will present how the framework gathers the provenance information, the efforts necessary to minimise the space used to store the provenance in the file and the tools that will be available to use the provenance.

  8. Provenance management in Swift with implementation details.

    Energy Technology Data Exchange (ETDEWEB)

    Gadelha, L. M. R; Clifford, B.; Mattoso, M.; Wilde, M.; Foster, I. (Mathematics and Computer Science); ( CLS-CI); (Federal Univ. of Rio de Janeiro); (National Lab. for Scientific Computing, Brazil); (Univ. of Chicago)

    2011-04-01

    The Swift parallel scripting language allows for the specification, execution and analysis of large-scale computations in parallel and distributed environments. It incorporates a data model for recording and querying provenance information. In this article we describe these capabilities and evaluate interoperability with other systems through the use of the Open Provenance Model. We describe Swift's provenance data model and compare it to the Open Provenance Model. We also describe and evaluate activities performed within the Third Provenance Challenge, which consisted of implementing a specific scientific workflow, capturing and recording provenance information of its execution, performing provenance queries, and exchanging provenance information with other systems. Finally, we propose improvements to both the Open Provenance Model and Swift's provenance system.

  9. Proven Weight Loss Methods

    Science.gov (United States)

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. It can lower ... at www.hormone.org/Spanish . Proven Weight Loss Methods Fact Sheet www.hormone.org

  10. Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols

    Directory of Open Access Journals (Sweden)

    Stacey Dawn

    2012-11-01

    Full Text Available Abstract Background Management of cancer treatment-related symptoms is an important safety issue given that symptoms can become life-threatening and often occur when patients are at home. With funding from the Canadian Partnership Against Cancer, a pan-Canadian steering committee was established with representation from eight provinces to develop symptom protocols using a rigorous methodology (CAN-IMPLEMENT©. Each protocol is based on a systematic review of the literature to identify relevant clinical practice guidelines. Protocols were validated by cancer nurses from across Canada. The aim of this study is to build an effective and sustainable approach for implementing evidence-informed protocols for nurses to use when providing remote symptom assessment, triage, and guidance in self-management for patients experiencing symptoms while undergoing cancer treatments. Methods A prospective mixed-methods study design will be used. Guided by the Knowledge to Action Framework, the study will involve (a establishing an advisory knowledge user team in each of three targeted settings; (b assessing factors influencing nurses’ use of protocols using interviews/focus groups and a standardized survey instrument; (c adapting protocols for local use, ensuring fidelity of the content; (d selecting intervention strategies to overcome known barriers and implementing the protocols; (e conducting think-aloud usability testing; (f evaluating protocol use and outcomes by conducting an audit of 100 randomly selected charts at each of the three settings; and (g assessing satisfaction with remote support using symptom protocols and change in nurses’ barriers to use using survey instruments. The primary outcome is sustained use of the protocols, defined as use in 75% of the calls. Descriptive analysis will be conducted for the barriers, use of protocols, and chart audit outcomes. Content analysis will be conducted on interviews/focus groups and usability testing

  11. GnRH and prostaglandin-based synchronization protocols as alternatives to progestogen-based treatments in sheep.

    Science.gov (United States)

    Rekik, M; Haile, A; Abebe, A; Muluneh, D; Goshme, S; Ben Salem, I; Hilali, M El-Dine; Lassoued, N; Chanyalew, Y; Rischkowsky, B

    2016-12-01

    The study investigated, for cycling sheep, synchronizing protocols simultaneously to the standard "P" protocol using progestogens priming with intravaginal devices and gonadotropin. In November 2014, 90 adult Menz ewes were assigned to either the "P" protocol, "PGF" treatment where oestrus and ovulation were synchronized using two injections of prostaglandin 11 days apart or a "GnRH" treatment where the ewes had their oestrus and ovulation synchronized with GnRH (day 0)-prostaglandin (day 6)-GnRH (day 9) sequence. The ewes were naturally mated at the induced oestrus and the following 36 days. Plasma progesterone revealed that 92% of the ewes were ovulating before synchronization and all, except one, ovulated in response to the applied treatments. All "P" ewes exhibited oestrus during the 96-hr period after the end of the treatments in comparison with only 79.3% and 73.3% for "PGF" and "GnRH" ewes, respectively (p sheep after the rainy season when most animals are spontaneously cycling. © 2016 Blackwell Verlag GmbH.

  12. A multigear protocol for sampling crayfish assemblages in Gulf of Mexico coastal streams

    Science.gov (United States)

    William R. Budnick; William E. Kelso; Susan B. Adams; Michael D. Kaller

    2018-01-01

    Identifying an effective protocol for sampling crayfish in streams that vary in habitat and physical/chemical characteristics has proven problematic. We evaluated an active, combined-gear (backpack electrofishing and dipnetting) sampling protocol in 20 Coastal Plain streams in Louisiana. Using generalized linear models and rarefaction curves, we evaluated environmental...

  13. Simple replantation protocol to avoid ankylosis in teeth intended for orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Yuli Nugraeni

    2009-03-01

    Full Text Available Background: Dento-alveolar trauma resulted from accidents involving the oral regions mostly affect the upper central incisors. Overjet that is beyond 5 mm and incompetent lip also contribute to increase the risk. Several literatures had already discussed different methods of replantation of avulsed teeth. However, it was not meant for further orthodontic treatment. Purpose: The objective of this review is to propose a simple replantation protocol of avulsed teeth which also prevent from ankylosis. Reviews: Protruded teeth usually need orthodontic treatment; therefore, an appropriate management should be done to avoid the development of ankylosis. Ankylosis of the periodontal ligament (PDL becomes a problem in orthodontic tooth movement in repositioned or replanted teeth. In addition, ankylosed teeth also more susceptible to root resorption. Actually, it was caused by the endodontic treatment. In particular, severely protruded or unoccluded teeth are hypofunctional, therefore have narrow PDL, thus it may facilitate to ankylosis development. Ideal management protocol such as the use of root canal sealer i.e. mineral trioxide aggregate (MTA; the using of Emdogain, and resilient wiring or semi-rigid fixation with brackets has become a solution in avulsed teeth arranged for orthodontic treatment. Nevertheless, the presence of oral surgeon, endodontist and orthodontist in the same time, and also ideal preparations after an accident was difficult to achieve. Conclusion: Considering that reducing the ongoing PDL inflammation with intracanal medicaments and maintaining the functional force during mastication is possible; it is concluded that this simple replantation protocol is likely.

  14. Active Provenance in Data-intensive Research

    Science.gov (United States)

    Spinuso, Alessandro; Mihajlovski, Andrej; Filgueira, Rosa; Atkinson, Malcolm

    2017-04-01

    Scientific communities are building platforms where the usage of data-intensive workflows is crucial to conduct their research campaigns. However managing and effectively support the understanding of the 'live' processes, fostering computational steering, sharing and re-use of data and methods, present several bottlenecks. These are often caused by the poor level of documentation on the methods and the data and how users interact with it. This work wants to explore how in such systems, flexibility in the management of the provenance and its adaptation to the different users and application contexts can lead to new opportunities for its exploitation, improving productivity. In particular, this work illustrates a conceptual and technical framework enabling tunable and actionable provenance in data-intensive workflow systems in support of reproducible science. It introduces the concept of Agile data-intensive systems to define the characteristic of our target platform. It shows a novel approach to the integration of provenance mechanisms, offering flexibility in the scale and in the precision of the provenance data collected, ensuring its relevance to the domain of the data-intensive task, fostering its rapid exploitation. The contributions address aspects of the scale of the provenance records, their usability and active role in the research life-cycle. We will discuss the use of dynamically generated provenance types as the approach for the integration of provenance mechanisms into a data-intensive workflow system. Enabling provenance can be transparent to the workflow user and developer, as well as fully controllable and customisable, depending from their expertise and the application's reproducibility, monitoring and validation requirements. The API that allows the realisation and adoption of a provenance type is presented, especially for what concerns the support of provenance profiling, contextualisation and precision. An actionable approach to provenance

  15. Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases

    Directory of Open Access Journals (Sweden)

    Gülsün Yildirim

    2010-07-01

    Full Text Available Background: The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour.Methods: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years.Results: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations.Conclusions: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

  16. Ocular Manifestations of Biopsy-Proven Pulmonary Sarcoidosis in Korea

    Directory of Open Access Journals (Sweden)

    Seung Yong Choi

    2018-01-01

    Full Text Available Purpose. To investigate the clinical features and ocular manifestations of biopsy-proven pulmonary sarcoidosis in Korea. Methods. 55 patients diagnosed with pulmonary sarcoidosis by bronchoscopic or excisional biopsy were included. By retrospective clinical chart review, we investigated features of uveitis, ocular and systemic treatments, visual acuity, angiotensin-converting enzyme level, chest radiography, and pulmonary function tests. Clinical features were analyzed by presence of uveitis, site of biopsy, and first manifested sign of sarcoidosis. Results. The group with uveitis (n=39 presented with higher systemic (71.8% and immunosuppressive treatment rates (35.9% than the group without uveitis (31.3%, 0%, resp. (P=0.007, P=0.005, resp.. There were no significant differences in clinical features, including systemic treatment rate, by type of biopsy. Of 39 patients with uveitis, the group with ocular manifestation as a first sign of sarcoidosis showed higher systemic and immunosuppressive treatment rates (88.9%, 55.6% compared to the group with pulmonary manifestation as a first sign (57.1%, 19.0% (P=0.037, P=0.018, resp.. Conclusions. In patients with biopsy-proven pulmonary sarcoidosis, the presence of ocular involvement and uveitis as a first sign could be significant factors associated with higher systemic treatment rate, especially with immunosuppressive agents. Biopsy site determined by location and size had no influence on clinical features.

  17. A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

    DEFF Research Database (Denmark)

    Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie

    2017-01-01

    BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

  18. Sensitivity Analysis of Per-Protocol Time-to-Event Treatment Efficacy in Randomized Clinical Trials

    Science.gov (United States)

    Gilbert, Peter B.; Shepherd, Bryan E.; Hudgens, Michael G.

    2013-01-01

    Summary Assessing per-protocol treatment effcacy on a time-to-event endpoint is a common objective of randomized clinical trials. The typical analysis uses the same method employed for the intention-to-treat analysis (e.g., standard survival analysis) applied to the subgroup meeting protocol adherence criteria. However, due to potential post-randomization selection bias, this analysis may mislead about treatment efficacy. Moreover, while there is extensive literature on methods for assessing causal treatment effects in compliers, these methods do not apply to a common class of trials where a) the primary objective compares survival curves, b) it is inconceivable to assign participants to be adherent and event-free before adherence is measured, and c) the exclusion restriction assumption fails to hold. HIV vaccine efficacy trials including the recent RV144 trial exemplify this class, because many primary endpoints (e.g., HIV infections) occur before adherence is measured, and nonadherent subjects who receive some of the planned immunizations may be partially protected. Therefore, we develop methods for assessing per-protocol treatment efficacy for this problem class, considering three causal estimands of interest. Because these estimands are not identifiable from the observable data, we develop nonparametric bounds and semiparametric sensitivity analysis methods that yield estimated ignorance and uncertainty intervals. The methods are applied to RV144. PMID:24187408

  19. Successful Short Desensitization Treatment Protocol with Narrowband UVB Phototherapy (TL-01) in Polymorphic Light Eruption.

    Science.gov (United States)

    Combalia, A; Fernández-Sartorio, C; Fustà, X; Morgado-Carrasco, D; Podlipnik, S; Aguilera, P

    2017-10-01

    Polymorphic light eruption (PLE) is a common idiopathic photodermatosis that typically presents with pruritic papular or papulovesicular lesions on sun-exposed skin between spring and autumn. In many subjects PLE is mild, and can usually be prevented by the use of broad-spectrum topical sunscreens and a gradual increase in sunlight exposure. However, in some individuals, sunlight exposure results in florid PLE and they often benefit from prophylactic desensitization treatment using phototherapy in early spring, an artificial method that induces a "hardening" phenomenon. To describe and evaluate the efficacy of a short desensitization protocol, based on a one-month-treatment, administered twice a week with narrow band UVB in subjects with severe polymorphic light eruption (PLE). A retrospective, open planned and non-randomized study to assess the efficacy of UVB phototherapy in prevention of polymorphic light eruption. Fifteen subjects diagnosed with severe PLE were treated with the standard protocol in our Photobiology Unit between 2014 and 2015. The effect of hardening was sustained during follow up in 87.5% of desensitization treatments. A statistically significant association (pPLE and the response to treatment was found. The effect of hardening was maintained in the vast majority of subjects, obtaining a good benefit with no PLE episodes during all the summer. We demonstrate that our standard protocol is effective, and produces a successful outcome for the majority of PLE subjects. Our protocol is shorter than those currently applied, being favourable both for the patient and the physician. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Fagus sylvatica L. provenances maintain different leaf metabolic profiles and functional response

    Science.gov (United States)

    Aranda, Ismael; Sánchez-Gómez, David; de Miguel, Marina; Mancha, Jose Antonio; Guevara, María Angeles; Cadahía, Estrella; Fernández de Simón, María Brígida

    2017-07-01

    Most temperate forest tree species will suffer important environmental changes as result of the climate change. Adaptiveness to local conditions could change at different sites in the future. In this context, the study of intra-specific variability is important to clarify the singularity of different local populations. Phenotypic differentiation between three beech provenances covering a wide latitudinal range (Spain/ES, Germany/DE and Sweden/SE), was studied in a greenhouse experiment. Non-target leaf metabolite profiles and ecophysiological response was analyzed in well-watered and water stressed seedlings. There was a provenance-specific pattern in the relative concentrations of some leaf metabolites regardless watering treatment. The DE and SE from the center and north of the distribution area of the species showed a clear differentiation from the ES provenance in the relative concentration of some metabolites. Thus the ES provenance from the south maintained larger relative concentration of some organic and amino acids (e.g. fumaric and succinic acids or valine and isoleucine), and in some secondary metabolites (e.g. kaempferol, caffeic and ferulic acids). The ecophysiological response to mild water stress was similar among the three provenances as a consequence of the moderate water stress applied to seedlings, although leaf N isotope composition (δ15N) and leaf C:N ratio were higher and lower respectively in DE than in the other two provenances. This would suggest potential differences in the capacity to uptake and post-process nitrogen according to provenance. An important focus of the study was to address for the first time inter-provenance leaf metabolic diversity in beech from a non-targeted metabolic profiling approach that allowed differentiation of the three studied provenances.

  1. Patient-Specific Internal Dosimetry Protocol for 131 treatment of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Deluca, G.M.; Rojo, Ana M.; Llina Fuentes, C.S.; Cabrejas, Mariana L.; Cabrejas, R.; Fadel, A.M.

    2008-01-01

    Full text: The most effective treatment against Differentiated Thyroid Cancer (DTC), in its most frequently types: papillar and follicular, is the administration of radioiodine. As a result of a multidisciplinary work, a dosimetrical protocol for radiological protection purpose has been developed that suggests the standards and formalisms for the determination of absorbed doses due to the administration of 131 I activity to DTC patients. This dosimetrical protocol takes into account individual data of each patient (age, gender, the presence or absence of metastases, physiology, physiopathology, biochemical parameters) and involves clinical aspects, the equipment that should be used and the dose assessment procedure of each treatment. Based on the Medical Internal radiation Dose (MIRD) scheme and considering the major critical organs for this therapy, the dosimetrical protocol states the 'how-to' of the following procedures, in adults and paediatric cases: 1) estimation of the red marrow dose (with/without bone metastases) to avoid mielotoxicity (200 cGy); 2) Estimation of the retention / dose rate / dose in lungs after 48 hours from the administration of radioiodine to avoid lung fibrosis; 3) Estimation of the testes dose in young male patients to avoid oligospermia; 4) Estimation of the maximum activity which can be safely administered without damaging the most critical organ for each patient; and 5) Acquisition of images and retention data from patients. This dosimetrical protocol also specifies the requirements and basic steps that should be followed, the essential information, the complementary studies and the basic equipment required to perform an appropriate internal dosimetry evaluation. To be fully implemented, the dosimetrical protocol needs the constitution of a multidisciplinary team including physicians, medical physicists and technicians. Clear instructions should be provided to the patient as his full collaboration is essential. Even though empirical

  2. Treatment influencing down-staging in EORTC Melanoma Group sentinel node histological protocol compared with complete step-sectioning: a national multicentre study.

    Science.gov (United States)

    Riber-Hansen, Rikke; Hastrup, Nina; Clemmensen, Ole; Behrendt, Nille; Klausen, Siri; Ramsing, Mette; Spaun, Eva; Hamilton-Dutoit, Stephen Jacques; Steiniche, Torben

    2012-02-01

    Metastasis size in melanoma sentinel lymph nodes (SLNs) is an emerging prognostic factor. Two European melanoma treatment trials include SLN metastasis diameters as inclusion criteria. Whilst diameter estimates are sensitive to the number of sections examined, the level of this bias is largely unknown. We performed a prospective multicentre study to compare the European Organisation for Research and Treatment of Cancer (EORTC) recommended protocol with a protocol of complete step-sectioning. One hundred and thirty-three consecutive SLNs from seven SLN centres were analysed by five central sections 50μm apart (EORTC Protocol) followed by complete 250μm step-sectioning. Overall, 29 patients (21.8%) were SLN-positive. The EORTC Protocol missed eight of these metastases (28%), one metastasis measuring less than 0.1mm in diameter, seven measuring between 0.1 and 1mm. Complete step-sectioning at 250μm intervals (Extensive Protocol) missed one metastasis (3%) that measured less than 0.1mm. Thirteen treatment courses (34%) performed if inclusion was based on the Combined Protocol would not be performed if assessed by the EORTC Protocol. Thus, 10 patients would be without completion lymph node dissection (EORTC MINITUB study), whilst three patients would not be eligible for anti-CTLA4 trial (EORTC protocol 18071). The corresponding number with the Extensive Protocol would be three; one patient for the MINITUB registration study and two patients for the anti-CTLA4 study. Examining SLNs by close central sectioning alone (EORTC Protocol) misses a substantial number of metastases and underestimates the maximum metastasis diameter, leading to important changes in patient eligibility for various treatment protocols. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Protocol for the estimation of average indoor radon-daughter concentrations: Second edition

    International Nuclear Information System (INIS)

    Langner, G.H. Jr.; Pacer, J.C.

    1988-05-01

    The Technical Measurements Center has developed a protocol which specifies the procedures to be used for determining indoor radon-daughter concentrations in support of Department of Energy remedial action programs. This document is the central part of the protocol and is to be used in conjunction with the individual procedure manuals. The manuals contain the information and procedures required to implement the proven methods for estimating average indoor radon-daughter concentration. Proven in this case means that these methods have been determined to provide reasonable assurance that the average radon-daughter concentration within a structure is either above, at, or below the standards established for remedial action programs. This document contains descriptions of the generic aspects of methods used for estimating radon-daughter concentration and provides guidance with respect to method selection for a given situation. It is expected that the latter section of this document will be revised whenever another estimation method is proven to be capable of satisfying the criteria of reasonable assurance and cost minimization. 22 refs., 6 figs., 3 tabs

  4. Comparison of carboplatin and doxorubicin-based chemotherapy protocols in 470 dogs after amputation for treatment of appendicular osteosarcoma.

    Science.gov (United States)

    Selmic, L E; Burton, J H; Thamm, D H; Withrow, S J; Lana, S E

    2014-01-01

    Many chemotherapy protocols have been reported for treatment of canine appendicular osteosarcoma (OSA), but outcome comparisons in a single population are lacking. To evaluate the effects of protocol and dose intensity (DI) on treatment outcomes for carboplatin and doxorubicin-based chemotherapy protocols. Four hundred and seventy dogs with appendicular OSA. A retrospective cohort study was performed comprising consecutive dogs treated (1997-2012) with amputation followed by 1 of 5 chemotherapy protocols: carboplatin 300 mg/m(2) IV q21d for 4 or 6 cycles (CARBO6), doxorubicin 30 mg/m(2) IV q14d or q21d for 5 cycles, and alternating carboplatin 300 mg/m(2) IV and doxorubicin 30 mg/m(2) IV q21d for 3 cycles. Adverse events (AE) and DI were evaluated. Kaplan-Meier survival curves and Cox proportional hazards regression were used to compare disease-free interval (DFI) and survival time (ST) among protocols. The overall median DFI and ST were 291 days and 284 days, respectively. A lower proportion of dogs prescribed CARBO6 experienced AEs compared to other protocols (48.4% versus 60.8-75.8%; P = .001). DI was not associated with development of metastases or death. After adjustment for baseline characteristics and prognostic factors, none of the protocols provided a significant reduction in risk of development of metastases or death. Although choice of protocol did not result in significant differences in DFI or ST, the CARBO6 protocol resulted in a lower proportion of dogs experiencing AEs, which could be advantageous in maintaining high quality of life during treatment. DI was not a prognostic indicator in this study. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  5. An Advanced Encryption Standard Powered Mutual Authentication Protocol Based on Elliptic Curve Cryptography for RFID, Proven on WISP

    Directory of Open Access Journals (Sweden)

    Alaauldin Ibrahim

    2017-01-01

    Full Text Available Information in patients’ medical histories is subject to various security and privacy concerns. Meanwhile, any modification or error in a patient’s medical data may cause serious or even fatal harm. To protect and transfer this valuable and sensitive information in a secure manner, radio-frequency identification (RFID technology has been widely adopted in healthcare systems and is being deployed in many hospitals. In this paper, we propose a mutual authentication protocol for RFID tags based on elliptic curve cryptography and advanced encryption standard. Unlike existing authentication protocols, which only send the tag ID securely, the proposed protocol could also send the valuable data stored in the tag in an encrypted pattern. The proposed protocol is not simply a theoretical construct; it has been coded and tested on an experimental RFID tag. The proposed scheme achieves mutual authentication in just two steps and satisfies all the essential security requirements of RFID-based healthcare systems.

  6. Optimization of the Treatment Protocol in Children with Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    T.O. Kriuchko

    2016-03-01

    Full Text Available The article deals with the substantiation and assessment of the effectiveness of the inclusion of ursodeoxycholic acid preparation Ukrliv suspension in the treatment protocol of children with gastroesophageal reflux disease. Taking into account the results of the studies, the use of ursodeoxycholic acid drug can be recommended as a pathogenetic therapy in the combination treatment of children with gastroesophageal reflux disease. The findings suggest both the efficiency and the high level of safety and tolerability of ursodeoxycholic acid, in particular Ukrliv suspension, during long-term use to prevent recurrences.

  7. Hemangiopericytoma - The need for a protocol-based treatment plan

    Directory of Open Access Journals (Sweden)

    Murugesan Krishnan

    2011-01-01

    Full Text Available Hemangiopericytoma is a vascular tumor which comprises only 1% of all vascular tumors. The frequency of occurrence in the head and neck accounts for about 16-33% of all hemangiopericytomas. In this paper we discuss the surgical management, the difficulties in decision-making and treatment-planning in a case of a maxillary tumor in a five-year-old boy with a two-year follow-up. A five-year-old boy presented with a large unilateral maxillary tumor with nasal obstruction. Computed tomography revealed a heterogeneous mass completely occupying the right maxillary sinus and displacing the lateral wall of the nose and nasal septum. The lesion was diagnosed as hemangiopericytoma after histopathological confirmation. The option of surgical resection (total maxillectomy was carried out after evaluating the available literature. Various treatment modalities like surgery, chemotherapy and radiotherapy were taken into consideration as the tumor has an aggressive nature. Due to the inadequate literature on definitive treatment options for these types of tumors, there was difficulty in arriving at a protocol-based treatment plan.

  8. Slipped capital femoral epiphysis: A modern treatment protocol

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2009-01-01

    Full Text Available The treatment of a patient with slipped capital femoral epiphysis begins with an early diagnosis and accurate classification. On the basis of symptom duration, clinical findings and radiographs, slipped capital femoral epiphysis is classified as pre-slip, acute, acute-on-chronic and chronic. The long-term outcome of slipped capital femoral epiphysis is directly related to severity and the presence or absence of avascular necrosis and/or chondrolysis. Therefore, the first priority in the treatment of slipped capital femoral epiphysis is to avoid complications while securing the epiphysis from further slippage. Medical treatment of patients with acute and acute-on-chronic slipped capital femoral epiphysis, as well as those presented in pre-slip stage, is the safest, although time-consuming. Manipulations, especially forced and repeated, are not recommended due to higher avascular necrosis risk. The use of intraoperative fluoroscopy to assist in the placement of internal fixation devices has markedly increased the success of surgical treatment. Controversy remains as to whether the proximal femoral epiphysis in severe, chronic slipped capital femoral epiphysis should be realigned by extracapsular osteotomies or just fixed in situ. The management protocol for slipped capital femoral epiphysis depends on the experience of the surgeon, motivation of the patient and technical facilities.

  9. Data transmission protocol for Pi-of-the-Sky cameras

    Science.gov (United States)

    Uzycki, J.; Kasprowicz, G.; Mankiewicz, M.; Nawrocki, K.; Sitek, P.; Sokolowski, M.; Sulej, R.; Tlaczala, W.

    2006-10-01

    The large amount of data collected by the automatic astronomical cameras has to be transferred to the fast computers in a reliable way. The method chosen should ensure data streaming in both directions but in nonsymmetrical way. The Ethernet interface is very good choice because of its popularity and proven performance. However it requires TCP/IP stack implementation in devices like cameras for full compliance with existing network and operating systems. This paper describes NUDP protocol, which was made as supplement to standard UDP protocol and can be used as a simple-network protocol. The NUDP does not need TCP protocol implementation and makes it possible to run the Ethernet network with simple devices based on microcontroller and/or FPGA chips. The data transmission idea was created especially for the "Pi of the Sky" project.

  10. PREMEDICATION PROTOCOLS IN DENTAL PRACTICE IN ALLERGIC PATIENTS.

    OpenAIRE

    Angelina Kisselova; Adriana Krasteva; Assya Krasteva

    2011-01-01

    The problem with choosing a suitable pre-medication protocols before local anesthesia in dentistry in allergic patients is always discussed, as in the dental practice different schemes are already proven (3,5). The propose of this communication is to share the experience on those pre-medication schemes in allergic patients during and outside pollen season.

  11. HISTOPATHOLOGICAL AND CYTOLOGICAL ANALYSIS OF TRANSMISSIBLE VENEREAL TUMOR IN DOGS AFTER TWO TREATMENT PROTOCOLS

    Directory of Open Access Journals (Sweden)

    Fabiana Aguena Sales Lapa

    2012-06-01

    Full Text Available The transmissible venereal tumor (TVT is a contagious neoplasm of round cells that frequently affect dogs. The treatment consists of chemotherapy being more effective the vincristine alone, however the resistance emergence to this agent due multidrug resistance of the P-glycoprotein (P-gp, a transporter protein encoded by the MDR1 gene, has been taking the association with other drugs. Recent studies demonstrated the antitumoral effect of the avermectins when associated to the vincristine in the treatment of some neoplasms. Therefore, the objective of the present study was to compare the effectiveness of standard treatment of TVT with vincristine only when compared to combined treatment with vincristine and ivermectin, evaluated through number of applications of the two protocols, histopathological and cytological analysis from 50 dogs diagnosed with TVT during the period of 2007 to 2010. The combined protocol significant reduced the number of applications and cytological and histopathological findings collaborate with the hypothesis that the combination of vincristine and ivermectin promotes faster healing than the use of vincristine alone. Combination treatment with vincristine and ivermectin could be in the future an excellent therapeutic alternative for the treatment of TVT for probably reducing the resistance to vincristine, simultaneously reducing the cost of TVT treatment and promoting a faster recovery of the dog.

  12. Protocol updated for the treatment of patients in radiotherapy with implanted cardiac devices

    International Nuclear Information System (INIS)

    Martin Martin, G.; Bermudez Luna, R.; Rodriguez Rodriguez, C.; Lopez Fernandez, A.; Rodriguez Perez, A.; Sotoca Ruiz, A.

    2013-01-01

    Radiotherapy treatment can be safely performed in patients with pacemakers or implanted defibrillators, however, it is very important to ensure that the patient receives the minimum dose possible in your heart device. Is considered essential good coordination with the cardiology service before, during and after radiotherapy treatment for the patient safety. Finally we present a protocol updated to treat these patients in radiotherapy. (Author)

  13. Recording Process Documentation for Provenance

    NARCIS (Netherlands)

    Groth, P.T.; Moreau, L

    2009-01-01

    Scientific and business communities are adopting large-scale distributed systems as a means to solve a wide range of resource-intensive tasks. These communities also have requirements in terms of provenance. We define the provenance of a result produced by a distributed system as the process that

  14. Economic comparison of common treatment protocols and J5 vaccination for clinical mastitis in dairy herds using optimized culling decisions.

    Science.gov (United States)

    Kessels, J A; Cha, E; Johnson, S K; Welcome, F L; Kristensen, A R; Gröhn, Y T

    2016-05-01

    This study used an existing dynamic optimization model to compare costs of common treatment protocols and J5 vaccination for clinical mastitis in US dairy herds. Clinical mastitis is an infection of the mammary gland causing major economic losses in dairy herds due to reduced milk production, reduced conception, and increased risk of mortality and culling for infected cows. Treatment protocols were developed to reflect common practices in dairy herds. These included targeted therapy following pathogen identification, and therapy without pathogen identification using a broad-spectrum antimicrobial or treating with the cheapest treatment option. The cost-benefit of J5 vaccination was also estimated. Effects of treatment were accounted for as changes in treatment costs, milk loss due to mastitis, milk discarded due to treatment, and mortality. Following ineffective treatments, secondary decisions included extending the current treatment, alternative treatment, discontinuing treatment, and pathogen identification followed by recommended treatment. Average net returns for treatment protocols and vaccination were generated using an existing dynamic programming model. This model incorporates cow and pathogen characteristics to optimize management decisions to treat, inseminate, or cull cows. Of the treatment protocols where 100% of cows received recommended treatment, pathogen-specific identification followed by recommended therapy yielded the highest average net returns per cow per year. Out of all treatment scenarios, the highest net returns were achieved with selecting the cheapest treatment option and discontinuing treatment, or alternate treatment with a similar spectrum therapy; however, this may not account for the full consequences of giving nonrecommended therapies to cows with clinical mastitis. Vaccination increased average net returns in all scenarios. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. Dosimetry study on the conventional and three dimensional conformal radiation treatment planning protocols for rectal cancer

    International Nuclear Information System (INIS)

    Cai Yong; He Yuxiang; Han Shukui; Wu Hao; Gong Jian; Xu Bo

    2007-01-01

    Objective: To compare the dose distribution of clinical target volume (CTV), in normal tissues and organs for patients with rectal cancer on the conventional radiotherapy (2D) and three dimension- al conformal radiation treatment (3DCRT). Methods: The CT image data of 36 rectal cancer patients treated with 3DCRT were studied. The CTV, small bowel, colon, bladder, pelvic bone marrow, and femoral head and neck were contoured on consecutive axial slices of CT images. Two 3DCRT and three conventional treatment planning protocols were simulated using three dimensional treatment planning system (CMS Focus 2.31), were defined as 3D-3, 3D-4, 2D-2, 2D-3, 2D-4. The difference of five treatment planning protocols on the CTV and normal structure by analysis of dose-volume histograms (DVHs) were compared. Results: The D 95 and V 95 of these five protocols all exceeded 97%. The conformity index(CI) of 3D was obviously larger than that of 2D protocol. The dose inhomogeneity(DI) in 4 DCRT was less than that of 3 DCRT. The 3D as compared with the 2D, significantly reduced the mean dose of 45 Gy to the small bowel and colon. The 3D-3 as compared with the 2D-3, the 3D-4 as compared with the 2D-4, the mean dose of small bowel and colon was reduced by 28.5% and 25.7%, respectively. The 3D-3 as compared with the 2D-2, the 3D-3 as compared with the 2D-3 and the 3D4 as compared with the 2D-4, the percentage volume of small bowel and colon which received 45 Gy was reduced by 80.8% , 51.1% and 54.7% , respectively. Either the mean dose, or the percentage volume receiving 35 Gy and 45 Gy to the pelvic bone and bladder, the 3D planning protocols had advanage over the 2D planning protocols. The V 45 of bladder in 2D-2 planning proto- col was the highest in all planning protocols, exceeding 98%, but the highest V 45 of bladder was only 50% in the other planning protocols. Conclusions: Even though the difference in pelvic CTV of rectal cancer patients between the conventional radiotherapy and 3

  16. The cost-effectiveness of an intensive treatment protocol for severe dyslexia in children.

    Science.gov (United States)

    Hakkaart-van Roijen, Leona; Goettsch, Wim G; Ekkebus, Michel; Gerretsen, Patty; Stolk, Elly A

    2011-08-01

    Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued by proxies using a general quality-of-life instrument (EQ-5D). We considered medical cost and non-medical cost (e.g. remedial teaching). The model computed cost per successful treatment and cost per quality adjusted life year (QALY) in time. About 75% of the total costs was related to diagnostic tests to distinguish between children with severe dyslexia and children who have reading difficulties for other reasons. The costs per successful treatment of severe dyslexia were €36 366. Successful treatment showed a quality-of-life gain of about 11%. At primary school, the average cost per QALY for severe dyslexia amounted to €58 647. In the long term, the cost per QALY decreased to €26 386 at secondary school and €17 663 thereafter. The results of this study provide evidence that treatment of severe dyslexia is cost-effective when the investigated protocol is followed. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Effectiveness of oxaliplatin desensitization protocols.

    Science.gov (United States)

    Cortijo-Cascajares, Susana; Nacle-López, Inmaculada; García-Escobar, Ignacio; Aguilella-Vizcaíno, María José; Herreros-de-Tejada, Alberto; Cortés-Funes Castro, Hernán; Calleja-Hernández, Miguel-Ángel

    2013-03-01

    Hypersensitivity reaction (HSR) to antineoplastic drugs can force doctors to stop treatment and seek other alternatives. These alternatives may be less effective, not as well tolerated and/or more expensive. Another option is to use desensitization protocols that induce a temporary state of tolerance by gradually administering small quantities of the antineoplastic drug until the therapeutic dosage is reached. The aim of this study is to assess the effectiveness of oxaliplatin desensitization protocols. A retrospective observational study was carried out between January 2006 and May 2011. The inclusion criteria were patients undergoing chemotherapy treatment with oxaliplatin who had developed an HSR to the drug and who were candidates for continuing the treatment using a desensitization protocol. The patients' clinical records were reviewed and variables were gathered relating to the patient, the treatment, the HSR, and the desensitization protocol administered. The data were analysed using version 18.0 of the statistics program SPSS. A total of 53 desensitization protocols were administered to 21 patients. In 89 % of these cases, no new reactions occurred while the drug was being administered. New reactions of mild severity only occurred in 11 % of cases, and none of these reactions were severe enough for treatment to be stopped. All patients were able to complete the desensitization protocol. This study confirms that oxaliplatin desensitization protocols are safe and effective and allow patients to continue with the treatment that initially caused an HSR.

  18. Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

    Science.gov (United States)

    Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

    2011-01-01

    Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

  19. Outcome of biopsy proven minimal change disease (MCD) in children

    African Journals Online (AJOL)

    Background and Objectives: MCD is the most common histological sub-type of nephrotic syndrome with variable clinical course in children. There are limited studies in literature on the outcome of biopsy proven MCD. The objective was to look at the treatment response and outcome of patients with MCD treated at a tertiary ...

  20. Data provenance assurance in the cloud using blockchain

    Science.gov (United States)

    Shetty, Sachin; Red, Val; Kamhoua, Charles; Kwiat, Kevin; Njilla, Laurent

    2017-05-01

    Ever increasing adoption of cloud technology scales up the activities like creation, exchange, and alteration of cloud data objects, which create challenges to track malicious activities and security violations. Addressing this issue requires implementation of data provenance framework so that each data object in the federated cloud environment can be tracked and recorded but cannot be modified. The blockchain technology gives a promising decentralized platform to build tamper-proof systems. Its incorruptible distributed ledger/blockchain complements the need of maintaining cloud data provenance. In this paper, we present a cloud based data provenance framework using block chain which traces data record operations and generates provenance data. We anchor provenance data records into block chain transactions, which provide validation on provenance data and preserve user privacy at the same time. Once the provenance data is uploaded to the global block chain network, it is extremely challenging to tamper the provenance data. Besides, the provenance data uses hashed user identifiers prior to uploading so the blockchain nodes cannot link the operations to a particular user. The framework ensures that the privacy is preserved. We implemented the architecture on ownCloud, uploaded records to blockchain network, stored records in a provenance database and developed a prototype in form of a web service.

  1. DIRECT PULP CAPPING IN TREATMENT OF REVERSIBLE PULPITIS IN PRIMARY TEETH- CLINICAL PROTOCOL

    Directory of Open Access Journals (Sweden)

    Nina Milcheva

    2016-10-01

    Full Text Available The pulp of primary teeth is identical morphologically and physiologically to that of permanent teeth and it is capable to answer to pathological stimuli by producing tertiary dentin. When the inflammation of the pulp is in its reversible stage vital methods of treatment are indicated in order to stimulate the healing processes in it and protect its vitality. In Bulgaria the most popular method of treatment of inflammation diseases of the pulp in primary dentition is the mortal amputation. The biological way of treatment is not very common even in cases where there are indications for it. Purpose: The aim of this paper is to present the approbated by us protocol for application of direct pulp capping for treatment of reversible pulpitis in primary teeth. Material and methods: On the base of world experience and our contemporary meta- analysis of the researches published in the last 15 years concerning the problems of diagnostics. We determined clinical and radiographic diagnostic criteria for reversible pulpitis in primary teeth and indications for application of direct pulp capping as a method of treatment. We give clinical steps for application of the method and summarized the clinical and radiographic criteria for success after treatment. Results/conclusion: We gather all the information for applying direct pulp cappingfor treatment of reversible pulpitis in primary dentition. We offer the method of direct pulp capping as a clinical protocol “step by step” and illustrated by scheme which can be useful for students and dentists in their everyday practice.

  2. Addressing Viral Hepatitis in People with Substance Use Disorders. Treatment Improvement Protocol (TIP) Series 53

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and…

  3. Logical provenance in data-oriented workflows?

    KAUST Repository

    Ikeda, R.; Das Sarma, Akash; Widom, J.

    2013-01-01

    for general transformations, introducing the notions of correctness, precision, and minimality. We then determine when properties such as correctness and minimality carry over from the individual transformations' provenance to the workflow provenance. We

  4. Multi-institutional evaluation of end-to-end protocol for IMRT/VMAT treatment chains utilizing conventional linacs.

    Science.gov (United States)

    Loughery, Brian; Knill, Cory; Silverstein, Evan; Zakjevskii, Viatcheslav; Masi, Kathryn; Covington, Elizabeth; Snyder, Karen; Song, Kwang; Snyder, Michael

    2018-03-20

    We conducted a multi-institutional assessment of a recently developed end-to-end monthly quality assurance (QA) protocol for external beam radiation therapy treatment chains. This protocol validates the entire treatment chain against a baseline to detect the presence of complex errors not easily found in standard component-based QA methods. Participating physicists from 3 institutions ran the end-to-end protocol on treatment chains that include Imaging and Radiation Oncology Core (IROC)-credentialed linacs. Results were analyzed in the form of American Association of Physicists in Medicine (AAPM) Task Group (TG)-119 so that they may be referenced by future test participants. Optically stimulated luminescent dosimeter (OSLD), EBT3 radiochromic film, and A1SL ion chamber readings were accumulated across 10 test runs. Confidence limits were calculated to determine where 95% of measurements should fall. From calculated confidence limits, 95% of measurements should be within 5% error for OSLDs, 4% error for ionization chambers, and 4% error for (96% relative gamma pass rate) radiochromic film at 3% agreement/3 mm distance to agreement. Data were separated by institution, model of linac, and treatment protocol (intensity-modulated radiation therapy [IMRT] vs volumetric modulated arc therapy [VMAT]). A total of 97% of OSLDs, 98% of ion chambers, and 93% of films were within the confidence limits; measurements were found outside these limits by a maximum of 4%, consistent despite institutional differences in OSLD reading equipment and radiochromic film calibration techniques. Results from this test may be used by clinics for data comparison. Areas of improvement were identified in the end-to-end protocol that can be implemented in an updated version. The consistency of our data demonstrates the reproducibility and ease-of-use of such tests and suggests a potential role for their use in broad end-to-end QA initiatives. Copyright © 2018 American Association of Medical

  5. SEIS-PROV: Practical Provenance for Seismological Data

    Science.gov (United States)

    Krischer, L.; Smith, J. A.; Tromp, J.

    2015-12-01

    It is widely recognized that reproducibility is crucial to advance science, but at the same time it is very hard to actually achieve. This results in it being recognized but also mostly ignored by a large fraction of the community. A key ingredient towards full reproducibility is to capture and describe the history of data, an issue known as provenance. We present SEIS-PROV, a practical format and data model to store provenance information for seismological data. In a seismological context, provenance can be seen as information about the processes that generated and modified a particular piece of data. For synthetic waveforms the provenance information describes which solver and settings therein were used to generate it. When looking at processed seismograms, the provenance conveys information about the different time series analysis steps that led to it. Additional uses include the description of derived data types, such as cross-correlations and adjoint sources, enabling their proper storage and exchange. SEIS-PROV is based on W3C PROV (http://www.w3.org/TR/prov-overview/), a standard for generic provenance information. It then applies an additional set of constraints to make it suitable for seismology. We present a definition of the SEIS-PROV format, a way to check if any given file is a valid SEIS-PROV document, and two sample implementations: One in SPECFEM3D GLOBE (https://geodynamics.org/cig/software/specfem3d_globe/) to store the provenance information of synthetic seismograms and another one as part of the ObsPy (http://obspy.org) framework enabling automatic tracking of provenance information during a series of analysis and transformation stages. This, along with tools to visualize and interpret provenance graphs, offers a description of data history that can be readily tracked, stored, and exchanged.

  6. Provenance trials of larch in Siberia

    Energy Technology Data Exchange (ETDEWEB)

    Milyutin, L.I. [V.N. Sukachev Inst. of Forest SB RAS, Krasnoyarsk (Russian Federation)

    1995-12-31

    Some results of provenance trials of larch in Siberia are given. These provenance trials were established in the last thirty years by efforts of V.N. Sukaczev Inst. of Forest. Provenances and species of larch were tested in some field trials distributed over Siberia between Lat. N 52 deg and 66 deg, Long. E 88 deg and 113 deg: near Krasnoyarsk, in Republic Khakasia (an altitudes of 800 and 1200 metres), in the Lower Yenisei near Turukhansk, in the west and south regions of Krasnoyarsk territory, in the Upper Lena, near Chita. 2 refs

  7. Archives and societal provenance Australian essays

    CERN Document Server

    Piggott, Michael

    2012-01-01

    Records and archival arrangements in Australia are globally relevant because Australia's indigenous people represent the oldest living culture in the world, and because modern Australia is an ex-colonial society now heavily multicultural in outlook. Archives and Societal Provenance explores this distinctiveness using the theoretical concept of societal provenance as propounded by Canadian archival scholars led by Dr Tom Nesmith. The book's seventeen essays blend new writing and re-workings of earlier work, comprising the fi rst text to apply a societal provenance perspective to a national sett

  8. Provenance trials of larch in Siberia

    Energy Technology Data Exchange (ETDEWEB)

    Milyutin, L I [V.N. Sukachev Inst. of Forest SB RAS, Krasnoyarsk (Russian Federation)

    1996-12-31

    Some results of provenance trials of larch in Siberia are given. These provenance trials were established in the last thirty years by efforts of V.N. Sukaczev Inst. of Forest. Provenances and species of larch were tested in some field trials distributed over Siberia between Lat. N 52 deg and 66 deg, Long. E 88 deg and 113 deg: near Krasnoyarsk, in Republic Khakasia (an altitudes of 800 and 1200 metres), in the Lower Yenisei near Turukhansk, in the west and south regions of Krasnoyarsk territory, in the Upper Lena, near Chita. 2 refs

  9. Intercept-resend attacks in the Bennett-Brassard 1984 quantum-key-distribution protocol with weak coherent pulses

    International Nuclear Information System (INIS)

    Curty, Marcos; Luetkenhaus, Norbert

    2005-01-01

    Unconditional security proofs of the Bennett-Brassard 1984 protocol of quantum key distribution have been obtained recently. These proofs cover also practical implementations that utilize weak coherent pulses in the four signal polarizations. Proven secure rates leave open the possibility that new proofs or new public discussion protocols will obtain larger rates over increased distance. In this paper we investigate limits to the error rate and signal losses that can be tolerated by future protocols and proofs

  10. Implementation of the protocol on treatment of outpatients and hospitalized patients with iodine 131r

    International Nuclear Information System (INIS)

    Mildred De Mendoza, L.

    1996-01-01

    In Nuclear medicine different working protocols are used which are adequate for the treatment of patients with radioactive materials and which at the same time prevent the contamination of the occupationally exposed workers In Guatemala (the implementation of these protocols aims at keeping a records all the personal and centers that make use of iodine 131, improving the quality of diagnostic information; utilizing the necessary amount of radionuclide activity so as to ensure a good diagnosis and effectively utilizing economic resources

  11. Treatment plan in amelogenesis imperfecta: A structured literature review on treatment protocols and dedicating the best possible options

    Directory of Open Access Journals (Sweden)

    Azari A.

    2008-12-01

    Full Text Available "nAmelogenesis imperfecta is an inherited disease that disturbs the formation of the enamel. It occurs as two main categories, hypomineralized and hypoplastic. Both deciduous and permanent teeth are affected, and the disorder may create unaesthetic appearance, dental sensitivity, and severe attrition. In this article through performing a structured literature review, numerous treatment modalities which so far advocated in rehabilitation of amelogenesis imperfecta in adults and children is discussed. The progressive changes on open bite, the problem of bonding during restorative phase of treatment , the rehabilitation difficulties of deciduous as well as permanent teeth is also discussed in detail and finally the interdisciplinary approach for treatment of this disability is demonstrated and some points for decision making in treatment protocols are suggested.

  12. Robust Multi-unit Auction Protocol against False-name Bids

    Science.gov (United States)

    Yokoo, Makoto; Sakurai, Yuko; Matsubara, Shigeo

    This paper presents a new multi-unit auction protocol (IR protocol) that is robust against false-name bids. Internet auctions have become an integral part of Electronic Commerce and a promising field for applying agent and Artificial Intelligence technologies. Although the Internet provides an excellent infrastructure for executing auctions, the possibility of a new type of cheating called false-name bids has been pointed out. A false-name bid is a bid submitted under a fictitious name. A protocol called LDS has been developed for combinatorial auctions of multiple different items and has proven to be robust against false-name bids. Although we can modify the LDS protocol to handle multi-unit auctions, in which multiple units of an identical item are auctioned, the protocol is complicated and requires the auctioneer to carefully pre-determine the combination of bundles to obtain a high social surplus or revenue. For the auctioneer, our newly developed IR protocol is easier to use than the LDS, since the combination of bundles is automatically determined in a flexible manner according to the declared evaluation values of agents. The evaluation results show that the IR protocol can obtain a better social surplus than that obtained by the LDS protocol.

  13. Biopsy-proven childhood glomerulonephritis in Johor.

    Science.gov (United States)

    Khoo, J J; Pee, S; Thevarajah, B; Yap, Y C; Chin, C K

    2004-06-01

    There has been no published study of biopsy-proven childhood glomerulonephritis in Malaysia. To determine the pattern of childhood glomerulonephritis in Johor, Malaysia from a histopathological perspective and the various indications used for renal biopsy in children. Retrospective study was done of all renal biopsies from children under 16 years of age, received in Sultanah Aminah Hospital, Johor between 1994 and 2001. The histopathological findings were reviewed to determine the pattern of biopsy-proven glomerulonephritis. The indications for biopsy, mode of therapy given after biopsy and the clinical outcome were studied. 122 adequate biopsies were received, 9 children had repeat biopsies. Of the 113 biopsies, minimal change disease formed the most common histopathological diagnosis (40.7%) while lupus nephritis formed the most common secondary glomerulonephritis (23.0%). The main indications for biopsy were nephrotic syndrome (50.8%), lupus nephritis (25.4%) and renal impairment (13.1%). The mode of therapy was changed in 59.8% of the children. Of 106 patients followed-up, 84 children were found to have normal renal function in remission or on treatment. 4 patients developed chronic renal impairment and 16 reached end stage renal disease. Five of the 16 children with end stage disease had since died while 11 were on renal replacement therapy. Another 2 patients died of other complications. The pattern of childhood GN in our study tended to reflect the more severe renal parenchymal diseases in children and those requiring more aggressive treatment. This was because of our criteria of selection (indication) for renal biopsy. Renal biopsy where performed appropriately in selected children may not only be a useful investigative tool for histological diagnosis and prognosis but may help clinicians plan the optimal therapy for these children.

  14. The Dana Farber consortium protocol (DFCP) vs. classic Hyper-CVAD for treatment of acute lymphoblastic leukemia in patients <50 Y. Single institution experience.

    Science.gov (United States)

    Alabdulwahab, Amal S; Elsayed, Hussein G; Sherisher, Mohamed A; Zeeneldin, Ahmed; Alghamdi, Khalofa; Elbjeirami, Wafaa M

    2017-09-01

    The use of intensive pediatric protocols for the treatment of ALL is being extended to older adults. Analysis of the efficacy and toxicity results of pediatric DFCP vs. classic Hyper-CVAD protocol for the treatment of patients with ALL Hyper-CVAD for first line treatment of patients with ALL Hyper-CVAD protocol. CR rate was 90.7% for DFCP vs. 83.7 for Hyper-CVAD (p 0.7). 3 Y Leukemia free survival was 57.4% (70.9% for DFCP vs. 41.6% Hyper-CVAD P 0.1) while 3Y OS was 62.6%% for the whole group, 72.6% DFCP vs. 48.5% Hyper-CVAD, P 0.04. Those with age Hyper-CVAD related to gall stones. Osteonecrosis affected 5 patients on DFCP. pediatric protocols are feasible in patients younger than 50 Y and they are more active than classic adult protocols. Although modifications of adult protocols may improve their results, this had to be investigated in randomized controlled trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Lightweight Provenance Service for High-Performance Computing

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Dong; Chen, Yong; Carns, Philip; Jenkins, John; Ross, Robert

    2017-09-09

    Provenance describes detailed information about the history of a piece of data, containing the relationships among elements such as users, processes, jobs, and workflows that contribute to the existence of data. Provenance is key to supporting many data management functionalities that are increasingly important in operations such as identifying data sources, parameters, or assumptions behind a given result; auditing data usage; or understanding details about how inputs are transformed into outputs. Despite its importance, however, provenance support is largely underdeveloped in highly parallel architectures and systems. One major challenge is the demanding requirements of providing provenance service in situ. The need to remain lightweight and to be always on often conflicts with the need to be transparent and offer an accurate catalog of details regarding the applications and systems. To tackle this challenge, we introduce a lightweight provenance service, called LPS, for high-performance computing (HPC) systems. LPS leverages a kernel instrument mechanism to achieve transparency and introduces representative execution and flexible granularity to capture comprehensive provenance with controllable overhead. Extensive evaluations and use cases have confirmed its efficiency and usability. We believe that LPS can be integrated into current and future HPC systems to support a variety of data management needs.

  16. Data Provenance and Data Management in eScience

    CERN Document Server

    Bai, Quan; Giugni, Stephen; Williamson, Darrell; Taylor, John

    2013-01-01

    eScience allows scientific research to be carried out in highly distributed environments. The complex nature of the interactions in an eScience infrastructure, which often involves a range of instruments, data, models, applications, people and computational facilities, suggests there is a need for data provenance and data management (DPDM). The W3C Provenance Working Group defines the provenance of a resource as a “record that describes entities and processes involved in producing and delivering or otherwise influencing that resource”. It has been widely recognised that provenance is a critical issue to enable sharing, trust, authentication and reproducibility of eScience process.   Data Provenance and Data Management in eScience identifies the gaps between DPDM foundations and their practice within eScience domains including clinical trials, bioinformatics and radio astronomy. The book covers important aspects of fundamental research in DPDM including provenance representation and querying. It also expl...

  17. The Cost-Effectiveness of an Intensive Treatment Protocol for Severe Dyslexia in Children

    Science.gov (United States)

    Hakkaart-van Roijen, Leona; Goettsch, Wim G.; Ekkebus, Michel; Gerretsen, Patty; Stolk, Elly A.

    2011-01-01

    Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued…

  18. Provenance tracking in the ViroLab Virtual Laboratory

    NARCIS (Netherlands)

    Baliś, B.; Bubak, M.; Wach, J.

    2008-01-01

    Provenance describes the process which led to the creation of a piece of data. Tracking provenance of experiment results is essential in modern environments which support conducting of in silico experiments. We present a provenance tracking approach developed as part of the virtual laboratory of the

  19. Secure Location Provenance for Mobile Devices

    Science.gov (United States)

    2015-07-01

    A malicious user should not be able to hide a temporary off-track movement from the claimed location provenance. • A malicious user may want to...Seltzer, “Provenance-aware storage systems,” in Proc. of USENIX ATC. USENIX Association, May 2006, pp. 43–56. [48] D. Bhagwat, L. Chiticariu, W.-C. Tan

  20. Provenance Usage in the OceanLink Project

    Science.gov (United States)

    Narock, T.; Arko, R. A.; Carbotte, S. M.; Chandler, C. L.; Cheatham, M.; Fils, D.; Finin, T.; Hitzler, P.; Janowicz, K.; Jones, M.; Krisnadhi, A.; Lehnert, K. A.; Mickle, A.; Raymond, L. M.; Schildhauer, M.; Shepherd, A.; Wiebe, P. H.

    2014-12-01

    A wide spectrum of maturing methods and tools, collectively characterized as the Semantic Web, is helping to vastly improve thedissemination of scientific research. The OceanLink project, an NSF EarthCube Building Block, is utilizing semantic technologies tointegrate geoscience data repositories, library holdings, conference abstracts, and funded research awards. Provenance is a vital componentin meeting both the scientific and engineering requirements of OceanLink. Provenance plays a key role in justification and understanding when presenting users with results aggregated from multiple sources. In the engineering sense, provenance enables the identification of new data and the ability to determine which data sources to query. Additionally, OceanLink will leverage human and machine computation for crowdsourcing, text mining, and co-reference resolution. The results of these computations, and their associated provenance, will be folded back into the constituent systems to continually enhance precision and utility. We will touch on the various roles provenance is playing in OceanLink as well as present our use of the PROV Ontology and associated Ontology Design Patterns.

  1. Successful treatment of methotrexate intolerance in juvenile idiopathic arthritis using eye movement desensitization and reprocessing - treatment protocol and preliminary results.

    Science.gov (United States)

    Höfel, Lea; Eppler, Bruno; Storf, Magdalena; Schnöbel-Müller, Elizabeth; Haas, Johannes-Peter; Hügle, Boris

    2018-02-13

    Methotrexate (MTX), commonly used in juvenile idiopathic arthritis (JIA), frequently has to be discontinued due to intolerance with anticipatory and associative gastrointestinal adverse effects. Eye Movement Desensitization and Reprocessing (EMDR) is a psychological method where dysfunctional experiences and memories are reprocessed by recall combined with bilateral eye movements. The objective of this study was to assess efficacy of EMDR for treatment of MTX intolerance in JIA patients. We performed an open prospective study on consecutive JIA patients with MTX intolerance. Intolerance was determined using the Methotrexate Intolerance Severity Score (MISS) questionnaire prior to treatment, directly after treatment and after four months. Health-related quality of life was determined using the PedsQL prior to and four months after treatment. Patients were treated according to an institutional EMDR protocol with 8 sessions over two weeks. Changes in MISS and PedsQL were analyzed using non-parametric statistics. Eighteen patients with MTX intolerance (median MISS at inclusion 16.5, IQR = 11.75-20.25) were included. Directly after treatment, MTX intolerance symptoms were significantly improved (median MISS 1 (IQR = 0-2). After four months, median MISS score was at 6.5 (IQR = 2.75-12.25, p = 0.001), with 9/18 patients showing MISS scores ≥6. Median PedsQL after 4 months improved significantly from 77.6% to 85.3% (p = 0.008). MTX intolerance in children with JIA was effectively treated using an EMDR protocol, with lasting effect over a period of 4 months. EMDR treatment can potentially increase quality of life of affected patients and enable continued MTX treatment.

  2. A Provenance Tracking Model for Data Updates

    Directory of Open Access Journals (Sweden)

    Gabriel Ciobanu

    2012-08-01

    Full Text Available For data-centric systems, provenance tracking is particularly important when the system is open and decentralised, such as the Web of Linked Data. In this paper, a concise but expressive calculus which models data updates is presented. The calculus is used to provide an operational semantics for a system where data and updates interact concurrently. The operational semantics of the calculus also tracks the provenance of data with respect to updates. This provides a new formal semantics extending provenance diagrams which takes into account the execution of processes in a concurrent setting. Moreover, a sound and complete model for the calculus based on ideals of series-parallel DAGs is provided. The notion of provenance introduced can be used as a subjective indicator of the quality of data in concurrent interacting systems.

  3. A Call for sting treatment protocol: Case report of a 3 year old with ...

    African Journals Online (AJOL)

    Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol.

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

    Science.gov (United States)

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

    2017-04-01

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

  5. LabelFlow Framework for Annotating Workflow Provenance

    Directory of Open Access Journals (Sweden)

    Pinar Alper

    2018-02-01

    Full Text Available Scientists routinely analyse and share data for others to use. Successful data (reuse relies on having metadata describing the context of analysis of data. In many disciplines the creation of contextual metadata is referred to as reporting. One method of implementing analyses is with workflows. A stand-out feature of workflows is their ability to record provenance from executions. Provenance is useful when analyses are executed with changing parameters (changing contexts and results need to be traced to respective parameters. In this paper we investigate whether provenance can be exploited to support reporting. Specifically; we outline a case-study based on a real-world workflow and set of reporting queries. We observe that provenance, as collected from workflow executions, is of limited use for reporting, as it supports queries partially. We identify that this is due to the generic nature of provenance, its lack of domain-specific contextual metadata. We observe that the required information is available in implicit form, embedded in data. We describe LabelFlow, a framework comprised of four Labelling Operators for decorating provenance with domain-specific Labels. LabelFlow can be instantiated for a domain by plugging it with domain-specific metadata extractors. We provide a tool that takes as input a workflow, and produces as output a Labelling Pipeline for that workflow, comprised of Labelling Operators. We revisit the case-study and show how Labels provide a more complete implementation of reporting queries.

  6. Provenance-based refresh in data-oriented workflows

    KAUST Repository

    Ikeda, Robert; Salihoglu, Semih; Widom, Jennifer

    2011-01-01

    We consider a general workflow setting in which input data sets are processed by a graph of transformations to produce output results. Our goal is to perform efficient selective refresh of elements in the output data, i.e., compute the latest values of specific output elements when the input data may have changed. We explore how data provenance can be used to enable efficient refresh. Our approach is based on capturing one-level data provenance at each transformation when the workflow is run initially. Then at refresh time provenance is used to determine (transitively) which input elements are responsible for given output elements, and the workflow is rerun only on that portion of the data needed for refresh. Our contributions are to formalize the problem setting and the problem itself, to specify properties of transformations and provenance that are required for efficient refresh, and to provide algorithms that apply to a wide class of transformations and workflows. We have built a prototype system supporting the features and algorithms presented in the paper. We report preliminary experimental results on the overhead of provenance capture, and on the crossover point between selective refresh and full workflow recomputation. © 2011 ACM.

  7. 2014 Building America House Simulation Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Engebrecht-Metzger, C. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Horowitz, S. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hendron, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-03-01

    As BA has grown to include a large and diverse cross-section of the home building and retrofit industries, it has become more important to develop accurate, consistent analysis techniques to measure progress towards the program's goals. The House Simulation Protocol (HSP) document provides guidance to program partners and managers so they can compare energy savings for new construction and retrofit projects. The HSP provides the program with analysis methods that are proven to be effective and reliable in investigating the energy use of advanced energy systems and of entire houses.

  8. 2014 Building America House Simulation Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, E. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Engebrecht, C. Metzger [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Horowitz, S. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hendron, R. [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2014-03-01

    As Building America has grown to include a large and diverse cross-section of the home building and retrofit industries, it has become more important to develop accurate, consistent analysis techniques to measure progress towards the program's goals. The House Simulation Protocol (HSP) document provides guidance to program partners and managers so they can compare energy savings for new construction and retrofit projects. The HSP provides the program with analysis methods that are proven to be effective and reliable in investigating the energy use of advanced energy systems and of entire houses.

  9. Neurofeedback Treatment and Posttraumatic Stress Disorder: Effectiveness of Neurofeedback on Posttraumatic Stress Disorder and the Optimal Choice of Protocol.

    Science.gov (United States)

    Reiter, Karen; Andersen, Søren Bo; Carlsson, Jessica

    2016-02-01

    Neurofeedback is an alternative, noninvasive approach used in the treatment of a wide range of neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). Many different neurofeedback protocols and methods exist. Likewise, PTSD is a heterogeneous disorder. To review the evidence on effectiveness and preferred protocol when using neurofeedback treatment on PTSD, a systematic search of PubMed, PsychInfo, Embase, and Cochrane databases was undertaken. Five studies were included in this review. Neurofeedback had a statistically significant effect in three studies. Neurobiological changes were reported in three studies. Interpretation of results is, however, limited by differences between the studies and several issues regarding design. The optimistic results presented here qualify neurofeedback as probably efficacious for PTSD treatment.

  10. [Neurofeedback for the treatment of chronic tinnitus : Review and future perspectives].

    Science.gov (United States)

    Kleinjung, T; Thüring, C; Güntensperger, D; Neff, P; Meyer, M

    2018-03-01

    Neurofeedback is a noninvasive neuromodulation technique employing real-time display of brain activity in terms of electroencephalography (EEG) signals to teach self-regulation of distinct patterns of brain activity or influence brain activity in a targeted manner. The benefit of this approach for control of symptoms in attention deficit disorders, hyperactivity, depression, and migraine has been proven. Studies in recent years have also repeatedly shown this treatment to improve tinnitus symptoms, although it has not become established as routine therapy. The primary focus of this review is the rational of EEG neurofeedback for tinnitus treatment and the currently available data from published studies. Furthermore, alternative neurofeedback protocols using real-time functional magnetic resonance imaging (fMRI) measurements for tinnitus control are considered. Finally, this article highlights how modern EEG analysis (source localization, connectivity) and the improving understanding of tinnitus pathology can contribute to development of more focused neurofeedback protocols for more sustainable control of tinnitus.

  11. Responses of leaf nitrogen and mobile carbohydrates in different Quercus species/provenances to moderate climate changes.

    Science.gov (United States)

    Li, M-H; Cherubini, P; Dobbertin, M; Arend, M; Xiao, W-F; Rigling, A

    2013-01-01

    Global warming and shortage of water have been evidenced in the recent past and are predicted for the future. Climate change will inevitably have considerable impact on plant physiology, growth, productivity and forest ecosystem functions. The present study determined the effects of simulated daytime air warming (+1 to 1.5 °C during the growing season), drought (-40% and -57% of mean precipitation of 728 mm during the 2007 and 2008 growing season, respectively) and their combination, on leaf nitrogen (N) and non-structural carbohydrates (NSC) of two Quercus species (Q. robur and Q. petraea) and provenances (two provenances for each species) grown in two soil types in Switzerland across two treatment years, to test the hypothesis that leaf N and NSC in the more water-sensitive species (Q. robur) and provenances (originating from water-rich locations) will more strongly respond to global warming and water deficit, compared to those in the more drought-tolerant species (Q. petraea) or provenances. No species- and provenance-specific responses in leaf N and NSC to the climate treatment were found, indicating that the results failed to support our hypothesis. The between-species variation of leaf N and NSC concentrations mainly reflected differences in biology of the two species, and the between-provenance variation of N and NSC concentrations apparently mirrored the climate of their origins. Hence, we conclude that (i) the two Quercus species studied are somewhat insensitive, due to their distribution covering a wide geographical and climate range, to moderate climate change within Switzerland, and (ii) a moderate global warming of B1 scenario (IPCC 2007) will not, or at least less, negatively affect the N and carbon physiology in Q. robur and Q. petraea. © 2012 German Botanical Society and The Royal Botanical Society of the Netherlands.

  12. Extending eScience Provenance with User-Submitted Semantic Annotations

    Science.gov (United States)

    Michaelis, J.; Zednik, S.; West, P.; Fox, P. A.; McGuinness, D. L.

    2010-12-01

    eScience based systems generate provenance of their data products, related to such things as: data processing, data collection conditions, expert evaluation, and data product quality. Recent advances in web-based technology offer users the possibility of making annotations to both data products and steps in accompanying provenance traces, thereby expanding the utility of such provenance for others. These contributing users may have varying backgrounds, ranging from system experts to outside domain experts to citizen scientists. Furthermore, such users may wish to make varying types of annotations - ranging from documenting the purpose of a provenance step to raising concerns about the quality of data dependencies. Semantic Web technologies allow for such kinds of rich annotations to be made to provenance through the use of ontology vocabularies for (i) organizing provenance, and (ii) organizing user/annotation classifications. Furthermore, through Linked Data practices, Semantic linkages may be made from provenance steps to external data of interest. A desire for Semantically-annotated provenance has been motivated by data management issues in the Mauna Loa Solar Observatory’s (MLSO) Advanced Coronal Observing System (ACOS). In ACOS, photomoeter-based readings are taken of solar activity and subsequently processed into final data products consumable by end users. At intermediate stages of ACOS processing, factors such as evaluations by human experts and weather conditions are logged, which could impact data product quality. If such factors are linked via user-submitted annotations to provenance, it could be significantly beneficial for other users. Likewise, the background of a user could impact the credibility of their annotations. For example, an annotation made by a citizen scientist describing the purpose of a provenance step may not be as reliable as a similar annotation made by an ACOS project member. For this work, we have developed a software package that

  13. Clinical benefits of incorporating doxycycline into a canine heartworm treatment protocol.

    Science.gov (United States)

    Nelson, C Thomas; Myrick, Elizabeth S; Nelson, Thomas A

    2017-11-09

    The objective of heartworm treatment is to improve the clinical condition of the patient and to eliminate pre-cardiac, juvenile, and adult worm stages with minimal complications. Pulmonary thromboembolisms are an inevitable consequence of worm death and can result in severe pulmonary reactions and even death of the patient. To minimize these reactions, various treatment protocols involving melarsomine, the only adulticidal drug approved by the US Food and Drug Administrations (FDA), in conjunction with macrocyclic lactone heartworm preventives and glucocorticosteroids have been advocated. The discovery of the bacterial endosymbiont Wolbachia in Dirofilaria immitis has led to several experimental studies examining the effects of administering doxycycline to reduce or eliminate Wolbachia organism. These studies have shown a decrease in gross and microscopic pathology of pulmonary parenchyma in experimental heartworm infections pretreated with doxycycline before melarsomine administration. Electronic medical records from a large veterinary practice in northeast Alabama were searched to identify dogs treated for heartworms with melarsomine from January 2005 through December 2012. The search was refined further to select for dogs that met the following criteria: 1) received two or three doses of ivermectin heartworm preventive prior to melarsomine injections, 2) received one injection of melarsomine followed by two injections 4 to 8 weeks later, and 3) were treated with prednisone following melarsomine injections. The dogs were then divided into those that also were treated with doxycycline 10 mg/kg BID for 4 weeks (Group A, n = 47) and those that did not receive doxycycline (Group B, n = 47). The medical notes of all 94 cases were then reviewed for comments concerning coughing, dyspnea, or hemoptysis in the history, physical exam template, or from telephone conversations with clients the week following each visit. Any dog that died within one year of treatment

  14. Clinical benefits of incorporating doxycycline into a canine heartworm treatment protocol

    Directory of Open Access Journals (Sweden)

    C. Thomas Nelson

    2017-11-01

    Full Text Available Abstract Background The objective of heartworm treatment is to improve the clinical condition of the patient and to eliminate pre-cardiac, juvenile, and adult worm stages with minimal complications. Pulmonary thromboembolisms are an inevitable consequence of worm death and can result in severe pulmonary reactions and even death of the patient. To minimize these reactions, various treatment protocols involving melarsomine, the only adulticidal drug approved by the US Food and Drug Administrations (FDA, in conjunction with macrocyclic lactone heartworm preventives and glucocorticosteroids have been advocated. The discovery of the bacterial endosymbiont Wolbachia in Dirofilaria immitis has led to several experimental studies examining the effects of administering doxycycline to reduce or eliminate Wolbachia organism. These studies have shown a decrease in gross and microscopic pathology of pulmonary parenchyma in experimental heartworm infections pretreated with doxycycline before melarsomine administration. Methods Electronic medical records from a large veterinary practice in northeast Alabama were searched to identify dogs treated for heartworms with melarsomine from January 2005 through December 2012. The search was refined further to select for dogs that met the following criteria: 1 received two or three doses of ivermectin heartworm preventive prior to melarsomine injections, 2 received one injection of melarsomine followed by two injections 4 to 8 weeks later, and 3 were treated with prednisone following melarsomine injections. The dogs were then divided into those that also were treated with doxycycline 10 mg/kg BID for 4 weeks (Group A, n = 47 and those that did not receive doxycycline (Group B, n = 47. The medical notes of all 94 cases were then reviewed for comments concerning coughing, dyspnea, or hemoptysis in the history, physical exam template, or from telephone conversations with clients the week following each visit. Any

  15. Treatment of peri-implant diseases: a review of the literature and protocol proposal.

    Science.gov (United States)

    Armas, Joshé; Culshaw, Shauna; Savarrio, Lee

    2013-01-01

    Over 100,000 implants were placed in the UK in 2010. As the numbers of patients with implant-retained prostheses increases, operators are encountering an increasing number of biological implant complications, most commonly peri-implant mucositis and peri-implantitis. The effective management of these complications is crucial to maintain patients' oral health. In particular, in contrast to common periodontal infections, some peri-implant infections may benefit from surgical intervention as a first line approach. This article reviews the literature on the treatment options for peri-implant mucositis and peri-implantitis and proposes a protocol for their treatment.

  16. Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

    OpenAIRE

    Zarski, Anna-Carlotta; Berking, Matthias; Ebert, David Daniel

    2018-01-01

    Introduction Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce. Aim This article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an...

  17. The PBase Scientific Workflow Provenance Repository

    Directory of Open Access Journals (Sweden)

    Víctor Cuevas-Vicenttín

    2014-10-01

    Full Text Available Scientific workflows and their supporting systems are becoming increasingly popular for compute-intensive and data-intensive scientific experiments. The advantages scientific workflows offer include rapid and easy workflow design, software and data reuse, scalable execution, sharing and collaboration, and other advantages that altogether facilitate “reproducible science”. In this context, provenance – information about the origin, context, derivation, ownership, or history of some artifact – plays a key role, since scientists are interested in examining and auditing the results of scientific experiments. However, in order to perform such analyses on scientific results as part of extended research collaborations, an adequate environment and tools are required. Concretely, the need arises for a repository that will facilitate the sharing of scientific workflows and their associated execution traces in an interoperable manner, also enabling querying and visualization. Furthermore, such functionality should be supported while taking performance and scalability into account. With this purpose in mind, we introduce PBase: a scientific workflow provenance repository implementing the ProvONE proposed standard, which extends the emerging W3C PROV standard for provenance data with workflow specific concepts. PBase is built on the Neo4j graph database, thus offering capabilities such as declarative and efficient querying. Our experiences demonstrate the power gained by supporting various types of queries for provenance data. In addition, PBase is equipped with a user friendly interface tailored for the visualization of scientific workflow provenance data, making the specification of queries and the interpretation of their results easier and more effective.

  18. PAV ontology: provenance, authoring and versioning.

    Science.gov (United States)

    Ciccarese, Paolo; Soiland-Reyes, Stian; Belhajjame, Khalid; Gray, Alasdair Jg; Goble, Carole; Clark, Tim

    2013-11-22

    Provenance is a critical ingredient for establishing trust of published scientific content. This is true whether we are considering a data set, a computational workflow, a peer-reviewed publication or a simple scientific claim with supportive evidence. Existing vocabularies such as Dublin Core Terms (DC Terms) and the W3C Provenance Ontology (PROV-O) are domain-independent and general-purpose and they allow and encourage for extensions to cover more specific needs. In particular, to track authoring and versioning information of web resources, PROV-O provides a basic methodology but not any specific classes and properties for identifying or distinguishing between the various roles assumed by agents manipulating digital artifacts, such as author, contributor and curator. We present the Provenance, Authoring and Versioning ontology (PAV, namespace http://purl.org/pav/): a lightweight ontology for capturing "just enough" descriptions essential for tracking the provenance, authoring and versioning of web resources. We argue that such descriptions are essential for digital scientific content. PAV distinguishes between contributors, authors and curators of content and creators of representations in addition to the provenance of originating resources that have been accessed, transformed and consumed. We explore five projects (and communities) that have adopted PAV illustrating their usage through concrete examples. Moreover, we present mappings that show how PAV extends the W3C PROV-O ontology to support broader interoperability. The initial design of the PAV ontology was driven by requirements from the AlzSWAN project with further requirements incorporated later from other projects detailed in this paper. The authors strived to keep PAV lightweight and compact by including only those terms that have demonstrated to be pragmatically useful in existing applications, and by recommending terms from existing ontologies when plausible. We analyze and compare PAV with related

  19. RESULTS OF ACUTE LYMPHOBLASTIC LEUKEMIA TREATMENT WITH INTENSIVE CHEMOTHERAPY IN CHILDREN IN ST.-PETERSBURG: RETROSPECTIVE EVALUATION OF TWO VERSIONS OF COALL-92 PROTOCOL

    Directory of Open Access Journals (Sweden)

    E.G. Boichenko

    2011-01-01

    Full Text Available Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048, probability of relapse-free survival (рRFS was 65 and 74% (plog-rank = 0,002, probability of overall survival was (pOS 78 and 70%, correspondingly (plog-rank = 0,079. Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy.Key words: children, acute lymphoblastic leukemia, intensive chemotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 33–42

  20. Big Data Provenance: Challenges, State of the Art and Opportunities.

    Science.gov (United States)

    Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay

    2015-01-01

    Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and utilization. This paper discusses the challenges and opportunities of Big Data provenance related to the veracity of the datasets themselves and the provenance of the analytical processes that analyze these datasets. It also explains our current efforts towards tracking and utilizing Big Data provenance using workflows as a programming model to analyze Big Data.

  1. The Symbiotic Relationship between Scientific Workflow and Provenance (Invited)

    Science.gov (United States)

    Stephan, E.

    2010-12-01

    The purpose of this presentation is to describe the symbiotic nature of scientific workflows and provenance. We will also discuss the current trends and real world challenges facing these two distinct research areas. Although motivated differently, the needs of the international science communities are the glue that binds this relationship together. Understanding and articulating the science drivers to these communities is paramount as these technologies evolve and mature. Originally conceived for managing business processes, workflows are now becoming invaluable assets in both computational and experimental sciences. These reconfigurable, automated systems provide essential technology to perform complex analyses by coupling together geographically distributed disparate data sources and applications. As a result, workflows are capable of higher throughput in a shorter amount of time than performing the steps manually. Today many different workflow products exist; these could include Kepler and Taverna or similar products like MeDICI, developed at PNNL, that are standardized on the Business Process Execution Language (BPEL). Provenance, originating from the French term Provenir “to come from”, is used to describe the curation process of artwork as art is passed from owner to owner. The concept of provenance was adopted by digital libraries as a means to track the lineage of documents while standards such as the DublinCore began to emerge. In recent years the systems science community has increasingly expressed the need to expand the concept of provenance to formally articulate the history of scientific data. Communities such as the International Provenance and Annotation Workshop (IPAW) have formalized a provenance data model. The Open Provenance Model, and the W3C is hosting a provenance incubator group featuring the Proof Markup Language. Although both workflows and provenance have risen from different communities and operate independently, their mutual

  2. Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

    OpenAIRE

    Anna-Carlotta Zarski; Anna-Carlotta Zarski; Matthias Berking; David Daniel Ebert

    2018-01-01

    IntroductionGenito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce.AimThis article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an In...

  3. Model-based Abstraction of Data Provenance

    DEFF Research Database (Denmark)

    Probst, Christian W.; Hansen, René Rydhof

    2014-01-01

    to bigger models, and the analyses adapt accordingly. Our approach extends provenance both with the origin of data, the actors and processes involved in the handling of data, and policies applied while doing so. The model and corresponding analyses are based on a formal model of spatial and organisational......Identifying provenance of data provides insights to the origin of data and intermediate results, and has recently gained increased interest due to data-centric applications. In this work we extend a data-centric system view with actors handling the data and policies restricting actions....... This extension is based on provenance analysis performed on system models. System models have been introduced to model and analyse spatial and organisational aspects of organisations, to identify, e.g., potential insider threats. Both the models and analyses are naturally modular; models can be combined...

  4. Provenance-Based Debugging and Drill-Down in Data-Oriented Workflows

    KAUST Repository

    Ikeda, Robert

    2012-04-01

    Panda (for Provenance and Data) is a system that supports the creation and execution of data-oriented workflows, with automatic provenance generation and built-in provenance tracing operations. Workflows in Panda are arbitrary a cyclic graphs containing both relational (SQL) processing nodes and opaque processing nodes programmed in Python. For both types of nodes, Panda generates logical provenance - provenance information stored at the processing-node level - and uses the generated provenance to support record-level backward tracing and forward tracing operations. In our demonstration we use Panda to integrate, process, and analyze actual education data from multiple sources. We specifically demonstrate how Panda\\'s provenance generation and tracing capabilities can be very useful for workflow debugging, and for drilling down on specific results of interest. © 2012 IEEE.

  5. Citation and Recognition of contributions using Semantic Provenance Knowledge Captured in the OPeNDAP Software Framework

    Science.gov (United States)

    West, P.; Michaelis, J.; Lebot, T.; McGuinness, D. L.; Fox, P. A.

    2014-12-01

    Providing proper citation and attribution for published data, derived data products, and the software tools used to generate them, has always been an important aspect of scientific research. However, It is often the case that this type of detailed citation and attribution is lacking. This is in part because it often requires manual markup since dynamic generation of this type of provenance information is not typically done by the tools used to access, manipulate, transform, and visualize data. In addition, the tools themselves lack the information needed to be properly cited themselves. The OPeNDAP Hyrax Software Framework is a tool that provides access to and the ability to constrain, manipulate, and transform, different types of data from different data formats, into a common format, the DAP (Data Access Protocol), in order to derive new data products. A user, or another software client, specifies an HTTP URL in order to access a particular piece of data, and appropriately transform it to suit a specific purpose of use. The resulting data products, however, do not contain any information about what data was used to create it, or the software process used to generate it, let alone information that would allow the proper citing and attribution to down stream researchers and tool developers. We will present our approach to provenance capture in Hyrax including a mechanism that can be used to report back to the hosting site any derived products, such as publications and reports, using the W3C PROV recommendation pingback service. We will demonstrate our utilization of Semantic Web and Web standards, the development of an information model that extends the PROV model for provenance capture, and the development of the pingback service. We will present our findings, as well as our practices for providing provenance information, visualization of the provenance information, and the development of pingback services, to better enable scientists and tool developers to be

  6. Protocol for the specialist supervised individualised multifactorial treatment of new clinically diagnosed type 2 diabetes in general practice (IDA)

    DEFF Research Database (Denmark)

    Stidsen, Jacob Volmer; Nielsen, Jens Steen; Henriksen, Jan Erik

    2017-01-01

    INTRODUCTION: We present the protocol for a multifactorial intervention study designed to test whether individualised treatment, based on pathophysiological phenotyping and individualised treatment goals, improves type 2 diabetes (T2D) outcomes. METHODS AND ANALYSIS: We will conduct a prospective...

  7. Effects of arbuscular mycorrhizae on growth and mineral nutrition of greenhouse propagated fruit trees from diverse geographic provenances

    Directory of Open Access Journals (Sweden)

    Guissou, T.

    2016-01-01

    Full Text Available Description of the subject. Arbuscular mycorrhizal (AM fungi are known to promote plant growth by enhancing mineral uptake in nutrient deficient soils. These beneficial effects on plant growth may vary considerably between cultivars of a given species and between plant species originating from different locations. Objectives. The present experiment evaluated the response of three Sahelian fruit trees: néré (Parkia biglobosa [Jacq.] G.Don, tamarind (Tamarindus indica L., and jujube (Ziziphus mauritiana Lam., originating from five different geographic provenances, to mycorrhizal colonization, evaluate their respective mycorrhizal dependency (MD and analyze their leaf and stem mineral composition. Method. Trees were cultivated in a nursery on pre-sterilized soil substrate low in available P (2.18 μg·g-1 with or without inoculum of Glomus aggregatum (Schenck & Smith emend. Koske. The experiment was arranged in a factorial design for each fruit tree species separately: 5 provenances x 2 AM treatments (inoculated and non-inoculated [control] with 10 replicates per treatment. Plants were harvested six months after inoculation and different parameters were measured. Results. Overall, the results showed significant provenance variations in the plant response to mycorrhizal inoculation. Néré mycorrhizal plants, from two seed sources, tamarind and jujube plants from one seed source had significant higher dry weight and shoot height than those from other provenances. Jujube plants from 3 out of the 5 provenances showed significant higher MD. It then appears that seed provenance happened to be determinant even though AM-root colonization levels (80-90% do not vary much from one provenance to another. In all cases, the fruit trees benefited from AM fungi with increased N, P and K mineral uptake in aerial parts. In particular P uptake was proportional to MD concentration in AM-jujube plants. Conclusions. These results demonstrate the importance of

  8. Efficiency of modified therapeutic protocol in the treatment of some varieties of canine cardiovascular dirofilariasis

    Directory of Open Access Journals (Sweden)

    Stepanović

    2015-12-01

    Full Text Available The paper presents clinical diagnostic approaches and therapeutic effects of a specific protocol for the treatment of dogs with cardiovascular dirofilariasis in the Belgrade City (Serbia territory. The study involved 50 privately owned dogs of different breeds, gender, and age, all showing signs of cardio - respiratory disorders. In addition to a general physical examination, blood tests were done to detect microfilaria and adult forms, and X-ray, ECG, and echocardiography were performed as well. At the first examination, 34 out of 50 examined dogs were positive for microfilaria and adult forms. Because of a lack of drug used as „the golden standard“ in dirofilariasis treatment, it involved a combination of doxycycline (10 mg/kg and ivermectin (6 μg/kg supported with Advocate - Bayer spot-on. After six months, the first control was performed while continuing treatment with the aforesaid protocol, and the second control was performed after 12 months. Of the 34 treated dogs, all were negative for microfilaria, as early as after the first six months of the treatment (100%. One dog was positive for adult forms of the parasite after six and 12 months. In echocardiography and X-ray examination after 12 months, six dogs showed evident chronic changes. At controls conducted at sixth month and at one year, the implemented therapy was successful in 97.05% (33/34 of primarily infected dogs.

  9. Provenance an introduction to PROV

    CERN Document Server

    Moreau, Luc

    2013-01-01

    The World Wide Web is now deeply intertwined with our lives, and has become a catalyst for a data deluge, making vast amounts of data available online, at a click of a button. With Web 2.0, users are no longer passive consumers, but active publishers and curators of data. Hence, from science to food manufacturing, from data journalism to personal well-being, from social media to art, there is a strong interest in provenance, a description of what influenced an artifact, a data set, a document, a blog, or any resource on the Web and beyond. Provenance is a crucial piece of information that can

  10. Effects of a screening and treatment protocol with haloperidol on post-cardiotomy delirium

    DEFF Research Database (Denmark)

    Schrøder Pedersen, Sofie; Kirkegaard, Thomas; Balslev Jørgensen, Martin

    2014-01-01

    OBJECTIVES: Post-cardiotomy delirium is common and associated with increased morbidity and mortality. No gold standard exists for detecting delirium, and evidence to support the choice of treatment is needed. Haloperidol is widely used for treating delirium, but indication, doses and therapeutic...... targets vary. Moreover, doubt has been raised regarding overall efficacy. The purpose of this study was to assess the effect of a combination of early detection and standardized treatment with haloperidol on post-cardiotomy delirium, with the hypothesis that the proportion of delirium- and coma-free days...... could be increased. Length of stay (LOS), complications and 180-day mortality are reported. METHODS: Prospective interventional cohort study. One hundred and seventeen adult patients undergoing cardiac surgery were included before introduction of a screening and treatment protocol with haloperidol...

  11. A Passive Testing Approach for Protocols in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Xiaoping Che

    2015-11-01

    Full Text Available Smart systems are today increasingly developed with the number of wireless sensor devices drastically increasing. They are implemented within several contexts throughout our environment. Thus, sensed data transported in ubiquitous systems are important, and the way to carry them must be efficient and reliable. For that purpose, several routing protocols have been proposed for wireless sensor networks (WSN. However, one stage that is often neglected before their deployment is the conformance testing process, a crucial and challenging step. Compared to active testing techniques commonly used in wired networks, passive approaches are more suitable to the WSN environment. While some works propose to specify the protocol with state models or to analyze them with simulators and emulators, we here propose a logic-based approach for formally specifying some functional requirements of a novel WSN routing protocol. We provide an algorithm to evaluate these properties on collected protocol execution traces. Further, we demonstrate the efficiency and suitability of our approach by its application into common WSN functional properties, as well as specific ones designed from our own routing protocol. We provide relevant testing verdicts through a real indoor testbed and the implementation of our protocol. Furthermore, the flexibility, genericity and practicability of our approach have been proven by the experimental results.

  12. RPV in-situ segmentation combined with off-site treatment for volume reduction and recycling - Proven In-Situ Segmentation Combined with Off-Site Treatment for Volume Reduction and Recycling. RPV case study

    International Nuclear Information System (INIS)

    Larsson, Arne; Lidar, Per; Segerud, Per; Hedin, Gunnar

    2014-01-01

    Decommissioning of nuclear power plants generates large volumes of radioactive or potentially radioactive waste. The proper management of the large components and the dismantling waste are key success factors in a decommissioning project. A large component of major interest is, due to its size and its span in radioactivity content, the RVP, which can be disposed as is or be segmented, treated, partially free released for recycling and conditioned for disposal in licensed packages. To a certain extent the decommissioning program have to be led by the waste management process. The costs for the plant decommissioning can be reduced by the usage of off-site waste treatment facilities as the time needed for performing the decommissioning project will be reduced as well as the waste volumes for disposal. Long execution times and delays due to problems with on-site waste management processes are major cost drivers for decommissioning projects. This involves also the RPV. In Sweden, the extension of the geological repository SFR plans for a potential disposal of whole RPVs. Disposal of whole RPVs is currently the main alternative but other options are considered. The target is to avoid extensive on-site waste management of RPVs to reduce the risk for delays. This paper describes in-situ RPV segmentation followed by off-site treatment aiming for free release for recycling of a substantial amount of the material, and volume efficient conditioning of the remaining parts. Real data from existing LWR RPVs was used for this study. Proven segmentation methods are intended to be used for the in situ segmentation followed by proven methods for packaging, transportation, treatment, recycling and conditioning for disposal. The expected volume reduction for disposal can be about 90% compared to whole RPV disposal. In this respect the in-situ segmentation of the RVPs to large pieces followed by off-site treatment is an interesting alternative that fits very well with the objective

  13. The impact of seeds provenance and nursery provenance method on Austrian pine (Pinus nigra Arn. seedlings quality

    Directory of Open Access Journals (Sweden)

    Vladan Ivetić

    2013-12-01

    Full Text Available The influence of seed provenances and seedling production methods on quality of one and two years old seedlings of Austrian pine were investigated. Seeds from three provenances of Austrian pine (Goc, Studenica and Sargan were used for seedlings production, combined with three production methods: (i the modified seedbeds (bare-root, (ii the container type Plantagrah II and (iii the container type Gocko. Provenance, as well as the combined influence of provenance and production method had minimal influence on the variability of one and two years old Austrian pine seedlings. Nevertheless, the production method had the highest influence. The production system, besides its importance in nursery, will have a high influence on seedlings growth during the first year after planting. Considering the results of this study (e.g. the highest values of the diameter, number of lateral roots, shoot and root dry weight, and quality index and the lowest value of SQ and satisfactory value of S:R, we can conclude that the seedlings produced in container type Gocko led to the highest seedlings quality, recommended especially for afforestation on hard sites.     

  14. Provenance research: investigation of genetic diversity associated with geography

    Science.gov (United States)

    Robert Z. Callaham

    1963-01-01

    Provenance in forestry refers to the population of trees growing at n particular place of origin. Provenance research defines the genetic and environmental components of phenotypic variation associated with geographic source. Information on provenance is important in assuring sources of seed to give well-adapted, productive trees and in directing breeding of...

  15. Provenance Store Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Paulson, Patrick R.; Gibson, Tara D.; Schuchardt, Karen L.; Stephan, Eric G.

    2008-03-01

    Requirements for the provenance store and access API are developed. Existing RDF stores and APIs are evaluated against the requirements and performance benchmarks. The team’s conclusion is to use MySQL as a database backend, with a possible move to Oracle in the near-term future. Both Jena and Sesame’s APIs will be supported, but new code will use the Jena API

  16. Utilizing Provenance in Reusable Research Objects

    Directory of Open Access Journals (Sweden)

    Zhihao Yuan

    2018-03-01

    Full Text Available Science is conducted collaboratively, often requiring the sharing of knowledge about computational experiments. When experiments include only datasets, they can be shared using Uniform Resource Identifiers (URIs or Digital Object Identifiers (DOIs. An experiment, however, seldom includes only datasets, but more often includes software, its past execution, provenance, and associated documentation. The Research Object has recently emerged as a comprehensive and systematic method for aggregation and identification of diverse elements of computational experiments. While a necessary method, mere aggregation is not sufficient for the sharing of computational experiments. Other users must be able to easily recompute on these shared research objects. Computational provenance is often the key to enable such reuse. In this paper, we show how reusable research objects can utilize provenance to correctly repeat a previous reference execution, to construct a subset of a research object for partial reuse, and to reuse existing contents of a research object for modified reuse. We describe two methods to summarize provenance that aid in understanding the contents and past executions of a research object. The first method obtains a process-view by collapsing low-level system information, and the second method obtains a summary graph by grouping related nodes and edges with the goal to obtain a graph view similar to application workflow. Through detailed experiments, we show the efficacy and efficiency of our algorithms.

  17. Reliability of kinetic visual field testing in children with mutation-proven retinal dystrophies: Implications for therapeutic clinical trials.

    Science.gov (United States)

    Dedania, Vaidehi S; Liu, Jerry Y; Schlegel, Dana; Andrews, Chris A; Branham, Kari; Khan, Naheed W; Musch, David C; Heckenlively, John R; Jayasundera, K Thiran

    2018-01-01

    Kinetic visual field testing is used to monitor disease course in retinal dystrophy clinical care and treatment response in treatment trials, which are increasingly recruiting children. This study investigates Goldmann visual field (GVF) changes in young children with mutation-proven retinal dystrophies as they age and with progression of the retinal degeneration. Retrospective review of children ≤ 17 years old with a mutation-proven retinal dystrophy. Objective clinical disease activity was assessed by a retinal degeneration specialist masked to GVF results. Digital quantification of GVF area was performed. Twenty-nine children (58 eyes), ages 5-16, were identified. GVF area increased with age despite progression in 20 children and clinical stability in nine children. Mean ± standard error increase in GVF area/year was 333 ± 130 mm 2 (I4e, p = 0.012), 720 ± 155 mm 2 (III4e, p children with mutation-proven retinal dystrophies, there is a significant increase in GVF area with age, particularly those children with retinal dystrophies can be an unreliable measure of response to treatment and on which to base appropriate counseling about visual impairment.

  18. [Multidisciplinary protocol for computed tomography imaging and angiographic embolization of splenic injury due to trauma: assessment of pre-protocol and post-protocol outcomes].

    Science.gov (United States)

    Koo, M; Sabaté, A; Magalló, P; García, M A; Domínguez, J; de Lama, M E; López, S

    2011-11-01

    To assess conservative treatment of splenic injury due to trauma, following a protocol for computed tomography (CT) and angiographic embolization. To quantify the predictive value of CT for detecting bleeding and need for embolization. The care protocol developed by the multidisciplinary team consisted of angiography with embolization of lesions revealed by contrast extravasation under CT as well as embolization of grade III-V injuries observed, or grade I-II injuries causing hemodynamic instability and/or need for blood transfusion. We collected data on demographic variables, injury severity score (ISS), angiographic findings, and injuries revealed by CT. Pre-protocol and post-protocol outcomes were compared. The sensitivity and specificity of CT findings were calculated for all patients who required angiographic embolization. Forty-four and 30 angiographies were performed in the pre- and post-protocol periods, respectively. The mean (SD) ISSs in the two periods were 25 (11) and 26 (12), respectively. A total of 24 (54%) embolizations were performed in the pre-protocol period and 28 (98%) after implementation of the protocol. Two and 7 embolizations involved the spleen in the 2 periods, respectively; abdominal laparotomies numbered 32 and 25, respectively, and 10 (31%) vs 4 (16%) splenectomies were performed. The specificity and sensitivity values for contrast extravasation found on CT and followed by embolization were 77.7% and 79.5%. The implementation of this multidisciplinary protocol using CT imaging and angiographic embolization led to a decrease in the number of splenectomies. The protocol allows us to take a more conservative treatment approach.

  19. Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

    Science.gov (United States)

    Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

    2018-03-07

    To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

  20. Radio and chemioinduced oral mucositis treatment: comparison between conventional drug protocol and treatments with low intensity lasers

    International Nuclear Information System (INIS)

    Alencar, Anelise Ribeiro Peixoto

    2011-01-01

    In this clinical study verified the effects of low intensity laser in the prevention and treatment of oral mucositis radio and/or chemical induced. Thirty one patients with head and neck cancer were selected before being submitted to cancer exclusive radiotherapy or radio and associated chemotherapy. The patients were distributed into three randomly groups as follows: group 1- (control) conventional medicine treatment; group 2 - conventional medicine treatment and daily laser therapy as soon as grade two oral mucositis appeared; group 3 - conventional medicine treatment and daily laser therapy to be initiated immediately before radiotherapy sessions.The irradiation parameters were: wavelength of 660nm, potency of 100mW, continuous mode, punctual application, 2J energy on thirty pre-determined 30 points, with 20s of exposure per point. The control group received medical treatment which consisted in using a set of preventive and therapeutic approach for acute radiation-induced adverse effects. Results were evaluated observing occurrence and grade of oral mucositis, score of pain, loss of body mass, use of nasogastric sound line, internment and interruption of oncologic treatment due to oral mucositis. The results showed that the preventive protocol as used was the most effective in prevention and treatment of oral mucositis and that its daily application contributed in relieving the painful symptomatology so collaborating to maintain and/or bettering the life quality of oncologic patients. (author)

  1. TH-CD-BRA-11: Implementation and Evaluation of a New 3D Dosimetry Protocol for Validating MRI Guided Radiation Therapy Treatments

    International Nuclear Information System (INIS)

    Mein, S; Rankine, L; Adamovics, J; Li, H; Oldham, M

    2016-01-01

    Purpose: To develop, evaluate and apply a novel high-resolution 3D remote dosimetry protocol for validation of MRI guided radiation therapy treatments (MRIdian by ViewRay™). We demonstrate the first application of the protocol (including two small but required new correction terms) utilizing radiochromic 3D plastic PRESAGE™ with optical-CT readout. Methods: A detailed study of PRESAGE™ dosimeters (2kg) was conducted to investigate the temporal and spatial stability of radiation induced optical density change (ΔOD) over 8 days. Temporal stability was investigated on 3 dosimeters irradiated with four equally-spaced square 6MV fields delivering doses between 10cGy and 300cGy. Doses were imaged (read-out) by optical-CT at multiple intervals. Spatial stability of ΔOD response was investigated on 3 other dosimeters irradiated uniformly with 15MV extended-SSD fields with doses of 15cGy, 30cGy and 60cGy. Temporal and spatial (radial) changes were investigated using CERR and MATLAB’s Curve Fitting Tool-box. A protocol was developed to extrapolate measured ΔOD readings at t=48hr (the typical shipment time in remote dosimetry) to time t=1hr. Results: All dosimeters were observed to gradually darken with time (<5% per day). Consistent intra-batch sensitivity (0.0930±0.002 ΔOD/cm/Gy) and linearity (R2=0.9996) was observed at t=1hr. A small radial effect (<3%) was observed, attributed to curing thermodynamics during manufacture. The refined remote dosimetry protocol (including polynomial correction terms for temporal and spatial effects, CT and CR) was then applied to independent dosimeters irradiated with MR-IGRT treatments. Excellent line profile agreement and 3D-gamma results for 3%/3mm, 10% threshold were observed, with an average passing rate 96.5%± 3.43%. Conclusion: A novel 3D remote dosimetry protocol is presented capable of validation of advanced radiation treatments (including MR-IGRT). The protocol uses 2kg radiochromic plastic dosimeters read-out by

  2. TH-CD-BRA-11: Implementation and Evaluation of a New 3D Dosimetry Protocol for Validating MRI Guided Radiation Therapy Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Mein, S [Duke University Medical Physics Graduate Program (United States); Rankine, L [Department of Radiation Oncology, University of North Carolina in Chapel Hill (United States); Department of Radiation Oncology, Washington University School of Medicine (United States); Adamovics, J [Department of Chemistry and Biology, Rider University, Lawrenceville, NJ (United States); Li, H [Department of Radiation Oncology, Washington University School of Medicine (United States); Oldham, M [Department of Radiation Oncology, Duke University Medical Center (United States)

    2016-06-15

    Purpose: To develop, evaluate and apply a novel high-resolution 3D remote dosimetry protocol for validation of MRI guided radiation therapy treatments (MRIdian by ViewRay™). We demonstrate the first application of the protocol (including two small but required new correction terms) utilizing radiochromic 3D plastic PRESAGE™ with optical-CT readout. Methods: A detailed study of PRESAGE™ dosimeters (2kg) was conducted to investigate the temporal and spatial stability of radiation induced optical density change (ΔOD) over 8 days. Temporal stability was investigated on 3 dosimeters irradiated with four equally-spaced square 6MV fields delivering doses between 10cGy and 300cGy. Doses were imaged (read-out) by optical-CT at multiple intervals. Spatial stability of ΔOD response was investigated on 3 other dosimeters irradiated uniformly with 15MV extended-SSD fields with doses of 15cGy, 30cGy and 60cGy. Temporal and spatial (radial) changes were investigated using CERR and MATLAB’s Curve Fitting Tool-box. A protocol was developed to extrapolate measured ΔOD readings at t=48hr (the typical shipment time in remote dosimetry) to time t=1hr. Results: All dosimeters were observed to gradually darken with time (<5% per day). Consistent intra-batch sensitivity (0.0930±0.002 ΔOD/cm/Gy) and linearity (R2=0.9996) was observed at t=1hr. A small radial effect (<3%) was observed, attributed to curing thermodynamics during manufacture. The refined remote dosimetry protocol (including polynomial correction terms for temporal and spatial effects, CT and CR) was then applied to independent dosimeters irradiated with MR-IGRT treatments. Excellent line profile agreement and 3D-gamma results for 3%/3mm, 10% threshold were observed, with an average passing rate 96.5%± 3.43%. Conclusion: A novel 3D remote dosimetry protocol is presented capable of validation of advanced radiation treatments (including MR-IGRT). The protocol uses 2kg radiochromic plastic dosimeters read-out by

  3. Bridging the provenance gap: opportunities and challenges tracking in and ex silico provenance in sUAS workflows

    Science.gov (United States)

    Thomer, A.

    2017-12-01

    Data provenance - the record of the varied processes that went into the creation of a dataset, as well as the relationships between resulting data objects - is necessary to support the reusability, reproducibility and reliability of earth science data. In sUAS-based research, capturing provenance can be particularly challenging because of the breadth and distributed nature of the many platforms used to collect, process and analyze data. In any given project, multiple drones, controllers, computers, software systems, sensors, cameras, imaging processing algorithms and data processing workflows are used over sometimes long periods of time. These platforms and processing result in dozens - if not hundreds - of data products in varying stages of readiness-for-analysis and sharing. Provenance tracking mechanisms are needed to make the relationships between these many data products explicit, and therefore more reusable and shareable. In this talk, I discuss opportunities and challenges in tracking provenance in sUAS-based research, and identify gaps in current workflow-capture technologies. I draw on prior work conducted as part of the IMLS-funded Site-Based Data Curation project in which we developed methods of documenting in and ex silico (that is, computational and non-computation) workflows, and demonstrate this approaches applicability to research with sUASes. I conclude with a discussion of ontologies and other semantic technologies that have potential application in sUAS research.

  4. Toothpaste use protocol with dental bleaching for a conservative treatment: Case reports

    Directory of Open Access Journals (Sweden)

    Waldemir F. Vieira-Junior

    2017-01-01

    Full Text Available In-office bleaching is a treatment based on products that contain hydrogen peroxide (HP while demonstrating whitening effectiveness. HP could promote alterations to surface morphologies and properties of dental tissues. The objective was describe a toothpaste protocol associated to bleaching therapy to promote a safer approach. Patient 1 (male and Patient 2 (female were attended, and toothbrushing (twice a day with a dentifrice containing bioactive glass (BG (NovaMin™ and fluoride was indicated before and during the treatment. Three bleaching sessions were made in cases, at intervals of 7 days. The gels used were 35% HP (Patient 1 and 35% HP supplied with calcium (Patient 2. The effectiveness of bleaching treatment was observed in both cases (Vita scale, with an esthetic self-acceptance. Sensitivity associated with the procedure was not reported. The indication of BG-based toothpaste is relevant in relation to enamel properties and did not affect the whitening effectiveness of dental bleaching.

  5. [Treatment and follow up protocol in differentiated thyroid carcinomas of follicular origin].

    Science.gov (United States)

    Rodrigues, Fernando; Limbert, Edward; Marques, Ana Paula; Santos, Ana Paula; Lopes, Carlos; Rodrigues, Elizabete; Borges, Fátima; Carrilho, Francisco; Castro, João Jácome de; Neto, João; Salgado, Lucília; Oliveira, Maria João

    2005-01-01

    Differentiated thyroid carcinoma of follicular origin (DTCFO), although not very frequent, has registered a raising incidence in the last decades. In the majority of the cases, DTCFO is a curable disease when treated and monitored by experienced, multidisciplinary teams. These factors contribute to an increasing number of DTCFO survivors requiring life-long monitoring, due to the possibility of occurrence of recurrences many years after the initial treatment. Several aspects of the treatment and management of these patients are still controversial. The present protocol represents the consensus of the members of the Grupo de Estudo da Tiróide of the Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. It aims to define guidelines, in agreement with the current state of the art and contemplating the necessary adaptations to local constrains, that ensure decreased mortality and protection of patients' quality of life, avoiding unnecessarily aggressive or ineffective treatments, optimizing the use of the available resources.

  6. A stepwise protocol for the treatment of refractory gastroesophageal reflux-induced chronic cough

    Science.gov (United States)

    Xu, Xianghuai; Lv, Hanjing; Yu, Li; Chen, Qiang; Liang, Siwei

    2016-01-01

    Background Refractory gastroesophageal reflux-induced chronic cough (GERC) is difficult to manage. The purpose of the study is to evaluate the efficacy of a novel stepwise protocol for treating this condition. Methods A total of 103 consecutive patients with suspected refractory reflux-induced chronic cough failing to a standard anti-reflux therapy were treated with a stepwise therapy. Treatment commences with high-dose omeprazole and, if necessary, is escalated to subsequent sequential treatment with ranitidine and finally baclofen. The primary end-point was overall cough resolution, and the secondary end-point was cough resolution after each treatment step. Results High-dose omeprazole eliminated or improved cough in 28.1% of patients (n=29). Further stepwise of treatment with the addition of ranitide yielded a favorable response in an additional 12.6% (n=13) of patients, and subsequent escalation to baclofen provoked response in another 36.9% (n=38) of patients. Overall, this stepwise protocol was successful in 77.6% (n=80) of patients. The diurnal cough symptom score fell from 3 [1] to 1 [0] (Z=6.316, P=0.000), and the nocturnal cough symptom score decreased from 1 [1] to 0 [1] (Z=–4.511, P=0.000), with a corresponding reduction in the Gastroesophageal Reflux Diagnostic Questionnaire score from 8.6±1.7 to 6.8±0.7 (t=3.612, P=0.000). Conversely, the cough threshold C2 to capsaicin was increased from 0.49 (0.49) µmol/L to 1.95 (2.92) µmol/L (Z=–5.892, P=0.000), and the cough threshold C5 was increased from 1.95 (2.92) µmol/L to 7.8 (5.85) µmol/L (Z=–5.171, P=0.000). Conclusions Sequential stepwise anti-reflux therapy is a useful therapeutic strategy for refractory reflux-induced chronic cough. PMID:26904227

  7. Efficacy of a protocol including heparin ointment for treatment of multikinase inhibitor-induced hand-foot skin reactions.

    Science.gov (United States)

    Li, Jian-ri; Yang, Chi-rei; Cheng, Chen-li; Ho, Hao-chung; Chiu, Kun-yuan; Su, Chung-Kuang; Chen, Wen-Ming; Wang, Shian-Shiang; Chen, Chuan-Shu; Yang, Cheng-Kuang; Ou, Yen-chuan

    2013-03-01

    The purpose of this study is to evaluate the efficacy of a protocol including topical heparin therapy for hand-foot skin reactions (HFSR) during multikinase (MKI) treatment. We prospectively collected 26 patients who had HFSRs during treatment with the MKIs, sunitinib, sorafenib, or axitinib. The age distribution ranged from 46 to 87 years, with a mean of 66 years. The distribution of HFSR severity was 12 patients with grade 1, 12 with grade 2, and 2 with grade 3. A heparin-containing topical ointment treatment, combined with hand-foot shock absorbers and skin moisturizers, was used at the lesion sites. Changes in the grade of HFSR, MKI dosage, and interruptions of MKI therapy were recorded. The results showed that 66.7% of grade 1 patients were cured of disease, 83.3% of grade 2 patients had improved symptoms, and both grade 3 patients (100%) had improved symptoms and were downgraded to grade 2. Four (15.4%) patients required reduction of MKI dosage, but there were no treatment interruptions or dropouts. Our protocol is beneficial in promoting resolution of HFSRs induced by MKIs. Further validation in large control studies should be investigated.

  8. Effect of consecutive re-synchronization protocols on pregnancy rate in buffalo (Bubalus bubalis) heifers out of the breeding season.

    Science.gov (United States)

    Neglia, Gianluca; Capuano, Massimo; Balestrieri, Anna; Cimmino, Roberta; Iannaccone, Francesco; Palumbo, Francesco; Presicce, Giorgio A; Campanile, Giuseppe

    2018-06-01

    The combined effect of six consecutive timed artificial inseminations (TAIs) on pregnancy rates, following two different synchronization protocols on buffalo heifers, over a period of seven months typically characterized by low breeding performances, were investigated in this study. A total of 2189 TAIs were performed on 1463 buffalo heifers within a large buffalo farm in the south of Italy. Individual animals were allowed to undergo synchronization protocol (either a slightly modified Ovsynch or Progesterone treatment) and TAI until establishment of pregnancy or else for not more than six consecutive times. Semen of seven proven bulls was used throughout the study, which was carried out from March to September of the same year. Therefore, other than the effect given by consecutive TAIs over time, a monthly and a seasonal effect could also be tested, once the entire period was split into a Low Breeding Season (LBS) from March to June, and a Transition to Breeding Season (TBS) from July to September. From the data recorded in this study and the statistical analysis performed, it can be stated that the two protocols for the synchronization of ovulation were similar in efficiency in determining pregnancies with an overall fertility rate of 89.4% when the comparison was run both on a monthly basis or when months were grouped into two different seasons. In addition, an average of 1.83 AI/pregnancy was reported, slightly higher for the Ovsynch when compared to the Progesterone protocol: 1.91 vs 1.70, respectively. Finally, when considering the number of progressive synchronization treatments implemented over time as covariate, neither Ovsynch nor Progesterone treatment significantly affected pregnancy rates following the first of the six synchronization sessions. However, repeating the synchronization procedure, the progesterone based protocol resulted in significantly higher probability of success in terms of established pregnancies during the second and third re

  9. Treatment of childhood encopresis: a randomized trial comparing three treatment protocols.

    Science.gov (United States)

    Borowitz, Stephen M; Cox, Daniel J; Sutphen, James L; Kovatchev, Boris

    2002-04-01

    To compare short- and long-term effectiveness of three additive treatment protocols in children experiencing chronic encopresis. Children, 6 to 15 years of age, who experienced at least weekly fecal soiling for 6 months or longer were eligible for the study. Children were randomly assigned to a group that received intensive medical therapy (IMT), a group that received intensive medical therapy plus a behavior management program called enhanced toilet training (ETT), or a group that received intensive medical therapy with enhanced toilet training and external anal sphincter electromyographic biofeedback (BF). Data concerning toileting habits were collected for 14 consecutive days before an initial visit, and at 3, 6, and 12 months after initiation of therapy. All data were collected using a computerized voice-mail system that telephoned the families each day. At 12 months, children were classified as significantly improved (reduction in soiling, P 0.90, P encopresis than either intensive medical therapy or anal sphincter biofeedback therapy. Although similar total cure rates at 1 year can be expected with these three forms of therapy, enhanced toilet training results in statistically significant decreases in the daily frequency of soiling for the greatest number of children.

  10. A comparison of more and less aggressive bone debridement protocols for the treatment of open supracondylar femur fractures.

    Science.gov (United States)

    Ricci, William M; Collinge, Cory; Streubel, Philipp N; McAndrew, Christopher M; Gardner, Michael J

    2013-12-01

    This study compared results of aggressive and nonaggressive debridement protocols for the treatment of high-energy, open supracondylar femur fractures after the primary procedure, with respect to the requirement for secondary bone grafting procedures, and deep infection. Retrospective review. Level I and level II trauma centers. Twenty-nine consecutive patients with high-grade, open (Gustilo types II and III) supracondylar femur fractures (OTA/AO 33A and C) treated with debridement and locked plating. Surgeons at 2 different level I trauma centers had different debridement protocols for open supracondylar femur fractures. One center used a more aggressive (MA) protocol in their patients (n = 17) that included removal of all devitalized bone and placement of antibiotic cement spacers to fill large segmental defects. The other center used a less aggressive (LA) protocol in their patients (n = 12) that included debridement of grossly contaminated bone with retention of other bone fragments and no use of antibiotic cement spacers. All other aspects of the treatment protocol at the 2 centers were similar: definitive fixation with locked plates in all cases, IV antibiotics were used until definitive wound closure, and weight bearing was advanced upon clinical and radiographic evidence of fracture healing. Healing after the primary procedure, requirement for secondary bone grafting procedures, and the presence of deep infection. Demographics were similar between included patients at each center with regard to age, gender, rate of open fractures, open fracture classification, mechanism, and smoking (P > 0.05). Patients at the MA center were more often diabetic (P debridement (35% vs. 0%, P debridement (71% vs. 8%, P debridement (92% vs. 35%, P debrided after a high-energy, high-grade, open supracondylar femur fracture is a matter of surgeon judgment and falls along a continuous spectrum. Based on the results of the current study, the theoretic trade-off between infection

  11. Provenance-Based Debugging and Drill-Down in Data-Oriented Workflows

    KAUST Repository

    Ikeda, Robert; Cho, Junsang; Fang, Charlie; Salihoglu, Semih; Torikai, Satoshi; Widom, Jennifer

    2012-01-01

    Panda (for Provenance and Data) is a system that supports the creation and execution of data-oriented workflows, with automatic provenance generation and built-in provenance tracing operations. Workflows in Panda are arbitrary a cyclic graphs

  12. Data Provenance and Trust

    Directory of Open Access Journals (Sweden)

    Stratis D Viglas

    2013-07-01

    Full Text Available The Oxford Dictionary defines provenance as “the place of origin, or earliest known history of something.” The term, when transferred to its digital counterpart, has morphed into a more general meaning. It is not only used to refer to the origin of a digital artefact but also to its changes over time. By changes in this context we may not only refer to its digital snapshots but also to the processes that caused and materialised the change. As an example, consider a database record r created at point in time t0; an update u to that record at time t1 causes it to have a value r’. In terms of provenance, we do not only want to record the snapshots (t0, r and (t1, r’ but also the transformation u that when applied to (t0, r results in (t1, r’, that is u(t0, r = (t1, r’.

  13. [Limiting factors in the class III camouflage treatment: a potential protocol].

    Science.gov (United States)

    Chaques Asensi, José

    2016-06-01

    The Class III skeletal malocclusion has been traditionally treated with a combined approach of orthodontics and orthognathic surgery or with a strategy of orthodontic camouflage. Some severe cases can be identified as ideal candidates for a surgical treatment whereas some others can be handled with orthodontics alone, with a reasonable expectation of an acceptable result. However, the problem remains for the borderline patient. In fact, limited information is available in the literature regarding the identification of the factors that can help in establishing the limits for one treatment modality or the other. Furthermore, the quantification of some of these factors, for practical purposes, is practically missing or very seldom suggested. Therefore, the decision making process remains a subjective reflection based on the "good clinical sense" of the orthodontist or just reduced to an "educated guess". In order to add some information, hopefully useful in deciding the most suitable treatment option for the individual patient, we propose a clinical protocol based on four different factors. Namely: the skeletal discrepancy, the occlusal discrepancy, the periodontal condition and facial aesthetics. For each one of these factors several parameters will be evaluated and, for some of them, an attempt to provide some reference numerical values will be made. Finally, clinical examples will be presented to illustrate the concepts discussed and the treatment alternatives, final treatment plan and treatment outcome will be analyzed for each one of them. © EDP Sciences, SFODF, 2016.

  14. On the feasibility of establishing the provenance of Australian Aboriginal artefacts using synchrotron radiation X-ray diffraction and proton-induced X-ray emission

    International Nuclear Information System (INIS)

    Creagh, D.C.; Kubik, M.E.; Sterns, M.

    2007-01-01

    Museums and galleries in Australia have extensive collections of Aboriginal artefacts in their custody. In particular, the National Museum of Australia and the National Gallery of Australia are custodians of works of very considerable significance, in both cultural and financial terms. Art fraud can occur, documentation relating to artefacts can be mislaid, or the artefacts can be incorrectly filed. Because of this, it has become essential to establish protocols for the objective determination of the provenance of artefacts through scientific tests. For the work reported here we are concerned with the comparison of very small quantities of materials, paint scrapings from artefacts. Scrapings from artefacts of unknown provenance are compared with those from artefacts of known provenance, and the database established using an extended set of analytical techniques by Kubik. We describe here our use of synchrotron radiation X-ray diffraction (SR-XRD) to determine the mineral phase compositions of very small amounts of pigment material (<50 μg), and the use of PIXE to give their atomic compositions to a threshold level of 1 ppm for similar masses of material

  15. Protocol for a systematic review of psychological interventions for cancer-related fatigue in post-treatment cancer survivors.

    Science.gov (United States)

    Corbett, Teresa; Devane, Declan; Walsh, Jane C; Groarke, AnnMarie; McGuire, Brian E

    2015-12-04

    Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase. Some evidence has been reported for interventions for fatigue during active treatment. However, to date, there is no systematic review on psychological interventions for fatigue after the completion of curative treatment for cancer. This is a protocol for a systematic review that aims to evaluate the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database. We will search the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library), PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and relevant sources of grey literature. Randomised controlled trials (RCTs) which have evaluated psychological interventions in adult cancer patients after the completion of treatment, with fatigue as an outcome measure, will be included. Two review authors will independently extract data from the selected studies and assess the methodological quality using the Cochrane Collaboration Risk of Bias Tool. Most existing evidence on cancer-related fatigue is from those in active cancer treatment. This systematic review and meta-analysis will build upon previous evaluations of psychological interventions in people during and after cancer treatment. With the growing need for stage-specific research in cancer, this review seeks to highlight a gap in current practice and to strengthen the evidence base of randomised controlled trials in the area. PROSPERO CRD42014015219.

  16. Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy.

    Science.gov (United States)

    Santos, Veruska Andrea; Freire, Rafael; Zugliani, Morená; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia

    2016-03-22

    The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (Paddiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (Panxiety, the correlation between scores was .724. This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the

  17. The challenges of treating paraganglioma patients with 177Lu-DOTATATE PRRT: Catecholamine crises, tumor lysis syndrome and the need for modification of treatment protocols

    International Nuclear Information System (INIS)

    Makis, William; Mccann, Karey; Mcewan, Alexander J. B.

    2015-01-01

    A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with 177 Lu-[DOTA0,Tyr3]octreotate (DOTATATE) radioisotope therapy using established protocols. Three paraganglioma patients were treated with 4–5 cycles of 177 Lu-DOTATATE and were evaluated for side effects and response to therapy. Two of the three patients developed severe adverse reactions following their first 177 Lu-DOTATATE treatment. One patient developed a catecholamine crisis and tumor lysis syndrome within hours of treatment, requiring intensive care unit (ICU) support, and another developed a catecholamine crisis 3 days after treatment, requiring hospitalization. The treatment protocols at our institution were subsequently modified by increasing the radioisotope infusion time from 15 to 30 min, as recommended in the literature, to 2–4 h and by reducing the administered dose of 177 Lu-DOTATATE. Subsequent 177 Lu-DOTATATE treatments utilizing the modified protocols were well tolerated, and response to therapy was achieved in all three patients, resulting in significantly improved quality of life. 177 Lu-DOTATATE is an exciting new therapeutic option in the management of paragangliomas; however, current treatment protocols described in the literature may need to be modified by lengthening the infusion time and/or lowering the initial treatment dose to prevent or reduce the severity of adverse reactions

  18. Big Data Provenance: Challenges, State of the Art and Opportunities

    OpenAIRE

    Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay

    2015-01-01

    Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and ut...

  19. Automation in an addiction treatment research clinic: computerised contingency management, ecological momentary assessment and a protocol workflow system.

    Science.gov (United States)

    Vahabzadeh, Massoud; Lin, Jia-Ling; Mezghanni, Mustapha; Epstein, David H; Preston, Kenzie L

    2009-01-01

    A challenge in treatment research is the necessity of adhering to protocol and regulatory strictures while maintaining flexibility to meet patients' treatment needs and to accommodate variations among protocols. Another challenge is the acquisition of large amounts of data in an occasionally hectic environment, along with the provision of seamless methods for exporting, mining and querying the data. We have automated several major functions of our outpatient treatment research clinic for studies in drug abuse and dependence. Here we describe three such specialised applications: the Automated Contingency Management (ACM) system for the delivery of behavioural interventions, the transactional electronic diary (TED) system for the management of behavioural assessments and the Protocol Workflow System (PWS) for computerised workflow automation and guidance of each participant's daily clinic activities. These modules are integrated into our larger information system to enable data sharing in real time among authorised staff. ACM and the TED have each permitted us to conduct research that was not previously possible. In addition, the time to data analysis at the end of each study is substantially shorter. With the implementation of the PWS, we have been able to manage a research clinic with an 80 patient capacity, having an annual average of 18,000 patient visits and 7300 urine collections with a research staff of five. Finally, automated data management has considerably enhanced our ability to monitor and summarise participant safety data for research oversight. When developed in consultation with end users, automation in treatment research clinics can enable more efficient operations, better communication among staff and expansions in research methods.

  20. Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

    Science.gov (United States)

    Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

    2017-08-24

    In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database. All consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications. The relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%. The

  1. Innocent Until Proven Guilty

    Science.gov (United States)

    Case, Catherine; Whitaker, Douglas

    2016-01-01

    In the criminal justice system, defendants accused of a crime are presumed innocent until proven guilty. Statistical inference in any context is built on an analogous principle: The null hypothesis--often a hypothesis of "no difference" or "no effect"--is presumed true unless there is sufficient evidence against it. In this…

  2. Tracing where and who provenance in Linked Data: A calculus

    OpenAIRE

    Dezani-Ciancaglini, Mariangiola; Horne, Ross; Sassone, Vladimiro

    2012-01-01

    Linked Data provides some sensible guidelines for publishing and consuming data on the Web. Data published on the Web has no inherent truth, yet its quality can often be assessed based on its provenance. This work introduces a new approach to provenance for Linked Data. The simplest notion of provenance-viz., a named graph indicating where the data is now-is extended with a richer provenance format. The format reflects the behaviour of processes interacting with Linked Data, tracing where the...

  3. Restful Implementation of Catalogue Service for Geospatial Data Provenance

    Science.gov (United States)

    Jiang, L. C.; Yue, P.; Lu, X. C.

    2013-10-01

    Provenance, also known as lineage, is important in understanding the derivation history of data products. Geospatial data provenance helps data consumers to evaluate the quality and reliability of geospatial data. In a service-oriented environment, where data are often consumed or produced by distributed services, provenance could be managed by following the same service-oriented paradigm. The Open Geospatial Consortium (OGC) Catalogue Service for the Web (CSW) is used for the registration and query of geospatial data provenance by extending ebXML Registry Information Model (ebRIM). Recent advance of the REpresentational State Transfer (REST) paradigm has shown great promise for the easy integration of distributed resources. RESTful Web Service aims to provide a standard way for Web clients to communicate with servers based on REST principles. The existing approach for provenance catalogue service could be improved by adopting the RESTful design. This paper presents the design and implementation of a catalogue service for geospatial data provenance following RESTful architecture style. A middleware named REST Converter is added on the top of the legacy catalogue service to support a RESTful style interface. The REST Converter is composed of a resource request dispatcher and six resource handlers. A prototype service is developed to demonstrate the applicability of the approach.

  4. An improved authenticated key agreement protocol for telecare medicine information system.

    Science.gov (United States)

    Liu, Wenhao; Xie, Qi; Wang, Shengbao; Hu, Bin

    2016-01-01

    In telecare medicine information systems (TMIS), identity authentication of patients plays an important role and has been widely studied in the research field. Generally, it is realized by an authenticated key agreement protocol, and many such protocols were proposed in the literature. Recently, Zhang et al. pointed out that Islam et al.'s protocol suffers from the following security weaknesses: (1) Any legal but malicious patient can reveal other user's identity; (2) An attacker can launch off-line password guessing attack and the impersonation attack if the patient's identity is compromised. Zhang et al. also proposed an improved authenticated key agreement scheme with privacy protection for TMIS. However, in this paper, we point out that Zhang et al.'s scheme cannot resist off-line password guessing attack, and it fails to provide the revocation of lost/stolen smartcard. In order to overcome these weaknesses, we propose an improved protocol, the security and authentication of which can be proven using applied pi calculus based formal verification tool ProVerif.

  5. Growth and provenance variation of Pinus caribaea var ...

    African Journals Online (AJOL)

    CAMCORE has visited 33 populations of Pinus caribaea var. hondurensis in Belize, Guatemala, Honduras, El Salvador, Nicaragua, and Quintana Roo, Mexico. Seed collections have been made in 29 provenances from 1, 325 mother trees. A total of 21 provenances and sources of Pinus caribaea var. hondurensis were ...

  6. A protocol proposition of cell therapy for the treatment of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Ribeiro-Paes, J T; Stessuk, T; Marcelino, M; Faria, C; Marinelli, T; Ribeiro-Paes, M J

    2014-01-01

    The main feature of pulmonary emphysema is airflow obstruction resulting from the destruction of the alveolar walls distal to the terminal bronchioles. Existing clinical approaches have improved and extended the quality of life of emphysema patients. However, no treatment currently exists that can change the disease course and cure the patient. The different therapeutic approaches that are available aim to increase survival and/or enhance the quality of life of emphysema patients. In this context, cell therapy is a promising therapeutic approach with great potential for degenerative pulmonary diseases. In this protocol proposition, all patients will be submitted to laboratory tests, such as evaluation of heart and lung function and routine examinations. Stem cells will be harvested by means of 10 punctures on each anterior iliac crest, collecting a total volume of 200mL bone marrow. After preparation, separation, counting and labeling (optional) of the mononuclear cells, the patients will receive an intravenous infusion from the pool of Bone Marrow Mononuclear Cells (BMMC). This article proposes a rational and safe clinical cellular therapy protocol which has the potential for developing new projects and can serve as a methodological reference for formulating clinical application protocols related to the use of cellular therapy in COPD. This study protocol was submitted and approved by the Brazilian National Committee of Ethics in Research (CONEP - Brazil) registration number 14764. It is also registered in ClinicalTrials.gov (NCT01110252). Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  7. Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial.

    Science.gov (United States)

    van der Roer, Nicole; van Tulder, Maurits; Barendse, Johanna; Knol, Dirk; van Mechelen, Willem; de Vet, Henrica

    2008-09-01

    Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study. In the intensive group training protocol exercise therapy, back school and operant-conditioning behavioural principles are combined. Patients were treated during 10 individual sessions along 20 group sessions. Usual care consisted of physiotherapy according to the Dutch guidelines for Low Back Pain. Main outcome measures were functional disability (Roland Morris disability questionnaire), pain intensity, perceived recovery and sick leave because of low back pain assessed at baseline and after 6, 13, 26 and 52 weeks. Both an intention-to-treat analysis and a per-protocol analysis were performed. Multilevel analysis did not show significant differences between both treatment groups on any outcome measures during the complete follow-up period, with one exception. After 26 weeks the protocol group showed more reduction in pain intensity than the guideline group, but this difference was absent after 52 weeks. We finally conclude that an intensive group training protocol was not more effective than usual physiotherapy for chronic low back pain.

  8. Treatment of cervical cancer in HIV-seropositive women from developing countries: a protocol for a systematic review.

    Science.gov (United States)

    Mapanga, Witness; Chipato, Tsungai; Feresu, Shingairai A

    2018-01-25

    Cervical cancer has become the most common cancer affecting women in Africa. Significantly, 85% of these annual deaths occur in the developing world, with the majority being middle-aged women. Research has shown that in sub-Saharan Africa, cervical cancer trends are on the rise in the past two decades because of HIV and this has resulted in an increase in cervical cancer cases among young women. However, little or no information exists that has shown that any of the available treatment methods are more effective than others when it comes to treating cervical cancer in HIV-seropositive women. The aim of this protocol is to offer a plan on how to systematically review cervical cancer treatment methods available for HIV-seropositive women in developing countries. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement was used to develop the protocol for the systematic review which will be reported in accordance with the PRISMA guidelines. A number of databases, Embase, MEDLINE, PubMed, CINAHL and Cochrane Library, will be searched for relevant studies, and citation and reference list tracking will be used to search for additional studies. Prospective and retrospective cohort studies, case-control, randomised controlled trials and cross-sectional studies that were carried out in and for the developing world will be eligible for inclusion. Peer-reviewed studies and grey literature examining cervical cancer treatment modalities in HIV-seropositive women will be included. Descriptive statistics and tables will be used to summarise results, and meta-analysis will be used where appropriate. The review findings will provide the current picture of the existing treatment methods being used to treat cervical cancer in HIV-seropositive women in developing countries. The findings might be used for the establishment of evidence-based guidelines for treatment of cervical cancer in seropositive women as well as prompt policy-makers and

  9. The challenges of treating paraganglioma patients with {sup 177}Lu-DOTATATE PRRT: Catecholamine crises, tumor lysis syndrome and the need for modification of treatment protocols

    Energy Technology Data Exchange (ETDEWEB)

    Makis, William; Mccann, Karey; Mcewan, Alexander J. B. [Dept. of Diagnostic Imaging, Cross Cancer Institute, Alberta (China)

    2015-09-15

    A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with {sup 177}Lu-[DOTA0,Tyr3]octreotate (DOTATATE) radioisotope therapy using established protocols. Three paraganglioma patients were treated with 4–5 cycles of {sup 177}Lu-DOTATATE and were evaluated for side effects and response to therapy. Two of the three patients developed severe adverse reactions following their first {sup 177}Lu-DOTATATE treatment. One patient developed a catecholamine crisis and tumor lysis syndrome within hours of treatment, requiring intensive care unit (ICU) support, and another developed a catecholamine crisis 3 days after treatment, requiring hospitalization. The treatment protocols at our institution were subsequently modified by increasing the radioisotope infusion time from 15 to 30 min, as recommended in the literature, to 2–4 h and by reducing the administered dose of {sup 177}Lu-DOTATATE. Subsequent {sup 177}Lu-DOTATATE treatments utilizing the modified protocols were well tolerated, and response to therapy was achieved in all three patients, resulting in significantly improved quality of life. {sup 177}Lu-DOTATATE is an exciting new therapeutic option in the management of paragangliomas; however, current treatment protocols described in the literature may need to be modified by lengthening the infusion time and/or lowering the initial treatment dose to prevent or reduce the severity of adverse reactions.

  10. Automation in an Addiction Treatment Research Clinic: Computerized Contingency Management, Ecological Momentary Assessment, and a Protocol Workflow System

    Science.gov (United States)

    Vahabzadeh, Massoud; Lin, Jia-Ling; Mezghanni, Mustapha; Epstein, David H.; Preston, Kenzie L.

    2009-01-01

    Issues A challenge in treatment research is the necessity of adhering to protocol and regulatory strictures while maintaining flexibility to meet patients’ treatment needs and accommodate variations among protocols. Another challenge is the acquisition of large amounts of data in an occasionally hectic environment, along with provision of seamless methods for exporting, mining, and querying the data. Approach We have automated several major functions of our outpatient treatment research clinic for studies in drug abuse and dependence. Here we describe three such specialized applications: the Automated Contingency Management (ACM) system for delivery of behavioral interventions, the Transactional Electronic Diary (TED) system for management of behavioral assessments, and the Protocol Workflow System (PWS) for computerized workflow automation and guidance of each participant’s daily clinic activities. These modules are integrated into our larger information system to enable data sharing in real time among authorized staff. Key Findings ACM and TED have each permitted us to conduct research that was not previously possible. In addition, the time to data analysis at the end of each study is substantially shorter. With the implementation of the PWS, we have been able to manage a research clinic with an 80-patient capacity having an annual average of 18,000 patient-visits and 7,300 urine collections with a research staff of five. Finally, automated data management has considerably enhanced our ability to monitor and summarize participant-safety data for research oversight. Implications and conclusion When developed in consultation with end users, automation in treatment-research clinics can enable more efficient operations, better communication among staff, and expansions in research methods. PMID:19320669

  11. Querying Provenance Information: Basic Notions and an Example from Paleoclimate Reconstruction

    Science.gov (United States)

    Stodden, V.; Ludaescher, B.; Bocinsky, K.; Kintigh, K.; Kohler, T.; McPhillips, T.; Rush, J.

    2016-12-01

    Computational models are used to reconstruct and explain past environments and to predict likely future environments. For example, Bocinsky and Kohler have performed a 2,000-year reconstruction of the rain-fed maize agricultural niche in the US Southwest. The resulting academic publications not only contain traditional method descriptions, figures, etc. but also links to code and data for basic transparency and reproducibility. Examples include ResearchCompendia.org and the new project "Merging Science and Cyberinfrastructure Pathways: The Whole Tale." Provenance information provides a further critical element to understand a published study and to possibly extend or challenge the findings of the original authors. We present different notions and uses of provenance information using a computational archaeology example, e.g., the common use of "provenance for others" (for transparency and reproducibility), but also the more elusive but equally important use of "provenance for self". To this end, we distinguish prospective provenance (a.k.a. workflow) from retrospective provenance (a.k.a. data lineage) and show how combinations of both forms of provenance can be used to answer different kinds of important questions about a workflow and its execution. Since many workflows are developed using scripting or special purpose languages such as Python and R, we employ an approach and toolkit called YesWorkflow that brings provenance modeling, capture, and querying into the realm of scripting. YesWorkflow employs the basic W3C PROV standard, as well as the ProvONE extension for sharing and exchanging retrospective and prospective provenance information, respectively. Finally, we argue that the utility of provenance information should be maximized by developing different kinds provenance questions and queries during the early phases of computational workflow design and implementation.

  12. Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: response to HLH-04 treatment protocol.

    Science.gov (United States)

    Jiménez-Hernández, Elva; Martínez-Villegas, Octavio; Sánchez-Jara, Berenice; Martínez-Martell, María Angélica; Hernández-Sánchez, Beatriz; Loza-Santiaguillo, Paloma Del Rocío; Pedro-Matías, Eduardo; Arellano-Galindo, José

    Hemophagocytic syndrome, macrophage activation syndrome, reactive histiocytosis or hemophagocytic lymphohistiocytosis (HLH) represent a group of diseases whose common thread is reactive or neoplastic mononuclear phagocytic system cells and dendritic cell proliferation. We present a case of an HLH probably associated with Epstein-Barr virus (EBV) in a 4-year-old male patient treated with HLH-04 protocol. Viral etiology in HLH is well accepted. In this case, clinical picture of HLH was assumed secondary to EBV infection because IgM serology at the time of clinical presentation was the only positive factor in the viral panel. Diagnosis of HLH is the critical first step to successful treatment. The earlier it is identified, the less the tissue damage and reduced risk of multiple organ failure, which favors treatment response. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Provenance variation in Eucalyptus camaldulensis Dehnh. in California

    Science.gov (United States)

    B.M. Emery; F. Thomas Ledig

    1987-01-01

    In California, the Lake Albacutya provenance of river red gum was clearly superior in volume growth to 22 other provenances collected throughout the range of the species in Australia. It had at least 2.5 times the volume of the plantation mean at 5.5 years, consistent with its performance in other countries with Mediterranean climates like California's. Other...

  14. Wellness protocol for smart homes an integrated framework for ambient assisted living

    CERN Document Server

    Ghayvat, Hemant

    2017-01-01

    This book focuses on the development of wellness protocols for smart home monitoring, aiming to forecast the wellness of individuals living in ambient assisted living (AAL) environments. It describes in detail the design and implementation of heterogeneous wireless sensors and networks as applied to data mining and machine learning, which the protocols are based on. Further, it shows how these sensor and actuator nodes are deployed in the home environment, generating real-time data on object usage and other movements inside the home, and therefore demonstrates that the protocols have proven to offer a reliable, efficient, flexible, and economical solution for smart home systems. Documenting the approach from sensor to decision making and information generation, the book addresses various issues concerning interference mitigation, errors, security and large data handling. As such, it offers a valuable resource for researchers, students and practitioners interested in interdisciplinary studies at the intersecti...

  15. Growth and Survival Variation among Scots Pine (Pinus sylvestris L. Provenances

    Directory of Open Access Journals (Sweden)

    Süleyman Gülcü

    2017-01-01

    Full Text Available Tree height, basal diameter, and survival were examined in thirteen-year-old provenance test established by 30 seed sources of Scots pine (Pinus sylvestris L. at two exotic sites of the species in Southern part of Turkey. Variations within provenance and among provenances and relations among the traits were estimated to compare Scots pine provenance and two other native species. Averages of tree height and basal diameter were 350 cm and 52.7 mm in Aydogmus site and 385 cm and 51.2 mm in Kemer site, respectively. There were large differences within and among provenances for the characters. Sites were similar (p>0.05 for the characters, while there were significant differences (p≤0.05 among provenances within site according to results of variance analysis (ANOVA. Scots pine provenances were higher and had more thickness than that of black pine (Pinus nigra Arnold and Taurus cedar (Cedrus libani A. Rich. which were natural species of the region. There were positive and significant (p<0.05 correlations between height and basal diameter in the species. Average survivals were 56% and 35% of the provenances in the sites. They were 71% and 11% in black pine and 53% in Taurus cedar for the sites respectively.

  16. Data Provenance for Agent-Based Models in a Distributed Memory

    Directory of Open Access Journals (Sweden)

    Delmar B. Davis

    2018-04-01

    Full Text Available Agent-Based Models (ABMs assist with studying emergent collective behavior of individual entities in social, biological, economic, network, and physical systems. Data provenance can support ABM by explaining individual agent behavior. However, there is no provenance support for ABMs in a distributed setting. The Multi-Agent Spatial Simulation (MASS library provides a framework for simulating ABMs at fine granularity, where agents and spatial data are shared application resources in a distributed memory. We introduce a novel approach to capture ABM provenance in a distributed memory, called ProvMASS. We evaluate our technique with traditional data provenance queries and performance measures. Our results indicate that a configurable approach can capture provenance that explains coordination of distributed shared resources, simulation logic, and agent behavior while limiting performance overhead. We also show the ability to support practical analyses (e.g., agent tracking and storage requirements for different capture configurations.

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

    Directory of Open Access Journals (Sweden)

    Botella C

    2015-10-01

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

  18. Improving biofeedback for the treatment of fecal incontinence in women: implementation of a standardized multi-site manometric biofeedback protocol.

    Science.gov (United States)

    Markland, A D; Jelovsek, J E; Whitehead, W E; Newman, D K; Andy, U U; Dyer, K; Harm-Ernandes, I; Cichowski, S; McCormick, J; Rardin, C; Sutkin, G; Shaffer, A; Meikle, S

    2017-01-01

    Standardized training and clinical protocols using biofeedback for the treatment of fecal incontinence (FI) are important for clinical care. Our primary aims were to develop, implement, and evaluate adherence to a standardized protocol for manometric biofeedback to treat FI. In a Pelvic Floor Disorders Network (PFDN) trial, participants were enrolled from eight PFDN clinical centers across the United States. A team of clinical and equipment experts developed biofeedback software on a novel tablet computer platform for conducting standardized anorectal manometry with separate manometric biofeedback protocols for improving anorectal muscle strength, sensation, and urge resistance. The training protocol also included education on bowel function, anal sphincter exercises, and bowel diary monitoring. Study interventionists completed online training prior to attending a centralized, standardized certification course. For the certification, expert trainers assessed the ability of the interventionists to perform the protocol components for a paid volunteer who acted as a standardized patient. Postcertification, the trainers audited interventionists during trial implementation to improve protocol adherence. Twenty-four interventionists attended the in-person training and certification, including 46% advanced practice registered nurses (11/24), 50% (12/24) physical therapists, and 4% physician assistants (1/24). Trainers performed audio audits for 88% (21/24), representing 84 audited visits. All certified interventionists met or exceeded the prespecified 80% pass rate for the audit process, with an average passing rate of 93%. A biofeedback protocol can be successfully imparted to experienced pelvic floor health care providers from various disciplines. Our process promoted high adherence to a standard protocol and is applicable to many clinical settings. © 2016 John Wiley & Sons Ltd.

  19. Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

    Science.gov (United States)

    2002-10-01

    issue paper does not address three technologies that have been used to treat water containing arsenic: • Biological treatment • Phytoremediation ...arsenic in water, and no aboveground treatments of groundwater conducted at full scale were found. Phytoremediation and electrokinetics are not...Roundtable. September 1998. http://www.frtr.gov/costperf.htm. 1.16 U.S. EPA. Office of Research and Development. Arsenic & Mercury - Workshop on Removal

  20. Internet-based attentional bias modification training as add-on to regular treatment in alcohol and cannabis dependent outpatients: a study protocol of a randomized control trial.

    Science.gov (United States)

    Heitmann, Janika; van Hemel-Ruiter, Madelon E; Vermeulen, Karin M; Ostafin, Brian D; MacLeod, Colin; Wiers, Reinout W; DeFuentes-Merillas, Laura; Fledderus, Martine; Markus, Wiebren; de Jong, Peter J

    2017-05-23

    The automatic tendency to attend to and focus on substance-related cues in the environment (attentional bias), has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, contribute to treatment outcome and the reduction of relapse rates. Based on some promising research findings, we designed a study to test the clinical relevance of ABM as an add-on component of regular intervention for alcohol and cannabis patients. The current protocol describes a study which will investigate the effectiveness and cost-effectiveness of a newly developed home-delivered, multi-session, internet-based ABM (iABM) intervention as an add-on to treatment as usual (TAU). TAU consists of cognitive behavioural therapy-based treatment according to the Dutch guidelines for the treatment of addiction. Participants (N = 213) will be outpatients from specialized addiction care institutions diagnosed with alcohol or cannabis dependency who will be randomly assigned to one of three conditions: TAU + iABM; TAU + placebo condition; TAU-only. Primary outcome measures are substance use, craving, and rates of relapse. Changes in attentional bias will be measured to investigate whether changes in primary outcome measures can be attributed to the modification of attentional bias. Indices of cost-effectiveness and secondary physical and psychological complaints (depression, anxiety, and stress) are assessed as secondary outcome measures. This randomized control trial will be the first to investigate whether a home-delivered, multi-session iABM intervention is (cost-) effective in reducing relapse rates in alcohol and cannabis dependency as an add-on to TAU, compared with an active and a waiting list control group. If proven effective, this ABM intervention could be easily implemented as a home-delivered component of current TAU. Netherlands Trial Register, NTR5497 , registered on 18th September 2015.

  1. DataONE: A Data Federation with Provenance Support

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Yang [University of Illinois at Urbana-Champaign; Jones, Christopher [National Center for Ecological Analysis and Synthesis, Santa Barbara; Cuevas-Vicenttin, Victor [ Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico; Jones, Matthew B. [National Center for Ecological Analysis and Synthesis, Santa Barbara; Ludascher, Bertram [University of Illinois at Urbana-Champaign; McPhillips, Timothy [University of Illinois at Urbana-Champaign; Missier, Paolo [Newcastle University, UK; Schwalm, Christopher [Woods Hole Research Center (WHRC), Massachusetts; Slaughter, Peter [National Center for Ecological Analysis and Synthesis, Santa Barbara; Vieglais, Dave [University of Kansas; Walker, Lauren [National Center for Ecological Analysis and Synthesis, Santa Barbara

    2016-01-01

    DataONE is a federated data network focusing on earth and environmental science data. We present the provenance and search features of DataONE by means of an example involving three earth scientists who interact through a DataONE Member Node. DataONE provenance systems enable reproducible research and facilitate proper attribution of scientific results transitively across generations of derived data products.

  2. Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial

    NARCIS (Netherlands)

    van der Roer, N.; van Tulder, M.W.; Barendse, J.; Knol, D.L.; van Mechelen, W.; de Vet, H.C.W.

    2008-01-01

    Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and

  3. Impact of two early treatment protocols for anterior dental crossbite on children’s quality of life

    Science.gov (United States)

    Miamoto, Cristina Batista; Marques, Leandro Silva; Abreu, Lucas Guimarães; Paiva, Saul Martins

    2018-01-01

    ABSTRACT Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used. PMID:29791690

  4. Addendum to the Building America House Simulation Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Engebrecht-Metzger, C.; Wilson, E.; Horowitz, S.

    2012-12-01

    As Building America (BA) has grown to include a large and diverse cross-section of the home building and retrofit industries, it has become more important to develop accurate, consistent analysis techniques to measure progress towards the program's goals. The House Simulation Protocols (HSP) provides guidance to program partners and managers so that energy savings for new construction and retrofit projects can be compared alongside each other. The HSP provides the program with analysis methods that are proven to be effective and reliable in investigating the energy use of advanced energy systems and of entire houses.

  5. Addendum to the Building America House Simulation Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Engebrecht, C. Metzger [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wilson, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Horowitz, S. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2012-12-01

    As DOE's Building America program has grown to include a large and diverse cross-section of the home building and retrofit industries, it has become more important to develop accurate, consistent analysis techniques to measure progress towards the program’s goals. The House Simulation Protocols (HSP) provide guidance to program partners and managers so that energy savings for new construction and retrofit projects can be compared alongside each other. The HSP provides the program with analysis methods that are proven to be effective and reliable in investigating the energy use of advanced energy systems and of entire houses.

  6. Prolonged first-line PEG-asparaginase treatment in pediatric acute lymphoblastic leukemia in the NOPHO ALL2008 protocol-Pharmacokinetics and antibody formation

    DEFF Research Database (Denmark)

    Tram Henriksen, Louise; Gottschalk Højfeldt, Sofie; Schmiegelow, Kjeld

    2017-01-01

    BACKGROUND: As pegylated asparaginase is becoming the preferred first-line asparaginase preparation in the chemotherapy regimens of childhood acute lymphoblastic leukemia (ALL), there is a need to evaluate this treatment. METHODS: The aim of this study was to evaluate the pharmacokinetics...... of prolonged upfront biweekly PEG-asparaginase (where PEG is polyethylene glycol) treatment by measuring serum l-asparaginase activity and formation of anti-PEG-asparaginase antibodies. A total of 97 evaluable patients (1-17 years), diagnosed with ALL, and treated according to the NOPHO ALL2008 protocol (where...... NOPHO is Nordic Society of Paediatric Haematology and Oncology) were included. In the NOPHO ALL2008 protocol, patients are randomized to 8 or 15 doses of intramuscular PEG-asparaginase (Oncaspar(®) ) 1,000 IU/m²/dose, at 2-week or 6-week intervals with a total of 30-week treatment (Clinical trials...

  7. Effects of a screening and treatment protocol with haloperidol on post-cardiotomy delirium: a prospective cohort study†

    Science.gov (United States)

    Schrøder Pedersen, Sofie; Kirkegaard, Thomas; Balslev Jørgensen, Martin; Lind Jørgensen, Vibeke

    2014-01-01

    OBJECTIVES Post-cardiotomy delirium is common and associated with increased morbidity and mortality. No gold standard exists for detecting delirium, and evidence to support the choice of treatment is needed. Haloperidol is widely used for treating delirium, but indication, doses and therapeutic targets vary. Moreover, doubt has been raised regarding overall efficacy. The purpose of this study was to assess the effect of a combination of early detection and standardized treatment with haloperidol on post-cardiotomy delirium, with the hypothesis that the proportion of delirium- and coma-free days could be increased. Length of stay (LOS), complications and 180-day mortality are reported. METHODS Prospective interventional cohort study. One hundred and seventeen adult patients undergoing cardiac surgery were included before introduction of a screening and treatment protocol with haloperidol for delirium, and 123 patients were included after. Nurses screened patients using validated tools (the Delirium Observation Screening (DOS) scale and confusion assessment method for the intensive care unit (CAM-ICU)). In case of delirium, a checklist to eliminate precipitating/ inducing factors and a protocol for standardized dosing with haloperidol was applied. Group comparison was done using non-parametric tests and analysis of fractions, and associations between delirium and predefined covariates were analysed with logistic regression. RESULTS Incidence of delirium after cardiac surgery was 21 (14–29) and 22 (15–30) %, onset was on postoperative day 1 (1–4) and 1 (1–3), duration was 1 (1–4) day and 3 (1–5) days, respectively, with no significant difference (Period 1 vs 2, all values are given as the median and 95% confidence interval). The proportion of delirium- and coma-free days was 67 (61–73) and 65 (60–70) %, respectively (ns). There was no difference in LOS or complication rate. Delirium was associated to increasing age, increased length of stay and

  8. Augmenting Outpatient Alcohol Treatment as Usual With Online Alcohol Avoidance Training: Protocol for a Double-Blind Randomized Controlled Trial.

    Science.gov (United States)

    Bratti-van der Werf, Marleen Kj; Laurens, Melissa C; Postel, Marloes G; Pieterse, Marcel E; Ben Allouch, Somaya; Wiers, Reinout W; Bohlmeijer, Ernst T; Salemink, Elske

    2018-03-01

    Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. The aim of the study is to examine the effectiveness of online CBM Alcohol Avoidance Training using an adapted Approach-Avoidance Task as a supplement to treatment as usual (TAU) in an outpatient treatment setting. The effectiveness of 8 online sessions of CBM Alcohol Avoidance Training added to TAU is tested in a double-blind, randomized controlled trial with pre- and postassessments, plus follow-up assessments after 3 and 6 months. Participants are adult patients (age 18 years or over) currently following Web-based or face-to-face TAU to reduce or stop drinking. These patients are randomly assigned to a CBM Alcohol Avoidance or a placebo training. The primary outcome measure is a reduction in alcohol consumption. We hypothesize that TAU + CBM will result in up to a 13-percentage point incremental effect in the number of patients reaching the safe drinking guidelines compared to TAU + placebo CBM. Secondary outcome measures include an improvement in health status and a decrease in depression, anxiety, stress, and possible mediation by the change in approach bias. Finally, patients' adherence, acceptability, and credibility will be examined. The trial was funded in 2014 and is currently in the active participant recruitment phase (since May 2015). Enrolment will be completed in 2019. First results are expected to be submitted for publication in 2020. The main purpose of this study is to increase our knowledge about the added value of online Alcohol Avoidance Training as a supplement to TAU in an outpatient treatment setting. If the added effectiveness of the training is proven, the next step could be to incorporate the intervention into current treatment. Netherlands Trial Register NTR5087; http

  9. Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Van Dorn, Richard A; Desmarais, Sarah L; Rade, Candalyn B; Burris, Elizabeth N; Cuddeback, Gary S; Johnson, Kiersten L; Tueller, Stephen J; Comfort, Megan L; Mueser, Kim T

    2017-08-04

    Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among this vulnerable and high-risk population. This paper describes a study that will develop research and communication protocols and adapt two evidence-based treatments, dual-diagnosis motivational interviewing (DDMI) and integrated group therapy (IGT), for delivery to adults with CODs across a jail-to-community treatment continuum. Adaptations to DDMI and IGT were guided by the Risk-Need-Responsivity model and the National Institute of Corrections' implementation competencies; the development of the implementation framework and communication protocols were guided by the Evidence-Based Interagency Implementation Model for community corrections and the Inter-organizational Relationship model, respectively. Implementation and evaluation of the protocols and adapted interventions will occur via an open trial and a pilot randomized trial. The clinical intervention consists of two in-jail DDMI sessions and 12 in-community IGT sessions. Twelve adults with CODs and four clinicians will participate in the open trial to evaluate the acceptability and feasibility of, and fidelity to, the interventions and research and communication protocols. The pilot controlled trial will be conducted with 60 inmates who will be randomized to either DDMI-IGT or treatment as usual. A baseline assessment will be conducted in jail, and four community-based assessments will be conducted during a 6-month follow-up period. Implementation, clinical, public health, and treatment preference outcomes will be evaluated

  10. Treatment of abdominal cellulite and circumference reduction with radiofrequency and dynamic muscle activation.

    Science.gov (United States)

    Wanitphakdeedecha, Rungsima; Iamphonrat, Thanawan; Thanomkitti, Kanchalit; Lektrakul, Nittaya; Manuskiatti, Woraphong

    2015-01-01

    Cellulite is a frequent skin condition for which treatment remains a challenge. A wide variety of treatments are available but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Only few therapeutic options have proven efficacy in the treatment of cellulite. To determine the efficacy and the safety profiles of radiofrequency and dynamic muscle activation technology in treatment of abdominal cellulite and circumference reduction. Twenty-five females with abdominal cellulite received 6 weekly radiofrequency and dynamic muscle activation treatments. Treatment areas included the abdomen and both sides of flanks. Subjects were evaluated using standardized photographs, and measurements of body weight and abdominal circumference at baseline, before every treatment visit, and 1 week and four weeks after the final treatment. Subcutaneous tissue thickness was recorded by ultrasound at baseline and 4 weeks after completion of treatment protocol. Physicians' evaluation and patient's satisfaction of clinical improvement were also measured. All subjects completed the treatment protocol and attended every follow-up visits. There was significant abdominal circumference reduction of 2.96 and 2.52 cm at 1-, and 4-week follow-up visits (p last treatment, the average circumferential reduction was sustained. Most of the patients were rated to have 25-49% improvement at 5th treatment, and 1- and 4-week follow-up visits. Ninety-two percent of the patients were satisfied with the treatment outcome. Radiofrequency provided beneficial effects on the reduction of abdomen and cellulite appearance. The benefit of muscle activation is yet to be determined.

  11. Staged protocol for the treatment of chronic femoral shaft osteomyelitis with Ilizarov's technique followed by the use of intramedullary locked nail

    Directory of Open Access Journals (Sweden)

    Po-Hsin Chou

    2017-06-01

    Conclusion: In the treatment of chronic femur osteomyelitis, the staged protocol of Ilizarov distraction osteogenesis followed by intramedullary nailing was safe and successful, and allowed for union, realignment, reorientation, and leg-length restoration. With regard to the soft tissue, this technique provides a unique type of reconstructive closure for infected wounds. It is suggested that the staged protocol is reliable in providing successful simultaneous reconstruction for bone and soft tissue defects without flap coverage.

  12. An example of the treatment protocol in the case of a patient who has received a radioactive product

    International Nuclear Information System (INIS)

    Izambard, N.

    2011-01-01

    At the end of 2009, the Radiation Protection Unit at Rouen University Hospital (Rouen CHU), took part in discussions initiated by the hospital's protocol review board (Nursing Care Directorate) regarding management of all hospital waste produced during health care activities (including activities involving radioactive materials) with a view to complying with French National Authority for Health requirements. Moreover, these new provisions had to incorporate management procedures relative to radioactive waste from the radio analysis laboratory at the hospital's Clinical Biology Institute in accordance with the Order of 23 July 2008. To this end, a study was carried out on the university hospital departments in question, in conjunction with the nuclear medicine department of the neighbouring Henry-Becquerel Regional Cancer Centre (CRLCC), the major producer of radioactive waste. This document presents the new protocol that takes into account the feedback experience from Rouen CHU and the CRLCC. This protocol is based on a better writing down and availability of all the information concerning the treatment received by the patient during his stay at the hospital. This protocol will allow a better identification of the waste and as a consequence a better optimization of its disposal

  13. A Self-Stabilizing Hybrid Fault-Tolerant Synchronization Protocol

    Science.gov (United States)

    Malekpour, Mahyar R.

    2015-01-01

    This paper presents a strategy for solving the Byzantine general problem for self-stabilizing a fully connected network from an arbitrary state and in the presence of any number of faults with various severities including any number of arbitrary (Byzantine) faulty nodes. The strategy consists of two parts: first, converting Byzantine faults into symmetric faults, and second, using a proven symmetric-fault tolerant algorithm to solve the general case of the problem. A protocol (algorithm) is also present that tolerates symmetric faults, provided that there are more good nodes than faulty ones. The solution applies to realizable systems, while allowing for differences in the network elements, provided that the number of arbitrary faults is not more than a third of the network size. The only constraint on the behavior of a node is that the interactions with other nodes are restricted to defined links and interfaces. The solution does not rely on assumptions about the initial state of the system and no central clock nor centrally generated signal, pulse, or message is used. Nodes are anonymous, i.e., they do not have unique identities. A mechanical verification of a proposed protocol is also present. A bounded model of the protocol is verified using the Symbolic Model Verifier (SMV). The model checking effort is focused on verifying correctness of the bounded model of the protocol as well as confirming claims of determinism and linear convergence with respect to the self-stabilization period.

  14. Staged protocol for the treatment of chronic femoral shaft osteomyelitis with Ilizarov's technique followed by the use of intramedullary locked nail.

    Science.gov (United States)

    Chou, Po-Hsin; Lin, Hsi-Hsien; Su, Yu-Pin; Chiang, Chao-Ching; Chang, Ming-Chau; Chen, Chuan-Mu

    2017-06-01

    Infected nonunion of the femoral shaft is uncommon, and usually presents with challenging therapeutic and reconstructive problems. There are still controversies over treating infected nonunion of the femoral shaft. The purposes of this retrospective study were to review the treatment outcomes and describe a staged protocol for spontaneous wound healing. Six patients with chronic femoral shaft infected-nonunion from October 2002 to September 2010 were included in this retrospective study. Serial plain films and triple films of lower legs were performed to evaluate the alignment of the treated femoral shaft and bony union following our staged protocol of Ilizarov distraction osteogenesis and intramedullary nailing. An average bone defect of 7 cm was noted after staged osteotomy. Mean follow-up was 87.5 (range, 38-133) months. Union was achieved in all six patients, with an average external fixation time of 6.8 (range, 5-11) months. There was no reinfection. One complication of a 4-cm leg discrepancy was noted, with an initial shortening of 15 cm. The mean knee ranges of motion (ROM) before staged protocols and at final follow-up were 64.2±8.6 (range, 60-75)° and 53.3±9.3 (range, 40-65)°, respectively. The ROM at the knee joint statistically decreased following staged protocols. In the treatment of chronic femur osteomyelitis, the staged protocol of Ilizarov distraction osteogenesis followed by intramedullary nailing was safe and successful, and allowed for union, realignment, reorientation, and leg-length restoration. With regard to the soft tissue, this technique provides a unique type of reconstructive closure for infected wounds. It is suggested that the staged protocol is reliable in providing successful simultaneous reconstruction for bone and soft tissue defects without flap coverage. Copyright © 2017. Published by Elsevier Taiwan LLC.

  15. Efecto de los tratamientos de semilla, la procedencia y el riego en el establecimiento de Hibiscus elatus Effect of seed treatments, provenance and irrigation on the establishment of Hibiscus elatus

    Directory of Open Access Journals (Sweden)

    Laura Montejo Valdés

    2012-09-01

    Full Text Available Se estudió la emergencia y el crecimiento de las plántulas de Hibiscus elatus en condiciones de vivero, en semillas sometidas a tratamientos de escarificación ácida en combinación o no con tratamientos de hidratación parcial en agua. Las semillas se colectaron en cuatro procedencias boscosas de la Reserva de la Biosfera Sierra del Rosario (dos bosques maduros siempreverdes estacionales y dos bosques secundarios y se sometieron a diferentes frecuencias de riego (diario, días alternos y una vez por semana durante su estancia en vivero. Los tratamientos pregerminativos fueron adecuados para incrementar la emergencia y el crecimiento de las plántulas en relación con el control (semillas no tratadas, para todas las procedencias, aunque el efecto positivo dependió del nivel de riego del sustrato. El estrés hídrico afectó de forma significativa el vigor de las plántulas, independientemente del tratamiento utilizado; sin embargo, bajo estas condiciones de siembra, el tratamiento hídrico resultó el más favorable para mejorar el funcionamiento de las plantas en las semillas colectadas en el bosque maduro; mientras que las del bosque secundario tuvieron una mejor habilidad para responder al estrés hídrico con el de escarificación, combinado con la hidratación parcial en agua. Se demostró que el empleo de tratamientos robustecedores a las semillas disminuyó el efecto dañino provocado por la insuficiente humedad del suelo sobre el establecimiento de las plántulas, independientemente del sitio de colecta.The emergence and growth of Hibiscus elatus seedlings under nursery conditions was studied, in seeds subject to acid scarification treatments in combination or not- with partial hydration treatments in water. The seeds were collected in four forest provenances of the Sierra del Rosario Biosphere Reserve (two seasonal evergreen mature forests and two secondary forests and were subject to different irrigation frequencies (daily

  16. Safety and effectiveness of collagenase clostridium histolyticum in the treatment of Peyronie's disease using a new modified shortened protocol.

    Science.gov (United States)

    Abdel Raheem, Amr; Capece, Marco; Kalejaiye, Odunayo; Abdel-Raheem, Tarek; Falcone, Marco; Johnson, Mark; Ralph, Oliver G; Garaffa, Giulio; Christopher, Andrew N; Ralph, David J

    2017-11-01

    To evaluate the efficacy and safety of collagenase clostridium histolyticum (CCH; Xiapex ® , Xiaflex ® ) in the treatment of Peyronie's disease (PD) using a new modified treatment protocol that aims at reducing the number of injections needed and reducing patient visits, thus reducing the duration and cost of treatment. A prospective study of 53 patients with PD who had treatment with CCH at a single centre using a new modified protocol. The angle of curvature assessment after an intracavernosal injection of prostaglandin E1, the International Index of Erectile Function (IIEF) and Peyronie's Disease Questionnaire (PDQ) were completed at baseline and at week 12 (4 weeks after the last injection). The Global Assessment of Peyronie's disease (GAPD) questionnaire was completed at week 12. Under a penile block of 10 mL plain lignocaine 1%, a total of three intralesional injections of CCH (0.9 mg) were given at 4-weekly intervals using a new modified injection technique. In between injections patients used a combination of home modelling, stretching and a vacuum device on a daily basis to mechanically stretch the plaque. Investigator modelling was not performed. The mean (range) penile curvature at baseline was 54 (30-90)°. Of the 53 patients in the study, 51 patients (96.2%) had an improvement in the angel of curvature by a mean (range) of 17.36 (0-40)° or 31.4 (0-57)% from baseline after three CCH injections. The final mean (range) curvature was 36.9 (12-75)° (P effective, and cost efficient. The results of using only three CCH injections according to this modified protocol are comparable to those of the clinical trials that used eight CCH injections. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  17. Climate Data Provenance Tracking for Just-In-Time Computation

    Science.gov (United States)

    Fries, S.; Nadeau, D.; Doutriaux, C.; Williams, D. N.

    2016-12-01

    The "Climate Data Management System" (CDMS) was created in 1996 as part of the Climate Data Analysis Tools suite of software. It provides a simple interface into a wide variety of climate data formats, and creates NetCDF CF-Compliant files. It leverages the NumPy framework for high performance computation, and is an all-in-one IO and computation package. CDMS has been extended to track manipulations of data, and trace that data all the way to the original raw data. This extension tracks provenance about data, and enables just-in-time (JIT) computation. The provenance for each variable is packaged as part of the variable's metadata, and can be used to validate data processing and computations (by repeating the analysis on the original data). It also allows for an alternate solution for sharing analyzed data; if the bandwidth for a transfer is prohibitively expensive, the provenance serialization can be passed in a much more compact format and the analysis rerun on the input data. Data provenance tracking in CDMS enables far-reaching and impactful functionalities, permitting implementation of many analytical paradigms.

  18. A Randomised Non-inferiority Trial on the Effect of an Antibiotic or Non-antibiotic Topical Treatment Protocol for Digital Dermatitis in Dairy Cattle : a knowledge summary

    NARCIS (Netherlands)

    Jorritsma, R.; Nielen, M.; Dotinga, Amarins

    2017-01-01

    Objective: Investigation of the therapeutic effect of a protocol using non-antibiotic Intra Epidine (IE) spray containing copper and zinc chelate on M2 digital dermatitis (DD) lesions compared to a treatment protocol using antibiotic chlortetracycline (CTC) spray for non-inferiority testing.

  19. Results of a phase II trial of external beam radiation with etanidazole (SR 2508) for the treatment of locally advanced prostate cancer (RTOG protocol 90-20)

    International Nuclear Information System (INIS)

    Lawton, Colleen A.; Coleman, C. Norman; Buzydlowski, Jan W.; Forman, Jeffrey D.; Marcial, Victor A.; DelRowe, John D.; Rotman, Marvin

    1996-01-01

    Purpose: RTOG Protocol 90-20 was designed to evaluate the effect of the hypoxic cell sensitizer Etanidazole (SR-2508) on locally advanced adenocarcinoma of the prostate treated with concurrent external beam irradiation. Methods and Materials: Patients with biopsy-proven adenocarcinoma of the prostate with locally advanced T 2b , T 3 , and T 4 tumors were eligible for this study. No patients with disease beyond the pelvis were eligible. Serum prostate specific antigen (PSA) was mandatory. All patients received definitive external beam irradiation using standard four-field whole pelvis treatment to 45-50 Gy, followed by a cone down with a minimum total dose to the prostate of 66 Gy at 1.8-2.0 Gy/fraction over 6.5-7.5 weeks. Etanidazole was delivered 1.8 g/m 2 given 3 times a week to a total of 34.2 g/m 2 or 19 doses. Results: Thirty-nine patients were entered onto the study. Three patients refused treatment; therefore, 36 patients were eligible for further evaluation. Median follow-up was 36.9 months from treatment end. All patients had elevated initial PSA levels, and 18 patients had PSAs of > 20 ng/ml. Tumor classification was T 2 , 12 patients (33.3%); T 3 , 22 patients (61.1%); and T 4 , 2 patients (5.6%). Complete clinical response, defined as PSA < 4 ng/ml and complete clinical disappearance, was attained in 17.9% of ((5(28)) pts) with information at 90 days and 56% of patients by 12 months following treatment. Relapse-free survival was 13% at 3 years with PSA < 4 ng/ml. There were no Grade 4 or 5 toxicities, either acute (during treatment) or in follow-up. Conclusions: Results of this trial regarding PSA response and clinical disappearance of disease are similar to historical controls and do not warrant further investigation of etanidazole as was done in this trial. Drug toxicity that, in the past, has been unacceptably high with other hypoxic cell sensitizers does not appear to be a significant problem with this drug

  20. Sudetic larch in Germany - Results of provenance and progeny research

    Energy Technology Data Exchange (ETDEWEB)

    Weisgerber, H. [Forest Centre for Management Planning, Research and Ecology, Hann Muenden (Germany)

    1995-12-31

    There are only a few older sources of Sudetic larch in Germany. They distinguish themselves by outstanding growth and low susceptibility to canker. This impression was confirmed by results of provenance research. The Sudetic larch tested in comparison with numerous other provenances proved to be fast-growing, site-tolerant, to a large extent insusceptible to canker, with straight but also slightly to moderately curved stems. The Sudetic provenances behave remarkably uniformly as regards these characteristics. In addition to provenance research investigations have been going on for a long time in Germany into individual differences within the Sudetic larch populations. A report is given on the results of progeny tests from free and controlled pollination, using the example of a seed orchard consisting of 54 clones. We point also to possibilities for improving stem quality by selection steps. The results of provenance and progeny research on Sudetic larch are in the meantime being put to use to a large extent in practical forestry. The forest administrations of various federal lands recommend the use of reproductive material of Sudetic origin and from seed orchards. 20 refs, 3 figs

  1. Sudetic larch in Germany - Results of provenance and progeny research

    Energy Technology Data Exchange (ETDEWEB)

    Weisgerber, H [Forest Centre for Management Planning, Research and Ecology, Hann Muenden (Germany)

    1996-12-31

    There are only a few older sources of Sudetic larch in Germany. They distinguish themselves by outstanding growth and low susceptibility to canker. This impression was confirmed by results of provenance research. The Sudetic larch tested in comparison with numerous other provenances proved to be fast-growing, site-tolerant, to a large extent insusceptible to canker, with straight but also slightly to moderately curved stems. The Sudetic provenances behave remarkably uniformly as regards these characteristics. In addition to provenance research investigations have been going on for a long time in Germany into individual differences within the Sudetic larch populations. A report is given on the results of progeny tests from free and controlled pollination, using the example of a seed orchard consisting of 54 clones. We point also to possibilities for improving stem quality by selection steps. The results of provenance and progeny research on Sudetic larch are in the meantime being put to use to a large extent in practical forestry. The forest administrations of various federal lands recommend the use of reproductive material of Sudetic origin and from seed orchards. 20 refs, 3 figs

  2. The effectiveness of Korean medicine treatment in male patients with infertility: a study protocol for a prospective observational pilot study.

    Science.gov (United States)

    Kim, Kwan-Ii; Jo, Junyoung

    2018-01-01

    Male factor subfertility has increasingly been considered the cause of infertility in couples. Many men with male infertility have sperm problems such as oligozoospermia, asthenozoospermia, or teratozoospermia. Because abnormal semen parameters are idiopathic to some extent, no standard therapy has been established to date. Herbal medicine has been reported to have beneficial properties in the treatment of subfertility, especially in improving semen quality both in vivo and in human studies. Therefore, we intend to investigate the effectiveness and safety of treatment using Korean medicine (KM) for infertile male patients with poor semen quality.This will be a single-center, prospective, case-only observational pilot study. About 20 male patients with infertility who visit Conmaul Hospital of Korean Medicine will be recruited. We will follow the standard treatment protocol, which has shown good results in the treatment of male infertility. The protocol is composed mainly of a 10-week herbal decoction treatment; acupuncture and/or pharmacopuncture are added when needed. Semen samples, quality of life, and the scrotal temperatures of infertile men will be observed before and after the 10-week treatment with KM.The study has received ethical approval from the Public Institutional Review Board (approval number: P01-201708-21-008). The findings will be disseminated to appropriate audiences via peer-reviewed publication and conference presentations. Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002611.

  3. Responses to mild water deficit and rewatering differ among secondary metabolites but are similar among provenances within Eucalyptus species.

    Science.gov (United States)

    McKiernan, Adam B; Potts, Brad M; Brodribb, Timothy J; Hovenden, Mark J; Davies, Noel W; McAdam, Scott A M; Ross, John J; Rodemann, Thomas; O'Reilly-Wapstra, Julianne M

    2016-02-01

    Water deficit associated with drought can severely affect plants and influence ecological interactions involving plant secondary metabolites. We tested the effect of mild water deficit and rewatering on physiological, morphological and chemical traits of juvenile Eucalyptus globulus Labill. and Eucalyptus viminalis Labill. We also tested if responses of juvenile eucalypts to water deficit and rewatering varied within species using provenances across a rainfall gradient. Both species and all provenances were similarly affected by mild water deficit and rewatering, as only foliar abscisic acid levels differed among provenances during water deficit. Across species and provenances, water deficit decreased leaf water potential, above-ground biomass and formylated phloroglucinol compound concentrations, and increased condensed tannin concentrations. Rewatering reduced leaf carbon : nitrogen, and total phenolic and chlorogenic acid concentrations. Water deficit and rewatering had no effect on total oil or individual terpene concentrations. Levels of trait plasticity due to water deficit and rewatering were less than levels of constitutive trait variation among provenances. The overall uniformity of responses to the treatments regardless of native provenance indicates limited diversification of plastic responses when compared with the larger quantitative variation of constitutive traits within these species. These responses to mild water deficit may differ from responses to more extreme water deficit or to responses of juvenile/mature eucalypts growing at each locality. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Seamless Provenance Representation and Use in Collaborative Science Scenarios

    Science.gov (United States)

    Missier, P.; Ludaescher, B.; Bowers, S.; Altintas, I.; Anand, M. K.; Dey, S.; Sarkar, A.; Shrestha, B.; Goble, C.

    2010-12-01

    The notion of sharing scientific data has only recently begun to gain ground in science, where data is still considered a private asset. There is growing evidence, however, that the benefits of scientific collaboration through early data sharing during the course of a science project may outgrow the risk of losing exclusive ownership of the data. As exemplar success stories are making the headlines[1], principles of effective information sharing have become the subject of e-science research. In particular, any piece of published data should be self-describing, to the extent necessary for consumers to determine its suitability for reuse in their own projects. This is accomplished by associating a body of formally specified and machine-processable metadata to the data. When data is produced and reused by independent groups, however, metadata interoperability issues emerge. This is the case for provenance, a form of metadata that describes the history of a data product, Y. Provenance is typically expressed as a graph-structured set of dependencies that account for the sequence of computational or interactive steps that led to Y, often starting from some primary, observational data. Traversing dependency graphs is one of the mechanisms used to answer questions on data reliability. In the context of the NSF DataONE project[2], we have been studying issues of provenance interoperability in scientific collaboration scenarios. Consider a first scientist, Alice, who publishes a data product X along with its provenance, and a second scientist who further transforms X into a new product Y, also along with its provenance. A third scientist, who is interested in Y, expects to be able to trace Y's history up to the inputs used by Alice. This is only possible, however, if provenance accumulates into a single, uniform graph that can be seamlessly traversed. This becomes problematic when provenance is captured using different tools and computational models (i.e. workflow systems

  5. The InterHerz project--a web-based psychological treatment for cardiac patients with depression: study protocol of a randomized controlled trial

    OpenAIRE

    Messerli-Bürgy, Nadine; Barth, Jürgen; Berger, Thomas

    2012-01-01

    Abstract Background Patients with heart disease often suffer from difficulties in psychological adaptation during cardiac rehabilitation. Mood disorders such as depression are known to be highly prevalent in cardiac patients and to have a negative impact on the progression of coronary heart disease. However, cardiac patients have difficulties to get psychological treatments due to low availability and motivational difficulties. Web-based interventions have been proven to be effective in treat...

  6. ProvenCare-Psoriasis: A disease management model to optimize care.

    Science.gov (United States)

    Gionfriddo, Michael R; Pulk, Rebecca A; Sahni, Dev R; Vijayanagar, Sonal G; Chronowski, Joseph J; Jones, Laney K; Evans, Michael A; Feldman, Steven R; Pride, Howard

    2018-03-15

    There are a variety of evidence-based treatments available for psoriasis. The transition of this evidence into practice is challenging. In this article, we describe the design of our disease management approach for Psoriasis (ProvenCare®) and present preliminary evidence of the effect of its implementation. In designing our approach, we identified three barriers to optimal care: 1) lack of a standardized and discrete disease activity measure within the electronic health record, 2) lack of a system-wide, standardized approach to care, and 3) non-uniform financial access to appropriate non-pharmacologic treatments. We implemented several solutions, which collectively form our approach. We standardized the documentation of clinical data such as body surface area (BSA), created a disease management algorithm for psoriasis, and aligned incentives to facilitate the implementation of the algorithm. This approach provides more coordinated, cost effective care for psoriasis, while being acceptable to key stakeholders. Future work will examine the effect of the implementation of our approach on important clinical and patient outcomes.

  7. Determination of marble provenance: limits of isotopic analysis

    International Nuclear Information System (INIS)

    Germann, K.; Holzmann, G.; Winkler, F.J.

    1980-01-01

    Provenance determination of Thessalian stelae marbles using the C/O isotopic analysis proved to be misleading, as the isotopic composition even in very small quarrying areas is heterogeneous and isotopic coincidence of marbles from very distant sources occurs. Therefore additional geological features must be taken into consideration and preference should be given to combinations of both petrographical and geochemical properties. Geological field work to establish the range of possible marble sources and the variability within these sources is one of the prerequisites of provenance studies. (author)

  8. Protocol for Communication Networking for Formation Flying

    Science.gov (United States)

    Jennings, Esther; Okino, Clayton; Gao, Jay; Clare, Loren

    2009-01-01

    An application-layer protocol and a network architecture have been proposed for data communications among multiple autonomous spacecraft that are required to fly in a precise formation in order to perform scientific observations. The protocol could also be applied to other autonomous vehicles operating in formation, including robotic aircraft, robotic land vehicles, and robotic underwater vehicles. A group of spacecraft or other vehicles to which the protocol applies could be characterized as a precision-formation- flying (PFF) network, and each vehicle could be characterized as a node in the PFF network. In order to support precise formation flying, it would be necessary to establish a corresponding communication network, through which the vehicles could exchange position and orientation data and formation-control commands. The communication network must enable communication during early phases of a mission, when little positional knowledge is available. Particularly during early mission phases, the distances among vehicles may be so large that communication could be achieved only by relaying across multiple links. The large distances and need for omnidirectional coverage would limit communication links to operation at low bandwidth during these mission phases. Once the vehicles were in formation and distances were shorter, the communication network would be required to provide high-bandwidth, low-jitter service to support tight formation-control loops. The proposed protocol and architecture, intended to satisfy the aforementioned and other requirements, are based on a standard layered-reference-model concept. The proposed application protocol would be used in conjunction with conventional network, data-link, and physical-layer protocols. The proposed protocol includes the ubiquitous Institute of Electrical and Electronics Engineers (IEEE) 802.11 medium access control (MAC) protocol to be used in the datalink layer. In addition to its widespread and proven use in

  9. IGCC based on proven technology developing towards 50% efficiency mark

    Energy Technology Data Exchange (ETDEWEB)

    Goudappel, E.; Berkhout, M. [Jacobs Consultancy, Leiden (Netherlands)

    2006-07-01

    In this paper the achievements made over the last 10 years in terms of reliability, load following and efficiency improvement potential at the Buggenum IGCC plant, are presented. Also the air side heat integration and its pros and cons are discussed. Additionally future business opportunities adjacent to the power production itself and the view on coal gasification in the near future are provided. The results are discussed and it is shown that with 'proven' gasifier and gas treatment technology, overall efficiency exceeding 47% (LHV basis) can be reached. It puts this technical potential in perspective and describes the view on interesting business opportunities around IGCC projects. 5 figs., 3 tabs.

  10. Pharmacists' Perception of the Sale of Non-Clinically Proven Health ...

    African Journals Online (AJOL)

    Pharmacists' Perception of the Sale of Non-Clinically Proven Health Supplements in Penang, Malaysia. ... A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists ... Keywords: Perception, Health promotion, Urban poor, Health supplements.

  11. A Randomized Trial of Comparing the Efficacy of Two Neurofeedback Protocols for Treatment of Clinical and Cognitive Symptoms of ADHD: Theta Suppression/Beta Enhancement and Theta Suppression/Alpha Enhancement

    Directory of Open Access Journals (Sweden)

    Arash Mohagheghi

    2017-01-01

    Full Text Available Introduction. Neurofeedback (NF is an adjuvant or alternative therapy for children with Attention Deficit Hyperactivity Disorder (ADHD. This study intended to compare the efficacy of two different NF protocols on clinical and cognitive symptoms of ADHD. Materials and Methods. In this clinical trial, sixty children with ADHD aged 7 to 10 years old were randomly grouped to receive two different NF treatments (theta suppression/beta enhancement protocol and theta suppression/alpha enhancement protocol. Clinical and cognitive assessments were conducted prior to and following the treatment and also after an eight-week follow-up. Results. Both protocols alleviated the symptoms of ADHD in general (p<0.001, hyperactivity (p<0.001, inattention (p<0.001, and omission errors (p<0.001; however, they did not affect the oppositional and impulsive scales nor commission errors. These effects were maintained after an eight-week intervention-free period. The only significant difference between the two NF protocols was that high-frequency alpha enhancement protocol performed better in suppressing omission errors (p<0.001. Conclusion. The two NF protocols with theta suppression/beta enhancement and theta suppression/alpha enhancement have considerable and comparable effect on clinical symptoms of ADHD. Alpha enhancement protocol was more effective in suppressing omission errors.

  12. Toxoplasma gondii and pre-treatment protocols for polymerase chain reaction analysis of milk samples: a field trial in sheep from Southern Italy

    Directory of Open Access Journals (Sweden)

    Alice Vismarra

    2017-02-01

    Full Text Available Toxoplasmosis is a zoonotic disease caused by the protozoan Toxoplasma gondii. Ingestion of raw milk has been suggested as a risk for transmission to humans. Here the authors evaluated pre-treatment protocols for DNA extraction on T. gondii tachyzoite-spiked sheep milk with the aim of identifying the method that resulted in the most rapid and reliable polymerase chain reaction (PCR positivity. This protocol was then used to analyse milk samples from sheep of three different farms in Southern Italy, including real time PCR for DNA quantification and PCR-restriction fragment length polymorphism for genotyping. The pre-treatment protocol using ethylenediaminetetraacetic acid and Tris-HCl to remove casein gave the best results in the least amount of time compared to the others on spiked milk samples. One sample of 21 collected from sheep farms was positive on one-step PCR, real time PCR and resulted in a Type I genotype at one locus (SAG3. Milk usually contains a low number of tachyzoites and this could be a limiting factor for molecular identification. Our preliminary data has evaluated a rapid, cost-effective and sensitive protocol to treat milk before DNA extraction. The results of the present study also confirm the possibility of T. gondii transmission through consumption of raw milk and its unpasteurised derivatives.

  13. International Study to Predict Optimized Treatment for Depression (iSPOT-D, a randomized clinical trial: rationale and protocol

    Directory of Open Access Journals (Sweden)

    Cooper Nicholas J

    2011-01-01

    Full Text Available Abstract Background Clinically useful treatment moderators of Major Depressive Disorder (MDD have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators. Methods/Design The International Study to Predict Optimized Treatment - in Depression (iSPOT-D is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65 from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls. Study-eligible patients are antidepressant medication (ADM naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary. Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm. Discussion First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide. Trial registration International Study to Predict Optimised Treatment - in Depression (iSPOT-D ClinicalTrials.gov Identifier

  14. Model-based Abstraction of Data Provenance

    NARCIS (Netherlands)

    Probst, Christian W.; Hansen, René Rydhof

    Identifying provenance of data provides insights to the origin of data and intermediate results, and has recently gained increased interest due to data-centric applications. In this work we extend a data-centric system view with actors handling the data and policies restricting actions. This

  15. Sleep Disturbances, TBI and PTSD: Implications for Treatment and Recovery

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M.; Gehrman, Philip; Bogdanova, Yelena

    2015-01-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. PMID:26164549

  16. Protocol: An updated integrated methodology for analysis of metabolites and enzyme activities of ethylene biosynthesis

    Directory of Open Access Journals (Sweden)

    Geeraerd Annemie H

    2011-06-01

    Full Text Available Abstract Background The foundations for ethylene research were laid many years ago by researchers such as Lizada, Yang and Hoffman. Nowadays, most of the methods developed by them are still being used. Technological developments since then have led to small but significant improvements, contributing to a more efficient workflow. Despite this, many of these improvements have never been properly documented. Results This article provides an updated, integrated set of protocols suitable for the assembly of a complete picture of ethylene biosynthesis, including the measurement of ethylene itself. The original protocols for the metabolites 1-aminocyclopropane-1-carboxylic acid and 1-(malonylaminocyclopropane-1-carboxylic acid have been updated and downscaled, while protocols to determine in vitro activities of the key enzymes 1-aminocyclopropane-1-carboxylate synthase and 1-aminocyclopropane-1-carboxylate oxidase have been optimised for efficiency, repeatability and accuracy. All the protocols described were optimised for apple fruit, but have been proven to be suitable for the analysis of tomato fruit as well. Conclusions This work collates an integrated set of detailed protocols for the measurement of components of the ethylene biosynthetic pathway, starting from well-established methods. These protocols have been optimised for smaller sample volumes, increased efficiency, repeatability and accuracy. The detailed protocol allows other scientists to rapidly implement these methods in their own laboratories in a consistent and efficient way.

  17. Growth dynamics variation of different larch provenances under the mountain conditions in Poland

    Energy Technology Data Exchange (ETDEWEB)

    Kulej, M. [Univ. of Agriculture, Cracow (Poland). Section of Seed Production and Selection

    1995-12-31

    The results of 25-year investigations based on measurements and statistical analysis concerning the growth dynamics variation of larch provenances from the entire area of Poland are reported in this paper. This is the first larch provenance experiment in Poland under mountain conditions. The results obtained showed a significant variability among the provenances tested as regards the basic growth characters (height, d.b.h., growth index) at the age of 5, 8, 11, 15, 20 and 25 years. The larch from Klodzko and Proszkow turned out to be the best in respect of growth during the entire 25-years period. Decidedly bad were provenances from Marcule, Grojec, Rawa mazowiecka and Kroscienko. We cannot forecast the future growth of larch when trees are 5-years old since such prognosis may carry an error. However, on the basis of the results obtained it may be concluded that when trees are about 8 years old the stabilization of the position of individual provenances as regards growth takes place. The height growth curves for the individual provenances during the 25-years period (with exception of the provenance from Marcule) fall within the interval {+-} 0,5S from the compensated curve for the entire population studied. All larch provenances in the experiment had reached the height growth culmination. A greatest differentiation in respect of this character occurred in case of the provenances from Sudetes. 27 refs, 4 figs, 8 tabs

  18. Growth dynamics variation of different larch provenances under the mountain conditions in Poland

    Energy Technology Data Exchange (ETDEWEB)

    Kulej, M [Univ. of Agriculture, Cracow (Poland). Section of Seed Production and Selection

    1996-12-31

    The results of 25-year investigations based on measurements and statistical analysis concerning the growth dynamics variation of larch provenances from the entire area of Poland are reported in this paper. This is the first larch provenance experiment in Poland under mountain conditions. The results obtained showed a significant variability among the provenances tested as regards the basic growth characters (height, d.b.h., growth index) at the age of 5, 8, 11, 15, 20 and 25 years. The larch from Klodzko and Proszkow turned out to be the best in respect of growth during the entire 25-years period. Decidedly bad were provenances from Marcule, Grojec, Rawa mazowiecka and Kroscienko. We cannot forecast the future growth of larch when trees are 5-years old since such prognosis may carry an error. However, on the basis of the results obtained it may be concluded that when trees are about 8 years old the stabilization of the position of individual provenances as regards growth takes place. The height growth curves for the individual provenances during the 25-years period (with exception of the provenance from Marcule) fall within the interval {+-} 0,5S from the compensated curve for the entire population studied. All larch provenances in the experiment had reached the height growth culmination. A greatest differentiation in respect of this character occurred in case of the provenances from Sudetes. 27 refs, 4 figs, 8 tabs

  19. Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Stahl, Franka

    2009-06-01

    The aim of this clinical trial was to compare the effects of 2 protocols for single-phase comprehensive treatment of Class II Division 1 malocclusion (bonded Herbst followed by fixed appliances [BH + FA] vs headgear followed by fixed appliances and Class II elastics [HG + FA]) at the pubertal growth spurt. Fifty-six Class II patients were enrolled in the trial and allocated by personal choice to 2 practices, where they underwent 1 of 2 treatment protocols (28 patients were treated consecutively with BH + FA, and 28 patients were treated consecutively with HG + FA). All patients started treatment at puberty (cervical stage [CS] 3 or CS 4) and completed treatment after puberty (CS 5 or CS 6). Lateral cephalograms were taken before therapy and 6 months after the end of comprehensive therapy, with an average interval of 28 months. Longitudinal observations of a matched group of 28 subjects with untreated Class II malocclusions were compared with the 2 treated groups. Analysis of variance (ANOVA) with post-hoc tests was used for statistical comparisons. Discriminant analysis was applied to identify preferential candidates for the BH + FA protocol on the basis of profile changes (advancement of the soft tissues of the chin). The success rate (full occlusal correction of the malocclusion after treatment) was 92.8% in both treatment groups. The BH + FA group showed a significant increase in mandibular protrusion. The increase in effective mandibular length (Co-Gn) was significantly greater in both treatment groups when compared with natural growth changes in the Class II controls. Significantly greater improvement in sagittal maxillomandibular relationships was found in the BH + FA group. Retrusion of maxillary incisors and mesial movement of mandibular molars were significant in the HG + FA group. The BH + FA group showed significantly greater forward movements of soft-tissue B-point and pogonion compared with both the HG + FA and the control groups. Two pretreatment

  20. Skeletal Class III and anterior open bite treatment with different retention protocols: a report of three cases.

    Science.gov (United States)

    Farret, Milton Meri Benitez; Farret, Marcel Marchiori; Farret, Alessandro Marchiori

    2012-09-01

    The treatment of skeletal class III and anterior open bite can be unstable and orthodontists frequently observe relapse. Here, we report on the management of three patients with skeletal class III profiles and open bites treated by orthodontic camouflage. Each received a retention protocol involving the use of two separate appliances during the night and day accompanied by myofunctional therapy. Long-term follow-up revealed a stable outcome.

  1. Protocol for the quality control systems of electronic portal imaging used in verification of radiotherapy treatment

    International Nuclear Information System (INIS)

    Silvestre, Ileana; Alfonso, Rodolfo; Garcia, Fernando

    2009-01-01

    Following the approach of quality control of radiotherapy equipment, conceived in the IAEA TECDOC-1151, we analyzed the different tests must be to an EPID to guarantee levels of accuracy required in the administration of radiation treatments, including the study of the impact of different parameters, geometric and dosimetric imaging, involved in the process. Established the types and frequency of checks, as well as procedures for their implementation, the allowable tolerances set of values records and forms for recording . Was carried out assessment protocol in various services based on amorphous silicon EPID for its applicability and scope. Was designed and validated in clinical practice protocol for EPID quality control, demonstrating its applicability with a minimum of material and human resources. It We concluded that with proper and systematic quality control program, tests including dosimetry, the EPID can provide valuable information about physico-beam dosimetry, and ensure adequate accuracy geometric in the patient's location. (author)

  2. Automated Generation of Technical Documentation and Provenance for Reproducible Research

    Science.gov (United States)

    Jolly, B.; Medyckyj-Scott, D.; Spiekermann, R.; Ausseil, A. G.

    2017-12-01

    Data provenance and detailed technical documentation are essential components of high-quality reproducible research, however are often only partially addressed during a research project. Recording and maintaining this information during the course of a project can be a difficult task to get right as it is a time consuming and often boring process for the researchers involved. As a result, provenance records and technical documentation provided alongside research results can be incomplete or may not be completely consistent with the actual processes followed. While providing access to the data and code used by the original researchers goes some way toward enabling reproducibility, this does not count as, or replace, data provenance. Additionally, this can be a poor substitute for good technical documentation and is often more difficult for a third-party to understand - particularly if they do not understand the programming language(s) used. We present and discuss a tool built from the ground up for the production of well-documented and reproducible spatial datasets that are created by applying a series of classification rules to a number of input layers. The internal model of the classification rules required by the tool to process the input data is exploited to also produce technical documentation and provenance records with minimal additional user input. Available provenance records that accompany input datasets are incorporated into those that describe the current process. As a result, each time a new iteration of the analysis is performed the documentation and provenance records are re-generated to provide an accurate description of the exact process followed. The generic nature of this tool, and the lessons learned during its creation, have wider application to other fields where the production of derivative datasets must be done in an open, defensible, and reproducible way.

  3. Lowering the Barrier to Reproducible Research by Publishing Provenance from Common Analytical Tools

    Science.gov (United States)

    Jones, M. B.; Slaughter, P.; Walker, L.; Jones, C. S.; Missier, P.; Ludäscher, B.; Cao, Y.; McPhillips, T.; Schildhauer, M.

    2015-12-01

    Scientific provenance describes the authenticity, origin, and processing history of research products and promotes scientific transparency by detailing the steps in computational workflows that produce derived products. These products include papers, findings, input data, software products to perform computations, and derived data and visualizations. The geosciences community values this type of information, and, at least theoretically, strives to base conclusions on computationally replicable findings. In practice, capturing detailed provenance is laborious and thus has been a low priority; beyond a lab notebook describing methods and results, few researchers capture and preserve detailed records of scientific provenance. We have built tools for capturing and publishing provenance that integrate into analytical environments that are in widespread use by geoscientists (R and Matlab). These tools lower the barrier to provenance generation by automating capture of critical information as researchers prepare data for analysis, develop, test, and execute models, and create visualizations. The 'recordr' library in R and the `matlab-dataone` library in Matlab provide shared functions to capture provenance with minimal changes to normal working procedures. Researchers can capture both scripted and interactive sessions, tag and manage these executions as they iterate over analyses, and then prune and publish provenance metadata and derived products to the DataONE federation of archival repositories. Provenance traces conform to the ProvONE model extension of W3C PROV, enabling interoperability across tools and languages. The capture system supports fine-grained versioning of science products and provenance traces. By assigning global identifiers such as DOIs, reseachers can cite the computational processes used to reach findings. And, finally, DataONE has built a web portal to search, browse, and clearly display provenance relationships between input data, the software

  4. A weight loss protocol and owners participation in the treatment of canine obesity

    Directory of Open Access Journals (Sweden)

    Carciofi Aulus Cavalieri

    2005-01-01

    Full Text Available The success of a weight loss program for pets depends on the owners collaboration. Their compliance is fundamental in establishing the correct food management. The objective of this study was to compare the effectiveness of a weight loss program in two groups of dogs, one maintained under experimental conditions and the other with their owners. The same hypocaloric food was used to feed all animals, the amount being restricted to 60% of the estimated maintenance energy requirement for a 15% reduction of the present body weight of the dog. The animals were followed during 90 days. A standard questionnaire was used to study the owners' perception of obesity and its treatment. The protocol and the diet were found to be effective. The control dogs had an average weight loss of 1.39% per week. Dogs with owners lost on average 0.75% of their body weight per week, a statistically lower result (P<0.05, suggesting that the owners did not follow the treatment closely. The owners were clearly satisfied with the results that were obtained, even with this modest weight loss. The questionnaires were shown to be an important tool in determining the causes of canine obesity, as well as in the follow-up of the treatment.

  5. Wood structural differences between northern and southern beech provenances growing at a moderate site.

    Science.gov (United States)

    Eilmann, B; Sterck, F; Wegner, L; de Vries, S M G; von Arx, G; Mohren, G M J; den Ouden, J; Sass-Klaassen, U

    2014-08-01

    Planting provenances originating from southern to northern locations has been discussed as a strategy to speed up species migration and mitigate negative effects of climate change on forest stability and productivity. Especially for drought-susceptible species such as European beech (Fagus sylvatica L.), the introduction of drought-tolerant provenances from the south could be an option. Yet, beech has been found to respond plastically to environmental conditions, suggesting that the climate on the plantation site might be more important for tree growth than the genetic predisposition of potentially drought-adapted provenances. In this study, we compared the radial growth, wood-anatomical traits and leaf phenology of four beech provenances originating from southern (Bulgaria, France) and northern locations (Sweden, the Netherlands) and planted in a provenance trial in the Netherlands. The distribution of precipitation largely differs between the sites of origin. The northern provenances experience a maximum and the southern provenances experience a minimum of rainfall in summer. We compared tree productivity and the anatomy of the water-conducting system for the period from 2000 to 2010, including the drought year 2003. In addition, tree mortality and the timing of leaf unfolding in spring were analysed for the years 2001, 2007 and 2012. Comparison of these traits in the four beech provenances indicates the influence of genetic predisposition and local environmental factors on the performance of these provenances under moderate site conditions. Variation in radial growth was controlled by environment, although the growth level slightly differed due to genetic background. The Bulgarian provenance had an efficient water-conducting system which was moreover unaffected by the drought in 2003, pointing to a high ability of this provenance to cope well with dry conditions. In addition, the Bulgarian provenance showed up as most productive in terms of height and radial

  6. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer.

    Science.gov (United States)

    Cavaliere, Carlo; Romeo, Valeria; Aiello, Marco; Mesolella, Massimo; Iorio, Brigida; Barbuto, Luigi; Cantone, Elena; Nicolai, Emanuele; Covello, Mario

    2017-03-01

    To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient's staging and treatment planning. 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K trans , V e , k ep and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen's kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p=0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Water use efficiency studies of Acacia senegal (L.) Willd provenances in Sudan

    International Nuclear Information System (INIS)

    Mustafa, A.F.; Elamin, K.H.; Salih, A.A.

    1996-01-01

    An experiment was conducted in 1989 to screen Acacia senegal L. Willd provenances collected from within the natural gum belt for high water use efficiency. Thirteen provenances were tested for water use efficiency and consequently 6 out of them were selected for further screening. The selection was based on their performance in the preliminary screening. Both the preliminary and the detailed study revealed that provenances 7, 3 and 11 combine high dry matter production with high water use efficiency. Water use efficiency and dry matter production appears to be negatively correlated with root length density and root/shoot ratios. Provenances 7 which exhibited the highest water use efficiency and dry matter yield had the lowest root/shoot ratio and also a low root length density. Based on these studies provenance 7 can be considered a suitable candidate for introduction into gum-belt of Sudan through for rehabilitation of this region. (author). 5 refs, 1 fig., 3 tabs

  8. Water use efficiency studies of Acacia senegal (L.) Willd provenances in Sudan

    Energy Technology Data Exchange (ETDEWEB)

    Mustafa, A F; Elamin, K H [Forestry Research Section, Wad Medani (Sudan); Salih, A A [Soil Science Section, Wad Medani (Sudan)

    1996-07-01

    An experiment was conducted in 1989 to screen Acacia senegal L. Willd provenances collected from within the natural gum belt for high water use efficiency. Thirteen provenances were tested for water use efficiency and consequently 6 out of them were selected for further screening. The selection was based on their performance in the preliminary screening. Both the preliminary and the detailed study revealed that provenances 7, 3 and 11 combine high dry matter production with high water use efficiency. Water use efficiency and dry matter production appears to be negatively correlated with root length density and root/shoot ratios. Provenances 7 which exhibited the highest water use efficiency and dry matter yield had the lowest root/shoot ratio and also a low root length density. Based on these studies provenance 7 can be considered a suitable candidate for introduction into gum-belt of Sudan through for rehabilitation of this region. (author). 5 refs, 1 fig., 3 tabs.

  9. Results of ERAS protocol in patients with colorectal cancer

    Directory of Open Access Journals (Sweden)

    A. O. Rasulov

    2016-01-01

    Full Text Available Objective: explore the use of enhanced recovery after surgery (ERAS in the treatment of patients with colorectal cancer, evaluate its efficacy and safety.Materials and methods. Prospective, single-site, randomized study for the implementation of enhanced recovery after surgery in patients with colorectal cancer has been conducted from October 2014 till the present time. All patients after laparoscopic surgeries undergo treatment according to ERAS protocol, patients after open surgeries are randomized (1:1 in groups of the standard treatment or treatment according to ERAS protocol. The study included patients with localized and locally disseminated colorectal cancer aged from 18 to 75 years, ECOG score ≤ 2. The primary evaluated parameters were the following: the number of postoperative complications (according to Clavien– Dindo classification, postoperative hospital days, incidence of complications and mortality in the 30-day period, timing of activation.Results. Up to date, the study includes 105 patients: laparoscopic group – 51 patients, open-surgery group of patients treated by ERAS protocol – 27 patients, open-surgery group of patients with the standard post-op treatment – 26 patients. Complications requiring emergency surgery for anastomotic leak (p = 0.159 developed in 3.7 % of patients with the standard post-op treatment and in 3.9 % of patients after laparoscopic surgery, while 1 patient required repeat hospitalization. The total number of complications was significantly lower in opensurgery group of patients treated by ERAS protocol compared with the standard post-op treatment (p = 0.021. However, there were no differences between laparoscopic and open-surgery group with the standard post-op treatment (p = 0.159. An average hospitalization stay in patients with the standard post-op treatment was equal to 10 days compared to 7 days in patients treated by ERAS protocol (p = 0.067 and 6 days after laparoscopic

  10. Nonalbumin proteinuria predominates in biopsy-proven tenofovir nephrotoxicity.

    Science.gov (United States)

    Sise, Meghan E; Hirsch, Jamie S; Canetta, Pietro A; Herlitz, Leal; Mohan, Sumit

    2015-05-15

    Tenofovir disoproxil fumarate (TDF) nephrotoxicity is characterized by proximal renal tubular injury and dysmorphic mitochondria resulting in proteinuria, orthoglycemic glycosuria, and other markers of proximal tubular dysfunction. The objective of this study was to determine the pattern of proteinuria in patients with biopsy-proven TDF nephrotoxicity. Retrospective chart review. Patients with biopsy-proven TDF nephrotoxicity were identified and their medical charts and biopsy reports were reviewed. Comparison was made with HIV-infected patients not on TDF who underwent kidney biopsy. We identified 43 biopsy-proven cases of TDF nephrotoxicity; mean age 54.7 ± 0.4 years, 53% men, 42% whites. Thirty-seven cases reported proteinuria by dipstick of which only 60% had at least 2+ proteinuria. Twenty-seven patients had urine protein quantified by either 24-h collection or spot urine protein-to-creatinine ratio; median proteinuria was 1742 mg/day [interquartile range (IQR) 1200-2000 mg] and 1667 mg/g creatinine (IQR 851-1967 mg/g), respectively. Ten patients had concurrent urinary albumin measured, with a median 236 mg/g creatinine (IQR 137-343 mg/g). The mean urine albumin-to-urine protein ratio (uAPR) was 0.17 (IQR 0.14-0.19), confirming that TDF nephrotoxicity is primarily associated with nonalbumin proteinuria. Control cases had a uAPR of 0.65 (IQR 0.55-0.79) P < 0.001. Histopathology showed the predominance of proximal tubular injury with characteristic mitochondrial abnormalities. In the largest published cohort of patients with biopsy-proven TDF nephrotoxicity, we show that low uAPR is a reliable feature of this disease. Because of the predominance of nonalbumin proteinuria, dipstick urinalysis may be unreliable in TDF nephrotoxicity.

  11. A Preliminary Investigation of the Long-Term Outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

    Science.gov (United States)

    Bullis, Jacqueline R.; Fortune, Meghan R.; Farchione, Todd J.; Barlow, David H.

    2014-01-01

    Objective To conduct a preliminary examination of long-term outcomes on a broad range of affective disorder symptoms treated with a newly developed intervention: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). Method Maintenance of treatment gains at long-term follow-up (LTFU) were explored in patients (n = 15, mean age = 32.27; 60% female) who completed a clinical trial of the UP. Results Treatment gains observed at 6-month follow-up (6MFU) on measures of clinical severity, general symptoms of depression and anxiety, and a measure of symptom interference in daily functioning were largely maintained 12 months later (at an average of 18 months posttreatment), and any significant changes from 6MFU to LTFU reflected small increases in symptoms that remained, on average, in the subclinical range. Conclusions These findings provide the first initial support for the durability of broad treatment gains following transdiagnostic treatment. PMID:25113056

  12. Assistance protocol for venous ulcers patients: validation of contents

    Directory of Open Access Journals (Sweden)

    Daniele Vieira Dantas

    2013-07-01

    Full Text Available Venous ulcers require complex treatment and are responsible for significant morbidity and mortality rates. This study aims at identifying aspects validated by the jury for the preparation of an assistance protocol for venous ulcer sufferers. It is a descriptive and quantitative research, with 39 professionals (30 nurses, 7 doctors and two physiotherapists, held at the Onofre Lopes University Hospital, between April and July/2010. Data collection began through a questionnaire checklist. Analysis was performed through Statistical Package for Social Science 15.0, assessing compliance with guidelines. Results were the compositional aspects of the protocol: assessment of patient and lesion history/documentation, wound care/perilesional skin, dressing suggestion, use of antibiotics and pain treatment, surgical treatment/medication, improving venous return and relapse prevention, patient referral, professional training and referral/counter-referral. It was concluded that to compose the protocol, aspects related to diagnosis, treatment and injury prevention must be considered.

  13. Two Case Reports and Actual Treatment Approachs of Retroperitoneal Fibrosis

    Directory of Open Access Journals (Sweden)

    Eymen Gazel

    2013-06-01

    Full Text Available Retroperitoneal fibrosis (RPF is a rare disease of unclear etiology, which is characterized by a chronic non specific inflammation of the retroperitoneum. This inflammation of the retroperitoneum may entrap and obstruct retroperitoneal structures, particularly the ureters. Patients with RPF show non specific clinical symptoms, including poorly localized back pain, general malaise, weight loss, anemia, features of renal failure and occasionally, mild fever. The early symptoms are non specific and an accurate diagnosis is often achieved only subsequent to urological obstruction or the occurrence of renal failure. Although a number of scientific journals devoted to RPF are present in the litera¬ture, there is no accepted diagnostic or therapeutic strategy for this disease. However, there are several therapeutic strate¬gies which have been proven to be effective. Hereby, we reported two cases of retroperitoneal fibrosis which had similar symptoms and findings but different responses to medical treatment .We aimed to discuss challanges of RPF%u2019s diagnosis and the treatment protocol.

  14. Changing provenance of late Cenozoic sediments in the Jianghan Basin

    Directory of Open Access Journals (Sweden)

    Lei Shao

    2015-07-01

    Full Text Available The Yangtze River is one of the most important components of the East Asia river system. In this study, sediments in the Jianghan Basin, middle Yangtze River, were selected for trace element and rare earth element (REE measurements, in order to decipher information on the change of sediment provenance and evolution of the Yangtze River. According to the elemental variations, the late Cenozoic sediments of the Jianghan Basin could be divided into four parts. During 2.68–2.28 Ma and 1.25–0 Ma, provenance of the sediments was consistent, whereas sediments were derived from variable sources during 2.28–1.25 Ma. Comparison of the elemental compositions between the Pliocene and Quaternary sediments revealed a change in sediment source from a more felsic source area to a more basic source area around the Pliocene–Quaternary boundary. Input from the Emeishan LIP should account for this provenance change. Based on the provenance analysis of sediments in the Jianghan Basin, we infer that the Yangtze River developed into a large river with its drainage basin extended to the Emeishan LIP no later than the Pliocene–Quaternary boundary.

  15. Development and implementation of the Dutch protocol for rehabilitative management in amyotrophic lateral sclerosis.

    Science.gov (United States)

    van den Berg, J P; de Groot, I J M; Joha, B C; van Haelst, J M; van Gorcom, P; Kalmijn, S

    2004-12-01

    In the Netherlands, rehabilitation care plays an important role in the symptomatic and palliative treatment of ALS patients. However, until 1999 there were no guidelines or practice parameters available for the management of ALS. Therefore, the Dutch protocol for rehabilitative management in ALS was developed. We describe the development process, the outcome and implementation of the protocol. A concept management protocol was written and the Delphi method was selected to develop the protocol further. This method comprises repetitive discussion sessions from postulates, using a combination of written questionnaires and work-conferences. Between 80 and 90 persons (rehabilitation team members of different professional backgrounds and neurologists) were involved in this process. The protocol was implemented by sending it to all consultants in rehabilitation medicine in the Netherlands; they were asked to inform all the treatment team members about the final protocol and to implement it in their treatment of ALS patients. The protocol was developed in 1999, implemented in 2000 and evaluated in 2001. Recommendations for improvement were made during the evaluation and improvements are currently being developed by an expert group. The protocol is widely used (88.9%) by consultants in rehabilitation medicine and their treatment teams in the Netherlands. The Dutch protocol for rehabilitative management was developed to provide an optimal and adequate care plan for patients with ALS. It is widely used in the Netherlands.

  16. An Inference-Based Framework to Manage Data Provenance in Geoscience Applications

    NARCIS (Netherlands)

    Huq, M.R.; Apers, Peter M.G.; Wombacher, Andreas

    2013-01-01

    Data provenance allows scientists to validate their model as well as to investigate the origin of an unexpected value. Furthermore, it can be used as a replication recipe for output data products. However, capturing provenance requires enormous effort by scientists in terms of time and training.

  17. Performance of Acacia tortilis, Prosopis juliflora and Casuarina equisetifolia provenances in soils low in phosphorus

    International Nuclear Information System (INIS)

    Nyamai, D.O.; Juma, P.O.

    1996-01-01

    Acacia tortilis, Prosopis juliflora and Casuarina equisetifolia provenances were screened to determine their potential for adaptability under P limiting conditions as a strategy to exploit genotypic differences in terms of utilization and uptake efficiencies. The experiment was conducted in the greenhouse at the Kenya Forestry Research Institute using soils taken from the field which are critically low in available P. The experimental treatments comprised of P application at 0 and 60 Kg P 2 O 5 /ha for 11 provenances of Acacia, 6 Prosopis and 4 Casuarina spp. Trait for adaptability to P deficiency was determined by measuring the growth performance, P uptake and utilization efficiencies at zero and moderate application of P. The results indicated considerable differences in the growth performance and phosphorus use efficiency (PUE). Acacia provenances showed the highest PUE compared with Prosopis and Casuarina spp although this was not reflected in the total dry matter yield. However, it was observed that P application resulted in an increase in shoot dry matter, height, root collar diameter and root dry matter in the case of Casuarina. Similarly, the highest total P uptake was obtained in Casuarina and Prosopis spp. The results further indicated that P application probably contributed to the reduction in root dry matter and root: shoot ratios of Acacia and Prosopis but not Casuarina spp. (author). 15 refs, 1 fig., 2 tabs

  18. Performance of Acacia tortilis, Prosopis juliflora and Casuarina equisetifolia provenances in soils low in phosphorus

    Energy Technology Data Exchange (ETDEWEB)

    Nyamai, D O; Juma, P O [Kenya Forestry Research Inst., Nairobi (Kenya). Agroforestry Research Programme

    1996-07-01

    Acacia tortilis, Prosopis juliflora and Casuarina equisetifolia provenances were screened to determine their potential for adaptability under P limiting conditions as a strategy to exploit genotypic differences in terms of utilization and uptake efficiencies. The experiment was conducted in the greenhouse at the Kenya Forestry Research Institute using soils taken from the field which are critically low in available P. The experimental treatments comprised of P application at 0 and 60 Kg P{sub 2}O{sub 5}/ha for 11 provenances of Acacia, 6 Prosopis and 4 Casuarina spp. Trait for adaptability to P deficiency was determined by measuring the growth performance, P uptake and utilization efficiencies at zero and moderate application of P. The results indicated considerable differences in the growth performance and phosphorus use efficiency (PUE). Acacia provenances showed the highest PUE compared with Prosopis and Casuarina spp although this was not reflected in the total dry matter yield. However, it was observed that P application resulted in an increase in shoot dry matter, height, root collar diameter and root dry matter in the case of Casuarina. Similarly, the highest total P uptake was obtained in Casuarina and Prosopis spp. The results further indicated that P application probably contributed to the reduction in root dry matter and root: shoot ratios of Acacia and Prosopis but not Casuarina spp. (author). 15 refs, 1 fig., 2 tabs.

  19. Provenance for Runtime Workflow Steering and Validation in Computational Seismology

    Science.gov (United States)

    Spinuso, A.; Krischer, L.; Krause, A.; Filgueira, R.; Magnoni, F.; Muraleedharan, V.; David, M.

    2014-12-01

    Provenance systems may be offered by modern workflow engines to collect metadata about the data transformations at runtime. If combined with effective visualisation and monitoring interfaces, these provenance recordings can speed up the validation process of an experiment, suggesting interactive or automated interventions with immediate effects on the lifecycle of a workflow run. For instance, in the field of computational seismology, if we consider research applications performing long lasting cross correlation analysis and high resolution simulations, the immediate notification of logical errors and the rapid access to intermediate results, can produce reactions which foster a more efficient progress of the research. These applications are often executed in secured and sophisticated HPC and HTC infrastructures, highlighting the need for a comprehensive framework that facilitates the extraction of fine grained provenance and the development of provenance aware components, leveraging the scalability characteristics of the adopted workflow engines, whose enactment can be mapped to different technologies (MPI, Storm clusters, etc). This work looks at the adoption of W3C-PROV concepts and data model within a user driven processing and validation framework for seismic data, supporting also computational and data management steering. Validation needs to balance automation with user intervention, considering the scientist as part of the archiving process. Therefore, the provenance data is enriched with community-specific metadata vocabularies and control messages, making an experiment reproducible and its description consistent with the community understandings. Moreover, it can contain user defined terms and annotations. The current implementation of the system is supported by the EU-Funded VERCE (http://verce.eu). It provides, as well as the provenance generation mechanisms, a prototypal browser-based user interface and a web API built on top of a NoSQL storage

  20. The Development of Korea Additional Protocol System

    International Nuclear Information System (INIS)

    Shim, Hye Won; Yeo, Jin Kyun

    2008-01-01

    The Agreement between the Republic of Korea (ROK) and the IAEA for the Application of Safeguards in Connection with the Treaty on the Non-Proliferation of Nuclear Weapons (the Safeguards Agreement) entered into force on 14 November 1975. The Additional Protocol to the Safeguards Agreement (the Additional Protocol) was signed on 21 June 1999 and entered into force on 19 February 2004. ROK has been submitting annual updated reports of initial declaration on every May 15th since August 2004. Additional protocol reports were submitted through Protocol Reporter provided by IAEA. Annual declarations were simply uploaded and stored in the Accounting Information Treatment System of KINAC, which did not provide data analysis and management function. There have been demands for improvement to handle ever-increasing information. KAPS (Korea Additional Protocol System) has been developed to assist and administrate the additional protocol related works effectively. The new system enables integrated management including composition of additional protocol report and version control, periodical update of related information, results of IAEA complementary access to each facility

  1. Draft Technical Protocol: A Treatability Test for Evaluating the Potential Applicability of the Reductive Anaerobic Biological in Situ Treatment Technology (Rabitt) to Remediate Chloroethenes

    National Research Council Canada - National Science Library

    Morse, Jeff

    1998-01-01

    This draft, unvalidated protocol describes a comprehensive approach for conducting a phased treatability test to determine the potential for employing the Reductive Anaerobic Biological In Situ Treatment Technology (RABITT...

  2. Scientific Reproducibility in Biomedical Research: Provenance Metadata Ontology for Semantic Annotation of Study Description.

    Science.gov (United States)

    Sahoo, Satya S; Valdez, Joshua; Rueschman, Michael

    2016-01-01

    Scientific reproducibility is key to scientific progress as it allows the research community to build on validated results, protect patients from potentially harmful trial drugs derived from incorrect results, and reduce wastage of valuable resources. The National Institutes of Health (NIH) recently published a systematic guideline titled "Rigor and Reproducibility " for supporting reproducible research studies, which has also been accepted by several scientific journals. These journals will require published articles to conform to these new guidelines. Provenance metadata describes the history or origin of data and it has been long used in computer science to capture metadata information for ensuring data quality and supporting scientific reproducibility. In this paper, we describe the development of Provenance for Clinical and healthcare Research (ProvCaRe) framework together with a provenance ontology to support scientific reproducibility by formally modeling a core set of data elements representing details of research study. We extend the PROV Ontology (PROV-O), which has been recommended as the provenance representation model by World Wide Web Consortium (W3C), to represent both: (a) data provenance, and (b) process provenance. We use 124 study variables from 6 clinical research studies from the National Sleep Research Resource (NSRR) to evaluate the coverage of the provenance ontology. NSRR is the largest repository of NIH-funded sleep datasets with 50,000 studies from 36,000 participants. The provenance ontology reuses ontology concepts from existing biomedical ontologies, for example the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), to model the provenance information of research studies. The ProvCaRe framework is being developed as part of the Big Data to Knowledge (BD2K) data provenance project.

  3. Provenance variations of scots pine (Pinus sylvestris L.) in the Southern PART of Turkey

    International Nuclear Information System (INIS)

    Gulcu, S.; Bilir, N.

    2015-01-01

    Tree height, basal diameter, stem form, number, angle and diameter of branches were assessed in eight-year-old provenance test established by 30 seed sources of Scots pine (Pinus sylvestris L.) at Aydogmus and Kemer experimental sites of Southern part of Turkey. Growth of the provenances was also compared to two native species (Taurus cedar- Cedrus libani A. Rich and Black pine-Pinus nigra Arnold.) of the region. Variations within provenance and among provenances, and relations among the traits were estimated. There were large differences (p <= 0.05) within provenance and among provenances for the traits, while sites showed similar (0.05 <= p) performance for tree height and stem form. For instance, average of tree height was 181 cm and varied between 138.3 cm and 229.8 cm in provenances of Aydogmus site, it was 184 cm and ranged from 130 cm to 246.1 cm in that of Kemer site. Averages of tree height of a provenance were 144.4 cm in Aydogmus and 194.5 cm in Kemer. Individual tree height of the provenance varied between 69 cm and 267 cm, and ranged from 51 cm to 280 cm in sites. Averages of tree height were 143.2 cm in Black pine 145.6 cm in Taurus cedar which were natural species of the region. There were mostly positive and significant (p <= 0.05) correlations among the traits. Results of the study were discussed for new plantations and breeding of the species. (author)

  4. Orthodontic treatment outcomes obtained by application of a finishing protocol

    Directory of Open Access Journals (Sweden)

    Alvaro Carvajal-Flórez

    2016-04-01

    Full Text Available ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS of the American Board of Orthodontics (ABO. Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG consisted of 17 patients (19.88 ± 4.4 years old treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old selected by stratified randomization without finishing intervention (CG. Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048, respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8 (p = 0.009 and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6 (p = 0.007. Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8 (p = 0.62 and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9 (p = 0.65. Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system.

  5. Oral breathing: new early treatment protocol

    Directory of Open Access Journals (Sweden)

    Gloria Denotti

    2014-01-01

    Full Text Available Oral breathing is a respiratory dysfunction that affects approximately 10-15% of child population. It is responsable of local effects and systemic effects, both immediate and long-term. They affect the growth of the subject and his physical health in many ways: pediatric, psycho-behavioral and cognitive. The etiology is multifactorial. It’s important the establishment of a vicious circle involving more areas and it is essential to stop it as soon as possible. In order to correct this anomaly, the pediatric dentist must be able to make a correct diagnosis to treat early the disfunction and to avoid the onset of cascade mechanisms. Who plays a central role is the pediatrician who first and frequently come into contact with little patients. He can identify the anomalies, and therefore collaborate with other specialists, including the dentist. The key aspect that guides us in the diagnosis, and allows us to identify the oral respirator, is the “adenoid facies”. The purpose of the study is to highlight the importance and benefits of an early and multidisciplinary intervention (pediatric, orthopedic-orthodontic-functional. A sample of 20 patients was selected with the following inclusion criteria: mouth breathing, transverse discrepancy > 4 mm, early mixed dentition, central and lateral permenent incisors, overjet increased, lip and nasal incompetence, snoring and/or sleep apnea episodes. The protocol of intervention includes the use of the following devices and procedures: a maxillary rapid expander (to correct the transverse discrepancy, to increase the amplitude of the upper respiratory airway and to reduce nasal resistances tract in association with myo-functional devices (nasal stimulator and oral obturator. They allow the reconstruction of a physiological balance between the perioral musculature and tongue, the acquisition of nasal and lips competence and the reduction of overjet. This protocol speeds up and stabilizes the results. The

  6. Study protocol for a randomized controlled trial: tongue strengthening exercises in head and neck cancer patients, does exercise load matter?

    Science.gov (United States)

    Van Nuffelen, Gwen; Van den Steen, Leen; Vanderveken, Olivier; Specenier, Pol; Van Laer, Carl; Van Rompaey, Diane; Guns, Cindy; Mariën, Steven; Peeters, Marc; Van de Heyning, Paul; Vanderwegen, Jan; De Bodt, Marc

    2015-09-04

    Reduced tongue strength is an important factor contributing to early and late dysphagia in head and neck cancer patients previously treated with chemoradiotherapy. The evidence is growing that tongue strengthening exercises can improve tongue strength and swallowing function in both healthy and dysphagic subjects. However, little is known about the impact of specific features of an exercise protocol for tongue strength on the actual outcome (strength or swallowing function). Previous research originating in the fields of sports medicine and physical rehabilitation shows that the degree of exercise load is an influential factor for increasing muscle strength in the limb skeletal muscles. Since the tongue is considered a muscular hydrostat, it remains to be proven whether the same concepts will apply. This ongoing randomized controlled trial in chemoradiotherapy-treated patients with head and neck cancer investigates the effect of three tongue strengthening exercise protocols, with different degrees of exercise load, on tongue strength and swallowing. At enrollment, 51 patients whose dysphagia is primarily related to reduced tongue strength are randomly assigned to a training schedule of 60, 80, or 100% of their maximal tongue strength. Patients are treated three times a week for 8 weeks, executing 120 repetitions of the assigned exercise once per training day. Exercise load is progressively adjusted every 2 weeks. Patients are evaluated before, during and after treatment by means of tongue strength measurements, fiber-optic endoscopic evaluation of swallowing and quality-of-life questionnaires. This randomized controlled trial is the first to systematically investigate the effect of different exercise loads in tongue strengthening exercise protocols. The results will allow the development of more efficacious protocols. Current Controlled Trials ISRCTN14447678.

  7. PIXE study on the provenance of Chinese ancient porcelain

    International Nuclear Information System (INIS)

    Zhu, D.; Cheng, H.S.; Lin, J.W.; Yang, F.J.

    2006-01-01

    This paper reports the PIXE study on the provenance of Chinese ancient porcelain made in 7-10th century. The chemical compositions of Jun celadon samples made at Juntai, Linru and Hunyuan kilns, the white-glazed porcelain samples made at Ding, Huangye and Dangyangyu kilns, and the Ru celadon samples made at Qiangliang Temple were measured by external-beam PIXE, and the factor analysis was applied for identifying their provenances. Experimental results show that the porcelain products made at different kilns can be distinguished according to the compositional differences measured by PIXE

  8. PIXE study on the provenance of Chinese ancient porcelain

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, D. [Institute of Modern Physics, Fudan University, 220 Handan Road, Shanghai 200433 (China); Cheng, H.S. [Institute of Modern Physics, Fudan University, 220 Handan Road, Shanghai 200433 (China)]. E-mail: hscheng@fudan.edu.cn; Lin, J.W. [Institute of Modern Physics, Fudan University, 220 Handan Road, Shanghai 200433 (China); Yang, F.J. [Institute of Modern Physics, Fudan University, 220 Handan Road, Shanghai 200433 (China)

    2006-08-15

    This paper reports the PIXE study on the provenance of Chinese ancient porcelain made in 7-10th century. The chemical compositions of Jun celadon samples made at Juntai, Linru and Hunyuan kilns, the white-glazed porcelain samples made at Ding, Huangye and Dangyangyu kilns, and the Ru celadon samples made at Qiangliang Temple were measured by external-beam PIXE, and the factor analysis was applied for identifying their provenances. Experimental results show that the porcelain products made at different kilns can be distinguished according to the compositional differences measured by PIXE.

  9. PIXE study on the provenance of Chinese ancient porcelain

    Science.gov (United States)

    Zhu, D.; Cheng, H. S.; Lin, J. W.; Yang, F. J.

    2006-08-01

    This paper reports the PIXE study on the provenance of Chinese ancient porcelain made in 7-10th century. The chemical compositions of Jun celadon samples made at Juntai, Linru and Hunyuan kilns, the white-glazed porcelain samples made at Ding, Huangye and Dangyangyu kilns, and the Ru celadon samples made at Qiangliang Temple were measured by external-beam PIXE, and the factor analysis was applied for identifying their provenances. Experimental results show that the porcelain products made at different kilns can be distinguished according to the compositional differences measured by PIXE.

  10. Using Blockchain and smart contracts for secure data provenance management

    OpenAIRE

    Ramachandran, Aravind; Kantarcioglu, Dr. Murat

    2017-01-01

    Blockchain technology has evolved from being an immutable ledger of transactions for cryptocurrencies to a programmable interactive the environment for building distributed reliable applications. Although, blockchain technology has been used to address various challenges, to our knowledge none of the previous work focused on using blockchain to develop a secure and immutable scientific data provenance management framework that automatically verifies the provenance records. In this work, we le...

  11. Effects of acupuncture treatment on depression insomnia: a study protocol of a multicenter randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chen Yuan-Fang

    2013-01-01

    Full Text Available Abstract Background More than 70% of patients with depression who see their doctors experience insomnia. Insomnia treatment is a very important link for depression treatment. Furthermore, antidepression treatment is also important for depression insomnia. In acupuncture, LU-7 (Lie Que and KID-6 (Zhao Hai, which are two of the eight confluence points in meridian theory, are used as main points. An embedded needle technique is used, alternately, at two groups of points to consolidate the treatment effect. These two groups of points are BL-15 (Xin Shu with BL-23 (Shen Shu and BL-19 (Dan Shu with N-HN-54 (An Mian. The effectiveness of these optimized acupuncture formulas is well proven in the practice by our senior acupuncturists in Guangdong Provincial Hospital of TCM. This study has been designed to examine whether this set of optimized clinical formulas is able to increase the clinical efficacy of depression insomnia treatment. Methods/design In this randomized controlled multicenter trial, all the eligible participants are diagnosed with depression insomnia. All participants are randomly assigned to one of two groups in a ratio of 1:1 and receive either conventional acupuncture treatment or optimized acupuncture treatment. Patients are evaluated using the Pittsburgh Sleep Quality Index(PSQIand the Hamilton rating scale(HAMD for depression. The use of antidepression and hypnotics drugs is also considered. Results are obtained at the start of treatment, 1 and 2 months after treatment has begun, and at the end of treatment. The entire duration of the study will be approximately 36 months. Discussion A high quality of trial methodologies is utilized in the study, and the results may provide better evidence for the effectiveness of acupuncture as a treatment for depression insomnia. The optimized acupuncture formula has potential benefits in increasing the efficacy of treating depression insomnia. Trial registration The trial was registered in

  12. One-year results of the use of endovenous radiofrequency ablation utilising an optimised radiofrequency-induced thermotherapy protocol for the treatment of truncal superficial venous reflux.

    Science.gov (United States)

    Badham, George E; Dos Santos, Scott J; Lloyd, Lucinda Ba; Holdstock, Judy M; Whiteley, Mark S

    2018-06-01

    Background In previous in vitro and ex vivo studies, we have shown increased thermal spread can be achieved with radiofrequency-induced thermotherapy when using a low power and slower, discontinuous pullback. We aimed to determine the clinical success rate of radiofrequency-induced thermotherapy using this optimised protocol for the treatment of superficial venous reflux in truncal veins. Methods Sixty-three patients were treated with radiofrequency-induced thermotherapy using the optimised protocol and were followed up after one year (mean 16.3 months). Thirty-five patients returned for audit, giving a response rate of 56%. Duplex ultrasonography was employed to check for truncal reflux and compared to initial scans. Results In the 35 patients studied, there were 48 legs, with 64 truncal veins treated by radiofrequency-induced thermotherapy (34 great saphenous, 15 small saphenous and 15 anterior accessory saphenous veins). One year post-treatment, complete closure of all previously refluxing truncal veins was demonstrated on ultrasound, giving a success rate of 100%. Conclusions Using a previously reported optimised, low power/slow pullback radiofrequency-induced thermotherapy protocol, we have shown it is possible to achieve a 100% ablation at one year. This compares favourably with results reported at one year post-procedure using the high power/fast pullback protocols that are currently recommended for this device.

  13. Non operative management of blunt splenic trauma: a prospective evaluation of a standardized treatment protocol.

    Science.gov (United States)

    Brillantino, A; Iacobellis, F; Robustelli, U; Villamaina, E; Maglione, F; Colletti, O; De Palma, M; Paladino, F; Noschese, G

    2016-10-01

    The advantages of the conservative approach for major spleen injuries are still debated. This study was designed to evaluate the safety and effectiveness of NOM in the treatment of minor (grade I-II according with the American Association for the Surgery of Trauma; AAST) and severe (AAST grade III-V) blunt splenic trauma, following a standardized treatment protocol. All the hemodynamically stable patients with computer tomography (CT) diagnosis of blunt splenic trauma underwent NOM, which included strict clinical and laboratory observation, 48-72 h contrast-enhanced ultrasonography (CEUS) follow-up and splenic angioembolization, performed both in patients with admission CT evidence of vascular injuries and in patients with falling hematocrit during observation. 87 patients [32 (36.7 %) women and 55 (63.2 %) men, median age 34 (range 14-68)] were included. Of these, 28 patients (32.1 %) had grade I, 22 patients (25.2 %) grade II, 20 patients (22.9 %) grade III, 11 patients (12.6 %) grade IV and 6 patients (6.8 %) grade V injuries. The overall success rate of NOM was 95.4 % (82/87). There was no significant difference in the success rate between the patients with different splenic injuries grade. Of 24 patients that had undergone angioembolization, 22 (91.6 %) showed high splenic injury grade. The success rate of embolization was 91.6 % (22/24). No major complications were observed. The minor complications (2 pleural effusions, 1 pancreatic fistula and 2 splenic abscesses) were successfully treated by EAUS or CT guided drainage. The non operative management of blunt splenic trauma, according to our protocol, represents a safe and effective treatment for both minor and severe injuries, achieving an overall success rate of 95 %. The angiographic study could be indicated both in patients with CT evidence of vascular injuries and in patients with high-grade splenic injuries, regardless of CT findings.

  14. Mecasin treatment in patients with amyotrophic lateral sclerosis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Kim, Sungha; Kim, Jae Kyoun; Son, Mi Ju; Kim, Dongwoung; Song, Bongkeun; Son, Ilhong; Kang, Hyung Won; Lee, Jongdeok; Kim, Sungchul

    2018-04-13

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that causes paralysis of limb, swallowing, and breathing muscles. Riluzole, the Food and Drug Administration-approved drug for ALS, provides minimal benefit, prolonging patient life by only 2-3 months. Previous studies have found a neuro-protective and anti-neuroinflammatory effect of Mecasin, with retrospective studies providing suggestive evidence for a beneficial effect of Mecasin. The aim of this study was to develop a protocol to determine the proper dosage of Mecasin. This is a phase II-A, multi-center, randomized study with three arms. Thirty-six patients with ALS will be randomly assigned to one of three groups, each receiving the standard treatment with 100 mg of riluzole in addition to one of 1.6 g of Mecasin, 2.4 g of Mecasin, or a placebo. The Primary outcome is the Korean version of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised result after 12 weeks of treatment. Secondary outcomes include results of the Short Form Health Survey-8, Medical Research Council Scale, Visual Analogue Scale for Pain, Hamilton Rating Scale for Depression, Fatigue Severity Scale, Patient Global Impression of Change, pulmonary function test, forced expiratory volume in 1 s and its ratio to forced vital capacity, creatine kinase, and body weight. The frequencies of total adverse events and serious adverse events will be described and documented. The trial protocol has been approved by the Institutional Review Board of the Wonkwang University Gwangju and Sanbon Hospital (2016-5-4 and 2016-34-01, respectively). An Investigational New Drug status (30731) was granted by the Korea Food and Drug Administration. This trial will aim to identify the optimal dosage of Mecasin. Additionally, it will test the efficacy and safety of Mecasin in conjunction with standard treatment, riluzole, for alleviating the functional decline in patients with ALS. Korean National Clinical Trial Registry CRIS; KCT

  15. Provenance Representation in the Global Change Information System (GCIS)

    Science.gov (United States)

    Tilmes, Curt

    2012-01-01

    Global climate change is a topic that has become very controversial despite strong support within the scientific community. It is common for agencies releasing information about climate change to be served with Freedom of Information Act (FOIA) requests for everything that led to that conclusion. Capturing and presenting the provenance, linking to the research papers, data sets, models, analyses, observation instruments and satellites, etc. supporting key findings has the potential to mitigate skepticism in this domain. The U.S. Global Change Research Program (USGCRP) is now coordinating the production of a National Climate Assessment (NCA) that presents our best understanding of global change. We are now developing a Global Change Information System (GCIS) that will present the content of that report and its provenance, including the scientific support for the findings of the assessment. We are using an approach that will present this information both through a human accessible web site as well as a machine readable interface for automated mining of the provenance graph. We plan to use the developing W3C PROV Data Model and Ontology for this system.

  16. Impact of treatment protocol on outcome of localized Ewing's sarcoma.

    Science.gov (United States)

    Nasaka, Srividya; Gundeti, Sadashivudu; Ganta, Ranga Raman; Arigela, Ravi Sankar; Linga, Vijay Gandhi; Maddali, Lakshmi Srinivas

    2016-01-01

    The outcome of localized Ewing's sarcoma has improved with multi-disciplinary approach. Survivals of Ewing's sarcoma from the Asian countries differed between centers. We retrospectively analyzed the records of newly diagnosed localized Ewing's sarcoma patients from 2002 to 2012. The patients were analyzed in three groups; Group 1(2002-2004) who received non-ifosfomide based regimens, Group 2(2005-2008) who received VDC/IE for 12 cycles, and Group 3(2009-2012), who received VDC/IE for 17 cycles. The groups were compared for their baseline characteristics, treatment protocol and outcome. Seventy three patients were included in the study. The median age of presentation was 15 years, with slight male predominance. Axial primary was seen in 62%. The median RFS of the three groups was 26.4, 31.4 and 36.8 months respectively ( P = 0.0018). The median OS was 27.9, 35 and 43 months respectively ( P = 0.0007). At a median follow-up of 35 months, the 3 year RFS and OS for the three treatment groups were 17%, 31%, 60% and 35%, 45% and 70% respectively. Larger tumor size, axial primary, high LDH were associated with poorer survival. Radiotherapy was associated with inferior local control and survival. We found that the survival of our ESFT patients improved over time with intensified multiagent chemotherapy and with lesser time to local therapy. But the results were still inferior to those reported in literature. We had majority of patients presenting in axial site and radiotherapy as the predominant mode of local control. The outcome may further improve with surgery as local control procedure.

  17. Towards an Ontology-Driven Blockchain Design for Supply Chain Provenance

    OpenAIRE

    Kim, Henry M.; Laskowski, Marek

    2016-01-01

    An interesting research problem in our age of Big Data is that of determining provenance. Granular evaluation of provenance of physical goods--e.g. tracking ingredients of a pharmaceutical or demonstrating authenticity of luxury goods--has often not been possible with today's items that are produced and transported in complex, inter-organizational, often internationally-spanning supply chains. Recent adoption of Internet of Things and Blockchain technologies give promise at better supply chai...

  18. A treatment for a chronic stroke patient with a plegic hand combining CI therapy with conventional rehabilitation procedures: case report.

    Science.gov (United States)

    Bowman, Mary H; Taub, Edward; Uswatte, Gitendra; Delgado, Adriana; Bryson, Camille; Morris, David M; McKay, Staci; Mark, Victor W

    2006-01-01

    Constraint-Induced Movement therapy (CI therapy) is a recognized rehabilitation approach for persons having stroke with mild to moderately severe motor upper extremity deficits. To date, no rehabilitation treatment protocol has been proven effective that addresses both motor performance and spontaneous upper extremity use in the life situation for chronic stroke participants having severe upper extremity impairment with no active finger extension or thumb abduction. This case report describes treatment of a chronic stroke participant with a plegic hand using a CI therapy protocol that combines CI therapy with selected occupational and physical therapy techniques. Treatment consisted of six sessions of adaptive equipment and upper extremity orthotics training followed by a three-week, six-hour daily intervention of CI therapy plus neurodevelopmental treatment. Outcome measures included the Motor Activity Log for very low functioning patients (Grade 5 MAL), upper extremity portion of the Fugl-Meyer Motor Assessment, Graded Wolf Motor Function Test - for very low functioning patients (gWMFT- Grade 5), and Modified Ashworth Scale. The participant showed improvement on each outcome measure with the largest improvement on the Grade 5 MAL. In follow-up, the participant had good retention of his gains in motor performance and use of his more affected arm for real world activities after 3 months; after a one-week brush-up at 3 months, and at one year post-treatment.

  19. EPR OF Mn2+ IMPURITIES IN CALCITE: A DETAILED STUDY PERTINENT TO MARBLE PROVENANCE DETERMINATION

    DEFF Research Database (Denmark)

    Weihe, H.; Piligkos, S.; Barra, A.L.

    2009-01-01

    We demonstrate that the electron paramagnetic resonance spectrum of Mn2+ impurities in calcite, and therefore also in marble, may be accurately reproduced by a traditional spin Hamiltonian formalism. The success of such a treatment, however, very much depends on the spin Hamiltonian parameters...... having the correct signs as well as magnitudes. We present data that determine the sign of the axial anisotropy parameter and thereby facilitate future quantum mechanical characterizations of marble electron paramagnetic resonance spectra that supplement provenance determination....

  20. Recommendations for Enhancing Implementation of Additional Protocol Declarations

    International Nuclear Information System (INIS)

    Niina, Toshiaki; Nidaira, Kazuo; Aono, Yosuke

    2010-01-01

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

  1. Data Provenance Inference in Logic Programming: Reducing Effort of Instance-driven Debugging

    NARCIS (Netherlands)

    Huq, M.R.; Mileo, Alessandra; Wombacher, Andreas

    Data provenance allows scientists in different domains validating their models and algorithms to find out anomalies and unexpected behaviors. In previous works, we described on-the-fly interpretation of (Python) scripts to build workflow provenance graph automatically and then infer fine-grained

  2. Provenance data in social media

    CERN Document Server

    Barbier, Geoffrey; Gundecha, Pritam

    2013-01-01

    Social media shatters the barrier to communicate anytime anywhere for people of all walks of life. The publicly available, virtually free information in social media poses a new challenge to consumers who have to discern whether a piece of information published in social media is reliable. For example, it can be difficult to understand the motivations behind a statement passed from one user to another, without knowing the person who originated the message. Additionally, false information can be propagated through social media, resulting in embarrassment or irreversible damages. Provenance data

  3. A comparison of two treatments for childhood apraxia of speech: methods and treatment protocol for a parallel group randomised control trial

    Directory of Open Access Journals (Sweden)

    Murray Elizabeth

    2012-08-01

    Syllable Transition Treatment than Nuffield Dyspraxia Programme treatment. This protocol was approved by the Human Research Ethics Committee, University of Sydney (#12924. Discussion This will be the first randomised control trial to test treatment for CAS. It will be valuable for clinical decision-making and providing evidence-based services for children with CAS. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12612000744853

  4. Physical activity as a treatment for depression: the TREAD randomised trial protocol.

    Science.gov (United States)

    Baxter, Helen; Winder, Rachel; Chalder, Melanie; Wright, Christine; Sherlock, Sofie; Haase, Anne; Wiles, Nicola J; Montgomery, Alan A; Taylor, Adrian H; Fox, Ken R; Lawlor, Debbie A; Peters, Tim J; Sharp, Deborah J; Campbell, John; Lewis, Glyn

    2010-11-12

    Depression is one of the most common reasons for consulting a General Practitioner (GP) within the UK. Whilst antidepressants have been shown to be clinically effective, many patients and healthcare professionals would like to access other forms of treatment as an alternative or adjunct to drug therapy for depression. A recent systematic review presented some evidence that physical activity could offer one such option, although further investigation is needed to test its effectiveness within the context of the National Health Service.The aim of this paper is to describe the protocol for a randomised, controlled trial (RCT) designed to evaluate an intervention developed to increase physical activity as a treatment for depression within primary care. The TREAD study is a pragmatic, multi-centre, two-arm RCT which targets patients presenting with a new episode of depression. Patients were approached if they were aged 18-69, had recently consulted their GP for depression and, where appropriate, had been taking antidepressants for less than one month. Only those patients with a confirmed diagnosis of a depressive episode as assessed by the Clinical Interview Schedule-Revised (CIS-R), a Beck Depression Inventory (BDI) score of at least 14 and informed written consent were included in the study. Eligible patients were individually randomised to one of two treatment groups; usual GP care or usual GP care plus facilitated physical activity. The primary outcome of the trial is clinical symptoms of depression assessed using the BDI four months after randomisation. A number of secondary outcomes are also measured at the 4-, 8- and 12-month follow-up points including quality of life, attitude to and involvement in physical activity and antidepressant use/adherence. Outcomes will be analysed on an intention-to-treat (ITT) basis and will use linear and logistic regression models to compare treatments. The results of the trial will provide information about the effectiveness of

  5. Physical activity as a treatment for depression: the TREAD randomised trial protocol

    Directory of Open Access Journals (Sweden)

    Lawlor Debbie A

    2010-11-01

    Full Text Available Abstract Background Depression is one of the most common reasons for consulting a General Practitioner (GP within the UK. Whilst antidepressants have been shown to be clinically effective, many patients and healthcare professionals would like to access other forms of treatment as an alternative or adjunct to drug therapy for depression. A recent systematic review presented some evidence that physical activity could offer one such option, although further investigation is needed to test its effectiveness within the context of the National Health Service. The aim of this paper is to describe the protocol for a randomised, controlled trial (RCT designed to evaluate an intervention developed to increase physical activity as a treatment for depression within primary care. Methods/design The TREAD study is a pragmatic, multi-centre, two-arm RCT which targets patients presenting with a new episode of depression. Patients were approached if they were aged 18-69, had recently consulted their GP for depression and, where appropriate, had been taking antidepressants for less than one month. Only those patients with a confirmed diagnosis of a depressive episode as assessed by the Clinical Interview Schedule-Revised (CIS-R, a Beck Depression Inventory (BDI score of at least 14 and informed written consent were included in the study. Eligible patients were individually randomised to one of two treatment groups; usual GP care or usual GP care plus facilitated physical activity. The primary outcome of the trial is clinical symptoms of depression assessed using the BDI four months after randomisation. A number of secondary outcomes are also measured at the 4-, 8- and 12-month follow-up points including quality of life, attitude to and involvement in physical activity and antidepressant use/adherence. Outcomes will be analysed on an intention-to-treat (ITT basis and will use linear and logistic regression models to compare treatments. Discussion The results of

  6. Quantifying public radiation exposure related to lutetium-177 octreotate therapy for the development of a safe outpatient treatment protocol.

    Science.gov (United States)

    Olmstead, Craig; Cruz, Kyle; Stodilka, Robert; Zabel, Pamela; Wolfson, Robert

    2015-02-01

    Radionuclide therapies, including treatment of neuroendocrine tumors with lutetium-177 (Lu-177) octreotate, often involve hospital admission to minimize radiation exposure to the public. Overnight admission due to Lu-177 octreotate therapy incurs additional cost for the hospital and is an inconvenience for the patient. This study endeavors to characterize the potential radiation risk to caregivers and the public should Lu-177 octreotate therapies be performed on an outpatient basis. Dose rate measurements of radiation emanating from 10 patients were taken 30 min, 4, and 20 h after initiation of Lu-177 octreotate therapy. Instadose radiation dose measurement monitors were also placed around the patients' rooms to assess the potential cumulative radiation exposure during the initial 30 min-4 h after treatment (simulating the hospital-based component of the outpatient model) as well as 4-20 h after treatment (simulating the discharged outpatient portion). The mean recorded dose rate at 30 min, 4, and 20 h after therapy was 20.4, 14.0, and 6.6 μSv/h, respectively. The majority of the cumulative dose readings were below the minimum recordable threshold of 0.03 mSv, with a maximum dose recorded of 0.18 mSv. Given the low dose rate and cumulative levels of radiation measured, the results support that an outpatient Lu-177 octreotate treatment protocol would not jeopardize public safety. Nevertheless, the concept of ALARA still requires that detailed radiation safety protocols be developed for Lu-177 octreotate outpatients to minimize radiation exposure to family members, caregivers, and the general public.

  7. Persistent identifiers for web service requests relying on a provenance ontology design pattern

    Science.gov (United States)

    Car, Nicholas; Wang, Jingbo; Wyborn, Lesley; Si, Wei

    2016-04-01

    Delivering provenance information for datasets produced from static inputs is relatively straightforward: we represent the processing actions and data flow using provenance ontologies and link to stored copies of the inputs stored in repositories. If appropriate detail is given, the provenance information can then describe what actions have occurred (transparency) and enable reproducibility. When web service-generated data is used by a process to create a dataset instead of a static inputs, we need to use sophisticated provenance representations of the web service request as we can no longer just link to data stored in a repository. A graph-based provenance representation, such as the W3C's PROV standard, can be used to model the web service request as a single conceptual dataset and also as a small workflow with a number of components within the same provenance report. This dual representation does more than just allow simplified or detailed views of a dataset's production to be used where appropriate. It also allow persistent identifiers to be assigned to instances of a web service requests, thus enabling one form of dynamic data citation, and for those identifiers to resolve to whatever level of detail implementers think appropriate in order for that web service request to be reproduced. In this presentation we detail our reasoning in representing web service requests as small workflows. In outline, this stems from the idea that web service requests are perdurant things and in order to most easily persist knowledge of them for provenance, we should represent them as a nexus of relationships between endurant things, such as datasets and knowledge of particular system types, as these endurant things are far easier to persist. We also describe the ontology design pattern that we use to represent workflows in general and how we apply it to different types of web service requests. We give examples of specific web service requests instances that were made by systems

  8. Obsidian provenance research in the Americas.

    Science.gov (United States)

    Glascock, Michael D

    2002-08-01

    The characterization of archaeological materials to support provenance research has grown rapidly over the past few decades. Volcanic obsidian has several unique properties that make it the ideal archaeological material for studying prehistoric trade and exchange. This Account describes our laboratory's development of a systematic methodology for the characterization of obsidian sources and artifacts from Mesoamerica and other regions of North and South America in support of archaeological research.

  9. Identification of provenance rocks based on EPMA analyses of heavy minerals

    Science.gov (United States)

    Shimizu, M.; Sano, N.; Ueki, T.; Yonaga, Y.; Yasue, K. I.; Masakazu, N.

    2017-12-01

    Information on mountain building is significant in the field of geological disposal of high-level radioactive waste, because this affects long-term stability in groundwater flow system. Provenance analysis is one of effective approaches for understanding building process of mountains. Chemical compositions of heavy minerals, as well as their chronological data, can be an index for identification of provenance rocks. The accurate identification requires the measurement of as many grains as possible. In order to achieve an efficient provenance analysis, we developed a method for quick identification of heavy minerals using an Electron Probe Micro Analyzer (EPMA). In this method, heavy mineral grains extracted from a sample were aligned on a glass slide and mounted in a resin. Concentration of 28 elements was measured for 300-500 grains per sample using EPMA. To measure as many grains as possible, we prioritized swiftness of measurement over precision, configuring measurement time of about 3.5 minutes for each grain. Identification of heavy minerals was based on their chemical composition. We developed a Microsoft® Excel® spread sheet input criteria of mineral identification using a typical range of chemical compositions for each mineral. The grains of 110 wt.% total were rejected. The criteria of mineral identification were revised through the comparison between mineral identification by optical microscopy and chemical compositions of grains classified as "unknown minerals". Provenance rocks can be identified based on abundance ratio of identified minerals. If no significant difference of the abundance ratio was found among source rocks, chemical composition of specific minerals was used as another index. This method was applied to the sediments of some regions in Japan where provenance rocks had lithological variations but similar formation ages. Consequently, the provenance rocks were identified based on chemical compositions of heavy minerals resistant to

  10. Biologic comparison of partial breast irradiation protocols

    International Nuclear Information System (INIS)

    Rosenstein, Barry S.; Lymberis, Stella C.; Formenti, Silvia C.

    2004-01-01

    Purpose: To analyze the dose/fractionation schedules currently used in ongoing clinical trials of partial breast irradiation (PBI) by comparing their biologically effective dose (BED) values to those of three standard whole breast protocols commonly used after segmental mastectomy in the treatment of breast cancer. Methods and materials: The BED equation derived from the linear-quadratic model for radiation-induced cell killing was used to calculate the BEDs for three commonly used whole breast radiotherapy regimens, in addition to a variety of external beam radiotherapy, as well as high-dose-rate and low-dose-rate brachytherapy, PBI protocols. Results: The BED values of most PBI protocols resulted in tumor control BEDs roughly equivalent to a 50-Gy standard treatment, but consistently lower than the BEDs for regimens in which the tumor bed receives a total dose of either 60 Gy or 66 Gy. The BED values calculated for the acute radiation responses of erythema and desquamation were nearly all lower for the PBI schedules, and the late-response BEDs for most PBI regimens were in a similar range to the BEDs for the standard treatments. Conclusion: Biologically effective dose modeling raises the concern that inadequate doses might be delivered by PBI to ensure optimal in-field tumor control

  11. Development of a calibration protocol and identification of the most sensitive parameters for the particulate biofilm models used in biological wastewater treatment.

    Science.gov (United States)

    Eldyasti, Ahmed; Nakhla, George; Zhu, Jesse

    2012-05-01

    Biofilm models are valuable tools for process engineers to simulate biological wastewater treatment. In order to enhance the use of biofilm models implemented in contemporary simulation software, model calibration is both necessary and helpful. The aim of this work was to develop a calibration protocol of the particulate biofilm model with a help of the sensitivity analysis of the most important parameters in the biofilm model implemented in BioWin® and verify the predictability of the calibration protocol. A case study of a circulating fluidized bed bioreactor (CFBBR) system used for biological nutrient removal (BNR) with a fluidized bed respirometric study of the biofilm stoichiometry and kinetics was used to verify and validate the proposed calibration protocol. Applying the five stages of the biofilm calibration procedures enhanced the applicability of BioWin®, which was capable of predicting most of the performance parameters with an average percentage error (APE) of 0-20%. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Efficacy of Lactobacillus Reuteri DSM 17938 for the Treatment of Acute Gastroenteritis in Children: Protocol of a Randomized Controlled Trial.

    Science.gov (United States)

    Szymański, Henryk; Szajewska, Hania

    2017-08-23

    Acute gastroenteritis (AGE) is one of the most common diseases among children. Oral rehydration therapy is the key treatment. However, despite proven efficacy, it remains underused. This is because oral rehydration solution neither reduces the frequency of bowel movements and fluid loss nor shortens the duration of illness. Hence, there is interest in adjunctive treatments. According to the 2014 guidelines developed by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, the use of the following probiotics may be considered in the management of children with AGE in addition to rehydration therapy: Lactobacillus rhamnosus GG (low quality of evidence; strong recommendation) and Saccharomyces boulardii (low quality of evidence; strong recommendation). Less compelling evidence is available for Lactobacillus reuteri DSM 17938 (very low quality of evidence; weak recommendation). Considering that evidence on L reuteri remains limited, the goal of the study is to assess the effectiveness of L reuteri DSM 17938 in the treatment of AGE in children. Children vaccinated and not vaccinated against rotavirus will be evaluated separately. This will be a double-blind, placebo-controlled, randomized trial. Children between 1 and 60 months of age with AGE, defined as a change in stool consistency to loose or liquid form (according to the Bristol Stool Form scale or Amsterdam Stool Form scale) and/or an increase in the frequency of evacuations (typically ≥3 in 24 h) lasting for no longer than 5 days, will be recruited. A total of 72 children will receive either L reuteri DSM 17938 at a dose of 2×10 8 colony-forming units twice daily or matching placebo for 5 consecutive days. A similar sample size for rotavirus vaccinated and nonvaccinated children is planned. The primary outcome measure is the duration of diarrhea. Two separate studies and reports for rotavirus vaccinated and nonvaccinated children are planned. The recruitment started in January 2017

  13. Surgical Interventions for the Treatment of Supracondylar Humerus Fractures in Children: Protocol of a Systematic Review.

    Science.gov (United States)

    Carrazzone, Oreste Lemos; Belloti, João Carlos; Matsunaga, Fabio Teruo; Mansur, Nacime Salomão Barbachan; Matsumoto, Marcelo Hide; Faloppa, Flavio; Tamaoki, Marcel Jun Sugawara

    2017-11-21

    The treatment of supracondylar humerus fracture in children (SHFC) is associated with complications such as functional deficit, residual deformity, and iatrogenic neurological damage. The standard treatment is closed reduction and percutaneous Kirschner wire fixation with different configurations. Despite this fact, there is still no consensus on the most effective technique for the treatment of these fractures. The aim of this systematic review will be to evaluate the effect of surgical interventions on the treatment of Gartland type II and III SHFC by assessing function, complications, and error as primary outcomes. Clinical outcomes such as range of motion and pain and radiographic outcomes will also be judged. A systematic review of randomized controlled trials or quasi-randomized controlled trials evaluating the surgical treatment of SHFC will be carried out in the Cochrane Central Register of Controlled Trials, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Excerpta Medica Database. The search will also occur at ongoing and recently completed clinical trials in selected databases. Data management and extraction will be performed using a data withdrawal form and by analyzing the following: study method characteristics, participant characteristics, intervention characteristics, results, methodological domains, and risk of bias. To assess the risk of bias of the included trials, the Cochrane Risk of Bias Tool will be used. Dichotomous outcome data will be analyzed as risk ratios, and continuous outcome data will be expressed as mean differences, both with 95% confidence intervals. Also, whenever possible, subgroup analysis, sensitivity analysis, and assessment of heterogeneity will be performed. Following the publication of this protocol, searches will be run and included studies will be deeply analyzed. We hope to obtain final results in the next few months and have the final paper published by the end of 2018. This study was funded

  14. Physiological response to drought stress in Camptotheca acuminata seedlings from two provenances

    Directory of Open Access Journals (Sweden)

    Yeqing eYing

    2015-05-01

    Full Text Available Drought stress is a key environmental factor limiting the growth and productivity of plants. The purpose of this study was to investigate the physiological responses of Camptotheca acuminata (C. acuminata to different drought stresses and compare the drought tolerance between the provenances Kunming (KM and Nanchang (NC, which are naturally distributed in different rainfall zones with annual rainfalls of 1000-1100 mm and 1600-1700 mm, respectively. We determined relative water content (RWC, chlorophyll content (Chl(a+b, net photosynthesis (Pn, gas exchange parameters, relative leakage conductivity (REC, malondialdehyde (MDA content and superoxide dismutase (SOD and peroxidase (POD activities of C. acuminata seedlings under both moderate (50% of maximum field capacity and severe drought stress (30% of maximum field capacity. As the degree of water stress increased, RWC, Chl(a+b content, Pn, stomatal conductance (Gs, transpiration rate (Tr and intercellular CO2 concentration (Ci values decreased, but water use efficiency (WUE, REC, MDA content and SOD and POD activities increased in provenances KM and NC. Under moderate and severe drought stress, provenance KM had higher RWC, Chl(a+b, Pn, WUE, SOD and POD and lower Gs, Tr, Ci and REC in leaves than provenance NC. The results indicated that provenance KM may maintain stronger drought tolerance via improvements in water-retention capacity, antioxidant enzyme activity and membrane integrity.

  15. A Qualitative Study of the Treatment Improvement Protocols (TIPs): An Assessment of the Use of TIPs by Individuals Affiliated with the Addiction Technology Transfer Centers (ATTCs).

    Science.gov (United States)

    Hayashi, Susan W.; Suzuki, Marcia; Hubbard, Susan M.; Huang, Judy Y.; Cobb, Anita M.

    2003-01-01

    Evaluated the Addiction Technology Transfer Centers (ATTCs) of the Center for Substance Abuse Treatment (CSAT) as a means of diffusion of innovations, focusing on use of the Treatment Improvement Protocols (TIPs). Qualitative studies at 6 ATTCs that included 57 interviews show that the CSAT is at the forefront of providing resources to the…

  16. Tinnitus in patients with temporo-mandibular joint disorder: Proposal for a new treatment protocol.

    Science.gov (United States)

    Attanasio, Giuseppe; Leonardi, Alessandra; Arangio, Paolo; Minni, Antonio; Covelli, Edoardo; Pucci, Resi; Russo, Francesca Yoshie; De Seta, Elio; Di Paolo, Carlo; Cascone, Piero

    2015-06-01

    The present study was designed to verify the correlation between tinnitus and temporomandibular joint dysfunction.86 consecutive patients were enrolled in the study, all affected by subjective tinnitus without hearing impairment, from both genders, age between 18 and 60 years old. The final number of patients included in the study was 55. All patients received a temporo-mandibular joint examination. All the patients were asked to rate the severity of their symptoms before and after treatment using a VAS scale and the Tinnitus Handicap Inventory (THI) and they followed a standardized protocol for the investigation of tinnitus. All the subjects were monitored by the same researcher and they underwent the same splint treatment. The comparison between pre- and posttreatment phase scores showed in patients with predisposition of TMD and with TMD a statistically significant decrease of THI and VAS values. The characteristics of tinnitus and the degree of response to treatment confirmed the relationship between tinnitus and TMD. The authors believe that, when the most common causes of tinnitus, such as otologic disorders and neurological diseases are excluded, it is correct to evaluate the functionality of the temporo-mandibular joint and eventually treat its pathology to obtain tinnitus improvement or even resolution. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Technical Note: Comparison of storage strategies of sea surface microlayer samples

    Directory of Open Access Journals (Sweden)

    K. Schneider-Zapp

    2013-07-01

    Full Text Available The sea surface microlayer (SML is an important biogeochemical system whose physico-chemical analysis often necessitates some degree of sample storage. However, many SML components degrade with time so the development of optimal storage protocols is paramount. We here briefly review some commonly used treatment and storage protocols. Using freshwater and saline SML samples from a river estuary, we investigated temporal changes in surfactant activity (SA and the absorbance and fluorescence of chromophoric dissolved organic matter (CDOM over four weeks, following selected sample treatment and storage protocols. Some variability in the effectiveness of individual protocols most likely reflects sample provenance. None of the various protocols examined performed any better than dark storage at 4 °C without pre-treatment. We therefore recommend storing samples refrigerated in the dark.

  18. Performance of Australian provenances of Eucalyptus grandis and Eucalyptus saligna in Hawaii

    Science.gov (United States)

    Roger G. Skolmen

    1986-01-01

    Australian provenances of Eucalyptus grandis and E. saligna were compared at four locations on the island of Hawaii to seek seed sources better than those in current use which were introduced earlier from unrecorded locations in Australia. A broad range of latitude and elevation was represented among the provenances. At all four...

  19. Newborn hearing screening protocol in tuscany region.

    Science.gov (United States)

    Berrettini, Stefano; Ghirri, Paolo; Lazzerini, Francesco; Lenzi, Giovanni; Forli, Francesca

    2017-09-20

    Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment. In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines. In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are

  20. Evaluation of the Implementation of a Rapid Response Treatment Protocol for Patients with Acute Onset Stroke: Can We Increase the Number of Patients Treated and Shorten the Time Needed

    Directory of Open Access Journals (Sweden)

    Rajiv Advani

    2014-06-01

    Full Text Available Aims: This study aims to evaluate the implementation of a rapid response treatment protocol for patients presenting with acute onset ischemic stroke. Improvements of routines surrounding the admission and treatment of patients with intravenous thrombolysis (IVT, such as door-to-needle (DTN times, and increasing the numbers of patients treated are discussed. Methods: We conducted a retrospective analysis of all patients (n = 320 treated with IVT for acute onset ischemic stroke at the Stavanger University Hospital, Norway, between 2003 and 2012. In 2009, a succession of changes to pre- and intra-hospital routines were made as well as an improvement in the education of primary health care physicians, nurses and paramedics involved in the treatment of acute onset stroke patients (rapid response treatment protocol. Analyses of DTN times, onset-to-needle times and the number of patients treated per year were carried out to ascertain the effect of the changes made. The primary aim was to analyze DTN times to look for any changes, and the secondary aim was to analyze changes in the number of patients treated per year. Results: In the years after the implementation of the rapid treatment protocol, we saw an improvement in the median DTN time with a decrease from 73 to 50 min in the first year (p = 0.03, a decrease of 45 min in the second year (p = 0.01 and a decrease of 31 min in the third year (p Conclusions: The implementation of the rapid treatment protocol for acute onset ischemic stroke patients led to a significant decrease in the DTN time at our center. These improvements also produced an increase in the number of patients treated per year. The extension of the therapeutic window from 3 to 4.5 h for the use of intravenous recombinant tissue plasminogen activator also played a role in the increased treatment numbers.

  1. Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?

    International Nuclear Information System (INIS)

    Mango, Victoria L.; Morris, Elizabeth A.; David Dershaw, D.; Abramson, Andrea; Fry, Charles; Moskowitz, Chaya S.; Hughes, Mary; Kaplan, Jennifer; Jochelson, Maxine S.

    2015-01-01

    Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting

  2. Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?

    Energy Technology Data Exchange (ETDEWEB)

    Mango, Victoria L., E-mail: vlm2125@columbia.edu [Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, 10th Floor, New York, NY 10032 (United States); Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: morrise@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); David Dershaw, D., E-mail: dershawd@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Abramson, Andrea, E-mail: abramsoa@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Fry, Charles, E-mail: charles_fry@nymc.edu [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595 (United States); Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Hughes, Mary, E-mail: hughesm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Kaplan, Jennifer, E-mail: kaplanj@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Jochelson, Maxine S., E-mail: jochelsm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States)

    2015-01-15

    Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting

  3. Transarterial chemoembolization of hepatocellular carcinoma in a rat model: the effect of additional injection of survivin siRNA to the treatment protocol

    International Nuclear Information System (INIS)

    Vogl, Thomas J.; Oppermann, Elsie; Qian, Jun; Imlau, Ulli; Tran, Andreas; Hamidavi, Yousef; Korkusuz, Huedayi; Bechstein, Wolf Otto; Nour-Eldin, Nour-Eldin Abdel-Rehim; Gruber-Rouh, Tatjana; Hammerstingl, Renate; Naguib, Nagy Naguib Naeem

    2016-01-01

    Transarterial chemoembolization is one of the most widely accepted interventional treatment options for treatment of hepatocellular carcinoma. Still there is a lack of a standard protocol regarding the injected chemotherapeutics. Survivin is an inhibitor of Apoptosis protein that functions to inhibit apoptosis, promote proliferation, and enhance invasion. Survivin is selectively up-regulated in many human tumors. Small interfering RNA (siRNA) can trigger an RNA interference response in mammalian cells and induce strong inhibition of specific gene expression including Survivin. The aim of the study is to assess the effectiveness of the additional injection of Survivin siRNA to the routine protocol of Transarterial Chemoembolization (TACE) for the treatment of hepatocellular carcinoma in a rat model. The study was performed on 20 male ACI rats. On day 0 a solid Morris Hepatoma 3924A was subcapsullary implanted in the liver. On day 12 MRI measurement of the initial tumor volume (V1) was performed. TACE was performed on day 13. The rats were divided into 2 groups; Group (A, n = 10) in which 0.1 mg mitomycin, 0.1 ml lipiodol and 5.0 mg degradable starch microspheres were injected in addition 2.5 nmol survivin siRNA were injected. The same agents were injected in Group (B,=10) without Survivin siRNA. MRI was repeated on day 25 to assess the tumor volume (V2). The tumor growth ratio (V2/V1) was calculated. Western blot and immunohistochemical analysis were performed. For group A the mean tumor growth ratio (V2/V1) was 1.1313 +/− 0.1381, and was 3.1911 +/− 0.1393 in group B. A statistically significant difference between both groups was observed regarding the inhibition of tumor growth (P < 0.0001) where Group A showed more inhibition compared to Group B. Similarly immunohistochemical analysis showed significantly lower (p < 0.002) VEGF staining in group A compared to group B. Western Blot analysis showed a similar difference in VEGF expression (P < 0.0001). The

  4. Towards Provenance and Traceability in CRISTAL for HEP

    CERN Document Server

    Shamdasani, Jetendr; McClatchey, Richard

    2014-01-01

    This paper discusses the CRISTAL object lifecycle management system and its use in provenance data management and the traceability of system events. This software was initially used to capture the construction and calibration of the CMS ECAL detector at CERN for later use by physicists in their data analysis. Some further uses of CRISTAL in different projects (CMS, neuGRID and N4U) are presented as examples of its flexible data model. From these examples, applications are drawn for the High Energy Physics domain and some initial ideas for its use in data preservation HEP are outlined in detail in this paper. Currently investigations are underway to gauge the feasibility of using the N4U Analysis Service or a derivative of it to address the requirements of data and analysis logging and provenance capture within the HEP long term data analysis environment.

  5. A School Passport as Part of a Protocol to Assist Educational Reintegration After Medulloblastoma Treatment in Childhood.

    Science.gov (United States)

    Tresman, Rachel; Brown, Morven; Fraser, Faye; Skinner, Roderick; Bailey, Simon

    2016-09-01

    Medulloblastoma is the most common malignant brain tumour in children and is treated with a combination of surgery, radiotherapy and chemotherapy. These children frequently experience long-term cognitive, social and physical sequelae, which significantly affect school reintegration. This study aimed to explore school-return experiences to create a more structured school reintegration protocol for children postmedulloblastoma. A cohort of nine patients who had completed treatment and for whom full neuropsychometric data were available was included in the study (median time since diagnosis 8 years). Data were collected using qualitative parental questionnaires, semistructured interviews with teachers (n = 12) and healthcare professionals (HCPs) (n = 6) involved in their school reintegration. Thematic analysis was employed. A focus group with five HCPs was then used for data validation. This study uncovered the following four main subjects: (1) Information sharing; (2) education and empowerment (of educational professionals (EP) and parents); (3) communication between parents, HCPs and EPs; and (4) long-term difficulties. Implementation of a standardised protocol delivered within the structure of a school passport document would aid uniform follow-up. The proposed multistage protocol includes early communication and reintegration planning followed by meetings at school re-entry. Follow-up meetings are suggested to reduce information loss and reassess the child's needs. Hospital support at school transitions, inclusion of school data in long-term clinical follow-up and long-term rehabilitation are also recommended. Each stage would be supported by school passport documentation and would facilitate school and parental empowerment, paramount to the long-term sustainability of successful schooling. © 2016 Wiley Periodicals, Inc.

  6. Age-related macular degeneration: using morphological predictors to modify current treatment protocols.

    Science.gov (United States)

    Ashraf, Mohammed; Souka, Ahmed; Adelman, Ron A

    2018-03-01

    therapy and extended follow-up intervals (4 weekly) can be suggested for patients who show adequate visual response and have both SRF and PVD at baseline. In addition, patients with poor prognostic indicators such as IRC, VMA, large CNV size, older age and poor response at 12 weeks should be extended very cautiously with the possibility of fixed monthly/bimonthly (every 2 months) treatments if they fail to achieve dryness. Patients with PED at baseline should receive monthly/bimonthly injections of anti-VEGF therapy or can be extended very cautiously (two weekly intervals) using a TAE protocol. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Transcranial direct current stimulation (tDCS) for treatment of major depression during pregnancy: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Vigod, Simone; Dennis, Cindy-Lee; Daskalakis, Zafiris; Murphy, Kellie; Ray, Joel; Oberlander, Tim; Somerton, Sarah; Hussain-Shamsy, Neesha; Blumberger, Daniel

    2014-09-18

    Women with depression in pregnancy are faced with difficult treatment decisions. Untreated, antenatal depression has serious negative implications for mothers and children. While antidepressant drug treatment is likely to improve depressive symptoms, it crosses the placenta and may pose risks to the unborn child. Transcranial direct current stimulation is a focal brain stimulation treatment that improves depressive symptoms within 3 weeks of treatment by inducing changes to brain areas involved in depression, without impacting any other brain areas, and without inducing changes to heart rate, blood pressure or core body temperature. The localized nature of transcranial direct current stimulation makes it an ideal therapeutic approach for treating depression during pregnancy, although it has never previously been evaluated in this population. We describe a pilot randomized controlled trial of transcranial direct current stimulation among women with depression in pregnancy to assess the feasibility of a larger, multicentre efficacy study. Women over 18 years of age and between 14 and 32 weeks gestation can be enrolled in the study provided they meet diagnostic criteria for a major depressive episode of at least moderate severity and have been offered but refused antidepressant medication. Participants are randomized to receive active transcranial direct current stimulation or a sham condition that is administered in 15 30-minute treatments over three weeks. Women sit upright during treatment and receive obstetrical monitoring prior to, during and after each treatment session. Depressive symptoms, treatment acceptability, and pregnancy outcomes are assessed at baseline (prior to randomization), at the end of each treatment week, every four weeks post-treatment until delivery, and at 4 and 12 weeks postpartum. Transcranial direct current stimulation is a novel therapeutic option for treating depression during pregnancy. This protocol allows for assessment of the

  8. Baseline demographics, clinical features, and treatment protocols of 240 patients with optic neuropathy: experiences from a neuro-ophthalmological clinic in the Aegean region of Turkey.

    Science.gov (United States)

    Karti, Omer; Karti, Dilek Top; Kilic, İlay Hilal; Gokcay, Figen; Celebisoy, Nese

    2017-12-19

    To analyze the demographic patterns, clinical characteristics, and treatment protocols of optic neuropathies. The hospital data of patients with optic neuropathy admitted to the Department of Neuro-ophthalmology in a tertiary referral center in Turkey between January 2010 to January 2017 were retrospectively analyzed. Demographic patterns, clinical features, treatment protocols, and the natural disease courses were assessed. The total number of patients with optic neuropathy seen over this period was 240, which consist of 43 with idiopathic optic neuritis (17.9%), 40 with multiple sclerosis-related optic neuritis (16.7%), 12 with chronic relapsing inflammatory optic neuritis (5.0%), 12 with atypical optic neuritis (5.0%), 11 with neuromyelitis optica spectrum disorders-related optic neuritis (4.6%), 90 with non-arteritic ischemic optic neuropathy (37.5%), 4 with arteritic ischemic optic neuropathy (1.7%), 10 with traumatic optic neuropathy (4.1%), 6 with compressive optic neuropathy (2.5%), and 12 with mitochondrial optic neuropathy [9 with toxic optic neuropathy (3.7%) and 3 with Leber's hereditary optic neuropathy (1.2%)]. There were 101 males (42%) and 139 females (58%). The mean age was 43.34 ± 15.86 years. This study reported the demographics, clinical characteristics, and treatment protocols of optic neuropathies in a neuro-ophthalmology specialty clinic at a tertiary referral center in Turkey during the past decade. The data may be useful in assessing the global status of optic neuropathies.

  9. Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial

    OpenAIRE

    van der Roer, Nicole; van Tulder, Maurits; Barendse, Johanna; Knol, Dirk; van Mechelen, Willem; de Vet, Henrica

    2008-01-01

    Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapist...

  10. Proven commercial reactor types: an introduction to their principal advantages and disadvantages

    International Nuclear Information System (INIS)

    Alesso, H.P.

    1981-01-01

    This study deals with the principal advantages and disadvantages of the five types of proven commercial reactors. A description of each class of commercial reactor (light water, gas-cooled, and heavy water) and their proven reactors is followed by a comparison of reactor types on the basis of technical merit, economics of operation, availability of technology, and associated political issues. (author)

  11. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer

    International Nuclear Information System (INIS)

    Cavaliere, Carlo; Romeo, Valeria; Aiello, Marco; Mesolella, Massimo; Iorio, Brigida; Barbuto, Luigi; Cantone, Elena; Nicolai, Emanuele; Covello, Mario

    2017-01-01

    Highlights: • PET/MRI is feasible and useful for primary staging of laryngeal cancer. • PET/MRI simultaneously provides morphological, metabolic and functional parameters of tumoral laryngeal lesions. • PET/MRI allows an appropriate tumoral staging in terms of lesion extension with significant impact on therapeutic strategies. - Abstract: Objectives: To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient’s staging and treatment planning. Methods: 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K trans , V e , k ep and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. Results: A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen’s kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p = 0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). Conclusions: PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies.

  12. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cavaliere, Carlo [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy); Romeo, Valeria, E-mail: valeria.romeo@unina.it [Department of Advanced Biomedical Sciences, Federico II University, Naples (Italy); Aiello, Marco [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy); Mesolella, Massimo; Iorio, Brigida [Department of Neuroscience, Reproductive and Odontostomatologic Science, ENT Section, Federico II University, Naples (Italy); Barbuto, Luigi [Department of Advanced Biomedical Sciences, Federico II University, Naples (Italy); Cantone, Elena [Department of Neuroscience, Reproductive and Odontostomatologic Science, ENT Section, Federico II University, Naples (Italy); Nicolai, Emanuele; Covello, Mario [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy)

    2017-03-15

    Highlights: • PET/MRI is feasible and useful for primary staging of laryngeal cancer. • PET/MRI simultaneously provides morphological, metabolic and functional parameters of tumoral laryngeal lesions. • PET/MRI allows an appropriate tumoral staging in terms of lesion extension with significant impact on therapeutic strategies. - Abstract: Objectives: To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient’s staging and treatment planning. Methods: 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K{sub trans}, V{sub e}, k{sub ep} and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. Results: A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen’s kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p = 0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). Conclusions: PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies.

  13. Towards Automatic Capturing of Manual Data Processing Provenance

    NARCIS (Netherlands)

    Wombacher, Andreas; Huq, M.R.

    2011-01-01

    Often data processing is not implemented by a work ow system or an integration application but is performed manually by humans along the lines of a more or less specified procedure. Collecting provenance information during manual data processing can not be automated. Further, manual collection of

  14. Scab susceptibility of a provenance collection of pecan

    Science.gov (United States)

    Scab (caused by Fusicladium effusum) is the most economically destructive disease of pecan in the Southeast US. Epidemics are favored by rainfall and high humidity. A provenance collection of ~950 pecan trees from 19 locations representing the native range of the species is located in Byron, Georgia...

  15. Facilitating Scientific Research through Workflows and Provenance on the DataONE Cyberinfrastructure (Invited)

    Science.gov (United States)

    Ludaescher, B.; Cuevas-Vicenttín, V.; Missier, P.; Dey, S.; Kianmajd, P.; Wei, Y.; Koop, D.; Chirigati, F.; Altintas, I.; Belhajjame, K.; Bowers, S.

    2013-12-01

    Provenance data has numerous applications in science. Two key ones are 1) replication: facilitate the repeatable derivation of results and 2) discovery: enable the location of data based on processing history and derivation relationships. The following scenario illustrates a typical use of provenance data. Alice, a climate scientist, has developed a VisTrails workflow to prepare Gross Primary Productivity (GPP) data. After verifying that the workflow generates data in the desired form, she uses the ReproZip tool to create a reproducible package that will enable other scientists to re-run the workflow without having to install and configure the particular libraries she is using. In addition, she exports the provenance information of the workflow execution and customizes it through a tool such as the ProvExplorer, in order to eliminate the information she regards as superfluous. She then creates and shares a DataONE data package containing the data she prepared, the ReproZip package, the customized provenance, and additional science/system metadata. Both the customized provenance and metadata are indexed by the DataONE Cyberinfrastructure (CI) for discovery purposes. Bob, another climate scientist, is looking for a benchmark GPP data to validate the Terrestrial Biosphere Model (TBM) he has developed. Searching the DataONE repository he finds Alice's data package. He retrieves its ReproZip package, customizes it (e.g. changing the spatial resolution), and re-runs it to generate the benchmark data in the form he desires. The newly generated data is then used as input for his own model evaluation workflow. His workflow generates residual maps and a Taylor diagram that enable him to evaluate the similarity between the results of his model and the benchmark data. At this point, Bob can also make use of the tools Alice used to publish his results as another discoverable and reproducible data package. In order to support these capabilities, we propose to extend the Data

  16. Growth and quality of Grevillea robusta provenances in Ruhande ...

    African Journals Online (AJOL)

    user

    used as sawn timber for furniture industry, for construction and packaging. ... seven Queensland (Australia) provenances and one land race on an oxisol at Ruhande .... Statistical analyses were carried out using Statistical Analysis Systems.

  17. Providing Global Change Information for Decision-Making: Capturing and Presenting Provenance

    Science.gov (United States)

    Ma, Xiaogang; Fox, Peter; Tilmes, Curt; Jacobs, Katherine; Waple, Anne

    2014-01-01

    Global change information demands access to data sources and well-documented provenance to provide evidence needed to build confidence in scientific conclusions and, in specific applications, to ensure the information's suitability for use in decision-making. A new generation of Web technology, the Semantic Web, provides tools for that purpose. The topic of global change covers changes in the global environment (including alterations in climate, land productivity, oceans or other water resources, atmospheric composition and or chemistry, and ecological systems) that may alter the capacity of the Earth to sustain life and support human systems. Data and findings associated with global change research are of great public, government, and academic concern and are used in policy and decision-making, which makes the provenance of global change information especially important. In addition, since different types of decisions benefit from different types of information, understanding how to capture and present the provenance of global change information is becoming more of an imperative in adaptive planning.

  18. Visualisation methods for large provenance collections in data-intensive collaborative platforms

    Science.gov (United States)

    Spinuso, Alessandro; Fligueira, Rosa; Atkinson, Malcolm; Gemuend, Andre

    2016-04-01

    This work investigates improving the methods of visually representing provenance information in the context of modern data-driven scientific research. It explores scenarios where data-intensive workflows systems are serving communities of researchers within collaborative environments, supporting the sharing of data and methods, and offering a variety of computation facilities, including HPC, HTC and Cloud. It focuses on the exploration of big-data visualization techniques aiming at producing comprehensive and interactive views on top of large and heterogeneous provenance data. The same approach is applicable to control-flow and data-flow workflows or to combinations of the two. This flexibility is achieved using the W3C-PROV recommendation as a reference model, especially its workflow oriented profiles such as D-PROV (Messier et al. 2013). Our implementation is based on the provenance records produced by the dispel4py data-intensive processing library (Filgueira et al. 2015). dispel4py is an open-source Python framework for describing abstract stream-based workflows for distributed data-intensive applications, developed during the VERCE project. dispel4py enables scientists to develop their scientific methods and applications on their laptop and then run them at scale on a wide range of e-Infrastructures (Cloud, Cluster, etc.) without making changes. Users can therefore focus on designing their workflows at an abstract level, describing actions, input and output streams, and how they are connected. The dispel4py system then maps these descriptions to the enactment platforms, such as MPI, Storm, multiprocessing. It provides a mechanism which allows users to determine the provenance information to be collected and to analyze it at runtime. For this work we consider alternative visualisation methods for provenance data, from infinite lists and localised interactive graphs, to radial-views. The latter technique has been positively explored in many fields, from text

  19. Desensitization to clopidogrel: a tailor-made protocol.

    Science.gov (United States)

    Barreira, P; Cadinha, S; Malheiro, D; Moreira da Silva, J P

    2014-01-01

    Clopidogrel is an antiplatelet drug widely used for treatment and prevention of a variety of cardiovascular diseases. We report a successful desensitization to clopidogrel in a 70-year-old Caucasian man with delayed hypersensitivity (HS) reaction. He developed lip, hand and foot swelling, erythematous papular non-pruritic lesions and arthralgias 2 weeks after starting treatment with clopidogrel 75 mg/d. A 3-hour desensitization protocol was started, achieving a cumulative dose of 154 mg without any reaction, and a daily dose of 75 mg was recommended. On the 4th day, the patient developed skin lesions similar to the previously described. He was treated with topical steroids and oral antihistamines, and the daily dose of clopidogrel was reduced to 20 mg. A new desensitization protocol was established, with a slow dose increment, according to the patient's response. It was only possible to achieve the dose of 75 mg/d after 2 months. Although well tolerated by most patients, HS reactions with clopidogrel may occur and desensitization is rising as a safe alternative in those patients. In delayed reactions with cutaneous lesions, a slower desensitization protocol may be necessary, as in this case.

  20. Early functional outcome of two surgical protocols used in the repair ...

    African Journals Online (AJOL)

    Background and objective The outcome of different treatment protocols for primary management of patients with complete unilateral cleft lip palate (UCLP) may vary considerably. This study aimed to compare the results of quality of speech and velopharyngeal sphincter mechanism between two surgical protocols used in ...

  1. Second-line treatment of recurrent HNSCC: tumor debulking in combination with high-dose-rate brachytherapy and a simultaneous cetuximab-paclitaxel protocol

    International Nuclear Information System (INIS)

    Ritter, M.; Teudt, I. U.; Meyer, J. E.; Schröder, U.; Kovács, G.; Wollenberg, B.

    2016-01-01

    After the failure of first-line treatment, the clinical prognosis in head and neck cancer (HNSCC) deteriorates. Effective therapeutic strategies are limited due to the toxicity of previous treatments and the diminished tolerance of surrounding normal tissue. This study demonstrates a promising second-line regimen, with function preserving surgical tumor debulking, followed by a combination of postoperative interstitial brachytherapy and a simultaneous protocol of cetuximab and taxol. From January 2006 to May 2013, 197 patients with HNSCC were treated with brachytherapy at the University Hospital Schleswig-Holstein Campus Lübeck, including 94 patients due to recurrent cancer. Within these, 18 patients were referred to our clinic because of early progressive disease following first- or second-line treatment failure. They received the new palliative regimen. A matched-pair analysis including recurrent tumor stage, status of resection margins, tissue invasion and previous therapy was performed to evaluate this treatment retrospectively. Overall survival (OS), disease-free survival (DFS), functional outcome and treatment toxicity was analyzed on the basis of medical records and follow-up data. DFS and OS of the study group were 8.7 and 14.8 months. Whereas, DFS and OS of the control group, treated only by function preserving tumor debulking and brachytherapy, was 3.9 and 6.1 months respectively. This demonstrates a positive trend through the additional use of the cetuximab-taxane protocol. Furthermore, no increase of therapy induced toxicities was displayed. Pre-treated patients with a further relapse benefit from the ‘cetuximab-taxane recurrency scheme’. It seems to be a valuable complement to interdisciplinary and multimodal tumor therapy, which improves OS and results in acceptable toxicity. The online version of this article (doi:10.1186/s13014-016-0583-0) contains supplementary material, which is available to authorized users

  2. SU-E-J-113: The Influence of Optimizing Pediatric CT Simulator Protocols On the Treatment Dose Calculation in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Y; Zhang, J; Hu, Q; Tie, J; Wu, H [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital ' Institute, Beijing (China); Deng, J [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States)

    2014-06-01

    Purpose: To investigate the possibility of applying optimized scanning protocols for pediatric CT simulation by quantifying the dosimetric inaccuracy introduced by using a fixed HU to density conversion. Methods: The images of a CIRS electron density reference phantom (Model 062) were acquired by a Siemens CT simulator (Sensation Open) using the following settings of tube voltage and beam current: 120 kV/190mA (the reference protocol used to calibrate CT for our treatment planning system (TPS)); Fixed 190mA combined with all available kV: 80, 100, and 140; fixed 120 kV and various current from 37 to 444 mA (scanner extremes) with interval of 30 mA. To avoid the HU uncertainty of point sampling in the various inserts of known electron densities, the mean CT numbers of the central cylindrical volume were calculated using DICOMan software. The doses per 100 MU to the reference point (SAD=100cm, Depth=10cm, Field=10X10cm, 6MV photon beam) in a virtual cubic phantom (30X30X30cm) were calculated using Eclipse TPS (calculation model: AcurosXB-11031) by assigning the CT numbers to HU of typical materials acquired by various protocols. Results: For the inserts of densities less than muscle, CT number fluctuations of all protocols were within the tolerance of 10 HU as accepted by AAPM-TG66. For more condensed materials, fixed kV yielded stable HU with any mA combination where largest disparities were found in 1750mg/cc insert: HU{sub reference}=1801(106.6cGy), HU{sub minimum}=1799 (106.6cGy, error{sub dose}=0.00%), HU{sub maximum}=1815 (106.8cGy, error{sub dose}=0.19%). Yet greater disagreements were observed with increasing density when kV was modified: HU{sub minimum}=1646 (104.5cGy, error{sub dose}=- 1.97%), HU{sub maximum}=2487 (116.4cGy, error{sub dose}=9.19%) in 1750mg/cc insert. Conclusion: Without affecting treatment dose calculation, personalized mA optimization of CT simulator can be conducted by fixing kV for a better cost-effectiveness of imaging dose and quality

  3. Evaluation of a follow-up protocol for patients on chloroquine and hydroxychloroquine treatment.

    Science.gov (United States)

    Sanabria, M R; Toledo-Lucho, S C

    2016-01-01

    To review the problems found after a new follow-up protocol for patients on chloroquine and hydroxychloroquine treatment. Retrospective study was conducted between May 2012 and January 2013 on the clinical files, retinographies, fundus auto-fluorescence (FAF) images, and central-10 degree visual fields (VF) of patients who were referred to the Ophthalmology Department as they had started treatment with hydroxychloroquine. One hundred twenty-six patients were included; 94.4% were referred from the Rheumatology Department and 5.6% from Dermatology. Mean age was 59.7 years, and 73.8% were women. All of them were on hydroxychloroquine treatment, and 300mg was the most frequent daily dose. Rheumatoid arthritis was the most common diagnosis (40.5%), followed by systemic lupus erythematosus (15.9%). The mean Snellen visual acuity was 0.76, and 26 patients had lens opacities. The VF were normal in 97 patients, 8 had mild to moderate defects with no definite pattern, and in 9 the results were unreliable. Of the 51 patients older than 65years, 16 (31.4%) had altered or unreliable VF. The FAF was normal in 104 patients (82.5%), and abnormal, but consistent with ophthalmoscopic features, in 12 patients (pathological myopia, age related changes, early, middle or late age-related macular degeneration). Visual fields as a reference test for the diagnosis of AP toxicity are not quite reliable for patients over 65. Therefore, the FAF is recommended as primary test, perhaps combined with another objective test, such as SD-OCT instead of VF. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Autumn frost hardiness in Norway spruce plus tree progeny and trees of the local and transferred provenances in central Sweden.

    Science.gov (United States)

    Hannerz, Mats; Westin, Johan

    2005-09-01

    Reforestation with provenances from locations remote from the planting site (transferred provenances) or the progeny of trees of local provenances selected for superior form and vigor (plus trees) offer alternative means to increase yield over that obtained by the use of seed from unselected trees of the local provenance. Under Swedish conditions, Norway spruce (Picea abies (L.) Karst.) of certain transferred provenances generally has an advantage in productivity relative to the local provenance comparable to that of progeny of plus trees. The aim of this study was to explore the extent to which productivity gains achieved by provenance transfer or the use of plus tree progeny are associated with reductions in autumn frost hardiness, relative to that of trees of the local provenance. In a field trial with 19-year-old trees in central Sweden, bud hardiness was tested on four occasions during the autumn of 2002. Trees of the local provenance were compared with trees of a south Swedish provenance originating 3 degrees of latitude to the south, a Belarusian provenance and the progeny of plus trees of local origin. The Belarusian provenance was the least hardy and the local provenance the most hardy, with plus tree progeny and the south Swedish provenance being intermediate in hardiness. Both the Belarusian provenance and the plus tree progeny were significantly taller than trees of the other populations. Within provenances, tree height was negatively correlated with autumn frost hardiness. Among the plus tree progeny, however, no such correlation between tree height and autumn frost hardiness was found. It is concluded that although the gain in productivity achieved by provenance transfer from Belarus was comparable to that achieved by using the progeny of plus trees of the local provenance, the use of trees of the Belarus provenance involved an increased risk of autumn frost damage because of later hardening.

  5. Synthesis of Pyrrolo[1,2-a]pyrimidine Enantiomers via Domino Ring-Closure followed by Retro Diels-Alder Protocol

    Directory of Open Access Journals (Sweden)

    Beáta Fekete

    2017-04-01

    Full Text Available From 2-aminonorbornene hydroxamic acids, a simple and efficient method for the preparation of pyrrolo[1,2-a]pyrimidine enantiomers is reported. The synthesis is based on domino ring-closure followed by microwave-induced retro Diels-Alder (RDA protocols, where the chirality of the desired products is transferred from norbornene derivatives. The stereochemistry of the synthesized compounds was proven by X-ray crystallography. The absolute configuration of the product is determined by the configuration of the starting amino hydroxamic acid.

  6. Synthesis of Pyrrolo[1,2-a]pyrimidine Enantiomers via Domino Ring-Closure followed by Retro Diels-Alder Protocol.

    Science.gov (United States)

    Fekete, Beáta; Palkó, Márta; Haukka, Matti; Fülöp, Ferenc

    2017-04-13

    From 2-aminonorbornene hydroxamic acids, a simple and efficient method for the preparation of pyrrolo[1,2- a ]pyrimidine enantiomers is reported. The synthesis is based on domino ring-closure followed by microwave-induced retro Diels-Alder (RDA) protocols, where the chirality of the desired products is transferred from norbornene derivatives. The stereochemistry of the synthesized compounds was proven by X-ray crystallography. The absolute configuration of the product is determined by the configuration of the starting amino hydroxamic acid.

  7. Pharmacokinetic-Pharmacodynamic Model To Evaluate Intramuscular Tetracycline Treatment Protocols To Prevent Antimicrobial Resistance in Pigs

    DEFF Research Database (Denmark)

    Ahmad, Amais; Græsbøll, Kaare; Christiansen, Lasse Engbo

    2015-01-01

    protocol for intramuscular administration of tetracycline and the composition of bacterial strains in a pig affect the level of resistance in the intestine of a pig. Predictions were generated by a mathematical model of competitive growth of Escherichia coli strains in pigs under specified plasma......High instances of antimicrobial resistance are linked to both routine and excessive antimicrobial use, but excessive or inappropriate use represents an unnecessary risk. The competitive growth advantages of resistant bacteria may be amplified by the strain dynamics; in particular, the extent...... to which resistant strains outcompete susceptible strains under antimicrobial pressure may depend not only on the antimicrobial treatment strategies but also on the epidemiological parameters, such as the composition of the bacterial strains in a pig. This study evaluated how variation in the dosing...

  8. Pharmacokinetic-Pharmacodynamic Model To Evaluate Intramuscular Tetracycline Treatment Protocols To Prevent Antimicrobial Resistance in Pigs

    DEFF Research Database (Denmark)

    Ahmad, Amais; Græsbøll, Kaare; Christiansen, Lasse Engbo

    2015-01-01

    High instances of antimicrobial resistance are linked to both routine and excessive antimicrobial use, but excessive or inappropriate use represents an unnecessary risk. The competitive growth advantages of resistant bacteria may be amplified by the strain dynamics; in particular, the extent...... to which resistant strains outcompete susceptible strains under antimicrobial pressure may depend not only on the antimicrobial treatment strategies but also on the epidemiological parameters, such as the composition of the bacterial strains in a pig. This study evaluated how variation in the dosing...... protocol for intramuscular administration of tetracycline and the composition of bacterial strains in a pig affect the level of resistance in the intestine of a pig. Predictions were generated by a mathematical model of competitive growth of Escherichia coli strains in pigs under specified plasma...

  9. MRI technique for the preoperative evaluation of deep infiltrating endometriosis: current status and protocol recommendation

    International Nuclear Information System (INIS)

    Schneider, C.; Oehmke, F.; Tinneberg, H.-R.; Krombach, G.A.

    2016-01-01

    Endometriosis is a common cause of chronic pelvic pain and infertility. It is defined as the occurrence of endometrial tissue outside the uterine cavity and can manifest as a peritoneal, ovarian or infiltrating form, the latter being referred to as deep infiltrating endometriosis (DIE). Surgery is essential in the treatment of DIE and depending on the severity of the disease, surgery can be difficult and extensive. Beside clinical examination and ultrasound, magnetic resonance imaging (MRI) has proven its value to provide useful information for planning surgery in patients with suspected DIE. To optimise the quality of MRI examinations, radiologists have to be familiar with the capabilities and also the limitations of this technique with respect to the assessment of DIE. MRI yields morphological information by using mainly T1- and T2-weighted sequences, but can also provide functional information by means of intravenous gadolinium, diffusion-weighted imaging or cine-MRI. In this article, these techniques and also adequate measures of patient preparation, which are indispensable for successful MRI imaging for the preoperative evaluation of DIE, are reviewed and a comprehensive protocol recommendation is provided.

  10. Opening Up Climate Research: A Linked Data Approach to Publishing Data Provenance

    Directory of Open Access Journals (Sweden)

    Arif Shaon

    2012-03-01

    Full Text Available Traditionally, the formal scientific output in most fields of natural science has been limited to peer-reviewed academic journal publications, with less attention paid to the chain of intermediate data results and their associated metadata, including provenance. In effect, this has constrained the representation and verification of the data provenance to the confines of the related publications. Detailed knowledge of a dataset’s provenance is essential to establish the pedigree of the data for its effective re-use, and to avoid redundant re-enactment of the experiment or computation involved. It is increasingly important for open-access data to determine their authenticity and quality, especially considering the growing volumes of datasets appearing in the public domain. To address these issues, we present an approach that combines the Digital Object Identifier (DOI – a widely adopted citation technique – with existing, widely adopted climate science data standards to formally publish detailed provenance of a climate research dataset as an associated scientific workflow. This is integrated with linked-data compliant data re-use standards (e.g. OAI-ORE to enable a seamless link between a publication and the complete trail of lineage of the corresponding dataset, including the dataset itself.

  11. Protocol updated for the treatment of patients in radiotherapy with implanted cardiac devices; Protocolo actualizado para el tratamiento de pacientes en radioterapia con dispositivos cardiacos implantados

    Energy Technology Data Exchange (ETDEWEB)

    Martin Martin, G.; Bermudez Luna, R.; Rodriguez Rodriguez, C.; Lopez Fernandez, A.; Rodriguez Perez, A.; Sotoca Ruiz, A.

    2013-07-01

    Radiotherapy treatment can be safely performed in patients with pacemakers or implanted defibrillators, however, it is very important to ensure that the patient receives the minimum dose possible in your heart device. Is considered essential good coordination with the cardiology service before, during and after radiotherapy treatment for the patient safety. Finally we present a protocol updated to treat these patients in radiotherapy. (Author)

  12. Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Anna-Carlotta Zarski

    2018-01-01

    Full Text Available IntroductionGenito-pelvic pain/penetration disorder (GPPPD not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce.AimThis article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an Internet-based guided intervention for GPPPD.MethodTwo hundred women who meet the criteria for GPPPD and have not been able to experience sexual intercourse for at least the last 6 months will be recruited and randomly assigned either to the intervention group (IG or a 6-month waitlist control group. Assessments take place at baseline (T1, peritreatment after completion of Session 5 in IG (T2, after completion of Session 8 or 12 weeks after randomization (T3, and after 6 months (T4. Data will be analyzed on an intention-to-treat and a completer basis.Main outcome measuresThe primary outcome will be sexual intercourse involving the insertion of the partner’s penis at posttreatment. Secondary outcomes include, e.g., improved non-intercourse penetration, sexual functioning, dyadic stress coping, reduced fear of sexuality and negative penetration-related cognitions. Fear of sexuality, penetration-related cognitions, and exercise intensity will be assessed as mediators of intercourse in the IG. Sexual dysfunctions of partners will be measured at baseline (T1 and investigated as a potential moderator of the primary treatment outcome.DiscussionGiven the burden associated with GPPPD and the need for specialized treatment, there is a surprising lack of evidence-based treatment options. This study aims to assess whether Internet-based interventions could contribute to closing this treatment gap.Clinical Trial RegistrationGerman Register of Clinical Studies (DRKS

  13. Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial.

    Science.gov (United States)

    Zarski, Anna-Carlotta; Berking, Matthias; Ebert, David Daniel

    2017-01-01

    Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women's sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce. This article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an Internet-based guided intervention for GPPPD. Two hundred women who meet the criteria for GPPPD and have not been able to experience sexual intercourse for at least the last 6 months will be recruited and randomly assigned either to the intervention group (IG) or a 6-month waitlist control group. Assessments take place at baseline (T1), peritreatment after completion of Session 5 in IG (T2), after completion of Session 8 or 12 weeks after randomization (T3), and after 6 months (T4). Data will be analyzed on an intention-to-treat and a completer basis. The primary outcome will be sexual intercourse involving the insertion of the partner's penis at posttreatment. Secondary outcomes include, e.g., improved non-intercourse penetration, sexual functioning, dyadic stress coping, reduced fear of sexuality and negative penetration-related cognitions. Fear of sexuality, penetration-related cognitions, and exercise intensity will be assessed as mediators of intercourse in the IG. Sexual dysfunctions of partners will be measured at baseline (T1) and investigated as a potential moderator of the primary treatment outcome. Given the burden associated with GPPPD and the need for specialized treatment, there is a surprising lack of evidence-based treatment options. This study aims to assess whether Internet-based interventions could contribute to closing this treatment gap. German Register of Clinical Studies (DRKS): DRKS00010228.

  14. Neutron activation analysis: a powerful tool in provenance investigations

    International Nuclear Information System (INIS)

    Meloni, Sandro; Oddone, Massimo

    2002-01-01

    It is well known that neutron activation analysis (NAA), both instrumental and destructive, allows the simultaneous determination of a number of elements, mostly trace elements, with high levels of precision and accuracy. These peculiar properties of NAA are very useful when applied to provenance studies, i.e. to the identification of the origin of raw materials with which artifacts had been manufactured in ancient times. Data reduction by statistical procedures, especially multivariate analysis techniques, provides a statistical 'fingerprint' of investigated materials, both raw materials and archaeological artifacts, that, upon comparison, allows the identification of the provenance of prime matters used for artifact manufacturing. Thus information on quarries and flows exploitation in the antiquity, on technological raw materials processing, on trade routes and about the circulation of fakes, can be obtained. In the present paper two case studies are reported. The first one deals with the identification of the provenance of clay used to make ceramic materials, mostly bricks and tiles, recovered from the excavation of a Roman 'villa' in Lomello (Roman name Laumellum) and of Roman settlings in Casteggio (Roman name Clastidium). Both sites are located in the Province of Pavia in areas called Lomellina and Oltrepo respectively. The second one investigates the origin of the white marble used to build medieval arks, Carolingian age, located in the church of San Felice, now property of the University of Pavia. Experimental set-up, analytical results and data reduction procedures are presented and discussed. (author)

  15. Combined Protocol for Acute Malnutrition Study (ComPAS) in rural South Sudan and urban Kenya

    DEFF Research Database (Denmark)

    Bailey, Jeanette; Lelijveld, Natasha; Marron, Bethany

    2018-01-01

    Background: Acute malnutrition is a continuum condition, but severe and moderate forms are treated separately, with different protocols and therapeutic products, managed by separate United Nations agencies. The Combined Protocol for Acute Malnutrition Study (ComPAS) aims to simplify and unify...... the treatment of uncomplicated severe and moderate acute malnutrition (SAM and MAM) for children 6-59 months into one protocol in order to improve the global coverage, quality, continuity of care and cost-effectiveness of acute malnutrition treatment in resource-constrained settings.  Methods/design: This study...... is a multi-site, cluster randomized non-inferiority trial with 12 clusters in Kenya and 12 clusters in South Sudan. Participants are 3600 children aged 6-59 months with uncomplicated acute malnutrition. This study will evaluate the impact of a simplified and combined protocol for the treatment of SAM and MAM...

  16. Defining the "proven technology" technical criterion in the reactor technology assessment for Malaysia's nuclear power program

    Science.gov (United States)

    Anuar, Nuraslinda; Kahar, Wan Shakirah Wan Abdul; Manan, Jamal Abdul Nasir Abd

    2015-04-01

    Developing countries that are considering the deployment of nuclear power plants (NPPs) in the near future need to perform reactor technology assessment (RTA) in order to select the most suitable reactor design. The International Atomic Energy Agency (IAEA) reported in the Common User Considerations (CUC) document that "proven technology" is one of the most important technical criteria for newcomer countries in performing the RTA. The qualitative description of five desired features for "proven technology" is relatively broad and only provides a general guideline to its characterization. This paper proposes a methodology to define the "proven technology" term according to a specific country's requirements using a three-stage evaluation process. The first evaluation stage screens the available technologies in the market against a predefined minimum Technology Readiness Level (TRL) derived as a condition based on national needs and policy objectives. The result is a list of technology options, which are then assessed in the second evaluation stage against quantitative definitions of CUC desired features for proven technology. The potential technology candidates produced from this evaluation is further narrowed down to obtain a list of proven technology candidates by assessing them against selected risk criteria and the established maximum allowable total score using a scoring matrix. The outcome of this methodology is the proven technology candidates selected using an accurate definition of "proven technology" that fulfills the policy objectives, national needs and risk, and country-specific CUC desired features of the country that performs this assessment. A simplified assessment for Malaysia is carried out to demonstrate and suggest the use of the proposed methodology. In this exercise, ABWR, AP1000, APR1400 and EPR designs assumed the top-ranks of proven technology candidates according to Malaysia's definition of "proven technology".

  17. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol.

    Science.gov (United States)

    Kootker, Joyce A; Rasquin, Sascha M C; Smits, Peter; Geurts, Alexander C; van Heugten, Caroline M; Fasotti, Luciano

    2015-09-01

    Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients' goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions. © The Author(s) 2014.

  18. Multiprofissional electronic protocol in ophtalmology with enfasis in strabismus

    Directory of Open Access Journals (Sweden)

    CHRISTIE GRAF RIBEIRO

    Full Text Available ABSTRACT Objective: to create and validate an electronic database in ophthalmology focused on strabismus, to computerize this database in the form of a systematic data collection software named Electronic Protocol, and to incorporate this protocol into the Integrated System of Electronic Protocols (SINPE(c. Methods: this is a descriptive study, with the methodology divided into three phases: (1 development of a theoretical ophthalmologic database with emphasis on strabismus; (2 computerization of this theoretical ophthalmologic database using SINPE(c and (3 interpretation of the information with demonstration of results to validate the protocol. We inputed data from the charts of fifty patients with known strabismus through the Electronic Protocol for testing and validation. Results: the new electronic protocol was able to store information regarding patient history, physical examination, laboratory exams, imaging results, diagnosis and treatment of patients with ophthalmologic diseases, with emphasis on strabismus. We included 2,141 items in this master protocol and created 20 new specific electronic protocols for strabismus, each with its own specifics. Validation was achieved through correlation and corroboration of the symptoms and confirmed diagnoses of the fifty included patients with the diagnostic criteria for the twenty new strabismus protocols. Conclusion: a new, validated electronic database focusing on ophthalmology, with emphasis on strabismus, was successfully created through the standardized collection of information, and computerization of the database using proprietary software. This protocol is ready for deployment to facilitate data collection, sorting and application for practitioners and researchers in numerous specialties.

  19. Isotopic provenance analysis and terrane tectonics: a warning about sediment transport distances

    International Nuclear Information System (INIS)

    Bassett, K.N.

    1999-01-01

    Full text: In the last 10 years the field of provenance analysis has undergone a revolution with the development of single-crystal isotopic dating techniques, the most common being U/Pb zircon and 40Ar/39Ar techniques. These have allowed age determination of single crystals thus providing more detail about probable provenance of each individual grain rather than an averaged population of grains. The usefulness for resolving complex terrane accretion and translation histories was immediately obvious and there have been many studies in many different regions aimed at tracking terrane motions by provenance of individual grains upward through the stratigraphy of a basin. Recent research in the North American Cordilleran terranes and in the New Zealand Torlesse Superterrane show how widely used and powerful these provenance analysis techniques are. However, isotopic provenance analysis has often been presented as key information to resolve controversies around terrane translation histories with very little discussion of the context of sedimentary facies and sediment transport mechanisms. An example is the recent use of U/Pb detrital zircon ages as the supposedly controversy-ending evidence for the amount of lateral translation of the Insular Superterrane in British Columbia (Baja BC) (Mahoney et al., 1999). The zircon grains were separated from fine-grained turbidite deposits and could easily have been transported over very large distances by a variety of mechanisms; yet they were presented as definitively resolving the Baja BC controversy. Modern examples illustrate the problem of using the provenance of fine grained sediment to constrain terrane tectonics. Sediment in the tip of the Bengal submarine fan was transported ∼3000 km from source, first by fluvial processes then by sediment gravity flow in the submarine fan. The detrital isotopic ages of single grains are the same as the depositional ages indicating a very rapid unroofing and transport rate with minimal

  20. The impact of oil price on additions to US proven reserves

    International Nuclear Information System (INIS)

    Farzin, Y.H.

    2001-01-01

    Departing from Hotelling's assumption of fixed and known reserves, this paper develops an economic model of additions to proven reserves that explicitly incorporates the effects of expected resource price, cumulative reserves development, and technological progress on reserve additions. The model treats additions to proven oil reserves as output of a production process in which drilling wells is a primary input to transform some of oil-in-place into the economic category of proven reserves. Application of the model to US data for the 1950-1995 period provides strong statistical support for the existence of all the three salient effects. We obtain an estimate of the price elasticity of reserve additions (absent from previous studies) which, although statistically highly significant, is rather small. Using this price elasticity estimate, it is shown that if in the face of steady economic growth, and hence, oil consumption, US oil import dependence is to be kept from rising in the future, ceteris paribus, a steady oil price increase in the range of 1.5-4.5% a year is essential

  1. Safety and Efficacy of miltefosine alone and in combination with sodium stibogluconate and liposomal amphotericin B for the treatment of primary visceral leishmaniasis in East Africa: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Omollo, Raymond; Alexander, Neal; Edwards, Tansy; Khalil, Eltahir A. G.; Younis, Brima M.; Abuzaid, Abuzaid A.; Wasunna, Monique; Njoroge, Njenga; Kinoti, Dedan; Kirigi, George; Dorlo, Thomas P. C.; Ellis, Sally; Balasegaram, Manica; Musa, Ahmed M.

    2011-01-01

    ABSTRACT: BACKGROUND: Treatment options for Visceral Leishmaniasis (VL) in East Africa are far from satisfactory due to cost, toxicity, prolonged treatment duration or emergence of parasite resistance. Hence there is a need to explore alternative treatment protocols such as miltefosine alone or in

  2. Drought effects on root and needle terpenoid content of a coastal and an interior Douglas fir provenance.

    Science.gov (United States)

    Kleiber, Anita; Duan, Qiuxiao; Jansen, Kirstin; Verena Junker, Laura; Kammerer, Bernd; Rennenberg, Heinz; Ensminger, Ingo; Gessler, Arthur; Kreuzwieser, Jürgen

    2017-12-01

    Douglas fir (Pseudotsuga menziesii) is a conifer species that stores large amounts of terpenoids, mainly monoterpenoids in resin ducts of various tissues. The effects of drought on stored leaf terpenoid concentrations in trees are scarcely studied and published data are partially controversial, since reduced, unaffected or elevated terpenoid contents due to drought have been reported. Even less is known on the effect of drought on root terpenoids. In the present work, we investigated the effect of reduced water availability on the terpenoid content in roots and needles of Douglas fir seedlings. Two contrasting Douglas fir provenances were studied: an interior provenance (var. glauca) with assumed higher drought resistance, and a coastal provenance (var. menziesii) with assumed lower drought resistance. We tested the hypothesis that both provenances show specific patterns of stored terpenoids and that the patterns will change in response to drought in both, needles and roots. We further expected stronger changes in the less drought tolerant coastal provenance. For this purpose, we performed an experiment under controlled conditions, in which the trees were exposed to moderate and severe drought stress. According to our expectations, the study revealed clear provenance-specific terpenoid patterns in needles. However, such patterns were not detected in the roots. Drought slightly increased the needle terpenoid contents of the coastal but not of the interior provenance. We also observed increased terpenoid abundance mainly in roots of the moderately stressed coastal provenance. Overall, from the observed provenance-specific reactions with increased terpenoid levels in trees of the coastal origin in response to drought, we conclude on functions of terpenoids for abiotic stress tolerance that might be fulfilled by other, constitutively expressed mechanisms in drought-adapted interior provenances. © The Author 2017. Published by Oxford University Press. All rights

  3. Evaluation of a protocol for the non-operative management of perforated peptic ulcer.

    Science.gov (United States)

    Marshall, C; Ramaswamy, P; Bergin, F G; Rosenberg, I L; Leaper, D J

    1999-01-01

    The non-operative management of perforated peptic ulcer has previously been shown to be both safe and effective although it remains controversial. A protocol for non-operative management was set up in this hospital in 1989. Adherence to the guidelines in the protocol has been audited over a 6-year period with a review of outcome. The case-notes of patients with a diagnosis of perforated peptic ulcer were reviewed. Twelve guidelines from the protocol were selected for evaluation of compliance to the protocol. Forty-nine patients underwent non-operative treatment initially. Eight patients failed to respond and underwent operation. Complications included abscess formation (seven patients), renal failure (one), gastric ileus (one), chest infection (two), and cardiac failure and stroke (one). Four deaths occurred in this group. Adherence to certain protocol guidelines was poor, notably those concerning prevention of thromboembolism, use of antibiotics, use of contrast examination to confirm the diagnosis and referral for follow-up endoscopy. Two gastric cancers were detected on subsequent endoscopy. This experience demonstrates that non-operative treatment can be used successfully in a general hospital. Adherence to protocol guidelines was found to be variable and the protocol has therefore been simplified. This study highlights the need for an accurate diagnosis and the importance of follow-up endoscopy.

  4. L-asparaginase treatment in acute lymphoblastic leukemia

    NARCIS (Netherlands)

    R. Pieters (Rob); S.P. Hunger (Stephen); J. Boos (Joachim); C. Rizzari (Carmelo); L.B. Silverman (Lewis); A. Baruchel (André); N. Goekbuget (Nicola); M. Schrappe (Martin); C.H. Pui (Ching-Hon)

    2011-01-01

    textabstractAsparaginases are a cornerstone of treatment protocols for acute lymphoblastic leukemia (ALL) and are used for remission induction and intensification treatment in all pediatric regimens and in the majority of adult treatment protocols. Extensive clinical data have shown that intensive

  5. WE-E-304-00: Implementing SBRT Protocols

    International Nuclear Information System (INIS)

    2015-01-01

    SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective even unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation

  6. WE-E-304-00: Implementing SBRT Protocols

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective even unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.

  7. Provenance metadata gathering and cataloguing of EFIT++ code execution

    Energy Technology Data Exchange (ETDEWEB)

    Lupelli, I., E-mail: ivan.lupelli@ccfe.ac.uk [CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Muir, D.G.; Appel, L.; Akers, R.; Carr, M. [CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Abreu, P. [Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa (Portugal)

    2015-10-15

    Highlights: • An approach for automatic gathering of provenance metadata has been presented. • A provenance metadata catalogue has been created. • The overhead in the code runtime is less than 10%. • The metadata/data size ratio is about ∼20%. • A visualization interface based on Gephi, has been presented. - Abstract: Journal publications, as the final product of research activity, are the result of an extensive complex modeling and data analysis effort. It is of paramount importance, therefore, to capture the origins and derivation of the published data in order to achieve high levels of scientific reproducibility, transparency, internal and external data reuse and dissemination. The consequence of the modern research paradigm is that high performance computing and data management systems, together with metadata cataloguing, have become crucial elements within the nuclear fusion scientific data lifecycle. This paper describes an approach to the task of automatically gathering and cataloguing provenance metadata, currently under development and testing at Culham Center for Fusion Energy. The approach is being applied to a machine-agnostic code that calculates the axisymmetric equilibrium force balance in tokamaks, EFIT++, as a proof of principle test. The proposed approach avoids any code instrumentation or modification. It is based on the observation and monitoring of input preparation, workflow and code execution, system calls, log file data collection and interaction with the version control system. Pre-processing, post-processing, and data export and storage are monitored during the code runtime. Input data signals are captured using a data distribution platform called IDAM. The final objective of the catalogue is to create a complete description of the modeling activity, including user comments, and the relationship between data output, the main experimental database and the execution environment. For an intershot or post-pulse analysis (∼1000

  8. Provenance metadata gathering and cataloguing of EFIT++ code execution

    International Nuclear Information System (INIS)

    Lupelli, I.; Muir, D.G.; Appel, L.; Akers, R.; Carr, M.; Abreu, P.

    2015-01-01

    Highlights: • An approach for automatic gathering of provenance metadata has been presented. • A provenance metadata catalogue has been created. • The overhead in the code runtime is less than 10%. • The metadata/data size ratio is about ∼20%. • A visualization interface based on Gephi, has been presented. - Abstract: Journal publications, as the final product of research activity, are the result of an extensive complex modeling and data analysis effort. It is of paramount importance, therefore, to capture the origins and derivation of the published data in order to achieve high levels of scientific reproducibility, transparency, internal and external data reuse and dissemination. The consequence of the modern research paradigm is that high performance computing and data management systems, together with metadata cataloguing, have become crucial elements within the nuclear fusion scientific data lifecycle. This paper describes an approach to the task of automatically gathering and cataloguing provenance metadata, currently under development and testing at Culham Center for Fusion Energy. The approach is being applied to a machine-agnostic code that calculates the axisymmetric equilibrium force balance in tokamaks, EFIT++, as a proof of principle test. The proposed approach avoids any code instrumentation or modification. It is based on the observation and monitoring of input preparation, workflow and code execution, system calls, log file data collection and interaction with the version control system. Pre-processing, post-processing, and data export and storage are monitored during the code runtime. Input data signals are captured using a data distribution platform called IDAM. The final objective of the catalogue is to create a complete description of the modeling activity, including user comments, and the relationship between data output, the main experimental database and the execution environment. For an intershot or post-pulse analysis (∼1000

  9. Developing adaptive interventions for adolescent substance use treatment settings: protocol of an observational, mixed-methods project.

    Science.gov (United States)

    Grant, Sean; Agniel, Denis; Almirall, Daniel; Burkhart, Q; Hunter, Sarah B; McCaffrey, Daniel F; Pedersen, Eric R; Ramchand, Rajeev; Griffin, Beth Ann

    2017-12-19

    Over 1.6 million adolescents in the United States meet criteria for substance use disorders (SUDs). While there are promising treatments for SUDs, adolescents respond to these treatments differentially in part based on the setting in which treatments are delivered. One way to address such individualized response to treatment is through the development of adaptive interventions (AIs): sequences of decision rules for altering treatment based on an individual's needs. This protocol describes a project with the overarching goal of beginning the development of AIs that provide recommendations for altering the setting of an adolescent's substance use treatment. This project has three discrete aims: (1) explore the views of various stakeholders (parents, providers, policymakers, and researchers) on deciding the setting of substance use treatment for an adolescent based on individualized need, (2) generate hypotheses concerning candidate AIs, and (3) compare the relative effectiveness among candidate AIs and non-adaptive interventions commonly used in everyday practice. This project uses a mixed-methods approach. First, we will conduct an iterative stakeholder engagement process, using RAND's ExpertLens online system, to assess the importance of considering specific individual needs and clinical outcomes when deciding the setting for an adolescent's substance use treatment. Second, we will use results from the stakeholder engagement process to analyze an observational longitudinal data set of 15,656 adolescents in substance use treatment, supported by the Substance Abuse and Mental Health Services Administration, using the Global Appraisal of Individual Needs questionnaire. We will utilize methods based on Q-learning regression to generate hypotheses about candidate AIs. Third, we will use robust statistical methods that aim to appropriately handle casemix adjustment on a large number of covariates (marginal structural modeling and inverse probability of treatment weights

  10. A history-tracing XML-based provenance framework for workflows

    NARCIS (Netherlands)

    Gerhards, M; Belloum, A.; Berretz, F.; Sander, V.; Skorupa, S.

    2010-01-01

    The importance of validating and reproducing the outcome of computational processes is fundamental to many application domains. Assuring the provenance of workflows will likely become even more important with respect to the incorporation of human tasks to standard workflows by emerging standards

  11. S-ProvFlow: provenance model and tools for scalable and adaptive analysis pipelines in geoscience.

    Science.gov (United States)

    Spinuso, A.; Mihajlovski, A.; Atkinson, M.; Filgueira, R.; Klampanos, I.; Sanchez, S.

    2017-12-01

    The reproducibility of scientific findings is essential to improve the quality and application of modern data-driven research. Delivering such reproducibility is challenging in the context of systems handling large data-streams with sophisticated computational methods. Similarly, the SKA (Square Kilometer Array) will collect an unprecedented volume of radio-wave signals that will have to be reduced and transformed into derived products, with impact on space-weather research. This highlights the importance of having cross-disciplines mechanisms at the producer's side that rely on usable lineage data to support validation and traceability of the new artifacts. To be informative, provenance has to describe each methods' abstractions and their implementation as mappings onto distributed platforms and their concurrent execution, capturing relevant internal dependencies at runtime. Producers and intelligent toolsets should be able to exploit the produced provenance, steering real-time monitoring activities and inferring adaptations of methods at runtime.We present a model of provenance (S-PROV) that extends W3C PROV and ProvONE, broadening coverage of provenance to aspects related to distribution, scale-up and steering of stateful streaming operators in analytic pipelines. This is supported by a technical framework for tuneable and actionable lineage, ensuring its relevance to the users' interests, fostering its rapid exploitation to facilitate research practices. By applying concepts such as provenance typing and profiling, users define rules to capture common provenance patterns and activate selective controls based on domain-metadata. The traces are recorded in a document-store with index optimisation and a web API serves advanced interactive tools (S-ProvFlow, https://github.com/KNMI/s-provenance). These allow different classes of consumers to rapidly explore the provenance data. The system, which contributes to the SKA-Link initiative, within technology and

  12. SAFETY AND TOXICITY OF AN ACCELERATED COARSELY FRACTIONATED RADIATION PROTOCOL FOR TREATMENT OF APPENDICULAR OSTEOSARCOMA IN 14 DOGS: 10 GY × 2 FRACTIONS.

    Science.gov (United States)

    Pagano, Candace; Boudreaux, Bonnie; Shiomitsu, Keijiro

    2016-09-01

    Coarsely fractionated radiation is commonly used as a method for pain control in dogs with appendicular osteosarcoma, however there is little published information on optimal protocols. The aim of this retrospective, descriptive study was to report safety and toxicity findings in a sample of dogs with appendicular osteosarcoma that had been treated with a radiation scheme of 10 Gy delivered over two consecutive days for a total of 20 Gy. Dogs were included in the study if they had osteosarcoma that was treated with the aforementioned protocol. Dogs were excluded if treated with the same protocol for any other bone tumor besides osteosarcoma or inadequate follow-up. Thirteen of the 14 patients received adjuvant therapy with pamidronate and a nonsteroidal anti-inflammatory. Nine dogs received adjuvant chemotherapy with carboplatin after radiation was complete. Within a median of 14 days, 92.8% of dogs subjectively had improved pain control. Median duration of response (DOR) was 80 days (range 20-365). The majority of patients developed VRTOG grade one toxicity, primarily alopecia. Five dogs (35.7%) developed pathologic fracture postradiation treatment. Timing of fracture was variable ranging from 24 to 250 days. This radiation protocol was well tolerated, with minimal toxicity, subjectively improved survival time, and had the benefit of being completed in two consecutive days. © 2016 American College of Veterinary Radiology.

  13. Omental deposits surveillance in gynecological malignancies at first setting follow up: 18F-FDG PET/CT compared to CT

    OpenAIRE

    Tamer W. Kassem

    2017-01-01

    Objective: The aim of this study was to compare the diagnostic performance of positron emission tomography/computed tomography (PET/CT) scan and CT scan in follow up of proven gynecological malignancies omental deposits in first setting follow up after treatment. Patients and methods: 60 female patients having proven omental deposits from gynecological malignancies underwent PET/CT examination following a preset protocol as baseline study. 34 cases of them had a second PET/CT examination f...

  14. Golden Trail: Retrieving the Data History that Matters from a Comprehensive Provenance Repository

    Directory of Open Access Journals (Sweden)

    Paolo Missier

    2012-03-01

    Full Text Available Experimental science can be thought of as the exploration of a large research space, in search of a few valuable results. While it is this “Golden Data” that gets published, the history of the exploration is often as valuable to the scientists as some of its outcomes. We envision an e-research infrastructure that is capable of systematically and automatically recording such history – an assumption that holds today for a number of workflow management systems routinely used in e-science. In keeping with our gold rush metaphor, the provenance of a valuable result is a “Golden Trail”. Logically, this represents a detailed account of how the Golden Data was arrived at, and technically it is a sub-graph in the much larger graph of provenance traces that collectively tell the story of the entire research (or of some of it.In this paper we describe a model and architecture for a repository dedicated to storing provenance traces and selectively retrieving Golden Trails from it. As traces from multiple experiments over long periods of time are accommodated, the trails may be sub-graphs of one trace, or they may be the logical representation of a virtual experiment obtained by joining together traces that share common data.The project has been carried out within the Provenance Working Group of the Data Observation Network for Earth (DataONE NSF project. Ultimately, our longer-term plan is to integrate the provenance repository into the data preservation architecture currently being developed by DataONE.

  15. The studsvik BNCT project: structure and the proposed protocols

    International Nuclear Information System (INIS)

    Capala, J.; Stenstam, B.H.; Skoeld, K.; Henriksson, R.; Salford, L.; Carlsson, J.

    2000-01-01

    The BNCT facility at Studsvik is now ready for clinical trials. Scientific operations of the Studsvik BNCT project are overseen by the Scientific Advisory Board comprised of representatives of all major universities in Sweden. Furthermore, special task groups for clinical and preclinical studies have been formed to facilitate collaboration with academia and to assure the quality of the research. Proposed clinical Phase II trials for glioblastoma are sponsored by the Swedish National Neuro-Oncology Group and, initially, will involve two protocols: Protocol no.1. BNCT for glioblastoma patients who have not received any therapy other than surgery (including stereotactic biopsy only). Protocol no.2. BNCT as a palliative treatment for patients with recurrent glioblastoma following conventional therapies or BNCT. In both protocols, BPA, administered by a 6 hour i.v. infusion, will be used as the boron delivery agent. (author)

  16. Streamlining tasks and roles to expand treatment and care for HIV: randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    van Vuuren Cloete

    2008-04-01

    Full Text Available Abstract Background A major barrier to accessing free government-provided antiretroviral treatment (ART in South Africa is the shortage of suitably skilled health professionals. Current South African guidelines recommend that only doctors should prescribe ART, even though most primary care is provided by nurses. We have developed an effective method of educational outreach to primary care nurses in South Africa. Evidence is needed as to whether primary care nurses, with suitable training and managerial support, can initiate and continue to prescribe and monitor ART in the majority of ART-eligible adults. Methods/design This is a protocol for a pragmatic cluster randomised trial to evaluate the effectiveness of a complex intervention based on and supporting nurse-led antiretroviral treatment (ART for South African patients with HIV/AIDS, compared to current practice in which doctors are responsible for initiating ART and continuing prescribing. We will randomly allocate 31 primary care clinics in the Free State province to nurse-led or doctor-led ART. Two groups of patients aged 16 years and over will be included: a 7400 registering with the programme with CD4 counts of ≤ 350 cells/mL (mainly to evaluate treatment initiation and b 4900 already receiving ART (to evaluate ongoing treatment and monitoring. The primary outcomes will be time to death (in the first group and viral suppression (in the second group. Patients' survival, viral load and health status indicators will be measured at least 6-monthly for at least one year and up to 2 years, using an existing province-wide clinical database linked to the national death register. Trial registration Controlled Clinical Trials ISRCTN46836853

  17. Protocol Implementation Generator

    DEFF Research Database (Denmark)

    Carvalho Quaresma, Jose Nuno; Probst, Christian W.

    2010-01-01

    Users expect communication systems to guarantee, amongst others, privacy and integrity of their data. These can be ensured by using well-established protocols; the best protocol, however, is useless if not all parties involved in a communication have a correct implementation of the protocol and a...... Generator framework based on the LySatool and a translator from the LySa language into C or Java....... necessary tools. In this paper, we present the Protocol Implementation Generator (PiG), a framework that can be used to add protocol generation to protocol negotiation, or to easily share and implement new protocols throughout a network. PiG enables the sharing, verification, and translation...

  18. Variability in growth of Vachellia nilotica provenances tested in the Sudano-Sahelian zone of Niger

    DEFF Research Database (Denmark)

    Larwanou, Mahamane; Issa, Rabiou; Saadou, Mahamane

    2014-01-01

    A provenance trial of Vachellia nilotica (Acacia nilotica) was conducted in Niger in order to assess variability in growth among 10 provenances from Africa (subsp. adstringens from Niger, Senegal and Cameroun) and outside the continent (subsp. indica from Pakistan and Yemen). Tree height, diameter...... at breast height and crown diameter were measured 15 years after trial establishment. Comparison of blocks located at slightly different elevation showed that trees had better survival and growth at the lower sites. The African provenances had better survival and total basal area than provenances from Yemen...

  19. Features of Scots pine radial growth in conditions of provenance trial.

    Science.gov (United States)

    Kuzmin, Sergey; Kuzmina, Nina

    2013-04-01

    Provenance trial of Scots pine in Boguchany forestry of Krasnoyarsk krai is conducted on two different soils - dark-grey loam forest soil and sod-podzol sandy soil. Complex of negative factors for plant growth and development appears in dry conditions of sandy soil. It could results in decrease of resistance to diseases. Sandy soils in different climatic zones have such common traits as low absorbing capacity, poorness of elemental nutrition, low microbiological activity and moisture capacity, very high water permeability. But Scots pine trees growing in such conditions could have certain advantages and perspectives of use. In the scope of climate change (global warming) the study of Scots pine growth on sandy soil become urgent because of more frequent appearance of dry seasons. Purpose of the work is revelation of radial growth features of Scots pine with different origin in dry conditions of sandy soil and assessment of external factors influence. The main feature of radial growth of majority of studied pine provenances in conditions of sandy soil is presence of significant variation of increment with distinct decline in 25-years old with loss of tree rings in a number of cases. The reason of it is complex of factors: deficit of June precipitation and next following outbreak of fungal disease. Found «frost rings» for all trees of studied clymatypes in 1992 are the consequence of temperature decline from May 21 to June 2 - from 23 down to 2 degree Celsius. Perspective climatypes with biggest radial increments and least sensitivity to fungal disease were revealed. Eniseysk and Vikhorevka (from Krasnoyarsk krai and Irkutsk oblast)provenances of pine have the biggest radial increments, the least sensitivity to Cenangium dieback and smallest increments decline. These climatypes are in the group of perspective provenances and in present time they are recommended for wide trial in the region for future use in plantation forest growing. Kandalaksha (Murmansk oblast

  20. Comparison of two oestrus synchronisation protocols administered to dairy cows during routine reproduction services

    DEFF Research Database (Denmark)

    Viora, L; Denwood, M; Ellis, K

    2015-01-01

    Progesterone-based oestrus synchronisation protocols are frequently used for treatment of cows presented for examination during routine reproduction management service. This study aimed to evaluate the effect of the addition of gonadotrophin-releasing hormone (GnRH) at the start of a progesterone......-based oestrus synchronisation protocol for cows presented for examination during routine veterinary service on a commercial dairy farm over 10 months. Overall 139 animals were retained in the study, of which 78 received a standard progesterone-based treatment (STD) and 61 received the same treatment...

  1. The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, I. [Univ. of Sheffield, Dept. of Ophthalmology and Orthoptics (United Kingdom); Forster, D.; Kemeny, A. [Royal Hallamshire Hospital, Dept. of Neurosurgery (United Kingdom); Walton, L. [Royal Hallamshire Hospital, Dept. of Medical Physics (United Kingdom); Kunkler, I. [Weston Park Hospital, Dept. of Radiotherapy, Sheffield (United Kingdom)

    1996-11-01

    Fourteen patients with posterior uveal melanomas were treated using single fraction stereotactic radiosurgery. In each case a dose of 70 Gy was administered to the periphery of the tumour. Regression of the tumour has been observed in 13 patients, whilst the lesion has remained unchanged in one patient. The visual acuity has deteriorated in all 14 patients. Significant radiation induced adverse reactions were noted in 13 patients and include; retinopathy, optic neuropathy, rubeosis iridis, and secondary glaucoma. Two patients have required enucleation because of intractable rubeotic glaucoma. One patient has died from proven metastases. Although stereotactic radiosurgery appears to be a practical and effective method of treating uveal melanomas, its usefulness is limited by a high incidence of radiation induced adverse reactions. Further works is required to refine the current treatment protocol and establish an optimal prescription dose. (au) 30 refs.

  2. The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma

    International Nuclear Information System (INIS)

    Rennie, I.; Forster, D.; Kemeny, A.; Walton, L.; Kunkler, I.

    1996-01-01

    Fourteen patients with posterior uveal melanomas were treated using single fraction stereotactic radiosurgery. In each case a dose of 70 Gy was administered to the periphery of the tumour. Regression of the tumour has been observed in 13 patients, whilst the lesion has remained unchanged in one patient. The visual acuity has deteriorated in all 14 patients. Significant radiation induced adverse reactions were noted in 13 patients and include; retinopathy, optic neuropathy, rubeosis iridis, and secondary glaucoma. Two patients have required enucleation because of intractable rubeotic glaucoma. One patient has died from proven metastases. Although stereotactic radiosurgery appears to be a practical and effective method of treating uveal melanomas, its usefulness is limited by a high incidence of radiation induced adverse reactions. Further works is required to refine the current treatment protocol and establish an optimal prescription dose. (au) 30 refs

  3. Incipient archaeometry in Venezuela. Provenance study of pre-Hispanic pottery figurines

    International Nuclear Information System (INIS)

    Sajo Bohus, L.; Greaves, E.D.; Bermudez, J.; Mackowiak de Antczak, Ma. M.; Antczak, A.; Kasztovszky, Zs.; Poirier, T.; Simonits, A.

    2005-01-01

    Application of different analytical techniques contributed with new results to the interpretation and the provenance study of Venezuelan figurines dating from the 12th and 15th centuries. Elements in bulk samples, powdered samples of figurines and soil were determined using total reflection X-ray fluorescence (TXRF), instrumental neutron activation analysis (INAA) and prompt gamma activation analysis (PGAA). Results and ceramics macroscopic observations indicate that average elemental composition of the figurines from the mainland significantly differ from those encountered on the Caribbean islands. The multidisciplinary experience de facto formed a group dedicated to archaeometry and provided data for provenance study of pre-Hispanic pottery figurines. (author)

  4. Conventional radiotherapy treatments (direct planning) of head and neck with photon X10 planning system (cms) and Siemens Primus accelerator: proposed protocol planning, difficulties encountered, tricks practical and possible amendments to the class solution

    International Nuclear Information System (INIS)

    Saez, F.; Benito, M. A.; Saez, M.

    2011-01-01

    In this paper we propose a protocol for the systematic planning process for a planner and an Accelerator XiO Primus. This protocol includes the creation of ancillary volumes for better dosimetric evaluation and design fields. Are some practical tips and cases arise in which you can change the Class Solution home. We compare this treatment with 10 turns without turning table with other tables. Finally, we show the advantages of this method from the radiobiological point of view to the bone, the main body of this type of risk treatments.

  5. Cost savings using a protocol approach to manage anemia in a hemodialysis unit.

    Science.gov (United States)

    Charlesworth, Emily C; Richardson, Robert M; Battistella, Marisa

    2014-01-01

    National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.

  6. The Nagoya Protocol – Justice in the Making?- Comment

    Directory of Open Access Journals (Sweden)

    Doris Schroeder

    2013-09-01

    Full Text Available Ratification of the Nagoya Protocol seems to be a long drawn out process for many parties to the Convention on Biological Diversity, delaying the Protocol's entering into force. This short paper suggests that four innovative elements of the Protocol may require time-consuming consideration prior to implementation: the Global Multilateral Benefit-Sharing Mechanism and the encouragement of Transboundary Co-operation; the reference to human pathogens, the reference to food security and affordable access to treatments and finally the demand to accommodate customary laws of indigenous peoples. At the same time, these four elements are essential to achieving global justice in access and benefit sharing regulations and therefore highly welcome.

  7. Vertical Protocol Composition

    DEFF Research Database (Denmark)

    Groß, Thomas; Mödersheim, Sebastian Alexander

    2011-01-01

    The security of key exchange and secure channel protocols, such as TLS, has been studied intensively. However, only few works have considered what happens when the established keys are actually used—to run some protocol securely over the established “channel”. We call this a vertical protocol.......e., that the combination cannot introduce attacks that the individual protocols in isolation do not have. In this work, we prove a composability result in the symbolic model that allows for arbitrary vertical composition (including self-composition). It holds for protocols from any suite of channel and application...

  8. Seqüência de Robin: protocolo único de tratamento Robin sequence: a single treatment protocol

    Directory of Open Access Journals (Sweden)

    Ilza L. Marques

    2005-02-01

    Full Text Available OBJETIVO: Apresentar protocolo único que possa atender tanto às dificuldades respiratórias como às dificuldades alimentares dos neonatos e lactentes com seqüência de Robin. FONTE DE DADOS: O artigo foi desenvolvido tomando como base as publicações mais recentes disponíveis em bancos de dados bibliográficos e livros que discutem o tratamento da seqüência de Robin, em especial os estudos realizados no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP. SÍNTESE DE DADOS: O artigo apresenta os aspectos morfológicos e genéticos da seqüência de Robin e conceitos sobre nasofaringoscopia e suas implicações clínicas, discute o tratamento das dificuldades respiratórias e alimentares e apresenta um protocolo único para atender a todos os casos de seqüência de Robin, independentemente de sua gravidade e complexidade. CONCLUSÕES: A seqüência de Robin não é somente uma patologia obstrutiva anatômica para ser resolvida com procedimentos cirúrgicos, mas os conhecimentos sobre crescimento e desenvolvimento devem ser aplicados por uma equipe multidisciplinar, porque possibilitam a rápida recuperação da permeabilidade das vias aéreas e da capacidade de alimentação oral, evitando-se, muitas vezes, os procedimentos cirúrgicos e seus riscos, principalmente quando realizados em neonatos e lactentes pequenos.OBJECTIVE: To present a single protocol that might cover both the respiratory and feeding difficulties of neonates and infants with Robin sequence. SOURCES OF DATA: The article was prepared on the basis of the most recent publications available in bibliographic databases and in books that discuss the treatment of Robin sequence, especially the studies conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of Universidade de São Paulo (HRAC/USP. SUMMARY OF THE FINDINGS: We present the morphological and genetic aspects of Robin sequence and concepts about

  9. Improving pain treatment with a smartphone app: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Suso-Ribera, Carlos; Mesas, Ángela; Medel, Javier; Server, Anna; Márquez, Esther; Castilla, Diana; Zaragozá, Irene; García-Palacios, Azucena

    2018-02-27

    Chronic pain has become a major health problem across the world, especially in older adults. Unfortunately, the effectiveness of medical interventions is modest. Some have argued that assessment strategies should be improved if the impact of medical interventions is to be improved. Ecological momentary assessment using smartphones is now considered the gold standard in monitoring in health settings, including chronic pain. However, to the best of our knowledge, there is no randomized controlled trial to show that telemonitoring using a smartphone app can indeed improve the effectiveness of medical treatments in adults with chronic pain. The goal of this study will be to explore the effects of using a smartphone app for telemonitoring adults with chronic pain. The study will be a randomized controlled trial with three groups: treatment as usual (TAU), TAU+app, and TAU+app+alarms. All groups will receive the adequate treatment for their pain, which will be prescribed the first day of study according to clinical guidelines. Assessment in the TAU group will be the usual at the Pain Clinic, that is, a paper-and-pencil evaluation at the onset of treatment (beginning of study) and at follow up (end of study, 30 days later). The other two groups (TAU+app and TAU+app+alarms) will be assessed daily using Pain Monitor, a smartphone app developed by our multidisciplinary team. Telemonitoring will only be made in the TAU+app+alarms group. For this group, physicians at the Pain Clinic may decide to adjust pain treatment in response to alarms. Telemonitoring is not the usual practice at the Pain Clinic and will not occur in the other two groups (TAU and TAU+app), so no changes in treatment are expected in these groups after the first appointment. The total sample size will be 150, with 50 patients in each group. The assessment protocol will be the same in all groups and will include pain intensity and side effects of the medication (primary outcomes), together with several pain

  10. Who needs inpatient detox? Development and implementation of a hospitalist protocol for the evaluation of patients for alcohol detoxification.

    Science.gov (United States)

    Stephens, John R; Liles, E Allen; Dancel, Ria; Gilchrist, Michael; Kirsch, Jonathan; DeWalt, Darren A

    2014-04-01

    Clinicians caring for patients seeking alcohol detoxification face many challenges, including lack of evidence-based guidelines for treatment and high recidivism rates. To develop a standardized protocol for determining which alcohol dependent patients seeking detoxification need inpatient versus outpatient treatment, and to study the protocol's implementation. Review of best evidence by ad hoc task force and subsequent creation of standardized protocol. Prospective observational evaluation of initial protocol implementation. Patients presenting for alcohol detoxification. Development and implementation of a protocol for evaluation and treatment of patients requesting alcohol detoxification. Number of admissions per month with primary alcohol related diagnosis (DRG), 30-day readmission rate, and length of stay, all measured before and after protocol implementation. We identified one randomized clinical trial and three cohort studies to inform the choice of inpatient versus outpatient detoxification, along with one prior protocol in this population, and combined that data with clinical experience to create an institutional protocol. After implementation, the average number of alcohol related admissions was 15.9 per month, compared with 18.9 per month before implementation (p = 0.037). There was no difference in readmission rate or length of stay. Creation and utilization of a protocol led to standardization of care for patients requesting detoxification from alcohol. Initial evaluation of protocol implementation showed a decrease in number of admissions.

  11. Growth and quality of Grevillea robusta provenances in Ruhande ...

    African Journals Online (AJOL)

    user

    seven Queensland (Australia) provenances and one land race on an oxisol at Ruhande Arboretum,. Butare, Rwanda was carried out. The species is .... could not be executed due to problems of war and genocide in 1994. Assessment procedures ..... Forest Ecology and Management 80: 279-285. 10. Kalinganire, A. 1999.

  12. Facilitating Fine Grained Data Provenance using Temporal Data Model

    NARCIS (Netherlands)

    Huq, M.R.; Wombacher, Andreas; Apers, Peter M.G.

    2010-01-01

    E-science applications use fine grained data provenance to maintain the reproducibility of scientific results, i.e., for each processed data tuple, the source data used to process the tuple as well as the used approach is documented. Since most of the e-science applications perform on-line

  13. The use of equine chorionic gonadotropin in the treatment of anestrous dairy cows in gonadotropin-releasing hormone/progesterone protocols of 6 or 7 days.

    Science.gov (United States)

    Bryan, M A; Bó, G; Mapletoft, R J; Emslie, F R

    2013-01-01

    In seasonally calving, pasture-based dairy farm systems, the interval from calving to first estrus is a critical factor affecting reproductive efficiency. This study evaluated the effects of equine chorionic gonadotropin (eCG) on the reproductive response of lactating, seasonally calving dairy cows diagnosed with anovulatory anestrus by rectal palpation. Cows on 15 commercial dairy farms were selected for initial inclusion based on nonobserved estrus by 7 d before the planned start of mating. All cows were palpated rectally and evaluated for body condition score and ovary score, and were included for treatment according to the trial protocol if diagnosed with anovulatory anestrus. All cows received a standard anestrous treatment protocol consisting of insertion of a progesterone device, injection of 100 µg of GnRH at the time of device insertion, and injection of PGF(2α) at device removal (GPG/P4). Cows were randomly assigned to 1 of 2 groups (6 d or 7 d) for duration of progesterone device insertion. Within each of these groups, cows were further randomly assigned to receive either 400 IU of eCG at device removal or to remain untreated as controls, resulting in a 2×2 arrangement of treatment groups: (1) 6-d device and no eCG (n=484); (2) 6-d device and eCG (n=462); (3) 7-d device and no eCG (n=546); and (4) 7-d device and eCG (n=499). Cows were detected for estrus from the time of progesterone device removal and were inseminated; those not detected in estrus within 60 h after progesterone device removal received 100 µg of GnRH and were inseminated at 72 h. The primary outcomes considered were proportion of cows conceiving within 7 d of the beginning of breeding (7-d conception rate; 7-d CR), proportion pregnant within 28 d (28-d in calf rate; 28-d ICR), and days to conception (DTC). We found no significant differences between the 6- and 7-d insertion periods and found no 6- or 7-d insertion period × eCG treatment interactions. Inclusion of eCG into either

  14. Pregnancy outcome of “delayed start” GnRH antagonist protocol versus GnRH antagonist protocol in poor responders: A clinical trial study

    Directory of Open Access Journals (Sweden)

    Abbas Aflatoonian

    2017-08-01

    Full Text Available Background: Management of poor-responding patients is still major challenge in assisted reproductive techniques (ART. Delayed-start GnRH antagonist protocol is recommended to these patients, but little is known in this regards. Objective: The goal of this study was assessment of delayed-start GnRH antagonist protocol in poor responders, and in vitro fertilization (IVF outcomes. Materials and Methods: This randomized clinical trial included sixty infertile women with Bologna criteria for ovarian poor responders who were candidate for IVF. In case group (n=30, delayed-start GnRH antagonist protocol administered estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation with gonadotropin. Control group (n=30 treated with estrogen priming antagonist protocol. Finally, endometrial thickness, the rates of oocytes maturation, , embryo formation, and pregnancy were compared between two groups. Results: Rates of implantation, chemical, clinical, and ongoing pregnancy in delayed-start cycles were higher although was not statistically significant. Endometrial thickness was significantly higher in case group. There were no statistically significant differences in the rates of oocyte maturation, embryo formation, and IVF outcomes between two groups. Conclusion: There is no significant difference between delayed-start GnRH antagonist protocol versus GnRH antagonist protocol.

  15. Use of laser induced breakdown spectroscopy in the determination of gem provenance: beryls

    International Nuclear Information System (INIS)

    McManus, Catherine E.; McMillan, Nancy J.; Harmon, Russell S.; Whitmore, Robert C.; De Lucia, Frank C. Jr.; Miziolek, Andrzej W.

    2008-01-01

    The provenance of gem stones has been of interest to geologists, gemologists, archeologists, and historians for centuries. Laser induced breakdown spectroscopy (LIBS) provides a minimally destructive tool for recording the rich chemical signatures of gem beryls (aquamarine, goshenite, heliodor, and morganite). Broadband LIBS spectra of 39 beryl (Be3Al2Si6O18) specimens from 11 pegmatite mines in New Hampshire, Connecticut, and Maine (USA) are used to assess the potential of using principal component analysis of LIBS spectra to determine specimen provenance. Using this technique, beryls from the three beryl-bearing zones in the Palermo no. 1 pegmatite (New Hampshire) can be recognized. However, the compositional variation within this single mine is comparable to that in beryls from all three states. Thus, a very large database with detailed location metadata will be required to routinely determine gem beryl provenance

  16. High performance biological process for waste water treatment proven in operation

    International Nuclear Information System (INIS)

    Timm, C.; Wienands, H.; Brauch, G.; Schlaeger, M.

    1993-01-01

    A BIOMEMBRAT plant has been in operation for over one year at the Thor Chemie GmbH facility at Speyer, Germany. The process is particularly suitable for waste water with a high organic content and with degradation-resistant components or high nitrogen contents. This article presents the operating results obtained so far with the waste water treatment plant and the operator's experience. (orig.) [de

  17. Clinical profile, treatment and survival outcomes of peadiatric germ cell tumours: A Pakistani perspective.

    Science.gov (United States)

    Islam Nasir, Irfan Ul; Ashraf, Muhammad Ijaz; Ahmed, Nouman; Shah, Muhammad Fahd; Pirzada, Muhammad Taqi; Syed, Amir Ali; Qazi, Abid Quddus

    2016-10-01

    Germ Cell Tumours (GCTs) are rare tumours. Generally 80% are benign and 20% malignant with a bimodal age distribution. The retrospective study was conducted at Shaukat Khanum Cancer Hospital, Lahore, Pakistan, and comprised all paediatric patients below 18 years of age who received treatment for histology-proven GCT from 2006 to 2014. Of the 207 patients, 98(42.3%) were males and 109(52.7%) were females. The most common GCT was yolk sac tumour in 90(43.5%) children followed by mixed GCT in 40(19.3%) and dysgerminoma in 34(16.4%). Gonads were most commonly involved in 165(79.7%) patients with metastasis in 24(11.6%) at presentation and recurrence in 26(12.5%) patients. Overall, 133(64.3%) patients are well and followed up at regular intervals and 55(26.5%) have been lost to follow-up with an expected overall 5-year median survival of 45%. Despite the distinct clinical profile of paediatric GCT, survival can be improved by early diagnosis, regimented treatment according to set guidelines, protocols and by improving follow-up.

  18. Pharmacists' Perception of the Sale of Non-Clinically Proven Health ...

    African Journals Online (AJOL)

    HP

    Proven Health Supplements in Penang, Malaysia. Mohamed A Hassali. 1 ... Conclusions: Pharmacists who participated in the study have mixed opinions on the efficacy ... acceptance amongst the general public in many parts of the world in ...

  19. Combining User Reputation and Provenance Analysis for Trust Assessment

    NARCIS (Netherlands)

    Ceolin, D.; Groth, P.T.; Maccatrozzo, V.; Fokkink, W.J.; van Hage, W.R.; Nottamkandath, A.

    2016-01-01

    Trust is a broad concept that in many systems is often reduced to user reputation alone. However, user reputation is just one way to determine trust. The estimation of trust can be tackled from other perspectives as well, including by looking at provenance. Here, we present a complete pipeline for

  20. High prevalence of complementary and alternative medicine use in patients with genetically proven mitochondrial disorders.

    Science.gov (United States)

    Franik, Sebastian; Huidekoper, Hidde H; Visser, Gepke; de Vries, Maaike; de Boer, Lonneke; Hermans-Peters, Marion; Rodenburg, Richard; Verhaak, Chris; Vlieger, Arine M; Smeitink, Jan A M; Janssen, Mirian C H; Wortmann, Saskia B

    2015-05-01

    Despite major advances in understanding the pathophysiology of mitochondrial diseases, clinical management of these conditions remains largely supportive, and no effective treatment is available. We therefore assumed that the burden of disease combined with the lack of adequate treatment leaves open a big market for complementary and alternative medicine use. The objective of this study was to evaluate the use and perceived effectiveness of complementary and alternative medicine in children and adults with genetically proven mitochondrial disease. The reported use was surprisingly high, with 88% of children and 91% of adults having used some kind of complementary and alternative medicine in the last 2 years. Also, the mean cost of these treatments was impressive, being 489/year for children and 359/year for adult patients. Over-the-counter remedies (e.g., food supplements, homeopathy) and self-help techniques (e.g., Reiki, yoga) were the most frequently used complementary and alternative therapies in our cohort: 54% of children and 60% of adults reported the various complementary and alternative medicine therapies to be effective. Given the fact that currently no effective treatment exists, further research toward the different therapies is needed, as our study clearly demonstrates that such therapies are highly sought after by affected patients.

  1. Comparison of two neonatal indomethacin protocols: efficacy and outcome for patent ductus arteriosus closure.

    Science.gov (United States)

    Rosito, G; Sum, K; Chorne, N

    2010-10-01

    Indomethacin, a non-selective inhibitor of prostaglandin synthesis, is the gold standard treatment for patent ductus arteriosus (PDA). Indomethacin has been shown to permanently close the ductus and when given prophylactically, it reduces the incidence of PDA (1, 2). This study compares PDA closure and surgical ligation rates between patients using two different indomethacin administration protocols. This is a retrospective comparison analysis of 72 neonates, who received one of two indomethacin administration protocols. Our previous protocol suggested an initial dose of 0·2 mg/kg followed by two 0·1 mg/kg, with doses infused over 4 h and a 24-h dosing interval. A new potentially more useful protocol using the same mg/kg dose regimen but with doses infused over 30 min and a 12-h dosing interval, was evaluated. Each neonate was allowed three courses of treatment before surgical ligation was performed for persistent PDA. There were no statistically significant differences between the two protocol groups when comparing percentages of neonates with gestational age≤28 weeks, birth weight≤1000 g, male gender or receiving indomethacin for the indication of PDA prophylaxis vs. treatment. There was a trend towards a higher PDA closure rate and subsequently a lower PDA ligation rate in the new protocol when compared with the previous protocol. In this small population of premature neonates, there was a trend, but no significant difference, towards increasing PDA closure and lower surgical ligation rates in neonates given indomethacin with more frequent dosing and shorter infusion time. A well-powered randomized controlled trial is now needed. Copyright © 2010 The Authors. JCPT © 2010 Blackwell Publishing Ltd.

  2. A Structured Review and Classification of Demolding Issues and Proven Solutions

    DEFF Research Database (Denmark)

    Delaney, K. D.; Bissacco, G.; Kennedy, D.

    2012-01-01

    The demolding of replicated parts can result in damage to both the replication tooling and finished parts and is a particular problem for the replication of smaller parts which can be quite fragile. Various techniques have been proposed in the literature to solve such problems by reducing....... Such a rationalization of existing knowledge will enable replication tool developers to systematically select and apply proven solutions to solve, and ultimately prevent, demolding problems....... the overall demolding force. This paper presents the challenge of demolding replicated parts and reviews the proven solutions from the literature which have been developed. A summary chart of these solutions is presented which may be used to implement plans to solve demolding problems with replicated parts...

  3. Chronic care treatment of obese children and adolescents

    DEFF Research Database (Denmark)

    Holm, Jens-Christian; Gamborg, Michael; Bille, Dorthe S

    2011-01-01

    Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity.......Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity....

  4. Provenance and recycling of Arabian desert sand

    Science.gov (United States)

    Garzanti, Eduardo; Vermeesch, Pieter; Andò, Sergio; Vezzoli, Giovanni; Valagussa, Manuel; Allen, Kate; Kadi, Khalid A.; Al-Juboury, Ali I. A.

    2013-05-01

    This study seeks to determine the ultimate origin of aeolian sand in Arabian deserts by high-resolution petrographic and heavy-mineral techniques combined with zircon U-Pb geochronology. Point-counting is used here as the sole method by which unbiased volume percentages of heavy minerals can be obtained. A comprehensive analysis of river and wadi sands from the Red Sea to the Bitlis-Zagros orogen allowed us to characterize all potential sediment sources, and thus to quantitatively constrain provenance of Arabian dune fields. Two main types of aeolian sand can be distinguished. Quartzose sands with very poor heavy-mineral suites including zircon occupy most of the region comprising the Great Nafud and Rub' al-Khali Sand Seas, and are largely recycled from thick Lower Palaeozoic quartzarenites with very minor first-cycle contributions from Precambrian basement, Mesozoic carbonate rocks, or Neogene basalts. Instead, carbonaticlastic sands with richer lithic and heavy-mineral populations characterize coastal dunes bordering the Arabian Gulf from the Jafurah Sand Sea of Saudi Arabia to the United Arab Emirates. The similarity with detritus carried by the axial Tigris-Euphrates system and by transverse rivers draining carbonate rocks of the Zagros indicates that Arabian coastal dunes largely consist of far-travelled sand, deposited on the exposed floor of the Gulf during Pleistocene lowstands and blown inland by dominant Shamal northerly winds. A dataset of detrital zircon U-Pb ages measured on twelve dune samples and two Lower Palaeozoic sandstones yielded fourteen identical age spectra. The age distributions all show a major Neoproterozoic peak corresponding to the Pan-African magmatic and tectonic events by which the Arabian Shield was assembled, with minor late Palaeoproterozoic and Neoarchean peaks. A similar U-Pb signature characterizes also Jafurah dune sands, suggesting that zircons are dominantly derived from interior Arabia, possibly deflated from the Wadi al

  5. MRI of pathology-proven peripheral nerve amyloidosis

    International Nuclear Information System (INIS)

    McKenzie, Gavin A.; Broski, Stephen M.; Howe, Benjamin M.; Spinner, Robert J.; Amrami, Kimberly K.; Dispenzieri, Angela; Ringler, Michael D.

    2017-01-01

    To highlight the MRI characteristics of pathologically proven amyloidosis involving the peripheral nervous system (PNS) and determine the utility of MRI in directing targeted biopsy for aiding diagnosis. A retrospective study was performed for patients with pathologically proven PNS amyloidosis who also underwent MRI of the biopsied or excised nerve. MRI signal characteristics, nerve morphology, associated muscular denervation changes, and the presence of multifocal involvement were detailed. Pathology reports were reviewed to determine subtypes of amyloid. Charts were reviewed to gather patient demographics, neurological symptoms and radiologist interpretation. Four men and three women with a mean age of 62 ± 11 years (range 46-76) were identified. All patients had abnormal findings on EMG with mixed sensorimotor neuropathy. All lesions demonstrated diffuse multifocal neural involvement with T1 hypointensity, T2 hyperintensity, and variable enhancement on MRI. One lesion exhibited superimposed T2 hypointensity. Six of seven patients demonstrated associated muscular denervation changes. Peripheral nerve amyloidosis is rare, and the diagnosis is difficult because of insidious symptom onset, mixed sensorimotor neurologic deficits, and the potential for a wide variety of nerves affected. On MRI, peripheral nerve involvement is most commonly characterized by T1 hypointensity, T2 hyperintensity, variable enhancement, maintenance of the fascicular architecture with fusiform enlargement, multifocal involvement and muscular denervation changes. While this appearance mimics other inflammatory neuropathies, MRI can readily detect neural changes and direct-targeted biopsy, thus facilitating early diagnosis and appropriate management. (orig.)

  6. MRI of pathology-proven peripheral nerve amyloidosis

    Energy Technology Data Exchange (ETDEWEB)

    McKenzie, Gavin A.; Broski, Stephen M.; Howe, Benjamin M.; Spinner, Robert J.; Amrami, Kimberly K.; Dispenzieri, Angela; Ringler, Michael D. [Mayo Clinic, Department of Musculoskeletal Radiology, Rochester, MN (United States)

    2017-01-15

    To highlight the MRI characteristics of pathologically proven amyloidosis involving the peripheral nervous system (PNS) and determine the utility of MRI in directing targeted biopsy for aiding diagnosis. A retrospective study was performed for patients with pathologically proven PNS amyloidosis who also underwent MRI of the biopsied or excised nerve. MRI signal characteristics, nerve morphology, associated muscular denervation changes, and the presence of multifocal involvement were detailed. Pathology reports were reviewed to determine subtypes of amyloid. Charts were reviewed to gather patient demographics, neurological symptoms and radiologist interpretation. Four men and three women with a mean age of 62 ± 11 years (range 46-76) were identified. All patients had abnormal findings on EMG with mixed sensorimotor neuropathy. All lesions demonstrated diffuse multifocal neural involvement with T1 hypointensity, T2 hyperintensity, and variable enhancement on MRI. One lesion exhibited superimposed T2 hypointensity. Six of seven patients demonstrated associated muscular denervation changes. Peripheral nerve amyloidosis is rare, and the diagnosis is difficult because of insidious symptom onset, mixed sensorimotor neurologic deficits, and the potential for a wide variety of nerves affected. On MRI, peripheral nerve involvement is most commonly characterized by T1 hypointensity, T2 hyperintensity, variable enhancement, maintenance of the fascicular architecture with fusiform enlargement, multifocal involvement and muscular denervation changes. While this appearance mimics other inflammatory neuropathies, MRI can readily detect neural changes and direct-targeted biopsy, thus facilitating early diagnosis and appropriate management. (orig.)

  7. [A security protocol for the exchange of personal medical data via Internet: monitoring treatment and drug effects].

    Science.gov (United States)

    Viviani, R; Fischer, J; Spitzer, M; Freudenmann, R W

    2004-04-01

    We present a security protocol for the exchange of medical data via the Internet, based on the type/domain model. We discuss two applications of the protocol: in a system for the exchange of data for quality assurance, and in an on-line database of adverse reactions to drug use. We state that a type/domain security protocol can successfully comply with the complex requirements for data privacy and accessibility typical of such applications.

  8. Biometric characters of seeds and wings as markers of geographical differentiation between European scots pine (Pinus sylvestris L. provenances

    Directory of Open Access Journals (Sweden)

    Lech Urbaniak

    2014-01-01

    Full Text Available Biometric characters of seeds and wings served to describe interprovenance differentiation of Scots pine in Europe. Grouping analysis was applied, Mahalanobis distances were calculated as well as Hotellings T2 statistics were applied. The similarity of East European and Finnish provenances was conspicuous. The provenance from Scotland proved to be similar to provenances originating from the region of Scandinavia. On the other hand, two southern provenances 54(Rychtal, Poland and 55(Luboml, Ukraine, were also found similar to provenances originating from the region of Scandinavia (western Norway. The obtained pattern of reciprocal relations may indicate pathways of Scots pine migration in the postglacial period or may be a result of adaptation to certain similar environmental conditions. No relations were detected between size of seeds and geographic origin of provenances.

  9. Primary care management for optimized antithrombotic treatment [PICANT]: study protocol for a cluster-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Siebenhofer Andrea

    2012-08-01

    . Recruitment of eligible patients will start in July 2012. Assessment will occur at three time points: baseline and follow-up after 12 months and after 24 months. Discussion The efficacy and effectiveness of individual elements of the intervention, such as antithrombotic interventions, self-management concepts in orally anticoagulated patients, and the methodological tool of case management, have already been extensively demonstrated. This project foresees the combination of several proven instruments, as a result of which we expect to profit from a reduction in the major complications associated with antithrombotic treatment. Trial registration Current Controlled Trials ISRCTN41847489

  10. An investigation into current protocols and radiographer opinions on contrast extravasation in Irish CT departments

    International Nuclear Information System (INIS)

    Cleary, N.; McNulty, J.P.; Foley, S.J.; Kelly, E.

    2017-01-01

    Background: Iodinated contrast extravasation is a serious complication associated with intravenous administration in radiology. Departmental protocols and the radiographer's approach on both prevention techniques and treatment will affect the prevalence of extravasation, and the eventual outcome for the patient when it does occur. Aims: To examine contrast extravasation protocols in place in Irish CT departments for alignment with European Society of Urogenital Radiology (ESUR) Guidelines (2014); to establish radiographer's opinions on contrast extravasation; and to examine radiographer adherence to protocols. Methods: Contrast extravasation protocols from a purposively selected sample of CT departments across Ireland (n = 6) were compared to ESUR guidelines, followed by an online survey of CT radiographers practicing in the participating centres. Results: All participating CT departments (n = 5) had written protocols in place. High risk patients, such as elderly or unconscious, were identified in most protocols, however, children were mentioned in just one protocol and obese patients were not specified in any. The response rate of CT radiographers was 23% (n = 24). 58% (n = 14) of respondents indicated that contrast extravasation was more likely during CTA examinations. While high levels of confidence in managing extravasation were reported, suggested treatment approaches, and confidence in same, was more variable. Clinical workload in CT departments was also identified as a factor impacting on patient care and management. Conclusion: While contrast extravasation protocols were generally in line with ESUR Guidelines, high risk patients may not be getting sufficient attention. More radiographer awareness of patient monitoring needs, particularly in busy departments with a heavy workload may also reduce extravasation risk, and improve management of same. - Highlights: • Irish protocols on contrast extravasation are generally in line with

  11. Neurofeedback as a nonpharmacological treatment for adults with attention-deficit/hyperactivity disorder (ADHD): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Mayer, Kerstin; Wyckoff, Sarah Nicole; Fallgatter, Andreas J; Ehlis, Ann-Christine; Strehl, Ute

    2015-04-18

    Neurofeedback has been applied effectively in various areas, especially in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). This study protocol is designed to investigate the effect of slow cortical potential (SCP) feedback and a new form of neurofeedback using near-infrared spectroscopy (NIRS) on symptomatology and neurophysiological parameters in an adult ADHD population. A comparison of SCP and NIRS feedback therapy methods has not been previously conducted and may yield valuable findings about alternative treatments for adult ADHD. The outcome of both neurofeedback techniques will be assessed over 30 treatment sessions and after a 6-month follow-up period, and then will be compared to a nonspecific biofeedback treatment. Furthermore, to investigate if treatment effects in this proof-of-principle study can be predicted by specific neurophysiological baseline parameters, regression models will be applied. Finally, a comparison with healthy controls will be conducted to evaluate deviant pretraining neurophysiological parameters, stability of assessment measures, and treatment outcome. To date, an investigation and comparison of SCP and NIRS feedback training to an active control has not been conducted; therefore, we hope to gain valuable insights in effects and differences of these types of treatment for ADHD in adults. This study is registered with the German Registry of Clinical Trials: DRKS00006767 , date of registration: 8 October 2014.

  12. Efficacy of intermittent Theta Burst Stimulation (iTBS) and 10-Hz high-frequency repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant unipolar depression: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bulteau, Samuel; Sébille, Veronique; Fayet, Guillemette; Thomas-Ollivier, Veronique; Deschamps, Thibault; Bonnin-Rivalland, Annabelle; Laforgue, Edouard; Pichot, Anne; Valrivière, Pierre; Auffray-Calvier, Elisabeth; Fortin, June; Péréon, Yann; Vanelle, Jean-Marie; Sauvaget, Anne

    2017-01-13

    The treatment of depression remains a challenge since at least 40% of patients do not respond to initial antidepressant therapy and 20% present chronic symptoms (more than 2 years despite standard treatment administered correctly). Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant therapy but still not ideal. Intermittent Theta Burst Stimulation (iTBS), which has only been used recently in clinical practice, could have a faster and more intense effect compared to conventional protocols, including 10-Hz high-frequency rTMS (HF-rTMS). However, no controlled study has so far highlighted the superiority of iTBS in resistant unipolar depression. This paper focuses on the design of a randomised, controlled, double-blind, single-centre study with two parallel arms, carried out in France, in an attempt to assess the efficacy of an iTBS protocol versus a standard HF- rTMS protocol. Sixty patients aged between 18 and 75 years of age will be enrolled. They must be diagnosed with major depressive disorder persisting despite treatment with two antidepressants at an effective dose over a period of 6 weeks during the current episode. The study will consist of two phases: a treatment phase comprising 20 sessions of rTMS to the left dorsolateral prefrontal cortex, localised via a neuronavigation system and a 6-month longitudinal follow-up. The primary endpoint will be the number of responders per group, defined by a decrease of at least 50% in the initial score on the Montgomery and Asberg Rating Scale (MADRS) at the end of rTMS sessions. The secondary endpoints will be: response rate 1 month after rTMS sessions; number of remissions defined by a MADRS score of iTBS superiority in the management of unipolar depression and we will discuss its effect over time. In case of a significant increase in the number of therapeutic responses with a prolonged effect, the iTBS protocol could be considered a first-line protocol in resistant unipolar depression

  13. Treatment for TMD with occlusal splint and electromyographic control: application of the FARC protocol in a Brazilian population.

    Science.gov (United States)

    Vieira e Silva, Carolina A; da Silva, Marco Antônio M Rodrigues; Melchior, Melissa de Oliveira; de Felício, Cláudia Maria; Sforza, Chiarella; Tartaglia, Gianluca M

    2012-07-01

    The purpose of this study was to apply Functional Anatomy Research Center (FARC) Protocol of TMD treatment, which includes the use of a specific type of mandibular occlusal splint, adjusted based on the electromyographic index, in a group of 15 patients with disc displacement, classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then analyzing the results compared with the control group. The clinical evaluations were completed both before and after the treatment. Electromyographic (EMG) data was collected and recorded on the day the splint was inserted (visit 1), after one week (visit 2) and after five weeks of treatment (visit 3). The control group consisted of 15 asymptomatic subjects, according to the same diagnostic criteria (RDC/TMD), who were submitted to the same evaluations with the same interval periods as the treatment group. Immediately after splint adjustment, masseter muscle symmetry and total muscular activity were significantly different with than without the splint (p < 0.05), showing an increased neuromuscular coordination. After treatment, significant variations (p < .05) were found in mouth opening and in pain remission. There were no significant differences among the three sessions, either with or without the splint. There were significant differences between the TMD and control groups for all analyzed indices of muscular symmetry, activity and torque, with the exception of total muscular activity. The use of the splint promoted balance of the EMG activities during its use, relieving symptoms. EMG parameters identified neuromuscular imbalance, and allowed an objective analysis of different phases of TMD treatment, differentiating individuals with TMD from the asymptomatic subjects.

  14. [Comparison of the present and previously used protocol of risk stratification in children with acute lymphoblastic leukemia].

    Science.gov (United States)

    Glodkowska, Eliza; Bialas, Agnieszka; Jackowska, Teresa

    2007-01-01

    Acute lymphoblastic leukaemia (ALL) is one of the most common cancers in children. In Poland, since November 2002 a new protocol of risk stratification has been recommended for assessment of risk factors and for choosing therapy regimens. assessment of accuracy of protocol ALL-IC 2002 in comparison to previously used risk stratification protocols. ALL was diagnosed in 100 children (44 girls, 56 boys; 1-18 years of age) in the Department of Pediatric Hematology and Oncology, Warsaw Medical University, over the period from November 2002 to November 2006. According to the ALL-IC 2002 protocol the patients were divided into three risk groups: SR-standard, IR-intermediate and HR-high. The stratification was by age, leukocyte count, cytogenetic changes, early response to prednisone therapy and bone marrow remission. In the previously used risk stratification protocols-BFM-90, only hepatosplenomegaly and the number of blasts in peripheral blood (PB) were considered, and the patients were divided into three risk groups: low (LRG1.2). out of the 100 patients qualified for treatment regimens according to the ALL-IC 2002 protocol, 97 entered remission, 11 died and 3 had a relapse. Under the ALL-IC 2002 protocol these children were stratified into the following groups: SR-31%, IR-44% and HR-25%. In the previously used stratification, there would be 26% children in low, 46% in the medium and 28% in the high risk group. According to the BFM-90 protocol 18/31 (58%) and 16/44 (36%) patients from the SR and IR groups respectively would be given more intensive treatment. On the other hand 11/44 (25%) and 14/25 (56%) patients from the IR and HR groups respectively would be given less intensive treatment. 1. ALL-IC 2002 protocol in comparison with the previously used protocol BFM-90, changes the qualification of children with ALL for the SR, IR and HR risk groups. This is linked to basic change of treatment protocol, adequate to severity of disease. 2. Children with ALL qualified

  15. Dry needling in a manual physiotherapy and therapeutic exercise protocol for patients with chronic mechanical shoulder pain of unspecific origin: a protocol for a randomized control trial.

    Science.gov (United States)

    Tejera-Falcón, Emma; Toledo-Martel, Nuria Del Carmen; Sosa-Medina, Francisco Manuel; Santana-González, Fátima; Quintana-de la Fe, Miriam Del Pino; Gallego-Izquierdo, Tomás; Pecos-Martín, Daniel

    2017-09-18

    Shoulder pain of musculoskeletal origin is the main cause of upper limb pain of non-traumatic origin. Despite being one of the most common reasons for consultation, there is no established protocol for treatment due to the complexity of its etiology. However, it has been shown that the presence of myofascial trigger points on the shoulder muscles is a common condition associated with patients suffering from shoulder pain. This protocol has been created which describes the design of a randomized controlled trial to evaluate the effectiveness of the inclusion of dry needling (DN) within a protocol of manual physiotherapy and therapeutic exercise in the treatment of chronic shoulder pain of unspecific origin. Thirty-six participants aged 18-65 years will be recruited having mechanical chronic shoulder pain on unspecific origin and meeting the inclusion criteria. These will be randomized to one of two interventions, (i) DN, manual physiotherapy and therapeutic exercise or (ii) sham DN, manual physiotherapy and therapeutic exercise. The protocol will cover 6 weeks of treatment, with a 6-month follow-up. Our main outcome measure will be the Visual Analogue Scale for pain. This is the first study to combine the use of DN, manual physiotherapy and an exercise program with a 6-month follow-up, thus becoming a new contribution to the treatment of chronic shoulder pain, while new lines of research may be established to help determine the effects of DN on chronic shoulder pain and the frequency and proper dosage. International Standard Randomized Controlled Trial Number Register: ISRCTN30604244 ( http://www.controlled-trials.com ) 29 June 2016.

  16. Multivariate analysis in provenance studies: Cerrillos obsidians case, Peru

    International Nuclear Information System (INIS)

    Bustamante, A.; Delgado, M.; Latini, R. M.; Bellido, A. V. B.

    2007-01-01

    We present the preliminary results of a provenance study of obsidians samples from Cerrillos (ca. 800-100 b.c.) using Moessbauer Spectroscopy. The Cerrillos archaeological site, located in the Upper Ica Valley, Peru, is the only Paracas ceremonial center excavated so far. The archaeological data collected suggest the existence of a complex social and economic organization on the south coast of Peru. Provenance research of obsidian provides valuable information about the selection of lithic resources by our ancestors and eventually about the existence of communication routes and exchange networks. We characterized 18 obsidian artifacts samples by Moessbauer spectroscopy from Cerrillos. The spectra, recorded at room temperature using different velocities, are mainly composed of broad asymmetric doublets due to the superposition of at least two quadrupole doublets corresponding to Fe 2+ in two different sites (species A and B), one weak Fe 3+ doublet (specie C) and magnetic components associated to the presence of small particles of magnetite. Multivariate statistical analysis of the Moessbauer data (hyperfine parameters) allows to defined two main groups of obsidians, reflecting different geographical origins.

  17. Multivariate analysis in provenance studies: Cerrillos obsidians case, Peru

    Science.gov (United States)

    Bustamante, A.; Delgado, M.; Latini, R. M.; Bellido, A. V. B.

    2007-02-01

    We present the preliminary results of a provenance study of obsidians samples from Cerrillos (ca. 800 100 b.c.) using Mössbauer Spectroscopy. The Cerrillos archaeological site, located in the Upper Ica Valley, Peru, is the only Paracas ceremonial center excavated so far. The archaeological data collected suggest the existence of a complex social and economic organization on the south coast of Peru. Provenance research of obsidian provides valuable information about the selection of lithic resources by our ancestors and eventually about the existence of communication routes and exchange networks. We characterized 18 obsidian artifacts samples by Mössbauer spectroscopy from Cerrillos. The spectra, recorded at room temperature using different velocities, are mainly composed of broad asymmetric doublets due to the superposition of at least two quadrupole doublets corresponding to Fe2+ in two different sites (species A and B), one weak Fe3+ doublet (specie C) and magnetic components associated to the presence of small particles of magnetite. Multivariate statistical analysis of the Mössbauer data (hyperfine parameters) allows to defined two main groups of obsidians, reflecting different geographical origins.

  18. Lapis lazuli provenance study by means of micro-PIXE

    Energy Technology Data Exchange (ETDEWEB)

    Re, Alessandro, E-mail: alessandro.re@to.infn.it [Dipartimento di Fisica Sperimentale, Universita di Torino, Via Giuria 1, 10125 Torino (Italy); INFN Sezione di Torino and Centre of Excellence ' Nanostructured Interfaces and Surfaces' , Universita di Torino, Via P. Giuria 1, 10125 Torino (Italy); Giudice, Alessandro Lo [Dipartimento di Fisica Sperimentale, Universita di Torino, Via Giuria 1, 10125 Torino (Italy); INFN Sezione di Torino and Centre of Excellence ' Nanostructured Interfaces and Surfaces' , Universita di Torino, Via P. Giuria 1, 10125 Torino (Italy); Angelici, Debora [Dipartimento di Fisica Sperimentale, Universita di Torino, Via Giuria 1, 10125 Torino (Italy); Calusi, Silvia; Giuntini, Lorenzo; Massi, Mirko [Dipartimento di Fisica, Universita and INFN Sezione di Firenze, Via Sansone 1, 50019 Sesto Fiorentino, Firenze (Italy); Pratesi, Giovanni [Dipartimento di Scienze della Terra and Museo di Storia Naturale, Universita di Firenze, Via G. La Pira 4, 50121 Firenze (Italy)

    2011-10-15

    In this paper we report about the micro-PIXE characterisation of lapis lazuli, for a provenance study of this semi-precious stone, used for glyptic as early as 7000 years ago. The final aim is to find markers permitting to identify the origin of the raw material coming from three quarries in regions of historical importance: Afghanistan, Pamir Mountains and Siberia. This may help to reconstruct trade routes, especially for ancient objects for which written testimonies are scanty or absent at all. Due to the heterogeneity of lapis lazuli we concentrate our attention on single phases instead of the whole stone; in particular we focused on two of the main phases: lazurite, responsible for the blue colour, and diopside, the most frequent accessory mineral. This study was preceded and completed by means of microanalysis with Scanning Electron Microscopy (SEM-EDX) and Cold-Cathodoluminescence (cold-CL) analysis. Despite the limited number of analysed samples, results are sufficient to exclude/suggest a few features as provenance markers, partly confirming what has been previously published in literature.

  19. Lapis lazuli provenance study by means of micro-PIXE

    International Nuclear Information System (INIS)

    Re, Alessandro; Giudice, Alessandro Lo; Angelici, Debora; Calusi, Silvia; Giuntini, Lorenzo; Massi, Mirko; Pratesi, Giovanni

    2011-01-01

    In this paper we report about the micro-PIXE characterisation of lapis lazuli, for a provenance study of this semi-precious stone, used for glyptic as early as 7000 years ago. The final aim is to find markers permitting to identify the origin of the raw material coming from three quarries in regions of historical importance: Afghanistan, Pamir Mountains and Siberia. This may help to reconstruct trade routes, especially for ancient objects for which written testimonies are scanty or absent at all. Due to the heterogeneity of lapis lazuli we concentrate our attention on single phases instead of the whole stone; in particular we focused on two of the main phases: lazurite, responsible for the blue colour, and diopside, the most frequent accessory mineral. This study was preceded and completed by means of microanalysis with Scanning Electron Microscopy (SEM-EDX) and Cold-Cathodoluminescence (cold-CL) analysis. Despite the limited number of analysed samples, results are sufficient to exclude/suggest a few features as provenance markers, partly confirming what has been previously published in literature.

  20. Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP Applied to Caregivers of Patients With Dementia

    Directory of Open Access Journals (Sweden)

    Serena Passoni

    2018-06-01

    Full Text Available Caregivers of patients with dementia experience high levels of stress and burden, with effects comparable to those of a traumatic event. Eye Movement Desensitization and Reprocessing (EMDR appear to be effective in recovering post-traumatic stress disorder (PTSD. We aimed at investigating the effectiveness of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP on the “caregiver syndrome”. Forty-four primary caregivers entered the study. They were randomly assigned to either the “immediate” branch, who received the treatment soon after recruitment, or to the “delayed” branch, who received it two months after recruitment. The treatment consisted of eight group sessions (one per week spanning over two months. Emotional distress was measured before the treatment, immediately after the end of it, and two months later (follow-up, by means of several clinical scales (Impact of Event Scale-Revised, IES-R; Caregiver Needs Assessment, CNA; Caregiver Burden Inventory, CBI; Anxiety and Depression Scale-Reduced Form, AD-R. The “immediate” branch improved significantly more than the “delayed” (control branch on The Impact of Event Scale-Revised, the Anxiety, and the Depression scales; however, after treatment such an improvement was maintained only in the first scale. The “delayed” branch took less advantage of the treatment, showing significant reduction only on the Depression scale, an effect which disappeared at follow-up. These preliminary results show for the first time that EMDR-IGTP reduces stress-related symptoms, anxiety, and depression in caregivers of patients with dementia. Interestingly, caregivers who were inserted in a waiting list after recruitment showed smaller treatment effects. Larger samples are needed to better interpret such differential clinical profiles.

  1. Cognitive Hypnotherapy as a Transdiagnostic Protocol for Emotional Disorders.

    Science.gov (United States)

    Alladin, Assen; Amundson, Jon

    2016-01-01

    This article describes cognitive hypnotherapy (CH), an integrative treatment that provides an evidence-based framework for synthesizing clinical practice and research. CH combines hypnotherapy with cognitive-behavior therapy in the management of emotional disorders. This blended version of clinical practice meets criteria for an assimilative model of integrative psychotherapy, which incorporates both theory and empirical findings. Issues related to (a) additive effect of hypnosis in treatment, (b) transdiagnostic consideration, and (c) unified treatment protocols in the treatment of emotional disorders are considered in light of cognitive hypnotherapy.

  2. Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases.

    Science.gov (United States)

    Cianci, Paul; Slade, John B

    2006-10-01

    Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

  3. Defining the “proven technology” technical criterion in the reactor technology assessment for Malaysia’s nuclear power program

    Energy Technology Data Exchange (ETDEWEB)

    Anuar, Nuraslinda, E-mail: nuraslinda@uniten.edu.my [College of Engineering, Universiti Tenaga Nasional, Jalan IKRAM-UNITEN, 43000 Kajang, Selangor (Malaysia); Kahar, Wan Shakirah Wan Abdul, E-mail: shakirah@tnb.com.my; Manan, Jamal Abdul Nasir Abd [Nuclear Energy Department, Regulatory Economics and Planning Division, Tenaga Nasional Berhad, No. 8 Jalan Tun Sambanthan, Brickfields, 50470 Kuala Lumpur (Malaysia)

    2015-04-29

    Developing countries that are considering the deployment of nuclear power plants (NPPs) in the near future need to perform reactor technology assessment (RTA) in order to select the most suitable reactor design. The International Atomic Energy Agency (IAEA) reported in the Common User Considerations (CUC) document that “proven technology” is one of the most important technical criteria for newcomer countries in performing the RTA. The qualitative description of five desired features for “proven technology” is relatively broad and only provides a general guideline to its characterization. This paper proposes a methodology to define the “proven technology” term according to a specific country’s requirements using a three-stage evaluation process. The first evaluation stage screens the available technologies in the market against a predefined minimum Technology Readiness Level (TRL) derived as a condition based on national needs and policy objectives. The result is a list of technology options, which are then assessed in the second evaluation stage against quantitative definitions of CUC desired features for proven technology. The potential technology candidates produced from this evaluation is further narrowed down to obtain a list of proven technology candidates by assessing them against selected risk criteria and the established maximum allowable total score using a scoring matrix. The outcome of this methodology is the proven technology candidates selected using an accurate definition of “proven technology” that fulfills the policy objectives, national needs and risk, and country-specific CUC desired features of the country that performs this assessment. A simplified assessment for Malaysia is carried out to demonstrate and suggest the use of the proposed methodology. In this exercise, ABWR, AP1000, APR1400 and EPR designs assumed the top-ranks of proven technology candidates according to Malaysia’s definition of “proven technology”.

  4. Defining the “proven technology” technical criterion in the reactor technology assessment for Malaysia’s nuclear power program

    International Nuclear Information System (INIS)

    Anuar, Nuraslinda; Kahar, Wan Shakirah Wan Abdul; Manan, Jamal Abdul Nasir Abd

    2015-01-01

    Developing countries that are considering the deployment of nuclear power plants (NPPs) in the near future need to perform reactor technology assessment (RTA) in order to select the most suitable reactor design. The International Atomic Energy Agency (IAEA) reported in the Common User Considerations (CUC) document that “proven technology” is one of the most important technical criteria for newcomer countries in performing the RTA. The qualitative description of five desired features for “proven technology” is relatively broad and only provides a general guideline to its characterization. This paper proposes a methodology to define the “proven technology” term according to a specific country’s requirements using a three-stage evaluation process. The first evaluation stage screens the available technologies in the market against a predefined minimum Technology Readiness Level (TRL) derived as a condition based on national needs and policy objectives. The result is a list of technology options, which are then assessed in the second evaluation stage against quantitative definitions of CUC desired features for proven technology. The potential technology candidates produced from this evaluation is further narrowed down to obtain a list of proven technology candidates by assessing them against selected risk criteria and the established maximum allowable total score using a scoring matrix. The outcome of this methodology is the proven technology candidates selected using an accurate definition of “proven technology” that fulfills the policy objectives, national needs and risk, and country-specific CUC desired features of the country that performs this assessment. A simplified assessment for Malaysia is carried out to demonstrate and suggest the use of the proposed methodology. In this exercise, ABWR, AP1000, APR1400 and EPR designs assumed the top-ranks of proven technology candidates according to Malaysia’s definition of “proven technology”

  5. Cloud-assisted mutual authentication and privacy preservation protocol for telecare medical information systems.

    Science.gov (United States)

    Li, Chun-Ta; Shih, Dong-Her; Wang, Chun-Cheng

    2018-04-01

     With the rapid development of wireless communication technologies and the growing prevalence of smart devices, telecare medical information system (TMIS) allows patients to receive medical treatments from the doctors via Internet technology without visiting hospitals in person. By adopting mobile device, cloud-assisted platform and wireless body area network, the patients can collect their physiological conditions and upload them to medical cloud via their mobile devices, enabling caregivers or doctors to provide patients with appropriate treatments at anytime and anywhere. In order to protect the medical privacy of the patient and guarantee reliability of the system, before accessing the TMIS, all system participants must be authenticated.  Mohit et al. recently suggested a lightweight authentication protocol for cloud-based health care system. They claimed their protocol ensures resilience of all well-known security attacks and has several important features such as mutual authentication and patient anonymity. In this paper, we demonstrate that Mohit et al.'s authentication protocol has various security flaws and we further introduce an enhanced version of their protocol for cloud-assisted TMIS, which can ensure patient anonymity and patient unlinkability and prevent the security threats of report revelation and report forgery attacks.  The security analysis proves that our enhanced protocol is secure against various known attacks as well as found in Mohit et al.'s protocol. Compared with existing related protocols, our enhanced protocol keeps the merits of all desirable security requirements and also maintains the efficiency in terms of computation costs for cloud-assisted TMIS.  We propose a more secure mutual authentication and privacy preservation protocol for cloud-assisted TMIS, which fixes the mentioned security weaknesses found in Mohit et al.'s protocol. According to our analysis, our authentication protocol satisfies most functionality features

  6. Research on supplying potential of uranium source from rocks in western provenance area of Hailaer basin

    International Nuclear Information System (INIS)

    Xia Yuliang; Liu Hanbin; Chinese Academy of Geological Sciences, Beijing

    2006-01-01

    Using U-Pb isotope composition evolution, this paper expounds the initial uranium content in volcanic rocks of provenance area of Xihulitu basin and in granites of provenance area of Kelulun sag, western Hailaer basin. The initial uranium content (U 0 ) in volcanic rocks of provenance area is higher, the average initial uranium content of volcanic rocks is 10.061 x 10 -6 , the average uranium variation coefficient (ΔU) is -49.57%; the average initial uranium content of granites is 18.381 x 10 -6 , the average uranium variation coefficient (ΔU) is -80%. The results indicate that rocks in provenance area could provide the pre-enrichment of uranium in deposited sandstone. U-Ra equilibrium coefficients of rocks indicate that there is obvious U-Ra disequilibrium phenomenon in volcanic rocks, and the time when granites provided uranium source occurred 16000 a ago. (authors)

  7. Antibiotic prophylaxis in orthopedic surgeries: the results of an implemented protocol

    Directory of Open Access Journals (Sweden)

    Raquel Queiroz

    Full Text Available Though the basic principles of antibiotic prophylaxis have been well established, there is still considerable incorrect usage, including how much is prescribed and especially in the duration of treatment, which is generally superior to what is indicated. The adequate use of these drugs contributes towards decreasing the time of internment of the patient, prevents surgical site infection (SSI, decreasing the development of resistant microorganisms, and towards reduced costs for the hospital pharmacy. A protocol for the use of antibiotic prophylaxis in the Orthopedics and Traumatology Service of the Hospital do Servidor Público Estadual de São Paulo was developed. The objectives of the study were to promote rational antibiotic surgical prophylaxis, through the implantation of a protocol for the use of these drugs in a surgical unit, with the direct contribution of a druggist in collaboration with the Infection Control Committee, to evaluate the adhesion of the health team to the protocol during three distinct periods (daily pre-protocol, early post-protocol and late post-protocol and to define the consumption of antimicrobials used, measured as daily defined dose.

  8. Quantifying the provenance of aeolian sediments using multiple composite fingerprints

    Science.gov (United States)

    Liu, Benli; Niu, Qinghe; Qu, Jianjun; Zu, Ruiping

    2016-09-01

    We introduce a new fingerprinting method that uses multiple composite fingerprints for studies of aeolian sediment provenance. We used this method to quantify the provenance of sediments on both sides of the Qinghai-Tibetan Railway (QTR) in the Cuona Lake section of the Tibetan Plateau (TP), in an environment characterized by aeolian and fluvial interactions. The method involves repeatedly solving a linear mixing model based on mass conservation; the model is not limited to spatial scale or transport types and uses all the tracer groups that passed the range check, Kruskal-Wallis H-test, and a strict analytical solution screening. The proportional estimates that result from using different composite fingerprints are highly variable; however, the average of these fingerprints has a greater accuracy and certainty than any single fingerprint. The results show that sand from the lake beach, hilly surface, and gullies contribute, respectively, 48%, 31% and 21% to the western railway sediments and 43%, 33% and 24% to the eastern railway sediments. The difference between contributions from various sources on either side of the railway, which may increase in the future, was clearly related to variations in local transport characteristics, a conclusion that is supported by grain size analysis. The construction of the QTR changed the local cycling of materials, and the difference in provenance between the sediments that are separated by the railway reflects the changed sedimentary conditions on either side of the railway. The effectiveness of this method suggests that it will be useful in other studies of aeolian sediments.

  9. A Standard Mutual Authentication Protocol for Cloud Computing Based Health Care System.

    Science.gov (United States)

    Mohit, Prerna; Amin, Ruhul; Karati, Arijit; Biswas, G P; Khan, Muhammad Khurram

    2017-04-01

    Telecare Medical Information System (TMIS) supports a standard platform to the patient for getting necessary medical treatment from the doctor(s) via Internet communication. Security protection is important for medical records (data) of the patients because of very sensitive information. Besides, patient anonymity is another most important property, which must be protected. Most recently, Chiou et al. suggested an authentication protocol for TMIS by utilizing the concept of cloud environment. They claimed that their protocol is patient anonymous and well security protected. We reviewed their protocol and found that it is completely insecure against patient anonymity. Further, the same protocol is not protected against mobile device stolen attack. In order to improve security level and complexity, we design a light weight authentication protocol for the same environment. Our security analysis ensures resilience of all possible security attacks. The performance of our protocol is relatively standard in comparison with the related previous research.

  10. Protocol for a randomised controlled trial of 90% kanuka honey versus 5% aciclovir for the treatment of herpes simplex labialis in the community setting.

    Science.gov (United States)

    Semprini, Alex; Singer, Joseph; Shortt, Nicholas; Braithwaite, Irene; Beasley, Richard

    2017-08-03

    Worldwide, about 90% of people are infected with the herpes simplex virus, 30% of whom will experience recurrent herpes simplex labialis, commonly referred to as 'cold sores', which can last up to 10 days. The most common treatment is aciclovir cream which reduces healing time by just half a day compared with no specific treatment. This is a protocol for a randomised controlled trial (RCT) to determine the efficacy of medical grade kanuka honey-based topical treatment (Honevo) in reducing the healing time and pain of cold sores, compared with topical aciclovir treatment (Viraban). This open-label, parallel-group, active comparator superiority RCT will compare the efficacy of medical grade kanuka honey with 5% aciclovir cream in the treatment of cold sores in the setting of a pharmacy research network of 60 sites throughout New Zealand. Adults presenting with a cold sore (N=950) will be randomised by pharmacy-based investigators. The pharmacy-based investigators will dispense the investigational product to randomised participants and both study groups apply the treatment five times daily until their skin returns to normal or for 14 days, whichever occurs first. In response to a daily SMS message, participants complete an assessment of their cold sore healing, with reference to a visual guide, and transmit it to the investigators by a smartphone eDiary in real time. The primary outcome variable is time (in days) from randomisation to return to normal skin. Secondary endpoints include total healing time stratified by stage of the lesion at onset of treatment, highest pain severity and time to pain resolution. New Zealand Ethics Registration 15/NTB/93. Results will be published in a peer-reviewed medical journal, presented at academic meetings and reported to participants. Australia New Zealand Clinical Trials Registry: ACTRN12615000648527, pre-results.SCOTT Registration: 15/SCOTT/14 PROTOCOL VERSION: 4.0 (12 June 2017). © Article author(s) (or their employer

  11. Provenance and evolution of miocene turbidite sedimentation in the central Apennines, Italy

    Science.gov (United States)

    Chiocchini, Ugo; Cipriani, Nicola

    1992-05-01

    A study of the siliciclastic detritus within the calcareous Miocene turbidite sandstones of the central Apennines has elucidated the provenance of these sandstones. Three ratios: Q/(Q+F), K/F, and Mc/M, have been used and binary correlations of these parameters show that: (1) the sandstones of the Marnoso-Arenacea are characterized by a northern Alpine supply, mainly derived from metamorphic rocks and subordinately from granitic rocks; (2) a secondary supply of western provenance, interbedded within the Marnoso-Arenacea, shows a typical arkosic composition and suggests that granitic rocks of Alpine-type were associated with the Ligurides; (3) the Urbania and Serraspinosa sandstones consist of detritus derived from sources almost identical to those supplying the Marnoso-Arenacea; (4) all the sandstones of the remaining central Apennine basins are characterized by a siliciclastic supply similar to the arkosic one; the rare carbonate fragments can be referred to the Apennine units. The continuity of the Alpine are in the Tyrrhenian area strongly suggests a connection between the western crystalline units and turbidite sedimentation in the basins examined. The crystalline units are associated with a segment of the Alpine chain tectonically linked to the Liguride nappes (Apennine source areas) during the eastwards migration of the Apennines deformation. The crystalline units were gradually eroded during the Burdigalian to Early Pliocene interval when the Laga basin was completely filled. Currently the term "Alpine" is used as synonymous with northern provenance. However, a detailed study carried out over ten years, revealed a western Alpine supply associated with an Apennine source area; we therefore suggest that it is necessary to distinguish a northern Alpine provenance from a western Alpine supply.

  12. Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology

    DEFF Research Database (Denmark)

    Stenbæk, D. S.; Toftager, M.; Hjordt, L. V.

    2015-01-01

    STUDY QUESTION: Do mental distress and mood fluctuations in women undergoing GnRH agonist and GnRH antagonist protocols for assisted reproductive technology (ART) differ depending on protocol and the personality trait, neuroticism? SUMMARY ANSWER: ART treatment did not induce elevated levels...... of mental distress in either GnRH antagonist or agonist protocols but neuroticism was positively associated with increased mental distress, independent of protocols. WHAT IS KNOWN ALREADY: ART treatment may increase mental distress by mechanisms linked to sex hormone fluctuations. General psychological...... characteristics, such as personality traits indexing negative emotionality, e.g. neuroticism, are likely to affect mental distress during ART treatment. STUDY DESIGN, SIZE, DURATION: A total of 83 women undergoing their first ART cycle were consecutively randomized 1:1 to GnRH antagonist (n = 42) or GnRH agonist...

  13. Barriers and enablers to implementing clinical treatment protocols for fever, hyperglycaemia, and swallowing dysfunction in the Quality in Acute Stroke Care (QASC) Project--a mixed methods study.

    Science.gov (United States)

    Dale, Simeon; Levi, Christopher; Ward, Jeanette; Grimshaw, Jeremy M; Jammali-Blasi, Asmara; D'Este, Catherine; Griffiths, Rhonda; Quinn, Clare; Evans, Malcolm; Cadilhac, Dominique; Cheung, N Wah; Middleton, Sandy

    2015-02-01

    The Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) in acute stroke care. This cluster-randomised controlled trial was conducted in 19 stroke units in Australia. To describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocols and, postimplementation, to determine which of these barriers eventuated as actual barriers. Preimplementation: Workshops were held at the intervention stroke units (n = 10). The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocols, the second workshop involved bedside clinicians. Postimplementation, an online survey with stroke champions from intervention sites was conducted. A total of 111 clinicians attended the preimplementation workshops, identifying 22 barriers covering four main themes: (a) need for new policies, (b) limited workforce (capacity), (c) lack of equipment, and (d) education and logistics of training staff. Preimplementation enablers identified were: support by clinical champions, medical staff, nursing management and allied health staff; easy adaptation of current protocols, care-plans, and local policies; and presence of specialist stroke unit staff. Postimplementation, only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption of the FeSS protocols, namely, no previous use of insulin infusions; hyperglycaemic protocols could not be commenced without written orders; medical staff reluctance to use the ASSIST swallowing screening tool; poor level of engagement of medical staff; and doctors' unawareness of the trial. The process of identifying barriers and enablers preimplementation allowed staff to take ownership and to address barriers and plan for change. As only five of the 22 barriers identified preimplementation were reported to be actual barriers at

  14. Improved treatment of radiation effects on the skin

    International Nuclear Information System (INIS)

    Wandl, E.O.; Kaercher, K.H.; Wandl-Hainberger, I.

    1985-01-01

    The treatment concept developed by K.H. Kaercher was extended by a therapy using Elasten S cream. In the course of a highvoltage therapy using fast electrons or cobalt-60, interesting aspects in the treatment and progression of the radiation reactions of the skin were established. The dermato-therapeutic principles layed down by K.H. Kaercher with the treatment palette used hitherto, have without doubt invariably proven their value. The exclusive powder treatment, however, may be made more practical by application of the new treatment cream in accordance with the intervals in radiation treatment or as a basic treatment towards the end of therapy. Furthermore it is ideally suited for the care and after-treatment of skin, strained by radiation. It reduces considerably the remaining visible radiation reactions. The treatment with powder and emulsion has for more than 10 years proven effective. After the excellent results of the new cream during radiation treatment, additional positive effects are expected in a long-term trial which will be reported on separately. (orig.) [de

  15. GnRH antagonist versus long agonist protocols in IVF

    DEFF Research Database (Denmark)

    Lambalk, C B; Banga, F R; Huirne, J A

    2017-01-01

    BACKGROUND: Most reviews of IVF ovarian stimulation protocols have insufficiently accounted for various patient populations, such as ovulatory women, women with polycystic ovary syndrome (PCOS) or women with poor ovarian response, and have included studies in which the agonist or antagonist...... was not the only variable between the compared study arms. OBJECTIVE AND RATIONALE: The aim of the current study was to compare GnRH antagonist protocols versus standard long agonist protocols in couples undergoing IVF or ICSI, while accounting for various patient populations and treatment schedules. SEARCH...... in couples undergoing IVF or ICSI. The primary outcome was ongoing pregnancy rate. Secondary outcomes were: live birth rate, clinical pregnancy rate, number of oocytes retrieved and safety with regard to ovarian hyperstimulation syndrome (OHSS). Separate comparisons were performed for the general IVF...

  16. A newly designed radiation therapy protocol in combination with prednisolone as treatment for meningoencephalitis of unknown origin in dogs: a prospective pilot study introducing magnetic resonance spectroscopy as monitor tool.

    Science.gov (United States)

    Beckmann, Katrin; Carrera, Inés; Steffen, Frank; Golini, Lorenzo; Kircher, Patrick R; Schneider, Uwe; Bley, Carla Rohrer

    2015-01-31

    A plethora of treatment options have been described for canine meningoencephalitis of unknown origin (MUO), yet a gold standard has not been established. The aim of this prospective pilot study was to document the effect of a newly designed 30 Gray (Gy) radiation therapy (RT) protocol plus corticosteroids as treatment for focal and multifocal MUO, to monitor clinical and imaging changes during the course of the disease with conventional magnetic resonance imaging (MRI) and proton MR Spectroscopy (H-1 MRS) and to detect the occurrence of radiation related side effects. Six dogs (3 with focal and 3 with multifocal lesions) were included in the study. The RT protocol used consisted of 30 Gy in 10 fractions. The neurological status of all six dogs improved during RT, with 3 of 6 cases returning to a normal condition. One dog was euthanized early during follow-up (dog and improved in 3 dogs and H-1 MRS normalized in 4. In the dog without improvement of the MRI lesions, the N-acetyl aspartate continued to decrease, while choline and creatine concentrations remained stable during that time. This dog was euthanized 18 month after the end of RT due to relapse. One dog was lost to follow up 12 month after completion of RT. The other 3 dogs are still alive at the time of writing. RT with 30 Gy in 10 fractions can provide an additional option for anti-inflammatory treatment of focal and multifocal MUO. The protocol used for treatment monitoring was feasible while no side effects of RT could be observed during the follow up period. Moreover, H-1 MRS could represent a new and non-invasive tool to control the progression of the disease during the treatment course.

  17. Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer

    Directory of Open Access Journals (Sweden)

    Shafquat Zaman

    2017-04-01

    Full Text Available Background/Aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC. However, its usefulness has been debated in this era of high-resolution computed tomography (CT diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.Methods: Records of patients with CT-proven acute diverticulitis between October 2007 and March 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmed the cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing the same endoscopic examination over the same period.Results: We identified 235 patients with CT-proven acute diverticulitis, of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%. Three cases of CRC were detected in the 187 patients managed conservatively (1.6%. Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy; one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitis compared with controls.Conclusions: CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than in screened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertainty in 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis is associated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

  18. [Idiopathic intracranial hypertension: Experience over 25 years and a management protocol].

    Science.gov (United States)

    Monge Galindo, Lorena; Fernando Martínez, Ruth; Fuertes Rodrigo, Cristina; Fustero de Miguel, David; Pueyo Royo, Victoria; García Iñiguez, Juan Pablo; López-Pisón, Javier; Peña-Segura, José Luis

    2017-08-01

    We present our experience on idiopathic intracranial hypertension (IIH), before and after the introduction of a specific diagnosis and management protocol. A descriptive retrospective study was conducted on patients with IIH over a 25year period (1990-2015), comparing the last 7years (after introduction of the protocol) with the previous 18years. Among the 18,865 patients evaluated, there were 54 cases of IIH (29 infants and 25 children). A comparison was made between the two time periods: 32 cases in 1990-2008 -published in An Pediatr (Barc). 2009;71:400-6-, and 23 cases in 2008-2015. In post-protocol period, there were 13 patients aged between 3-10months (62% males) with transient bulging fontanelle, and 10 aged between 2-14years (50% males), with papilloedema. A total of 54% of infants had recently finished corticosteroid treatment for bronchitis. In the older children, there was one case associated with venous thrombosis caused by otomastoiditis, one case on corticosteroid treatment for angioma, and another case treated with growth hormone. Transfontanelle ultrasound was performed on all infants, and CT, MRI and angio-MRI was performed on every child. Lumbar puncture was performed on 2 infants in whom meningitis was suspected, and in all children. All patients progressed favourably, with treatment being started in 3 of them. One patient relapsed. Characteristics and outcomes of patients overlap every year. IIH usually has a favourable outcome, although it may be longer in children than in infants. It can cause serious visual disturbances, so close ophthalmological control is necessary. The protocol is useful to ease diagnostic decisions, monitoring, and treatment. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group

    International Nuclear Information System (INIS)

    Hayakawa, F; Sakura, T; Yujiri, T; Kondo, E; Fujimaki, K; Sasaki, O; Miyatake, J; Handa, H; Ueda, Y; Aoyama, Y; Takada, S; Tanaka, Y; Usui, N; Miyawaki, S; Suenobu, S; Horibe, K; Kiyoi, H; Ohnishi, K; Miyazaki, Y; Ohtake, S; Kobayashi, Y; Matsuo, K; Naoe, T

    2014-01-01

    The superiority of the pediatric protocol for adolescents with acute lymphoblastic leukemia (ALL) has already been demonstrated, however, its efficacy in young adults remains unclear. The ALL202-U protocol was conducted to examine the efficacy and feasibility of a pediatric protocol in adolescents and young adults (AYAs) with BCR–ABL-negative ALL. Patients aged 15–24 years (n=139) were treated with the same protocol used for pediatric B-ALL. The primary objective of this study was to assess the disease-free survival (DFS) rate and its secondary aims were to assess toxicity, the complete remission (CR) rate and the overall survival (OS) rate. The CR rate was 94%. The 5-year DFS and OS rates were 67% (95% confidence interval (CI) 58–75%) and 73% (95% CI 64–80%), respectively. Severe adverse events were observed at a frequency that was similar to or lower than that in children treated with the same protocol. Only insufficient maintenance therapy significantly worsened the DFS (hazard ratio 5.60, P<0.001). These results indicate that this protocol may be a feasible and highly effective treatment for AYA with BCR–ABL-negative ALL

  20. Protocollering is essentieel : Behandeling van paracetamolintoxicatie in Nederland

    NARCIS (Netherlands)

    Van Roon, E.N.; Van Den Bemt, P.M.L.A.; Van Zantvoort, C.A.; Touw, D.J.

    2000-01-01

    Paracetamol poisoning occurs frequently in the Netherlands. In order to study the way in which paracetamol poisonings are being treated in Dutch hospitals, a survey was sent to all Dutch hospital pharmacies, in which they were asked to sent their current protocol for the treatment of paracetamol

  1. Evaluation of ovsynch protocols for timed artificial insemination in water buffaloes in Bangladesh

    International Nuclear Information System (INIS)

    Hoque, M.N.; Talukder, A.K.; Akter, M.; Shamsuddin, M.

    2016-01-01

    Full text: A total of 65 water buffaloes (groups A, B, and C) at =>60 days postpartum with a body condition score (BCS) of =>2.5 were selected to evaluate ovsynch protocols for timed artificial insemination (TAI). The group A buffaloes (n = 25) were treated with a simple ovsynch protocol (GnRH - Day 7 - PGF alpha - Day 2 - GnRH - 16 h - TAI). The group B buffaloes (n = 22) received PGF2 alpha treatment 12 days before the initiation of simple ovsynch (PGF2 alpha at Day -12 + simple ovsynch; modified ovsynch). The group C buffaloes (n = 18) were treated with a double ovsynch protocol (GnRH - Day 7 - PGF2 alpha - Day 3 - GnRH - Day 7 - GnRH - Day 7 - PGF2 alpha - 48 h - GnRH - 16 h - TAI). Milk P4 ELISA was used for tracking ovulation and conception rates. Ovulation rates were higher in buffaloes that received the double ovsynch treatment (group C; 83.3%) than those with simple ovsynch (group A; 72.0%; P < 0.05). The group C cows (44.4%) achieved a higher concentration rate than the cows of groups A (28.0%) and B (36.4%) (P < 0.05) and multiparous buffaloes having BCS of =>3.5 responded better to the ovsynch treatments than the primiparous ones (P < 0.05). The double ovsynch protocol increases both ovulation and conception rates in comparison to the simple and modified ovsynch protocols and is more effective in multiparous cows than in primiparous ones. (author)

  2. Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment.

    Science.gov (United States)

    de Ornelas Maia, Ana Claudia Corrêa; Sanford, Jenny; Boettcher, Hannah; Nardi, Antonio E; Barlow, David

    2017-10-01

    Patients with multiple mental disorders often experience sexual dysfunction and reduced quality of life. The unified protocol (UP) is a transdiagnostic treatment for emotional disorders that has the potential to improve quality of life and sexual functioning via improved emotion management. The present study evaluates changes in quality of life and sexual functioning in a highly comorbid sample treated with the UP in a group format. Forty-eight patients were randomly assigned to either a UP active-treatment group or a medication-only control group. Treatment was delivered in 14 sessions over the course of 4 months. Symptoms of anxiety and depression were assessed using the Beck Anxiety Inventory and Beck Depression Inventory. Sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX), and quality of life was assessed by the World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). Quality of life, anxiety and depression all significantly improved among participants treated with the UP. Some improvement in sexual functioning was also noted. The results support the efficacy of the UP in improving quality of life and sexual functioning in comorbid patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Ontology development for provenance tracing in National Climate Assessment of the US Global Change Research Program

    Science.gov (United States)

    Fu, Linyun; Ma, Xiaogang; Zheng, Jin; Goldstein, Justin; Duggan, Brian; West, Patrick; Aulenbach, Steve; Tilmes, Curt; Fox, Peter

    2014-05-01

    This poster will show how we used a case-driven iterative methodology to develop an ontology to represent the content structure and the associated provenance information in a National Climate Assessment (NCA) report of the US Global Change Research Program (USGCRP). We applied the W3C PROV-O ontology to implement a formal representation of provenance. We argue that the use case-driven, iterative development process and the application of a formal provenance ontology help efficiently incorporate domain knowledge from earth and environmental scientists in a well-structured model interoperable in the context of the Web of Data.

  4. Probiotics do not improve the benefits of a hospital treatment protocol for acute diarrhea in the breastfed child.

    Directory of Open Access Journals (Sweden)

    Sergio Santana Porbén

    2016-11-01

    Full Text Available Rationale: Probiotics have been used in the treatment of acute diarrhea occurring in pediatric ages with mixed results. Objective: To assess the impact of a probiotic (CFU per capsule: Lactobacillus rhamnosus G: 2 x 109, Lactobacillus cassei: 1 x 109, Bifidobacterium brevis: 2 x 109 upon the features and duration of acute diarrhea in breastfed children. Study location: Digestive Diseases and Nutrition Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Marianao, Havana City, Cuba. Study design: Open, quasi-experimental trial. Thirty children with ages 0.05; Improvement of the features of stools: Non-Treated: 93.3% vs. Treated: 96.1% (p > 0.05. Use of probiotics produced an increase of Hemoglobin ( = -0.44; p 0.05 values of indicators of systemic inflammatory response. Conclusions: Inclusion of probiotics within an institutional protocol for treatment of acute diarrhea does not significantly change the stool pattern of the breastfed child, but might reduce the systemic inflammatory tone which, in turn, would result in a better use of body iron.

  5. The fingerprint element analysis on provenance of ancient chinese Jun porcelain

    International Nuclear Information System (INIS)

    Gao Zhengyao; Chen Songhua; Wang Jie; Huang Zhongxiang; Jia Xiuqin; Han Song

    1997-01-01

    Forty-three samples of ancient Jun porcelains and so on were chosen. Neutron activation analysis (NAA) was used to measure the 36 trace elements in every sample. Seven elements were chosen as the 'fingerprint elements'. The provenance of the glazes and bodies of ancient Chinese Jun porcelain were investigated by the fingerprint element analysis method. The result shows that although the ancient Chinese Jun porcelain samples have been leapt over six hundred years, and glaze colors are utterly different and are from many different kilns, there are long term, stable and same mainly raw material source. The near provenance relation between ancient Jun porcelain and ancient Ru porcelain is preliminarily analyzed. A few modern Jun porcelains approximate from ancient Jun porcelains, the majority become estranged from ancient Jun porcelain

  6. South African Research Ethics Committee Review of Standards of Prevention in HIV Vaccine Trial Protocols.

    Science.gov (United States)

    Essack, Zaynab; Wassenaar, Douglas R

    2018-04-01

    HIV prevention trials provide a prevention package to participants to help prevent HIV acquisition. As new prevention methods are proven effective, this raises ethical and scientific design complexities regarding the prevention package or standard of prevention. Given its high HIV incidence and prevalence, South Africa has become a hub for HIV prevention research. For this reason, it is critical to study the implementation of relevant ethical-legal frameworks for such research in South Africa. This qualitative study used in-depth interviews to explore the practices and perspectives of eight members of South African research ethics committees (RECs) who have reviewed protocols for HIV vaccine trials. Their practices and perspectives are compared with ethics guideline requirements for standards of prevention.

  7. Impact of fresh and saline water flooding on leaf gas exchange in two Italian provenances of Tamarix africana Poiret.

    Science.gov (United States)

    Abou Jaoudé, R; de Dato, G; Palmegiani, M; De Angelis, P

    2013-01-01

    In Mediterranean coastal areas, changes in precipitation patterns and seawater levels are leading to increased frequency of flooding and to salinization of estuaries and freshwater systems. Tamarix spp. are often the only woody species growing in such environments. These species are known for their tolerance to moderate salinity; however, contrasting information exists regarding their tolerance to flooding, and the combination of the two stresses has never been studied in Tamarix spp. Here, we analyse the photosynthetic responses of T. africana Poiret to temporary flooding (45 days) with fresh or saline water (200 mm) in two Italian provenances (Simeto and Baratz). The measurements were conducted before and after the onset of flooding, to test the possible cumulative effects of the treatments and effects on twig aging, and to analyse the responses of twigs formed during the experimental period. Full tolerance was evident in T. africana with respect to flooding with fresh water, which did not affect photosynthetic performances in either provenance. Saline flooding was differently tolerated by the two provenances. Moreover, salinity tolerance differently affected the two twig generations. In particular, a reduction in net assimilation rate (-48.8%) was only observed in Baratz twigs formed during the experimental period, compared to pre-existing twigs. This reduction was a consequence of non-stomatal limitations (maximum carboxylation rate and electron transport), probably as a result of higher Na transport to the twigs, coupled with reduced Na storage in the roots. © 2012 German Botanical Society and The Royal Botanical Society of the Netherlands.

  8. "hCG priming" effect in controlled ovarian stimulation through a long protocol

    Directory of Open Access Journals (Sweden)

    Antsaklis Aris

    2009-08-01

    Full Text Available Abstract Background Recently, it has been demonstrated that, in patients down-regulated by GnRH analogues (GnRHa, a short-term pre-treatment with recombinant LH (rLH, prior to recombinant FSH (rFSH administration, increases the number of small antral follicle prior to FSH stimulation and the yield of normally fertilized embryos. However, no data exist in the literature regarding the potential beneficial effect of "hCG priming" in controlled ovarian hyperstimulation (COH through a long GnRH-a protocol, which binds the same receptor (LH/hCGR, though it is a much more potent compared to LH. The primary aims of this study were to assess the effect of short-term pre-rFSH administration of hCG in women entering an ICSI treatment cycle on follicular development, quality of oocytes and early embryo development. The secondary endpoints were to record the effects on endometrial quality and pregnancy rate. Methods Patients with a history of at least one previous unsuccessful ICSI cycle were randomly assigned into two groups to receive treatment with either a long protocol with rFSH (control group or a long protocol with rFSH and pre-treatment with hCG (hCG group. In particular, in the latter group, a fixed 7 days course of 200 IU/day hCG was administered as soon as pituitary desensitization was confirmed. Results The mean number of oocytes retrieved was not significantly different between the two treatment groups, although the percentage of mature oocytes tended to be higher but not significantly different in hCG-treated patients. The percentage of patients with more than one grade 3 embryos was higher in the pre-treatment group, which also showed a higher pregnancy rate. Conclusion All the above clinical observations, in conjunction with previous data, suggest a point towards a beneficial "hCG priming" effect in controlled ovarian hyperstimulation through a long GnRH-a down-regulation protocol, particularly in patients with previous ART failures.

  9. Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Salvo, Vera; Kristeller, Jean; Marin, Jesus Montero; Sanudo, Adriana; Lourenço, Bárbara Hatzlhoffer; Schveitzer, Mariana Cabral; D'Almeida, Vania; Morillo, Héctor; Gimeno, Suely Godoy Agostinho; Garcia-Campayo, Javier; Demarzo, Marcelo

    2018-05-11

    Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes-partly responsible for weight regain for a large number of people-and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme's impact on the participants' lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of

  10. The interventional effect of new drugs combined with the Stupp protocol on glioblastoma: A network meta-analysis.

    Science.gov (United States)

    Li, Mei; Song, Xiangqi; Zhu, Jun; Fu, Aijun; Li, Jianmin; Chen, Tong

    2017-08-01

    New therapeutic agents in combination with the standard Stupp protocol (a protocol about the temozolomide combined with radiotherapy treatment with glioblastoma was research by Stupp R in 2005) were assessed to evaluate whether they were superior to the Stupp protocol alone, to determine the optimum treatment regimen for patients with newly diagnosed glioblastoma. We implemented a search strategy to identify studies in the following databases: PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang, and VIP, and assessed the quality of extracted data from the trials included. Statistical software was used to perform network meta-analysis. The use of novel therapeutic agents in combination with the Stupp protocol were all shown to be superior than the Stupp protocol alone for the treatment of newly diagnosed glioblastoma, ranked as follows: cilengitide 2000mg/5/week, bevacizumab in combination with irinotecan, nimotuzumab, bevacizumab, cilengitide 2000mg/2/week, cytokine-induced killer cell immunotherapy, and the Stupp protocol. In terms of serious adverse effects, the intervention group showed a 29% increase in the incidence of adverse events compared with the control group (patients treated only with Stupp protocol) with a statistically significant difference (RR=1.29; 95%CI 1.17-1.43; P<0.001). The most common adverse events were thrombocytopenia, lymphopenia, neutropenia, pneumonia, nausea, and vomiting, none of which were significantly different between the groups except for neutropenia, pneumonia, and embolism. All intervention drugs evaluated in our study were superior to the Stupp protocol alone when used in combination with it. However, we could not conclusively confirm whether cilengitide 2000mg/5/week was the optimum regime, as only one trial using this protocol was included in our study. Copyright © 2017. Published by Elsevier B.V.

  11. Heidelberg Neuro-Music Therapy for chronic-tonal tinnitus - treatment outline and psychometric evaluation.

    Science.gov (United States)

    Argstatter, Heike; Grapp, Miriam; Plinkert, Peter K; Bolay, Hans Volker

    2012-01-01

    Musical training positively influences the cortical plasticity of the brain and has proven to be effective in treating chronic tinnitus. A neuro-music therapy concept, the "Heidelberg Neuro-Music Therapy" treatment was developed and evaluated. A prospective, cross-sectional design was used. N = 135 patients (mean age 47 years) with chronic, tonal tinnitus attended a standardized protocol for Neuro-Music Therapy (either "standard therapy" ST or "compact therapy" CT). The results were compared to a cognitive behavioral placebo music therapy procedure (PT). Tinnitus distress was assessed using the German version of the Tinnitus-Questionnaire (TQ) at admission, at discharge and six months after therapy. Changes were assessed statistically and by means of clinical significance. TQ scores significantly improved - independent of group allocation. But more than 80% of the music therapy patients (both ST and CT) revealed a reliable improvement ("responder") compared to 44% in the PT group. Therapy impact seems to be lasting since TQ scores remained stable until follow-up at six months. The "Heidelberg Neuro-Music Therapy" is a method with fast onset and long lasting effect for patients with "tonal" tinnitus. A number of potential working factors accounting for the treatment success are highlighted.

  12. Safety of protocol violations in acute stroke tPA administration.

    Science.gov (United States)

    Lyerly, Michael J; Albright, Karen C; Boehme, Amelia K; Bavarsad Shahripour, Reza; Houston, James T; Rawal, Pawan V; Kapoor, Niren; Alvi, Muhammad; Sisson, April; Alexandrov, Anne W; Alexandrov, Andrei V

    2014-01-01

    Intravenous (IV) tissue plasminogen activator remains the only approved therapy for acute ischemic stroke (AIS) in the United States; however, less than 10% of patients receive treatment. This is partially because of the large number of contraindications, narrow treatment window, and physician reluctance to deviate from these criteria. We retrospectively analyzed consecutive patients who received IV thrombolysis at our stroke center for National Institute of Neurological Disorders and Stroke (NINDS) protocol violations and rates of symptomatic intracerebral hemorrhage (sICH). Other outcome variables included systemic hemorrhage, modified Rankin Scale at discharge, and discharge disposition. A total of 212 patients were identified in our stroke registry between 2009 and 2011 and included in the analysis. Protocol violations occurred in 76 patients (36%). The most common violations were thrombolysis beyond 3 hours (26%), aggressive blood pressure management (15%), elevated prothrombin time (PT) or partial thromboplastin time (PTT) (6.6%), minor or resolving deficits (4.2%), unclear time of onset (3.9%), and stroke within 3 months (3%). There were no significant differences in any of the safety outcomes or discharge disposition between patients with or without protocol violations. Controlling for age, National Institutes of Health Stroke Scale on admission, and glucose on admission, there was no significant increase in sICH (odds ratio: 3.8; 95% confidence interval: .37-38.72) in the patients who had protocol violations. Despite more than one third of patients receiving thrombolysis with protocol violations, overall rates of hemorrhage remained low and did not differ from those who did not have violations. Our data support the need to expand access to thrombolysis in AIS patients. Published by Elsevier Inc.

  13. Evaluation of the Effectiveness of Two Morphine Protocols to Treat Neonatal Abstinence Syndrome in a Level II Nursery in a Community Hospital.

    Science.gov (United States)

    DeAtley, Heather N; Burton, Amanda; Fraley, Michelle DeLuca; Haltom, Joan

    2017-07-01

    The authors sought to evaluate the impact on length of hospital stay and treatment duration of morphine after implementation of a change in the institutional protocol for managing neonatal abstinence syndrome (NAS) in an effort to improve patient outcomes. A single-center, retrospective chart review was conducted at a Level II nursery in a community hospital in Kentucky. Fifty-nine neonates born between January 1, 2014, and December 31, 2015, who were diagnosed with NAS and received morphine for treatment were included. The protocol 1 group consisted of 33 neonates who received an initial dose of morphine 0.04 mg/kg/dose administered orally every 4 hours (January 1-December 31, 2014), and the protocol 2 group consisted of 26 neonates who received an initial dose of morphine 0.06 mg/kg/dose administered orally every 3 hours (January 1-November 30, 2015), after a change in the protocol for managing NAS was implemented on January 1, 2015. Data were reviewed and compared between the two protocol groups to determine the impact that the dosage change had on length of hospital stay and morphine treatment duration. The average length of stay decreased by 7 days in the protocol 2 group compared with the protocol 1 group (21 vs 28.65 days). The average duration of treatment decreased by 7 days in the protocol 2 group compared with the protocol 1 group (18.3 vs 25.4 days). These differences between groups were not statistically significant, however, because the population size was not large enough to achieve adequate power. These results indicate that protocol 2 displayed the potential to decrease length of stay and duration of treatment compared with protocol 1 at this facility; however, balancing higher starting doses with the risk of oversedation will continue to challenge the health care team. Concern for oversedation when using the higher starting dose in protocol 2 has prompted further research (e.g., protocol 3, initial morphine 0.05 mg/kg/dose every 3 hrs). Continued

  14. Analyzing the effect of routing protocols on media access control protocols in radio networks

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, C. L. (Christopher L.); Drozda, M. (Martin); Marathe, A. (Achla); Marathe, M. V. (Madhav V.)

    2002-01-01

    We study the effect of routing protocols on the performance of media access control (MAC) protocols in wireless radio networks. Three well known MAC protocols: 802.11, CSMA, and MACA are considered. Similarly three recently proposed routing protocols: AODV, DSR and LAR scheme 1 are considered. The experimental analysis was carried out using GloMoSim: a tool for simulating wireless networks. The main focus of our experiments was to study how the routing protocols affect the performance of the MAC protocols when the underlying network and traffic parameters are varied. The performance of the protocols was measured w.r.t. five important parameters: (i) number of received packets, (ii) average latency of each packet, (iii) throughput (iv) long term fairness and (v) number of control packets at the MAC layer level. Our results show that combinations of routing and MAC protocols yield varying performance under varying network topology and traffic situations. The result has an important implication; no combination of routing protocol and MAC protocol is the best over all situations. Also, the performance analysis of protocols at a given level in the protocol stack needs to be studied not locally in isolation but as a part of the complete protocol stack. A novel aspect of our work is the use of statistical technique, ANOVA (Analysis of Variance) to characterize the effect of routing protocols on MAC protocols. This technique is of independent interest and can be utilized in several other simulation and empirical studies.

  15. [New protocol combining orthodontics and implant therapy for partially edentulous adult patients. Part I: Description of the Decker protocol].

    Science.gov (United States)

    Davarpanah, K; Decker, A; Sache, M P; Deffrennes, D; Demurashvili, G; Szmukler-Moncler, S

    2014-12-01

    The treatment of adult malocclusion is usually complex and pluridisciplinary. Its prognosis is not reliable. We present a new clinical protocol to improve the management and final result. We use a specific software (Simplant®, OMS®, Materialise Dental) and its accessory modules. It allows visualization of the expected final clinical result of the orthodontic treatment. Combined with guided-surgery, it allows placing implants at the beginning of treatment in a position that is compatible with the final position. The implants serve as absolute anchorage for dental motions during the orthodontic step; it is also used to support the final prosthesis. The treatment is thus optimized and its prognosis is improved. Finally, the reversed surgical sequences shorten the treatment thus promoting the compliance of patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Study of provenance properties on ancient porcelain of Yue Kiln at Si-long-kou with NAA

    International Nuclear Information System (INIS)

    Feng Songlin; Fan Dongyu; Feng Xiangqian; Cheng Lin; Lei Yong; Xu Qing; Quan Huishan; Shen Yueming; Zhou Zhexi; Zhang Wenjiang

    2005-01-01

    Chinese ancient porcelain history has lasted about three thousands years from Shang Dynasty (1100∼1600 BC). A large amount of ancient porcelain sherds with accuracy provenance and ages were excavated from a lot of kiln sites in China. Archaeologists and ceramic experts have recognized and researched it with excavated stratum, utensil shape, body quality, glaze color and painting pattern. However, the appearance characteristic of some ancient porcelain manufactured in different kilns is similar. Therefore, it is still difficult to identify the provenance and ages of the samples excavated from some sites using traditional methods. Up, to now, many problems of Chinese ancient porcelain are confused for archaeologist and collecting experts. The elemental composition of ancient porcelain shows certain information of provenance and age. Especially, the sorts and contents of the elements in porcelain didn't change, so it is very useful to determine the provenance of ancient porcelain with elemental composition characteristics. Provenance characteristic is the important scientific information to identify ancient porcelain wares excavated from sites and graves. The porcelain samples of Si-Long-Kou Yue kiln in Zhejiang Province of china have been analyzed with NAA in this paper. The provenance characteristic was compared with it of Hong-Zhou kiln of Jiang-Xi Province and Yao-Zhou kiln of Shan-Xi Province. The experimental data were studied with statistic methods. The results show that the chemical compositions of porcelain body samples for three kilns were different. The difference was been able identified. The porcelain body materials of both Si-Long-Kou Yue kiln and Hong-Zhou kiln of Jiang-Xi were similar. The samples of Yao-Zhou kiln in north of China existed obvious difference.

  17. SU-F-T-227: A Comprehensive Patient Specific, Structure Specific, Pre-Treatment 3D QA Protocol for IMRT, SBRT and VMAT - Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Gueorguiev, G; Cotter, C; Young, M; Toomeh, D [Massachusetts General Hospital Boston MA (United States); University of Massachusetts Lowell Lowell, MA (United States); Khan, F; Crawford, B; Turcotte, J; Sharp, G [Massachusetts General Hospital Boston MA (United States); Mah’D, M [University of Massachusetts Lowell Lowell, MA (United States)

    2016-06-15

    Purpose: To present a 3D QA method and clinical results for 550 patients. Methods: Five hundred and fifty patient treatment deliveries (400 IMRT, 75 SBRT and 75 VMAT) from various treatment sites, planned on Raystation treatment planning system (TPS), were measured on three beam-matched Elekta linear accelerators using IBA’s COMPASS system. The difference between TPS computed and delivered dose was evaluated in 3D by applying three statistical parameters to each structure of interest: absolute average dose difference (AADD, 6% allowed difference), absolute dose difference greater than 6% (ADD6, 4% structure volume allowed to fail) and 3D gamma test (3%/3mm DTA, 4% structure volume allowed to fail). If the allowed value was not met for a given structure, manual review was performed. The review consisted of overlaying dose difference or gamma results with the patient CT, scrolling through the slices. For QA to pass, areas of high dose difference or gamma must be small and not on consecutive slices. For AADD to manually pass QA, the average dose difference in cGy must be less than 50cGy. The QA protocol also includes DVH analysis based on QUANTEC and TG-101 recommended dose constraints. Results: Figures 1–3 show the results for the three parameters per treatment modality. Manual review was performed on 67 deliveries (27 IMRT, 22 SBRT and 18 VMAT), for which all passed QA. Results show that statistical parameter AADD may be overly sensitive for structures receiving low dose, especially for the SBRT deliveries (Fig.1). The TPS computed and measured DVH values were in excellent agreement and with minimum difference. Conclusion: Applying DVH analysis and different statistical parameters to any structure of interest, as part of the 3D QA protocol, provides a comprehensive treatment plan evaluation. Author G. Gueorguiev discloses receiving travel and research funding from IBA for unrelated to this project work. Author B. Crawford discloses receiving travel funding from

  18. Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study.

    Science.gov (United States)

    Sanchez, Katherine; Eghaneyan, Brittany H; Trivedi, Madhukar H

    2016-07-29

    Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications. Stigma is primarily perpetuated due to inadequate disease literacy and cultural factors. Common concerns about depression treatments among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. The current manuscript presents the study protocol for the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) study funded by the Center for Medicare and Medicaid Services (CMS) Grants to Support the Hispanic Health Services Research Grant Program. DESEO will implement universal screening with a self-report depression screening tool (the 9-item Patient Health Questionnaire (PHQ-9)) that is presented through a customized web application and a Depression Education Intervention (DEI) designed to increase disease literacy, and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. This project will be conducted at one community health center whose patient population is majority Hispanic. The target enrollment for recruitment is 350 patients over the 24-month study period. A one-group, pretest-posttest design will be used to asses knowledge of depression and its treatment and related stigma before, immediately after, and one month post intervention. Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment

  19. Provenance of sandstone on the western flank of Anambra Basin ...

    African Journals Online (AJOL)

    Petrographic and heavy mineral studies were carried out on clastic deposits that crop out in Ikpeshi, Auchi and Fugar localities in order to determine the provenance of the ... The heavy mineral suites and the petrographic signatures of the sandstones suggest derivation mainly from acid igneous rocks, gneisses and older ...

  20. Can cathodoluminescence of feldspar be used as provenance indicator?

    Science.gov (United States)

    Scholonek, Christiane; Augustsson, Carita

    2016-05-01

    We have studied feldspar from crystalline rocks for its textural and spectral cathodoluminescence (CL) characteristics with the aim to reveal their provenance potential. We analyzed ca. 60 rock samples of plutonic, volcanic, metamorphic, and pegmatitic origin from different continents and of 16 Ma to 2 Ga age for their feldspar CL textures and ca. 1200 feldspar crystals from these rocks for their CL color spectra. Among the analyzed rocks, igneous feldspar is most commonly zoned, whereby oscillatory zoning can be confirmed to be typical for volcanic plagioclase. The volcanic plagioclase also less commonly contains twin lamellae that are visible in CL light than crystals from other rock types. Alkali feldspar, particularly from igneous and pegmatitic rocks, was noted to be most affected by alteration features, visible as dark spots, lines and irregular areas. The size of all textural features of up to ca. 150 μm, in combination with possible alteration in both the source area and the sedimentary system, makes the CL textures of feldspar possible to use for qualitative provenance research only. We observed alkali feldspar mostly to luminesce in a bluish color and sometimes in red, and plagioclase in green to yellow. The corresponding CL spectra are dominated by three apparent intensity peaks at 440-520 nm (mainly blue), 540-620 nm (mainly green) and 680-740 nm (red to infrared). A dominance of the peak in the green wavelength interval over the blue one for plagioclase makes CL particularly useful for the differentiation of plagioclase from alkali feldspar. An apparent peak position in red to infrared at < 710 nm for plagioclase mainly is present in mafic rocks. Present-day coastal sand from Peru containing feldspar with the red to infrared peak position mainly exceeding 725 nm for northern Peruvian sand and a larger variety for sand from southern Peru illustrates a discriminative effect of different source areas. We conclude that the provenance application

  1. The photon is no strict particle and nonlocality is far from being proven

    Energy Technology Data Exchange (ETDEWEB)

    Greulich, Karl Otto [Fritz Lipmann Institut, Jena (Germany)

    2010-07-01

    Two aspects of philosophical discussions on physics are the wave particle dualism and non locality including entanglement. However the strict particle aspect of the photon, in the common sense view, has never been proven. The accumulation time argument, the only experimental verification of a strictly particle like photon, has so far not yet been satisfied. Also, experiments thought to prove nonlocality have loophole which have so far not yet been safely closed, and now an even more serious loophole emerges. Thus, also nonlocality cannot be seen as proven. This demands some fine tuning of philosophical discussions on critical experiments in physics.

  2. Different types of power reactors and provenness

    International Nuclear Information System (INIS)

    Goodman, E.I.

    1977-01-01

    The lecture guides the potential buyer in the selection of a reactor type. Recommended criteria regarding provenness, licensability, and contractual arrangements are defined and discussed. Tabular data summarizing operating experience and commercial availability of units are presented and discussed. The status of small and medium power reactors which are of interest to many developing countries is presented. It is stressed that each prospective buyer will have to establish his own criteria based on specific conditions which will be applied to reactor selection. In all cases it will be found that selection, either pre-selection of bidders or final selection of supplier, will be a fairly complex evaluation. (orig.) [de

  3. Real-world outcomes of treatment for acute lymphoblastic leukemia during adolescence in a financially restricted environment: Results at a single center in Latin America.

    Science.gov (United States)

    Jaime-Pérez, José C; Jiménez-Castillo, Raúl A; Pinzón-Uresti, Mónica A; Cantú-Rodríguez, Olga G; Herrera-Garza, José L; Marfil-Rivera, Luis J; Gómez-Almaguer, David

    2017-07-01

    There is a paucity of the studies of adolescents with acute lymphoblastic leukemia (ALL). This is more noticeable in low- and middle-income countries. The international 5-year event-free survival (EFS) and overall survival (OS) for this age group is around 80%, with pediatric-inspired protocols offering better results. A retrospective analysis of adolescents aged 16-20 diagnosed with ALL during the period 2004-2015 treated with a high-risk pediatric protocol at an academic center from a middle-income country was performed. Five-year OS and EFS were estimated by the Kaplan-Meier analysis. Hazard ratios of relapse and death were estimated by the Cox regression model. Five-year EFS and OS for 57 adolescents were 23.3% and 48.9%, respectively. From the 41 patients who achieved complete remission, 24 (58.5%) relapsed. Bone marrow and central nervous system were the most frequent sites of relapse. Hazard ratio of treatment failure and death for patients with organomegaly at diagnosis was 2.026 and 2.970, respectively. Treatment-related toxicity developed in 31 (54.4%) patients and febrile neutropenia was the most frequent in 14 (24.6%) cases. Twelve patients (21.1%) had poor adherence to treatment. High relapse rate and low 5-year EFS compared with international standards, was documented. Use of intensified pediatric regimens, adherence to proven effective medications, improved supportive care, and prevention of abandonment are necessary to improve survival rates in these patients. © 2016 Wiley Periodicals, Inc.

  4. PyPedia: using the wiki paradigm as crowd sourcing environment for bioinformatics protocols.

    Science.gov (United States)

    Kanterakis, Alexandros; Kuiper, Joël; Potamias, George; Swertz, Morris A

    2015-01-01

    Today researchers can choose from many bioinformatics protocols for all types of life sciences research, computational environments and coding languages. Although the majority of these are open source, few of them possess all virtues to maximize reuse and promote reproducible science. Wikipedia has proven a great tool to disseminate information and enhance collaboration between users with varying expertise and background to author qualitative content via crowdsourcing. However, it remains an open question whether the wiki paradigm can be applied to bioinformatics protocols. We piloted PyPedia, a wiki where each article is both implementation and documentation of a bioinformatics computational protocol in the python language. Hyperlinks within the wiki can be used to compose complex workflows and induce reuse. A RESTful API enables code execution outside the wiki. Initial content of PyPedia contains articles for population statistics, bioinformatics format conversions and genotype imputation. Use of the easy to learn wiki syntax effectively lowers the barriers to bring expert programmers and less computer savvy researchers on the same page. PyPedia demonstrates how wiki can provide a collaborative development, sharing and even execution environment for biologists and bioinformaticians that complement existing resources, useful for local and multi-center research teams. PyPedia is available online at: http://www.pypedia.com. The source code and installation instructions are available at: https://github.com/kantale/PyPedia_server. The PyPedia python library is available at: https://github.com/kantale/pypedia. PyPedia is open-source, available under the BSD 2-Clause License.

  5. Ocean Optics Protocols for Satellite Ocean Color Sensor Validation. Revised

    Science.gov (United States)

    Fargion, Giulietta S.; Mueller, James L.

    2000-01-01

    The document stipulates protocols for measuring bio-optical and radiometric data for the Sensor Intercomparison and Merger for Biological and Interdisciplinary Oceanic Studies (SIMBIOS) Project activities and algorithm development. This document supersedes the earlier version (Mueller and Austin 1995) published as Volume 25 in the SeaWiFS Technical Report Series. This document marks a significant departure from, and improvement on, theformat and content of Mueller and Austin (1995). The authorship of the protocols has been greatly broadened to include experts specializing in some key areas. New chapters have been added to provide detailed and comprehensive protocols for stability monitoring of radiometers using portable sources, abovewater measurements of remote-sensing reflectance, spectral absorption measurements for discrete water samples, HPLC pigment analysis and fluorometric pigment analysis. Protocols were included in Mueller and Austin (1995) for each of these areas, but the new treatment makes significant advances in each topic area. There are also new chapters prescribing protocols for calibration of sun photometers and sky radiance sensors, sun photometer and sky radiance measurements and analysis, and data archival. These topic areas were barely mentioned in Mueller and Austin (1995).

  6. Treatment of neonatal sepsis with intravenous immune globulin

    DEFF Research Database (Denmark)

    Brocklehurst, Peter; Farrell, Barbara; King, Andrew

    2011-01-01

    Neonatal sepsis is a major cause of death and complications despite antibiotic treatment. Effective adjunctive treatments are needed. Newborn infants are relatively deficient in endogenous immunoglobulin. Meta-analyses of trials of intravenous immune globulin for suspected or proven neonatal sepsis...

  7. Early functional outcome of two surgical protocols used in the repair ...

    African Journals Online (AJOL)

    treatment protocols for primary management of patients with complete unilateral cleft ... Pediatric Surgery Unit, Zagazig University, Faculty of Medicine, Zagazig, Egypt. Tel: +0553655220 ..... Dental arch relationships. Cleft Palate. Craniofac J ...

  8. Procalcitonin-guided antibiotic treatment in critically ill patients.

    Science.gov (United States)

    Hohn, Andreas; Heising, Bernhard; Schütte, Jan-Karl; Schroeder, Olaf; Schröder, Stefan

    2017-02-01

    In critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (PCT) protocols. International sepsis guidelines and guidelines on antibiotic stewardship strategies recommend PCT as helpful laboratory marker for a rational use of antibiotics. A number of studies and meta-analyses have confirmed the effectiveness of PCT-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. But in clinical practice, there is still uncertainty how to interpret PCT levels and how to adjust antibiotic treatment in various infectious situations, especially in the perioperative period. This narrative review gives an overview on the application of PCT-protocols in critically ill patients with severe bacterial infections on the basis of 5 case reports and the available literature. Beside strengths and limitations of this biomarker, also varying kinetics and different maximum values with regard to the infectious focus and pathogens are discussed. PCT-guided antibiotic treatment appears to be safe and effective. Most of the studies revealed a shorter antibiotic treatment without negative clinical outcomes. Cost effectiveness is still a matter of debate and effects on bacterial resistance due to shorter treatments, possible lower rates of drug-related adverse events, or decreased rates of Clostridium difficile infections are not yet evaluated. Guidance of antibiotic treatment can effectively be supported by PCT-protocols. However, it is important to consider the limitations of this biomarker and to use PCT protocols along with antibiotic stewardship programmes and regular clinical rounds together with infectious diseases specialists.

  9. Implementation of a protocol to reduce occurrence of retained sponges after vaginal delivery.

    Science.gov (United States)

    Lutgendorf, Monica A; Schindler, Lynnett L; Hill, James B; Magann, Everett F; O'Boyle, John D

    2011-06-01

    Retained sponges (gossypiboma) following vaginal delivery are an uncommon occurrence. Although significant morbidity from such an event is unlikely, there are many reported adverse effects, including symptoms of malodorous discharge, loss of confidence in providers and the medical system, and legal claims. To report a protocol intended to reduce the occurrence of retained sponges following vaginal delivery. After identification of limitations with existing delivery room protocols, we developed a sponge count protocol to reduce occurrence of retained vaginal sponges. We report our experience at Naval Medical Center Portsmouth, a large tertiary care military treatment facility with our efforts to implement a sponge count protocol to reduce retained sponges following vaginal delivery. With appropriate pre-implementation training, protocols which incorporate post-delivery vaginal sweep and sponge counts are well accepted by the health care team and can be incorporated into the delivery room routine.

  10. Using external and internal locking plates in a two-stage protocol for treatment of segmental tibial fractures.

    Science.gov (United States)

    Ma, Ching-Hou; Tu, Yuan-Kun; Yeh, Jih-Hsi; Yang, Shih-Chieh; Wu, Chin-Hsien

    2011-09-01

    The tibial segmental fractures usually follow high-energy trauma and are often associated with many complications. We designed a two-stage protocol for these complex injuries. The aim of this study was to assess the outcome of tibial segmental fractures treated according to this protocol. A prospective series of 25 consecutive segmental tibial fractures were treated using a two-stage procedure. In the first stage, a low-profile locking plate was applied as an external fixator to temporarily immobilize the fractures after anatomic reduction had been achieved followed by soft-tissue reconstruction. The second stage involved definitive internal fixation with a locking plate using a minimally invasive percutaneous plate osteosynthesis technique. The median follow-up was 32 months (range, 20-44 months). All fractures achieved union. The median time for the proximal fracture union was 23 weeks (range, 12-30 weeks) and that for distal fracture union was 27 weeks (range, 12-46 weeks; p = 0.08). Functional results were excellent in 21 patients and good in 4 patients. There were three cases of delayed union of distal fracture. Valgus malunion >5 degrees occurred in two patients, and length discrepancy >1 cm was observed in two patients. Pin tract infection occurred in three patients. Use of the two-stage procedure for treatment of segmental tibial fractures is recommended. Surgeons can achieve good reduction with stable temporary fixation, soft-tissue reconstruction, ease of subsequent definitive fixation, and high union rates. Our patients obtained excellent knee and ankle joint motion, good functional outcomes, and a comfortable clinical course.

  11. Evaluation of empirical treatment for blood culture-negative endocarditis.

    Science.gov (United States)

    Menu, Estelle; Gouriet, Frédérique; Casalta, Jean-Paul; Tissot-Dupont, Hervé; Vecten, Maude; Saby, Ludivine; Hubert, Sandrine; Salaun, Erwan; Theron, Alexis; Grisoli, Dominique; Lavoute, Cécile; Collart, Frédéric; Habib, Gilbert; Raoult, Didier

    2017-01-01

    Much progress has been made in understanding the main causes of blood culture-negative endocarditis (BCNE). Few studies concerning BCNE treatment (due to previous antibiotics used or fastidious pathogens) are available. We performed this study to evaluate the effectiveness of our therapeutic protocol in BCNE, based on compliance with the protocol, outcome and 1 year mortality. We collected prospectively and analysed retrospectively cases of BCNE between 2002 and 2014, using a simplified and standardized protocol developed by our multidisciplinary team. We apply two kinds of protocols to treat BCNE, which include only four intravenous antimicrobial agents: amoxicillin, vancomycin, gentamicin and amphotericin B. We had 177 patients with definite BCNE. There were 154 (87.0%) patients treated with both appropriate antimicrobial agents and appropriate duration of treatment. We analysed the causes of inappropriate treatment in 13 (7.3%) cases and inappropriate duration in 10 (5.6%) cases. The treatment changes were justified in all cases except one of discharge against medical advice. The fatality rate was 5.1% (nine cases) and all deaths occurred in the group of patients who were treated with appropriate treatment; however, four deaths were not attributable to empirical treatment failure. Concerning the other deaths, the lack of surgical management, in association with empirical treatment, could explain our protocol's failure, such as poorly tolerated surgery. Our protocol is efficient and our mortality rate was low, compared with the literature review. This may result from a strategy that uses a sampling procedure and a standardized protocol at the same time. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. A protocol for the secure two-party quantum scalar product

    Energy Technology Data Exchange (ETDEWEB)

    He, Li-Bao, E-mail: helibao@mail.ustc.edu.cn [National High Performance Computing Center, Department of Computer Science and Technology, USTC, Hefei 230027 (China); Suzhou Institute for Advanced Study, USTC, Suzhou 215123 (China); Huang, Liu-Sheng; Yang, Wei; Xu, Rui [National High Performance Computing Center, Department of Computer Science and Technology, USTC, Hefei 230027 (China); Suzhou Institute for Advanced Study, USTC, Suzhou 215123 (China)

    2012-03-19

    Secure scalar product serves as an important primitive for secure multi-party computation and has a wide application in different areas, such as statistical analysis, data mining, computational geometry, etc. How to collaboratively compute the correct scalar product result without leaking any participants' private information becomes the primary principle of designing secure scalar product schemes. In this Letter, we present a secure two-party quantum scalar product scheme via quantum entanglement and quantum measurement with the help of a non-colluding third party (TP). Furthermore, the scheme is proven to be secure under various kinds of outside attacks and participant attacks. -- Highlights: ► We extend the secure two-party scalar product to the quantum field. ► Our protocol is built upon quantum entanglement and quantum measurement. ► Communication cost is acceptable if the elements of participants' private vectors are not too sparse. ► Participants will leak no private information under the no-collusion model.

  13. A protocol for the secure two-party quantum scalar product

    International Nuclear Information System (INIS)

    He, Li-Bao; Huang, Liu-Sheng; Yang, Wei; Xu, Rui

    2012-01-01

    Secure scalar product serves as an important primitive for secure multi-party computation and has a wide application in different areas, such as statistical analysis, data mining, computational geometry, etc. How to collaboratively compute the correct scalar product result without leaking any participants' private information becomes the primary principle of designing secure scalar product schemes. In this Letter, we present a secure two-party quantum scalar product scheme via quantum entanglement and quantum measurement with the help of a non-colluding third party (TP). Furthermore, the scheme is proven to be secure under various kinds of outside attacks and participant attacks. -- Highlights: ► We extend the secure two-party scalar product to the quantum field. ► Our protocol is built upon quantum entanglement and quantum measurement. ► Communication cost is acceptable if the elements of participants' private vectors are not too sparse. ► Participants will leak no private information under the no-collusion model.

  14. Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077

    Directory of Open Access Journals (Sweden)

    Rickard Kristen R

    2011-03-01

    Full Text Available Abstract Background Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple Candida testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases. Methods/Design Using a prospective, randomised, open-label, blinded-endpoint (PROBE study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care. Outcomes will be obtained from population databases. A sample size of 3,208 women with Candida colonisation (1,604 per arm is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8. Analyses will be by intention to treat. Discussion For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with Candida may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design. This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in

  15. Low among-provenance differences in structural and functional plasticity in response to nutrients in saplings of the circum-Mediterranean tree Arbutus unedo L.

    Science.gov (United States)

    Santiso, Xabier; Retuerto, Rubén

    2015-10-01

    The Mediterranean region is an area of special interest for conservation where the incidence of multiple drivers of global change is expected to increase. One of the factors predicted to change is soil-nutrient availability, an essential factor for plant growth. Thus, study of the effects of variation in this parameter is especially relevant in species with a circum-Mediterranean distribution, such as Arbutus unedo L., in which the different provenances grow in different habitats, which must differ in nutritional conditions. We aimed to determine the effect of provenance on plasticity, to establish whether structural and morphological traits differ in the level of plasticity and to assess how nutrients affect the photosynthetic light response. In a common garden experiment, we studied seven provenances from the circum-Mediterranean range of A. unedo and established two nutrient treatments (low and high nutrient availability). We measured physiological and structural traits in 1-year-old sapling and determined a phenotypic plasticity index (PPI) to quantify the level of plasticity, whereas the radiation effects were tested by construction and analysis of light response curves. Interestingly, provenance did not explain a significant amount of variance, but the plasticity was four times higher for the structural traits than for the physiological traits. Therefore, the plasticity to nutrient availability will not favour or prevent the expansion or contraction of the range of any of these provenances of A. unedo. Furthermore, the structural plasticity demonstrated the ability of the strawberry tree to optimize resource allocation, whereas the physiology remained stable, thus avoiding extra expenditure. The study findings also suggest that increased availability of nutrients would improve the performance of the species during the Mediterranean summer, characterized by high irradiance. These abilities will be key to the survival of saplings of the species under the future

  16. Neoadjuvant chemoradiation (modified Eilber protocol) versus adjuvant radiotherapy in the treatment of extremity soft tissue sarcoma

    International Nuclear Information System (INIS)

    Lehane, Chris; Parasyn, Andrew; Ho, Frederick; Thompson, Stephen R.; Smee, Robert; Links, David; Crowe, Phil; Lewis, Craig; Friedlander, Michael; Williams, Janet

    2016-01-01

    Local control for extremity soft tissue sarcomas (STS) requires surgery combined with radiotherapy, usually given pre-operatively or post-operatively. The modified Eilber protocol, a neoadjuvant chemoradiation regimen, has been reported with excellent local control rates. This retrospective single-centre study compared outcomes for patients treated with the modified Eilber protocol with those treated with standard adjuvant radiotherapy. Twenty-nine patients were treated with modified Eilber protocol. Thirty-four patients received adjuvant radiotherapy. Three patients (10%) in the Eilber group and five patients (15%) in the Adjuvant group developed local recurrence (P = 0.87). Major acute wound complications were noted in four patients in each group (P = 0.55). One patient (3.4%) in the Eilber group developed Grade 3 or 4 late toxicities after 1 year compared with nine patients (27%) in the Adjuvant group (P = 0.02). Patients with a diagnosis of extremity STS were retrospectively reviewed from the Prince of Wales Hospital Sarcoma Database from 1995 to 2012. Sixty-three patients underwent curative surgery with either neoadjuvant Eilber chemoradiotherapy (Eilber) or adjuvant radiotherapy (Adjuvant). Neoadjuvant chemoradiation (Eilber protocol) provided similar rates of local control when compared with adjuvant radiotherapy. Acute wound complication rates were similar but there was less severe late toxicity in the Eilber group.

  17. Effects Of Drought Stress on Germination in Fourteen Provenances of Pinus Brutia Ten. Seeds in Turkey

    Directory of Open Access Journals (Sweden)

    Hakan Şevik

    2015-02-01

    Full Text Available Pinus brutia Ten., Red pine, known to be tough drought resistant pine specie, could effectively be used for afforestation of disturbed areas. It is of great interest for the afforestation in arid zones. Appropriate seed sources for the specific areas guarantees reforestation success. Away from its native areas Pinus brutia Ten. is planted for its ornamental value and timber production purposes. Selection of drought resistant provenances can very well increase the survival success. In this study, the effects of water potential on germination were studied in fourteen provenances of Pinus brutia Ten. from Turkey. Water potentials between 0 and -8 bars were obtained using polyethylene glycol 6000 (PEG-6000 solutions. Seeds were kept for 35 day at 20 ± 0.5°C. A decrease in water potential produced a marked reduction in germination percentage and germination value. As a result, significant variations between the provenances were found. It was determined that, under a -8 bar water stress, Isparta-Bucak and Mersin-Silifke, respectively corresponding to 58% and 57% of the control group, were the least water stress affected provenances.

  18. Rehabilitation protocol for patellar tendinopathy applied among 16- to 19-year old volleyball players.

    Science.gov (United States)

    Biernat, Ryszard; Trzaskoma, Zbigniew; Trzaskoma, Lukasz; Czaprowski, Dariusz

    2014-01-01

    The aim of the study was to investigate the efficacy of rehabilitation protocol applied during competitive period for the treatment of patellar tendinopathy. A total of 28 male volleyball players were divided into two groups. Fifteen from experimental group (E) and 13 from control group (C) fulfilled the same tests 3 times: before the training program started (first measurement), after 12 weeks (second measurement) and after 24 weeks (third measurement). The above-mentioned protocol included the following: USG imagining with color Doppler function, clinical testing, pain intensity evaluation with VISA-P questionnaire, leg muscle strength and power and jumping ability measurements. The key element of the rehabilitation program was eccentric squat on decline board with additional unstable surface. The essential factor of the protocol was a set of preventive functional exercises, with focus on eccentric exercises of hamstrings. Patellar tendinopathy was observed in 18% of the tested young volleyball players. Implementation of the presented rehabilitation protocol with eccentric squat on decline board applied during sports season lowered the pain level of the young volleyball players. Presented rehabilitation protocol applied without interrupting the competitive period among young volleyball players together with functional exercises could be an effective method for the treatment of patellar tendinopathy.

  19. Examining recombinant human TSH primed 131I therapy protocol in patients with metastatic differentiated thyroid carcinoma: comparison with the traditional thyroid hormone withdrawal protocol

    International Nuclear Information System (INIS)

    Rani, Deepa; Kaisar, Sushma; Awasare, Sushma; Kamaldeep; Abhyankar, Amit; Basu, Sandip

    2014-01-01

    Recombinant human thyroid-stimulating hormone (rhTSH)-based protocol is a promising recent development in the management of differentiated thyroid carcinoma (DTC). The objectives of this prospective study were: (1) to assess the feasibility and efficacy of the rhTSH primed 131 I therapy protocol in patients with DTC with distant metastatic disease, (2) to perform lesional dosimetry in this group of patients compared to the traditional protocol, (3) to document the practical advantages (patient symptoms and hospital stay) of the rhTSH protocol compared to the traditional thyroid hormone withdrawal protocol, (4) to document and record any adverse effect of this strategy, (5) to compare the renal function parameters, and (6) to compare the serum TSH values achieved in either of the protocols in this group of patients. The study included 37 patients with metastatic DTC having lung or skeletal metastases or both. A comparison of lesional radiation absorbed dose, hospital stay, renal function tests, and symptom profile was undertaken between the traditional thyroid hormone withdrawal protocol and rhTSH-based therapy protocol. Dosimetric calculations of metastatic lesions were performed using lesion uptake and survey meter readings for calculation of effective half-life. Non-contrast-enhanced CT was used for assessment of tumor volume. Quality of life was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QOL forms. A comparison of pretreatment withdrawal thyroglobulin (TG) was done with the withdrawal TG level 3 months after treatment. The mean effective half-life of 131 I in metastatic lesions was less during the rhTSH protocol (29.49 h) compared to the thyroid hormone withdrawal protocol (35.48 h), but the difference was not statistically significant (p = 0.056). The mean 24-h % uptake of the lesions during the traditional protocol (4.84 %) was slightly higher than the 24-h % uptake during the rhTSH protocol (3.56 %), but the

  20. Treatment results of the Tokai-POSG 8610HR pilot protocol for children with high-risk acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Hongo, Teruaki; Inoue, Noriko [Hamamatsu Medical Univ., Shizuoka (Japan); Horibe, Keizo [and others

    1997-10-01

    We reported the treatment results of Tokai-POSG 8610HR pilot protocol for children with high-risk acute lymphoblastic leukemia (ALL). From Oct. 1986 to Jan. 1991, 43 eligible children were enrolled, who had one or more following high-risk factors: age{>=}10 years old, initial white blood cell count (WBC) of 50,000/{mu}l or more, and extramedullary leukemia. All patients received induction therapy consisting of vincristine, dexamethasone, cyclophosphamide and daunorubicin, followed by central nervous system prophylaxis by 24 Gy cranial irradiation, consolidation therapy and cyclic maintenance by multidrugs for 3 years after diagnosis. Complete remission was achieved in 39 patients. The 5-year event-free survival (EFS) rate was 72.6{+-}7.1%. The only factor of an adverse association with EFS was a initial WBC of 10,000/{mu}l or more (p=0.002) in the 24 patients who were 10 years old or over. The factors related to a negative survival were male gender (p=0.031) and an initial WBC of 10,000/{mu}l or more (p=0.0012) in 43 patients. The major toxicities of the therapy were pancreatitis and allergic reaction due to{sub L}-ASP administration, and growth hormone deficiency due to cranial irradiation. Tokai 8610HR pilot protocol was a promising regimen, but further intensive chemotherapy was needed for improvement or the prognosis of the older patients with high initial WBC greater than 10,000/{mu}l. (author)

  1. Treatment results of the Tokai-POSG 8610HR pilot protocol for children with high-risk acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Hongo, Teruaki; Inoue, Noriko; Horibe, Keizo

    1997-01-01

    We reported the treatment results of Tokai-POSG 8610HR pilot protocol for children with high-risk acute lymphoblastic leukemia (ALL). From Oct. 1986 to Jan. 1991, 43 eligible children were enrolled, who had one or more following high-risk factors: age≥10 years old, initial white blood cell count (WBC) of 50,000/μl or more, and extramedullary leukemia. All patients received induction therapy consisting of vincristine, dexamethasone, cyclophosphamide and daunorubicin, followed by central nervous system prophylaxis by 24 Gy cranial irradiation, consolidation therapy and cyclic maintenance by multidrugs for 3 years after diagnosis. Complete remission was achieved in 39 patients. The 5-year event-free survival (EFS) rate was 72.6±7.1%. The only factor of an adverse association with EFS was a initial WBC of 10,000/μl or more (p=0.002) in the 24 patients who were 10 years old or over. The factors related to a negative survival were male gender (p=0.031) and an initial WBC of 10,000/μl or more (p=0.0012) in 43 patients. The major toxicities of the therapy were pancreatitis and allergic reaction due to L -ASP administration, and growth hormone deficiency due to cranial irradiation. Tokai 8610HR pilot protocol was a promising regimen, but further intensive chemotherapy was needed for improvement or the prognosis of the older patients with high initial WBC greater than 10,000/μl. (author)

  2. Studies on 13C isotope discrimination for identifying tree provenances efficient in water use under water deficit conditions in Kenya

    International Nuclear Information System (INIS)

    Nyamai, D.O.; Juma, P.O.

    1996-01-01

    Screening for drought resistance traits was conducted in a semi-arid site in Machakos using 11 provenances of Acacia tortilis, 6 provenances of Prosopis juliflora and 4 provenances of Casuarina equisetifolia. Tolerance to drought was assessed by the 13 C isotope discrimination (Δ) technique as well as by determining the waster use efficiency (WUE). Measurements of dry matter and early growth performance were also taken as indicators of drought resistance. The results showed significant differences in the 13 C Isotope discrimination, water use efficiency and dry matter yields by the different provenances tested. Generally, the results indicated that there were significant linear negative relationships between 13 C discrimination with water use efficiency as well as dry matter yield. The results further showed highly significant positive relationship between dry matter yield and water use efficiency. Acacia tortilis provenances from middle East and neighbouring North Eastern Africa region appear to possess the greatest abilities for drought resistance in comparison with those from sub-saharan Africa as indicated by their 13 C Isotope discrimination levels, dry matter yield and water use efficiency. However, Acacia provenance from Israel had the highest drought resistance trail. Prosopis provenance from Costa Rica and Casuarina from Dakar region in Senegal also emerged as the best provenances in terms of drought tolerance as shown by the 13 C isotope discrimination and dry matter traits. (author). 8 refs, 4 figs, 3 tabs

  3. SU-E-T-148: Benchmarks and Pre-Treatment Reviews: A Study of Quality Assurance Effectiveness

    International Nuclear Information System (INIS)

    Lowenstein, J; Nguyen, H; Roll, J; Walsh, A; Tailor, A; Followill, D

    2015-01-01

    Purpose: To determine the impact benchmarks and pre-treatment reviews have on improving the quality of submitted clinical trial data. Methods: Benchmarks are used to evaluate a site’s ability to develop a treatment that meets a specific protocol’s treatment guidelines prior to placing their first patient on the protocol. A pre-treatment review is an actual patient placed on the protocol in which the dosimetry and contour volumes are evaluated to be per protocol guidelines prior to allowing the beginning of the treatment. A key component of these QA mechanisms is that sites are provided timely feedback to educate them on how to plan per the protocol and prevent protocol deviations on patients accrued to a protocol. For both benchmarks and pre-treatment reviews a dose volume analysis (DVA) was performed using MIM softwareTM. For pre-treatment reviews a volume contour evaluation was also performed. Results: IROC Houston performed a QA effectiveness analysis of a protocol which required both benchmarks and pre-treatment reviews. In 70 percent of the patient cases submitted, the benchmark played an effective role in assuring that the pre-treatment review of the cases met protocol requirements. The 35 percent of sites failing the benchmark subsequently modified there planning technique to pass the benchmark before being allowed to submit a patient for pre-treatment review. However, in 30 percent of the submitted cases the pre-treatment review failed where the majority (71 percent) failed the DVA. 20 percent of sites submitting patients failed to correct their dose volume discrepancies indicated by the benchmark case. Conclusion: Benchmark cases and pre-treatment reviews can be an effective QA tool to educate sites on protocol guidelines and to minimize deviations. Without the benchmark cases it is possible that 65 percent of the cases undergoing a pre-treatment review would have failed to meet the protocols requirements.Support: U24-CA-180803

  4. A Comparison Between Inter-Asterisk eXchange Protocol and Jingle Protocol: Session Time

    Directory of Open Access Journals (Sweden)

    H. S. Haj Aliwi

    2016-08-01

    Full Text Available Over the last few years, many multimedia conferencing and Voice over Internet Protocol (VoIP applications have been developed due to the use of signaling protocols in providing video, audio and text chatting services between at least two participants. This paper compares between two widely common signaling protocols: InterAsterisk eXchange Protocol (IAX and the extension of the eXtensible Messaging and Presence Protocol (Jingle in terms of delay time during call setup, call teardown, and media sessions.

  5. Provenance variation in subalpine fir grown as an exotic tree species in Denmark and Iceland

    DEFF Research Database (Denmark)

    Skúlason, Brynjar

    Neonectria neomacrospora in Denmark. In Iceland the corkbark fir showed superior results, especially for survival rate and Christmas tree quality. The White River provenance from British Columbia is recommended for use in Denmark. The Mount Taylor provenance from the Cibola National Forest in New Mexico...... fir (A. lasiocarpa var. lasiocarpa) and corkbark fir (A. lasiocarpa var. arizonica (Merriam) Lemmon) was established at three sites in Denmark and at one site in Iceland in 1999. Adaptability, Christmas tree quality, growth rhythm and susceptibility to pests and pathogens were measured and assessed...... and the most spring frost damage on buds. The westernmost subalpine fir provenances from Washington state and British Columbia showed the overall best results in Denmark, with the highest survival (after 15 years), fastest height growth and highest Christmas tree quality and profitability, as well as both good...

  6. Growth response of seedlings of six Betula pubescens Ehrh. provenances to six ozone exposure regimes

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, L.M. [Agricultural Univ. of Norway, Aas (Norway). Dept. of Horticulture and Crop Science

    1998-07-01

    Seedlings of six provenances of Betula pubescens Ehrh. from different latitudes (59-70 deg N) were grown under six ozone exposure regimes by combining different concentrations and daily exposure periods. The different treatments at increasing O{sub 3} exposure over 40 nmol/mol (AOT40 given in parentheses) were: 19 nmol mol{sup -1}/24 h day{sup -1} (0.1 {mu}mol/mol-h), 42 nmol mol{sup -1}/12 h day{sup -1} (2.5 {mu}mol/mol-h), 44 nmol mol{sup -1}/24 h day{sup -1} (7.1 {mu}mol/mol-h), 76 nmol mol{sup -1}/6 day{sup -1} (9.4 {mu}mol/mol-h), 75 nmol mol{sup -1}/12 h day{sup -1} (17.8 {mu}mol/mol{sup -1}) and 116 nmol mol{sup -1}/6 h day{sup -1} (19.8 {mu}mol/mol{sup -1}) for 40 days at a 24 h day{sup -1} photoperiod in growth chambers placed in a greenhouse. The effect of increasing the O{sub 3} exposure from 19 nmol mol{sup -1}/24 h to 42 nmol mol{sup -1}/12 h was a decrease in root but not shoot dry weight. A further increase in the exposure to 44 nmol mol{sup -1}/24 h also decreased the shoot dry weight. An increase in the O{sub 3} concentration to 75 and 116 nmol mol{sup -1} further decreased shoot and root dry weights. A moderate O{sub 3} exposure (42 nmol mol{sup -1}/12 h) increased the plant height and leaf size, while a further increase in O{sub 3} concentration and exposure time decreased both of these variables. The birch provenances generally had a similar response to the O{sub 3} treatments. The accumulated O{sub 3} exposure over the 0, 10, 20, 30, 40 and 50 nmol mol{sup -1} concentrations (AOT0, AOT10, AOT20, AOT30, AOT40 and AOT50, respectively) was calculated for all O{sub 3} treatments. The shoot and root dry weights were correlated best with AOT40 and AOT30, and were estimated to decrease by 10% at an AOT40 of 7.0 and 5.5 {mu}mol mol{sup -1}-h, respectively. The development of O{sub 3} injury (yellow stipples/chlorosis) was most marked when correlated with AOT40 26 refs, 6 figs, 1 tab

  7. Rituximab in treatment of idiopathic glomerulopathy

    Directory of Open Access Journals (Sweden)

    Kamel El-Reshaid

    2012-01-01

    Full Text Available The aim of our study was to assess the role of rituximab (Mabthera in the treatment of patients with corticosteroid-resistant and calcineurin-inhibitors ± cellcept refractory idiopathic nephrotic syndrome (INS. A total of 83 patients who had required the previous treatment for a minimum of two years were included in the study. Our protocol included the use of rituximab in four-weekly slow infusions. Five patients were excluded as they could not tolerate rituximab infusion for allergic reaction. As expected, none of the patients had a decline in the total circulating lymphocyte counts yet all had achieved decline of their initially normal CD20 to < 0.5% one month after infusion. The decline persisted for eight to ten months later. In the minimal change disease (MCD group, 31 of the 32 patients had complete remission (CR and were off any immunosuppressive therapy and one of the previous non-responders (NR did not respond. Excluding two patients who had required retreatment, the others remained in CR (17 up to 28 months and six up to 36 months. Treatment with rituximab resulted in amelioration of NS in 17 of the 18 patients with focal segmental glomerulosclerosis (FSGS, while only one patient remained NR. Although renal function remained stable, proteinuria reappeared by eight to 12 months. Retreatment with rituximab resulted in a similar response with stable kidney function. In the 28 patients with membranous glomerulopathy (MG, 24 had achieved CR. Two patients failed to respond and two had partial remission. By 12 months, all patients relapsed. The response was within one month following treatment in patient with MCD, but was gradual within three months in FSGS and MG. Relapsers in all groups responded in a similar pattern to repeat dosing with the drug subsequently. Our prospective study represents an adequate number of patients with biopsy-proven subgroups of INS in both children and adults with long-term follow-up of treatment with rituximab

  8. Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols.

    Science.gov (United States)

    Bleakley, C M; McDonough, S M; MacAuley, D C; Bjordal, J

    2006-08-01

    The use of cryotherapy in the management of acute soft tissue injury is largely based on anecdotal evidence. Preliminary evidence suggests that intermittent cryotherapy applications are most effective at reducing tissue temperature to optimal therapeutic levels. However, its efficacy in treating injured human subjects is not yet known. To compare the efficacy of an intermittent cryotherapy treatment protocol with a standard cryotherapy treatment protocol in the management of acute ankle sprains. Sportsmen (n = 44) and members of the general public (n = 45) with mild/moderate acute ankle sprains. Subjects were randomly allocated, under strictly controlled double blind conditions, to one of two treatment groups: standard ice application (n = 46) or intermittent ice application (n = 43). The mode of cryotherapy was standardised across groups and consisted of melting iced water (0 degrees C) in a standardised pack. Function, pain, and swelling were recorded at baseline and one, two, three, four, and six weeks after injury. Subjects treated with the intermittent protocol had significantly (p<0.05) less ankle pain on activity than those using a standard 20 minute protocol; however, one week after ankle injury, there were no significant differences between groups in terms of function, swelling, or pain at rest. Intermittent applications may enhance the therapeutic effect of ice in pain relief after acute soft tissue injury.

  9. Two-stage palatoplasty, is it still a valuable treatment protocol for patients with a cleft of lip, alveolus, and palate?

    Science.gov (United States)

    Gundlach, Karsten K H; Bardach, Janusz; Filippow, Daniel; Stahl-de Castrillon, Franka; Lenz, Jan-Hendrik

    2013-01-01

    Speech development is of utmost importance and requires early closure of a palatal cleft. On the other hand, it is well known that all types and timings of surgical repair of facial clefts are detrimental to maxillary growth. Nevertheless, these days one is more and more confronted with a world-wide tendency in favour of the one-in-all operation to close clefts of the lip, alveolus, and palate. Therefore, a three-centre study was performed for testing - once more - the value of two-stage palatoplasty as a means to reduce the detrimental effects of surgery on palatal growth and at the same time to also enable early speech development. Plaster casts from 85 patients have been re-evaluated. All of them had a complete unilateral cleft of lip, alveolus, and palate. They had been treated according to the old therapy protocols followed in either one of the three different cleft centres many years ago, namely in Hamburg, (Western) Germany, Iowa City, IO, USA, and Rostock, (in those days still Eastern) Germany. The impressions had been taken already in 1987 from patients being either 8 years (36 pts.) or 16 years of age (49 pts.). Three different treatment protocols had been followed for these patients in those centres in those days: The main difference was that in centres A and B the palates were closed in two stages whilst in centre C palatoplasty was performed in just one operation. The most interesting results regarding the palatal growth were that: 1. In centre C (one-stage palatoplasty) the patients had more constricted palates. 2. In centre A (two-stage palatoplasty) the patients had least often an anterior cross-bite. It appears that it was possible to show once more that closing the palate in one stage at age 1 year or less is interfering most with maxillary growth. This study leads us to conclude that two-stage palatoplasty is still a valuable treatment protocol for patients with a complete unilateral cleft of lip, alveolus, and palate, especially as apparently

  10. Age and gender leucocytes variances and references values generated using the standardized ONE-Study protocol

    DEFF Research Database (Denmark)

    Kverneland, Anders H.; Streitz, Mathias; Geissler, Edward

    2016-01-01

    blood flow cytometry. The performance of our protocols was challenged here by profiling samples from healthy volunteers to reveal age- and gender-dependent differences and to establish a standardized reference cohort for use in clinical trials. Whole blood samples from two different cohorts were...... analyzed (first cohort: n = 52, second cohort: n = 46, both 20–84 years with equal gender distribution). The second cohort was run as a validation cohort by a different operator. The “ONE Study” panels were applied to analyze expression of >30 different surface markers to enumerate proportional...... cohort. Thus, we have proven the utility of our strategy and generated reproducible reference ranges accounting for age- and gender-dependent differences, which are crucial for a better patient monitoring and individualized therapy....

  11. Provenance-specific growth responses to drought and air warming in three European oak species

    Energy Technology Data Exchange (ETDEWEB)

    Arend, Matthias; Kuster, Thomas; Gunthardt-Goerg, Madeleine S.; Dobbertin, Matthias

    2011-03-15

    This study evaluated oak growth responses to air warming through research conducted with species coming from climatically different sites submitted to differing climates including periodic drought and air warming. Results showed different responses to drought and air warming as an adaptation to the conditions, and differences in growth response from one provenance to another were found but local climate factors were not responsible. This study highlighted that provenance was important to growth responses and it will have to be taken into account for regeneration of oaks in a changed climate if these results are confirmed.

  12. Effet du travail du sol sur la productivité de différentes provenances de Jatropha curcas

    Directory of Open Access Journals (Sweden)

    Barro Lamine

    2013-05-01

    Full Text Available Jatropha curcas L. (JCL, an oleaginous species traditionally used as live fence, is massively planted in Africa to produce biofuel. However, the influence of many factors on its productivity remains scientifically unknown. This study aimed to assess the effect of subsoiling (factor 1 : subsoiling and control and plant material provenance (factor 2 : Casamance and Diobass on its development and productivity. The results have shown two years after planting that plant provenance had a significant effect on growth variables, plant above ground architecture and fruits number. The Casamance provenance has generally produced the highest values. Subsoiling did not have a significant effect on most of the studied variables, except for low primary branches number and fruiting branches number. Even more, subsoiling appeared to enhance JCL growth. These results have allowed to understand the importance of provenances but also of soil preparation on the performances of JCL and to identify priority areas for research.

  13. Radial variation of basic density and wood cells dimensions of Cariniana legalis (Mart. O. Kuntze depending on the provenance

    Directory of Open Access Journals (Sweden)

    Israel Luiz de Lima

    2011-12-01

    Full Text Available Provenance tests can provide information about the silvicultural behavior and wood quality for the exploration of variability and conservation of genetic material for future use. This study aims to investigate the effect of provenances on some wood properties of the Cariniana legalis. Seedlings of three provenances (Porto Ferreira, Piracicaba and Campinas were planted in Luiz Antonio-SP using randomized block design with six replicates. After 26 years of planting, eighteen trees, six of each provenance, were felled. The properties studied were basic density and the cellular dimensions. The results revealed that the basic density, fiber length, fiber wall thickness, vessel element length, vessel diameter, uniseriate ray height and width were influenced by the provenances. A good positive relationship was found among the fiber length, fiber wall thickness, vessel element length; vessel diameter and multiseriate ray height with radial position and a negative relation between vessel frequency with the radial position.

  14. Somatic Treatments in Treatment of Depression During Pregnancy

    Directory of Open Access Journals (Sweden)

    Eylem Ozten

    2015-09-01

    Full Text Available Although some psychotropic drugs are known to be teratogenic no psychotropic drug is of proven safety for treatment of depression during pregnancy. Untreated mood disorders during pregnancy pose significant risks for mother and the newborn. This review focuses on the use of somatic tretments of depression during pregnancy.Electroconvulsive therapy, bright light therapy, transcranial magnetic stimulation and vagal nerve stimulation are relatively safe and effective treatments during pregnancy if steps are taken to decrease potential risks. A clear information related to the somatic treatment should be given to the patient and informed consent should be obtained. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 244-254

  15. Economics of "essential use exemptions" for metered-dose inhalers under the Montreal Protocol.

    Science.gov (United States)

    DeCanio, Stephen J; Norman, Catherine S

    2007-10-01

    The Montreal Protocol on Substances that Deplete the Ozone Layer has led to rapid reductions in the use of ozone-depleting substances worldwide. However, the Protocol provides for "essential use exemptions" (EUEs) if there are no "technically and economically feasible" alternatives. An application that might qualify as an "essential use" is CFC-powered medical metered-dose inhalers (MDIs) for the treatment of asthma and chronic obstructive pulmonary disease (COPD), and the US and other nations have applied for exemptions in this case. One concern is that exemptions are necessary to ensure access to medications for low-income uninsureds. We examine the consequences of granting or withholding such exemptions, and conclude that government policies and private-sector programs are available that make it economically feasible to phase out chlorofluorocarbons (CFCs) in this application, thereby furthering the global public health objectives of the Montreal Protocol without compromising the treatment of patients who currently receive medication by means of MDIs.

  16. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Specific targeting for the treatment of neuroendocrine tumors

    International Nuclear Information System (INIS)

    Hoefnagel, C.A.

    2003-01-01

    For the treatment of neuroendocrine tumors three ways of specific targeting of radionuclides prevail: by 131 I-meta-iodo-benzyl-guanidine (MIBG), which is taken up by an active uptake-1 mechanism and stored in neurosecretory granules of neural crest tumor cells, by radiolabeled peptides, in particular the somatostatin analogs octreotide and lanreotide, targeting the peptide receptors, and by radiolabeled antibodies, which target tumor cell surface antigens. The choice depends on the indication, the results of diagnostic imaging using tracer amounts of these agents, the availability and feasibility of radionuclide therapy and of other treatment modalities. The applications, clinical results and developments for the major indications are reviewed. 131 I-MIBG therapy has a cumulative response rate of 50%, associated with little toxicity, in metastatic pheochromocytoma, paraganglioma and neuroblastoma, whereas its role is primarily palliative in patients with medullary thyroid carcinoma and carcinoid tumors. Treatment using 90 Y- or 177 Lu-labeled octreotide/lanreotide is mostly used in neuroendocrine gastro-entero-pancreatic (GEP) tumors and paraganglioma, attaining stabilization of disease anti-palliation in the majority of patients. As this treatment is specific for the receptor rather than for the tumor type, it may also be applicable to other, non-neuroendocrine tumors. Radioimmunotherapy is applied in medullary thyroid carcinoma, in which a phase I/II study using bi-specific anti-DTPA/anti-CEA immuno-conjugates followed by 131 I-hapten has proven some degree of success, and may be used in neuroblastoma more effectively than before, once chimeric and humanized monoclonal antibodies become available for therapy. Integration of these specific and noninvasive therapies at an optimal moment into the treatment protocols of these diseases may enhance their effectiveness and acceptance. (author)

  18. The French dosimetry protocol

    International Nuclear Information System (INIS)

    Dutreix, A.

    1985-01-01

    After a general introduction the protocol is divided in five sections dealing with: determination of the quality of X-ray, γ-ray and electron beams; the measuring instrument; calibration of the reference instrument; determination of the reference absorbed dose in the user's beams; determination of the absorbed dose in water at other points, in other conditions. The French protocol is not essentially different from the Nordic protocol and it is based on the experience gained in using both the American and the Nordic protocols. Therefore, only the main difference with the published protocols are discussed. (Auth.)

  19. Treatment of Cutaneous Lupus Erythematosus

    Science.gov (United States)

    Kim, Grace K.; Del Rosso, James Q.

    2013-01-01

    The treatment of cutaneous lupus erythematosus is centered upon formulating a regimen of topical and systemic therapies designed to reduce disease activity and minimize cosmetic damage. Sun avoidance and sunscreen are important preventative measures proven to minimize cutaneous lupus erythematosus exacerbations. Limited disease is typically managed with topical corticosteroids or calcineurin inhibitors. Antimalarial therapy is the gold standard of systemic therapy. Many other treatments have been studied in patients with recalcitrant cutaneous lupus erythematosus, and their use must be evaluated based on individual risk-benefit concerns. R-salbutamol and pulsed dye laser therapy have proven to be effective topical alternatives. Additional systemic agents include retinoids, immunosuppressants, immunomodulators, biologics, and other experimental therapies with novel modes of action. According to the Oxford Centre for Evidence-based Medicine criteria for evaluating the strength of evidence supporting an individual treatment measure, no therapy for cutaneous lupus erythematosus has achieved Level 1 status. This demonstrates the need for randomized, controlled trials and systematic reviews of all cutaneous lupus erythematosus interventions in order to meet increasing standards and demand for evidence-based practice. PMID:23320123

  20. QEMSCAN+LA-ICP-MS: a 'big data' generator for sedimentary provenance analysis

    Science.gov (United States)

    Vermeesch, Pieter; Rittner, Martin; Garzanti, Eduardo

    2017-04-01

    Sedimentary provenance may be traced by 'fingerprinting' sediments with chemical, mineralogical or isotopic means. Normally, each of these provenance proxies is characterised on a separate aliquot of the same sample. For example, the chemical composition of the bulk sample may be analysed by X-ray fluorescence (XRF) on one aliquot, framework petrography on another, heavy mineral analysis on a density separate of a third split, and zircon U-Pb dating on a further density separate of the heavy mineral fraction. The labour intensity of this procedure holds back the widespread application of multi-method provenance studies. We here present a new method to solve this problem and avoid mineral separation by coupling a QEMSCAN electron microscope to an LA-ICP-MS instrument and thereby generate all four aforementioned provenance datasets as part of the same workflow. Given a polished hand specimen, a petrographic thin section, or a grain mount, the QEMSCAN+LA-ICP-MS method produces chemical and mineralogical maps from which the X-Y coordinates of the datable mineral are extracted. These coordinates are subsequently passed on to the laser ablation system for isotopic and, hence, geochronological analysis. In the process of finding all the zircons in a sediment grain mount, the QEMSCAN yields the compositional and mineralogical compositions as byproducts. We have applied the new QEMSCAN+LA-ICP-MS instrument suite to over 100 samples from three large sediment routing systems: (1) the Tigris-Euphrates river catchments and Rub' Al Khali desert in Arabia; (2) the Nile catchment in northeast Africa and (3) desert and beach sands between the Orange and Congo rivers in southwest Africa. These studies reveal (1) that Rub' Al Khali sand is predominantly derived from the Arabian Shield and not from Mesopotamia; (2) that the Blue Nile is the principal source of Nile sand; and (3) that Orange River sand is carried northward by longshore drift nearly 1,800km from South Africa to southern

  1. Artery-only fingertip replantations using a controlled nailbed bleeding protocol.

    Science.gov (United States)

    Erken, H Yener; Takka, Semih; Akmaz, Ibrahim

    2013-11-01

    We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replantations treated using the artery-only technique without vein or nerve repair. We performed a retrospective review of 24 patients who had undergone fingertip replantation at the same center between 2005 and 2011. All patients in this study had complete fingertip amputation at or distal to the distal interphalangeal joint of the fingers or interphalangeal joint of the thumb. Patients with incomplete and complete amputations who had undergone vein and/or nerve repair along with artery repair were excluded. All patients received the same protocol including removal of the nail at the surgery and intravenous heparin 70 U/kg administered at the time of arterial anastomosis. After surgery, the nailbed was mechanically made to bleed with a sterile needle and mechanically scrubbed with a heparin-saline gauze. All patients received the same postoperative medical treatment protocol until physiological outflow was restored. Successful replantation was confirmed with clinical observation. Twenty-one of the 24 fingertip replantations (88%) were successful. The mean length of hospital stay was 7 days (range, 4-9 d). Fifteen of 22 patients required blood transfusion. The average amount of blood transfusion was 1.2 U (range, 0-3 U). This study shows that the described technique and protocol reconstructed circulation without vein anastomosis and with a high success rate. Furthermore, adequate sensory recovery without any nerve repair had occurred by the 2-year follow-up. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Change in Sediment Provenance Near the Current Estuary of Yellow River Since the Holocene Transgression

    Science.gov (United States)

    Song, Sheng; Feng, Xiuli; Li, Guogang; Liu, Xiao; Xiao, Xiao; Feng, Li

    2018-06-01

    Sedimentary sequence and sediment provenance are important factors when it comes to the studies on marine sedimentation. This paper studies grain size distribution, lithological characteristics, major and rare earth elemental compositions, micropaleontological features and 14C ages in order to examine sedimentary sequence and sediment provenance of the core BH6 drilled at the mouth of the Yellow River in Bohai Sea. According to the grain size and the micropaleontological compositions, 4 sedimentary units have been identified. Unit 1 (0-8.08 mbsf) is of the delta sedimentary facies, Unit 2 (8.08-12.08 mbsf) is of the neritic shelf facies, Unit 3 (12.08-23.85 mbsf) is of near-estuary beach-tidal facies, and Unit 4 (23.85 mbsf-) is of the continental lake facies. The deposits from Unit 1 to Unit 3 have been found to be marine strata formed after the Holocene transgression at about 10 ka BP, while Unit 4 is continental lacustrine deposit formed before 10 ka BP. The provenances of core BH6 sediments show properties of the continental crust and vary in different sedimentary periods. For Unit 4 sediments, the source regions are dispersed while the main provenance is not clear, although the parent rock characteristics of a few samples are similar to the Luanhe River sediments. For Unit 3, sediments at 21.1-23.85 mbsf have been mainly transported from the Liaohe River, while sediments above 21.1 mbsf are mainly from the Yellow River and partially from the Liaohe River. For Unit 2, the sediments have been mainly transported from the Yellow River, with a small amount from other rivers. For Unit 1, the provenance is mainly the Yellow River catchment. These results help in better understanding the evolution of the Yellow River Delta.

  3. Unimolecular Polypharmacy for Treatment of Diabetes and Obesity

    DEFF Research Database (Denmark)

    Tschöp, Matthias H; Finan, Brian; Clemmensen, Christoffer

    2016-01-01

    Many complex diseases have historically proven to be defiant to the best mono-therapeutic approaches. Several examples of combination therapies have largely overcome such challenges, notably for the treatment of severe hypertension and tuberculosis. Obesity and its consequences, such as type 2...... diabetes, have proven to be equally resistant to therapeutic approaches based on single medicines. Proper management of type 2 diabetes often requires adjunctive medications, and the recent registration of a few compound mixtures has set the precedent for combinatorial treatment of obesity. On the other...... to reverse obesity and type 2 diabetes. Here, we summarize the discovery, pre-clinical validation, and first clinical test of such peptide hormone poly-agonist drug candidates....

  4. Integrating prediction, provenance, and optimization into high energy workflows

    Energy Technology Data Exchange (ETDEWEB)

    Schram, M.; Bansal, V.; Friese, R. D.; Tallent, N. R.; Yin, J.; Barker, K. J.; Stephan, E.; Halappanavar, M.; Kerbyson, D. J.

    2017-10-01

    We propose a novel approach for efficient execution of workflows on distributed resources. The key components of this framework include: performance modeling to quantitatively predict workflow component behavior; optimization-based scheduling such as choosing an optimal subset of resources to meet demand and assignment of tasks to resources; distributed I/O optimizations such as prefetching; and provenance methods for collecting performance data. In preliminary results, these techniques improve throughput on a small Belle II workflow by 20%.

  5. Development of a Decision Support System to Predict Physicians' Rehabilitation Protocols for Patients with Knee Osteoarthritis

    Science.gov (United States)

    Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.

    2012-01-01

    To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…

  6. VisTrails is an open-source scientific workflow and provenance management system

    CSIR Research Space (South Africa)

    Mthombeni, Thabo DM

    2011-12-01

    Full Text Available VisTrails is an open-source scientific workflow and provenance management system that provides support for simulations, data exploration and visualization. Whereas workflows have been traditionally used to automate repetitive tasks, for applications...

  7. Development of a manualized protocol of massage therapy for clinical trials in osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ali Ather

    2012-10-01

    Full Text Available Abstract Background Clinical trial design of manual therapies may be especially challenging as techniques are often individualized and practitioner-dependent. This paper describes our methods in creating a standardized Swedish massage protocol tailored to subjects with osteoarthritis of the knee while respectful of the individualized nature of massage therapy, as well as implementation of this protocol in two randomized clinical trials. Methods The manualization process involved a collaborative process between methodologic and clinical experts, with the explicit goals of creating a reproducible semi-structured protocol for massage therapy, while allowing some latitude for therapists’ clinical judgment and maintaining consistency with a prior pilot study. Results The manualized protocol addressed identical specified body regions with distinct 30- and 60-min protocols, using standard Swedish strokes. Each protocol specifies the time allocated to each body region. The manualized 30- and 60-min protocols were implemented in a dual-site 24-week randomized dose-finding trial in patients with osteoarthritis of the knee, and is currently being implemented in a three-site 52-week efficacy trial of manualized Swedish massage therapy. In the dose-finding study, therapists adhered to the protocols and significant treatment effects were demonstrated. Conclusions The massage protocol was manualized, using standard techniques, and made flexible for individual practitioner and subject needs. The protocol has been applied in two randomized clinical trials. This manualized Swedish massage protocol has real-world utility and can be readily utilized both in the research and clinical settings. Trial registration Clinicaltrials.gov NCT00970008 (18 August 2009

  8. The HPA photon protocol and proposed electron protocol

    International Nuclear Information System (INIS)

    Pitchford, W.G.

    1985-01-01

    The Hospital Physicists Association (HPA) photon dosimetry protocol has been produced and was published in 1983. Revised values of some components of Csub(lambda) and refinements introduced into the theory in the last few years have enabled new Csub(lambda) values to be produced. The proposed HPA electron protocol is at present in draft form and will be published shortly. Both protocels are discussed. (Auth.)

  9. Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Arabi, Yaseen M; Alothman, Adel; Balkhy, Hanan H; Al-Dawood, Abdulaziz; AlJohani, Sameera; Al Harbi, Shmeylan; Kojan, Suleiman; Al Jeraisy, Majed; Deeb, Ahmad M; Assiri, Abdullah M; Al-Hameed, Fahad; AlSaedi, Asim; Mandourah, Yasser; Almekhlafi, Ghaleb A; Sherbeeni, Nisreen Murad; Elzein, Fatehi Elnour; Memon, Javed; Taha, Yusri; Almotairi, Abdullah; Maghrabi, Khalid A; Qushmaq, Ismael; Al Bshabshe, Ali; Kharaba, Ayman; Shalhoub, Sarah; Jose, Jesna; Fowler, Robert A; Hayden, Frederick G; Hussein, Mohamed A

    2018-01-30

    It had been more than 5 years since the first case of Middle East Respiratory Syndrome coronavirus infection (MERS-CoV) was recorded, but no specific treatment has been investigated in randomized clinical trials. Results from in vitro and animal studies suggest that a combination of lopinavir/ritonavir and interferon-β1b (IFN-β1b) may be effective against MERS-CoV. The aim of this study is to investigate the efficacy of treatment with a combination of lopinavir/ritonavir and recombinant IFN-β1b provided with standard supportive care, compared to treatment with placebo provided with standard supportive care in patients with laboratory-confirmed MERS requiring hospital admission. The protocol is prepared in accordance with the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. Hospitalized adult patients with laboratory-confirmed MERS will be enrolled in this recursive, two-stage, group sequential, multicenter, placebo-controlled, double-blind randomized controlled trial. The trial is initially designed to include 2 two-stage components. The first two-stage component is designed to adjust sample size and determine futility stopping, but not efficacy stopping. The second two-stage component is designed to determine efficacy stopping and possibly readjustment of sample size. The primary outcome is 90-day mortality. This will be the first randomized controlled trial of a potential treatment for MERS. The study is sponsored by King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Enrollment for this study began in November 2016, and has enrolled thirteen patients as of Jan 24-2018. ClinicalTrials.gov, ID: NCT02845843 . Registered on 27 July 2016.

  10. Evaluation of the efficacy and toxicity of protocol cisplatin, 5-fluorouracil, leucovorin compared to protocol fluorouracil, doxorubicin and mitomycin C in locally advanced and metastatic gastric cancer

    Directory of Open Access Journals (Sweden)

    Andrić Zoran

    2012-01-01

    Full Text Available Introduction. Still there is no consensus on the choice of the most efficient and the least toxic chemotherapy regimen in the treatment of advanced gastric cancer. Nowadays few therapy protocols are available for treating this disease. Objective. Study was conducted to compare the efficacy and toxicity of FAM (flurouracil, doxorubicin, mitomycin C with CDDP and FU/FA (cisplatin, 5-fluorouracil, leucovorin protocols in patients with locally advanced and metastatic gastric cancer. Methods. This randomized study involved a group of 50 patients with locally advanced or metastatic gastric cancer, who had not previously undergone chemotherapy treatment. Progression free survival, overall survival and drug toxicity were evaluated. For statistical analysis chi-square test, Kaplan-Meier curve and the log rank test were used. Results. The overall response rate was 20% in the group treated with FAM and 24% in the group treated with CDDP, FU/FA (4% of patients from each group had complete response, but without significant statistical difference. Median survival was 10.9 months in the FAM group and 11.8 months in CDDP, FU/FA group, with no statistically significant difference. Non-haematological and haematological toxicities of CDDP, FU/FA were considerably less frequent than of FAM, and there was no treatment related deaths in any of the groups. Conclusion. Both investigated regimens demonstrated moderate efficacy. The study shows in favour of justified application of both protocols, while in regard to toxicity CDDP and FU/FA can be recommended as preferable treatment for locally advanced and metastatic gastric cancer. New strategies should be considered for better efficacy in the treatment of advanced gastric cancer. New strategies are necessary with the goal to achieve a better therapeutic effect.

  11. Enhancing Privacy in Wearable IoT through a Provenance Architecture

    Directory of Open Access Journals (Sweden)

    Richard K. Lomotey

    2018-04-01

    Full Text Available The Internet of Things (IoT is inspired by network interconnectedness of humans, objects, and cloud services to facilitate new use cases and new business models across multiple enterprise domains including healthcare. This creates the need for continuous data streaming in IoT architectures which are mainly designed following the broadcast model. The model facilitates IoT devices to sense and deliver information to other nodes (e.g., cloud, physical objects, etc. that are interested in the information. However, this is a recipe for privacy breaches since sensitive data, such as personal vitals from wearables, can be delivered to undesired sniffing nodes. In order to protect users’ privacy and manufacturers’ IP, as well as detecting and blocking malicious activity, this research paper proposes privacy-oriented IoT architecture following the provenance technique. This ensures that the IoT data will only be delivered to the nodes that subscribe to receive the information. Using the provenance technique to ensure high transparency, the work is able to provide trace routes for digital audit trail. Several empirical evaluations are conducted in a real-world wearable IoT ecosystem to prove the superiority of the proposed work.

  12. Evaluation of aspect-oriented frameworks in Python for extending a project with provenance documentation features

    Directory of Open Access Journals (Sweden)

    2011-08-01

    Full Text Available In this paper we describe two sides of a real life use case of introducing an aspect-oriented framework into an industrial-grade project. This paper is divided into two parts: the selection process for an AOP framework in the Python programming language, and its use for modularized non-invasive recording of provenance data in a distributed data management tool. Criteria for the choice of such a framework are discussed and the background of provenance documentation is laid out.

  13. Comparison of decellularization protocols for preparing a decellularized porcine annulus fibrosus scaffold.

    Directory of Open Access Journals (Sweden)

    Haiwei Xu

    Full Text Available Tissue-specific extracellular matrix plays an important role in promoting tissue regeneration and repair. We hypothesized that decellularized annular fibrosus matrix may be an appropriate scaffold for annular fibrosus tissue engineering. We aimed to determine the optimal decellularization method suitable for annular fibrosus. Annular fibrosus tissue was treated with 3 different protocols with Triton X-100, sodium dodecyl sulfate (SDS and trypsin. After the decellularization process, we examined cell removal and preservation of the matrix components, microstructure and mechanical function with the treatments to determine which method is more efficient. All 3 protocols achieved decellularization; however, SDS or trypsin disturbed the structure of the annular fibrosus. All protocols maintained collagen content, but glycosaminoglycan content was lost to different degrees, with the highest content with TritonX-100 treatment. Furthermore, SDS decreased the tensile mechanical property of annular fibrosus as compared with the other 2 protocols. MTT assay revealed that the decellularized annular fibrosus was not cytotoxic. Annular fibrosus cells seeded into the scaffold showed good viability. The Triton X-100-treated annular fibrosus retained major extracellular matrix components after thorough cell removal and preserved the concentric lamellar structure and tensile mechanical properties. As well, it possessed favorable biocompatibility, so it may be a suitable candidate as a scaffold for annular fibrosus tissue engineering.

  14. Early pain management after periodontal treatment in dogs – comparison of single and combined analgesic protocols

    Directory of Open Access Journals (Sweden)

    Petr Raušer

    2015-01-01

    Full Text Available The aim of this study was to assess the analgesic effectiveness of three analgesic protocols in dogs undergoing a periodontal treatment. The study was performed as a prospective, randomized, “double blind” clinical study. A total of 45 client-owned dogs scheduled for periodontal treatment were included. Dogs of Group C received carprofen (4 mg·kg-1, dogs of Group B received bupivacaine (1 mg·kg-1 and dogs of Group CB received a combination of carprofen (4 mg·kg-1 and bupivacaine (1 mg·kg-1. Carprofen was administered subcutaneously 30 min before anaesthesia, bupivacaine was administered by nerve blocks in anaesthetized dogs. Painful periodontal treatment was performed in all patients, lasting up to one hour. Modified University of Melbourne Pain Score (UMPS, Visual Analogue Scale for pain assessment (VAS, plasma glucose and serum cortisol levels were assessed 30 min before administration of analgesics (C-0, B-0, CB‑0 and 2 h after recovery from anaesthesia (C-2, B-2, CB-2. For statistical analysis Friedman test, Mann-Whitney U-test, ANOVA and Fischer exact tests were used (P < 0.05. In CB‑2 compared to CB‑0 significantly decreased modified UMPS values. In CB‑2 UMPS values were significantly lower compared to C‑2 or B‑2. In C‑2 VAS values were significantly increased compared to C‑0, and in B‑2 VAS values were significantly increased compared to B‑0. Visual Analogue Scale values were significantly lower in CB‑2 compared to C‑2 or B‑2. Significantly increased plasma glucose concentrations were found in C‑2 compared to C‑0 and in B‑2 compared to B‑0. No other significant differences were detected. Administration of carprofen, bupivacaine or their combination is sufficient for early postoperative analgesia following periodontal treatment. Carprofen-bupivacaine combination is superior to carprofen or bupivacaine administered separately.

  15. Satellite Communications Using Commercial Protocols

    Science.gov (United States)

    Ivancic, William D.; Griner, James H.; Dimond, Robert; Frantz, Brian D.; Kachmar, Brian; Shell, Dan

    2000-01-01

    NASA Glenn Research Center has been working with industry, academia, and other government agencies in assessing commercial communications protocols for satellite and space-based applications. In addition, NASA Glenn has been developing and advocating new satellite-friendly modifications to existing communications protocol standards. This paper summarizes recent research into the applicability of various commercial standard protocols for use over satellite and space- based communications networks as well as expectations for future protocol development. It serves as a reference point from which the detailed work can be readily accessed. Areas that will be addressed include asynchronous-transfer-mode quality of service; completed and ongoing work of the Internet Engineering Task Force; data-link-layer protocol development for unidirectional link routing; and protocols for aeronautical applications, including mobile Internet protocol routing for wireless/mobile hosts and the aeronautical telecommunications network protocol.

  16. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  17. Examining recombinant human TSH primed {sup 131}I therapy protocol in patients with metastatic differentiated thyroid carcinoma: comparison with the traditional thyroid hormone withdrawal protocol

    Energy Technology Data Exchange (ETDEWEB)

    Rani, Deepa; Kaisar, Sushma; Awasare, Sushma; Kamaldeep; Abhyankar, Amit; Basu, Sandip [Bhabha Atomic Research Centre (BARC), Radiation Medicine Centre, Mumbai (India)

    2014-09-15

    Recombinant human thyroid-stimulating hormone (rhTSH)-based protocol is a promising recent development in the management of differentiated thyroid carcinoma (DTC). The objectives of this prospective study were: (1) to assess the feasibility and efficacy of the rhTSH primed {sup 131}I therapy protocol in patients with DTC with distant metastatic disease, (2) to perform lesional dosimetry in this group of patients compared to the traditional protocol, (3) to document the practical advantages (patient symptoms and hospital stay) of the rhTSH protocol compared to the traditional thyroid hormone withdrawal protocol, (4) to document and record any adverse effect of this strategy, (5) to compare the renal function parameters, and (6) to compare the serum TSH values achieved in either of the protocols in this group of patients. The study included 37 patients with metastatic DTC having lung or skeletal metastases or both. A comparison of lesional radiation absorbed dose, hospital stay, renal function tests, and symptom profile was undertaken between the traditional thyroid hormone withdrawal protocol and rhTSH-based therapy protocol. Dosimetric calculations of metastatic lesions were performed using lesion uptake and survey meter readings for calculation of effective half-life. Non-contrast-enhanced CT was used for assessment of tumor volume. Quality of life was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QOL forms. A comparison of pretreatment withdrawal thyroglobulin (TG) was done with the withdrawal TG level 3 months after treatment. The mean effective half-life of {sup 131}I in metastatic lesions was less during the rhTSH protocol (29.49 h) compared to the thyroid hormone withdrawal protocol (35.48 h), but the difference was not statistically significant (p = 0.056). The mean 24-h % uptake of the lesions during the traditional protocol (4.84 %) was slightly higher than the 24-h % uptake during the rhTSH protocol (3.56 %), but

  18. Security Protocols in a Nutshell

    OpenAIRE

    Toorani, Mohsen

    2016-01-01

    Security protocols are building blocks in secure communications. They deploy some security mechanisms to provide certain security services. Security protocols are considered abstract when analyzed, but they can have extra vulnerabilities when implemented. This manuscript provides a holistic study on security protocols. It reviews foundations of security protocols, taxonomy of attacks on security protocols and their implementations, and different methods and models for security analysis of pro...

  19. Evaluation of a biodegradation screening protocol for contaminated soil from manufactured gas plant sites

    International Nuclear Information System (INIS)

    Morgan, D.J.; Battaglia, A.; Smith, J.R.; Middleton, A.C.; Nakles, D.V.; Linz, D.G.

    1991-01-01

    Bioremediation has been demonstrated to be a viable alternative for treating soils contaminated with PAHs. however, given the variability encountered in soils characteristics and contamination level, their susceptibility to biological treatment must be assessed on a case-by-case basis. This paper discusses a new treatability protocol, the GRI Accelerated Treatability Protocol. The mainstay of the protocol, which is designed to quickly provide treatability data for a given contaminated soil is a bioslurry experiment, in which the contaminated soil is continuously stirred and provided with abundant oxygen, nutrients and water, to maximize biological activity and thus contaminant removal. The results of using such protocol on four soils, widely differing in physical characteristics and contamination levels, are compared to the results of traditional pan studies, and an empirical equation, describing the observed soil concentrations as a function of time in both slurry and pans, is presented. Similarities and differences between achievable endpoints and biodegradation rates are discussed, and the applicability of the GRI Accelerated Treatability Protocol to full-scale engineered systems is addressed. Results to date indicate that, for soils with less than 10% fines slurry and pan experiments yield approximately the same endpoint, so that for those soils the GRI Accelerated Treatability Protocol can be used to assess the viability of an unsaturated bioremediation system. For soils with more than 10% fines, the slurry treatment endpoints are better than the pans. For those soils a traditional pan study experiment should be performed to evaluate the potential capabilities of unsaturated bioremediation

  20. Studies on {sup 13}C isotope discrimination for identifying tree provenances efficient in water use under water deficit conditions in Kenya

    Energy Technology Data Exchange (ETDEWEB)

    Nyamai, D O; Juma, P O [Kenya Forestry Research Inst., Nairobi (Kenya). Agroforestry Research Programme

    1996-07-01

    Screening for drought resistance traits was conducted in a semi-arid site in Machakos using 11 provenances of Acacia tortilis, 6 provenances of Prosopis juliflora and 4 provenances of Casuarina equisetifolia. Tolerance to drought was assessed by the {sup 13}C isotope discrimination ({Delta}) technique as well as by determining the waster use efficiency (WUE). Measurements of dry matter and early growth performance were also taken as indicators of drought resistance. The results showed significant differences in the {sup 13}C Isotope discrimination, water use efficiency and dry matter yields by the different provenances tested. Generally, the results indicated that there were significant linear negative relationships between {sup 13}C discrimination with water use efficiency as well as dry matter yield. The results further showed highly significant positive relationship between dry matter yield and water use efficiency. Acacia tortilis provenances from middle East and neighbouring North Eastern Africa region appear to possess the greatest abilities for drought resistance in comparison with those from sub-saharan Africa as indicated by their {sup 13}C Isotope discrimination levels, dry matter yield and water use efficiency. However, Acacia provenance from Israel had the highest drought resistance trail. Prosopis provenance from Costa Rica and Casuarina from Dakar region in Senegal also emerged as the best provenances in terms of drought tolerance as shown by the {sup 13}C isotope discrimination and dry matter traits. (author). 8 refs, 4 figs, 3 tabs.

  1. Mini-PROven. Reduced emissions from small and medium-size coke ovens thanks to single-chamber pressure control; Mini-PROven. Emissionsreduzierung an kleinen und mittleren Koksoefen mit einer Einzelkammerdruckregelung

    Energy Technology Data Exchange (ETDEWEB)

    Huhn, Friedrich; Krebber, Frank; Kuehn-Gajdzik, Joanna; Ueberschaer, Kerstin [ThyssenKrupp Uhde GmbH, Dortmund (Germany). Coke Plant Technologies Div.

    2012-07-01

    For environment and occupational health reasons it is becoming increasingly important for coke plants to be operated with the lowest possible level of emissions. In the past, changing pressure conditions in each individual oven, with particularly high values at the beginning of the coking period, often resulted in considerable emissions at the oven closures. To prevent this happening on modern large-scale ovens, ThyssenKrupp Uhde developed the PROven trademark (Pressure Regulated Oven), a single-chamber pressure control system which regulates the pressure in the individual coke chambers down to a constantly low level. In the meantime, after many years of successful service, the system has been upgraded in both its design and process engineering. The result is Mini-PROven, which in future can also be retro-fitted to old small and medium-size coke oven batteries in the interest of better environmental protection. (orig.)

  2. Treatment of stage III carcinoma of the uterine cervix with telecobalt irradiation

    International Nuclear Information System (INIS)

    Souhami, L.; Melo, J.A.; Pareja, G.

    1987-01-01

    This is a retrospective analysis of 148 patients with histologically proven carcinoma of the cervix, stage III, treated with irradiation. All patients received external irradiation with cobalt 60 followed by intracavitary radium application. The median age was 55 years. Squamous cell carcinoma was found in 96.5% of the cases. The 8-year actuarial survival rate was 41%. Bilateral parametrial invasion proved to be a strong prognostic factor. Patients with unilateral disease had a survival rate of 43% whereas in those with bilateral involvement it was only 15% (P less than 0.005). The total pelvic failure rate was 29.5%. The overall incidence of distant metastasis was 11%. The complication rate (minor and major complications) was high, with vaginal stenosis (22.5%), proctitis (21.5%), cystitis (13.5%), and fistulae (4%) occurring in 33, 32, 20, and 6 patients, respectively. New treatment modalities are urgently needed for advanced carcinoma of the cervix. Bilateral parametrial involvement is an unfavorable prognostic factor and this should be kept in mind when designing new protocols

  3. Prednisolone and acupuncture in Bell's palsy: study protocol for a randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Wang Kangjun

    2011-06-01

    Full Text Available Abstract Background There are a variety of treatment options for Bell's palsy. Evidence from randomized controlled trials indicates corticosteroids can be used as a proven therapy for Bell's palsy. Acupuncture is one of the most commonly used methods to treat Bell's palsy in China. Recent studies suggest that staging treatment is more suitable for Bell's palsy, according to different path-stages of this disease. The aim of this study is to compare the effects of prednisolone and staging acupuncture in the recovery of the affected facial nerve, and to verify whether prednisolone in combination with staging acupuncture is more effective than prednisolone alone for Bell's palsy in a large number of patients. Methods/Design In this article, we report the design and protocol of a large sample multi-center randomized controlled trial to treat Bell's palsy with prednisolone and/or acupuncture. In total, 1200 patients aged 18 to 75 years within 72 h of onset of acute, unilateral, peripheral facial palsy will be assessed. There are six treatment groups, with four treated according to different path-stages and two not. These patients are randomly assigned to be in one of the following six treatment groups, i.e. 1 placebo prednisolone group, 2 prednisolone group, 3 placebo prednisolone plus acute stage acupuncture group, 4 prednisolone plus acute stage acupuncture group, 5 placebo prednisolone plus resting stage acupuncture group, 6 prednisolone plus resting stage acupuncture group. The primary outcome is the time to complete recovery of facial function, assessed by Sunnybrook system and House-Brackmann scale. The secondary outcomes include the incidence of ipsilateral pain in the early stage of palsy (and the duration of this pain, the proportion of patients with severe pain, the occurrence of synkinesis, facial spasm or contracture, and the severity of residual facial symptoms during the study period. Discussion The result of this trial will assess the

  4. TIGA-CUB - manualised psychoanalytic child psychotherapy versus treatment as usual for children aged 5-11 years with treatment-resistant conduct disorders and their primary carers: study protocol for a randomised controlled feasibility trial.

    Science.gov (United States)

    Edginton, Elizabeth; Walwyn, Rebecca; Burton, Kayleigh; Cicero, Robert; Graham, Liz; Reed, Sadie; Tubeuf, Sandy; Twiddy, Maureen; Wright-Hughes, Alex; Ellis, Lynda; Evans, Dot; Hughes, Tom; Midgley, Nick; Wallis, Paul; Cottrell, David

    2017-09-15

    The National Institute for Health and Care Excellence (NICE) recommends evidence-based parenting programmes as a first-line intervention for conduct disorders (CD) in children aged 5-11 years. As these are not effective in 25-33% of cases, NICE has requested research into second-line interventions. Child and Adolescent Psychotherapists (CAPTs) address highly complex problems where first-line treatments have failed and there have been small-scale studies of Psychoanalytic Child Psychotherapy (PCP) for CD. A feasibility trial is needed to determine whether a confirmatory trial of manualised PCP (mPCP) versus Treatment as Usual (TaU) for CD is practicable or needs refinement. The aim of this paper is to publish the abridged protocol of this feasibility trial. TIGA-CUB (Trial on improving Inter-Generational Attachment for Children Undergoing Behaviour problems) is a two-arm, pragmatic, parallel-group, multicentre, individually randomised (1:1) controlled feasibility trial (target n = 60) with blinded outcome assessment (at 4 and 8 months), which aims to develop an optimum practicable protocol for a confirmatory, pragmatic, randomised controlled trial (RCT) (primary outcome: child's behaviour; secondary outcomes: parental reflective functioning and mental health, child and parent quality of life), comparing mPCP and TaU as second-line treatments for children aged 5-11 years with treatment-resistant CD and inter-generational attachment difficulties, and for their primary carers. Child-primary carer dyads will be recruited following a referral to, or re-referral within, National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) after an unsuccessful first-line parenting intervention. PCP will be delivered by qualified CAPTs working in routine NHS clinical practice, using a trial-specific PCP manual (a brief version of established PCP clinical practice). Outcomes are: (1) feasibility of recruitment methods, (2) uptake and follow-up rates, (3

  5. Electrostatic protocol treatment lens. The purpose of this device is to transport Antiprotons from the new ELENA storage beam to all AD experiments. The electrostatic device was successfully tested in ASACUSA two weeks ago.

    CERN Multimedia

    Maximilien Brice

    2012-01-01

    Electrostatic protocol treatment lens. The purpose of this device is to transport Antiprotons from the new ELENA storage beam to all AD experiments. The electrostatic device was successfully tested in ASACUSA two weeks ago.

  6. Effects of herbal medicine for dysmenorrhea treatment on accompanied acne vulgaris: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Kim, Kwan-Il; Nam, Hae Jeong; Kim, Mia; Lee, Junhee; Kim, Kyuseok

    2017-06-17

    The incidence of preadolescent acne among women is increasing. Acne deteriorates the quality of life; conventional treatment options are limited and have not been effective against acne, particularly acne associated with menstruation. Despite evidence that acne associated with menstruation abnormalities naturally improves when menstruation recovers to normal, there have only been few studies on the effects of dysmenorrhea treatment on acne. Therefore- we designed this study to assess the effects of gyejibokryung-hwan (GBH) and dangguijagyag-san (DJS), which are widely used in dysmenorrhea treatment, on acne associated with menstruation cycle. This is a protocol for a randomized, double-blind, parallel-group, placebo-controlled and multicenter trial. One hundred and sixteen participants with dysmenorrhea accompanied by acne vulgaris will be recruited at three centers and randomized into two groups, the herbal treatment group and placebo group. The participants will receive GBH or DJS based on pattern identification or placebo granules thrice daily for 8 weeks, with an 8-week follow up. The primary outcome will be the mean percentage change in the count of inflammatory acne lesions. The secondary outcomes would be based on dysmenorrhea numeric rating scale, verbal multidimensional scoring system for dysmenorrhea, acne numeric rating scale, investigator's static global assessment scale of facial acne vulgaris, and safety testing. Adverse events will also be reported. The effects of GBH or DJS used in dysmenorrhea treatment on acne associated with the menstrual cycle will be evaluated. The findings of this trial will provide evidence regarding the effect of herbal medicine in improving acne vulgaris associated with menstruation in women. Korean Clinical Trial Registry ( http://cris.nih.go.kr ; registration number: KCT0002259). Date of registration: March 10, 2017.

  7. [Impact of the chemotherapy protocols for metastatic breast cancer on the treatment cost and the survival time of 371 patients treated in three hospitals of the Rhone-Alpes region].

    Science.gov (United States)

    Paviot, B Trombert; Bachelot, T; Clavreul, G; Jacquin, J-P; Mille, D; Rodrigues, J-M

    2009-10-01

    The chemotherapy of the metastatic breast cancer is characterized by the diversity of the treatment protocols and the utilisation of new expensive molecules posing the double problem of outcomes for the patients and financial effects for the hospitals. This survey describes the different chemotherapy treatments prescribed in the metastatic breast cancer and the direct costs supported by the hospitals according to the patient survival time. A cohort of 371 patients treated for a metastatic breast cancer was followed in three hospitals of the Rhone-Alpes region between 2001 and 2006. The detail of their different antineoplasic treatments, as well as the purchase cost of the drugs and their cost of hospital administration, the cost of the other hospital stays are presented in relation with the survival. The median survival time (35,8 months; CI 95%: [31.7-39.1]) since the first metastasis does not differ significantly according to the hospital. Ninety-three different chemotherapy protocols are observed combining from one to five molecules. Thirty-two different molecules are identified. In first line treatment, there is a significant difference in the use of the new molecules according to hospital (Chi(2) test; P cost of a chemotherapy treatment is 3,919 euro (+/- 8,069 euro), the higher cost is observed for trastuzumab (23,443 euro). The average time period before the beginning of a new chemotherapy line is 212 days (+/- 237 days) and the mean cost of hospital stay during this period is 3,903 euro (+/- 4,097 euro). If no impact of the chemotherapy treatment strategy is observed on the survival time of the patient, it is the opposite for the hospital treatment cost. These results are asking for a better control system of the authorization procedure of new molecules marketing and the harmonization of the practices.

  8. Ultrasound guided injection of dexamethasone versus placebo for treatment of plantar fasciitis: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gilheany Mark F

    2010-07-01

    Full Text Available Abstract Background Plantar fasciitis is the most commonly reported cause of chronic pain beneath the heel. Management of this condition commonly involves the use of corticosteroid injection in cases where less invasive treatments have failed. However, despite widespread use, only two randomised trials have tested the effect of this treatment in comparison to placebo. These trials currently offer the best available evidence by which to guide clinical practice, though both were limited by methodological issues such as insufficient statistical power. Therefore, the aim of this randomised trial is to compare the effect of ultrasound-guided corticosteroid injection versus placebo for treatment of plantar fasciitis. Methods The trial will be conducted at the La Trobe University Podiatry Clinic and will recruit 80 community-dwelling participants. Diagnostic ultrasound will be used to diagnose plantar fasciitis and participants will be required to meet a range of selection criteria. Participants will be randomly allocated to one of two treatment arms: (i ultrasound-guided injection of the plantar fascia with 1 mL of 4 mg/mL dexamethasone sodium phosphate (experimental group, or (ii ultrasound-guided injection of the plantar fascia with 1 mL normal saline (control group. Blinding will be applied to participants and the investigator performing procedures, measuring outcomes and analysing data. Primary outcomes will be pain measured by the Foot Health Status Questionnaire and plantar fascia thickness measured by ultrasound at 4, 8 and 12 weeks. All data analyses will be conducted on an intention-to-treat basis. Conclusion This will be a randomised trial investigating the effect of dexamethasone injection on pre-specified treatment outcomes in people with plantar fasciitis. Within the parameters of this protocol, the trial findings will be used to make evidence-based recommendations regarding the use of corticosteroid injection for treatment of this

  9. The Provenance of Late Bronze Age Transport Amphorae found in Egypt

    Directory of Open Access Journals (Sweden)

    L.M.V. Smith

    2000-10-01

    Full Text Available This study, which forms part of a larger project on Canaanite amphorae, illustrates the use of ceramic petrography in refining the visual classification of the fabrics of imported New Kingdom amphorae excavated from Memphis and Amarna in Egypt. Provenances for the Canaanite amphorae are suggested which contradict previous assumptions.

  10. Design of PDT protocols using delta-aminolevulinic acid (5ALA)

    Science.gov (United States)

    Jacques, Steven L.; He, Xiao-Yan; Gofstein, Gary

    1993-06-01

    The kinetics of protoporphyrin IX (PPIX) synthesis, bioconversion to other metabolic products, and photobleaching were measured in cell cultures after incubation in media containing the metabolic precursor for heme synthesis, (delta) -aminolevulinic acid (5 ALA). A compartmental model described the kinetics in terms of rate constants for the three processes. The maximum amount of PPIX that can be attained in the cells and the concentration of 5 ALA in the medium that obtains this maximum were determined. Using this information, two dosimetry protocols are outlined which both involve complete photobleaching of the PPIX: (1) the classical acute protocol using maximum 5 ALA to produce maximum PPIX and a light treatment of about 0.5 - 1 hr, and (2) a novel prolonged protocol using continuous low-level 5 ALA delivery to produce only slightly elevated PPIX and an extended light exposure time of over 24 hrs.

  11. Business protocol in integrated Europe

    OpenAIRE

    Pavelová, Nina

    2009-01-01

    The first chapter devotes to definitions of basic terms such as protocol or business protocol, to differences between protocol and etiquette, and between social etiquette and business etiquette. The second chapter focuses on the factors influencing the European business protocol. The third chapter is devoted to the etiquette of business protocol in the European countries. It touches the topics such as punctuality and planning of business appointment, greeting, business cards, dress and appear...

  12. Cost-effectiveness comparison between pituitary down-regulation with a gonadotropin-releasing hormone agonist short regimen on alternate days and an antagonist protocol for assisted fertilization treatments.

    Science.gov (United States)

    Maldonado, Luiz Guilherme Louzada; Franco, José Gonçalves; Setti, Amanda Souza; Iaconelli, Assumpto; Borges, Edson

    2013-05-01

    To compare cost-effectiveness between pituitary down-regulation with a GnRH agonist (GnRHa) short regimen on alternate days and GnRH antagonist (GnRHant) multidose protocol on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcome. Prospective, randomized. A private center. Patients were randomized into GnRHa (n = 48) and GnRHant (n = 48) groups. GnRHa stimulation protocol: administration of triptorelin on alternate days starting on the first day of the cycle, recombinant FSH (rFSH), and recombinant hCG (rhCG) microdose. GnRHant protocol: administration of a daily dose of rFSH, cetrorelix, and rhCG microdose. ICSI outcomes and treatment costs. A significantly lower number of patients underwent embryo transfer in the GnRHa group. Clinical pregnancy rate was significantly lower and miscarriage rate was significantly higher in the GnRHa group. It was observed a significant lower cost per cycle in the GnRHa group compared with the GnRHant group ($5,327.80 ± 387.30 vs. $5,900.40 ± 472.50). However, mean cost per pregnancy in the GnRHa was higher than in the GnRHant group ($19,671.80 ± 1,430.00 vs. $11,328.70 ± 907.20). Although the short controlled ovarian stimulation protocol with GnRHa on alternate days, rFSH, and rhCG microdose may lower the cost of an individual IVF cycle, it requires more cycles to achieve pregnancy. NCT01468441. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Influence of tree provenance on biogenic VOC emissions of Scots pine (Pinus sylvestris) stumps

    Science.gov (United States)

    Kivimäenpää, Minna; Magsarjav, Narantsetseg; Ghimire, Rajendra; Markkanen, Juha-Matti; Heijari, Juha; Vuorinen, Martti; Holopainen, Jarmo K.

    2012-12-01

    Resin-storing plant species such as conifer trees can release substantial amounts of volatile organic compounds (VOCs) into the atmosphere under stress circumstances that cause resin flow. Wounding can be induced by animals, pathogens, wind or direct mechanical damage e.g. during harvesting. In atmospheric modelling of biogenic VOCs, actively growing vegetation has been mostly considered as the source of emissions. Root systems and stumps of resin-storing conifer trees could constitute a significant store of resin after tree cutting. Therefore, we assessed the VOC emission rates from the cut surface of Scots pine stumps and estimated the average emission rates for an area with a density of 2000 stumps per ha. The experiment was conducted with trees of one Estonian and three Finnish Scots pine provenances covering a 1200 km gradient at a common garden established in central Finland in 1991. VOC emissions were dominated by monoterpenes and less than 0.1% of the total emission was sesquiterpenes. α-Pinene (7-92% of the total emissions) and 3-carene (0-76% of the total emissions) were the dominant monoterpenes. Proportions of α-pinene and camphene were significantly lower and proportions of 3-carene, sabinene, γ-terpinene and terpinolene higher in the southernmost Saaremaa provenance compared to the other provenances. Total terpene emission rates (standardised to +20 °C) from stumps varied from 27 to 1582 mg h-1 m-2 when measured within 2-3 h after tree cutting. Emission rates decreased rapidly to between 2 and 79 mg h-1 m-2 at 50 days after cutting. The estimated daily terpene emission rates on a hectare basis from freshly cut stumps at a cut tree density of 2000 per ha varied depending on provenance. Estimated emission ranges were 100-710 g ha-1 d-1 and 137-970 g ha-1 d-1 in 40 and in 60 year-old forest stands, respectively. Our result suggests that emission directly from stump surfaces could be a significant source of monoterpene emissions for a few weeks after

  14. Signal or noise? Separating grain size-dependent Nd isotope variability from provenance shifts in Indus delta sediments, Pakistan

    Science.gov (United States)

    Jonell, T. N.; Li, Y.; Blusztajn, J.; Giosan, L.; Clift, P. D.

    2017-12-01

    Rare earth element (REE) radioisotope systems, such as neodymium (Nd), have been traditionally used as powerful tracers of source provenance, chemical weathering intensity, and sedimentary processes over geologic timescales. More recently, the effects of physical fractionation (hydraulic sorting) of sediments during transport have called into question the utility of Nd isotopes as a provenance tool. Is source terrane Nd provenance resolvable if sediment transport strongly induces noise? Can grain-size sorting effects be quantified? This study works to address such questions by utilizing grain size analysis, trace element geochemistry, and Nd isotope geochemistry of bulk and grain-size fractions (Pakistan. Here we evaluate how grain size effects drive Nd isotope variability and further resolve the total uncertainties associated with Nd isotope compositions of bulk sediments. Results from the Indus delta indicate bulk sediment ɛNd compositions are most similar to the <63 µm fraction as a result of strong mineralogical control on bulk compositions by silt- to clay-sized monazite and/or allanite. Replicate analyses determine that the best reproducibility (± 0.15 ɛNd points) is observed in the 125-250 µm fraction. The bulk and finest fractions display the worst reproducibility (±0.3 ɛNd points). Standard deviations (2σ) indicate that bulk sediment uncertainties are no more than ±1.0 ɛNd points. This argues that excursions of ≥1.0 ɛNd points in any bulk Indus delta sediments must in part reflect an external shift in provenance irrespective of sample composition, grain size, and grain size distribution. Sample standard deviations (2s) estimate that any terrigenous bulk sediment composition should vary no greater than ±1.1 ɛNd points if provenance remains constant. Findings from this study indicate that although there are grain-size dependent Nd isotope effects, they are minimal in the Indus delta such that resolvable provenance-driven trends can be

  15. A robust ECC based mutual authentication protocol with anonymity for session initiation protocol.

    Science.gov (United States)

    Mehmood, Zahid; Chen, Gongliang; Li, Jianhua; Li, Linsen; Alzahrani, Bander

    2017-01-01

    Over the past few years, Session Initiation Protocol (SIP) is found as a substantial application-layer protocol for the multimedia services. It is extensively used for managing, altering, terminating and distributing the multimedia sessions. Authentication plays a pivotal role in SIP environment. Currently, Lu et al. presented an authentication protocol for SIP and profess that newly proposed protocol is protected against all the familiar attacks. However, the detailed analysis describes that the Lu et al.'s protocol is exposed against server masquerading attack and user's masquerading attack. Moreover, it also fails to protect the user's identity as well as it possesses incorrect login and authentication phase. In order to establish a suitable and efficient protocol, having ability to overcome all these discrepancies, a robust ECC-based novel mutual authentication mechanism with anonymity for SIP is presented in this manuscript. The improved protocol contains an explicit parameter for user to cope the issues of security and correctness and is found to be more secure and relatively effective to protect the user's privacy, user's masquerading and server masquerading as it is verified through the comprehensive formal and informal security analysis.

  16. A robust ECC based mutual authentication protocol with anonymity for session initiation protocol.

    Directory of Open Access Journals (Sweden)

    Zahid Mehmood

    Full Text Available Over the past few years, Session Initiation Protocol (SIP is found as a substantial application-layer protocol for the multimedia services. It is extensively used for managing, altering, terminating and distributing the multimedia sessions. Authentication plays a pivotal role in SIP environment. Currently, Lu et al. presented an authentication protocol for SIP and profess that newly proposed protocol is protected against all the familiar attacks. However, the detailed analysis describes that the Lu et al.'s protocol is exposed against server masquerading attack and user's masquerading attack. Moreover, it also fails to protect the user's identity as well as it possesses incorrect login and authentication phase. In order to establish a suitable and efficient protocol, having ability to overcome all these discrepancies, a robust ECC-based novel mutual authentication mechanism with anonymity for SIP is presented in this manuscript. The improved protocol contains an explicit parameter for user to cope the issues of security and correctness and is found to be more secure and relatively effective to protect the user's privacy, user's masquerading and server masquerading as it is verified through the comprehensive formal and informal security analysis.

  17. Multi-Method Provenance Analysis of Namibian Desert Sand

    Science.gov (United States)

    Vermeesch, P.; Garzanti, E.

    2014-12-01

    Mineralogical, geochemical and geochronological provenance proxies each have their own strengths and weaknesses: a. Bulk geochemistry, framework petrography and heavy mineral compositions can differentiate between source areas characterised by different lithologies, but are sensitive to hydraulic sorting and chemical alteration. b. Detrital zircon U-Pb geochronology is insensitive to winnowing effects, but is 'blind' to lithologies devoid of zircon and cannot differentiate between first cycle and recycled sediments. c. Cosmogenic neon isotopes can be used to identify different generations of surface exposure while simultaneously tracking different magmatic sources. The challenge is then to combine these different proxies into a self consistent story, and do so in as objective a manner as possible. We here present a case study of Namibia's Namib Sand Sea and Skeleton Coast ergs, in which all the aforementioned methods have been combined using a three-way multidimensional scaling (aka INDividual Differences SCALing or INDSCAL) analysis: 1. Each of the datasets was represented by a 'dissimilarity matrix' of pairwise distances between samples. 2. The set of these matrices was fed into the INDSCAL algorithm, which produces two pieces of graphical output: the 'group configuration', which is a scatter plot or 'map' in which similar samples plot close together and dissimilar samples plot far apart, and the 'proxy weights', in which not the samples but the proxies are plotted according to the weight they attached to the 'group configuration' axes. The INDSCAL map of the Namibia dataset indicates that (a) long-shore drift of Orange River sediments dominates the coastal sediment compositions all along the Namibian coast until Angola, and (b) that light and heavy minerals tell complementary parts of the provenance story.

  18. Mise au point d'un protocole de test de vélocimètres ultrasonores à effet Doppler

    OpenAIRE

    LARRARTE, F; BOUTAMAR, O; JOANNIS, C

    2001-01-01

    Les vélocimètres ultrasonores à effet Doppler fournissent une mesure globale d'une grandeur réputée représentative de la vitesse de l'écoulement. Afin de mieux appréhender les relations entre cette grandeur mesurée et la vitesse, et de déboucher sur une mesure précise du débit, il est nécessaire de connaître des caractéristiques fonctionnelles des capteurs : volume de mesure, pondération des échos provenant de différentes zones de ce volume. Un protocole a donc été développé pour mesurer ces ...

  19. Association of radiotherapy and chemotherapy in limited small cell lung cancers: interest of alternating protocols

    International Nuclear Information System (INIS)

    Le Chevalier, T.; Arriagada, R.; Ruffie, P.; Cremoux, H. de; Douillard, J.Y.; Tuchais, C.; Chomy, P.; Riviere, A.; Tarayre, M.

    1992-01-01

    From 1980, alternating protocols of chemotherapy and thorax radiotherapy in limited small cell lung cancers have been elaborated in order to control locally the disease, to improve the total survival and to reduce the toxicity that are bound the simultaneous treatments of chemotherapy and radiotherapy. Thanks to these protocols, the two-year survival rate is 27% and the five-year survival rate, 16%

  20. New Dimensional Staging of Bisphosphonate-Related Osteonecrosis of the Jaw Allowing a Guided Surgical Treatment Protocol: Long-Term Follow-Up of 266 Lesions in Neoplastic and Osteoporotic Patients from the University of Bari

    Directory of Open Access Journals (Sweden)

    Simonetta Franco

    2014-01-01

    Full Text Available Bisphosphonate-related osteonecrosis of the jaw (BRONJ is the most serious side effect in patients receiving bisphosphonates (BPs for neoplastic disease and osteoporosis. The aim of this study is to propose a new dimensional stage classification, guiding the surgical treatment of BRONJ patients, and to evaluate the success rate of this new management. From 2004 to 2013, 203 neoplastic and osteoporotic patients with 266 BRONJ lesions were referred to the Odontostomatology Unit of the University of Bari. All patients underwent surgery after suspension of BPs therapy and antibiotic treatment. The surgical procedure was complemented by piezosurgery and followed by the application of hyaluronate and amino acids. The new dimensional staging suggests the choice of the surgical approach, and allows the prediction of postoperative complications and soft and hard tissues healing time, guiding the surgical treatment protocol. This protocol could be a successful management strategy for BRONJ, considering the low recurrences rate and the good stabilisation of the surgical sites observed after a long-term follow-up.