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Sample records for reviewing pra treatments

  1. Treatment of system dependencies and human interactions in PRA studies: a review and sensitivity study

    International Nuclear Information System (INIS)

    Orvis, D.D.; Joksimovich, V.; Worledge, D.H.

    1985-01-01

    The Electric Power Research Institute sponsored the review and comparison of five PRA studies: Arkansas Nuclear One - Unit 1, Big Rock Point, Grand Gulf, Limerick, and Zion - Unit 1. The review has been conducted in two phases. The Phase I review may be characterized as a qualitative look into many aspects of a PRA study. The Phase II review was performed to quantify the extent that differences in analytical techniques or key assumptions in these areas affect the differences in study results. In each of the PRA studies reviewed, the general descriptions of analytical approaches and descriptions of the analyses of event tree, fault tree and human interaction analyses that affected the dominant core damage sequences were reviewed. When these descriptions aroused interest because of seeming inconsistencies within the study or with other studies, they were pursued in some depth. The approaches or assumptions were contrasted to similar elements from other studies, and sensitivity analyses were performed in many cases to test the significance of results to the analytical models or assumptions. Inferences were drawn from the results regarding significance of the item to plant-specific results and, where possible, were generalized to other PRAs. This paper describes the results of the review of system dependencies and human interactions

  2. Review of PRA methodology for LMFBR

    International Nuclear Information System (INIS)

    Yang, J. E.

    1999-02-01

    Probabilistic Risk Assessment (PRA) has been widely used as a tool to evaluate the safety of NPPs (Nuclear Power Plants), which are in the design stage as well as in operation. Recently, PRA becomes one of the licensing requirements for many existing and new NPPs. KALIMER is a Liquid Metal Fast Breeder Reactor (LMFBR) being developed by KAERI. Since the design concept of KALIMER is similar to that of the PRISM plant developed by GE, it would be appropriate to review the PRA methodology of PRISM as the first step of KALIMER PRA. Hence, in this report summarizes the PRA methodology of PRISM plant, and the required works for the PSA of KALIMER based on the reviewed results. The PRA technology of PRISM plant consists of following five major tasks: (1) development of initiating event list, (2) development of system event tree, (3) development of core response event tree, (4) development of containment response event tree, and (5) consequences and risk estimation. The estimated individual and societal risk measures show that the risk from a PRISM module is substantially less than the NRC goal. Each task is compared to the PRA methodology of Light Water Reactor (LWR)/Pressurized Heavy Water Reactor (PHWR). In the report, each task of PRISM PRA methodology is reviewed and compared to the corresponding part of LWR/PHWR PSA performed in Korea. The parts that are not modeled appropriately in PRISM PRA are identified, and the recommendations for KALIMER PRA are stated. (author). 14 refs., 9 tabs., 4 figs

  3. Insights on PRA Review Practices: Necessity for Model Shaking

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Inn Seock; Jang, Mi suk; Kim, Seoung Rae [NESS, Daejeon (Korea, Republic of)

    2016-05-15

    Probabilistic risk assessment (PRA) is increasingly used as a technique to help ensure design and operational safety of nuclear power plants (NPPs) in the nuclear industry. Hence, there is considerable interest in the PRA quality, and as a result, a peer review of the PRA model is typically performed to ensure its technical adequacy as part of the PRA development process or for any other reason (e.g., regulatory requirement). For the PRA model to be used as a valuable vehicle for risk-informed applications, it is essential that the PRA model must yield correct and physically meaningful accident sequences and minimal cutsets for specific plant configurations or conditions relating to the applications. Hence, the existing peer review guidelines need to be updated to reflect these insights so that risk-informed applications could be more actively pursued with confidence.

  4. Automated system for review of radiotherapy treatment sheets; Sistema automatizado pra la revision de hojas de tratamiento en radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Collado Chamorro, P.; Sanz Freire, C. J.; Vazquez Galinanes, A.; Diaz Pascual, V.; Gomez amez, J.; Martinez Sanchez, S.; Ossola Lentati, G. A.

    2011-07-01

    In many modern radiotherapy services begins to leaf treatment implemented in electronic form. In our department has developed an automated reporting system, that check the following parameters: treatment completed correctly, number of sessions and cumulative dose administered. Likewise treatments are verified in the allocated separate unit, and over-writing table parameters.

  5. Comments of the PRA Senior Review Panel on the meeting held December 1--3, 1987

    International Nuclear Information System (INIS)

    Sharp, D.A.

    1988-01-01

    This memorandum records the minutes of the PRA Senior Review Panel meeting held at Savannah River Laboratory (SRL) on December 1--3, 1987, and the report on that meeting written subsequently by the panel members. The minutes are contained as Attachment 2 of this memorandum, and the report as Attachment 1. The Panel indicated two principal concerns in their report: (1) that insufficient emphasis is being placed on the reliability data development program, and (2) that excessive detail is being built into the fault trees. These concerns have been addressed in a subsequent meeting with the Panel, held March 2--4, 1988. In addition, the members have been provided with a program document (Reference 1) indicating the extent, the timing, and the limitations of the data analysis effort for the PRA

  6. PRA and Risk Informed Analysis

    International Nuclear Information System (INIS)

    Bernsen, Sidney A.; Simonen, Fredric A.; Balkey, Kenneth R.

    2006-01-01

    The Boiler and Pressure Vessel Code (BPVC) of the American Society of Mechanical Engineers (ASME) has introduced a risk based approach into Section XI that covers Rules for Inservice Inspection of Nuclear Power Plant Components. The risk based approach requires application of the probabilistic risk assessments (PRA). Because no industry consensus standard existed for PRAs, ASME has developed a standard to evaluate the quality level of an available PRA needed to support a given risk based application. The paper describes the PRA standard, Section XI application of PRAs, and plans for broader applications of PRAs to other ASME nuclear codes and standards. The paper addresses several specific topics of interest to Section XI. Important consideration are special methods (surrogate components) used to overcome the lack of PRA treatments of passive components in PRAs. The approach allows calculations of conditional core damage probabilities both for component failures that cause initiating events and failures in standby systems that decrease the availability of these systems. The paper relates the explicit risk based methods of the new Section XI code cases to the implicit consideration of risk used in the development of Section XI. Other topics include the needed interactions of ISI engineers, plant operating staff, PRA specialists, and members of expert panels that review the risk based programs

  7. Review of KSNP LPSD PSA model based of ANS LPSD PRA standard, rev.0

    International Nuclear Information System (INIS)

    Jang, S. C.; Park, J. H.; Kim, T. W.; Lim, H. G.; Yang, J. E.; Ha, J. J.

    2004-02-01

    Recently, under the de-regulation environment, nuclear industry has attempted various approaches to improve the economics of Nuclear Power Plants (NPP). One of these efforts is the Risk Informed/Performance-based Operation (RIPBO). This approach uses the risk and performance information to manage the resources effectively and efficiently that are used in the operation of NPP. In RIPBO, PSA quality is one of the most important things. The nuclear industry and regulatory body of U.S.A have developed a measure to evaluate the quality of PSA. NEI (Nuclear Energy Institute) has developed a guidance called 'NEI PRA Peer Review Guidance,' and NRC (Nuclear Regulatory Committee) and ASME have developed the 'PRA Standard.' In Korea, several projects are on going now, such as the extension of AOT/STI of RPS/ESFAS, Risk-informed In-service Inspection (RI-ISI). However, in Korea, there have been no attempts to evaluate the quality of PSA model itself. Therefore, we cannot be sure about the quality of PSA whether or not the present PSA model can be used for the risk-informed applications such as mentioned above. We can say that the evaluation of PSA model quality is the basis for the RIPBO. In this report, we have evaluated the quality of PSA model at Low power and Shutdown operation model for Yongkwang 5 and 6 units based on the ANS LPSD PRA Standard. We, also, have derived what items are to be improved to upgrade the quality of LPSD PSA model and how it can be improved. This report can be used as the base of RIPBO work in Korea

  8. Review of UCN 3,4 PSA model based on NEI PRA peer review process guidance, rev.0

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Kang, D. I.; Kim, K. Y.; Lee, Y. H.; Jang, S. C.; Ha, J. J.; Han, S. H.; Han, S. J.; Hwang, M. J.

    2003-05-01

    Recently, under the de-regulation environment, nuclear industry has attempted various approaches to improve the economics of Nuclear Power Plants (NPP). One of these efforts is the Risk Informed/Performance-Based Operation (RIPBO). This approach uses the risk and performance information to manage the resources effectively and efficiently that are used in the operation of NPP. In RIPBO, PSA quality is one of the most important things. The nuclear industry and regulatory body of U.S.A have developed a measure to evaluate the quality of PSA. NEI (Nuclear Energy Institute) has developed a guidance called 'NEI PRA Peer Review Guidance,' and NRC (Nuclear Regulatory Committee) and ASME have developed the 'PRA Standard.' In Korea, several projects are on going now, such as the extension of AOT/STI of RPS/ESFAS, Risk-Informed In-Service Inspection (RI-ISI). However, in Korea, there have been no attempts to evaluate the quality of PSA model itself. Therefore, we cannot be sure about the quality of PSA whether or not the present PSA model can be used for the risk-informed applications such as mentioned above. We can say that the evaluation of PSA model quality is the basis for the RIPBO. In this report, we have evaluated the quality of PSA model for Ulchin 3 and 4 units based on the NEI guidance. We, also, have derived what items are to be improved to upgrade the quality of PSA model and how it can be improved. This report can be used as the base of RIPBO work in Korea. The review result based on ASME Standard is published as the separated technical report of KAERI

  9. Review of UCN 5,6 Fire PSA Model based on ANS Fire PRA Standard

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Lee, Yoon Hwan

    2006-12-01

    Recently, under the de-regulation environment, nuclear industry has attempted various approaches to improve the economics of Nuclear Power Plants (NPP). This approach uses the fire risk and performance information to manage the resources effectively and efficiently that are used in the operation of NPP. In fire risk informed/performance-based decision/operation, fire PSA quality is one of the most important things. The nuclear industry and regulatory body of U.S.A have developed a measure to evaluate the quality of fire PSA. ANS (American Nuclear Society) has developed a guidance called 'ANS Fire PRA Methodology Standard'. However, in Korea, there have been no attempts to evaluate the quality of fire PSA model itself. Therefore, we cannot be sure about the quality of fire PSA whether or not the present fire PSA model can be used for the risk-informed applications such as mentioned above. We can say that the evaluation of fire PSA model quality is the basis for the fire risk informed/performance-based decision/operation. In this report, we have evaluated the quality of fire PSA model for Ulchin 5 and 6 units based on the ANS Fire PRA Standard. We, also, have derived what items are to be improved to upgrade the quality of fire PSA model and how it can be improved. This report can be used as the base of the fire risk informed/performance-based decision/operation work in Korea

  10. PRA quality and use

    International Nuclear Information System (INIS)

    Okrent, D.; Apostolakis, G.; Whitley, R.; Garrick, B.J.

    1982-10-01

    This report deals with several inter-related aspects of probabilistic risk assessment. Some prior opinion regarding quality assurance, methodology and questions of peer review are reviewed, followed by comments by the authors on these and related subjects. Problems arising in decision-making by different groups concerning the meaning and validity of a PRA are examined, and the role of performance criteria in helping to achieve consensus is treated. Finally, a general approach to the development of performance criteria for systems and functions by the retrospective comparison of existing PRAs is proposed and examined in a preliminary fashion

  11. Review of the turbine-building flooding study of the Oconee PRA

    International Nuclear Information System (INIS)

    Ilberg, D.; Hanan, N.A.

    1986-01-01

    A peer review of the Oconee Probabilistic Risk Assessment (OPRA) for Unit no. 3 was conducted at BNL for the NRC. This paper discusses the review of the OPRA turbine-building internal-flooding study, which is one of the dominant contributors, and was performed in great detail. This paper also includes a comparison with other flooding studies performed elsewhere. 5 refs., 1 tab

  12. Diablo Canyon internal events PRA [Probabilistic Risk Assessment] review: Methodology and findings

    International Nuclear Information System (INIS)

    Fitzpatrick, R.G.; Bozoki, G.; Sabek, M.

    1990-01-01

    The review of the Diablo Canyon Probabilistic Risk Assessment (DCRPA) incorporated some new and innovative approaches. These were necessitated by the unprecedented size, scope and level of detail of the DCRPA, which was submitted to the NRC for licensing purposes. This paper outlines the elements of the internal events portion of the review citing selected findings to illustrate the various approaches employed. The paper also provides a description of the extensive and comprehensive importance analysis applied by BNL to the DCRPA model. Importance calculations included: top event/function level; individual split fractions; pair importances between frontline-support and support-support systems; system importance by initiator; and others. The paper concludes with a brief discussion of the effectiveness of the applied methodology. 3 refs., 5 tabs

  13. PRA and the implementation of quantitative safety goals

    International Nuclear Information System (INIS)

    Okrent, D.

    1983-01-01

    With the adoption by the U.S. Nuclear Regulatory Commission (NRC) in January, 1983, of a Policy Statement on Safety Goals for the Operation of Nuclear Power Plants, probabilitstic risk assessment (PRA) has taken on increased importance in nuclear reactor safety. Although the Reactor Safety Study, WASH-1400, was a major pioneering effort that revolutionized thinking about reactor safety, PRA was used only on occasion by the NRC regulatory staff prior to the accident at Three Mile Island. Since then, PRA has been used more and more as an important factor in decision making, usually for specific issues. The nuclear industry has also employed PRA, sometimes to make its case on specific issues, sometimes to present a position on overall risk. The advent of the Zion and Indian Point PRAs, with their treatment of risks from fire, wind, and earthquakes, and their examination of the course of core melt accidents, has added a new dimension to the overall picture. Although the NRC has stated that during the next two year evolution period, its quantitative design objectives and PRA are not to enter directly into the licensing process, many important issues will be influenced significantly by the results of risk and reliability studies. In fact, PRA may be coming into a position of great importance before the methodology, data, and process are sufficiently mature for the task. Large gaps still exist in our understanding of phenomena and in input information; and much of the final result depends on subjective input; large differences of opinion can and should be expected to persist. Accepted standards for quality assurance, and adequacy and depth of independent, peer review remain to be formulated and achieved. This paper will summarize the recently adopted NRC safety policy and the two-year evaluation plan, and will provide, by example, some words of caution concerning a few of the difficulties which may arise. (orig.)

  14. Probabilistic risk assessment (PRA) reference document. Final report

    International Nuclear Information System (INIS)

    Murphy, J.A.

    1984-09-01

    This document describes the current status of probabilistic risk assessment (PRA) as practiced in the nuclear reactor regulatory process. The PRA studies that have been completed or are under way are reviewed. The levels of maturity of the methodologies used in a PRA are discussed. Insights derived from PRAs are listed. The potential uses of PRA results for regulatory purposes are discussed. This document was issued for comment in February 1984 entitled Probabilistic Risk Assessment (PRA): Status Report and Guidance for Regulatory Application. The comments received on the draft have been considered for this final version of the report

  15. Uses of PRA in nuclear reactor regulation

    International Nuclear Information System (INIS)

    Congel, F.

    1987-01-01

    For the past five years, more than ten probabilistic risk assessment (PRA) studies were conducted by the owners of nuclear utilities and were submitted for the review of US Nuclear Regulatory Commission staff. These PRA studies were reviewed under various types of regulatory activities depending on the nature of plant licensing stage. The reviews of these PRAs provided very valuable uses to both the staff and the licensees on safety matters of the plant operation. The licensees developed perspectives using PRA models on the safety profiles of their plants. These PRA perspectives influenced licensees' major decisions to implement improvements to plant design and operating and emergency procedures to reduce and/or eliminate the plant's vulnerability to core damage accidents. The staff's review of these PRAs particularly emphasized the dominant accident sequences. The resulting findings led to the identification of dominant risk contributors, critical areas of plant locations, mechanisms leading to potential early containment failures, and instances of noncompliances of staff's deterministic criteria. Specific examples include single failure criterion and separation requirements to assess the need for any additional measures to further improve the safety of the plant. Some of these PRAs were reviewed under regulatory activities other than safety review such as environmental review, final design review, and licensing hearings. Most importantly, the risk profiles of generic PRAs will continue to be used in reviewing and evaluating unresolved safety issues and other generic issues. The major regulatory uses of PRAs, a summary of full scope PRA review, a summary of plant improvements as a result of PRA reviews, and the future role of PRA reviews are presented

  16. IRIS PRA preliminary results and future direction

    International Nuclear Information System (INIS)

    Finnicum, D.J.; Kling, C.L.; Carelli, M.D.

    2004-01-01

    Westinghouse is currently conducting the pre-application licensing of the International Reactor Innovative and Secure (IRIS) on behalf of the IRIS Consortium. One of the key aspects of the IRIS design is the concept of safety-by-design. The PRA (Probabilistic Risk Analysis) is being used as an integral part of the design process. As part of this effort, a PRA of the initial design was generated to address 2 key areas. First, the IRIS PRA supported the evaluation of IRIS design issues by providing a solid risk basis for design and analyses required for the pre-licensing evaluation of the IRIS design. The PRA provides the tool for quantifying the benefit of the safety-by-design approach. Second, the current PRA task is beginning the preparation of the more complete PRA analyses and documentation eventually required for Design Certification. One of the key risk-related goals for IRIS is to reduce the EPZ (Emergency Protection Zone) to within the exclusion area by demonstrating that the off-site doses are consistent with the US Protective Action Guidelines (PAGs) for initiation of emergency response so that the required protective actions would be limited to the exclusion area. The results of the preliminary PRA indicated a core damage frequency of 1.2 E-08 for internal initiators. This is a very good result but much work is needed to meet the ambitious goal of no emergency response. The next phase of the PRA analyses will involve a two-fold expansion of the PRA. First, as the design and analyses approach a greater level of detail, the assumptions used for the initial PRA will be reviewed and the models will be revised as needed to reflect the improved knowledge of the system design and performance. Furthermore, as the full plant design advances, the PRA will be expanded to incorporate risk associated with external challenges such as seismic and fire, and to address low power and shutdowns modes of operation. As with the initial work, the PRA will serve as a tool to

  17. Treatment of complementary events in event trees in constructing linked fault trees for level 1 and level 2 PRA

    International Nuclear Information System (INIS)

    Jo, Y. G.

    2008-01-01

    Complementary events in the event trees for a PRA model should be treated properly in order to evaluate plant risk correctly. In this study, the characteristics of the following three different cut-set generation methods were investigated first in order to find the best practical way for treating complementary events: 1) exact method which treats complementary events logically, 2) no-delete term method which does not treat complementary events at all, and 3) delete term method which treats complementary events by deleting nonsense cut-sets which are generated as a result of ignoring complementary events. Then, practical methods for treating complementary events in constructing linked fault trees for level 1 and level 2 PRA in EPRI R and R workstation software environment, where CAFTA is the fault tree editor and FORTE is the cut-set engine, were suggested and demonstrated. The suggested methods deal with the following selected four typical cases: Case 1: an event tree event (E) is represented by a fault tree gate whose inputs consist of only fault tree gates, Case 2: E is represented by a single basic event, Case 3: E is represented by an OR fault tree gate which has a single basic event and a fault tree gate as inputs, and Case 4: E is represented by an AND fault tree gate which has a single basic event and a fault tree gate as inputs. In the suggested methods, first the high level logic structures of event tree events are examined and restructured, if needed. Then, the delete term method, the exact method, and the combination of the two methods are applied to Case 1, Case 2, and Cases 3 and 4, respectively. Also, it is recommended to treat complementary events, using the suggested methods, before level 1 and level 2 PRA fault trees are coupled. It should be noted that the selected four typical cases may not cover all different cases encountered in level 1 and level 2 PRA modeling. However, a process similar to the one suggested in this study may be used to find

  18. Probabilistic risk assessment (PRA): status report and guidance for regulatory application. Draft report for comment

    International Nuclear Information System (INIS)

    1984-02-01

    This document describes the current status of the methodologies used in probabilistic risk assessment (PRA) and provides guidance for the application of the results of PRAs to the nuclear reactor regulatory process. The PRA studies that have been completed or are underway are reviewed. The levels of maturity of the methodologies used in a PRA are discussed. Insights derived from PRAs are listed. The potential uses of PRA results for regulatory purposes are discussed

  19. Use of PRA in Shuttle Decision Making Process

    Science.gov (United States)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

    How do you use PRA to support an operating program? This presentation will explore how the Shuttle Program Management has used the Shuttle PRA in its decision making process. It will reveal how the PRA has evolved from a tool used to evaluate Shuttle upgrades like Electric Auxiliary Power Unit (EAPU) to a tool that supports Flight Readiness Reviews (FRR) and real-time flight decisions. Specific examples of Shuttle Program decisions that have used the Shuttle PRA as input will be provided including how it was used in the Hubble Space Telescope (HST) manifest decision. It will discuss the importance of providing management with a clear presentation of the analysis, applicable assumptions and limitations, along with estimates of the uncertainty. This presentation will show how the use of PRA by the Shuttle Program has evolved overtime and how it has been used in the decision making process providing specific examples.

  20. A desktop PRA

    International Nuclear Information System (INIS)

    Dolan, B.J.; Weber, B.J.

    1989-01-01

    This paper reports that Duke Power Company has completed full-scope PRAs for each of its nuclear stations - Oconee, McGuire and Catawba. These living PRAs are being maintained using desktop personal computers. Duke's PRA group now has powerful personal computer-based tools that have both decreased direct costs (computer analysis expenses) and increased group efficiency (less time to perform analyses). The shorter turnaround time has already resulted in direct savings through analyses provided in support of justification for continued station operation. Such savings are expected to continue with similar future support

  1. PRA and Conceptual Design

    Science.gov (United States)

    DeMott, Diana; Fuqua, Bryan; Wilson, Paul

    2013-01-01

    Once a project obtains approval, decision makers have to consider a variety of alternative paths for completing the project and meeting the project objectives. How decisions are made involves a variety of elements including: cost, experience, current technology, ideologies, politics, future needs and desires, capabilities, manpower, timing, available information, and for many ventures management needs to assess the elements of risk versus reward. The use of high level Probabilistic Risk Assessment (PRA) Models during conceptual design phases provides management with additional information during the decision making process regarding the risk potential for proposed operations and design prototypes. The methodology can be used as a tool to: 1) allow trade studies to compare alternatives based on risk, 2) determine which elements (equipment, process or operational parameters) drives the risk, and 3) provide information to mitigate or eliminate risks early in the conceptual design to lower costs. Creating system models using conceptual design proposals and generic key systems based on what is known today can provide an understanding of the magnitudes of proposed systems and operational risks and facilitates trade study comparisons early in the decision making process. Identifying the "best" way to achieve the desired results is difficult, and generally occurs based on limited information. PRA provides a tool for decision makers to explore how some decisions will affect risk before the project is committed to that path, which can ultimately save time and money.

  2. Hiperurisemia pada Pra Diabetes

    Directory of Open Access Journals (Sweden)

    Ellyza Nasrul

    2012-09-01

    Full Text Available AbstrakAsam urat (AU merupakan produk akhir dari katabolisme adenin dan guanin yang berasal dari pemecahannukleotida purin. Urat dihasilkan oleh sel yang mengandung xanthine oxidase, terutama hepar dan usus kecil.Hiperurisemia adalah keadaan kadar asam urat dalam darah lebih dari 7,0 mg/dL.Pra diabetes adalah subjek yangmempunyai kadar glukosa plasma meningkat akan tetapi peningkatannya masih belum mencapai nilai minimaluntuk kriteria diagnosis diabetes melitus (DM. Glukosa darah puasa terganggu merupakan keadaan dimanapeningkatan kadar FPG≥100 mg/dL dan <126 mg/dL. Toleransi glukosa terganggu merupakan peningkatanglukosa plasma 2 jam setelah pembebanan 75 gram glukosa oral (≥140 mg/dL dan <200mg/dL dengan FPG<126 mg/dL.Insulin juga berperan dalam meningkatkan reabsorpsi asam urat di tubuli proksimal ginjal. Sehinggapada keadaan hiperinsulinemia pada pra diabetes terjadi peningkatan reabsorpsi yang akan menyebabkanhiperurisemia. Transporter urat yang berada di membran apikal tubuli renal dikenal sebagai URAT-1 berperandalam reabsorpsi urat.Kata kunci: Hiperurisemia, Pra DiabetesAbstractUric acid (AU is the end product of the catabolism of adenine and guanine nucleotides derived from thebreakdown of purines. Veins produced by cells containing xanthine oxidase, especially the liver and small intestine.Hyperuricemia is a state in the blood uric acid levels over 7.0 mg / dL.Pre-diabetes is a subject which has a plasmaglucose level will rise but the increase is still not reached the minimum value for the diagnostic criteria for diabetesmellitus (DM. Impaired fasting blood glucose is a condition in which increased levels of FPG ≥ 100 mg / dL and<126 mg / dL. Impaired glucose tolerance is an increase in plasma glucose 2 hours after 75 gram oral glucose load(≥ 140 mg / dL and <200mg/dl with FPG <126 mg / dL.Insulin also plays a role in increasing the reabsorption ofuric acid in renal proximal tubule. So that the hyperinsulinemia in the pre

  3. Summary of PRA assessment of transient accident risks, human factors considerations, and PRA methods and applications

    International Nuclear Information System (INIS)

    Carnino, A.

    1984-01-01

    This chapter reviews the progress made in the probabilistic risk assessment (PRA) area to help in solving operational transient problems and to integrate human factors considerations, as discussed at the American Nuclear Society Topical Meeting on Anticipated and Abnormal Plant Transients in Light Water Reactors. Topics considered include core-melt frequency, external events (e.g., fires, floods), diagnostic errors, and operator aids. It is concluded that confidence in PRA results, predictions and uses for decisions in both the safety of the plants and their availability will improve

  4. Insights into PRA methodologies

    International Nuclear Information System (INIS)

    Gallagher, D.; Lofgren, E.; Atefi, B.; Liner, R.; Blond, R.; Amico, P.

    1984-08-01

    Probabilistic Risk Assessments (PRAs) for six nuclear power plants were examined to gain insight into how the choice of analytical methods can affect the results of PRAs. The PRA sreflectope considered was limited to internally initiated accidents sequences through core melt. For twenty methodological topic areas, a baseline or minimal methodology was specified. The choice of methods for each topic in the six PRAs was characterized in terms of the incremental level of effort above the baseline. A higher level of effort generally reflects a higher level of detail or a higher degree of sophistication in the analytical approach to a particular topic area. The impact on results was measured in terms of how additional effort beyond the baseline level changed the relative importance and ordering of dominant accident sequences compared to what would have been observed had methods corresponding to the baseline level of effort been employed. This measure of impact is a more useful indicator of how methods affect perceptions of plant vulnerabilities than changes in core melt frequency would be. However, the change in core melt frequency was used as a secondary measure of impact for nine topics where availability of information permitted. Results are presented primarily in the form of effort-impact matrices for each of the twenty topic areas. A suggested effort-impact profile for future PRAs is presented

  5. Role of PRA in new NPP projects

    International Nuclear Information System (INIS)

    Julin, A.; Sandberg, J.; Virolainen, R.

    2012-01-01

    In Finland, a plant specific, Level 1 and 2 Probabilistic Risk Analysis (PRA) is required as a prerequisite for issuing the construction license and operating license. The use of PRA in various applications and the main insights are presented. These applications include e.g. PRA support to the design of SSCs (Systems, Structures and Components), definition of pre-service and in-service inspection programs, evaluation of the safety classification of SSCs, development of procedures, training and in definition of risk informed technical specifications, periodic testing and on-line preventive maintenance programs. In addition, PRA shall be used to assess the adequacy and coverage of the phase and system commissioning programs. Also the potential risks related to commissioning tests during nuclear test phase, shall be assessed with the help of PRA. In OL3 project, risk informed approach has been applied on a large scale for the first time in the design, construction and commissioning of a new NPP unit. Pre-nuclear commissioning tests have started at OL3 site and the plant is foreseen to begin commercial operation in 2013. Decisions have been made to launch new NPP projects. Teollisuuden Voima Oyj (TVO) is planning to build a new unit (OL4) at Olkiluoto site and a new utility, Fennovoima, is planning to build one unit at one of two alternative green field sites in Northern parts of Finland. Insights from PRAs of operating NPPs have been used in the evaluation of possible new sites to ensure that the site specific concerns and environmental conditions are adequately taken into account in the design of SSCs. Although the seismic activity at the Olkiluoto site is low, a comprehensive seismic risk analysis is being conducted. Its results support the review of the deterministic seismic design. For new sites, a probabilistic seismic hazard analysis has been carried out for the determination of the design earthquake. Experiences from OL3 licensing have been utilized in the

  6. Linkage of PRA models. Phase 1, Results

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C.L.; Knudsen, J.K.; Kelly, D.L.

    1995-12-01

    The goal of the Phase I work of the ``Linkage of PRA Models`` project was to postulate methods of providing guidance for US Nuclear Regulator Commission (NRC) personnel on the selection and usage of probabilistic risk assessment (PRA) models that are best suited to the analysis they are performing. In particular, methods and associated features are provided for (a) the selection of an appropriate PRA model for a particular analysis, (b) complementary evaluation tools for the analysis, and (c) a PRA model cross-referencing method. As part of this work, three areas adjoining ``linking`` analyses to PRA models were investigated: (a) the PRA models that are currently available, (b) the various types of analyses that are performed within the NRC, and (c) the difficulty in trying to provide a ``generic`` classification scheme to groups plants based upon a particular plant attribute.

  7. Linkage of PRA models. Phase 1, Results

    International Nuclear Information System (INIS)

    Smith, C.L.; Knudsen, J.K.; Kelly, D.L.

    1995-12-01

    The goal of the Phase I work of the ''Linkage of PRA Models'' project was to postulate methods of providing guidance for US Nuclear Regulator Commission (NRC) personnel on the selection and usage of probabilistic risk assessment (PRA) models that are best suited to the analysis they are performing. In particular, methods and associated features are provided for (a) the selection of an appropriate PRA model for a particular analysis, (b) complementary evaluation tools for the analysis, and (c) a PRA model cross-referencing method. As part of this work, three areas adjoining ''linking'' analyses to PRA models were investigated: (a) the PRA models that are currently available, (b) the various types of analyses that are performed within the NRC, and (c) the difficulty in trying to provide a ''generic'' classification scheme to groups plants based upon a particular plant attribute

  8. A model for assessing human cognitive reliability in PRA studies

    International Nuclear Information System (INIS)

    Hannaman, G.W.; Spurgin, A.J.; Lukic, Y.

    1985-01-01

    This paper summarizes the status of a research project sponsored by EPRI as part of the Probabilistic Risk Assessment (PRA) technology improvement program and conducted by NUS Corporation to develop a model of Human Cognitive Reliability (HCR). The model was synthesized from features identified in a review of existing models. The model development was based on the hypothesis that the key factors affecting crew response times are separable. The inputs to the model consist of key parameters the values of which can be determined by PRA analysts for each accident situation being assessed. The output is a set of curves which represent the probability of control room crew non-response as a function of time for different conditions affecting their performance. The non-response probability is then a contributor to the overall non-success of operating crews to achieve a functional objective identified in the PRA study. Simulator data and some small scale tests were utilized to illustrate the calibration of interim HCR model coefficients for different types of cognitive processing since the data were sparse. The model can potentially help PRA analysts make human reliability assessments more explicit. The model incorporates concepts from psychological models of human cognitive behavior, information from current collections of human reliability data sources and crew response time data from simulator training exercises

  9. Standardized procedure for tsunami PRA by AESJ

    International Nuclear Information System (INIS)

    Kirimoto, Yukihiro; Yamaguchi, Akira; Ebisawa, Katsumi

    2013-01-01

    After Fukushima Accident (March 11, 2011), the Atomic Energy Society of Japan (AESJ) started to develop the standard of Tsunami Probabilistic Risk Assessment (PRA) for nuclear power plants in May 2011. As Japan is one of the countries with frequent earthquakes, a great deal of efforts has been made in the field of seismic research since the early stage. To our regret, the PRA procedures guide for tsunami has not yet been developed although the importance is held in mind of the PRA community. Accordingly, AESJ established a standard to specify the standardized procedure for tsunami PRA considering the results of investigation into the concept, the requirements that should have and the concrete methods regarding tsunami PRA referring the opinions of experts in the associated fields in December 2011 (AESJ-SC-RK004:2011). (author)

  10. Practical PRA applications at Consumers Power Company

    International Nuclear Information System (INIS)

    Blanchard, D.P.

    1985-01-01

    Consumers Power Company has completed two probabilistic risk assessments (PRAs), one each at its Big Rock Point and Midland plants and is in the process of performing a third study at its Palisades Plant. Each PRA is summarized briefly in this paper. Each PRA has been used to evaluate specific plant design features and make operating and design recommendations to plant and Company management as well as to the regulator. This paper is a sumary of those issues on which Consumers Power Company has applied PRAs to date. The technique used in applying PRA to these issues has varied as more was learned about the plants from the PRA and about PRA itself. Some issue resolutions involved deriving technical arguments from small parts of the PRA only, such as the logic models or consequence analysis. Still others required use of the entire PRA including sequence quantification, plant and containment response, consequence analysis and eventually cost-benefit evaluation of proposed resolutions. The benefits derived from these analyses have also varied and include not only a perceived reduction in the risks associated with plant operation but also economic benefit to the Company in that cost-effective alternatives to resolving safety issues have been permitted

  11. Reliability design of a critical facility: An application of PRA methods

    International Nuclear Information System (INIS)

    Souza Vieira Neto, A.; Souza Borges, W. de

    1987-01-01

    Although a general agreement concerning the enforcement of reliability (probabilistic) design criteria for nuclear utilities is yet to be achieved. PRA methodology can still be used successfully as a project design and review tool, aimed at improving system's prospective performance or minimizing expected accident consequences. In this paper, the potential of such an application of PRA methods is examined in the special case of a critical design project currently being developed in Brazil. (orig.)

  12. PRA -- Now that operators have it, what do they do with it?

    International Nuclear Information System (INIS)

    Rasmussen, M.A.; Kolo, R.J.

    1996-01-01

    Many utilities have had Probabilistic Risk Assessment (PRA) projects underway for several years in order to satisfy the NRC Generic Letter 88-20 requirement for an Individual Plant Examination, or IPE. Typically the studies have reached the conclusion that there are significant differences in the contribution of different plant components to preventing core damage should a major plant transient occur. How nuclear plant operators can use this knowledge to DECREASE the overall risk of performing the routine tasks of testing and maintenance is not an easy task. 10CFR50.65; ''The Maintenance Rule,'' requires that any plant maintenance performed with the unit on line be evaluated for risk. Byron Station will satisfy the 10CFR50.65 requirement by using PRA methodology to evaluate testing and maintenance activities performed with the unit at power. The challenge is to effectively use the results of PRA studies to aid in plant operations without having to make on shift plant operations personnel experts in PRA. At Byron, PRA is used to help build the weekly work schedules. Operations personnel tasked with reviewing the work schedule are the departmental experts on the use of the PRA results. The on shift SRO's role in implementing the program is to accurately execute and monitor the work week schedule as written, and to react to unforeseen equipment failures with an appropriate level of response. The response to such emergent work items is also predefined. Handling emergent work in a prescribed manner minimizes the overall risk to the unit and also eliminates the need to have PRA expertise available to make emergent work risk evaluations. Thus the on shift operators' required knowledge of PRA methods and intricacies is minimized. PRA is just another of the many tools used by the shift operator to run the plant in a safe, conservative manner

  13. Observations on PRA and its applications

    International Nuclear Information System (INIS)

    Yeh, Y.-C.; Shieh, S.-L.

    2004-01-01

    An overview on the experience of PRA and its prospective application in Taiwan's three nuclear power plants is presented. Through the PRA, plant design improvements are performed and several engineering findings are illuminated. The sensitivity study including the internal, seismic, and typhoon events are conducted to justify items that can significantly reduce core meltdown risk. Its resulted plant betterment plans are thus highlighted accordingly. For PRA application, a risk-based inspection program for allocating inspection human resources has been resulted following the importance ranking of each component. The developing risk-based regulation to rationalize technical specification and maintenance program will also be entailed. To enhance the accuracy of the PRA model and its reproducibility, several issues are considered to have high priority for improvement such as external event data and analyses, uncertainty, common mode failure, human reliability, and the relative component importance. Highlight of their significance along with some typical sensitivity analyses are discussed for further investigation. (author)

  14. PRA studies: results, insights and applications

    International Nuclear Information System (INIS)

    Levine, S.; Stetson, F.T.

    1983-01-01

    This paper deals with Probalistic Risk Assessment (PRA) studies and their results. The PRA is a combination of logic structures and analytical techniques that can be used to estimate the likelihood and consequences of events that have not been observed because of their low frequency occurrence. At first attitudes concerning PRA reports were controversial principally because of their new techniques and complex multidisciplinary nature. However these attitudes changed following the accident at Three Mile Island in 1979. Many people after this event came to appreciate the risks associated with the operation of nuclear power plants, and since the TMI accident there has been a rapid expansion, in the use of PRA in the US and other countries. (NEA) [fr

  15. Management and Organization Influences in PRA

    International Nuclear Information System (INIS)

    Gertman, D.I.; Hallbert, B. P.; Blackman, H. S.

    1998-01-01

    The authors present a research program which aimed at increasing the quality of comprehensiveness of contemporary PRA (Probability Risk Assessment) by providing a tool that allows for incorporating M and O in PRA, at improving the quality of NRC assessments, at conducting research to support the risk informed regulation process, at identifying impact of management and organization, safety culture, workplace environment, down-sizing and deregulation on human performance and reliability

  16. Applications of PRA in nuclear criticality safety

    International Nuclear Information System (INIS)

    McLaughlin, T.P.

    1992-01-01

    Traditionally, criticality accident prevention at Los Alamos has been based on a thorough review and understanding of proposed operations of changes to operations, involving both process supervision and criticality safety staff. The outcome of this communication was usually an agreement, based on professional judgement, that certain accident sequences were credible and had to be reduced in likelihood either by administrative controls or by equipment design and others were not credible, and thus did not warrant expenditures to further reduce their likelihood. The extent of analysis and documentation was generally in proportion to the complexity of the operation but did not include quantified risk assessments. During the last three years nuclear criticality safety related Probabilistic Risk Assessments (PRAs) have been preformed on operations in two Los Alamos facilities. Both of these were conducted in order to better understand the cost/benefit aspects of PRA's as they apply to largely ''hands-on'' operations with fissile material for which human errors or equipment failures significant to criticality safety are both rare and unique. Based on these two applications and an appreciation of the historical criticality accident record (frequency and consequences) it is apparent that quantified risk assessments should be performed very selectively

  17. Two decades of PRA: What next?

    International Nuclear Information System (INIS)

    Rasmussen, N.C.

    1992-01-01

    Two decades ago, in the spring of 1972, the Reactor Safety Study was undertaken for the US Atomic Energy Commission (AEC). The goal of this study was to assess the risk to the public posed by the nuclear power plants operating in the US. Some three and one-half years later in October 1975, the study group issued its final report titled The Reactor Safety Study, also commonly known by its document number WASH 1400. Because it was issued at a time of heated public debate about nuclear safety, WASH 1400 received considerable critical review. By the late 1970s, as a result of the Lewis Report and the accident at Three Mile Island, the value of the WASH 1400 methodology was gradually recognized. A number of utilities undertook such studies of their own plants. The field of probabilistic risk assessment (PRA) developed from these efforts. Challenges remain. Among these are how to effectively communicate the results of the analysis. Just what does a probability of one in a million mean? Is there a de minimis probability - one so small that it can be ignored? How should society make decisions under substantial uncertainty? A number of these questions pose real challenges for the future

  18. Task analysis: How far are we from usable PRA input

    International Nuclear Information System (INIS)

    Gertman, D.I.; Blackman, H.S.; Hinton, M.F.

    1984-01-01

    This chapter reviews data collected at the Idaho National Engineering Laboratory for three DOE-owned reactors (the Advanced Test Reactor, the Power Burst Facility, and the Loss of Fluids Test Reactor) in order to identify usable Probabilistic Risk Assessment (PRA) input. Task analytic procedures involve the determination of manning and skill levels as a means of determining communication requirements, in assessing job performance aids, and in assessing the accuracy and completeness of emergency and maintenance procedures. The least understood aspect in PRA and plant reliability models is the human factor. A number of examples from the data base are discussed and offered as a means of providing more meaningful data than has been available to PRA analysts in the past. It is concluded that the plant hardware-procedures-personnel interfaces are essential to safe and efficient plant operations and that task analysis is a reasonably sound way of achieving a qualitative method for identifying those tasks most strongly associated with task difficulty, severity of consequence, and error probability

  19. PRA (Probabilistic Risk Assessments) Participation versus Validation

    Science.gov (United States)

    DeMott, Diana; Banke, Richard

    2013-01-01

    Probabilistic Risk Assessments (PRAs) are performed for projects or programs where the consequences of failure are highly undesirable. PRAs primarily address the level of risk those projects or programs posed during operations. PRAs are often developed after the design has been completed. Design and operational details used to develop models include approved and accepted design information regarding equipment, components, systems and failure data. This methodology basically validates the risk parameters of the project or system design. For high risk or high dollar projects, using PRA methodologies during the design process provides new opportunities to influence the design early in the project life cycle to identify, eliminate or mitigate potential risks. Identifying risk drivers before the design has been set allows the design engineers to understand the inherent risk of their current design and consider potential risk mitigation changes. This can become an iterative process where the PRA model can be used to determine if the mitigation technique is effective in reducing risk. This can result in more efficient and cost effective design changes. PRA methodology can be used to assess the risk of design alternatives and can demonstrate how major design changes or program modifications impact the overall program or project risk. PRA has been used for the last two decades to validate risk predictions and acceptability. Providing risk information which can positively influence final system and equipment design the PRA tool can also participate in design development, providing a safe and cost effective product.

  20. Individual plant examination and future PRA applications

    International Nuclear Information System (INIS)

    Monty, B.S.; Sursock, J.P.; Thierry, R.J.

    1992-01-01

    PRA is being used in many areas of plant operation as has been demonstrated in previous studies. With the U.S. NRC's emphasis on the use of risk to identify plant vulnerabilities and the development of plant specific PRA models for all plants, it is expected that the use of PRA will be expanded. Key areas where this is expected to occur include the development of risk-based Technical Specifications, risk management, and risk-centered maintenance programs. This paper focuses on the Individual Plant Examination requirement and the possible uses of risk-based methods in controlling plant operation to enhance plant safety and availability, and how the IPE requirement will potentially further this area of development. (orig./DG)

  1. Level 2 PRA for a German BWR

    International Nuclear Information System (INIS)

    Sassen, F.; Rapp, W.; Tietsch, W.; Roess, P.

    2007-01-01

    A concept for a Level 2 Probabilistic Risk Assessment (L2 PRA) for a German Boiling Water Reactor (BWR) has been developed taking into account the role of L2 PRA within the German regulatory landscape. According to this concept, a plant specific evaluation of the severe accident phenomenology as well as analyses of the accident progression for the severe accident scenarios has been performed. Furthermore a plant specific MELCOR 1.8.6 model has been developed and special MELCOR source term calculations have been performed for the different release paths. This paper will present examples from the different areas described above. (author)

  2. Probabilistic risk assessment course documentation. Volume 1: PRA fundamentals

    International Nuclear Information System (INIS)

    Breeding, R.J.; Leahy, T.J.; Young, J.

    1985-08-01

    The full range of PRA topics is presented, with a special emphasis on systems analysis and PRA applications. Systems analysis topics include system modeling such as fault tree and event tree construction, failure rate data, and human Reliability. The discussion of PRA applications is centered on past and present PRA based programs, such as WASH-1400 and the Interim Reliability Evaluation Program, as well as on some of the potential future applications of PRA. The relationship of PRA to generic safety issues such as station blackout and Anticipated Transient Without Scram (ATWS) is also discussed. In addition to system modeling, the major PRA tasks of accident process analysis, and consequence analysis are presented. An explanation of the results of these activities, and the techniques by which these results are derived, forms the basis for a discussion of these topics. An additional topic which is presented in this course is the topic of PRA management, organization, and evaluation. 84 figs., 41 tabs

  3. The Angra 1 fire PRA project

    International Nuclear Information System (INIS)

    Silva, Luiz E. Massiere de C.; Kassawara, Robert

    2009-01-01

    The Angra 1 Fire PRA (Probabilistic Risk Assessment) is under development by ELETRONUCLEAR jointly with EPRI (Electric Power Research Institute). The project was started January of 2007 and it is foreseen to be finished in the middle of the next year. The study is being conducted according to the newest methodology developed by EPRI and NRC/RES (U.S. Nuclear Regulatory Commission - Office of Regulatory Research) published in 2005 as Fire PRA Methodology for Nuclear Power Facilities (NUREG/CR-6850 or EPRI TR-1011989) [1]. Starting from the Internal Events Angra 1 PRA model Level 1 the project aims to be a comprehensive plant-specific fire analysis to identify the possible consequences of a fire in the plant vital areas which threaten the integrity of systems relevant to the safety, challenging the safety functions and representing a risk of accident that can lead to a core damage. The main tasks include the plant boundary and partitioning, the fire PRA component selection and the identification of the possible fire scenarios (ignition, propagation, detection, extinction and hazards) considering human failure events to establish the fire-induced risk model for quantification of the risk for nuclear core damage taking into account the plant design and its fire protection resources. This work presents a general discussion on the methodology applied to the completed steps of the project. (author)

  4. PRA: a powerful engineering decision tool

    International Nuclear Information System (INIS)

    Carvalho, H.G. de.

    1988-03-01

    The probabilistic risk analysis (PRA) is studied and its historical development is briefly presented. Human factors, sofware and guides, improvement of utility management of nuclear power operations are discussed. The development of a standardized LWR design, optimized for safety, reliability and economy is studied. The impact of risk assessments in public acceptance of nuclear power is discussed. (M.A.C.) [pt

  5. Use of PRA in the nuclear regulatory field in South Africa

    International Nuclear Information System (INIS)

    Hill, T.F.

    1994-01-01

    The nuclear regulatory authority in South Africa (since 1988 the Council for Nuclear Safety (CNS)), established in 1973 nuclear safety criteria against which to assess the level of safety of any facility using radioactive material. It is a regulatory requirement in South Africa to develop and maintain a living PRA for each facility and thereby to provide the necessary information to demonstrate compliance against these criteria. All safety submissions to the CNS must include at least a risk statement based on an accepted PRA study. The function of the CNS is to regulate all activities in South Africa involving the use of radioactive material and posing a significant risk to the public or plant personnel. This includes most aspects of the nuclear fuel cycle and the Koeberg NPS (two 2775 MW(th) PWRs). A PRA study including source terms for the two Koeberg units was presented by the contractor in 1979. This included the risk due to power and shutdown states and non reactor related accidents involving spent fuel storage, fuel handling and waste treatment related activities. At least 20 PRA studies have been performed for other nuclear facilities in the country. The CNS maintains an in-house PRA capability to perform independent assessments of licensee submission, to participate in developments of PRA methodology in the regulatory field, to perform pro-active safety work and to assist in regulatory decision making. Present ongoing work includes the development of a risk monitor, a risk management system, improvement in PRA codes, models, data collection and analysis, off-site risk assessment methodology and associated regulatory policy. (author). 1 fig

  6. Probabilistic risk assessment course documentation. Volume 2. Probability and statistics for PRA applications

    International Nuclear Information System (INIS)

    Iman, R.L.; Prairie, R.R.; Cramond, W.R.

    1985-08-01

    This course is intended to provide the necessary probabilistic and statistical skills to perform a PRA. Fundamental background information is reviewed, but the principal purpose is to address specific techniques used in PRAs and to illustrate them with applications. Specific examples and problems are presented for most of the topics

  7. Estrogen and progesterone receptors have distinct roles in the establishment of the hyperplastic phenotype in PR-A transgenic mice

    Energy Technology Data Exchange (ETDEWEB)

    Simian, Marina; Bissell, Mina J.; Barcellos-Hoff, Mary Helen; Shyamala, Gopalan

    2009-05-11

    Expression of the A and B forms of progesterone receptor (PR) in an appropriate ratio is critical for mammary development. Mammary glands of PR-A transgenic mice, carrying an additional A form of PR as a transgene, exhibit morphological features associated with the development of mammary tumors. Our objective was to determine the roles of estrogen (E) and progesterone (P) in the genesis of mammary hyperplasias/preneoplasias in PR-A transgenics. We subjected PR-A mice to hormonal treatments and analyzed mammary glands for the presence of hyperplasias and used BrdU incorporation to measure proliferation. Quantitative image analysis was carried out to compare levels of latency-associated peptide and transforming growth factor beta 1 (TGF{beta}1) between PR-A and PR-B transgenics. Basement membrane disruption was examined by immunofluorescence and proteolytic activity by zymography. The hyperplastic phenotype of PR-A transgenics is inhibited by ovariectomy, and is reversed by treatment with E + P. Studies using the antiestrogen ICI 182,780 or antiprogestins RU486 or ZK 98,299 show that the increase in proliferation requires signaling through E/estrogen receptor alpha but is not sufficient to give rise to hyperplasias, whereas signaling through P/PR has little impact on proliferation but is essential for the manifestation of hyperplasias. Increased proliferation is correlated with decreased TGF{beta}1 activation in the PR-A transgenics. Analysis of basement membrane integrity showed loss of laminin-5, collagen III and collagen IV in mammary glands of PR-A mice, which is restored by ovariectomy. Examination of matrix metalloproteases (MMPs) showed that total levels of MMP-2 correlate with the steady-state levels of PR, and that areas of laminin-5 loss coincide with those of activation of MMP-2 in PR-A transgenics. Activation of MMP-2 is dependent on treatment with E and P in ovariectomized wild-type mice, but is achieved only by treatment with P in PR-A mice. These data

  8. Selecting the seismic HRA approach for Savannah River Plant PRA revision 1

    International Nuclear Information System (INIS)

    Papouchado, K.; Salaymeh, J.

    1993-10-01

    The Westinghouse Savannah River Company (WSRC) has prepared a level I probabilistic risk assessment (PRA), Rev. 0 of reactor operations for externally-initiated events including seismic events. The SRS PRA, Rev. 0 Seismic HRA received a critical review that expressed skepticism with the approach used for human reliability analysis because it had not been previously used and accepted in other published PRAs. This report provides a review of published probabilistic risk assessments (PRAs), the associated methodology guidance documents, and the psychological literature to identify parameters important to seismic human reliability analysis (HRA). It also describes a recommended approach for use in the Savannah River Site (SRS) PRA. The SRS seismic event PRA performs HRA to account for the contribution of human errors in the accident sequences. The HRA of human actions during and after a seismic event is an area subject to many uncertainties and involves significant analyst judgment. The approach recommended by this report is based on seismic HRA methods and associated issues and concerns identified from the review of these referenced documents that represent the current state-of-the- art knowledge and acceptance in the seismic HRA field

  9. PRA: A PERSPECTIVE ON STRENGTHS, CURRENT LIMITATIONS, AND POSSIBLE IMPROVEMENTS

    Directory of Open Access Journals (Sweden)

    ALI MOSLEH

    2014-02-01

    Full Text Available Probabilistic risk assessment (PRA has been used in various technological fields to assist regulatory agencies, managerial decision makers, and systems designers in assessing and mitigating the risks inherent in these complex arrangements. Has PRA delivered on its promise? How do we gage PRA performance? Are our expectations about value of PRA realistic? Are there disparities between what we get and what we think we are getting form PRA and its various derivatives? Do current PRAs reflect the knowledge gained from actual events? How do we address potential gaps? These are some of the questions that have been raised over the years since the inception of the field more than forty years ago. This paper offers a brief assessment of PRA as a technical discipline in theory and practice, its key strengths and weaknesses, and suggestions on ways to address real and perceived shortcomings.

  10. PRA: A Perspective on Strengths, Current Limitations, And Possible Improvements

    International Nuclear Information System (INIS)

    Mosleh, Ail

    2014-01-01

    Probabilistic risk assessment (PRA) has been used in various technological fields to assist regulatory agencies, managerial decision makers, and systems designers in assessing and mitigating the risks inherent in these complex arrangements. Has PRA delivered on its promise? How do we gage PRA performance? Are our expectations about value of PRA realistic? Are there disparities between what we get and what we think we are getting form PRA and its various derivatives? Do current PRAs reflect the knowledge gained from actual events? How do we address potential gaps? These are some of the questions that have been raised over the years since the inception of the field more than forty years ago. This paper offers a brief assessment of PRA as a technical discipline in theory and practice, its key strengths and weaknesses, and suggestions on ways to address real and perceived shortcomings

  11. PRISIM: a computer program that makes PRA useful

    International Nuclear Information System (INIS)

    Fussell, J.B.; Campbell, D.J.; Glynn, J.C.; Burdick, G.R.

    1986-01-01

    PRISIM is an IBM personal computer program that translates probabilistic risk assessment (PRA) information and calculates additional PRA type information for use by those who are not PRA experts. Specifically, PRISIM was developed for the US Nuclear Regulatory Commission for use by their resident inspectors at nuclear power plants. Inspector activities are either scheduled or are in response to a particular status of a plant. PRISIM is useful for either activity

  12. Seismic PRA of a BWR plant

    International Nuclear Information System (INIS)

    Nishio, Masahide; Fujimoto, Haruo

    2014-01-01

    Since the occurrence of nuclear power plant accidents in the Fukushima Daichi nuclear power station, the regulatory framework on severe accident (SA) has been discussed in Japan. The basic concept is to typify and identify the accident sequences leading to core/primary containment vessel (PCV) damage and to implement SA measures covering internal and external events extensively. As Japan is an earthquake-prone country and earthquakes and tsunami are important natural external events for nuclear safety of nuclear power plants, JNES performed the seismic probabilistic risk assessment (PRA) on a typical nuclear power plant and evaluated the dominant accident sequences leading to core/PCV damage to discuss dominant scenarios of severe accident (SA). The analytical models and the results of level-1 seismic PRA on a 1,100 MWe BWR-5 plant are shown here. Seismic PRA was performed for a typical BWR5 plant. Initiating events with large contribution to core damage frequency are the loss of all AC powers (station blackout) and the large LOCA. The top of dominant accident sequences is the simultaneous occurrence of station blackout and large LOCA. Important components to core damage frequency are electric power supply equipment. It needs to keep in mind that the results are influenced on site geologic characteristic to a greater or lesser. In the process of analysis, issues such as conservative assumptions related to damages of building or structure and success criteria for excessive LOCA are left to be resolved. These issues will be further studied including thermal hydric analysis in the future. (authors)

  13. Certification plan for safety and PRA codes

    International Nuclear Information System (INIS)

    Toffer, H.; Crowe, R.D.; Ades, M.J.

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA ampersand PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan's objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations

  14. Fire PRA requantification studies. Final report

    International Nuclear Information System (INIS)

    Parkinson, W.

    1993-03-01

    This report describes the requantification of two existing fire probabilistic risk assessments (PRAs) using a fire PRA method and data that are being developed by the Electric Power Research Institute (EPRI). The two existing studies are the Seabrook Station Probabilistic Safety Assessment that was made in 1983 and the 1989 NUREG-1150 analysis of the Peach Bottom Plant. Except for the fire methods and data, the original assumptions were used. The results from the requantification show that there were excessive conservatisms in the original studies. The principal reason for a hundredfold reduction in the Peach Bottom core- damage frequency is the determination that no electrical cabinet fire in a switchgear room would damage both offsite power feeds. Past studies often overestimated the heat release from electrical cabinet fires. EPRI's electrical cabinet heat release rates are based on tests that were conducted for Sandia's fire research program. The rates are supported by the experience in the EPRI Fire Events Database for U.S. nuclear plants. Test data and fire event experience also removed excessive conservatisms in the Peach Bottom control and cable spreading rooms, and the Seabrook primary component cooling pump, turbine building relay and cable spreading rooms. The EPRI fire PRA method and data will show that there are excessive conservatisms in studies that were made for many plants and can benefit them accordingly

  15. Systematic review of catatonia treatment

    Directory of Open Access Journals (Sweden)

    Pelzer ACM

    2018-01-01

    Full Text Available Anne CM Pelzer,1 Frank MMA van der Heijden,2 Erik den Boer3 1Department of Psychiatry, Reinier van Arkel, ‘s-Hertogenbosch, 2Department of Psychiatry, Vincent van Gogh Institute for Psychiatry, Venlo, 3Department of Psychiatry, GGzE, Eindhoven, the Netherlands Objective: To investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol. Materials and methods: A systematic review of published treatment articles (case series, cohort or randomized controlled studies which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO. Results: Thirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%–100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder. Conclusion: Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted. Keywords: review, catatonia, therapeutics, electroconvulsive therapy, benzodiazepines, lorazepam, ECT

  16. Preliminary ATWS analysis for the IRIS PRA

    International Nuclear Information System (INIS)

    Maddalena Barra; Marco S Ghisu; David J Finnicum; Luca Oriani

    2005-01-01

    Full text of publication follows: The pressurized light water cooled, medium power (1000 MWt) IRIS (International Reactor Innovative and Secure) has been under development for four years by an international consortium of over 21 organizations from ten countries. The plant conceptual design was completed in 2001 and the preliminary design is nearing completion. The pre-application licensing process with NRC started in October, 2002. IRIS has been primarily focused on establishing a design with innovative safety characteristics. The first line of defense in IRIS is to eliminate event initiators that could potentially lead to core damage. In IRIS, this concept is implemented through the 'safety by design' approach, which allows to minimize the number and complexity of the safety systems and required operator actions. The end result is a design with significantly reduced complexity and improved operability, and extensive plant simplifications to enhance construction. To support the optimization of the plant design and confirm the effectiveness of the safety by design approach in mitigating or eliminating events and thus providing a significant reduction in the probability of severe accidents, the PRA is being used as an integral part of the design process. A preliminary but extensive Level 1 PRA model has been developed to support the pre-application licensing of the IRIS design. As a result of the Preliminary IRIS PRA, an optimization of the design from a reliability point of view was completed, and an extremely low (about 1.2 E -8 ) core damage frequency (CDF) was assessed to confirm the impact of the safety by design approach. This first assessment is a result of a PRA model including internal initiating events. During this assessment, several assumptions were necessary to complete the CDF evaluation. In particular Anticipated Transients Without Scram (ATWS) were not included in this initial assessment, because their contribution to core damage frequency was assumed

  17. Development of insights from PRAs for non-PRA people

    International Nuclear Information System (INIS)

    Reilly, H.J.; Meale, B.M.

    1992-01-01

    A probabilistic risk assessment (PRA) of the Savannah River K-Reactor was completed in 1990. The PRA estimated the frequency of core damage accidents caused by operational occurrences during power operation of the reactor. The US Department of Energy (DOE) requested Idaho National Engineering Laboratory (INEL) to prepare guidance based on the PRA for use by DOE personnel at the Savannah River Site (SRS). The document had the purpose of informing the DOE system engineers and site representatives about how the information in the PRA might be used to help guide their activities. Opportunities existed to develop a document somewhat different than those developed previously by other programs. The opportunities existed because the audience is different: the principal audience for the document consists of DOE engineers who have continuing oversight responsibility for activities performed by the operating contractor at the K-Reactor, but who may not be knowledgeable about PRA

  18. The tsunami probabilistic risk assessment (PRA). Example of accident sequence analysis of tsunami PRA according to the standard for procedure of tsunami PRA for nuclear power plants

    International Nuclear Information System (INIS)

    Ohara, Norihiro; Hasegawa, Keiko; Kuroiwa, Katsuya

    2013-01-01

    After the Fukushima Daiichi nuclear power plant (NPP) accident, standard for procedure of tsunami PRA for NPP had been established by the Standardization Committee of AESJ. Industry group had been conducting analysis of Tsunami PRA for PWR based on the standard under the cooperation with electric utilities. This article introduced overview of the standard and examples of accident sequence analysis of Tsunami PRA studied by the industry group according to the standard. The standard consisted of (1) investigation of NPP's composition, characteristics and site information, (2) selection of relevant components for Tsunami PRA and initiating events and identification of accident sequence, (3) evaluation of Tsunami hazards, (4) fragility evaluation of building and components and (5) evaluation of accident sequence. Based on the evaluation, countermeasures for further improvement of safety against Tsunami could be identified by the sensitivity analysis. (T. Tanaka)

  19. Seabrook Station Level 2 PRA Update to Include Accident Management

    International Nuclear Information System (INIS)

    Lutz, Robert; Lucci, Melissa; Kiper, Kenneth; Henry, Robert

    2006-01-01

    A ground-breaking study was recently completed as part of the Seabrook Level 2 PRA update. This study updates the post-core damage phenomena to be consistent with the most recent information and includes accident management activities that should be modeled in the Level 2 PRA. Overall, the result is a Level 2 PRA that fully meets the requirements of the ASME PRA Standard with respect to modeling accident management in the LERF assessment and NRC requirements in Regulatory Guide 1.174 for considering late containment failures. This technical paper deals only with the incorporation of operator actions into the Level 2 PRA based on a comprehensive study of the Seabrook Station accident response procedures and guidance. The paper describes the process used to identify the key operator actions that can influence the Level 2 PRA results and the development of success criteria for these key operator actions. This addresses a key requirement of the ASME PRA Standard for considering SAMG. An important benefit of this assessment was the identification of Seabrook specific accident management insights that can be fed back into the Seabrook Station accident management procedures and guidance or the training provided to plant personnel for these procedures and guidance. (authors)

  20. Overview of seismic margin insights gained from seismic PRA results

    International Nuclear Information System (INIS)

    Kennedy, R.P.; Sues, R.H.; Campbell, R.D.

    1986-01-01

    This paper presents the findings of a study conducted under NRC and EPRI sponsorship in which published seismic PRAs were reviewed in order to gain insight to the seismic margins inherent in existing nuclear plants. The approach taken was to examine the fragilities of those components which have been found to be dominant contributors to seismic risk at plants in low-to-moderate seismic regions (SSE levels between 0.12g and 0.25g). It is concluded that there is significant margin inherent in the capacity of most critical components above the plant design basis. For ground motions less than about 0.3g, the predominant sources of seismic risk are loss of offsite power coupled with random failure of the emergency diesels, non-recoverable circuit breaker trip due to relay chatter, unanchored equipment, unreinforced non-load bearing block walls, vertical water storage tanks, systems interactions and possibly soil liquefaction. Recommendations as to which components should be reviewed in seismic margin studies for margin earthquakes less than 0.3g, between 0.3g and 0.5g, and greater than 0.5g, developed by the NRC expert panel on the quantification of seismic margins (based on the review of past PRA data, earthquake experience data, and their own personal experience) are presented

  1. How the chemical industry can benefit from PRA

    International Nuclear Information System (INIS)

    Guymer, P.; Kaiser, G.D.; Mc Kelvey, T.W.; Hannaman, G.W.

    1986-01-01

    Probabilistic Risk Assessment (PRA) is a method of quantifying the frequency of occurrence and the magnitude of the consequences of accidents in systems that contain hazardous materials such as radioactive fission products, and toxic, flammable or explosive chemicals. The frequency and the magnitude of the consequences are the basic elements of any definition or risk, which is often simply expressed as the product of frequency and magnitude, summed over all accident sequences. PRA is now a mature technique that has been used to estimate risk for a number of industrial facilities. In this paper the author gives examples of beneficial uses of PRA

  2. PRA-Code Upgrade to Handle a Generic Problem

    International Nuclear Information System (INIS)

    Wilson, J. R.

    1999-01-01

    During the probabilistic risk assessment (PRA) for the proposed Yucca Mountain nuclear waste repository, a problem came up that could not be handled by most PRA computer codes. This problem deals with dependencies between sequential events in time. Two similar scenarios that illustrate this problem are LOOP nonrecovery and sequential wearout failures with units of time. The purpose of this paper is twofold: To explain the problem generically, and to show how the PRA code at the INEEL, SAPHIRE, has been modified to solve this problem correctly

  3. Application of the NUREG/CR-6850 EPRI/NRC Fire PRA Methodology to a DOE Facility

    International Nuclear Information System (INIS)

    Elicson, Tom; Harwood, Bentley; Yorg, Richard; Lucek, Heather; Bouchard, Jim; Jukkola, Ray; Phan, Duan

    2011-01-01

    The application NUREG/CR-6850 EPRI/NRC fire PRA methodology to DOE facility presented several challenges. This paper documents the process and discusses several insights gained during development of the fire PRA. A brief review of the tasks performed is provided with particular focus on the following: Tasks 5 and 14: Fire-induced risk model and fire risk quantification. A key lesson learned was to begin model development and quantification as early as possible in the project using screening values and simplified modeling if necessary. Tasks 3 and 9: Fire PRA cable selection and detailed circuit failure analysis. In retrospect, it would have been beneficial to perform the model development and quantification in 2 phases with detailed circuit analysis applied during phase 2. This would have allowed for development of a robust model and quantification earlier in the project and would have provided insights into where to focus the detailed circuit analysis efforts. Tasks 8 and 11: Scoping fire modeling and detailed fire modeling. More focus should be placed on detailed fire modeling and less focus on scoping fire modeling. This was the approach taken for the fire PRA. Task 14: Fire risk quantification. Typically, multiple safe shutdown (SSD) components fail during a given fire scenario. Therefore dependent failure analysis is critical to obtaining a meaningful fire risk quantification. Dependent failure analysis for the fire PRA presented several challenges which will be discussed in the full paper.

  4. Glaucoma treatment trends: a review.

    Science.gov (United States)

    Conlon, Ronan; Saheb, Hady; Ahmed, Iqbal Ike K

    2017-02-01

    Glaucoma is one of the most common causes of blindness worldwide, and its prevalence is increasing. The aim of the present review is to describe the current medical and surgical treatment trends in the management of open-angle glaucoma. There has been an increase in the availability of glaucoma medications and the use of laser trabeculoplasty over the past decade, with a subsequent decrease in invasive incisional surgery. In addition, a new class of glaucoma procedures, termed microinvasive glaucoma surgery, has emerged, which aims to fill the gap between conservative medical management and more invasive surgery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  5. TREATMENT OF PERIPARTUM CARDIOMYOPATHY (REVIEW

    Directory of Open Access Journals (Sweden)

    N. T. Vatutin

    2017-01-01

    Full Text Available The presented review concerns discussion about current insights into treatment of peripartum cardiomyopathy. The definition of peripartum cardiomyopathy and general issues about diagnosis and pathogenesis of the disorder are provided at the head of the review. Particularly, the role of the system «prolactin — cathepsin D — prolactin 16 kDa» in cardiomyopathy development is disclosed. The general approaches to management of the patients are highlighted. The review provides detailed data about indications, adverse effects and derived clinical experience concerning the main pharmacological drugs which had been used in peripartum cardiomyopathy treatment given their possible unfavorable influence on fetus maturation and maternal lactation. The detailed description is provided on diuretics including loop, thiazide and potassium-sparing drugs. It was noted relative safety and efficiency of nitrates and hydralazine in conditions of limited choice from vasodilator group and, particularly, angiotensinconverting-enzyme inhibitors and angiotensin-II receptor blockers which are contraindicated in pregnancy. A special attention is paid to the group of inotropic drugs: levosimendan, milrinone, and cardiac glycosides. The role of β-blockers and ivabradine is disclosed in heart failure treatment of peripartum cardiomyopathy. Anticoagulants were presented in details given that these drugs are justified in severe cardiac chambers dilation, decrease in ejection fraction, and in presence of intracardiac thrombosis. The place of antiarrhythmic drugs administrating in various cardiac rhythm disorders is discussed in the review. The data is given with account of potential influence on fetus in antenatal peripartum cardiomyopathy in which lidocaine and sotalol are the most preferable drugs; adenosine, quinidine, and flecainide are useful with caution, but amiodarone and dronedarone are absolutely contraindicated. Taking into account proposed pathogenic

  6. The radioprotective effect of a new aminothiol (20-PRA)

    International Nuclear Information System (INIS)

    Dolabela, M.F.; Lopes, M.T.P.; Pereira, M.T.; Steffani, G.M.; Pilo-Veloso, D.; Salas, C.E.; Nelson, D.L.

    1998-01-01

    We examined the radioprotective effect of aminothiol 2-N-propylamine-cyclohexane thiol (20-PRA) on a human leukemic cell line (K562) following various radiation doses (5,7.5 and 20 Gy) using a source of 60 Co γ-rays. At 5 Gy and 1nM 20-PRA, a substantial protective effect (58%) was seen 24 h after irradiation, followed by a decrease at 48 h (11%). At the high radiation dose (20 Gy) a low protective effect was also seen (35%). In addition, the anti tumorigenic potential of 10 nM 20-PRA was shown by the inhibition of crown gall formation induced by Agrobacterium tumefaciens. The radioprotective potency of 20-PRA is 10 5- 10 6 times higher than that of the aminothiol WR-1065 (N(2-mercaptoethyl)-1,3-diamino propane) whose protective effect is in the 0.1 to 1.0 nM range. (author)

  7. The radioprotective effect of a new aminothiol (20-PRA

    Directory of Open Access Journals (Sweden)

    M.F. Dolabela

    1998-08-01

    Full Text Available We examined the radioprotective effect of aminothiol 2-N-propylamine-cyclo-hexanethiol (20-PRA on a human leukemic cell line (K562 following various radiation doses (5, 7.5 and 20 Gy using a source of 60Co g-rays. At 5 Gy and 1 nM 20-PRA, a substantial protective effect (58% was seen 24 h after irradiation, followed by a decrease at 48 h (11%. At the high radiation dose (20 Gy a low protective effect was also seen (35%. In addition, the antitumorigenic potential of 10 nM 20-PRA was shown by the inhibition of crown gall formation induced by Agrobacterium tumefaciens. The radioprotective potency of 20-PRA is 105-106 times higher than that of the aminothiol WR-1065 (N-(2-mercaptoethyl-1,3-diaminopropane whose protective effect is in the 0.1 to 1.0 mM range.

  8. Chinshan living PRA model using NUPRA software package

    International Nuclear Information System (INIS)

    Cheng, S.-K.; Lin, T.-J.

    2004-01-01

    A living probabilistic risk assessment (PRA) model has been established for Chinshan Nuclear Power Station (BWR-4, MARK-I) using NUPRA software package. The core damage frequency due to internal events, seismic events and typhoons are evaluated in this model. The methodology and results considering the recent implementation of the 5th emergency diesel generator and automatic boron injection function are presented. The dominant sequences of this PRA model are discussed, and some possible applications of this living model are proposed. (author)

  9. 'Living PRA' concept for plant risk: Reliability and availability tracking

    International Nuclear Information System (INIS)

    Sancaktar, S.; Sharp, D.R.

    1985-01-01

    The 'Living PRA' (Probabilistic Risk Assessment) is based on placing a PRA plant model on an interactive computer. This model consists of fault tree analyses for plant systems, event tree analyses for abnormal events and site specific consequence analysis for public and/or financial risks, for a nuclear power plant. A living PRA allows updates and sensitivity analyses by the plant owner throughout the lifetime of a plant. Recently, event and fault trees from two major PRAs were placed in a computerized format. The BYRON PRA study and the Living PRA and Economic Risk examples for Indian Point Unit-3 enabled analysts to gain experience and insight into the problems of plant operation. The above concept is well established for the Nuclear Power Plant evaluation. It has been also used for evaluation of processing facilities. In these studies, systems modeling was carried out by using the GRAFTER system for automated fault tree construction. Presently both the tools and the experience exists to set up useful and viable living PRA models for nuclear and chemical processing plants to enhance risk management by the plant owners through in-house use of micro computer based models

  10. Expected proton signal sizes in the PRaVDA Range Telescope for proton Computed Tomography

    International Nuclear Information System (INIS)

    Price, T.; Parker, D.J.; Green, S.; Esposito, M.; Waltham, C.; Allinson, N.M.; Poludniowski, G.; Evans, P.; Taylor, J.; Manolopoulos, S.; Anaxagoras, T.; Nieto-Camero, J.

    2015-01-01

    Proton radiotherapy has demonstrated benefits in the treatment of certain cancers. Accurate measurements of the proton stopping powers in body tissues are required in order to fully optimise the delivery of such treaments. The PRaVDA Consortium is developing a novel, fully solid state device to measure these stopping powers. The PRaVDA Range Telescope (RT), uses a stack of 24 CMOS Active Pixel Sensors (APS) to measure the residual proton energy after the patient. We present here the ability of the CMOS sensors to detect changes in the signal sizes as the proton traverses the RT, compare the results with theory, and discuss the implications of these results on the reconstruction of proton tracks

  11. Uncertainty and sensitivity studies supporting the interpretation of the results of TVO I/II PRA

    International Nuclear Information System (INIS)

    Holmberg, J.

    1992-01-01

    A comprehensive Level 1 probabilistic risk assessment (PRA) has been performed for the TVO I/II nuclear power units. As a part of the PRA project, uncertainties of risk models and methods were systematically studied in order to describe them and to demonstrate their impact by way of results. The uncertainty study was divided into two phases: a qualitative and a quantitative study. The qualitative study contained identification of uncertainties and qualitative assessments of their importance. The PRA was introduced, and identified assumptions and uncertainties behind the models were documented. The most significant uncertainties were selected by importance measures or other judgements for further quantitative studies. The quantitative study included sensitivity studies and propagation of uncertainty ranges. In the sensitivity studies uncertain assumptions or parameters were varied in order to illustrate the sensitivity of the models. The propagation of the uncertainty ranges demonstrated the impact of the statistical uncertainties of the parameter values. The Monte Carlo method was used as a propagation method. The most significant uncertainties were those involved in modelling human interactions, dependences and common cause failures (CCFs), loss of coolant accident (LOCA) frequencies and pressure suppression. The qualitative mapping out of the uncertainty factors turned out to be useful in planning quantitative studies. It also served as internal review of the assumptions made in the PRA. The sensitivity studies were perhaps the most advantageous part of the quantitative study because they allowed individual analyses of the significance of uncertainty sources identified. The uncertainty study was found reasonable in systematically and critically assessing uncertainties in a risk analysis. The usefulness of this study depends on the decision maker (power company) since uncertainty studies are primarily carried out to support decision making when uncertainties are

  12. Treatment Approaches in Down's Syndrome: A Review.

    Science.gov (United States)

    Foreman, Philip J.; Ward, James

    1986-01-01

    The paper reviews research into treatment approaches in Down's Syndrome. Pharmacological treatments reviewed include thyroid therapy, 5-hydroxytryptophan, vitamin therapy, and cell therapy. Other treatments considered are movement patterning, early intervention, and facial surgery. Early educational intervention is seen as the most effective…

  13. Interaction of CREDO [Centralized Reliability Data Organization] with the EBR-II [Experimental Breeder Reactor II] PRA [probabilistic risk assessment] development

    International Nuclear Information System (INIS)

    Smith, M.S.; Ragland, W.A.

    1989-01-01

    The National Academy of Sciences review of US Department of Energy (DOE) class 1 reactors recommended that the Experimental Breeder Reactor II (EBR-II), operated by Argonne National Laboratory (ANL), develop a level 1 probabilistic risk assessment (PRA) and make provisions for level 2 and level 3 PRAs based on the results of the level 1 PRA. The PRA analysis group at ANL will utilize the Centralized Reliability Data Organization (CREDO) at Oak Ridge National Laboratory to support the PRA data needs. CREDO contains many years of empirical liquid-metal reactor component data from EBR-II. CREDO is a mutual data- and cost-sharing system sponsored by DOE and the Power Reactor and Nuclear Fuels Development Corporation of Japan. CREDO is a component based data system; data are collected on components that are liquid-metal specific, associated with a liquid-metal environment, contained in systems that interface with liquid-metal environments, or are safety related for use in reliability/availability/maintainability (RAM) analyses of advanced reactors. The links between the EBR-II PRA development effort and the CREDO data collection at EBR-II extend beyond the sharing of data. The PRA provides a measure of the relative contribution to risk of the various components. This information can be used to prioritize future CREDO data collection activities at EBR-II and other sites

  14. Probabilistic Risk Assessment (PRA): A Practical and Cost Effective Approach

    Science.gov (United States)

    Lee, Lydia L.; Ingegneri, Antonino J.; Djam, Melody

    2006-01-01

    The Lunar Reconnaissance Orbiter (LRO) is the first mission of the Robotic Lunar Exploration Program (RLEP), a space exploration venture to the Moon, Mars and beyond. The LRO mission includes spacecraft developed by NASA Goddard Space Flight Center (GSFC) and seven instruments built by GSFC, Russia, and contractors across the nation. LRO is defined as a measurement mission, not a science mission. It emphasizes the overall objectives of obtaining data to facilitate returning mankind safely to the Moon in preparation for an eventual manned mission to Mars. As the first mission in response to the President's commitment of the journey of exploring the solar system and beyond: returning to the Moon in the next decade, then venturing further into the solar system, ultimately sending humans to Mars and beyond, LRO has high-visibility to the public but limited resources and a tight schedule. This paper demonstrates how NASA's Lunar Reconnaissance Orbiter Mission project office incorporated reliability analyses in assessing risks and performing design tradeoffs to ensure mission success. Risk assessment is performed using NASA Procedural Requirements (NPR) 8705.5 - Probabilistic Risk Assessment (PRA) Procedures for NASA Programs and Projects to formulate probabilistic risk assessment (PRA). As required, a limited scope PRA is being performed for the LRO project. The PRA is used to optimize the mission design within mandated budget, manpower, and schedule constraints. The technique that LRO project office uses to perform PRA relies on the application of a component failure database to quantify the potential mission success risks. To ensure mission success in an efficient manner, low cost and tight schedule, the traditional reliability analyses, such as reliability predictions, Failure Modes and Effects Analysis (FMEA), and Fault Tree Analysis (FTA), are used to perform PRA for the large system of LRO with more than 14,000 piece parts and over 120 purchased or contractor

  15. Comparison of SKIFS 2004:1 and Tillsynshandbok PSA against the ASME PRA Standard and European requirements on PSA

    International Nuclear Information System (INIS)

    Hellstroem, Per

    2005-04-01

    Requirements on PSA for risk informed applications are expressed in different international documents. The ASME PRA standard published in spring 2002 is one such document, PSA requirements are also expressed in the European Utility Requirements (EUR) for new reactors. The Swedish PSA requirements are provided in the Swedish regulators (SKI) statutes SKIFS 2004:1. SKI also has a review handbook for PSA activities (SKI report 2003:48). The review handbook is a support during review of the utilities PSA activities and the PSAs themselves. The review handbook expresses SKIs expectations by providing so called important aspects for both the PSA work and the PSAs, A comparison of SKIFS requirements and the important aspects in the Review handbook, on one side, and the requirements on PSA in EUR and ASME on the other side, is presented. The comparison shows a large difference in the level of detail in the different documents, where ASME is most detailed and specific. This is expected since the SKI review handbook not is a 'PSA guide' in the same way as the ASME PRA standard. A direct comparison of the ASME PRA standard requirements with the important aspects in the review handbook cannot answer the question which ASME capacity level that is achieved by a PSA meeting all important aspects. The conclusion is that it is not likely to achieve capacity level 2 and 3, since very few ASME level 3 attributes are explicitly expressed as important aspects, though many are expressed in general terms. The review handbook important aspects that are most similar to the ASME capacity level 1 attributes are initiating events, sequence analysis, and system analysis while less similarity is found for analysis of operator actions data analysis, quantification and containment analysis (level 2). Less similarity is found for capacity level 2 and 3. However, the number of additional ASME attributes on capacity level 2 and 3 are few. There are also important aspects in the review handbook that

  16. 77 FR 10576 - Methodology for Low Power/Shutdown Fire PRA

    Science.gov (United States)

    2012-02-22

    ... NUCLEAR REGULATORY COMMISSION [NRC-2011-0295] Methodology for Low Power/Shutdown Fire PRA AGENCY.../Shutdown Fire PRA.'' In response to request from members of the public, the NRC is extending the public... risk assessment (PRA) method for quantitatively analyzing fire risk in commercial nuclear power plants...

  17. 76 FR 81998 - Methodology for Low Power/Shutdown Fire PRA

    Science.gov (United States)

    2011-12-29

    ... NUCLEAR REGULATORY COMMISSION [NRC-2011-0295] Methodology for Low Power/Shutdown Fire PRA AGENCY..., ``Methodology for Low Power/Shutdown Fire PRA--Draft Report for Comment.'' DATES: Submit comments by March 01... risk assessment (PRA) method for quantitatively analyzing fire risk in commercial nuclear power plants...

  18. Load out and offshore lifting of the PRA-1 platform modules; Embarque e icamento offshore dos modulos de PRA-1

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Fernando; Raigorodsky, Jacques; Mitidieri, Jorge L.U.; Ricardi, Paulo S. [Construtora Norberto Odebrecht S.A., Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The technology innovations are characteristics of offshore Engineering around the world. These technologies just make sense when they aim the productivity, security and costs gains compared to ordinary methods. It is in this context that the proposal of the Consorcio PRA-1 (Odebrecht e UTC) team makes sense, in the definition of basic methodology for the PRA-1 platform construction and installation. Through the innovative concept, It was defined (still in the proposal phase) the basic premise that the modules construction and assembly were onshore ending up that just few hours after the offshore installation the modules should be operational in minimal habitability conditions. This innovative method allowed the lack of Flotel, that is a platform which provide support to the offshore construction and assembly (Flotel represents a high costs to the project) and, as consequence, the contract signature by CONSORCIO PRA-1. This work aims to describe the method used for the LOUD-OUT of the PRA-1 modules and the installation of them on the jacket through a vessel provide with cranes the has performed the lifting. Theses operations became unique in Brazil due its challengers characteristics: Module 12 weight = 7203 tf and Module 35 = 5725 tf. For the accomplishment of the Load-out and offshore lifting, was performed a detailed planning and a high level of subcontract interface management. The operations mentioned above were filmed/photographed and published in the specialized media. (author)

  19. Grey water treatment systems: A review

    NARCIS (Netherlands)

    Abu-Ghunmi, L.N.A.H.; Zeeman, G.; Fayyad, M.; Lier, van J.B.

    2011-01-01

    This review aims to discern a treatment for grey water by examining grey water characteristics, reuse standards, technology performance and costs. The review reveals that the systems for treating grey water, whatever its quality, should consist of processes that are able to trap pollutants with a

  20. EPRI/NRC-RES fire PRA guide for nuclear power facilities. Volume 1, summary and overview

    International Nuclear Information System (INIS)

    2004-01-01

    This report documents state-of-the-art methods, tools, and data for the conduct of a fire Probabilistic Risk Assessment (PRA) for a commercial nuclear power plant (NPP) application. The methods have been developed under the Fire Risk Re-quantification Study. This study was conducted as a joint activity between EPRI and the U. S. NRC Office of Nuclear Regulatory Research (RES) under the terms of an EPRI/RES Memorandum of Understanding (RS.1) and an accompanying Fire Research Addendum (RS.2). Industry participants supported demonstration analyses and provided peer review of this methodology. The documented methods are intended to support future applications of Fire PRA, including risk-informed regulatory applications. The documented method reflects state-of-the-art fire risk analysis approaches. The primary objective of the Fire Risk Study was to consolidate recent research and development activities into a single state-of-the-art fire PRA analysis methodology. Methodological issues raised in past fire risk analyses, including the Individual Plant Examination of External Events (IPEEE) fire analyses, have been addressed to the extent allowed by the current state-of-the-art and the overall project scope. Methodological debates were resolved through a consensus process between experts representing both EPRI and RES. The consensus process included a provision whereby each major party (EPRI and RES) could maintain differing technical positions if consensus could not be reached. No cases were encountered where this provision was invoked. While the primary objective of the project was to consolidate existing state-of-the-art methods, in many areas, the newly documented methods represent a significant advancement over previously documented methods. In several areas, this project has, in fact, developed new methods and approaches. Such advances typically relate to areas of past methodological debate.

  1. Compulsory Treatment in Anorexia Nervosa : A Review

    NARCIS (Netherlands)

    Elzakkers, Isis F. F. M.; Danner, Unna N.; Hoek, Hans W.; Schmidt, Ulrike; van Elburg, Annemarie A.

    2014-01-01

    ObjectiveCompulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN.

  2. Treatment of Childhood Obesity: A Systematic Review

    Science.gov (United States)

    Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

    2012-01-01

    Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

  3. Nail Psoriasis: A Review of Treatment Options.

    Science.gov (United States)

    Pasch, Marcel C

    2016-04-01

    Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

  4. PRA: an evaluation of state-of-the-art

    International Nuclear Information System (INIS)

    Joksimovich, V.

    1985-01-01

    Some elements of the probabilistic risk assessment (PRA) methodology can be characterized as mature and are even ready for some kind of a standardization effort. Other elements are still, however, in a rapid state of evolution. Questions are continuously being asked regarding maturity of PRA techniques vis-a-vis a regulatory decision-making process. Establishing a framework for evaluating state-of-the-art in any technological field is a challenging task. An implementation of a selected framework to a satisfactory conclusion is a monumental task. Of course, these types of issues can be discussed meaningfully only if they are tied to a particular application. The author's participation in the NSF-sponsored risk assessment project is discussed in the paper. The evaluation employed here makes use of the following five evaluation criteria: logical soundness, completeness, accuracy, acceptability, and practicality

  5. Organizational extension of PRA models and NASA application

    International Nuclear Information System (INIS)

    Pate-Cornell, E.

    1989-01-01

    This paper describes a probabilistic method which extends classical PRA to include some characteristics of the organization that processes or manages an engineering system. Ataxonomy of errors is presented and their organizational roots are examined. An assembly model is proposed for the analysis of the resulting spectrum of capacities of the system. The management of the Thermal Protection system of the Space Shuttle is used as an illustration. The model allows assessment of the benefits of organizational improvements of the orbiter's processing

  6. Overview of NRC PRA research program

    International Nuclear Information System (INIS)

    Cunningham, M.A.; Drouin, M.T.; Ramey-Smith, A.M.; VanderMolen, M.T.

    1997-01-01

    The NRC's research program in probabilistic risk analysis includes a set of closely-related elements, from basic research to regulatory applications. The elements of this program are as follows: (1) Development and demonstration of methods and advanced models and tools for use by the NRC staff and others performing risk assessments; (2) Support to agency staff on risk analysis and statistics issues; (3) Reviews of risk assessments submitted by licensees in support of regulatory applications, including the IPEs and IPEEEs. Each of these elements is discussed in the paper, providing highlights of work within an element, and, where appropriate, describing important support and feedback mechanisms among elements

  7. Applications of PRA in nuclear criticality safety

    International Nuclear Information System (INIS)

    McLaughlin, T.P.

    1992-01-01

    Traditionally, criticality accident prevention at Los Alamos National Laboratory (LANL) has been based on a thorough review and understanding of proposed operations or changes to operations involving both process supervision and criticality safety staff. The outcome of this communication was usually an agreement, based on professional judgment, that certain accident sequences were credible and had to be precluded by design; others were incredible and thus did not warrant expenditures to further reduce their likelihood. The extent of documentation was generally in proportion to the complexity of the operation but never as detailed as that associated with quantified risk assessments. During the last 3 yr, nuclear criticality safety-related probabilistic risk assessments (PRAs) have been performed on operations in two LANL facilities. Both of these were conducted in order to better understand the cost/benefit aspects of PRAs as they apply to largely hands-on operations with fissile material

  8. Liquid Radioactive Wastes Treatment: A Review

    Directory of Open Access Journals (Sweden)

    Yung-Tse Hung

    2011-05-01

    Full Text Available Radioactive wastes are generated during nuclear fuel cycle operation, production and application of radioisotope in medicine, industry, research, and agriculture, and as a byproduct of natural resource exploitation, which includes mining and processing of ores, combustion of fossil fuels, or production of natural gas and oil. To ensure the protection of human health and the environment from the hazard of these wastes, a planned integrated radioactive waste management practice should be applied. This work is directed to review recent published researches that are concerned with testing and application of different treatment options as a part of the integrated radioactive waste management practice. The main aim from this work is to highlight the scientific community interest in important problems that affect different treatment processes. This review is divided into the following sections: advances in conventional treatment of aqueous radioactive wastes, advances in conventional treatment of organic liquid wastes, and emerged technological options.

  9. Role of seismic PRA in seismic safety decisions of nuclear power plants

    International Nuclear Information System (INIS)

    Ravindra, M.K.; Kennedy, R.P.; Sues, R.H.

    1985-01-01

    This paper highlights the important roles that seismic probabilistic risk assessments (PRAs) can play in the seismic safety decisions of nuclear power plants. If a seismic PRA has been performed for a plant, its results can be utilized to evaluate the seismic capability beyond the safe shutdown event (SSE). Seismic fragilities of key structures and equipment, fragilities of dominant plant damage states and the frequencies of occurrence of these plant damage states are reviewed to establish the seismic safety of the plant beyond the SSE level. Guidelines for seismic margin reviews and upgrading may be developed by first identifying the generic classes of structures and equipment that have been shown to be dominant risk contributors in the completed seismic PRAs, studying the underlying causes for their contribution and examining why certain other items (e.g., piping) have not proved to be high-risk-contributors

  10. Conservative treatment of sciatica : A systematic review

    NARCIS (Netherlands)

    Vroomen, PCAJ; de Krom, MCTFM; Slofstra, PD; Knottnerus, JA

    2000-01-01

    Most patients with sciatica (often caused by disc herniations) are managed conservatively at first. The natural course seems to be favorable. The additional value of many conservative therapies remains controversial. Because a systematic review of the conservative treatment of sciatica is lacking,

  11. Musical hallucinations : Review of treatment effects

    NARCIS (Netherlands)

    Coebergh, Jan A. F.; Lauw, R. F.; Bots, R.; Sommer, I. E. C.; Blom, J. D.

    2015-01-01

    Background: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. Objective: To review the

  12. Musical hallucinations : review of treatment effects

    NARCIS (Netherlands)

    Coebergh, Jan A F; Lauw, R F; Bots, R; Sommer, I E C; Blom, J D

    2015-01-01

    BACKGROUND: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE: To review the

  13. Surgically facilitated orthodontic treatment : A systematic review

    NARCIS (Netherlands)

    Hoogeveen, Eelke J.; Jansma, Johan; Ren, Yijin

    INTRODUCTION: Corticotomy and dental distraction have been proposed as effective and safe methods to shorten orthodontic treatment duration in adolescent and adult patients. A systematic review was performed to evaluate the evidence supporting these claims. METHODS: PubMed, Embase, and Cochrane

  14. Electron beam flue gas treatment process. Review

    International Nuclear Information System (INIS)

    Honkonen, V.A.

    1996-01-01

    The basis of the process for electron beam flue gas treatment are presented in the report. In tabular form the history of the research is reviewed. Main dependences of SO 2 and NO x removal efficiencies on different physico-chemical parameters are discussed. Trends concerning industrial process implementation are presented in the paper,finally. (author). 74 refs, 11 figs, 1 tab

  15. Treatment of Cutaneous Pseudolymphoma: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Diana Miguel

    2017-12-01

    Full Text Available Cutaneous pseudolymphoma (CPL is a reactive polyclonal T- or B-cell lymphoproliferative process. CPL may appear as localized or disseminated skin lesions. While most cases of CPL are idiopathic, they may also occur as a response to, for example, contact dermatitis, arthropod reactions, and bacterial infections. CPL can be classified based on its clinical features, but all variants have similar histopathological patterns of either predominantly B-cell infiltrates, T-cell infiltrates, or mixed T/B-cell infiltrates. The prognosis of CPL is good, but the underlying disease process should be taken into account. If an antigenic stimulus is identified, it should be removed. In patients with idiopathic CPL, a close follow-up control strategy should be adopted. The aim of this systematic review is to summarize all reported treatments for CPL. The review was based on articles from the PubMed database, using the query “skin pseudolymphoma treatment”, English and German, about “human” subjects, and published between 1990 and 2015 documenting adequate treatment and/or aetiology. Mainly individual case reports and small case series were found. Treatment options include topical and intralesional agents, systemic agents, and physical modalities. The final part of the review proposes a treatment algorithm for CPL according to each aetiology, based on the literature of the last 25 years. Future research should focus on randomized controlled trials and studies on long-term outcomes, which were not identified in the current review.

  16. Diagnosis and treatment of phagophobia: a review.

    Science.gov (United States)

    Baijens, Laura W J; Koetsenruijter, Krista; Pilz, Walmari

    2013-06-01

    This narrative review summarizes published studies on diagnostic examinations and therapeutic interventions for phagophobia. The electronic databases Embase, PubMed, PsycINFO(®), and The Cochrane Library were used. The literature search was limited to publications in the English, German, French, Spanish, or Dutch language. The original articles are summarized in the present narrative review. The body of literature on phagophobia and swallowing fear remains very limited; only 12 studies were found. The present narrative review discovered heterogeneity in the definitions of phagophobia or similar syndromes. A systematic review, including a qualitative analysis, was planned but not carried out as studies were not of sufficient quality to warrant doing so. All the studies had severe methodological shortcomings. In general, the conclusions could not be compared across the studies because of the different study designs, small populations, different ways of evaluating and treating phagophobia, and complex combinations of treatments. A general conclusion is provided.

  17. An evaluation of the reliability and usefulness of external-initiator PRA [probabilistic risk analysis] methodologies

    International Nuclear Information System (INIS)

    Budnitz, R.J.; Lambert, H.E.

    1990-01-01

    The discipline of probabilistic risk analysis (PRA) has become so mature in recent years that it is now being used routinely to assist decision-making throughout the nuclear industry. This includes decision-making that affects design, construction, operation, maintenance, and regulation. Unfortunately, not all sub-areas within the larger discipline of PRA are equally ''mature,'' and therefore the many different types of engineering insights from PRA are not all equally reliable. 93 refs., 4 figs., 1 tab

  18. An evaluation of the reliability and usefulness of external-initiator PRA (probabilistic risk analysis) methodologies

    Energy Technology Data Exchange (ETDEWEB)

    Budnitz, R.J.; Lambert, H.E. (Future Resources Associates, Inc., Berkeley, CA (USA))

    1990-01-01

    The discipline of probabilistic risk analysis (PRA) has become so mature in recent years that it is now being used routinely to assist decision-making throughout the nuclear industry. This includes decision-making that affects design, construction, operation, maintenance, and regulation. Unfortunately, not all sub-areas within the larger discipline of PRA are equally mature,'' and therefore the many different types of engineering insights from PRA are not all equally reliable. 93 refs., 4 figs., 1 tab.

  19. Pemikiran Suksesi Dalam Politik Islam Masa Pra Modern

    Directory of Open Access Journals (Sweden)

    Mazro'atus Sa'adah

    2016-12-01

    Abstrak: Pemikiran politik Islam muncul setelah Islam melalui Nabi Muhammad SAW berhasil membentuk sebuah ummat baru, dari peralihan kekuasaan kerajaan/kesukuan kepada Nabi yang kemudian kepada umat. Nabi Muhammad dinilai berhasil dalam mengatur komunitas barunya yang dikendalikan oleh ajarannya dalam seluruh lini kehidupan. Persoalan muncul kemudian setelah beliau wafat, yang akhirnya memunculkan pemikiran tentang suksesi. Artikel ini akan membahas tentang mengapa terjadi suksesi setelah Nabi Muhammad SAW wafat, bagaimana pemikiran para tokoh politik Islam masa pra modern terkait dengan suksesi, dan apa kontribusi pemikiran suksesi ini terhadap politik Islam di Indonesia. Dengan menggunakan pendekatan sejarah, ditemukan bahwa Nabi Muhammad tidak menetapkan siapa yang akan menggantikannya, dan ketika beliau wafat (632 M, para sahabat memilih seorang pemimpin (imam/khalifah. Masa pemerintahan Abu Bakar, Umar dan Usman banyak terjadi perselisihan yang awalnya terkait kepentingan agama namun berkembang menjadi kepentingan politik. Ketika Ali bin Abi Talib diangkat sebagai khalifah, konflik politik berkepanjangan berkaitan dengan pembunuhan Usman, menjadikan timbulnya perang jamal antara Aisyah dan Ali. Pada masa ini perbedaan kepentingan aqidah dipolitisir lebih jauh menjadi sebuah kepentingan politik. Dinamika politik ini kemudian melahirkan mazhab politik Islam klasik yang terbagi dalam tiga mazhab besar yaitu Sunni, Syi'ah dan Khawarij, yang darinya muncul istilah-istilah khilafah, imamah, ahlul halli wal aqdi, bay’ah, walayah dan lain-lain. Dari ketiga mazhab politik ini, kemudian muncul ide pemikiran politik Islam yang sangat kompleks dan berkepanjangan dari para tokoh politik Islam pra modern yang banyak dipengaruhi oleh filosof Yunani. Di Indonesia, pemikiran suksesi dalam politik Islam masa pra modern ini pernah diwacanakan. Namun untuk pemilihan kepala Negara belum terealisasi mengingat Indonesia bukan Negara Islam.

  20. SARS: systematic review of treatment effects.

    Directory of Open Access Journals (Sweden)

    Lauren J Stockman

    2006-09-01

    Full Text Available BACKGROUND: The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO expert panel on SARS treatment requested a systematic review and comprehensive summary of treatments used for SARS-infected patients in order to guide future treatment and identify priorities for research. METHODS AND FINDINGS: In response to the WHO request we conducted a systematic review of the published literature on ribavirin, corticosteroids, lopinavir and ritonavir (LPV/r, type I interferon (IFN, intravenous immunoglobulin (IVIG, and SARS convalescent plasma from both in vitro studies and in SARS patients. We also searched for clinical trial evidence of treatment for acute respiratory distress syndrome. Sources of data were the literature databases MEDLINE, EMBASE, BIOSIS, and the Cochrane Central Register of Controlled Trials (CENTRAL up to February 2005. Data from publications were extracted and evidence within studies was classified using predefined criteria. In total, 54 SARS treatment studies, 15 in vitro studies, and three acute respiratory distress syndrome studies met our inclusion criteria. Within in vitro studies, ribavirin, lopinavir, and type I IFN showed inhibition of SARS-CoV in tissue culture. In SARS-infected patient reports on ribavirin, 26 studies were classified as inconclusive, and four showed possible harm. Seven studies of convalescent plasma or IVIG, three of IFN type I, and two of LPV/r were inconclusive. In 29 studies of steroid use, 25 were inconclusive and four were classified as causing possible harm. CONCLUSIONS: Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage

  1. Adhesive capsulitis: review of imaging and treatment

    International Nuclear Information System (INIS)

    Harris, Guy; Bou-Haider, Pascal; Harris, Craig

    2013-01-01

    Adhesive capsulitis is one of the most common conditions affecting the shoulder; however, early clinical diagnosis can be challenging. Treatment is most effective when commenced prior to the onset of capsular thickening and contracture; consequently, the role of imaging is increasing. The aim of this review is to demonstrate the typical imaging appearances of adhesive capsulitis and to examine some of the evidence regarding each of these imaging modalities. An evaluation of the various management options available to the clinician is also presented.

  2. Musical hallucinations: review of treatment effects

    Directory of Open Access Journals (Sweden)

    Jan eCoebergh

    2015-06-01

    Full Text Available AbstractBackground: Despite an increased scientific interest in musical hallucinations throughout the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analysed the treatment results in relation to the aetiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion and other pathology, epilepsy or intoxication.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct aetiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g. more acoustic stimulation are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being more helpful than antiepileptics (which are still better than antipsychotics. The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication is the main aetiological factor, it is important to stop or switch the

  3. SHARP - a framework for incorporating human interactions into PRA studies

    International Nuclear Information System (INIS)

    Hannaman, G.W.; Joksimovich, V.; Spurgin, A.J.; Worledge, D.H.

    1985-01-01

    Recently, increased attention has been given to understanding the role of humans in the safe operation of nuclear power plants. By virtue of the ability to combine equipment reliability with human reliability probabilistic risk assessment (PRA) technology was deemed capable of providing significant insights about the contributions of human interations in accident scenarios. EPRI recognized the need to strengthen the methodology for incorporating human interactions into PRAs as one element of their broad research program to improve the credibility of PRAs. This research project lead to the development and detailed description of SHARP (Systematic Human Application Reliability Procedure) in EPRI NP-3583. The objective of this paper is to illustrate the SHARP framework. This should help PRA analysts state more clearly their assumptions and approach no matter which human reliability assessment technique is used. SHARP includes a structure of seven analysis steps which can be formally or informally performed during PRAs. The seven steps are termed definition, screening, breakdown, representation, impact assessment, quantification, and documentation

  4. Evaluation of allowed outage time using PRA results

    International Nuclear Information System (INIS)

    Johanson, G.

    1985-01-01

    In a probabilistic risk assessment (PRA) different measures of risk importance can be established. These measures can be used as a basis for further evaluation and determination of allowed outage time for specific components, within safety systems of a nuclear power plant. In order to optimize the allowed outage time (AOT) stipulated in the plant's Technical Specification it is necessary to create a methodology which could incorporate existing PRA data into a quantitative extrapolation. In order to evaluate the plant risk status due to AOT in a quantitative manner, the risk achievement worth is utilized. Risk achievement worth is defined as follows: to measure the worth of a feature, in achieving the present risk, one approach is to remove the feature and then determine how much the risk has increased. Thus, the risk achievement worth is formally defined to be the increase in risk if the feature were assumed not be there or to be failed. Another parameter of interest for this analysis is the shutdown risk increase. The shutdown risk achievement worth must be incorporated into the accident sequence risk achievement worth to arrive at an optimal set of plant specific AOTs

  5. Spatially Informed Plant PRA Models for Security Assessment

    International Nuclear Information System (INIS)

    Wheeler, Timothy A.; Thomas, Willard; Thornsbury, Eric

    2006-01-01

    Traditional risk models can be adapted to evaluate plant response for situations where plant systems and structures are intentionally damaged, such as from sabotage or terrorism. This paper describes a process by which traditional risk models can be spatially informed to analyze the effects of compound and widespread harsh environments through the use of 'damage footprints'. A 'damage footprint' is a spatial map of regions of the plant (zones) where equipment could be physically destroyed or disabled as a direct consequence of an intentional act. The use of 'damage footprints' requires that the basic events from the traditional probabilistic risk assessment (PRA) be spatially transformed so that the failure of individual components can be linked to the destruction of or damage to specific spatial zones within the plant. Given the nature of intentional acts, extensive modifications must be made to the risk models to account for the special nature of the 'initiating events' associated with deliberate adversary actions. Intentional acts might produce harsh environments that in turn could subject components and structures to one or more insults, such as structural, fire, flood, and/or vibration and shock damage. Furthermore, the potential for widespread damage from some of these insults requires an approach that addresses the impacts of these potentially severe insults even when they occur in locations distant from the actual physical location of a component or structure modeled in the traditional PRA. (authors)

  6. Autism Treatment and Family Support Models Review

    Directory of Open Access Journals (Sweden)

    Mehrnoush Esbati

    2009-04-01

    Full Text Available Autism is a lifelong neurological disability of unknown etiology. The criteria for a diagnosis of autism are based on a triad of impairments in social interaction, communication and a lack of flexibility in thinking and behavior There are several factors which are likely to contribute to this variation including the definition of autism and variability in diagnosis amongst professionals, however anecdotally there appears to have been a steadily increasing demand for services. The purpose of this review of research literature relating to the management and treatment of children with autism is to identify the most effective models of best practice. The review includes Comparative evidence supporting a range of treatment and intervention models, across the range of individuals included within autism spectrum disorders, psychodynamic treatment/management which are based on the assumption that autism is the result of emotional damage to the child, usually because of failure to develop a close attachment to parents, especially the mother, biological treatments, educational and behavioral interventions, communication therapies, cost benefits and supporting families.The research is examined for evidence to support best practice models in supporting families at the time of diagnosis and assessment and an overview of the nature of comprehensive supports that help reduce stresses that may be experienced by families of a child with autism and promote inclusion in community activities.

  7. Treatment of mezcal vinasses: a review.

    Science.gov (United States)

    Robles-González, Vania; Galíndez-Mayer, Juvencio; Rinderknecht-Seijas, Noemí; Poggi-Varaldo, Héctor M

    2012-02-20

    Mexican distilleries produce near eight million liters of mezcal per year, and generate about 90 million liters of mezcal vinasses (MV). This acidic liquid waste is very aggressive to the environment because of its high content of toxic and recalcitrant organic matter. As a result, treatment is necessary before discharge to water bodies. It is interesting, yet disturbing; verify that there is a significant gap on the treatment of MV. However, there is an abundant body of research on treatment of other recalcitrant toxic effluents that bear some similarity to MV, for example, wine vinasse, vinasses from the sugar industry, olive oil, and industrial pulp and paper wastewaters. The objective of this review is to critically organize the treatment alternatives of MV, assess their relative advantages and disadvantages, and finally detect the trends for future research and development. Experience with treatment of this set of residuals, indicates the following trends: (i) anaerobic digestion, complemented by oxidative chemical treatments (e.g. ozonation) are usually placed as pretreatments, (ii) aerobic treatment alone and combined with ozone which have been directed to remove phenolic compounds and color have been successfully applied, (iii) physico-chemical treatments such as Fenton, electro-oxidation, oxidants and so on., which are now mostly at lab scale stage, have demonstrated a significant removal of recalcitrant organic compounds, (iv) fungal pretreatment with chemical treatment followed by oxidative (O(3)) or anaerobic digestion, this combination seems to give attractive results, (v) vinasses can be co-composted with solid organic wastes, particularly with those from agricultural activities and agro-industies; in addition to soil amenders with fertilizing value to improve soil quality in typical arid lands where agave is cultivated, it seems to be a low cost technology very well suited for rural regions in underdeveloped countries where more sophisticated

  8. Mozart ear: diagnosis, treatment, and literature review.

    Science.gov (United States)

    Yamashita, Ken; Yotsuyanagi, Takatoshi; Saito, Tamotsu; Isogai, Noritaka; Mori, Hiromasa; Itani, Yoshihito

    2011-11-01

    Mozart ear is a congenital auricular deformity, which is mainly characterized by a bulging appearance of the anterosuperior portion of the auricle, a convexly protruded cavum conchae, and a slit-like narrowing of the orifice of the external auditory meatus. It is said to be uncommon, and because no one has yet fully described neither the disease nor the treatment, the concept of Mozart ear has not been unified. This report describes a case of a 13-year-old girl presented with an unusual congenital deformity which showed the features of Mozart ear. It is an extremely rare deformity that only about 4 clinical cases have been reported in medical literature thereby a treatment method has not been fully discussed. For surgical correction of our cases, we excised deformed conchal cartilage, turned it over, regrafted, and maintained a cosmetically positive result. We also reviewed and described the origin, current concept, and treatment method of Mozart ear.

  9. A review of treatment technologies for MTBE

    International Nuclear Information System (INIS)

    Bass, D.

    1995-01-01

    Available treatment technologies for methyl tertiary butyl ether (MTBE) contamination in soil, groundwater, and recovered groundwater are reviewed and assessed. MTBE contamination is becoming an important issue due to the increasing prevalence and regulation of this gasoline additive. In addition, MTBE is more soluble and more mobile in groundwater than most hydrocarbons, so it is usually the first gasoline constituent to reach sensitive receptors. Treatment of MTBE is complicated by its Henry's constant, which is lower than most other gasoline constituents. Furthermore, evidence of biodegradability of MTBE is mixed, and MTBE does not degrade rapidly abiotically. Groundwater pumping is usually employed to contain and collect MTBE-contaminated groundwater, often successfully because of its high aqueous solubility. Air sparging/soil vapor extraction is also successfully employed to treat MTBE, but its effectiveness is reduced by the low Henry's constant of MTBE. Sparging and other aerobic bioremediation approaches are hampered by the poor biodegradability of MTBE. Oxidation technologies, such as ozone injection, hold promise for rapid in situ remediation of MTBE. Treatment of recovered groundwater contaminated with MTBE is also problematic. MTBE adsorbs poorly to granular activated carbon; advanced oxidation processes are effective on MTBE, but entail high capital and operating costs; bioreactors are of questionable effectiveness on MTBE. Air stripping is usually the most cost-effective treatment technology for MTBE so long as the off gas from the air stripper can be discharged without treatment. However, off gas treatment is expensive, so groundwater is sometimes heated to reduce the requirement for stripping air

  10. Application of RIA of PRA, AT II and NPY in typing and therapy of EH patients

    International Nuclear Information System (INIS)

    Yang Yongqing; Wang Xiaozhou; Jiang Qinian

    2001-01-01

    Objective: To study the typing and AT II receptor inhibitor therapy for essential hypertension (EH) patients. Methods: Plasma RA, AT II and NPY levels were measured by radioimmunoassay (RIA) in 208 Patients with EH and 100 controls; plasma NPY levels were measured in 40 EH patients before and after AT II receptor inhibitor therapy. The mean coefficient of variation for intra and inter batch-assay were less than 10% and 15% respectively. Results: In 208 EH patients plasma PRA levels were increased, normal and decreased in 17.8%, 71.6% and 10.6% respectively, while in 128 EH patients Plasma AT II levels were increased, normal and decreased in 20.3%, 64.1% and 15.6% respectively. In 69 EH Plasma NPY levels were significantly higher than those in 40 control subjects. (17 grade I EH, 137.3 +- 32.6 pg/mL; 28 grade II EH, 148.5 +- 41.1 pg/mL; 24 grade III EH, 162.4 +- 42.7 pg/mL; 40 controls, 118.5 +- 30.5 pg/mL). In 40 EH patients plasma NPY levels were decreased after AT II receptor inhibitor therapy as the blood pressure decreased. Conclusion: Typing of EH patients according to levels of plasma PRA and AT II is useful in guiding treatment. AT II receptor inhibitors are indicated in those patients with increased plasma levels and NPY levels can be used for appraisal of the treatment efficacy

  11. Bruxism and prosthetic treatment: a critical review.

    Science.gov (United States)

    Johansson, Anders; Omar, Ridwaan; Carlsson, Gunnar E

    2011-07-01

    Based on the findings from available research on bruxism and prosthetic treatment published in the dental literature, an attempt was made to draw conclusions about the existence of a possible relationship between the two, and its clinical relevance. MEDLINE/PubMed searches were conducted using the terms 'bruxism' and 'prosthetic treatment', as well as combinations of these and related terms. The few studies judged to be relevant were critically reviewed, in addition to papers found during an additional manual search of reference lists within selected articles. Bruxism is a common parafunctional habit, occurring both during sleep and wakefulness. Usually it causes few serious effects, but can do so in some patients. The etiology is multifactorial. There is no known treatment to stop bruxism, including prosthetic treatment. The role of bruxism in the process of tooth wear is unclear, but it is not considered a major cause. As informed by the present critical review, the relationship between bruxism and prosthetic treatment is one that relates mainly to the effect of the former on the latter. Bruxism may be included among the risk factors, and is associated with increased mechanical and/or technical complications in prosthodontic rehabilitation, although it seems not to affect implant survival. When prosthetic intervention is indicated in a patient with bruxism, efforts should be made to reduce the effects of likely heavy occlusal loading on all the components that contribute to prosthetic structural integrity. Failure to do so may indicate earlier failure than is the norm. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  12. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia. In order to achieve disease control, combinations of systemic treatments are sometimes needed for variable time periods. However, no evidence-based guidelines...... exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...

  13. Granuloma Faciale Treatment: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Claudia Lindhaus

    2017-10-01

    Full Text Available Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.

  14. Treatment of pulmonary brucellosis: a systematic review.

    Science.gov (United States)

    Solera, Javier; Solís García Del Pozo, Julián

    2017-01-01

    Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.

  15. Top event prevention analysis: A deterministic use of PRA

    International Nuclear Information System (INIS)

    Worrell, R.B.; Blanchard, D.P.

    1996-01-01

    This paper describes the application of Top Event Prevention Analysis. The analysis finds prevention sets which are combinations of basic events that can prevent the occurrence of a fault tree top event such as core damage. The problem analyzed in this application is that of choosing a subset of Motor-Operated Valves (MOVs) for testing under the Generic Letter 89-10 program such that the desired level of safety is achieved while providing economic relief from the burden of testing all safety-related valves. A brief summary of the method is given, and the process used to produce a core damage expression from Level 1 PRA models for a PWR is described. The analysis provides an alternative to the use of importance measures for finding the important combination of events in a core damage expression. This application of Top Event Prevention Analysis to the MOV problem was achieve with currently available software

  16. 40 CFR 180.1200 - Pseudomonas fluorescens strain PRA-25; temporary exemption from the requirement of a tolerance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Pseudomonas fluorescens strain PRA-25... RESIDUES IN FOOD Exemptions From Tolerances § 180.1200 Pseudomonas fluorescens strain PRA-25; temporary... established for residues of the microbial pesticide, pseudomonas fluorescens strain PRA-25 when used on peas...

  17. Studi Awal Pra Desain Pabrik Bioetanol dari Nira Siwalan

    Directory of Open Access Journals (Sweden)

    Novarian Budisetyowati

    2017-01-01

    Full Text Available Bioetanol kini banyak dikembangkan sebagai bahan bakar alternatif pengganti bahan bakar fosil. Bioetanol untuk campuran bensin harus memiliki kemurnian sebesar 99,5-100%. Bioetanol dapat diperoleh dengan proses fermentasi yang melibatkan mikroorganisme. Pra desain pabrik bioetanol dari nira siwalan ini menggunakan proses fermentasi. Bahan baku berupa nira siwalan diasamkan dengan menggunakan H2SO4, kemudian disterilisasi sebelum difermentasi di fermentor selama 36 jam. Adapun mikroorganisme yang digunakan adalah Saccharomyces cereviceae. Bakteri ini mampu mengurai gula tanpa kehadiran oksigen dan menghasilkan etanol dan karbondioksida. Bioetanol dapat diperoleh dengan proses fermentasi yang melibatkan mikroorganisme. Pra desain pabrik bioetanol dari nira siwalan ini menggunakan proses fermentasi. Bahan baku berupa nira siwalan diasamkan dengan menggunakan H2SO4, kemudian disterilisasi sebelum difermentasi di fermentor selama 36 jam. Adapun mikroorganisme yang digunakan adalah Saccharomyces cereviceae. Setelah dari fermentor nira yang sudah difermentasi dinetralkan pH nya menggunakan NH4OH di tangki netralisasi. Dari tangki netralisasi nira dipompakan melewati preheater sebelum masuk ke kolom distilasi. Pemurnian dilakukan dengan menggunakan kolom distilasi sebanyak 2 buah. Pada distilasi yang pertama diperoleh kadar etanol sebesar 60% dan pada distilasi yang kedua diperoleh kadar 96%. Dari kolom distilasi 2 larutan didinginkan menggunakan cooler untuk didapatkan suhu 32oC agar sesuai dengan suhu proses dehidrasi dengan menggunakan Molecular Sieve yang diinginkan. Proses dehidrasi dilakukan untuk mendapat kadar etanol 99,5%. Etanol 99,5% yang dihasilkan kemudian disimpan dalam tangki penampung. Kebutuhan bioetanol dalam negeri pada tahun 2018 diperkirakan 3.166.015,13 kL/tahun. Berdasarkan analisa ekonomi yang dilakukan, diperoleh hasil sebagai berikut internal rate of return 26,53 % per tahun, pay out time 4,73 tahun, dan BEP 34,62 % Ditinjau

  18. Clinical significance of determination of SAC/PRA value in patients with primary aldosteronism

    International Nuclear Information System (INIS)

    Li Liren; Dai Yaozong; Liu Jiumin

    2003-01-01

    Objective: To investigate the diagnostic significance of determining SAC/PRA valve in hyperaldosteronism. Methods: Plasma renin activity (PRA) and angiotensin (AT-II) as well as serum aldosterone contents were measured with RIA in 48 patients with primary aldosteronism and 30 controls. The SAC/PRA value was calculated. Results: Contents of PRA, AT-II and Aldo in blood of patients with primary aldosteronism were very significantly different from those in controls (p < 0.001) (PRA 0.14 ± 0.08 ng/ml/h vs 0.57 ± 0.08 ng/ml/h; AT-II 21.21 ± 7.55 ng/L vs 36.03 ± 6.11 ng/L; Aldo 1.07 ± 0.34 nmol/L vs 0.33 ± 0.04 nmol/L). Calculated SAC/PRA value was 913 ± 409 (normal upper limit 400). Conclusion: SAC/PRA value is an useful accessory diagnostic criterion for primary aldosteronism

  19. Risk assessment of CST-7 proposed waste treatment and storage facilities Volume I: Limited-scope probabilistic risk assessment (PRA) of proposed CST-7 waste treatment ampersand storage facilities. Volume II: Preliminary hazards analysis of proposed CST-7 waste storage ampersand treatment facilities

    International Nuclear Information System (INIS)

    Sasser, K.

    1994-06-01

    In FY 1993, the Los Alamos National Laboratory Waste Management Group [CST-7 (formerly EM-7)] requested the Probabilistic Risk and Hazards Analysis Group [TSA-11 (formerly N-6)] to conduct a study of the hazards associated with several CST-7 facilities. Among these facilities are the Hazardous Waste Treatment Facility (HWTF), the HWTF Drum Storage Building (DSB), and the Mixed Waste Receiving and Storage Facility (MWRSF), which are proposed for construction beginning in 1996. These facilities are needed to upgrade the Laboratory's storage capability for hazardous and mixed wastes and to provide treatment capabilities for wastes in cases where offsite treatment is not available or desirable. These facilities will assist Los Alamos in complying with federal and state requlations

  20. Risk assessment of CST-7 proposed waste treatment and storage facilities Volume I: Limited-scope probabilistic risk assessment (PRA) of proposed CST-7 waste treatment & storage facilities. Volume II: Preliminary hazards analysis of proposed CST-7 waste storage & treatment facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sasser, K.

    1994-06-01

    In FY 1993, the Los Alamos National Laboratory Waste Management Group [CST-7 (formerly EM-7)] requested the Probabilistic Risk and Hazards Analysis Group [TSA-11 (formerly N-6)] to conduct a study of the hazards associated with several CST-7 facilities. Among these facilities are the Hazardous Waste Treatment Facility (HWTF), the HWTF Drum Storage Building (DSB), and the Mixed Waste Receiving and Storage Facility (MWRSF), which are proposed for construction beginning in 1996. These facilities are needed to upgrade the Laboratory`s storage capability for hazardous and mixed wastes and to provide treatment capabilities for wastes in cases where offsite treatment is not available or desirable. These facilities will assist Los Alamos in complying with federal and state requlations.

  1. Targeted treatments for cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Peralta-Zaragoza O

    2012-11-01

    Full Text Available Oscar Peralta-Zaragoza,1 Víctor Hugo Bermúdez-Morales,1 Carlos Pérez-Plasencia,2,3 Jonathan Salazar-León,1 Claudia Gómez-Cerón,1 Vicente Madrid-Marina11Direction of Chronic Infections and Cancer, Research Center in Infection Diseases, National Institute of Public Health, Cuernavaca, Morelos, México; 2Oncogenomics Laboratory, National Cancer Institute of Mexico, Tlalpan, México; 3Biomedicine Unit, FES-Iztacala UNAM, México City, MéxicoAbstract: Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%–95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development.Keywords: Cervical cancer, clinical trials, gene therapy, HPV E6 and E7 oncogenes, siRNAs

  2. Perfluoroalkyl acids (PFAAs) in the Pra and Kakum River basins and associated tap water in Ghana.

    Science.gov (United States)

    Essumang, David K; Eshun, Albert; Hogarh, Jonathan N; Bentum, John K; Adjei, Joseph K; Negishi, Junya; Nakamichi, Shihori; Habibullah-Al-Mamun, Md; Masunaga, Shigeki

    2017-02-01

    Perfluoroalkyl acids (PFAAs) are persistent environmental pollutants that have been detected in various media including human serum. Due to concerns regarding their bioaccumulation and possible negative health effects, an understanding of routes of human exposure is necessary. PFAAs are recalcitrant in many water treatment processes, making drinking water a potential source of human exposure. This study presents the first report on contamination from PFAAs in river and drinking water in Ghana. The targeted PFAAs were perfluoroalkyl carboxylic acids (PFCAs) with C 4-14 carbon chain and perfluoroalkane sulphonic acids (PFSAs) with C 6, 8, 10 . Five PFAA congeners - PFOA, PFOS, PFHxA, PFDA and PFPeA - were commonly detected in river and tap water. The mean concentrations of ∑PFAAs in the Kakum and Pra Rivers were 281 and 398ng/L, while tap water (supplied from the treatment of water from those rivers) contained concentrations of 197 and 200ng/L, respectively. PFOA and PFOS constituted about 99% of the ∑PFAAs. The risk quotient (RQ) attributed to drinking of tap water was estimated at 1.01 and 1.74 for PFOA and PFOS, respectively. For a country that has not produced these compounds, the RQs were unexpectedly high, raising concerns particularly about contamination from such emerging pollutants in local water sources. The study revealed limitations of local tap water treatment in getting rid of these emerging pollutants. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Systematic review of treatments for atopic eczema.

    Science.gov (United States)

    Hoare, C; Li Wan Po, A; Williams, H

    2000-01-01

    Atopic eczema is the commonest inflammatory skin disease of childhood, affecting 15-20% of children in the UK at any one time. Adults make up about one-third of all community cases. Moderate-to-severe atopic eczema can have a profound effect on the quality of life for both sufferers and their families. In addition to the effects of intractable itching, skin damage, soreness, sleep loss and the social stigma of a visible skin disease, other factors such as frequent visits to doctors, special clothing and¿the need to constantly apply messy topical applications all add to the burden of disease. The cause of atopic eczema is unknown, though a genetic pre-disposition and a combination of allergic and non-allergic factors appear to be important in determining disease expression. Treatment of atopic eczema in the UK is characterised by a profusion of treatments aimed at disease control. The evidential basis of these treatments is often unclear. Most people with atopic eczema are managed in primary care where the least research has been done. The objectives of this scoping review are two-fold. To produce an up-to-date coverage 'map' of randomised controlled trials (RCTs) of treatments of atopic eczema. To assist in making treatment recommendations by summarising the available RCT evidence using qualitative and quantitative methods. Data sources included electronic searching of MEDLINE, EMBASE, the Cochrane Controlled Clinical Trials Register, the Cochrane Skin Group specialised register of trials, hand-searching of atopic eczema conference proceedings, follow-up of references in retrieved articles, contact with leading researchers and requests to relevant pharmaceutical companies. Only RCTs of therapeutic agents used in the prevention and treatment of people with atopic eczema of any age were considered for inclusion. Only studies where a physician diagnosed atopic eczema or atopic dermatitis were included. Data extraction was conducted by two observers onto abstraction

  4. Issues and insights of PRA methodology in nuclear and space applications

    International Nuclear Information System (INIS)

    Hsu, F.

    2005-01-01

    This paper presents some important issues and technical insights on the scope, conceptual framework, and essential elements of nuclear power plant Probabilistic Risk Assessments (PRAs) and that of the PRAs in general applications of the aerospace industry, such as the Space Shuttle PRA being conducted by NASA. Discussions are focused on various lessons learned in nuclear power plant PRA applications and their potential applicability to the PRAs in the aerospace and launch vehicle systems. Based on insights gained from PRA projects for nuclear power plants and from the current Space Shuttle PRA effort, the paper explores the commonalities and the differences between the conduct of the different PRAs and the key issues and risk insights derived from extensive modeling practices in both industries of nuclear and space. (author)

  5. How Can You Support RIDM/CRM/RM Through the Use of PRA

    Science.gov (United States)

    DoVemto. Tpmu

    2011-01-01

    Probabilistic Risk Assessment (PRA) is one of key Risk Informed Decision Making (RIDM) tools. It is a scenario-based methodology aimed at identifying and assessing Safety and Technical Performance risks in complex technological systems.

  6. Current and future applications of PRA in regulatory activities

    Energy Technology Data Exchange (ETDEWEB)

    Speis, T.P.; Murphy, J.A.; Cunningham, M.A. [Nuclear Regulatory Commission, Washington, DC (United States)] [and others

    1995-04-01

    Probabilistic Risk Assessments (PRAs) have proven valuable in providing the regulators, the nuclear plant operators, and the reactor designers insights into plant safety, reliability, design and operation. Both the NRC Commissioners and the staff have grown to appreciate the valuable contributions PRAs can have in the regulatory arena, though I will admit the existence of some tendencies for strict adherence to the deterministic approach within the agency and the public at large. Any call for change, particularly one involving a major adjustment in approach to the regulation of nuclear power, will meet with a certain degree of resistance and retrenchment. Change can appear threatening and can cause some to question whether the safety mission is being fulfilled. This skepticism is completely appropriate and is, in fact, essential to a proper transition towards risk and performance-based approaches. Our task in the Office of Nuclear Regulatory Research is to increase the PRA knowledge base within the agency and develop appropriate guidance and methods needed to support the transitioning process.

  7. ASSESSMENT OF DYNAMIC PRA TECHNIQUES WITH INDUSTRY AVERAGE COMPONENT PERFORMANCE DATA

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, Vaibhav; Agarwal, Vivek; Gribok, Andrei V.; Smith, Curtis L.

    2017-06-01

    In the nuclear industry, risk monitors are intended to provide a point-in-time estimate of the system risk given the current plant configuration. Current risk monitors are limited in that they do not properly take into account the deteriorating states of plant equipment, which are unit-specific. Current approaches to computing risk monitors use probabilistic risk assessment (PRA) techniques, but the assessment is typically a snapshot in time. Living PRA models attempt to address limitations of traditional PRA models in a limited sense by including temporary changes in plant and system configurations. However, information on plant component health are not considered. This often leaves risk monitors using living PRA models incapable of conducting evaluations with dynamic degradation scenarios evolving over time. There is a need to develop enabling approaches to solidify risk monitors to provide time and condition-dependent risk by integrating traditional PRA models with condition monitoring and prognostic techniques. This paper presents estimation of system risk evolution over time by integrating plant risk monitoring data with dynamic PRA methods incorporating aging and degradation. Several online, non-destructive approaches have been developed for diagnosing plant component conditions in nuclear industry, i.e., condition indication index, using vibration analysis, current signatures, and operational history [1]. In this work the component performance measures at U.S. commercial nuclear power plants (NPP) [2] are incorporated within the various dynamic PRA methodologies [3] to provide better estimates of probability of failures. Aging and degradation is modeled within the Level-1 PRA framework and is applied to several failure modes of pumps and can be extended to a range of components, viz. valves, generators, batteries, and pipes.

  8. Dynamic Positioning System (DPS) Risk Analysis Using Probabilistic Risk Assessment (PRA)

    Science.gov (United States)

    Thigpen, Eric B.; Boyer, Roger L.; Stewart, Michael A.; Fougere, Pete

    2017-01-01

    The National Aeronautics and Space Administration (NASA) Safety & Mission Assurance (S&MA) directorate at the Johnson Space Center (JSC) has applied its knowledge and experience with Probabilistic Risk Assessment (PRA) to projects in industries ranging from spacecraft to nuclear power plants. PRA is a comprehensive and structured process for analyzing risk in complex engineered systems and/or processes. The PRA process enables the user to identify potential risk contributors such as, hardware and software failure, human error, and external events. Recent developments in the oil and gas industry have presented opportunities for NASA to lend their PRA expertise to both ongoing and developmental projects within the industry. This paper provides an overview of the PRA process and demonstrates how this process was applied in estimating the probability that a Mobile Offshore Drilling Unit (MODU) operating in the Gulf of Mexico and equipped with a generically configured Dynamic Positioning System (DPS) loses location and needs to initiate an emergency disconnect. The PRA described in this paper is intended to be generic such that the vessel meets the general requirements of an International Maritime Organization (IMO) Maritime Safety Committee (MSC)/Circ. 645 Class 3 dynamically positioned vessel. The results of this analysis are not intended to be applied to any specific drilling vessel, although provisions were made to allow the analysis to be configured to a specific vessel if required.

  9. Advances in Probabilistic Risk Assessment (PRA): a look into practitioners toolbox

    International Nuclear Information System (INIS)

    Mok, J.; Kaasalainen, S.; Donnelly, K.

    2007-01-01

    The ever-increasing emphasis on the use of Probabilistic Risk Assessment (PRA) in risk-informed decision making translates into increased expectations relating to PRA applications for the groups tasked with developing and maintaining the facility PRAs. In order to succeed in meeting the demand for PRA work, it is essential to develop methodologies and tools (or utilities) that improve the efficiency with which the PRAs are processed and manipulated to obtain a solution. Examples from the Nuclear Safety Solutions (NSS) PRA Practitioners tool box include utilities for cutting logical loops, optimizing fault trees (to decrease run-times), modularizing fault trees, and converting event trees into high level fault tree logic (an important element if the PRA study is to be used to support a risk monitor such as an Equipment Out-of-Service (EOOS) Monitor). The objective of this paper is be to briefly describe the main features of these utilities, and to illustrate the value they have in terms of improving the efficiency and effectiveness of PRA development and maintenance at NSS. (author)

  10. A review of the radiological treatment

    International Nuclear Information System (INIS)

    Mueller, C.J.; Folga, S.; Nabelssi, B.; Kohout, E.

    1996-01-01

    The Draft Waste Management Programmatic Environmental Impact Statement (WM PEIS) was released by the U.S. Department of Energy (DOE) for public comment on September 22, 1995. Prepared in accordance with the National Environmental Policy Act (NEPA), the Final WM PEIS is currently scheduled for release in late summer 1996. The Draft WM PEIS was published after about 3 years of effort to select and evaluated the best alternatives for treating, storing, and disposing of the 50-year legacy of radioactive and chemically hazardous wastes existing within the DOE complex. The evaluation examined the potential health and environmental impacts of integrated waste management alternatives for five categories of waste types at 54 DOE sites. A primary consideration as a potential source of human health impacts at all sites is that of radiological releases resulting from postulated accidents involving facilities used to treat radioactive wastes. This paper first provides a brief, updated summary of the approach used to define and perform treatment facility accident analyses in the Draft WM PEIS. It reviews the selection of dominant sequences for the major sites most affected by the preferred waste management alternatives and highlights the salient accident analysis results. Finally, it summarizes and addresses key public and state and federal agency comments relating to accident analysis that were received in the public comment process

  11. A Review of Behavioral Conceptualizations and Treatments of Child Noncompliance.

    Science.gov (United States)

    Houlihan, Daniel; And Others

    1992-01-01

    This review of behavioral conceptualizations and approaches to the treatment of child noncompliance includes discussion of behavioral definitions, methods of assessment, types of behavioral interventions, generalization of treatment effects, future research directions, and potential ethical concerns. (Author/JDD)

  12. PRA-1 offshore platform start-up within seven days; Operacionalizacao da plataforma offshore PRA-1 em sete dias

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Fernando; Mitidieri, Jorge; Faria, Jose Luis Coutinho de; Ribeiro, Juan Carlos; Moura, Mario Arthur [Construtora Norberto Oderbrecht S.A., Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The technologic innovations are very hard features with regards to Offshore Engineering and Construction over the worldwide. The innovations only make sense since they are focus on the high productivity, safe job and cost reduction compared with the current technologies. Inside the scenario mentioned above is Construtora Norberto Odebrecht S.A. concept for the PRA-1 platform Engineering and Construction. Through a very advanced and innovation concept, it was defined as the Main Strategic Planning of the undertaking not use a temporary platform support (named in Brazil as 'Flotel') during the 'Hook-up', commissioning and star-up offshore phase. The success of the strategic made possible through the implementation of new engineering tools, and, besides this, through a very careful offshore planning focused on minimizing and make easier as much as possible the offshore activities. The planning can be basically spitted on the following parts: A- Onshore preparations (Assembly, Integration and Commissioning of the Utilities and Accommodation Modules) B- Offshore detailed planning of the critical activities concerning the start-up of the systems responsible for leaving the platform ready for 'live'. This operation was defined as 'seven days of platform live support' (main target of this paper). (author)

  13. A Review of Pharmacologic Treatment for Compulsive Buying Disorder

    OpenAIRE

    Soares, Célia; Fernandes, Natália; Morgado, Pedro

    2016-01-01

    At present, no treatment recommendations can be made for compulsive buying disorder. Recent studies have found evidence for the efficacy of psychotherapeutic options, but less is known regarding the best pharmacologic treatment. The purpose of this review is to present and analyze the available published evidence on the pharmacological treatment of compulsive buying disorder. To achieve this, we conducted a review of studies focusing on the pharmacological treatment of compulsive buying by se...

  14. Examination of Conservatism in Early/Latent Fatality Estimation in Level 3 PRA

    International Nuclear Information System (INIS)

    Kim, Sung-yeop; Lee, Haneol; Yim, Man-Sung

    2014-01-01

    Due to the computational model driven-nature of the work, there exist various sources of uncertainty in level 3 PRA. They are related with source release, environmental transport and deposition, human behavior involved in dosimetry, health effect and risk assessment. For instance, a total of 376 parameters have been considered in Probabilistic Accident Consequence Uncertainty Assessment Using COSYMA and the details on the number of parameters in each analysis are listed in Table 1. In 2012, the report of NPP accident consequence simulation was distributed by the Korean Federation for Environmental Movement (KFEM). They insisted that Kori Nuclear Power Plant (NPP) accident would lead to 48,000 early fatalities and 850,000 cancer fatalities in Busan and Hanbit NPP accident would lead to 550,000 cancer fatalities in Seoul. This report exemplifies the misuse of collective dose, that is effective dose multiplied by population and time. Even though very low effective dose is considered, collective dose could give over-conservative estimate when high population and long time period is multiplied. International Commission on Radiological Protection (ICRP) forewarned about the misuse of collective dose, in their ICRP Publication 103, such as applying it to simplified calculation of fatality and risk. As part of investigation of conservatism in early and latent fatality estimation, the existing methods of early and latent fatality calculation was reviewed and the results from the use of the existing methodology were examined in this study. The method of early and latent fatality estimation in level 3 PRA was investigated and the conservatism in the result was examined in this study. For the purpose of estimating both early and latent fatality, appropriate dose distributions among the affected population are found to be important. This study showed that large conservatism may be involved in the estimated fatality if the distribution of population dose as a function of

  15. Examination of Conservatism in Early/Latent Fatality Estimation in Level 3 PRA

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung-yeop; Lee, Haneol; Yim, Man-Sung [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2014-10-15

    Due to the computational model driven-nature of the work, there exist various sources of uncertainty in level 3 PRA. They are related with source release, environmental transport and deposition, human behavior involved in dosimetry, health effect and risk assessment. For instance, a total of 376 parameters have been considered in Probabilistic Accident Consequence Uncertainty Assessment Using COSYMA and the details on the number of parameters in each analysis are listed in Table 1. In 2012, the report of NPP accident consequence simulation was distributed by the Korean Federation for Environmental Movement (KFEM). They insisted that Kori Nuclear Power Plant (NPP) accident would lead to 48,000 early fatalities and 850,000 cancer fatalities in Busan and Hanbit NPP accident would lead to 550,000 cancer fatalities in Seoul. This report exemplifies the misuse of collective dose, that is effective dose multiplied by population and time. Even though very low effective dose is considered, collective dose could give over-conservative estimate when high population and long time period is multiplied. International Commission on Radiological Protection (ICRP) forewarned about the misuse of collective dose, in their ICRP Publication 103, such as applying it to simplified calculation of fatality and risk. As part of investigation of conservatism in early and latent fatality estimation, the existing methods of early and latent fatality calculation was reviewed and the results from the use of the existing methodology were examined in this study. The method of early and latent fatality estimation in level 3 PRA was investigated and the conservatism in the result was examined in this study. For the purpose of estimating both early and latent fatality, appropriate dose distributions among the affected population are found to be important. This study showed that large conservatism may be involved in the estimated fatality if the distribution of population dose as a function of

  16. Treatment of olecranon bursitis: a systematic review.

    Science.gov (United States)

    Sayegh, Eli T; Strauch, Robert J

    2014-11-01

    The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis. Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis. Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis. Therapeutic IV.

  17. ANALISIS INFLASI PRA DAN PASCA KRISIS MONETER DALAM PEREKONOMIAN INDONESIA

    Directory of Open Access Journals (Sweden)

    Deni Sri Haryati

    2014-10-01

    Full Text Available Abstrak ___________________________________________________________________ Penelitian ini menganalisis fluktuasi inflasi yang terjadi pada masa pra, saat, dan pasca krisis moneter. Terdapat 5 variabel yang berkorelasi dengan inflasi di Indonesia. Variabel-variabel tersebut adalah jumlah uang beredar (JUB, nilai tukar nominal (NTN, pertumbuhan ekonomi, pengeluaran pemerintah (PeP,dan  bahan bakar minyak (BBM. Sebenarnya variabel tersebut memiliki hubungan dengan inflasi pada seluruh era. Namun, variabel tesebut memiliki dominasi yang berbeda pada masing-masing eranya. Era prakrisis didominasi oleh 3 variabel, yakni; pertumbuhan ekonomi, NTN, dan JUB, era krisis didominasi oleh seluruh variabel yang ada, dan era pasca krisis didominasi oleh 3 variabel, yakni; PeP, NTN, dan JUB. Variabel-variabel ini akan dijelaskan pengaruhnya terhadap inflasi pada era yang didominasi dimana apakah memiliki hubungan sebanding atau berbanding terbalik. Abstract ___________________________________________________________________ This study analyzes the fluctuations in inflation that occurred in the pre, during and post the financial crisis. There are 5 variables that correlated with inflation in Indonesia. These variables are the money supply (MS, the nominal exchange rate (NER, economic growth, government expenditure (GE, and fuel oil (BBM. Actually, these variables have a relationship with inflation on the whole era. However, the variable has a predominance of different proficiency level in each era. Pre-crisis era dominated by three variables, namely; economic growth, NER, and MS, crisis era dominated by all the variables that exist, and the post-crisis era dominated by three variables, namely; GE, NER, and MS. These variables will be explained influence on inflation in an era dominated where or whether proportional or inversely proportional relationship. © 2014 Universitas Negeri Semarang

  18. A critical review of treatment approaches for gambling disorders.

    Science.gov (United States)

    Stea, Jonathan N; Hodgins, David C

    2011-06-01

    This review presents the theoretical model, evidence base, and theoretical and methodological issues for seven treatment approaches to gambling disorders: 1) psychoanalytic and psychodynamic treatments, 2) Gamblers Anonymous, 3) behavioural treatments, 4) cognitive and cognitive-behavioural therapies, 5) brief, motivational, and self-directed interventions, 6) pharmacotherapies, and 7) family therapy approaches. Throughout the review, broader clinical and research issues are also discussed, including barriers to treatment-seeking, controlled gambling versus abstinence as a treatment goal, comorbidity, and the evaluation of treatment efficacy and effectiveness.

  19. Nonpharmacologic Treatments for Childhood Constipation : Systematic Review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine.

  20. Nonpharmacologic treatments for childhood constipation: systematic review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. We

  1. Practical Application of PRA as an Integrated Design Tool for Space Systems

    Science.gov (United States)

    Kalia, Prince; Shi, Ying; Pair, Robin; Quaney, Virginia; Uhlenbrock, John

    2013-01-01

    This paper presents the application of the first comprehensive Probabilistic Risk Assessment (PRA) during the design phase of a joint NASA/NOAA weather satellite program, Geostationary Operational Environmental Satellite Series R (GOES-R). GOES-R is the next generation weather satellite primarily to help understand the weather and help save human lives. PRA has been used at NASA for Human Space Flight for many years. PRA was initially adopted and implemented in the operational phase of manned space flight programs and more recently for the next generation human space systems. Since its first use at NASA, PRA has become recognized throughout the Agency as a method of assessing complex mission risks as part of an overall approach to assuring safety and mission success throughout project lifecycles. PRA is now included as a requirement during the design phase of both NASA next generation manned space vehicles as well as for high priority robotic missions. The influence of PRA on GOES-R design and operation concepts are discussed in detail. The GOES-R PRA is unique at NASA for its early implementation. It also represents a pioneering effort to integrate risks from both Spacecraft (SC) and Ground Segment (GS) to fully assess the probability of achieving mission objectives. PRA analysts were actively involved in system engineering and design engineering to ensure that a comprehensive set of technical risks were correctly identified and properly understood from a design and operations perspective. The analysis included an assessment of SC hardware and software, SC fault management system, GS hardware and software, common cause failures, human error, natural hazards, solar weather and infrastructure (such as network and telecommunications failures, fire). PRA findings directly resulted in design changes to reduce SC risk from micro-meteoroids. PRA results also led to design changes in several SC subsystems, e.g. propulsion, guidance, navigation and control (GNC

  2. MAAP4.0.7 analysis and justification for PRA level 1 mission success criteria

    International Nuclear Information System (INIS)

    Butler, J.S.; Kapitz, D.; Martin, R.P.; Seifaee, F.; Sundaram, R.K.

    2008-01-01

    The U.S. EPR is a 4590 MWth evolutionary pressurized water reactor that incorporates proven technology with innovative system architecture to provide an unprecedented level of safety. One of the measures of safety is provided by Probability Risk Assessment (PRA). PRA Level 1 concerns the evaluation of core damage frequency based on various initiating events and the success or failure of various plant event mitigation features. Determination of this measure requires mission success criteria, which are used to build the logic that makes up the fault trees and event trees of the Level 1 PRA. Developing mission success criteria for the wide variety of accident sequences modeled in the PRA Level 1 model requires a large number of thermal hydraulic calculations. The MAAP4 code, developed by Fauske and Associates, Inc. and distributed by EPRI, was chosen to perform these calculations because of its fast computation times relative to more sophisticated thermal-hydraulics codes This is a unique application of MAAP4, which was developed specifically for severe accident and PRA Level 2 analysis. As such, a study was performed to assess MAAP4 's thermal-hydraulic response capabilities against AREVA 's S-RELAP5 best-estimate integral systems thermal-hydraulic analysis code. (authors)

  3. Mandibular overdentures: a review of treatment philosophy and prosthodontic maintenance.

    Science.gov (United States)

    Al-Zubeidi, Mohammed I; Payne, Alan G T

    2007-12-01

    Root overdentures and implant overdentures are two similar treatment options for the nearly-edentulous or edentulous mandible. The purpose of this literature review was to specifically compare their prosthodontic treatment philosophies and follow-up maintenance requirements. Critical comparison of these two prosthodontic treatment philosophies revealed that the foundation for overdentures which is provided by oral implants is more predictable than that provided by the roots of natural teeth. The two treatment modalities have both similarities and differences in their associated prosthodontic maintenance. The findings of this literature review suggest the future possibility that mandibular root overdentures may become obsolete as a treatment approach.

  4. Hyperthyroidism: a review of the treatment options

    International Nuclear Information System (INIS)

    Chen Danyun; Jing Jin

    2007-01-01

    Hyperthyroidism is commonly treated with anti-thyroid medications, radioactive iodine, or surgery. Three kinds of treatments have their own advantages and disadvantages. Therefore, the treatment of hyperthyroidism is still controversial. With regard to the first choice, strategies vary among different countries. (authors)

  5. A review of water treatment membrane nanotechnologies

    KAUST Repository

    Pendergast, MaryTheresa M.; Hoek, Eric M.V.

    2011-01-01

    readiness was based on known or anticipated material costs, scalability (for large scale water treatment applications), and compatibility with existing manufacturing infrastructure. Overall, bio-inspired membranes are farthest from commercial reality

  6. Using level-I PRA for enhanced safety of the advanced neutron source reactor

    International Nuclear Information System (INIS)

    Ramsey, C.T.; Linn, M.A.

    1995-01-01

    The phase-1, level-I probabilistic risk assessment (PRA) of the Advanced Neutron Source (ANS) reactor has been completed as part of the conceptual design phase of this proposed research facility. Since project inception, PRA and reliability concepts have been an integral part of the design evolutions contributing to many of the safety features in the current design. The level-I PRA has been used to evaluate the internal events core damage frequency against project goals and to identify systems important to safety and availability, and it will continue to guide and provide support to accident analysis, both severe and nonsevere. The results also reflect the risk value of defense-in-depth safety features in reducing the likelihood of core damage

  7. System 80+TM PRA insights on severe accident prevention and mitigation

    International Nuclear Information System (INIS)

    Finnicum, D.J.; Jacob, M.C.; Schneider, R.E.; Weston, R.A.

    2004-01-01

    The System 80 + design is ABB-CE's standardized evolutionary Advanced Light Water Reactor (ALWR) design. It incorporates design enhancements based on Probabilistic Risk Assessment (PRA) insights, guidance from the ALWR Utility Requirements Document (URD), and US NRC's Severe Accident Policy. Major severe accident prevention and mitigation design features of the System 80 + design are described. The results of the System 80 + PRA are presented and the insights gained from the PRA sensitivity analyses are discussed. ABB-CE considered defense-in-depth for accident prevention and mitigation early in the design process and used robust design features to ensure that the System 80 + design achieved a low core damage frequency, low containment conditional failure probability, and excellent deterministic containment performance under severe accident conditions and to ensure that the risk was properly allocated among design features and between prevention and mitigation. (author)

  8. Urgensi Pemeriksaan Psikis Pra-Nikah (Studi Pandangan Kepala KUA dan Psikolog Kota Malang

    Directory of Open Access Journals (Sweden)

    Ika Kurnia Fitriani

    2015-06-01

    Full Text Available Beberapa negara muslim memberikan perhatian terhadap pemeriksaan psikis pra-nikah bagi calon mempelai, sebagai upaya menanggulangi masalah rumah tangga akibat gangguan kejiwaan di masa yang akan datang. Penelitian ini bertujuan menggali informasi dari Kepala KUA dan Psikolog di Kota Malang tentang pemeriksaan psikis pra-nikah dan urgensinya bagi calon mempelai. Penelitian ini termasuk dalam penelitian lapangan (field reasearch, dengan menggunakan pendekatan kualitatif.  Alanisis data dilakukan melalui tiga tahapan yaitu reduksi data, penyajian data, dan menarik kesimpulan. Pengecekan keabsahan data menggunakan triangulasi sumber yang membandingkan hasil wawancara dengan data sekunder, dan triangulasi teori. Hasil dari penelitian ini menunjukkan bahwa Kepala KUA dan Psikolog di kota Malang menyetujui diadakan pemeriksaan psikis pranikah akan tetapi harus ada aturan hukumnya dan dilakukan sosialisasi agar program menjadi efektif. Selain itu, pemeriksaan psikis pra-nikah tidak bertentangan dengan konsep maqashid al-syari’ah dan konsep sadz al-dzari’ah dalam hukum Islam.

  9. Applicability of PRA methods and data to the financial risk assessment of nuclear power plants

    International Nuclear Information System (INIS)

    El-Sheik, K.A.

    1985-01-01

    Financial risk assessment, where the probability and severity of financial consequences are estimated, offers a logical framework for organizing and evaluating data pertinent to nuclear power plant accidents. Under the sponsorship of the Electric Power Research Institute, General Electric investigated the feasibility of financial risk assessment of nuclear power plants and of applying PRA methods and data in such an assessment. This paper summarizes the main findings of this investigation. Specifically, the paper discussed the following topics: definition of financial consequences and financial risk; overall approach for financial risk assessment and how it compares with the approach for PRA used in the Reactor Safety Study; and specific financial risk assessment procedures for defining initiating events, plant response sequences, institutional scenarios, and financial consequences and how they compare to analogous procedures for PRA

  10. Evidence-based treatment strategies for treatment-resistant bipolar depression: a systematic review

    NARCIS (Netherlands)

    Sienaert, P.; Lambrichts, L.; Dols, A.; De Fruyt, J.

    2013-01-01

    Objectives: Treatment resistance in bipolar depression is a common clinical problem that constitutes a major challenge for the treating clinician as there is a paucity of treatment options. The objective of this paper was to review the evidence for treatment options in treatment-resistant bipolar

  11. Novel technologies for reverse osmosis concentrate treatment: a review.

    Science.gov (United States)

    Joo, Sung Hee; Tansel, Berrin

    2015-03-01

    Global water shortages due to droughts and population growth have created increasing interest in water reuse and recycling and, concomitantly, development of effective water treatment processes. Pressured membrane processes, in particular reverse osmosis, have been adopted in water treatment industries and utilities despite the relatively high operational cost and energy consumption. However, emerging contaminants are present in reverse osmosis concentrate in higher concentrations than in the feed water, and have created challenges for treatment of the concentrate. Further, standards and guidelines for assessment and treatment of newly identified contaminants are currently lacking. Research is needed regarding the treatment and disposal of emerging contaminants of concern in reverse osmosis concentrate, in order to develop cost-effective methods for minimizing potential impacts on public health and the environment. This paper reviews treatment options for concentrate from membrane processes. Barriers to emerging treatment options are discussed and novel treatment processes are evaluated based on a literature review. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...

  13. Review of Irritable Bowel Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    M.R Ghadir

    2012-05-01

    Full Text Available

    Background and Objectives: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders striking 10-20% of the world population. Although most patients do not take medical assistance, this disease enforces significant cost on the patient and health systems and has negative effects on quality of life of the individual. After diagnosis ,treatment of this disease is the next step. Many pathways of treatment has been introduced and the efficacy of each other has been established in one way or another. The first step in the path of treatment is education and confidence of patients that might also be the most important step. Fiber diet, probiotic, anti-cholinergic and anti antispasmodics, laxatives, anti-diarrhea, the drugs affecting serotonin receptors, antidepressants and anti-anxiety, the chloride channel activator and non-drug methods such as cognitive-behavior therapy, hypnotherapy, acupuncture and herbal medicine each of which has been tested on irritable bowel syndrome and efficacy of each one has been indicated in one way or another. This paper tried to outline new treatments available in addition to categorization and discussion of various treatments for irritable bowel syndrome.

  14. Review of Irritable Bowel Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    Ghadir M.R.

    2010-06-01

    Full Text Available Background and Objectives: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders striking 10-20% of the world population. Although most patients do not take medical assistance, this disease enforces significant cost on the patient and health systems and has negative effects on quality of life of the individual. After diagnosis ,treatment of this disease is the next step. Many pathways of treatment has been introduced and the efficacy of each other has been established in one way or another. The first step in the path of treatment is education and confidence of patients that might also be the most important step. Fiber diet, probiotic, anti-cholinergic and anti antispasmodics, laxatives, anti-diarrhea, the drugs affecting serotonin receptors, antidepressants and anti-anxiety, the chloride channel activator and non-drug methods such as cognitive-behavior therapy, hypnotherapy, acupuncture and herbal medicine each of which has been tested on irritable bowel syndrome and efficacy of each one has been indicated in one way or another. This paper tried to outline new treatments available in addition to categorization and discussion of various treatments for irritable bowel syndrome.Keywords: Irritable Bowel Syndrome; Probiotics; Parasmpatholytics; Laxatives.

  15. Probiotics in allergy treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Louise Crovesy

    2017-10-01

    Full Text Available Allergy is a exacerbate response of immune system to a triggering element. A probable cause of allergies is gut microbiota composition. It has strong relationship with development of human immune system and this is formed in intrauterine life and early childhood, crucial periods for formation adequate microbiota. In this sense modulation gut microbiota by probiotics could prevent or help in the treatment of allergic diseases such as allergic rhinitis, asthma, atopic dermatitis and food allergy. Studies published to date are controversial. It is difficult to determine whether the probiotic can be used in the treatment and prevention of allergic diseases.

  16. Review of hormonal treatment of breast cancer

    African Journals Online (AJOL)

    2011-07-28

    Jul 28, 2011 ... Although tamoxifen is the established drug for hormonal treatment of breast cancer, cases of .... This is a growth factor protein which is over‑expressed in different types of .... These groups of drugs act as receptor binding competitors of estrogens and ... Mechanism of Action of Selective Estrogen. Receptor ...

  17. Review of treatment modalities of malleolar fractures

    Directory of Open Access Journals (Sweden)

    Xinhao Li

    2015-01-01

    Full Text Available The frequency of malleolar fractures according to available literature data is about 40% of bone fractures, the majority of them are severe articular or compound fractures. The article covers the experience, accumulated by the generations of orthopedists concerning diagnostics, choice of efficient treatment, decrease of disability and improvement of patients' living standards.

  18. Chronic orchialgia: Review of treatments old and new

    OpenAIRE

    Tojuola, Bayo; Layman, Jeffrey; Kartal, Ibrahim; Gudelogul, Ahmet; Brahmbhatt, Jamin; Parekattil, Sijo

    2016-01-01

    Introduction: Chronic orchialgia is historically and currently a challenging disease to treat. It is a diagnostic and therapeutic challenge for physicians. Conservative therapy has served as the first line of treatment. For those who fail conservative therapy, surgical intervention may be required. We aim to provide a review of currently available surgical options and novel surgical treatment options. Methods: A review of current literature was performed using PubMed. Literature discussing...

  19. Surgical treatment of Chiari malformation: review and progress

    Directory of Open Access Journals (Sweden)

    ZHANG Yuan-zheng

    2012-08-01

    Full Text Available The surgical treatment of Chiari malformation (CM began in 1932. With the advance of medical technology, the surgical technique of CM is also in constant improvement. But due to its pathogenesis has not yet clear, there is no accepted optimal method, and different levels of the operation is still controversial. The author reviewed the concept, pathogenesis, diagnosis and surgical treatment of CM. The hot topics and new technological application were also reviewed in this article.

  20. Perbandingan Tinggi Tulang Maksila dan Mandibula di Regio Interisisivi Sentral antara Pra dan Pasca Perawatan Ortodontik dengan Pencabutan ke Empat Gigi Premolar Pertama (Kajian pada Foto Panoramik

    Directory of Open Access Journals (Sweden)

    Wayan Ardhana

    2012-12-01

    Full Text Available Latar belakang. Perawatan ortodontik pada kasus-kasus gigi berjejal dan protusif sering membutuhkan pencabutan gigi premolar untuk penyediaan ruang agar gigi berjejal dapat dirapikan dan gigi depan yang protusif dapat diundurkan. Gigi insisivus sentral merupakan salah satu gigi yang paling banyak mengalami pergerakan selama proses retrusi. Pergerakan gigi insisivus mengakibatkan terjadinya perubahan pada puncak tulang alveolar selama perawatan yang mungkin akan mempengaruhi tinggi tulang maksila dan mandibula pasca perawatan. Tujuan penelitian. Membandingkan tinggi tulang maksila dan mandibula di daerah interdental gigi insisivi sentral pada foto panoramic antara pra dan pasca perawatan maloklusi dengan pencabutan ke empat gigi premolar pertama. Metode penelitian. Digunakan 30 pasang foto panoramic pra dan pasca perawatan yang dipilih sesuai dengan kriteria penelitian dari pasien-pasien peneliti yang telah selesai mendapat perawatan aktif dengan teknik edgewise. Analisis Kolmogorov-Smirnov dan Shaviro-Wilk digunakan untuk uji normalitas dan Student t-test data berpasangan digunakan untuk menguji perbedaan tinggi tulang maksila dan mandibula antara pra dan pasca perawatan. Hasil Penelitian. Tidak didapatkan perbedaan (p>0,05 tinggi tulang maksila dan amndibula antara pra dan pasca perawatan ortodontik dengan pencabutan keempat gigi premolar pertama.   Background. In orthodontic treatment, premolar extractions are often needed in crowding and prostrusive cases to provide space for the teeth can be aligned and retracted to their desire position. Central incisor teeth are the teeth that mostly undergone more movement during retrusion. The change of the alveolar bone crest in this incisors might affect the maxillary and mandibular bone height post-treatment. Research objectives. The present study aimed to compare the bone height in the interdental maxillary and mandibular central incisors regions before and after orthodontic treatment with four

  1. A Review of Neurofeedback Treatment for Pediatric ADHD

    Science.gov (United States)

    Lofthouse, Nicholas; Arnold, L. Eugene; Hersch, Sarah; Hurt, Elizabeth; DeBeus, Roger

    2012-01-01

    Objective: The aim of this paper was to review all randomized published trials and unpublished conference presentations on the neurofeedback (NF) treatment of pediatric ADHD, and their relevance, strengths, and limitations. Method: Via PsychInfo and Medline searches and contacts with NF researchers 14 studies were identified and reviewed. Results:…

  2. Root resorption after orthodontic treatment: a review.

    Science.gov (United States)

    Jatania, Archana; Shivalinga, B M; Kiran, Jyothi

    2012-01-01

    Root resorption that occurs in permanent teeth is an unwanted process and is considered pathologic. Although apical root resorption occurs in individuals who have never experienced orthodontic tooth movement, the incidence among treated individuals is seen to be significantly higher. Some resorption occurs in most orthodontic patients, but because of repair the changes are difficult to detect with radiographic examination and therefore are clinically insignificant. This article gives a review of the various types of root resorption, the etiological factors, the biology and the identification of root resorption.

  3. Inhibition of Anaerobic Biological Treatment: A Review

    Science.gov (United States)

    Hou, Li; Ji, Dandan; Zang, Lihua

    2018-01-01

    Anaerobic digestion is a method for treating living and industrial wastewater by anaerobic degradation of organic compounds, which can produce biogas (carbon dioxide and methane mixture) and microbial biomass. And biogas as a renewable resource, can replace the use of ore fuel. In the process of anaerobic digestion, the problems of low methane yield and unstable reaction process are often encountered, which limits the widespread use of this technology. Various inhibitors are the main limiting factors for anaerobic digestion. In this paper, the main factors limiting anaerobic digestion are reviewed, and the latest research progress is introduced.

  4. Review : Pressure Ulcer and Its treatment

    Directory of Open Access Journals (Sweden)

    Bijan Khorasani

    2004-10-01

    Full Text Available Pressure ulcer is a signifcant problem in elderly and critically ill patients, causing pain, decreasing quality of life and leading to prolonged hospital stay. Treatment of pressure ulcer to improve health status is a cost-effective approach. So, preventing the ulcers will be economical. Pressure ulcer is considered as a damage or necrosis of skin and its layers, which happens when there is a considerable pressure over the tissues. If the capillary arterie's pressure reaches 70 mmHg (2 times more than the normal pressure pressure ulcer happens and depending on the depth of the ulcer, will be divided into 4 stages. The most important point for preventing the ulcers is reducing the pressure. Patients should be repositioned to relieve or minimize the tissue pressure. Considering the type of the ulcer, the necessary treatment (dressing, Antibiotic Therapy, debridement or surgery should be performed.

  5. Review : Pressure Ulcer and Its treatment

    OpenAIRE

    Bijan Khorasani; Ali Ghafouri

    2004-01-01

    Pressure ulcer is a signifcant problem in elderly and critically ill patients, causing pain, decreasing quality of life and leading to prolonged hospital stay. Treatment of pressure ulcer to improve health status is a cost-effective approach. So, preventing the ulcers will be economical. Pressure ulcer is considered as a damage or necrosis of skin and its layers, which happens when there is a considerable pressure over the tissues. If the capillary arterie's pressure reaches 70 mmHg (2 ti...

  6. Treatment of nasopharyngeal tumors: literature review

    International Nuclear Information System (INIS)

    Noel, G.; Dessard-Diana, B.; Vignot, S.; Mazeron, J.J.; Noel, G.; Mazeron, J.J.

    2002-01-01

    The conventional radiotherapy and the associated treatments improved the prognostic of nasopharyngeal cancer. A better selection of the patients who must have a more aggressive treatment also probably contributed to this improvement. Even if a relation could be found between the locoregional relapse rate and the distant relapse rate, these two events remain often independent. It results from it that the improvement of local control rate necessarily does not result in a better control of the disease. The patients with a locally advanced tumor, with or not an invasion of the base of the skull and/or neurological symptoms, must have an aggressive locally treatment. This probably includes the increase in dose delivered to the tumor via a more conformational radiotherapy, a brachytherapy, radiotherapy in stereotaxic conditions or other techniques. Dose within the tumor must be at least 70 Gy and the prophylactic nodal dose, at least 50 Gy. CT scan and MRI are essential for delineating the volumes of interest. The protocols of hyperfractionated radiotherapy did not give convincing results. Association with chemotherapy allowed, on the other hand, an improvement of the prognostic locally advanced cancers. Neo-adjuvant or adjuvant chemotherapy was largely used to attempt to limit the risks of systemic dissemination, but an improvement of results was not clearly demonstrated. An improvement of the rates of survival and control of the disease, on the other hand, was observed in a certain number of studies with the chemoradiotherapy. In the event of locoregional relapse, an aggressive attitude can allow the control of the disease in the absence of systemic dissemination. Salvage treatments are, however, disappointing for when distant relapse occurs which suggests. (author)

  7. Review of the optic neuritis treatment trial

    International Nuclear Information System (INIS)

    Chuman, Hideki

    2007-01-01

    The Optic Neuritis Treatment Trial (ONTT) is a multicenter controlled clinical trial. The primary objective of this trial is to assess the efficacy of corticosteroids in the treatment of optic neuritis. Treatment with intravenous methylprednisolone resulted in a more rapid return of the visual function to normal. Oral prednisone alone was associated with a significantly increased risk of recurrent optic neuritis. The trial also provided invaluable information about the clinical profile of optic neuritis and its relationship to Multiple Sclerosis (MS). At 6 months after the initial optic neuritis attack, a 12-month follow-up of patients was begun and the data collected during this period indicated that visual acuity was more than 20/20 in 69%, 20/40 in 93%, and 20/200 or less in only 3% of the patients. The risk of MS within 10 years after the first episode of optic neuritis was 56% among patients who were found to have had one or more characteristic white-matter lesions at baseline, as compared to only 22% for patients who had no observable lesions at baseline. (author)

  8. Treatments for esophageal cancer. A review

    International Nuclear Information System (INIS)

    Kato, Hiroyuki; Nakajima, Masanobu

    2013-01-01

    Esophageal cancer is the eighth most common form of cancer worldwide. The treatments for esophageal cancer depend on its etiology. For mucosal cancer, endoscopic mucosal resection and endoscopic submucosal dissection are standard, while for locally advanced cancer, esophagectomy remains the mainstay. The three most common techniques for thoracic esophagectomy are the transhiatal approach, the Ivor Lewis esophagectomy (right thoracotomy and laparotomy), and the McKeown technique (right thoracotomy followed by laparotomy and neck incision with cervical anastomosis). Surgery for carcinoma of the cervical esophagus requires an extensive procedure with laryngectomy in many cases. When the tumor is more advanced, neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy is added. The theoretical advantages of adding chemotherapy to the treatment of esophageal cancer are potential tumor down-staging prior to surgery, as well as targeting micrometastases and, thus, decreasing the risk of distant metastasis. Cisplatin- and 5-fluorouracil-based regimes are used worldwide. Chemoradiotherapy is the standard for unresectable esophageal cancer and could also be considered as an option for resectable tumors. For patients who are medically or technically inoperable, concurrent chemoradiotherapy should be the standard of care. Although neoadjuvant chemoradiotherapy followed by surgery or salvage surgery after definitive chemoradiotherapy is a practical treatment; judicious patient selection is crucial. It is important to have a thorough understanding of these therapeutic modalities to assist in this endeavor. (author)

  9. Anthracycline extravasation: a comprehensive review of experimental and clinical treatments

    DEFF Research Database (Denmark)

    Langer, S.W.; Sehested, M.; Jensen, P.B.

    2009-01-01

    , and is the only approved treatment against anthracyline extravasation. It is thus now widely recommended. The present article represents a comprehensive review of, and historical insight to, the experimental and clinical studies of surgical and non-surgical treatments of extravasation during forty years...

  10. SOLAR ENERGY APPLICATION IN WASTE TREATMENT- A REVIEW

    African Journals Online (AJOL)

    This review is an exposure on the various ways that solar energy can be harnessed for numerous waste treatment processes. Almost all forms of waste treatment require energy which is scarcely available considering the global energy crisis. The objective of this study is to enumerate the solar energy applications in waste ...

  11. Tooth wear : a systematic review of treatment options

    NARCIS (Netherlands)

    Muts, Erik-Jan; van Pelt, Hans; Edelhoff, Daniel; Krejci, Ivo; Cune, Marco

    2014-01-01

    STATEMENT OF PROBLEM: Treatment of tooth wear is increasing. Because no evidence-based guidelines are available, the clinician may have difficulties deciding which treatment option to choose to resolve complex situations. PURPOSE: The purpose of this systematic review was to identify similarities

  12. Chelation Treatment for Autism Spectrum Disorders: A Systematic Review

    Science.gov (United States)

    Davis, Tonya N.; O'Reilly, Mark; Kang, Soyeon; Lang, Russell; Rispoli, Mandy; Sigafoos, Jeff; Lancioni, Giulio; Copeland, Daelynn; Attai, Shanna; Mulloy, Austin

    2013-01-01

    Chelation treatment is used to eliminate specific metals from the body, such as mercury. It has been hypothesized that mercury poisoning may be a factor in autism and data suggest that perhaps 7% of individuals with autism spectrum disorder (ASD) have received chelation treatment. It would therefore seem timely to review studies investigating the…

  13. Mutation of praR in Rhizobium leguminosarum enhances root biofilms, improving nodulation competitiveness by increased expression of attachment proteins.

    Science.gov (United States)

    Frederix, Marijke; Edwards, Anne; Swiderska, Anna; Stanger, Andrew; Karunakaran, Ramakrishnan; Williams, Alan; Abbruscato, Pamela; Sanchez-Contreras, Maria; Poole, Philip S; Downie, J Allan

    2014-08-01

    In Rhizobium leguminosarum bv. viciae, quorum-sensing is regulated by CinR, which induces the cinIS operon. CinI synthesizes an AHL, whereas CinS inactivates PraR, a repressor. Mutation of praR enhanced biofilms in vitro. We developed a light (lux)-dependent assay of rhizobial attachment to roots and demonstrated that mutation of praR increased biofilms on pea roots. The praR mutant out-competed wild-type for infection of pea nodules in mixed inoculations. Analysis of gene expression by microarrays and promoter fusions revealed that PraR represses its own transcription and mutation of praR increased expression of several genes including those encoding secreted proteins (the adhesins RapA2, RapB and RapC, two cadherins and the glycanase PlyB), the polysaccharide regulator RosR, and another protein similar to PraR. PraR bound to the promoters of several of these genes indicating direct repression. Mutations in rapA2, rapB, rapC, plyB, the cadherins or rosR did not affect the enhanced root attachment or nodule competitiveness of the praR mutant. However combinations of mutations in rapA, rapB and rapC abolished the enhanced attachment and nodule competitiveness. We conclude that relief of PraR-mediated repression determines a lifestyle switch allowing the expression of genes that are important for biofilm formation on roots and the subsequent initiation of infection of legume roots. © 2014 The Authors. Molecular Microbiology published by John Wiley & Sons Ltd.

  14. Cutaneous lichen planus: A systematic review of treatments.

    Science.gov (United States)

    Fazel, Nasim

    2015-06-01

    Various treatment modalities are available for cutaneous lichen planus. Pubmed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database were searched for all the systematic reviews and randomized controlled trials related to cutaneous lichen planus. Two systematic reviews and nine relevant randomized controlled trials were identified. Acitretin, griseofulvin, hydroxychloroquine and narrow band ultraviolet B are demonstrated to be effective in the treatment of cutaneous lichen planus. Sulfasalazine is effective, but has an unfavorable safety profile. KH1060, a vitamin D analogue, is not beneficial in the management of cutaneous lichen planus. Evidence from large scale randomized trials demonstrating the safety and efficacy for many other treatment modalities used to treat cutaneous lichen planus is simply not available.

  15. Tennis injuries: prevention and treatment. A review.

    Science.gov (United States)

    Kulund, D N; McCue, F C; Rockwell, D A; Gieck, J H

    1979-01-01

    When players are engaged in the sport of tennis, injuries may occur to the eyes, in the neck, to the shoulder and back, arm and elbow, wrist and hand, and feet. The key to prevention and treatment of these injuries is good coaching and a formal stretching and strengthening program. The drooped "tennis shoulder" of professionals and senior tennis players is a natural response to heavy use. Shoulder elevating exercises are useful when soreness is associated. The treatment of tennis elbow includes wrist extensor stretching, isometrics, and light weightlifting. When a player follows this program, injections or counterforce braces are rarely needed. It is important for the player to bring his racket to the examination so that his stroke mechanics and grip can be checked. Wrist soreness in a tennis player may denote a hamate hook fracture. Special radiographic views are needed to discern the fracture and it is treated with a short arm cast and little finger extension splint. Nonunion of a hamate hook requires excision. The calf pain prodrome of "tennis leg" requires rest and then a stretching program. Tennis shoes should have rolled heels and large toe boxes with reinforced toe bumpers. The physician may have to fashion soft inserts for the tennis shoes; arch supports may be insufficient.

  16. A review of water treatment membrane nanotechnologies

    KAUST Repository

    Pendergast, MaryTheresa M.

    2011-01-01

    Nanotechnology is being used to enhance conventional ceramic and polymeric water treatment membrane materials through various avenues. Among the numerous concepts proposed, the most promising to date include zeolitic and catalytic nanoparticle coated ceramic membranes, hybrid inorganic-organic nanocomposite membranes, and bio-inspired membranes such as hybrid protein-polymer biomimetic membranes, aligned nanotube membranes, and isoporous block copolymer membranes. A semi-quantitative ranking system was proposed considering projected performance enhancement (over state-of-the-art analogs) and state of commercial readiness. Performance enhancement was based on water permeability, solute selectivity, and operational robustness, while commercial readiness was based on known or anticipated material costs, scalability (for large scale water treatment applications), and compatibility with existing manufacturing infrastructure. Overall, bio-inspired membranes are farthest from commercial reality, but offer the most promise for performance enhancements; however, nanocomposite membranes offering significant performance enhancements are already commercially available. Zeolitic and catalytic membranes appear reasonably far from commercial reality and offer small to moderate performance enhancements. The ranking of each membrane nanotechnology is discussed along with the key commercialization hurdles for each membrane nanotechnology. © 2011 The Royal Society of Chemistry.

  17. Radiation treatment of wastes: A review

    International Nuclear Information System (INIS)

    Feates, F.S.; George, D.

    1975-01-01

    Since 1945 over 70 papers have been published on various applications of radiation to waste treatment. Work carried out up to 1970 showed consistently that radiation is effective in degrading organic matter in wastes, destroying pathogenic organisms, and enhancing the sedimentation and filterability of sludges, but at a cost about ten times that of conventional treatment methods. Increased cost of energy, scarcity of potable water, environmental awareness and consequent legislation, and technical developments may be changing the picture. For example, ozone, already being widely used as an alternative to chlorine for sterilization, is claimed to be produced by gamma-irradiation of air or oxygen at half the cost of electrical methods. Radiation may solve specific problems associated with industrial wastes and evidence is reported of synergistic effects with oxygen and chlorine. In-situ reactivation of carbon used as an absorbent for textile dye wastes has been observed, and is being further studied. Prototype plant for complete sterilization of sewage sludge for use as fertilizer is in operation. Safety precautions necessary if large radiation sources are used by non-technical operatives will also be considered. (author)

  18. Review of iron oxides for water treatment

    International Nuclear Information System (INIS)

    Navratil, J. D.

    2001-01-01

    Many processes have utilized iron oxides for the treatment of liquid wastes containing radioactive and hazardous metals. These processes have included adsorption, precipitation and other chemical and physical techniques. For example, a radioactive wastewater precipitation process includes addition of a ferric hydroxide floc to scavenge radioactive contaminants, such as americium, plutonium and uranium. Some adsorption processes for wastewater treatment have utilized ferrites and a variety of iron containing minerals. Various ferrites and natural magnetite were used in batch modes for actinide and heavy metal removal from wastewater. Supported magnetite was also used in a column mode, and in the presence of an external magnetic field, enhanced capacity was found for removal of plutonium and americium from wastewater. These observations were explained by a nano-level high gradient magnetic separation effect, as americium, plutonium and other hydrolytic metals are known to form colloidal particles at elevated pHs. Recent modeling work supports this assumption and shows that the smaller the magnetite particle the larger the induced magnetic field around the particle from the external field. Other recent studies have demonstrated the magnetic enhanced removal of arsenic, cobalt and iron from simulated groundwater. (author)

  19. Constellation Probabilistic Risk Assessment (PRA): Design Consideration for the Crew Exploration Vehicle

    Science.gov (United States)

    Prassinos, Peter G.; Stamatelatos, Michael G.; Young, Jonathan; Smith, Curtis

    2010-01-01

    Managed by NASA's Office of Safety and Mission Assurance, a pilot probabilistic risk analysis (PRA) of the NASA Crew Exploration Vehicle (CEV) was performed in early 2006. The PRA methods used follow the general guidance provided in the NASA PRA Procedures Guide for NASA Managers and Practitioners'. Phased-mission based event trees and fault trees are used to model a lunar sortie mission of the CEV - involving the following phases: launch of a cargo vessel and a crew vessel; rendezvous of these two vessels in low Earth orbit; transit to th$: moon; lunar surface activities; ascension &om the lunar surface; and return to Earth. The analysis is based upon assumptions, preliminary system diagrams, and failure data that may involve large uncertainties or may lack formal validation. Furthermore, some of the data used were based upon expert judgment or extrapolated from similar componentssystemsT. his paper includes a discussion of the system-level models and provides an overview of the analysis results used to identify insights into CEV risk drivers, and trade and sensitivity studies. Lastly, the PRA model was used to determine changes in risk as the system configurations or key parameters are modified.

  20. MATILDA: A Military Laser Range Safety Tool Based on Probabilistic Risk Assessment (PRA) Techniques

    Science.gov (United States)

    2014-08-01

    3 2.1 UK Need for a PRA-Based Approach ............................................................... 3 2.2 A Risk-Based Approach to...Figure 6: MATILDA Coordinate Transformations ....................................................... 22  Figure 7: Geocentric and MICS Coordinates...Star-Shaped Condition ................................................................................. 27  Figure 11: Points of Closest Approach

  1. An integrated PRA module for fast determination of risk significance and improvement effectiveness

    International Nuclear Information System (INIS)

    Chao, Chun-Chang; Lin, Jyh-Der

    2004-01-01

    With the widely use of PRA technology in risk-informed applications, to predict the changes of CDF and LERF becomes a standard process for risk-informed applications. This paper describes an integrated PRA module prepared for risk-informed applications. The module contains a super risk engine, a super fault tree engine, an advanced PRA model and a tool for data base maintenance. The individual element of the module also works well for purpose other than risk-informed applications. The module has been verified and validated through a series of scrupulous benchmark tests with similar software. The results of the benchmark tests showed that the module has remarkable accuracy and speed even for an extremely large-size top-logic fault tree as well as for the case in which large amount of MCSs may be generated. The risk monitor for nuclear power plants in Taiwan is the first application to adopt the module. The results predicted by the risk monitor are now accepted by the regulatory agency. A tool to determine the risk significance according to the inspection findings will be the next application to adopt the module in the near future. This tool classified the risk significance into four different color codes according to the level of increase on CDF. Experience of application showed that the flexibility, the accuracy and speed of the module make it useful in any risk-informed applications when risk indexes must be determined by resolving a PRA model. (author)

  2. Introduction of accidental procedures in the event trees of the 900MW PWR PRA

    International Nuclear Information System (INIS)

    Bars, G.; Champ, M.; Lanore, J.M.; Pochard, R.

    1985-02-01

    This paper presents the example of the small LOCA Event Trees and the studies related to the introduction of procedure actions is case of HPSI failure. The results illustrate the interest of the approach and its significant impact on the PRA. The present studies are related to the Y actions in case of small LOCAs without HPIS

  3. Integrated thermal treatment systems study. Internal review panel report

    International Nuclear Information System (INIS)

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel

  4. Nuclear particles in cancer treatment: Brief review

    International Nuclear Information System (INIS)

    Raju, M.R.

    1990-01-01

    This report consist of comments in response to specific topics pertaining to temperature and radionuclides as requested by the Hanford Operations Office, US Atomic Energy Commission. These comments include scientific opinion and engineering judgment in addition to factual information. The material has been grouped in a convenient manner because of the relationships between topics but the reader is cautioned that this does not constitute complete treatment of the subjects outlined. The literature has been cited, particularly the recent reports, but the bibliography is by no means exhaustive. This report is based on material provided by Radiological Engineering and Water Plant and Utilities Engineering personnel of Irradiation processing Department; Biology Operation and Radiation Protection Operation personnel of Hanford Laboratories Operation

  5. Hydrogeochemical processes influencing groundwater quality within the Lower Pra Basin

    International Nuclear Information System (INIS)

    Tay, Collins

    2015-12-01

    Hydrogeochemical and social impact studies were carried out within the Lower Pra Basin where groundwater serves as a source of potable water supply to majority of the communities. The main objective of the study was to investigate the hydrogeochemical processes and the anthropogenic impact that influence groundwater as well as the perception of inhabitants about the impact of their socio-economic activities on the quality of groundwater and subsequently make recommendations towards proper management and development of groundwater resources within the basin. The methodology involved quarterly sampling of selected surface and groundwater sources between January 2011 and October 2012 for major ions, minor ions, stable isotopes of deuterium ( 2 H) and oxygen-18 ( 18 O) and trace metals analyses as well as administration of questionnaires designed to collect information on the socio-economic impact on the water resources within the basin. In all, a chemical data-base on three hundred and ninety seven (397) point sources was generated and three hundred (300) questionnaires were administered. The hydrochemical results show that, the major processes responsible for chemical evolution of groundwater include: silicate (SiO 4 ) 4- weathering, ion-exchange reactions, sea aerosol spray, the leaching of biotite, chlorite and actinolite. The groundwater is mildly acidic to neutral (pH 3.5 – 7.3) due principally to natural biogeochemical processes. Groundwater acidity studies show that, notwithstanding the moderately low pH, the groundwater still has the potential to neutralize acids due largely to the presence of silicates/aluminosilicates. Results of the Total Dissolved Solids (TDS) show that 98.6 % of groundwater is fresh (TDS < 500 mg/L). The relative abundance of cations and anions is in the order: Na + > Ca 2 + > Mg 2 + > K + and HCO 3 - > Cl - > SO 4 2- respectively. Stable isotopes results show that, the groundwater emanated primarily from meteoric origin with

  6. Treatment of Female Sexual Pain Disorders: A Systematic Review.

    Science.gov (United States)

    Al-Abbadey, Miznah; Liossi, Christina; Curran, Natasha; Schoth, Daniel E; Graham, Cynthia A

    2016-01-01

    Sexual pain disorders affect women's sexual and reproductive health and are poorly understood. Although many treatments have been evaluated, there is no one "gold standard" treatment. The aim of this systematic review was to investigate what treatments for female sexual pain have been evaluated in clinical studies and their effectiveness. The search strategy resulted in 65 papers included in this review. The articles were divided into the following categories: medical treatments; surgical treatments; physical therapies; psychological therapies; comparative treatment studies; and miscellaneous and combined treatments. Topical and systemic medical treatments have generally been found to lead to improvements in, but not complete relief of, pain, and side effects are quite common. Surgical procedures have demonstrated very high success rates, although there has been variability in complete relief of pain after surgery, which suggests less invasive treatments should be considered first. Physical therapies and psychological therapies have been shown to be promising treatments, supporting a biopsychosocial approach to sexual pain disorders. Although most of the interventions described have been reported as effective, many women still experience pain. A multidisciplinary team with active patient involvement may be needed to optimize treatment outcome.

  7. Manutenção de brinquedo em praças públicas

    Directory of Open Access Journals (Sweden)

    Fabio Namiki

    2007-12-01

    Full Text Available O artigo apresenta o jacaré, um dos brinquedos executados no âmbito do Programa Centros de Bairro, que foi responsável pela implantação de cerca de 50 praças na cidade de São Paulo entre 2002 e 2004. O conjunto dos brinquedos deste programa foi apresentado e analisado no mestrado “Manutenção de praças na cidade de São Paulo. Estudo de caso: brinquedos do programa Centros de Bairro”, segundo metodologia que pode ser também aplicada para outros componentes de uma praça e mesmo para a praça em si. Espera-se que esta metodologia sirva como instrumento para o planejamento das ações de manutenção de praças e de mobiliários urbanos de modo geral. Neste texto, são apresentadas informações (da mesma forma que seriam em um manual de uso, operação e manutenção do projeto do brinquedo, obtidas junto aos responsáveis pelo programa, em entrevista com o executor dos brinquedos e através dos desenhos e documentos produzidos para a licitação e execução das peças. São também apresentadas as informações obtidas a partir das inspeções a campo e estimativas do custo de manutenção preventiva. Frente ao custo de reposição de um brinquedo novo, os valores da manutenção nos provam a importância econômica de tais ações.

  8. Applications of Living Fire PRA models to Fire Protection Significance Determination Process in Taiwan

    International Nuclear Information System (INIS)

    De-Cheng, Chen; Chung-Kung, Lo; Tsu-Jen, Lin; Ching-Hui, Wu; Lin, James C.

    2004-01-01

    The living fire probabilistic risk assessment (PRA) models for all three operating nuclear power plants (NPPs) in Taiwan had been established in December 2000. In that study, a scenario-based PRA approach was adopted to systematically evaluate the fire and smoke hazards and associated risks. Using these fire PRA models developed, a risk-informed application project had also been completed in December 2002 for the evaluation of cable-tray fire-barrier wrapping exemption. This paper presents a new application of the fire PRA models to fire protection issues using the fire protection significance determination process (FP SDP). The fire protection issues studied may involve the selection of appropriate compensatory measures during the period when an automatic fire detection or suppression system in a safety-related fire zone becomes inoperable. The compensatory measure can either be a 24-hour fire watch or an hourly fire patrol. The living fire PRA models were used to estimate the increase in risk associated with the fire protection issue in terms of changes in core damage frequency (CDF) and large early release frequency (LERF). In compliance with SDP at-power and the acceptance guidelines specified in RG 1.174, the fire protection issues in question can be grouped into four categories; red, yellow, white and green, in accordance with the guidelines developed for FD SDP. A 24-hour fire watch is suggested only required for the yellow condition, while an hourly fire patrol may be adopted for the white condition. More limiting requirement is suggested for the red condition, but no special consideration is needed for the green condition. For the calculation of risk measures, risk impacts from any additional fire scenarios that may have been introduced, as well as more severe initiating events and fire damages that may accompany the fire protection issue should be considered carefully. Examples are presented in this paper to illustrate the evaluation process. (authors)

  9. PPoma Review: Epidemiology, Aetiopathogenesis, Prognosis and Treatment

    Directory of Open Access Journals (Sweden)

    Thais Ligiero Braga

    2018-01-01

    Full Text Available Generally, pancreatic polypeptide-secreting tumor of the distal pancreas (PPoma is classified as a rare tumor, and may occur sporadically or be associated in families or with multiple endocrine neoplasia type 1 (NEM 1. It grows slowly, reaching large dimensions at the time of diagnosis and the symptomatology is fundamentally due to the mass effect, causing either non-specific abdominal pain or symptoms suggestive of obstruction of the pancreatic or biliary duct. Therefore, when detected, they are usually malignant, with metastases mainly in the liver. The combination of serum analysis of increased levels of chromogranin A and pancreatic polypeptide and pancreastatin is very useful with a sensitivity of up to 95%. However, in addition, scintigraphicexams with somatostatin analogues should be performed to better clarify the diagnosis. Surgical resection is the treatment of choice, despite surgical difficulty and because they are generally palliative due to the metastases. Surgeries for tumor volume reduction are also performed to relieve symptoms. Chemotherapy commonly uses streptozotocin and somatostatin analogues to treat residual disease. Unfortunately, the survival rates are still very low, less than 10%, and if metastases already exist, this percentage drops to 3%.

  10. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  11. Review of the integrated thermal and nonthermal treatment system studies

    International Nuclear Information System (INIS)

    1996-08-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

  12. Amitriptyline for the treatment of fibromyalgia: a comprehensive review.

    Science.gov (United States)

    Rico-Villademoros, Fernando; Slim, Mahmoud; Calandre, Elena P

    2015-10-01

    Fibromyalgia is characterized by chronic generalized pain accompanied by a wide range of clinical manifestations. Most clinical practice guidelines recommend multidisciplinary treatment using a combination of pharmacological and non-pharmacological therapies. The tricyclic antidepressant amitriptyline has been most thoroughly studied in fibromyalgia. Amitriptyline has been evaluated in placebo-controlled studies, and it has served as an active comparator to other therapeutic interventions in the treatment of fibromyalgia. In addition, several systematic reviews and meta-analyses have evaluated its efficacy and safety for the treatment of fibromyalgia. Data from individual studies as well as from systematic reviews indicate that low doses (10-75 mg/day) of amitriptyline are effective for the treatment of fibromyalgia and, despite the limited quality of the data, they do not seem to be associated with relevant tolerability or safety issues. Consistent with some clinical guidelines, we believe amitriptyline in low doses should be considered a first-line drug for the treatment of fibromyalgia.

  13. [Updated treatment of peritoneal carcinomas: a review].

    Science.gov (United States)

    Deraco, M; Laterza, B; Kusamura, S; Baratti, D

    2007-12-01

    Peritoneal surface malignancy (PSM) is a clinical entity with an unfavourable prognosis, which characterizes the evolution of neoplastic diseases from the abdominal and/or pelvic organs and could also be the terminal stage of extra-abdominal tumors. Examples of diseases that can spread mainly within the peritoneal cavity are appendiceal tumors, ovarian cancer, colorectal cancer, abdominal sarcomatosis, gastric cancer and peritoneal mesothelioma. The locoregional therapy is defined as the combination of cytoreductive surgery (CRS) and intraperitoneal hyperthermic perfusion (IPHP). The rationale of this combined therapy for PSM is based on the natural history of this clinical entity that remains confined in the peritoneal cavity for most of its natural history. This pattern of spread would seem to indicate the potential usefulness of selectively increasing drug concentration in the tumour-bearing area by direct intraperitoneal chemotherapy instillation. This approach led to these outcomes: the median survival of colorectal carcinoma and ovarian cancer was 32 months; patients with peritoneal mesothelioma showed 57% survival at 5 years, while in patients with appendiceal mucinous tumors and pseudomyxoma peritonei (PMP) the 10 years overall survival was 78%. A significant improvement in survival was associated with hyperthermic intra-peritoneal chemotherapy (HIPEC) in patients with gastric cancer. Considering the constant increasing of diseases treatable with this procedure, more centres should be activated. The establishment of a clear policy and scientific guidelines is mandatory, in order to perform the CRS+HIPEC safely, minimizing treatment-related morbidity and mortality and maximizing the results in terms of survival and quality of life.

  14. Sportsman hernia; the review of current diagnosis and treatment modalities.

    Science.gov (United States)

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.

  15. Paresthesia during orthodontic treatment: case report and review.

    Science.gov (United States)

    Monini, André da Costa; Martins, Renato Parsekian; Martins, Isabela Parsekian; Martins, Lídia Parsekian

    2011-10-01

    Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.

  16. The Evaluation of the Adequacy of PRA Results for Risk-informed Decision Makings With Respect to Incompleteness

    International Nuclear Information System (INIS)

    Kang, Kyungmin; Jae, Moosung

    2007-01-01

    PRA(Probabilistic Risk Assessment), as a quantitative tool, has many strengths as well as weaknesses. There are several limitations on the use of PRA techniques for risk modeling and analysis. First, the true values of most model inputs are unknown. Ideally, probability distribution models are well developed and assigned to the unknown input parameters to reflect the analyst's state of knowledge of the values of this input parameter. The problem of overconfidence and lack of confidence in the values of certain model input parameters can lead to inaccurate PRA results. Secondly, the analyst's lack of knowledge of a system's practical application as opposed to its theoretical operation can lead to modeling errors. The quality of PRAs has been addressed by a number of regulatory and industry organizations Some have argued that a good PRA should be a complete, full scope, three level PRA, while others have claimed that the quality of a PRA should be measured with respect to the application and decision supported. we show by way of an example that the adequacy of a PRA results is important to risk-informed decision making process and should be measured with respect to the application and decision supported

  17. PRA research and the development of risk-informed regulation at the U.S. nuclear regulatory commission

    International Nuclear Information System (INIS)

    Siu, Nathan; Collins, Dorothy

    2008-01-01

    Over the years, Probabilistic Risk Assessment (PRA) research activities conducted at the U.S. Nuclear Regulatory Commission (NRC) have played an essential role in support of the agency's move towards risk-informed regulation. These research activities have provided the technical basis for NRC's regulatory activities in key areas; provided PRA methods, tools, and data enabling the agency to meet future challenges; supported the implementation of NRC's 1995 PRA Policy Statement by assessing key sources of risk; and supported the development of necessary technical and human resources supporting NRC's risk-informed activities. PRA research aimed at improving the NRC's understanding of risk can positively affect the agency's regulatory activities, as evidenced by three case studies involving research on fire PRA, Human Reliability Analysis (HRA), and Pressurized Thermal Shock (PTS) PRA. These case studies also show that such research can take a considerable amount of time, and that the incorporation of research results into regulatory practice can take even longer. The need for sustained effort and appropriate lead time is an important consideration in the development of a PRA research program aimed at helping the agency address key sources of risk for current and potential future facilities

  18. Probabilistic risk assessment (PRA) update in light of the accident at Fukushima Daiichi Nuclear Power Station - 15461

    International Nuclear Information System (INIS)

    Maeda, K.; Abe, H.; Hirokawa, N.; Satou, C.

    2015-01-01

    We have performed internal and external event probabilistic risk assessments (PRA) for boiling water reactor power nuclear plants to identify the important accident sequence groups and to evaluate the effectiveness of the additional severe accident measures, regarding to the new regulatory requirements implemented after the accident at Fukushima Daiichi Nuclear Power Station in Japan in 2011. In addition, we will further update our PRA by extracting problems and improvements from the current PRA, by catching up the state-of-the-art knowledge, modern PRA methodologies in order to contribute voluntarily to safety improvement as well as to comply with regulations. In this document, prior to the extensive PRA updates, we would describe technical contents and qualitative results about PRA updates that have been performed preliminary so far, especially about the external event (seismic) PRA and how to model the additionally deployed severe accident measures (e.g. power supply car, fire engine) so that they can be function external hazards, such as component failure rate of equipment, human reliability 'out of control room', and mission time extension. (authors)

  19. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  20. Review of the integrated thermal and nonthermal treatment system studies

    International Nuclear Information System (INIS)

    1996-01-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

  1. Treatment, Therapy and Management of Metabolic Epilepsy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Vanessa Lin Lin Lee

    2018-03-01

    Full Text Available Metabolic epilepsy is a metabolic abnormality which is associated with an increased risk of epilepsy development in affected individuals. Commonly used antiepileptic drugs are typically ineffective against metabolic epilepsy as they do not address its root cause. Presently, there is no review available which summarizes all the treatment options for metabolic epilepsy. Thus, we systematically reviewed literature which reported on the treatment, therapy and management of metabolic epilepsy from four databases, namely PubMed, Springer, Scopus and ScienceDirect. After applying our inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, we reviewed a total of 43 articles. Based on the reviewed articles, we summarized the methods used for the treatment, therapy and management of metabolic epilepsy. These methods were tailored to address the root causes of the metabolic disturbances rather than targeting the epilepsy phenotype alone. Diet modification and dietary supplementation, alone or in combination with antiepileptic drugs, are used in tackling the different types of metabolic epilepsy. Identification, treatment, therapy and management of the underlying metabolic derangements can improve behavior, cognitive function and reduce seizure frequency and/or severity in patients.

  2. Challenges when performing economic optimization of waste treatment: A review

    DEFF Research Database (Denmark)

    Juul, Nina; Münster, Marie; Ravn, H.

    2013-01-01

    -criteria analysis have been developed.A thorough updated review of the existing models is presented, and the main challenges and crucial parameters that need to be taken into account when assessing the economic performance of waste treatment alternatives are identified. The review article will assist both policy...... example, but models focusing on energy production have also been developed, as well as models which take into account a plant’s economies of scale, environmental impact, material recovery and social costs. Finally, models combining different criteria for the selection of waste treatment methods in multi...

  3. Considering resistance in systematic reviews of antibiotic treatment.

    Science.gov (United States)

    Leibovici, Leonard; Soares-Weiser, Karla; Paul, Mical; Goldberg, Elad; Herxheimer, Andrew; Garner, Paul

    2003-10-01

    Microorganisms resistant to antibiotic drugs are a threat to the health and chances of survival of patients. Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences. To examine whether systematic reviews of antibiotic treatment consider resistance; if not, to find out whether data on resistance were reported in the original trials; and based on that, to offer a framework for taking resistance into account in systematic reviews. The Cochrane Database of Systematic Reviews (the Cochrane Library, 2001, issue 2); and MEDLINE, 1996-2000. (i) Systematic reviews or meta-analyses of antimicrobial therapy, published during 1996-2000. (ii) Randomized, controlled trials abstracted in systematic reviews that addressed a topic highly relevant to antibiotic resistance. We examined each systematic review, and each article, to see whether the implications of resistance were discussed; and whether data on resistance were collected. Out of 111 systematic reviews, only 44 (40%) discussed resistance. Ten reviews (9%) planned or performed collection of data on the response of patients with susceptible or resistant isolates. In 22 systematic reviews (20%), collection of data on induction of resistance was planned or performed. The topic of 41 reviews was judged highly relevant to resistance, and these reviews extracted data from 337 articles, out of which we retrieved 279 articles (83%). In 201 (72%) articles, resistance was discussed or data pertaining to it were collected. Ninety-seven articles (35%) gave actual data on resistance of pathogens to the study drugs, 71 articles (25%) data on efficacy of antibiotic drugs in patients with susceptible and resistant pathogens, and 55 articles (20%) provided data on infection or colonization with resistant strains during treatment. Most systematic reviews on antibiotic treatment ignored the issue of

  4. Review process and quality assurance in the EBR-II probabilistic risk assessment

    International Nuclear Information System (INIS)

    Roglans, J.; Hill, D.J.; Ragland, W.A.

    1992-01-01

    A Probabilistic Risk Assessment (PRA) of the Experimental Breeder Reactor II (EBR-II), a Department of Energy (DOE) Category A reactor, has recently been completed at Argonne National Laboratory (ANL). Within the scope of the ANL QA Programs, a QA Plan specifically for the EBR-II PRA was developed. The QA Plan covered all aspects of the PRA development, with emphasis on the procedures for document and software control, and the internal and external review process. The effort spent in the quality assurance tasks for the EBR-II PRA has reciprocated by providing acceptance of the work and confidence in the quality of the results

  5. Pharmacological treatment of chronic constipation: a literature review

    Directory of Open Access Journals (Sweden)

    Roshanak Salari

    2016-07-01

    Full Text Available Chronic constipation is a very common disease that is particularly commonplace among members of the elderly population. It is one of the most widespread bowel disorders, and it causes significant pain and discomfort; as such, it usually requires medical attention. The major causes of constipation are slow colonic movements and/or functional gastrointestinal disorders. This review aimed to examine the pharmacological treatments that are currently available for chronic constipation. To develop insights into the causes and treatments of chronic constipation, relevant review articles that were published on the Pubmed, Cochrane database, and Embase websites, were examined. The outputs of these studies indicated that high daily intake of fibers and fluids in addition to regular exercise can be very helpful in avoiding and treating constipation. The pharmacological treatments that are administered to treat this disease typically increase the water content of the bowel lumen, and this leads to more regular bowel movements. Novel drugs have been introduced to treat constipation, and many of these are now subject to formal research studies. Since constipation can facilitate the development of other gastrointestinal diseases, it is important that we develop an understanding the therapeutic treatments that are available with the intention of identifying which of these may represent the most effective method for treating this disease. With that objective in mind, this review was undertaken to review the clinical effectiveness of the different pharmacological treatments that are employed to treat or prevent constipation.

  6. Review of Saccharomyces boulardii as a treatment option in IBD

    DEFF Research Database (Denmark)

    Sivananthan, Kavitha; Petersen, Andreas Munk

    2018-01-01

    CONTEXT: Review of the yeast Saccharomyces boulardii as a treatment option for the inflammatory bowel diseases (IBD) ulcerative colitis and Crohn's disease. OBJECTIVE: IBD is caused by an inappropriate immune response to gut microbiota. Treatment options could therefore be prebiotics, probiotics......, antibiotics and/or fecal transplant. In this review, we have looked at the evidence for the yeast S. boulardii as a treatment option. MATERIAL AND METHODS: Searches in PubMed and the Cochrane Library with the MeSH words 'Saccharomyces boulardii AND IBD', 'Saccharomyces boulardii AND Inflammatory Bowel Disease....... Saccharomyces boulardii is, however, a plausible treatment option in the future, but more placebo-controlled clinical studies on both patients with ulcerative colitis and Crohn's disease are needed....

  7. Review of Topical Treatment of Upper Tract Urothelial Carcinoma

    Directory of Open Access Journals (Sweden)

    Kenneth G. Nepple

    2009-01-01

    Full Text Available A select group of patients with upper tract urothelial carcinoma may be appropriate candidates for minimally invasive management. Organ-preserving endoscopic procedures may be appropriate for patients with an inability to tolerate major surgery, solitary kidney, bilateral disease, poor renal function, small tumor burden, low-grade disease, or carcinoma in situ. We review the published literature on the use of topical treatment for upper tract urothelial carcinoma and provide our approach to treatment in the office setting.

  8. Challenges when performing economic optimization of waste treatment: A review

    International Nuclear Information System (INIS)

    Juul, N.; Münster, M.; Ravn, H.; Söderman, M. Ljunggren

    2013-01-01

    Highlights: • Review of main optimization tools in the field of waste management. • Different optimization methods are applied. • Different fractions are analyzed. • There is focus on different parameters in different geographical regions. • More research is needed which encompasses both recycling and energy solutions. - Abstract: Strategic and operational decisions in waste management, in particular with respect to investments in new treatment facilities, are needed due to a number of factors, including continuously increasing amounts of waste, political demands for efficient utilization of waste resources, and the decommissioning of existing waste treatment facilities. Optimization models can assist in ensuring that these investment strategies are economically feasible. Various economic optimization models for waste treatment have been developed which focus on different parameters. Models focusing on transport are one example, but models focusing on energy production have also been developed, as well as models which take into account a plant’s economies of scale, environmental impact, material recovery and social costs. Finally, models combining different criteria for the selection of waste treatment methods in multi-criteria analysis have been developed. A thorough updated review of the existing models is presented, and the main challenges and crucial parameters that need to be taken into account when assessing the economic performance of waste treatment alternatives are identified. The review article will assist both policy-makers and model-developers involved in assessing the economic performance of waste treatment alternatives

  9. Challenges when performing economic optimization of waste treatment: A review

    Energy Technology Data Exchange (ETDEWEB)

    Juul, N., E-mail: njua@dtu.dk [DTU Management, Risø Campus, Technical University of Denmark (Denmark); Münster, M., E-mail: maem@dtu.dk [DTU Management, Risø Campus, Technical University of Denmark (Denmark); Ravn, H., E-mail: hans.ravn@aeblevangen.dk [RAM-løse edb, Æblevangen 55, 2765 Smørum (Denmark); Söderman, M. Ljunggren, E-mail: maria.ljunggren@chalmers.se [Energy and Environment, Chalmers University of Technology, Gothenburg (Sweden); IVL Swedish Environmental Research Institute, Gothenburg (Sweden)

    2013-09-15

    Highlights: • Review of main optimization tools in the field of waste management. • Different optimization methods are applied. • Different fractions are analyzed. • There is focus on different parameters in different geographical regions. • More research is needed which encompasses both recycling and energy solutions. - Abstract: Strategic and operational decisions in waste management, in particular with respect to investments in new treatment facilities, are needed due to a number of factors, including continuously increasing amounts of waste, political demands for efficient utilization of waste resources, and the decommissioning of existing waste treatment facilities. Optimization models can assist in ensuring that these investment strategies are economically feasible. Various economic optimization models for waste treatment have been developed which focus on different parameters. Models focusing on transport are one example, but models focusing on energy production have also been developed, as well as models which take into account a plant’s economies of scale, environmental impact, material recovery and social costs. Finally, models combining different criteria for the selection of waste treatment methods in multi-criteria analysis have been developed. A thorough updated review of the existing models is presented, and the main challenges and crucial parameters that need to be taken into account when assessing the economic performance of waste treatment alternatives are identified. The review article will assist both policy-makers and model-developers involved in assessing the economic performance of waste treatment alternatives.

  10. Treatment modalities of palmoplantar lichen planus: a brief review.

    Science.gov (United States)

    Feily, Amir; Yaghoobi, Reza; Nilforoushzadeh, Mohammad Ali

    2016-12-01

    Palmoplantar lichen planus is a localized and uncommon variant of lichen planus which is mostly resistant to treatment. Our purpose was to discuss all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. A systematic review of the literature was conducted to evaluate evidence regarding all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. Two major databases (PubMed, Google scholar) were searched. The review included all case reports, letters and original articles reporting any treatment for palmoplantar lichen planus but not treatment used in the other type of lichen planus, generalized lichen planus or other type of palmoplantar dermatoses. We have gone over more than 50 articles. There are many drugs that have been used in the treatment of lichen planus and generalized lichen planus but the palmoplantar type is a rare variety of lichen planus. That is why we could not find any clinical trial on the subject and just case reports have been described in this manuscript. In spite of plentiful investigations carried out on lichen planus, there is no treatment modality that has proved to be utterly satisfactory in treatment of palmoplantar lichen planus.

  11. Paediatric gastrostomy stoma complications and treatments: A rapid scoping review.

    Science.gov (United States)

    Townley, Ashleigh; Wincentak, Joanne; Krog, Kim; Schippke, Julia; Kingsnorth, Shauna

    2018-04-01

    To provide a scoping review of the types of treatments used to address paediatric skin-related stoma complications specific to infection, hypergranulation and gastric leakage, and explore their effectiveness and indications for use. Stoma-related complications can be a common occurrence for children with gastrostomy (G) and gastrojejunostomy (GJ) tubes. Nurses require guidance to inform decision-making of the broad spectrum of treatments used in clinical practice. A scoping review using a rapid review approach. Working with a multidisciplinary health professional team, search terms were generated. A systematic search of CINAHL, MEDLINE and EMBASE databases was completed, coupled with an Internet search to identify relevant clinical practice guidelines and hand searching of citation lists. Eligible articles were peer-reviewed English publications, focused on paediatric populations aged 18 years and under, dating from 2002-2016 and described complications and treatment approaches related to G- and GJ-tube stomas. Pertinent information was extracted using a standardised template, and a narrative synthesis approach was used to analyse the data. Twenty-five articles were included in this review. Study designs varied, and complication management was often a secondary focus. A broad spectrum of treatments was used to manage each complication type. There was a lack of consensus on lines of therapy; however, a stepwise approach was often used for complication management, particularly for infections. The evidence on the comparative effectiveness of different treatment strategies of skin-related gastrostomy stoma complications in paediatric practice is sparse. Current evidence is generally limited to expert opinions. Future studies examining efficacy of treatments and their indications for use with children are warranted. Effective management of skin-related stoma complications is important to maintain health and wellness among children who rely on G- and GJ-tubes for

  12. Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews.

    Science.gov (United States)

    Parker, Jacqui A; Barroso, Filipa; Stanworth, Simon J; Spiby, Helen; Hopewell, Sally; Doree, Carolyn J; Renfrew, Mary J; Allard, Shubha

    2012-06-24

    Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

  13. Review on clinical trials of targeted treatments in malignant mesothelioma

    DEFF Research Database (Denmark)

    Jakobsen, Jan Nyrop; Sørensen, Jens Benn

    2011-01-01

    Malignant mesothelioma (MM) is an aggressive tumor of the serosal surfaces with a poor prognosis. Advances in the understanding of tumor biology have led to the development of several targeted treatments, which have been evaluated in clinical trials. This article is a comprehensive review of all...

  14. Review of hormonal treatment of breast cancer | Abdulkareem ...

    African Journals Online (AJOL)

    This critical review focuses on the role of steroid hormones and their receptors in the development and treatment of breast cancer, with special reference to estrogen receptors, as well as mechanisms of receptor.ligand interactions, response or resistance to hormonal therapy against breast cancer, in conjunction with other ...

  15. A review of current investigations and treatment modalities of the ...

    African Journals Online (AJOL)

    Infertility of the couple is a major health problem in Africa, affecting between 37- 66% of women of childbearing age in some regions of the continent. Because of the high cost of evaluation, a good history and thorough physical examination will narrow the investigations necessary for treatment. This paper briefly reviews the ...

  16. Treatment of uranium contaminated wastewater – a review

    International Nuclear Information System (INIS)

    Dulama, M.; Iordache, M.; Deneanu, N.

    2013-01-01

    The paper presents a study of the treatment techniques used for uranium recovery from aqueous solutions, such as: precipitation, ion exchange processes, sorption processes, solvent extractions, separation by liquid membrane, nanofiltration and reverse osmosis. The necessary elements for rigorous treatment experiments that can be used to define innovative procedure for uranium contaminated wastewater treatment are described in this review. The published data were summarized and the areas for further research were identified in order to be able to propose an environmental friendly technology in the field of uranium production and recovery cycle. (authors)

  17. Constructed wetlands for wastewater treatment in cold climate - A review.

    Science.gov (United States)

    Wang, Mo; Zhang, Dong Qing; Dong, Jian Wen; Tan, Soon Keat

    2017-07-01

    Constructed wetlands (CWs) have been successfully used for treating various wastewaters for decades and have been identified as a sustainable wastewater management option worldwide. However, the application of CW for wastewater treatment in frigid climate presents special challenges. Wetland treatment of wastewater relies largely on biological processes, and reliable treatment is often a function of climate conditions. To date, the rate of adoption of wetland technology for wastewater treatment in cold regions has been slow and there are relatively few published reports on CW applications in cold climate. This paper therefore highlights the practice and applications of treatment wetlands in cold climate. A comprehensive review of the effectiveness of contaminant removal in different wetland systems including: (1) free water surface (FWS) CWs; (2) subsurface flow (SSF) CWs; and (3) hybrid wetland systems, is presented. The emphasis of this review is also placed on the influence of cold weather conditions on the removal efficacies of different contaminants. The strategies of wetland design and operation for performance intensification, such as the presence of plant, operational mode, effluent recirculation, artificial aeration and in-series design, which are crucial to achieve the sustainable treatment performance in cold climate, are also discussed. This study is conducive to further research for the understanding of CW design and treatment performance in cold climate. Copyright © 2017. Published by Elsevier B.V.

  18. Treatment modalities for burning mouth syndrome: a systematic review.

    Science.gov (United States)

    de Souza, Isadora Follak; Mármora, Belkiss Câmara; Rados, Pantelis Varvaki; Visioli, Fernanda

    2018-06-01

    In the burning mouth syndrome (BMS), patients experience a burning sensation in the oral cavity with no associated injury or clinical manifestation. The etiology of this condition is still poorly understood, and therefore, treatment is challenging. The aim of this study is to perform a systematic review of treatment possibilities described in the literature for BMS. PubMed, Embase, and SciELO databases were searched for randomized clinical trials published between 1996 and 2016. Following application of inclusion and exclusion criteria, 29 papers were analyzed and divided into five subcategories according to the type of treatment described: antidepressants, alpha-lipoic acid, phytotherapeutic agents, analgesic and anti-inflammatory agents, and non-pharmacological therapies. In each category, the results found were compared with regard to the methodology employed, sample size, assessment method, presence or absence of adverse effects, and treatment outcomes. The analysis revealed that the use of antidepressants and alpha-lipoic acid has been showing promising results; however, more studies are necessary before we can have a first-line treatment strategy for patients with BMS. To review systematically the literature about Burning Mouth Syndrome treatment may aid the clinicians to choose the treatment modality to improve patients symptoms based on the best evidence.

  19. Development of fire PRA methodologies for the analysis of typical Italian NPP designs

    International Nuclear Information System (INIS)

    Silvestri, E.; Dore, B.; Ferro, G.; Apostolakis, G.

    1987-01-01

    To compute fire induced Core Melt probability, the results of hazard and propagation analyses were combined with the Core Melt frequency computed for the initiating event and the support state as determined by the fire considered. From the PRA for internal event, the average value of this frequency was found 2.5x10 -3 event/year. Using the average fire frequency the resulting fire induced Core Melt frequency is 1.4x10 -8 event/year. Although high separation of safety systems is required in Italian PWR plants, the frequency of fire induced Core Melt can reach values not negligible with respect to Italian safety standards. For this reason, fire PRA studies for the entire plant are considered necessary and should be performed with appropriate modifications of the methods used for the American plants in order to be able to estimate lower fire induced Core Melt frequencies. (orig./HP)

  20. A PRA case study of extended long term decay heat removal for shutdown risk assessment

    International Nuclear Information System (INIS)

    Roglans, J.; Ragland, W.A.; Hill, D.J.

    1992-01-01

    A Probabilistic Risk Assessment (PRA) of the Experimental Breeder Reactor II (EBR-II), a Department of Energy (DOE) Category A research reactor, has recently been completed at Argonne National Laboratory (ANL). The results of this PRA have shown that the decay heat removal system for EBR-II is extremely robust and reliable. In addition, the methodology used demonstrates how the actions of other systems not normally used for actions of other systems not normally used for decay heat removal can be used to expand the mission time of the decay heat removal system and further increase its reliability. The methodology may also be extended to account for the impact of non-safety systems in enhancing the reliability of other dedicated safety systems

  1. Methodology and application of surrogate plant PRA analysis to the Rancho Seco Power Plant: Final report

    International Nuclear Information System (INIS)

    Gore, B.F.; Huenefeld, J.C.

    1987-07-01

    This report presents the development and the first application of generic probabilistic risk assessment (PRA) information for identifying systems and components important to public risk at nuclear power plants lacking plant-specific PRAs. A methodology is presented for using the results of PRAs for similar (surrogate) plants, along with plant-specific information about the plant of interest and the surrogate plants, to infer important failure modes for systems of the plant of interest. This methodology, and the rationale on which it is based, is presented in the context of its application to the Rancho Seco plant. The Rancho Seco plant has been analyzed using PRA information from two surrogate plants. This analysis has been used to guide development of considerable plant-specific information about Rancho Seco systems and components important to minimizing public risk, which is also presented herein

  2. Advanced Small Modular Reactor (SMR) Probabilistic Risk Assessment (PRA) Technical Exchange Meeting

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Curtis [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-09-01

    During FY13, the INL developed an advanced SMR PRA framework which has been described in the report Small Modular Reactor (SMR) Probabilistic Risk Assessment (PRA) Detailed Technical Framework Specification, INL/EXT-13-28974 (April 2013). In this framework, the various areas are considered: Probabilistic models to provide information specific to advanced SMRs Representation of specific SMR design issues such as having co-located modules and passive safety features Use of modern open-source and readily available analysis methods Internal and external events resulting in impacts to safety All-hazards considerations Methods to support the identification of design vulnerabilities Mechanistic and probabilistic data needs to support modeling and tools In order to describe this framework more fully and obtain feedback on the proposed approaches, the INL hosted a technical exchange meeting during August 2013. This report describes the outcomes of that meeting.

  3. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

    1996-07-01

    This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications.

  4. Review of Saccharomyces boulardii as a treatment option in IBD.

    Science.gov (United States)

    Sivananthan, Kavitha; Petersen, Andreas Munk

    2018-05-17

    Review of the yeast Saccharomyces boulardii as a treatment option for the inflammatory bowel diseases (IBD) ulcerative colitis and Crohn's disease. IBD is caused by an inappropriate immune response to gut microbiota. Treatment options could therefore be prebiotics, probiotics, antibiotics and/or fecal transplant. In this review, we have looked at the evidence for the yeast S. boulardii as a treatment option. Searches in PubMed and the Cochrane Library with the MeSH words 'Saccharomyces boulardii AND IBD', 'Saccharomyces boulardii AND Inflammatory Bowel Disease', 'Saccharomyces boulardii AND ulcerative colitis' and 'Saccharomyces boulardii AND Crohn's disease' gave total a total of 80 articles. After exclusions because of irrelevance, articles in other languages and some articles that were not available, 16 articles were included in this review. Three of the clinical trials showed a positive effect of S. boulardii in IBD patients (two Crohn's disease, one ulcerative colitis), while there was one trial that didn't prove any effect (Crohn's disease). Included Animal trials and cell assays describes different anti-inflammatory mechanisms of S. boulardii supporting a possible effect when treating IBD patients. The number of studies of S. boulardii as treatment for IBD is limited. Furthermore, the existing trials have small populations and short duration. We do not have enough evidence to prove the effect of S. boulardii in IBD. Saccharomyces boulardii is, however, a plausible treatment option in the future, but more placebo-controlled clinical studies on both patients with ulcerative colitis and Crohn's disease are needed.

  5. Amelogenesis imperfecta: review of diagnostic findings and treatment concepts.

    Science.gov (United States)

    Sabandal, Martin M I; Schäfer, Edgar

    2016-09-01

    Mineralization defects like amelogenesis imperfecta are often of hereditary origin. This article reviews the diagnostic findings and summarizes the suggested treatment approaches. Currently, there are no defined therapy recommendations available for patients suffering from amelogenesis imperfecta. The mentioned therapies are more or less equal but no comprehensive therapy recommendation is evident. When treating patients suffering from amelogenesis imperfecta, a comprehensive therapy of almost every dental discipline has to be considered. The earlier the diagnosis of amelogenesis imperfecta is confirmed, the better the outcome is. Optimal treatment approaches consist of early diagnosis and treatment approach and frequent dental recall appointments to prevent progressive occlusal wear or early destruction by caries. Full-mouth prosthetic treatment seems to be the best treatment option.

  6. Clinical analysis of the changes of plasma PRA, AT-II and Aid levels in patients with acute renal failure

    International Nuclear Information System (INIS)

    Zhang Qiuyue; Yang Yongqing

    2002-01-01

    Objective: To investigate the role of changes of plasma PRA, AT-II and Ald levels in the pathogenesis of acute renal failure. Methods: Plasma PRA, AT-II and Ald levels were determined with RIA in 40 normal subjects and 72 cases of acute renal failure. Results: Plasma PRA, AT-II and Ald levels in the patients were markedly increased as compared with those in normal subjects (p < 0.05, p < 0.01, p < 0.001 respectively). There were no linearity and exponential relationship between plasma PRA, AT-II, Ald levels and the 24 h urinary sodium excretion amount (within the range of 89.1 - 365.2 mEq). Conclusion: Acute renal failure could activate the RAAS function

  7. Evaluation of hsp65 Nested PCR-Restriction Analysis (PRA) for Diagnosing Tuberculosis in a High Burden Country

    Science.gov (United States)

    Macente, Sara; Fujimura Leite, Clarice Queico; Santos, Adolfo Carlos Barreto; Siqueira, Vera Lúcia Dias; Machado, Luzia Neri Cosmo; Marcondes, Nadir Rodrigues; Hirata, Mario Hiroyuki; Hirata, Rosário Dominguez Crespo

    2013-01-01

    Current study evaluated the hsp65 Nested PCR Restriction Fragment Length Polymorphism Analysis (hsp65 Nested PCR-PRA) to detect and identify Mycobacterium tuberculosis complex directly in clinical samples for a rapid and specific diagnosis of tuberculosis (TB). hsp65 Nested PCR-PRA was applied directly to 218 clinical samples obtained from 127 patients suspected of TB or another mycobacterial infection from July 2009 to July 2010. The hsp65 Nested PCR-PRA showed 100% sensitivity and 95.0 and 93.1% specificity in comparison with culture and microscopy (acid fast bacillus smear), respectively. hsp65 Nested PCR-PRA was shown to be a fast and reliable assay for diagnosing TB, which may contribute towards a fast diagnosis that could help the selection of appropriate chemotherapeutic and early epidemiological management of the cases which are of paramount importance in a high TB burden country. PMID:24260739

  8. Treatment of childhood sexual abuse: an updated review.

    Science.gov (United States)

    Cummings, Marissa; Berkowitz, Steven J; Scribano, Philip V

    2012-12-01

    Childhood sexual abuse (CSA) involves multiple complex factors that make the evaluation of therapeutic interventions especially complicated. PTSD prevalence rates of CSA are approximately 37 % -53 %. Several other psychiatric sequelae of CSA exist. CSA appears to disrupt brain and body physiology. One co-located service delivery model reported a 52 % linkage rate of CSA survivors with mental health treatment. This article reviews current literature on the treatment of CSA, including psychosocial interventions, pharmacotherapy, and early preventative interventions. It also provides an update on the short- and long-term sequelae of CSA and implications for future research directions. A literature search of papers published in the last 3 years was conducted using the keywords treatment, sexual abuse, childhood, epigenetics, resilience and review, and searching the following databases: PsycInfo, PubMed, Substance Abuse and Mental Health Services Administration, and Centers for Disease Control.

  9. Relay chatter and operator response after a large earthquake: An improved PRA methodology with case studies

    International Nuclear Information System (INIS)

    Budnitz, R.J.; Lambert, H.E.; Hill, E.E.

    1987-08-01

    The purpose of this project has been to develop and demonstrate improvements in the PRA methodology used for analyzing earthquake-induced accidents at nuclear power reactors. Specifically, the project addresses methodological weaknesses in the PRA systems analysis used for studying post-earthquake relay chatter and for quantifying human response under high stress. An improved PRA methodology for relay-chatter analysis is developed, and its use is demonstrated through analysis of the Zion-1 and LaSalle-2 reactors as case studies. This demonstration analysis is intended to show that the methodology can be applied in actual cases, and the numerical values of core-damage frequency are not realistic. The analysis relies on SSMRP-based methodologies and data bases. For both Zion-1 and LaSalle-2, assuming that loss of offsite power (LOSP) occurs after a large earthquake and that there are no operator recovery actions, the analysis finds very many combinations (Boolean minimal cut sets) involving chatter of three or four relays and/or pressure switch contacts. The analysis finds that the number of min-cut-set combinations is so large that there is a very high likelihood (of the order of unity) that at least one combination will occur after earthquake-caused LOSP. This conclusion depends in detail on the fragility curves and response assumptions used for chatter. Core-damage frequencies are calculated, but they are probably pessimistic because assuming zero credit for operator recovery is pessimistic. The project has also developed an improved PRA methodology for quantifying operator error under high-stress conditions such as after a large earthquake. Single-operator and multiple-operator error rates are developed, and a case study involving an 8-step procedure (establishing feed-and-bleed in a PWR after an earthquake-initiated accident) is used to demonstrate the methodology

  10. The Prenylated Rab GTPase Receptor PRA1.F4 Contributes to Protein Exit from the Golgi Apparatus.

    Science.gov (United States)

    Lee, Myoung Hui; Yoo, Yun-Joo; Kim, Dae Heon; Hanh, Nguyen Hong; Kwon, Yun; Hwang, Inhwan

    2017-07-01

    Prenylated Rab acceptor1 (PRA1) functions in the recruitment of prenylated Rab proteins to their cognate organelles. Arabidopsis ( Arabidopsis thaliana ) contains a large number of proteins belonging to the AtPRA1 family. However, their physiological roles remain largely unknown. Here, we investigated the physiological role of AtPRA1.F4, a member of the AtPRA1 family. A T-DNA insertion knockdown mutant of AtPRA1.F4 , atpra1.f4 , was smaller in stature than parent plants and possessed shorter roots, whereas transgenic plants overexpressing HA:AtPRA1.F4 showed enhanced development of secondary roots and root hairs. However, both overexpression and knockdown plants exhibited increased sensitivity to high-salt stress, lower vacuolar Na + /K + -ATPase and plasma membrane ATPase activities, lower and higher pH in the vacuole and apoplast, respectively, and highly vesiculated Golgi apparatus. HA:AtPRA1.F4 localized to the Golgi apparatus and assembled into high-molecular-weight complexes. atpra1.f4 plants displayed a defect in vacuolar trafficking, which was complemented by low but not high levels of HA : AtPRA1.F4 Overexpression of HA:AtPRA1.F4 also inhibited protein trafficking at the Golgi apparatus, albeit differentially depending on the final destination or type of protein: trafficking of vacuolar proteins, plasma membrane proteins, and trans-Golgi network (TGN)-localized SYP61 was strongly inhibited; trafficking of TGN-localized SYP51 was slightly inhibited; and trafficking of secretory proteins and TGN-localized SYP41 was negligibly or not significantly inhibited. Based on these results, we propose that Golgi-localized AtPRA1.F4 is involved in the exit of many but not all types of post-Golgi proteins from the Golgi apparatus. Additionally, an appropriate level of AtPRA1.F4 is crucial for its function at the Golgi apparatus. © 2017 American Society of Plant Biologists. All Rights Reserved.

  11. Results of the Level 1 probabilistic risk assessment (PRA) of internal events for heavy water production reactors (U)

    International Nuclear Information System (INIS)

    Tinnes, S.P.; Cramer, D.S.; Logan, V.E.; Topp, S.V.; Smith, J.A.; Brandyberry, M.D.

    1990-01-01

    This paper reports on a full-scope probabilistic risk assessment (PRA) performed for the Savannah River Site (SRS) production reactors. The Level 1 PRA for the K Reactor has been completed and includes the assessment of reactor systems response to accidents and estimates of the severe core melt frequency (SCMF). The internal events spectrum includes those events related directly to plant systems and safety functions for which transients or failures may initiate an accident

  12. Survey of seismic fragilities used in PRA studies of nuclear power plants

    International Nuclear Information System (INIS)

    Park, Y.J.; Hofmayer, C.H.; Chokshi, N.C.

    1998-01-01

    In recent years, seismic PRA studies have been performed on a large number of nuclear power plants in the USA. This paper presents a summary of a survey on fragility databases and the range of evaluated fragility values of various equipment categories based on past PRAs. The survey includes the use of experience data, the interpretations of available test data, and the quantification of uncertainties. The surveyed fragility databases are limited to data available in the public domain such as NUREG reports, conference proceedings and other publicly available reports. The extent of the availability of data as well as limitations are studied and tabulated for various equipment categories. The survey of the fragility values in past PRA studies includes not only the best estimate values, but also the dominant failure modes and the estimated uncertainty levels for each equipment category. The engineering judgments employed in estimating the uncertainty in the fragility values are also studied. This paper provides a perspective on the seismic fragility evaluation procedures for equipment in order to clearly identify the engineering analysis and judgment used in past seismic PRA studies

  13. Development of a methodology for conducting an integrated HRA/PRA --

    International Nuclear Information System (INIS)

    Luckas, W.J.; Barriere, M.T.; Brown, W.S.; Wreathall, J.; Cooper, S.E.

    1993-01-01

    During Low Power and Shutdown (LP ampersand S) conditions in a nuclear power plant (i.e., when the reactor is subcritical or at less than 10--15% power), human interactions with the plant's systems will be more frequent and more direct. Control is typically not mediated by automation, and there are fewer protective systems available. Therefore, an assessment of LP ampersand S related risk should include a greater emphasis on human reliability than such an assessment made for power operation conditions. In order to properly account for the increase in human interaction and thus be able to perform a probabilistic risk assessment (PRA) applicable to operations during LP ampersand S, it is important that a comprehensive human reliability assessment (HRA) methodology be developed and integrated into the LP ampersand S PRA. The tasks comprising the comprehensive HRA methodology development are as follows: (1) identification of the human reliability related influences and associated human actions during LP ampersand S, (2) identification of potentially important LP ampersand S related human actions and appropriate HRA framework and quantification methods, and (3) incorporation and coordination of methodology development with other integrated PRA/HRA efforts. This paper describes the first task, i.e., the assessment of human reliability influences and any associated human actions during LP ampersand S conditions for a pressurized water reactor (PWR)

  14. Development of a methodology for conducting an integrated HRA/PRA --

    Energy Technology Data Exchange (ETDEWEB)

    Luckas, W.J.; Barriere, M.T.; Brown, W.S. (Brookhaven National Lab., Upton, NY (United States)); Wreathall, J. (Wreathall (John) and Co., Dublin, OH (United States)); Cooper, S.E. (Science Applications International Corp., McLean, VA (United States))

    1993-01-01

    During Low Power and Shutdown (LP S) conditions in a nuclear power plant (i.e., when the reactor is subcritical or at less than 10--15% power), human interactions with the plant's systems will be more frequent and more direct. Control is typically not mediated by automation, and there are fewer protective systems available. Therefore, an assessment of LP S related risk should include a greater emphasis on human reliability than such an assessment made for power operation conditions. In order to properly account for the increase in human interaction and thus be able to perform a probabilistic risk assessment (PRA) applicable to operations during LP S, it is important that a comprehensive human reliability assessment (HRA) methodology be developed and integrated into the LP S PRA. The tasks comprising the comprehensive HRA methodology development are as follows: (1) identification of the human reliability related influences and associated human actions during LP S, (2) identification of potentially important LP S related human actions and appropriate HRA framework and quantification methods, and (3) incorporation and coordination of methodology development with other integrated PRA/HRA efforts. This paper describes the first task, i.e., the assessment of human reliability influences and any associated human actions during LP S conditions for a pressurized water reactor (PWR).

  15. The role of PRA in the safety assessment of VVER Nuclear Power Plants in Ukraine

    International Nuclear Information System (INIS)

    Kot, C.

    1999-01-01

    Ukraine operates thirteen (13) Soviet-designed pressurized water reactors, VVERS. All Ukrainian plants are currently operating with annually renewable permits until they update their safety analysis reports (SARs), in accordance with new SAR content requirements issued in September 1995, by the Nuclear Regulatory Authority and the Government Nuclear Power Coordinating Committee of Ukraine. The requirements are in three major areas: design basis accident (DBA) analysis, probabilistic risk assessment (PRA), and beyond design-basis accident (BDBA) analysis. The last two requirements, on PRA and BDBA, are new, and the DBA requirements are an expanded version of the older SAR requirements. The US Department of Energy (USDOE), as part of its Soviet-Designed Reactor Safety activities, is providing assistance and technology transfer to Ukraine to support their nuclear power plants (NPPs) in developing a Western-type technical basis for the new SARs. USDOE sponsored In-Depth Safety Assessments (ISAs) are in progress at three pilot nuclear reactor units in Ukraine, South Ukraine Unit 1, Zaporizhzhya Unit 5, and Rivne Unit 1, and a follow-on study has been initiated at Khmenytskyy Unit 1. The ISA projects encompass most areas of plant safety evaluation, but the initial emphasis is on performing a detailed, plant-specific Level 1 Internal Events PRA. This allows the early definition of the plant risk profile, the identification of risk significant accident sequences and plant vulnerabilities and provides guidance for the remainder of the safety assessments

  16. Use of plant-specific PRA in an EOP scope audit

    International Nuclear Information System (INIS)

    O'Brien, J.J.

    1991-01-01

    Traditionally, decisions on which accident scenarios to proceduralize as emergency operating procedures (EOPs) have been based on existing design basis analyses, engineering judgment, and probabilistic risk assessments (PRAs) on generic plants. This approach has important strengths and limits. The major limitation of generic PRAs is their inability to account for plant-specific features. Use of plant-specific PRA to determine the impact of proceduralizing, or not proceduralizing, responses to scenarios considers plant-specific features. This helps to eliminate unnecessary EOPs, thus allowing resources to be concentrated on scenarios that are more important for a particular plant. In preparation for a US Nuclear Regulatory Commission audit, a plant-specific PRA was used to assess and quantify the plant's previous decision not to implement six reference emergency response guidelines (ERGs) as procedures. The original justification for nonimplementation of the ERGs was based on engineering judgment. The PRA provided a quantitative justification for implementation/nonimplementation of each guidelines. This analysis accounted for plant-specific design features not common to all reference plants

  17. Use of probabilistic risk assessment (PRA) in expert systems to advise nuclear plant operators and managers

    International Nuclear Information System (INIS)

    Uhrig, R.E.

    1988-01-01

    The use of expert systems in nuclear power plants to provide advice to managers, supervisors and/or operators is a concept that is rapidly gaining acceptance. Generally, expert systems rely on the expertise of human experts or knowledge that has been codified in publications, books, or regulations to provide advice under a wide variety of conditions. In this work, a probabilistic risk assessment (PRA) of a nuclear power plant performed previously is used to assess the safety status of nuclear power plants and to make recommendations to the plant personnel. Nuclear power plants have many redundant systems and can continue to operate when one or more of these systems is disabled or removed from service for maintenance or testing. PRAs provide a means of evaluating the risk to the public associated with the operation of nuclear power plants with components or systems out of service. While the choice of the source term and methodology in a PRA may influence the absolute probability and consequences of a core melt, the ratio of the PRA calculations for two configurations of the same plant, carried out on a consistent basis, can readily identify the increase in risk associated with going from one configuration to the other

  18. Treatment of chikungunya musculoskeletal disorders: a systematic review.

    Science.gov (United States)

    Guaraldo, Lusiele; Wakimoto, Mayumi Duarte; Ferreira, Heloisa; Bressan, Clarisse; Calvet, Guilherme Amaral; Pinheiro, Geraldo Castelar; Siqueira, Andre Machado; Brasil, Patrícia

    2018-04-01

    Chikungunya virus is amongst the fastest expanding vector transmissible diseases in recent years and has been causing massive epidemics in Africa, Asia, Latin America and the Caribbean. Despite human infection by this virus being first described in the 1950s, there is a lack of adequate therapeutic evaluations to guide evidence-based recommendations. The current guidelines rely heavily in specialists' opinion and experience instead of using higher rated evidence. Areas covered: A systematic review of the literature was performed- not restricted to clinical trials - reporting the therapeutic response against this infection with the intent to gather the best evidence of the treatment options against musculoskeletal disorders following chikungunya fever. The 15 studies included in the analysis were categorized considering the initiation of treatment during the acute, subacute and chronic phase. Expert commentary: This review demonstrates the complexity of chikungunya fever and difficulty of therapeutic management. This review found no current evidence-based treatment recommendations for the musculoskeletal disorders following chikungunya fever. To provide an optimal treatment that prevents perpetuation or progression of chikungunya infection to a potentially destructive and permanent condition without causing more harm is an aim that must be pursued by researchers and health professionals working with this disease.

  19. Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews.

    Science.gov (United States)

    Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar

    2017-06-19

    Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of

  20. Olive mill wastewater treatment in Jordan: A Review

    Science.gov (United States)

    Bawab, Abeer Al; Ghannam, Noor; Abu-Mallouh, Saida; Bozeya, Ayat; Abu-Zurayk, Rund A.; Al-Ajlouni, Yazan A.; Alshawawreh, Fida'a.; Odeh, Fadwa; Abu-Dalo, Muna A.

    2018-02-01

    The environmental impact of olive mill wastewater (OMW) pollution is a public concern. OMW contains high levels of phenols, organic compounds, chemical oxygen demand (COD), biological oxygen demand (BOD), microorganisms, nutrients, and toxic compounds. The treatment of OMW has been investigated by many researchers in the Mediterranean region, using several treatment techniques to remove contaminants from OMW. These techniques include chemical, biological, physiochemical, and biophysical techniques. Surfactants and some adsorbents were used in chemical techniques, anaerobic and aerobic in biological techniques, while the combined treatment methods used Electroosmosis, ozonation and electrocoagulation processes as physiochemical methods, and ultrasonic irradiation combined with aerobic biodegradation as biophysical method. The effects of OMW, whether treated or untreated, have been evaluated on both plants’ growth and soil properties. The treatment methods as well as the environmental impact of OMW in Jordan were summarized in this review.

  1. Treatment of textile wastewater with membrane bioreactor: A critical review.

    Science.gov (United States)

    Jegatheesan, Veeriah; Pramanik, Biplob Kumar; Chen, Jingyu; Navaratna, Dimuth; Chang, Chia-Yuan; Shu, Li

    2016-03-01

    Membrane bioreactor (MBR) technology has been used widely for various industrial wastewater treatments due to its distinct advantages over conventional bioreactors. Treatment of textile wastewater using MBR has been investigated as a simple, reliable and cost-effective process with a significant removal of contaminants. However, a major drawback in the operation of MBR is membrane fouling, which leads to the decline in permeate flux and therefore requires membrane cleaning. This eventually decreases the lifespan of the membrane. In this paper, the application of aerobic and anaerobic MBR for textile wastewater treatment as well as fouling and control of fouling in MBR processes have been reviewed. It has been found that long sludge retention time increases the degradation of pollutants by allowing slow growing microorganisms to establish but also contributes to membrane fouling. Further research aspects of MBR for textile wastewater treatment are also considered for sustainable operations of the process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. A Review on Assessment and Treatment for Depression in Malaysia

    Directory of Open Access Journals (Sweden)

    Firdaus Mukhtar

    2011-01-01

    Full Text Available This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation.

  3. A Review on Assessment and Treatment for Depression in Malaysia

    Science.gov (United States)

    Mukhtar, Firdaus; Oei, Tian P. S.

    2011-01-01

    This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT) was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation. PMID:21804939

  4. Treatment of petroleum hydrocarbon polluted environment through bioremediation: a review.

    Science.gov (United States)

    Singh, Kriti; Chandra, Subhash

    2014-01-01

    Bioremediation play key role in the treatment of petroleum hydrocarbon contaminated environment. Exposure of petroleum hydrocarbon into the environment occurs either due to human activities or accidentally and cause environmental pollution. Petroleum hydrocarbon cause many toxic compounds which are potent immunotoxicants and carcinogenic to human being. Remedial methods for the treatment of petroleum contaminated environment include various physiochemical and biological methods. Due to the negative consequences caused by the physiochemical methods, the bioremediation technology is widely adapted and considered as one of the best technology for the treatment of petroleum contaminated environment. Bioremediation utilizes the natural ability of microorganism to degrade the hazardous compound into simpler and non hazardous form. This paper provides a review on the role of bioremediation in the treatment of petroleum contaminated environment, discuss various hazardous effects of petroleum hydrocarbon, various factors influencing biodegradation, role of various enzymes in biodegradation and genetic engineering in bioremediation.

  5. Loss of spent fuel pool cooling PRA: Model and results

    International Nuclear Information System (INIS)

    Siu, N.; Khericha, S.; Conroy, S.; Beck, S.; Blackman, H.

    1996-09-01

    This letter report documents models for quantifying the likelihood of loss of spent fuel pool cooling; models for identifying post-boiling scenarios that lead to core damage; qualitative and quantitative results generated for a selected plant that account for plant design and operational practices; a comparison of these results and those generated from earlier studies; and a review of available data on spent fuel pool accidents. The results of this study show that for a representative two-unit boiling water reactor, the annual probability of spent fuel pool boiling is 5 x 10 -5 and the annual probability of flooding associated with loss of spent fuel pool cooling scenarios is 1 x 10 -3 . Qualitative arguments are provided to show that the likelihood of core damage due to spent fuel pool boiling accidents is low for most US commercial nuclear power plants. It is also shown that, depending on the design characteristics of a given plant, the likelihood of either: (a) core damage due to spent fuel pool-associated flooding, or (b) spent fuel damage due to pool dryout, may not be negligible

  6. A Review of Pharmacologic Treatment for Compulsive Buying Disorder.

    Science.gov (United States)

    Soares, Célia; Fernandes, Natália; Morgado, Pedro

    2016-04-01

    At present, no treatment recommendations can be made for compulsive buying disorder. Recent studies have found evidence for the efficacy of psychotherapeutic options, but less is known regarding the best pharmacologic treatment. The purpose of this review is to present and analyze the available published evidence on the pharmacological treatment of compulsive buying disorder. To achieve this, we conducted a review of studies focusing on the pharmacological treatment of compulsive buying by searching the PubMed/MEDLINE database. Selection criteria were applied, and 21 studies were identified. Pharmacological classes reported included antidepressants, mood stabilizers, opioid antagonists, second-generation antipsychotics, and N-methyl-D-aspartate receptor antagonists. We found only placebo-controlled trials for fluvoxamine; none showed effectiveness against placebo. Three open-label trials reported clinical improvement with citalopram; one was followed by a double-blind discontinuation. Escitalopram was effective in an open-label trial but did not show efficacy in the double-blind phase. Memantine was identified as effective in a pilot open-label study. Fluoxetine, bupropion, nortriptyline, clomipramine, topiramate and naltrexone were only reported to be effective in clinical cases. According to the available literature, there is no evidence to propose a specific pharmacologic agent for compulsive buying disorder. Future research is required for a better understanding of both pathogenesis and treatment of this disorder.

  7. Primary Orgasmic Dysfunction: Diagnostic Considerations and Review of Treatment

    Science.gov (United States)

    Andersen, Barbara L.

    2009-01-01

    As a diagnostic category, primary orgasmic dysfunction includes all women who have never experienced orgasm under any circumstances except sleep or fantasy. However, the research samples of nonorgasmic women in clinical reports and empirical investigations are heterogeneous with regard to disruption of earlier phases of the sexual response cycle and emotional concomitants of the dysfunction. The major treatment models—systematic desensitization, sensate focus, directed masturbation, and hypnosis—are presented, and empirical support is reviewed. Separate discussion is included for investigations comparing treatment modalities. Finally, a strategy for future programmatic sex therapy research is suggested within the broader context of psychotherapy outcome research. PMID:6828600

  8. Pharmacological treatment of chronic constipation: a literature review

    OpenAIRE

    Roshanak Salari; Mahdi Yousefi; Masoumeh Salari

    2016-01-01

    Chronic constipation is a very common disease that is particularly commonplace among members of the elderly population. It is one of the most widespread bowel disorders, and it causes significant pain and discomfort; as such, it usually requires medical attention. The major causes of constipation are slow colonic movements and/or functional gastrointestinal disorders. This review aimed to examine the pharmacological treatments that are currently available for chronic constipation. To develop ...

  9. Burning mouth syndrome: a review on diagnosis and treatment.

    Science.gov (United States)

    Coculescu, E C; Radu, A; Coculescu, B I

    2014-01-01

    Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in the clinically healthy oral mucosa. It is difficult to diagnose BMS because there is a discrepancy between the severity, extensive objective pain felt by the patient and the absence of any clinical changes of the oral mucosa. This review presents some aspects of BMS, including its clinical diagnosis, classification, differential diagnosis, general treatment, evolution and prognosis.

  10. A Review of Antibacterial Agents in Endodontic Treatment

    OpenAIRE

    Rahimi, Saeed; Janani, Maryam; Lotfi, Mehrdad; Shahi, Shahriar; Aghbali, Amirala; Vahid Pakdel, Mahdi; Salem Milani, Amin; Ghasemi, Negin

    2014-01-01

    Microorganisms play a major role in initiation and perpetuation of pulpal and periapical diseases. Therefore, elimination of the microorganisms present in the root canal system is the fundamental objective of endodontic treatment. The use of mechanical debridement, chemical irrigation or other antimicrobial protocols and intra-canal medicaments are critical to attain this goal. The aim of this article was to review the antimicrobial agents and their properties in endodontics.

  11. Common Ice Hockey Injuries and Treatment: A Current Concepts Review.

    Science.gov (United States)

    Mosenthal, William; Kim, Michael; Holzshu, Robert; Hanypsiak, Bryan; Athiviraham, Aravind

    Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article. Lower-extremity injuries reviewed in this article include adductor strain, athletic pubalgia, femoroacetabular impingement, sports hernia, medial collateral and anterior cruciate ligament tears, skate bite, and ankle sprains. This review is intended to aid the sports medicine physician in providing optimal sports-specific care to allow their athlete to return to their preinjury level of performance.

  12. [Ecological security of wastewater treatment processes: a review].

    Science.gov (United States)

    Yang, Sai; Hua, Tao

    2013-05-01

    Though the regular indicators of wastewater after treatment can meet the discharge requirements and reuse standards, it doesn't mean the effluent is harmless. From the sustainable point of view, to ensure the ecological and human security, comprehensive toxicity should be considered when discharge standards are set up. In order to improve the ecological security of wastewater treatment processes, toxicity reduction should be considered when selecting and optimizing the treatment processes. This paper reviewed the researches on the ecological security of wastewater treatment processes, with the focus on the purposes of various treatment processes, including the processes for special wastewater treatment, wastewater reuse, and for the safety of receiving waters. Conventional biological treatment combined with advanced oxidation technologies can enhance the toxicity reduction on the base of pollutants removal, which is worthy of further study. For the process aimed at wastewater reuse, the integration of different process units can complement the advantages of both conventional pollutants removal and toxicity reduction. For the process aimed at ecological security of receiving waters, the emphasis should be put on the toxicity reduction optimization of process parameters and process unit selection. Some suggestions for the problems in the current research and future research directions were put forward.

  13. Treatment effects for dysphagia in Parkinson's disease: a systematic review.

    Science.gov (United States)

    van Hooren, M R A; Baijens, L W J; Voskuilen, S; Oosterloo, M; Kremer, B

    2014-08-01

    Dysphagia remains a common problem in Parkinson's disease (PD). Previous systematic reviews on therapy effects for oropharyngeal dysphagia in PD have shown a lack of evidence. In the past 5 years several placebo or sham-controlled trials with varying results have been published. The aim of this systematic literature review is to summarize and qualitatively analyze the published studies on this matter. Studies published up to December 2013 were found via a systematic comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Twelve studies were included and qualitatively analyzed using critical appraisal items. The review includes rehabilitative (exercises, electrical stimulation, bolus modification etc.) and pharmacologic treatment. Some well-designed controlled trials were included. However, none of the included studies fulfilled all criteria for external and internal validity. A meta-analysis was not carried out as most of the studies were not of sufficient quality to warrant doing so. Expiratory Muscle Strength Training (EMST) and Video-Assisted Swallowing Therapy (VAST) may be effective dysphagia treatments solely or in addition to dopaminergic therapy for PD. However, these preliminary results warrant further investigation concerning their clinical applicability, and further research should be based on randomized sham-controlled trials to determine the effectiveness and long-term effects of different therapies for dysphagia in PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Measuring treatment outcomes in gambling disorders: a systematic review.

    Science.gov (United States)

    Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

    2018-03-01

    Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

  15. Static Magnetic Field Therapy: A Critical Review of Treatment Parameters

    Directory of Open Access Journals (Sweden)

    Agatha P. Colbert

    2009-01-01

    Full Text Available Static magnetic field (SMF therapy, applied via a permanent magnet attached to the skin, is used by people worldwide for self-care. Despite a lack of established SMF dosage and treatment regimens, multiple studies are conducted to evaluate SMF therapy effectiveness. Our objectives in conducting this review are to: (i summarize SMF research conducted in humans; (ii critically evaluate reporting quality of SMF dosages and treatment parameters and (iii propose a set of criteria for reporting SMF treatment parameters in future clinical trials. We searched 27 electronic databases and reference lists. Only English language human studies were included. Excluded were studies of electromagnetic fields, transcranial magnetic stimulation, magnets placed on acupuncture points, animal studies, abstracts, posters and editorials. Data were extracted on clinical indication, study design and 10 essential SMF parameters. Three reviewers assessed quality of reporting and calculated a quality assessment score for each of the 10 treatment parameters. Fifty-six studies were reviewed, 42 conducted in patient populations and 14 in healthy volunteers. The SMF treatment parameters most often and most completely described were site of application, magnet support device and frequency and duration of application. Least often and least completely described were characteristics of the SMF: magnet dimensions, measured field strength and estimated distance of the magnet from the target tissue. Thirty-four (61% of studies failed to provide enough detail about SMF dosage to permit protocol replication by other investigators. Our findings highlight the need to optimize SMF dosing parameters for individual clinical conditions before proceeding to a full-scale clinical trial.

  16. Radioactive sodium waste treatment and conditioning. Review of main aspects

    International Nuclear Information System (INIS)

    2007-01-01

    This publication reviews the main aspects relating to the treatment and conditioning of radioactive sodium waste. This waste arises from the operation of liquid metal fast reactors (LMFRs). In this type of reactor, sodium (Na) or sodium-potassium alloys (NaK) are used as a low-effect neutron moderating coolant medium for extracting and transferring thermal energy from the core and they represent a significant technical and safety challenge during operation and decommissioning. This publication provides the reader with technologically oriented information on the present status of sodium waste management approaches and recent achievements related to treatment and conditioning, with the objective of facilitating planning and preparatory work for the decommissioning of LMFRs. This publication provides a comprehensive review of the hazards associated with sodium waste management. Given the large quantities of sodium waste arising during decommissioning or reactor refurbishment, as well as the challenges and varied techniques associated with removal of 100% of all sodium and NaK bulk quantities and residues during decommissioning, a hazards review and analysis is a critical component in planning the dismantling and waste management activities. Roughly half of this publication focuses on sodium waste generating, handling and treatment processes. This includes draining sodium and NaK from plant systems; in situ treatment of residual sodium; cutting techniques for pumps, valves, piping and other components; cleaning of components; potential reuse of sodium; and removal of selected radionuclides from sodium waste with the objective of reducing the waste classification or converting it to exempt waste. The focus is on proven techniques and technologies, and each discussed method includes a review of the associated principle or theory, practical applications, advantages and disadvantages, limitations, industry experience, and final waste products. A review is provided of final

  17. Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Parker Jacqui A

    2012-06-01

    Full Text Available Abstract Background Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Methods Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. Results 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24 and postnatal periods (n = 3. Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19. Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. Conclusions The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

  18. Jaundice associated pruritis: a review of pathophysiology and treatment.

    Science.gov (United States)

    Bassari, Ramez; Koea, Jonathan B

    2015-02-07

    To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice. English language literature was reviewed using MEDLINE, PubMed, EMBASE and clinicaltrials.gov for papers and trails addressing the pathophysiology and potential treatments for pruritis associated with jaundice. Recent advances in the understanding of the peripheral anatomy of itch transmission have defined a histamine stimulated pathway and a cowhage stimulated pathway with sensation conveyed centrally via the contralateral spinothalamic tract. Centrally, cowhage and histamine stimulated neurons terminate widely within the thalamus and sensorimotor cortex. The causative factors for itch in jaundice have not been clarified although endogenous opioids, serotonin, steroid and lysophosphatidic acid all play a role. Current guidelines for the treatment of itching in jaundice recommend initial management with biliary drainage where possible and medical management with ursodeoxycholic acid, followed by cholestyramine, rifampicin, naltrexone and sertraline. Other than biliary drainage no single treatment has proved universally effective. Pruritis associated with jaundice is a common but poorly understood condition for which biliary drainage is the most effective therapy. Pharmacological therapy has advanced but remains variably effective.

  19. Periodontal health during clear aligners treatment: a systematic review.

    Science.gov (United States)

    Rossini, Gabriele; Parrini, Simone; Castroflorio, Tommaso; Deregibus, Andrea; Debernardi, Cesare L

    2015-10-01

    Clear aligner treatment (CAT) has been cited as a safe and comfortable orthodontic procedure for adult patients. However, the available evidence is scarce. To perform a systematic review of the existing literature in order to assess periodontal health during CAT. Pubmed, Pubmed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACS were searched from January 1945 to September 2014 to identify all peer-reviewed papers potentially relevant to the review. After duplicate selection and extraction procedures, the risk of bias was assessed according to the Centre for Reviews and Dissemination criteria, and a 3-point grading system, as described by the Swedish Council on Technology Assessment in Health Care (SBU), was used to rate the methodological quality of the selected papers. A PICOS table was used for data extraction. Five relevant articles were selected from the 1247 identified articles. The level of evidence was moderate for all the studies. A significant improvement of the periodontal health indexes was revealed, in particular when CAT was compared to fixed appliances. No periodontal CAT adverse effects were observed in the selected studies. Periodontal health indexes were significantly improved during CAT. The results of this review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Treatment of unicameral bone cyst: systematic review and meta analysis.

    Science.gov (United States)

    Kadhim, Muayad; Thacker, Mihir; Kadhim, Amjed; Holmes, Laurens

    2014-03-01

    Different treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities. We utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome. Sixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7-101.8). Active treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.

  1. Mechanical valve obstruction: Review of diagnostic and treatment strategies

    Science.gov (United States)

    Salamon, Jason; Munoz-Mendoza, Jerson; Liebelt, Jared J; Taub, Cynthia C

    2015-01-01

    Prosthetic valve obstruction (PVO) is a rare but feared complication of mechanical valve replacement. Diagnostic evaluation should focus on differentiating prosthetic valve thrombosis (PVT) from pannus formation, as their treatment options differ. History of sub-optimal anti-coagulation and post-op time course to development of PVO are useful clinical characteristics in differentiating thrombus from pannus formation. Treatment of PVT is influenced by the patient’s symptoms, valve location, degree of obstruction and thrombus size and may include thrombolysis or surgical intervention. Alternatively, pannus formation requires surgical intervention. The purpose of this article is to review the pathophysiology, epidemiology, diagnostic approach and treatment options for aortic and mitral valve PVO. PMID:26730292

  2. Hypoplastic left heart syndrome - a review of supportive percutaneous treatment.

    Science.gov (United States)

    Moszura, Tomasz; Góreczny, Sebastian; Dryżek, Paweł

    2014-01-01

    Due to the complex anatomical and haemodynamic consequences of hypoplastic left heart syndrome (HLHS), patients with the condition require multistage surgical and supportive interventional treatment. Percutaneous interventions may be required between each stage of surgical palliation, sometimes simultaneously with surgery as hybrid interventions, or after completion of multistage treatment. Recent advances in the field of interventional cardiology, including new devices and techniques, have significantly contributed to improving results of multistage HLHS palliation. Knowledge of the potential interventional options as well as the limitation of percutaneous interventions will enable the creation of safe and effective treatment protocols in this highly challenging group of patients. In this comprehensive review we discuss the types, goals, and potential complications of transcatheter interventions in patients with HLHS.

  3. Applications of nanotechnology in wastewater treatment--a review.

    Science.gov (United States)

    Bora, Tanujjal; Dutta, Joydeep

    2014-01-01

    Water on Earth is a precious and finite resource, which is endlessly recycled in the water cycle. Water, whose physical, chemical, or biological properties have been altered due to the addition of contaminants such as organic/inorganic materials, pathogens, heavy metals or other toxins making it unsafe for the ecosystem, can be termed as wastewater. Various schemes have been adopted by industries across the world to treat wastewater prior to its release to the ecosystem, and several new concepts and technologies are fast replacing the traditional methods. This article briefly reviews the recent advances and application of nanotechnology for wastewater treatment. Nanomaterials typically have high reactivity and a high degree of functionalization, large specific surface area, size-dependent properties etc., which makes them suitable for applications in wastewater treatment and for water purification. In this article, the application of various nanomaterials such as metal nanoparticles, metal oxides, carbon compounds, zeolite, filtration membranes, etc., in the field of wastewater treatment is discussed.

  4. Systematic review of nonoperative versus operative treatment of uncomplicated appendicitis.

    Science.gov (United States)

    Gorter, Ramon R; The, Sarah-May M L; Gorter-Stam, Marguerite A W; Eker, Hasan H; Bakx, Roel; van der Lee, Johanna H; Heij, Hugo A

    2017-08-01

    To compare the risk of complications between initial nonoperative treatment and appendectomy of uncomplicated (simple) appendicitis in children. Systematic literature search. Eligible for inclusion were both and randomized controlled trials and cohort studies including children in which the outcome of nonoperative treatment of uncomplicated appendicitis was reported with a minimum follow-up period of one year. Two authors extracted data independently and assessed quality. Primary outcome parameter was the percentage of children experiencing complications. Secondary outcomes were early failures, recurrent appendicitis and appendectomies, for all indications and on request. Five of the 2051 articles screened were eligible for inclusion, including 147 children (nonoperative treatment) and 173 children (appendectomy) with one year follow-up. Percentage of children experiencing complications ranged from 0 to 13% versus 0-17% for nonoperative and appendectomy, respectively. Nonoperative treatment avoided an appendectomy in 62-81% of the children after one year follow-up. The evidence base for initial nonoperative treatment of acute uncomplicated appendicitis in children is by far insufficient. It suggests that the percentage of patients experiencing complications in the initial nonoperative treatment group is comparable to the appendectomy group, and it may avoid an appendectomy in the large majority of children after one year follow-up. Systematic review. 1. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Non-surgical treatments for hidradenitis suppurativa: A systematic review.

    Science.gov (United States)

    Robert, E; Bodin, F; Paul, C; Konstantinou, M-P; Gall, Y; Grolleau, J-L; Laloze, J; Chaput, B

    2017-08-01

    The management of hidradenitis suppurativa is multidisciplinary, involving general measures, medical treatment and surgery. Non-surgical treatments, often first-line procedures, mainly concern forms of low-to-moderate severity or, conversely, very severe forms in non-operable patients or those refusing surgery. While many treatments have been attempted, few randomized controlled trials have been conducted, so the choice of treatments is most often based on the personal experience of the clinicians. The objective of this systematic review is to propose a synthetic analysis of the currently available non-surgical procedures. This systematic review of the literature was conducted in accordance with the PRISMA criteria. We searched for articles in the Medline ® , PubMed Central, Embase and Cochrane databases published between January 2005 and September 2015. Sixty-four articles were included. They generally had a low level of evidence; indeed, the majority of them were retrospective observational studies. They involved biotherapy (44%), dynamic phototherapy (16%), antibiotics (11%), Laser (8%), retinoids (6%) and immunosuppressive therapies, anti-inflammatory drugs, zinc, metformin, gammaglobulins and fumarates. None of the non-surgical treatments can treat all stages of the disease and offer long-term remission. Antibiotics and biotherapy seem to have real effectiveness but their effect remains suspensive and the disease is almost certain to reappear once they are stopped. As regards antibiotics, no association has shown their superiority in a study with a high level of evidence. And while some biotherapies seem quite effective, due to their side effects they should be reserved for moderate-to-severe, resistant or inoperable forms of the disease. Randomized controlled studies are needed before valid conclusions can be drawn. In the resistant or disabling forms, it is consequently advisable to orientate to the greatest possible extent towards radical surgery, which

  6. Treatment of holistic suffering in cancer: A systematic literature review.

    Science.gov (United States)

    Best, Megan; Aldridge, Lynley; Butow, Phyllis; Olver, Ian; Price, Melanie A; Webster, Fleur

    2015-12-01

    Holistic suffering is a debilitating problem for cancer patients. Although many treatments have been suggested for its alleviation, they have not been compared for effectiveness. This literature review seeks to identify what interventions are effective in treatment of holistic suffering of cancer patients. A systematic review was conducted to identify and evaluate studies of interventions for holistic suffering in adult cancer patients. Search terms were generated iteratively from the literature. MEDLINE, EMBASE, the Cochrane Library and PsycINFO databases were searched for the years 1992-2015. Included studies were peer-reviewed, English language reports of either a controlled trial or a randomised controlled trial focusing on therapies aimed at relieving suffering in adult cancer patients. Articles were excluded if focused predominantly on spiritual or existential issues or concerns not leading to suffering. Studies were graded for quality using the QualSyst quantitative checklist. Levels of evidence were ascertained by completing the National Health and Medical Research Council criteria. Results are reported according to AMSTAR guidelines. The studies represented seven intervention types. Meaning-centred, hope-centred and stress-reduction interventions were found to be effective. Results of both psycho-educational and spiritual interventions in improving spiritual well-being were mixed. Supportive-expressive interventions - with the exception of forgiveness therapy - were not efficacious. There was little or no evidence for the efficacy of creative and healing arts and other assessed interventions such as animal therapy and haptotherapy. This systematic review found that spiritual well-being, meaning, hope and benefit finding can be positively impacted by a variety of treatment modalities. © The Author(s) 2015.

  7. Tongue-tie, from embriology to treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Maria Dezio

    2015-03-01

    Full Text Available The aim of this review is to create a complete analysis about tongue-tie (or short lingual frenum or ankyloglossia according to the most important works published in literature. The analysis allowed us to do a complete evaluation of this problem, from embriology to the therapeutic approach we could use today, focusing our attention on laser-assisted therapy. This review is based on the research on the PubMed Database (www.ncbi.nlm.nih.gov of studies about lingual frenum written in English between January 1980 and May 2014. The keywords inserted were “lingual frenum”, “frenectomy”, “laser therapy”. We have analyzed: case series, case reports, clinical studies, and also literature reviews in which embryology, physiology, diagnosis and treatment of ankyloglossia were described. We excluded laboratory studies, studies based on animal tests and studies about patients with particular syndromes in which we can also find tongue-tie. The selection criteria allowed us to select 42 articles. The treatment options for the releasing of the frenum are surgically represented by frenotomy (i.e. simple horizontal cut of this training and frenectomy (i.e. removal. In both cases, the intervention on the short lingual frenum is simple, short-lasting, and without particular complications. Furthermore, this kind of treatment can be carried out with different devices: with the typical cold blade scalpel or by the use of laser, a new method that shows more advantages over the prior art. Laser-assisted therapy permits to intervene on newborns (from 0 to 20 days, when there are breastfeeding problems without total anesthesia and suture. The Er:YAG, CO2 laser (according to literature data and Diode laser (according to our experience are advantageous, safe and effective in tongue-tie treatment.

  8. Current and Under Development Treatment Modalities of Psoriasis: A Review.

    Science.gov (United States)

    Albaghdadi, Abdullah

    2017-01-01

    Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade. Advancement in molecular knowledge leads to better understanding of the disease, thus influencing the development of efficient treatment modalities. However, even with the availability of various options of treatment most of the efficient treatment modalities are costly. Expenses of health care bring about major financial weight to the patients as well as to health care systems. Thus, it was important to review the available current treatment options and those which are under development, in terms of efficacy, safety and cost to assist in selecting the most appropriate treatment for psoriasis patients. Literatures were searched by using key words psoriasis, topical treatment, systemic treatment, biologics and phototherapies, on Embase, Medline, Jstor, Cochrane and Merck Index databases. Life-style choices such as smoking, alcohol consumption, obesity and stress are recognised as risk factors and triggers associated with psoriasis. Psoriasis poses psycho-social and economic burden on affected patients that sometimes leads to depression, reduced social interaction and suicidal tendencies in patients. Depending on the type, severity and extent of the disease, comorbidities, patient preference, efficacy and safety profile, numerous treatment modalities and therapeutic agents are available such as topical, systemic, biologic and phototherapeutic treatments. However, it was found that among all the current available treatments for psoriasis, biologic agents and phototherapeutic modalities are

  9. Treatment of chikungunya chronic arthritis: A systematic review

    Directory of Open Access Journals (Sweden)

    Gabriella Maria Pitt Gameiro Sales

    Full Text Available Summary Introduction: Chikungunya (CHIK is a tropical arbovirus, transmitted by the female mosquito Aedes aegypti and Aedes albopictus. In Brazil, there have been cases reported since 2014. The initial manifestations of this virus are sudden onset high fever, headache, chills, rashes, myalgia and intense joint pain. Usually, CHIK presents the acute and chronic phases, the latter characterized by bilateral polyarthralgia, which can last for months or even years. During this period, autoimmune diseases can be triggered, making the picture even more complicated. Method: A systematic review was performed on the PubMed and Scielo databases in January 2017. Clinical trials, cohorts, case-control and case reports were included in the study. Expert opinions, societal consensuses and literary reviews were exclusion criteria. Studies were conducted in English, Spanish and Portuguese. The studies were descriptively analyzed and the data was grouped according to methodological similarity. Results: Twenty-four (24 articles were selected and, in compliance with the inclusion and exclusion criteria, 18 were eliminated, with six studies remaining in the present review: five clinical trials and one case report. Conclusion: When the manifestations of CHIK become chronic and, the longer they last, more complications arise. Polyarthralgia can be immaterial, distancing individuals from their daily-life activities. Anti-inflammatory drugs (either steroid or not, in addition to immunosuppressants, homeopathy and physiotherapy are measures of treatment that, according to the literature, have been successful in relieving or extinguishing symptoms. However, it is fundamental that studies of CHIK treatment be further developed.

  10. Treatment of chikungunya chronic arthritis: A systematic review.

    Science.gov (United States)

    Sales, Gabriella Maria Pitt Gameiro; Barbosa, Izabel Crystine Pereira; Canejo Neta, Laura Maia Sampaio; Melo, Paloma Lopes de; Leitão, Raphael de Azevedo; Melo, Hugo Moura de Albuquerque

    2018-01-01

    Chikungunya (CHIK) is a tropical arbovirus, transmitted by the female mosquito Aedes aegypti and Aedes albopictus. In Brazil, there have been cases reported since 2014. The initial manifestations of this virus are sudden onset high fever, headache, chills, rashes, myalgia and intense joint pain. Usually, CHIK presents the acute and chronic phases, the latter characterized by bilateral polyarthralgia, which can last for months or even years. During this period, autoimmune diseases can be triggered, making the picture even more complicated. A systematic review was performed on the PubMed and Scielo databases in January 2017. Clinical trials, cohorts, case-control and case reports were included in the study. Expert opinions, societal consensuses and literary reviews were exclusion criteria. Studies were conducted in English, Spanish and Portuguese. The studies were descriptively analyzed and the data was grouped according to methodological similarity. Twenty-four (24) articles were selected and, in compliance with the inclusion and exclusion criteria, 18 were eliminated, with six studies remaining in the present review: five clinical trials and one case report. When the manifestations of CHIK become chronic and, the longer they last, more complications arise. Polyarthralgia can be immaterial, distancing individuals from their daily-life activities. Anti-inflammatory drugs (either steroid or not), in addition to immunosuppressants, homeopathy and physiotherapy are measures of treatment that, according to the literature, have been successful in relieving or extinguishing symptoms. However, it is fundamental that studies of CHIK treatment be further developed.

  11. Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review

    Science.gov (United States)

    Lustenberger, David P; Ng, Vincent Y; Best, Thomas M; Ellis, Thomas J

    2013-01-01

    Objective Trochanteric bursitis (TB) is a self-limiting disorder in the majority of patients and typically responds to conservative measures. However, multiple courses of nonoperative treatment or surgical intervention may be necessary in refractory cases. The purpose of this systematic review was to evaluate the efficacy of the treatment of TB. Data Sources A literature search in the PubMed, MEDLINE, CINAHL, and ISI Web of Knowledge databases was performed for all English language studies up to April 2010. Terms combined in a Boolean search were greater trochanteric pain syndrome, trochanteric bursitis, trochanteric, bursitis, surgery, therapy, drug therapy, physical therapy, rehabilitation, injection, Z-plasty, Z-lengthening, aspiration, bursectomy, bursoscopy, osteotomy, and tendon repair. Study Selection All studies directly involving the treatment of TB were reviewed by 2 authors and selected for further analysis. Expert opinion and review articles were excluded, as well as case series with fewer than 5 patients. Twenty-four articles were identified. According to the system described by Wright et al, 2 studies, each with multiple arms, qualified as level I evidence, 1 as level II, 1 as level III, and the rest as level IV. More than 950 cases were included. Data Extraction The authors extracted data regarding the type of intervention, level of evidence, mean age of patients, patient gender, number of hips in the study, symptom duration before the study, mean number of injections before the study, prior hip surgeries, patient satisfaction, length of follow-up, baseline scores, and follow-up scores for the visual analog scale (VAS) and Harris Hip Scores (HHS). Data Synthesis Symptom resolution and the ability to return to activity ranged from 49% to 100% with corticosteroid injection as the primary treatment modality with and without multimodal conservative therapy. Two comparative studies (levels II and III) found low-energy shock-wave therapy (SWT) to be

  12. Relationship between temporomandibular disorders and orthodontic treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Ronaldo Antônio Leite

    2013-02-01

    Full Text Available OBJECTIVE: The objective of this study was to review the most recent studies from the last 15 years, in search of clinical studies that report the relationship between TMD and orthodontic treatment and/or malocclusion. Our intention was to determine whether orthodontic treatment would increase the incidence of signs and symptoms of TMD, and whether orthodontic treatment would be recommended for treating or preventing signs and symptoms of TMD. METHODS: Literature reviews, editorials, letters to the editor, experimental studies in animals and short communications were excluded from this review. Were included only prospective, longitudinal, case-control or retrospective studies with a large sample and significant statistical analysis. Studies that dealt with craniofacial deformities and syndromes or orthognathic surgery treatment were also excluded, as well as those that reported only the association between malocclusion and TMD. RESULTS: There were 20 articles relating orthodontics to TMD according to the inclusion criteria. The studies that associated signs and symptoms of TMD to orthodontic treatment showed discrepant results. Some have found positive effects of orthodontic treatment on signs and symptoms of TMD, however, none showed a statistically significant difference. CONCLUSIONS: All studies cited in this literature review reported that orthodontic treatment did not provide risk to the development of signs and symptoms of TMD, regardless of the technique used for treatment, the extraction or non-extraction of premolars and the type of malocclusion previously presented by the patient. Some studies with long-term follow-up concluded that orthodontic treatment would not be preventive or a treatment option for TMD.OBJETIVO: revisar a literatura mais atual, dos últimos 15 anos, em busca de estudos clínicos que relatem a relação entre a disfunção temporomandibular (DTM e o tratamento ortodôntico e/ou a má oclusão. A intenção foi

  13. RAVEN: a GUI and an Artificial Intelligence Engine in a Dynamic PRA Framework

    Energy Technology Data Exchange (ETDEWEB)

    C. Rabiti; D. Mandelli; A. Alfonsi; J. Cogliati; R. Kinoshita; D. Gaston; R. Martineau; C. Curtis

    2013-06-01

    Increases in computational power and pressure for more accurate simulations and estimations of accident scenario consequences are driving the need for Dynamic Probabilistic Risk Assessment (PRA) [1] of very complex models. While more sophisticated algorithms and computational power address the back end of this challenge, the front end is still handled by engineers that need to extract meaningful information from the large amount of data and build these complex models. Compounding this problem is the difficulty in knowledge transfer and retention, and the increasing speed of software development. The above-described issues would have negatively impacted deployment of the new high fidelity plant simulator RELAP-7 (Reactor Excursion and Leak Analysis Program) at Idaho National Laboratory. Therefore, RAVEN that was initially focused to be the plant controller for RELAP-7 will help mitigate future RELAP-7 software engineering risks. In order to accomplish this task, Reactor Analysis and Virtual Control Environment (RAVEN) has been designed to provide an easy to use Graphical User Interface (GUI) for building plant models and to leverage artificial intelligence algorithms in order to reduce computational time, improve results, and help the user to identify the behavioral pattern of the Nuclear Power Plants (NPPs). In this paper we will present the GUI implementation and its current capability status. We will also introduce the support vector machine algorithms and show our evaluation of their potentiality in increasing the accuracy and reducing the computational costs of PRA analysis. In this evaluation we will refer to preliminary studies performed under the Risk Informed Safety Margins Characterization (RISMC) project of the Light Water Reactors Sustainability (LWRS) campaign [3]. RISMC simulation needs and algorithm testing are currently used as a guidance to prioritize RAVEN developments relevant to PRA.

  14. Effect of antigravity suit inflation on cardiovascular, PRA, and PVP responses in humans.

    Science.gov (United States)

    Kravik, S E; Keil, L C; Geelen, G; Wade, C E; Barnes, P R; Spaul, W A; Elder, C A; Greenleaf, J E

    1986-08-01

    Blood pressure, pulse rate (PR), serum osmolality and electrolytes, as well as plasma vasopressin (PVP) and plasma renin activity (PRA), were measured in five men and two women [mean age 38.6 +/- 3.9 (SE) yr] before, during, and after inflation of an antigravity suit that covered the legs and abdomen. After 24 h of fluid deprivation the subjects stood quietly for 3 h: the 1st h without inflation, the 2nd with inflation to 60 Torr, and the 3rd without inflation. A similar control noninflation experiment was conducted 10 mo after the inflation experiment using five of the seven subjects except that the suit was not inflated during the 3-h period. Mean arterial pressure increased by 14 +/- 4 (SE) Torr (P less than 0.05) with inflation and decreased by 15 +/- 5 Torr (P less than 0.05) after deflation. Pulse pressure (PP) increased by 7 +/- 2 Torr (P less than 0.05) with inflation and PR decreased by 11 +/- 5 beats/min (P less than 0.05); PP and PR returned to preinflation levels after deflation. Plasma volume decreased by 6.1 +/- 1.5% and 5.3 +/- 1.6% (P less than 0.05) during hours 1 and 3, respectively, and returned to base line during inflation. Inflation decreased PVP from 6.8 +/- 1.1 to 5.6 +/- 1.4 pg/ml (P less than 0.05) and abolished the significant rise in PRA during hour 1. Both PVP and PRA increased significantly after deflation: delta = 18.0 +/- 5.1 pg/ml and 4.34 +/- 1.71 ng angiotensin I X ml-1 X h-1, respectively. Serum osmolality and Na+ and K+ concentrations were unchanged during the 3 h of standing.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Biofeedback treatment for sleep bruxism: a systematic review.

    Science.gov (United States)

    Wang, Lu-Fei; Long, Hu; Deng, Meng; Xu, Hui; Fang, Jie; Fan, Yi; Bai, Ding; Han, Xiang-Long

    2014-05-01

    The aim of this systematic review was to evaluate the efficacy of any biofeedback treatment on sleep bruxism. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, ISI Web of Science, System for Information on Grey Literature in Europe, Chinese Biomedical Literature Database, and PsycINFO up to October 2012 for randomized controlled trials and controlled clinical trials involving biofeedback treatment for sleep bruxism. Reference lists of relevant studies were hand searched. Quality assessment and data extraction were performed by two reviewers independently. Seven eligible studies involving 240 participants were finally included. Three of them had moderate risk of bias, and four had high risk of bias. In an electromyographic-measured sleep bruxism episode, meta-analysis showed no significant difference between contingent electrical stimulation and blank control (95% confidence interval = -12.33, 3.38, P = 0.26). Moreover, five studies reported electromyographic activity index. Due to the diversity of biofeedback modalities (auditory, electrical, and visual stimulus) and controls (splint, occlusal adjustment, etc.), these data were unable to be pooled, so only qualitative description was provided. In the current stage, there is no powerful evidence to support the use of biofeedback technology on sleep bruxism treatment. Contingent electrical stimulation which is defined as a kind of biofeedback modality shows no effect on reducing sleep bruxism episode compared with the no-treatment group. Although many studies support the efficacy of biofeedback treatment, more large sample-sized randomized controlled trials which adopt uniform outcome index are necessitated to verify its application.

  16. A review on acidifying treatments for vegetable canned food.

    Science.gov (United States)

    Derossi, A; Fiore, A G; De Pilli, T; Severini, C

    2011-12-01

    As is well known, pasteurization treatments are not sufficient for destroying heat resistance of spore forming microorganisms, which are prevented from germination and growing by pH reducing. So, the acidification process becomes one of the most important pre-treatments for the canning industry. It is commonly applied before pasteurization treatment with the purpose of inhibiting spore germination and for reducing heat resistance of the microorganism, thereby allowing to reduce the time or temperature values of the heat treatment. With the aim to reduce the pH of vegetables several techniques are available but their application is not easy to plan. Often, industries define operative conditions only on the basis of empirical experience, thus increasing the risk of microbial growth or imparting an unpleasant sour taste. With the aim of highlighting the correct plan and management of acidification treatments to reach safety without degrading quality of canned fruit and vegetables, the topics that are reviewed and discussed are the effects of low pH on heat resistance of the most important microorganisms, acidification techniques and significant process variables, the effect of low pH on sensorial properties, and future trends.

  17. Laser treatment of cutaneous angiokeratomas: A systematic review.

    Science.gov (United States)

    Nguyen, Jannett; Chapman, Lance W; Korta, Dorota Z; Zachary, Christopher B

    2017-11-01

    Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty-five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence-Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non-laser options. Additional studies are needed to establish guidelines and to optimize laser parameters. © 2017 Wiley Periodicals, Inc.

  18. Safety of treatment options for spondyloarthritis: a narrative review.

    Science.gov (United States)

    D'Angelo, Salvatore; Carriero, Antonio; Gilio, Michele; Ursini, Francesco; Leccese, Pietro; Palazzi, Carlo

    2018-05-01

    Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed. Readers will be provided with a comprehensive overview on frequent and rare adverse events associated with each drug listed in current SpA treatment recommendations. Expert opinion: The overall safety profile of such molecules is good and serious adverse events are rare but need to be promptly recognized and treated. However, the monitoring of adverse events is a major challenge for clinicians because it is not adequately addressed by current treatment recommendations. A tailored treatment is crucial and rheumatologists must accurately select patients in order to identify those more susceptible to develop adverse events.

  19. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

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

  20. Tuberculosis treatment outcome monitoring in European Union countries: systematic review

    Science.gov (United States)

    van Hest, Rob; Ködmön, Csaba; Verver, Suzanne; Erkens, Connie G.M.; Straetemans, Masja; Manissero, Davide; de Vries, Gerard

    2013-01-01

    Treatment success measured by treatment outcome monitoring (TOM) is a key programmatic output of tuberculosis (TB) control programmes. We performed a systematic literature review on national-level TOM in the 30 European Union (EU)/European Economic Areas (EEA) countries to summarise methods used to collect and report data on TOM. Online reference bibliographic databases PubMed/MEDLINE and EMBASE were searched to identify relevant indexed and non-indexed literature published between January 2000 and August 2010. The search strategy resulted in 615 potentially relevant indexed citations, of which 27 full-text national studies (79 data sets) were included for final analysis. The selected studies were performed in 10 EU/EEA countries and gave a fragmented impression of TOM in the EU/EEA. Publication year, study period, sample size, databases, definitions, variables, patient and outcome categories, and population subgroups varied widely, portraying a very heterogeneous picture. This review confirmed previous reports of considerable heterogeneity in publications of TOM results across EU/EEA countries. PubMed/MEDLINE and EMBASE indexed studies are not a suitable instrument to measure representative TOM results for the 30 EU/EEA countries. Uniform and complete reporting to the centralised European Surveillance System will produce the most timely and reliable results of TB treatment outcomes in the EU/EEA. PMID:22790913

  1. Fractionated laser skin resurfacing treatment complications: a review.

    Science.gov (United States)

    Metelitsa, Andrei I; Alster, Tina S

    2010-03-01

    Fractional photothermolysis represents a new modality of laser skin resurfacing that was developed to provide a successful clinical response while minimizing postoperative recovery and limiting treatment complications. To review all of the reported complications that develop as a result of fractional ablative and nonablative laser skin resurfacing. A literature review was based on a MEDLINE search (1998-2009) for English-language articles related to laser treatment complications and fractional skin resurfacing. Articles presenting the highest level of evidence and the most recent reports were preferentially selected. Complications with fractional laser skin resurfacing represent a full spectrum of severity and can be longlasting. In general, a greater likelihood of developing post-treatment complications is seen in sensitive cutaneous areas and in patients with intrinsically darker skin phototypes or predisposing medical risk factors. Although the overall rate of complications associated with fractional laser skin resurfacing is much lower than with traditional ablative techniques, recent reports suggest that serious complications can develop. An appreciation of all of the complications associated with fractional laser skin resurfacing is important, especially given that many of them can be potentially prevented. The authors have indicated no significant interest with commercial supporters.

  2. Illicit drug use and treatment in South Africa: a review.

    Science.gov (United States)

    Peltzer, Karl; Ramlagan, Shandir; Johnson, Bruce D; Phaswana-Mafuya, Nancy

    2010-11-01

    This review synthesizes available epidemiological data on current drug use and substance user treatment admissions in South Africa since 1994, and how changes in the political, economic, and social structures within South Africa, both before and after Apartheid, has made the country more vulnerable to drug use. Based on national surveys, current use of cannabis ranged among adolescents from 2% to 9% and among adults it was 2%, cocaine/crack (0.3%), mandrax/sedatives (0.3%), club drugs/amphetamine-type stimulants (0.2%), opiates (0.1%), and hallucinogens (0.1%). The use of primary illicit substance at admission to South African drug user treatment centers was cannabis 16.9%, methamphetamine (tik) 12.8%, crack/cocaine 9.6%, cannabis and mandrax 3.4%, heroin/opiates 9.2%, and prescription and OTC drugs 2.6%. An increase in substance user treatment admissions has increased. While the prevalence of illicit drug use in South Africa is relatively low compared to the United States and Australia, prevention and intervention policies need to be designed to reduce these levels by targeting the more risky subpopulations identified from this review.

  3. Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H

    2014-10-01

    Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD. © 2014 Wiley Periodicals, Inc.

  4. Use of probabilistic risk assessment (PRA) in expert systems to advise nuclear plant operators and managers

    International Nuclear Information System (INIS)

    Uhrig, R.E.

    1988-01-01

    The use of expert systems in nuclear power plants to provide advice to managers, supervisors and/or operators is a concept that is rapidly gaining acceptance. Generally, expert systems rely on the expertise of human experts or knowledge that has been modified in publications, books, or regulations to provide advice under a wide variety of conditions. In this work, a probabilistic risk assessment (PRA) 3 of a nuclear power plant performed previously is used to assess the safety status of nuclear power plants and to make recommendations to the plant personnel. 5 refs., 1 fig., 2 tabs

  5. ANTISECRETORY TREATMENT FOR PEDIATRIC GASTROESOPHAGEAL REFLUX DISEASE - A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Mattos, Ângelo Zambam de; Marchese, Gabriela Meirelles; Fonseca, Bárbara Brum; Kupski, Carlos; Machado, Marta Brenner

    2017-12-01

    Proton pump inhibitors and histamine H2 receptor antagonists are two of the most commonly prescribed drug classes for pediatric gastroesophageal reflux disease, but their efficacy is controversial. Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux, even that causal relation is not proven. To evaluate the use of proton pump inhibitors and histamine H2 receptor antagonists in pediatric gastroesophageal reflux disease through a systematic review. A systematic review was performed, using MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases. The search was limited to studies published in English, Portuguese or Spanish. There was no limitation regarding date of publication. Studies were considered eligible if they were randomized-controlled trials, evaluating proton pump inhibitors and/or histamine H2 receptor antagonists for the treatment of pediatric gastroesophageal reflux disease. Studies published only as abstracts, studies evaluating only non-clinical outcomes and studies exclusively comparing different doses of the same drug were excluded. Data extraction was performed by independent investigators. The study protocol was registered at PROSPERO platform (CRD42016040156). After analyzing 735 retrieved references, 23 studies (1598 randomized patients) were included in the systematic review. Eight studies demonstrated that both proton pump inhibitors and histamine H2 receptor antagonists were effective against typical manifestations of gastroesophageal reflux disease, and that there was no evidence of benefit in combining the latter to the former or in routinely prescribing long-term maintenance treatments. Three studies evaluated the effect of treatments on children with asthma, and neither proton pump inhibitors nor histamine H2 receptor antagonists proved to be significantly better than placebo. One study compared different combinations of omeprazole, bethanechol and placebo for the

  6. Calculation of Fire Severity Factors and Fire Non-Suppression Probabilities For A DOE Facility Fire PRA

    International Nuclear Information System (INIS)

    Elicson, Tom; Harwood, Bentley; Lucek, Heather; Bouchard, Jim

    2011-01-01

    Over a 12 month period, a fire PRA was developed for a DOE facility using the NUREG/CR-6850 EPRI/NRC fire PRA methodology. The fire PRA modeling included calculation of fire severity factors (SFs) and fire non-suppression probabilities (PNS) for each safe shutdown (SSD) component considered in the fire PRA model. The SFs were developed by performing detailed fire modeling through a combination of CFAST fire zone model calculations and Latin Hypercube Sampling (LHS). Component damage times and automatic fire suppression system actuation times calculated in the CFAST LHS analyses were then input to a time-dependent model of fire non-suppression probability. The fire non-suppression probability model is based on the modeling approach outlined in NUREG/CR-6850 and is supplemented with plant specific data. This paper presents the methodology used in the DOE facility fire PRA for modeling fire-induced SSD component failures and includes discussions of modeling techniques for: Development of time-dependent fire heat release rate profiles (required as input to CFAST), Calculation of fire severity factors based on CFAST detailed fire modeling, and Calculation of fire non-suppression probabilities.

  7. Application of determination of PRA, Ang II and IGF-1 levels in the study of typing of essential hypertension

    International Nuclear Information System (INIS)

    Lu Yongyi; Chen Qun; Yang Yongqing

    2010-01-01

    Objective: To study the clinical application of determination of plasma renin activity (PRA), Angiotensin II (Ang II ) and insulin-like growth factor-1 (IGF-1) levels in typing of essential hypertension (EH). Methods: Determined the levels of PRA and Aug II in 256 patients with EH and 70 healthy volunteers (as control group) by radioimmunoassay, and measured IGF-1 level by enzyme immunoassay. Research on the typing of EH and the difference between the groups. Results: The PRA and Ang II in control group was (0.432±0.236) μg·L -1 ·h -1 and (31.7±7.4) μg/L respectively. In 256 patients with EH, PRA was increased, normal and decreased in 18.0%, 71.8% and 10.2% respectively, while the level of Ang II was increased, normal and decreased in 12.9%, 76.2% and 10.9% respectively. The IGF-1 levels in 256 patients with EH were increased following the increase of blood pressure. Conclusion: Typing of EH patients with PRA and Ang II as well as the determination of IGF-1 were useful in treating and following up the patients with EH. (authors)

  8. Varicocelectomy in the treatment of testicular pain: a review.

    Science.gov (United States)

    Shridharani, Anand; Lockwood, Gina; Sandlow, Jay

    2012-11-01

    Varicoceles are a common finding in adolescent boys and men. Most are asymptomatic, although up to 10% may cause testicular pain. This study will review the use of varicocelectomy in the treatment of testicular pain in men with clinical varicoceles, as well as provide prognostic indicators for successful outcome. Recent studies that examined the impact of varix ligation on preoperative testicular pain were reviewed. Most studies are retrospective and uncontrolled; although objective outcome measures were used in the majority. Varicocele grade, duration of discomfort, and the quality of pain tended to predict outcome but have not been universally supported. On the basis of the majority of the recently published studies, varicocelectomy, in the properly chosen patients, results in significant improvement or resolution of testicular pain.

  9. Prevalence, assessment, and treatment of pathological gambling: a review.

    Science.gov (United States)

    Petry, N M; Armentano, C

    1999-08-01

    Although pathological gambling is an increasing problem, many mental health providers are unfamiliar with its diagnosis and treatment. To improve recognition and treatment of pathological gambling, the authors reviewed the literature on its prevalence, assessment, and treatment. Entries in PsycLIT and MEDLINE were examined for the years 1984 to 1998. The prevalence of pathological gambling seems to be increasing with the spread of legalized gambling; casinos are now operating in 27 states. Point and lifetime prevalence rates of pathological gambling are reported to be as high as 1.4 percent and 5.1 percent, respectively. The most commonly used assessment instrument is the DSM-based, 20-item South Oaks Gambling Screen. There is no standard treatment for pathological gambling. Gamblers Anonymous (GA) is the most popular intervention, and about 1,000 chapters exist in the U.S. Studies suggest that only 8 percent of GA attendees achieve a year of abstinence. Combining professional therapy and GA participation may improve retention and abstinence. Marital and family treatments, including participation in Gam-Anon, the spousal component of GA, have not been sufficiently evaluated. The few studies of cognitive-behavioral treatments suggest that this approach, which may include cognitive restructuring, problem solving, social skills training, and relapse prevention, is promising. Carbamazepine, naltrexone, clomipramine, fluvoxamine, and lithium have been used with some effect. Therapists' manuals and self-help manuals are available. Although research evaluating their efficacy is necessary, manuals can provide a start for therapists who encounter patients with gambling problems. Brief motivational interviewing may be a useful strategy for decreasing gambling among heavy gamblers who are ambivalent about entering treatment or who do not desire abstinence.

  10. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Alireza Salehi

    2015-10-01

    Full Text Available Abstract Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.

  11. Home treatment for mental health problems: a systematic review.

    Science.gov (United States)

    Burns, T; Knapp, M; Catty, J; Healey, A; Henderson, J; Watt, H; Wright, C

    2001-01-01

    This review investigates the effectiveness of 'home treatment' for mental health problems in terms of hospitalisation and cost-effectiveness. For the purposes of this review, 'home treatment' is defined as a service that enables the patient to be treated outside hospital as far as possible and remain in their usual place of residence. METHODS - SYSTEMATIC LITERATURE SEARCH: 'Home treatment' excluded studies focused on day, residential and foster care. The review was based on Cochrane methodology, but non-randomised studies were included if they compared two services; these were only analysed if they provided evidence of the groups' baseline clinical comparability. METHODS - REVIEW OF ECONOMIC EVALUATIONS: Economic evaluations among the studies found were reviewed against established criteria. METHODS - IDENTIFICATION OF SERVICE COMPONENTS: A three-round Delphi exercise ascertained the degree of consensus among expert psychiatrists concerning the important components of community-based services that enable them to treat patients outside hospital. The identified components were used to construct the follow-up questionnaire. METHODS - FOLLOW-UP OF AUTHORS: As a supplement to the information available in the papers, authors of all the studies were followed up for data on service components, sustainability of programmes and service utilisation. METHODS - DATA ANALYSIS: The outcome measure was mean days in hospital per patient per month over the follow-up period. (1) Comparative analysis - compared experimental to control services. It analysed all studies with available data, divided into 'inpatient-control' and 'community-control' studies, and tested for associations between service components and difference in hospital days. (2) Experimental services analysis - analysed only experimental service data and tested for associations between service components and hospital days. RESULTS - SYSTEMATIC LITERATURE SEARCH: A total of 91 studies were found, conducted over a 30

  12. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.

    Science.gov (United States)

    Kemler, Ellen; van de Port, Ingrid; Backx, Frank; van Dijk, C Niek

    2011-03-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of taping the ankle. The purpose of this review is to evaluate the effectiveness of ankle braces as a treatment for acute ankle sprains compared with other types of functional treatments such as ankle tape and elastic bandages. A computerized literature search was conducted using PubMed, EMBASE, CINAHL and the Cochrane Clinical Trial Register. This review includes randomized controlled trials in English, German and Dutch, published between 1990 and April 2009 that compared ankle braces as a treatment for lateral ankle sprains with other functional treatments. The inclusion criteria for this systematic review were (i) individuals (sports participants as well as non-sports participants) with an acute injury of the ankle (acute ankle sprains); (ii) use of an ankle brace as primary treatment for acute ankle sprains; (iii) control interventions including any other type of functional treatment (e.g. Tubigrip™, elastic wrap or ankle tape); and (iv) one of the following reported outcome measures: re-injuries, symptoms (pain, swelling, instability), functional outcomes and/or time to resumption of sports, daily activities and/or work. Eight studies met all inclusion criteria. Differences in outcome measures, intervention types and patient characteristics precluded pooling of the results, so best evidence syntheses were conducted. A few individual studies reported positive outcomes after treatment with an ankle brace compared with other functional methods, but our best evidence syntheses only demonstrated a better treatment result in terms of functional outcome. Other studies have suggested that ankle brace treatment is a more cost-effective method, so the use of braces after acute

  13. Brachytherapy in the treatment of cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Banerjee R

    2014-05-01

    Full Text Available Robyn Banerjee,1 Mitchell Kamrava21Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada; 2Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USAAbstract: Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Consequently, advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This review provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer.Keywords: cervical cancer, brachytherapy, image-guided brachytherapy

  14. Second cancers after treatment for Hodgkin's disease: A review

    International Nuclear Information System (INIS)

    Boivin, J.F.; Hutchison, G.B.

    1984-01-01

    The authors review several reports of series of patients with Hodgkin's disease among whom second primary cancers have been diagnosed after radiotherapy or chemotherapy or both for Hodgkin's disease. An analysis of these reports suggests that (a) chemotherapy is a strong risk factor for leukemia, and (b) in the absence of chemotherapy, leukemia shows little or no increased incidence over ''spontaneous'' rates. Seven drugs have been identified as being frequently used in treatment of Hodgkin's disease (nitrogen mustard, cyclophosphamide, chlorambucil, procarbazine, vinglastine, vincristine, and prednisone). A large proportion of the patients receiving chemotherapy for Hodgkin's disease are exposed to several drugs and quantitative estimates of the independent leukemogenic effects of these drugs have not yet been obtained. Most of the person-years' experience accrued in the published studies occurred in the first decade after treatment for Hodgkin's disease. Follow-up over longer intervals of time will be necessary before solid tumor risk after therapy for Hodgkin's disease can be evaluated

  15. Review of nutritional supplements for the treatment of bipolar depression.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Dunlop, Boadie W

    2014-05-01

    Many patients view psychotropics with skepticism and fear and view nutritional supplements as more consistent with their values and beliefs. The purpose of this review was to critically evaluate the evidence base for nutritional supplements in the treatment of bipolar depression (BD). A literature search for all randomized, controlled clinical trials using nutritional supplements in the treatment of BD was conducted via PubMed and Ovid MEDLINE computerized database. The studies were organized into essential nutrients/minerals, nonessential nutrients, and combinations of nutritional products. Among essential nutrients/minerals, omega-3-fatty acids (O3FAs) have the strongest evidence of efficacy for bipolar depression, although some studies failed to find positive effects from O3FAs. Weak evidence supports efficacy of vitamin C whereas no data support the usefulness of folic acid and choline. Among nonessential nutrients, cytidine is the least supported treatment. Studies of N-acetylcysteine have not resolved its efficacy in treating acute depressive episodes relative to placebo. However, one study demonstrates its potential to improve depressive symptoms over time and the other, though nonsignificant, suggests it has a prophylactic effect. Studies of inositol have been mostly negative, except for 1 study. Those that were negative were underpowered but demonstrated numerically positive effects for inositol. There is no evidence that citicholine is efficacious for uncomplicated BD depression, though it may have value for comorbid substance abuse among BD patients. Finally, combination O3FA-cytidine lacks evidence of efficacy. The findings of this review do not support the routine use of nutritional supplements in the treatment or prophylaxis of BD depression. Studies with more rigorous designs are required before definitive conclusions can be made. Despite the inadequacy of the existing data, clinicians should remain open to the value of nutritional supplements: after

  16. [Periodontal treatment for cardiovascular risk factors: a systematic review].

    Science.gov (United States)

    Deng, Linkai; Li, Chunjie; Li, Qian; Zhang, Yukui; Zhao, Hongwei

    2013-10-01

    To evaluate the efficacy of periodontal treatment for the management of cardiovascular risk factors. Eligible studies in Cochrane Controlled Trials Register/CENTRAL, PubMed, EMBASE, and China Biology Medicine disc (CBMdisc) were searched until October 13, 2011. References of the included studies were hand searched. Two reviewers assessed the risk of bias and extracted the data of the included studies in duplicate. Meta-analysis was conducted with Revman 5.1. Six randomized controlled trials involving 682 participants were included. One case had low risk of bias, another one had moderate risk of bias, and the remaining four had high risk of bias. Meta-analysis showed that periodontal treatment has no significant effect on C-reactive protein, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P > 0.05). However, the treatment had a significant effect on high-density lipoprotein cholesterol [MD = 0.05, 95% CI (0.00, 0.09), P = 0.04]. Periodontal treatment has good effects on controlling high-density lipoprotein cholesterol although more randomized controlled trials must be conducted to verify its effectiveness.

  17. Neurofeedback for Tinnitus Treatment - Review and Current Concepts.

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  18. Neurofeedback for Tinnitus TreatmentReview and Current Concepts

    Directory of Open Access Journals (Sweden)

    Dominik Güntensperger

    2017-12-01

    Full Text Available An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB, a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  19. Neurofeedback for Tinnitus TreatmentReview and Current Concepts

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically. PMID:29249959

  20. Systematic review of pharmacological treatments in fragile X syndrome

    Directory of Open Access Journals (Sweden)

    Tejada Maria-Isabel

    2009-10-01

    Full Text Available Abstract Background Fragile X syndrome (FXS is considered the most common cause of inherited mental retardation. Affected people have mental impairment that can include Attention Deficit and/or Hyperactivity Disorder (ADHD, autism disorder, and speech and behavioural disorders. Several pharmacological interventions have been proposed to treat those impairments. Methods Systematic review of the literature and summary of the evidence from clinical controlled trials that compared at least one pharmacological treatment with placebo or other treatment in individuals with diagnosis of FXS syndrome and assessed the efficacy and/or safety of the treatments. Studies were identified by a search of PubMed, EMBASE and the Cochrane Databases using the terms fragile X and treatment. Risk of bias of the studies was assessed by using the Cochrane Collaboration criteria. Results The search identified 276 potential articles and 14 studies satisfied inclusion criteria. Of these, 10 studies on folic acid (9 with crossover design, only 1 of them with good methodological quality and low risk of bias did not find in general significant improvements. A small sample size trial assessed dextroamphetamine and methylphenidate in patients with an additional diagnosis of ADHD and found some improvements in those taking methylphenidate, but the length of follow-up was too short. Two studies on L-acetylcarnitine, showed positive effects and no side effects in patients with an additional diagnosis of ADHD. Finally, one study on patients with an additional diagnosis of autism assessed ampakine compound CX516 and found no significant differences between treatment and placebo. Regarding safety, none of the studies that assessed that area found relevant side effects, but the number of patients included was too small to detect side effects with low incidence. Conclusion Currently there is no robust evidence to support recommendations on pharmacological treatments in patients with

  1. Results of the Level 1 probabilistic risk assessment (PRA) of internal events for heavy water production reactors

    International Nuclear Information System (INIS)

    Tinnes, S.P.; Cramer, D.S.; Logan, V.E.; Topp, S.V.; Smith, J.A.; Brandyberry, M.D.

    1990-01-01

    A full-scope probabilistic risk assessment (PRA) is being performed for the Savannah River site (SRS) production reactors. The Level 1 PRA for the K Reactor has been completed and includes the assessment of reactor systems response to accidents and estimates of the severe core melt frequency (SCMF). The internal events spectrum includes those events related directly to plant systems and safety functions for which transients or failures may initiate an accident. The SRS PRA has three principal objectives: improved understanding of SRS reactor safety issues through discovery and understanding of the mechanisms involved. Improved risk management capability through tools for assessing the safety impact of both current standard operations and proposed revisions. A quantitative measure of the risks posed by SRS reactor operation to employees and the general public, to allow comparison with declared goals and other societal risks

  2. Pharmacological Treatment of Cannabis-Related Disorders: A Narrative Review.

    Science.gov (United States)

    Gorelick, David A

    2016-01-01

    Cannabis is the most widely used illicit psychoactive substance world-wide, yet no medication is approved for the treatment of intoxication, withdrawal, or cannabis use disorder (CUD). To comprehensively review the current state of knowledge. Search of the PubMed electronic data base and review of reference lists of relevant articles to identify controlled clinical trials of pharmacological treatment. The search identified 4 trials for specific intoxication symptoms (none for global intoxication), 7 trials for withdrawal, and 12 phase II trials for CUD. One or two trials each suggest that propranolol is effective for some intoxication symptoms, antipsychotics for cannabis-induced psychosis, and dronabinol (synthetic THC) and gabapentin for cannabis withdrawal. Of 10 medications and one medication combination studied in 12 trials for CUD, only two medications were effective (in single trials): gabapentin and Nacetylcysteine (in adolescents). Not effective were dronabinol and several antidepressants, anticonvulsants, and antianxiety medications. Three trials of antidepressants for CUD with comorbid depression gave inconsistent results. A trial of atomoxetine for CUD with comorbid ADHD showed no efficacy. Five trials of second-generation antipsychotics for CUD with comorbid schizophrenia showed none better than any other. Further research is needed to confirm the efficacy of gabapentin for withdrawal and gabapentin and N-acetylcysteine for CUD and to develop new medications for all 3 cannabis-related disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  3. A review of current treatment strategies for gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kristi W Kelley

    2015-07-01

    Full Text Available Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM. It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.

  4. A review of virus removal in wastewater treatment pond systems.

    Science.gov (United States)

    Verbyla, Matthew E; Mihelcic, James R

    2015-03-15

    Wastewater treatment ponds (lagoons) are one of the most common types of technologies used for wastewater management worldwide, especially in small cities and towns. They are particularly well-suited for systems where the effluent is reused for irrigation. However, the efficiency of virus removal in wastewater treatment pond systems is not very well understood. The main objective of this paper is to critically review the major findings related to virus removal in wastewater treatment pond systems and to statistically analyze results reported in the literature from field studies on virus removal in these systems. A comprehensive analysis of virus removal reported in the literature from 71 different wastewater treatment pond systems reveals only a weak to moderate correlation of virus removal with theoretical hydraulic retention time. On average, one log10 reduction of viruses was achieved for every 14.5-20.9 days of retention, but the 95th percentile value of the data analyzed was 54 days. The mechanisms responsible for virus removal in wastewater treatment ponds were also reviewed. One recent finding is that sedimentation may not be a significant virus removal mechanism in some wastewater ponds. Recent research has also revealed that direct and indirect sunlight-mediated mechanisms are not only dependent on pond water chemistry and optics, but also on the characteristics of the virus and its genome. MS2 coliphage is considered to be the best surrogate for studying sunlight disinfection in ponds. The interaction of viruses with particles, with other microorganisms, and with macroinvertebrates in wastewater treatment ponds has not been extensively studied. It is also unclear whether virus internalization by higher trophic-level organisms has a protective or a detrimental effect on virus viability and transport in pond systems. Similarly, the impact of virus-particle associations on sunlight disinfection in ponds is not well understood. Future research should focus on

  5. Technical requirements for the ASME PRA standard for nuclear power plant applications

    International Nuclear Information System (INIS)

    Fleming, Karl N.; Bernsen, Sidney A.; Simard, Ronald L.

    2000-01-01

    In 1998 the American Society of Mechanical Engineers (ASME) formed the Committee on Nuclear Risk Management (CNRM) and a Project Team to develop a standard on PRAs for use in risk informed applications. This ASME standard is being developed to help provide an adequate level of quality in PRAs that are being used to support ASME initiatives to risk informed in-service inspection (ISI) and in-service testing (IST) of nuclear power plant components. A related need supported by the industry and the U.S. Nuclear Regulatory Commission is to reduce the level of effort that is being expended in pilot applications of risk informed initiatives to address questions about the sufficiency of quality in the supporting PRA models. The purpose of this paper is to discuss the authors' views on some of the technical issues that were encountered in the effort to develop the ASME PRA standard. Draft 12 of this standard has been issued for comment, and is currently being finalized with the aim of releasing the standard in early 2001. (author)

  6. Human factors assessment in PRA using task analysis linked evaluation technique (TALENT)

    International Nuclear Information System (INIS)

    Wells, J.E.; Banks, W.W.

    1990-01-01

    Human error is a primary contributor to risk in complex high-reliability systems. A 1985 U.S. Nuclear Regulatory Commission (USNRC) study of licensee event reports (LERs) suggests that upwards of 65% of commercial nuclear system failures involve human error. Since then, the USNRC has initiated research to fully and properly integrate human errors into the probabilistic risk assessment (PRA) process. The resulting implementation procedure is known as the Task Analysis Linked Evaluation Technique (TALENT). As indicated, TALENT is a broad-based method for integrating human factors expertise into the PRA process. This process achieves results which: (1) provide more realistic estimates of the impact of human performance on nuclear power safety, (2) can be fully audited, (3) provide a firm technical base for equipment-centered and personnel-centered retrofit/redesign of plants enabling them to meet internally and externally imposed safety standards, and (4) yield human and hardware data capable of supporting inquiries into human performance issues that transcend the individual plant. The TALENT procedure is being field-tested to verify its effectiveness and utility. The objectives of the field-test are to examine (1) the operability of the process, (2) its acceptability to the users, and (3) its usefulness for achieving measurable improvements in the credibility of the analysis. The field-test will provide the information needed to enhance the TALENT process

  7. Human reliability analysis in support of a level 1 PRA for Surry during midloop operations

    International Nuclear Information System (INIS)

    Lin, J.C.; Bley, D.C.; Chu, T.-L.

    2004-01-01

    The objectives of this Level 1 probabilistic risk assessment (PRA) are to evaluate the important accident sequences initiated during midloop operations and to compare the qualitative and quantitative results with those for accidents initiated during power operations. The primary types of human actions analyzed in this study involve the dynamic operator actions and recovery actions that take place during the accident sequence following an initiating event. Two parts of the human actions were analyzed: failure to diagnose and failure to perform the action. The scope of the Level 1 PRA for Surry during midloop operations includes internal, fire, and flood initiating events. The major categories of dynamic operator actions taken during the accident sequence following an initiating event are: providing makeup to the reactor coolant system (RCS), restoring residual heat removal (RHR) cooling, establishing steam generator reflux cooling, establishing primary feed and spill, establishing gravity feed from refueling water storage tank (RWST), establishing high pressure recirculation, establishing recirculation spray, and cross-connecting RWSTs. All categories are not applicable to all initiating events and all plant operating states (POS). (author)

  8. Development of extreme rainfall PRA methodology for sodium-cooled fast reactor

    International Nuclear Information System (INIS)

    Nishino, Hiroyuki; Kurisaka, Kenichi; Yamano, Hidemasa

    2016-01-01

    The objective of this study is to develop a probabilistic risk assessment (PRA) methodology for extreme rainfall with focusing on decay heat removal system of a sodium-cooled fast reactor. For the extreme rainfall, annual excess probability depending on the hazard intensity was statistically estimated based on meteorological data. To identify core damage sequence, event trees were developed by assuming scenarios that structures, systems and components (SSCs) important to safety are flooded with rainwater coming into the buildings through gaps in the doors and the SSCs fail when the level of rainwater on the ground or on the roof of the building becomes higher than thresholds of doors on first floor or on the roof during the rainfall. To estimate the failure probability of the SSCs, the level of water rise was estimated by comparing the difference between precipitation and drainage capacity. By combining annual excess probability and the failure probability of SSCs, the event trees led to quantification of core damage frequency, and therefore the PRA methodology for rainfall was developed. (author)

  9. Aromatherapy for treatment of hypertension: a systematic review.

    Science.gov (United States)

    Hur, Myung-Haeng; Lee, Myeong Soo; Kim, Chan; Ernst, Edzard

    2012-02-01

    The objective of this review is to systematically review the evidence for the effectiveness of aromatherapy in the treatment of high blood pressure. Twelve databases were searched from their inception through December 2009. Controlled trials testing aromatherapy in patients with hypertension of any origin that assessed blood pressure were considered. The selection of studies, data extraction and validations were performed independently by two reviewers. One randomized clinical trial (RCT) and four non-randomized controlled clinical trials (CCTs) met our inclusion criteria. The one RCT included tested the effects of aromatherapy as compared with placebo and showed significant reduction of systolic blood pressure and diastolic blood pressure. All of the four CCTs showed favourable effects of aromatherapy. However, all of the CCTs also had a high risk of bias. The existing trial evidence does not show convincingly that aromatherapy is effective for hypertension. Future studies should be of high quality with a particular emphasis on designing an adequate control intervention. © 2010 Blackwell Publishing Ltd.

  10. Physical Exercise for Treatment of Mood Disorders: A Critical Review

    Science.gov (United States)

    Hearing, CM; Chang, WC; Szuhany, KL; Deckersbach, T; Nierenberg, AA; Sylvia, LG

    2016-01-01

    Purpose of the review The purpose of this review is to critically assess the evidence for exercise as an adjunct intervention for major depressive disorder and bipolar disorder, chronic conditions characterized by frequent comorbid conditions as well as interepisodic symptoms with poor quality of life and impaired functioning. Individuals with these mood disorders are at higher risk of cardiovascular disease and premature death in part because of increased rates of obesity, inactivity, and diabetes mellitus compared to the general population. Exercise may not only mitigate the increased risk of cardiovascular disease, but could also potentially improve the long term outcomes of mood disorders. Recent findings We conducted a literature review on the impact of exercise on mood disorders and associated comorbid conditions as well as possible biological mechanisms. We found that exercise impacts both the physical health parameters of mood disorders as well as mental health outcomes. Exercise also positively impacts conditions frequently comorbid with mood disorders (i.e. anxiety, pain, and insomnia). There are multiple candidate biomarkers for exercise, with brain-derived neurotrophic factor and oxidative stress as two main promising components of exercise’s anti-depressant effect. Summary Exercise appears to be a promising adjunct treatment for mood disorders. We conclude with recommendations for future research of exercise as an adjunct intervention for mood disorders. PMID:28503402

  11. Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

    Science.gov (United States)

    Butler, Doug; Bauman, David; Johnson-Throop, Kathy

    2011-01-01

    The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

  12. Laser treatment of infantile hemangioma: A systematic review.

    Science.gov (United States)

    Chinnadurai, Sivakumar; Sathe, Nila A; Surawicz, Tanya

    2016-03-01

    To systematically review studies of laser treatment of infantile hemangioma (IH). We searched multiple databases including MEDLINE® and EMBASE from 1982 to June 2015. Two investigators independently screened studies against predetermined criteria and extracted key data. Investigators independently assessed study risk of bias and the strength of the evidence of the body of literature. We identified 29 studies addressing lasers: 4 randomized controlled trials, 8 retrospective cohort studies, and 17 case series. Lasers varied across studies in type, pulse width, or cooling materials. Most comparative studies (n = 9) assessed variations of pulsed dye laser (PDL) and examined heterogeneous endpoints. Most studies reported on treatment of cutaneous lesions. Overall, longer pulse PDL with epidermal cooling was the most commonly used laser for cutaneous lesions; Nd:YAG was the most commonly used intralesionally. Most studies reported a higher success rate with longer pulse PDL compared with observation in managing the size of IH, although the magnitude of effect differed substantially. CO2 laser was used for subglottic IH in a single study, and was noted to have a higher success rate and lower complication rate than both Nd:YAG and observation. Studies comparing laser with β-blockers or in combination with β-blockers reported greater improvements in lesion size in combination arms versus β-blockers alone and greater effects of lasers on mixed superficial and deep IH. Strength of the evidence for outcomes after laser treatments ranged from insufficient to low for effectiveness outcomes. Strength of the evidence was insufficient for the effects of laser compared with β-blockers or in combination with β-blockers as studies evaluated different agents and laser types. Studies assessing outcomes after CO2 and Nd:YAG lasers typically reported some resolution of lesion size, but heterogeneity among studies limits our abilities to draw conclusions. Studies of laser

  13. Burning mouth syndrome: a systematic review of treatments.

    Science.gov (United States)

    Liu, Y F; Kim, Y; Yoo, T; Han, P; Inman, J C

    2018-04-01

    Burning mouth syndrome (BMS) is a chronic oral pain syndrome that primarily affects peri- and postmenopausal women. It is characterized by oral mucosal burning and may be associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. The etiology of the disease process is unknown, but is thought to be neuropathic in origin. The goal of this systematic review was to assess the efficacy of the various treatments for BMS. Literature searches were conducted through PubMed, Web of Science, and Cochrane Library databases, which identified 22 randomized controlled trials. Eight studies examined alpha-lipoic acid (ALA), three clonazepam, three psychotherapy, and two capsaicin, which all showed modest evidence of potentially decreasing pain/burning. Gabapentin was seen in one study to work alone and synergistically with ALA. Other treatments included vitamins, benzydamine hydrochloride, bupivacaine, Catuama, olive oil, trazodone, urea, and Hypericum perforatum. Of these other treatments, Catuama and bupivacaine were the only ones with significant positive results in symptom improvement. ALA, topical clonazepam, gabapentin, and psychotherapy may provide modest relief of pain in BMS. Gabapentin may also boost the effect of ALA. Capsaicin is limited by its side effects. Catuama showed potential for benefit. Future studies with standardized methodology and outcomes containing more patients are needed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. What do we know about canine osteosarcoma treatment? Review.

    Science.gov (United States)

    Szewczyk, M; Lechowski, R; Zabielska, K

    2015-03-01

    Osteosarcoma (OSA) is the most common type of bone tumors in dogs, which has high metastasis ability. 80 % of dogs with OSA die due to lung metastasis. As a result its treatment is a challenge for veterinary practitioners. The authors discuss the etiology, pathogenesis and the possible risk factors of OSA. The article focuses on literature review and the study of recent advances in OSA treatment. The authors describe therapies which have significantly prolonged the lives of dogs, as well as those that have proven to be ineffective. Advantages and disadvantages of limb amputation and limb-sparing surgery have been described. Authors present also the results of both single agent's therapies with the most commonly used drugs as cisplatin, carboplatin and doxorubicin and compare them to the results obtained using combined chemotherapy. The use of nanotechnology as a new approach in OSA treatment in order to avoid multidrug resistance and reduce negative side effects of cytostatic drugs is presented. The main reasons of the therapies failure are also provided in this article.

  15. Updating the treatment of recurrent tonsillitis in adults. Review

    Directory of Open Access Journals (Sweden)

    María Cristina GASCÓN-RUBIO

    2016-03-01

    Full Text Available Introduction and Objectives: Acute pharyngitis in adults (APA is one of the most frequent reasons for consultation in primary care. The main objective of this review is to update the therapeutic options for the prevention and treatment of APA and to determine which interventions have the greatest impact in reducing morbidity and improving the quality of life of patients, which directly affects the consumption of health resources. Material and Methods: First clinical criteria of the FAA, indications of tonsillectomy and patterns of antibiotic therapy according to clinical guidelines of national and international scientific societies were defined. Subsequently, the literature related to the treatment of the FAA including other therapeutic options not covered in previous clinical guidelines (P. Leucotomos extract, vaccination by the mucosal route, AM3 and beta-glucans, homeopathy and herbal medicine was revised. ClinicalKey bases and PubMed data were used. Results: The comparison of the studies was difficult due to the disparity of criteria for inclusion and diagnostics, sample sizes, time tracking and poor uniformity in the clinical scales measuring variations. Conclusions: Therefore we cannot conclude whether a therapeutic option is more effective than another in the treatment and prevention of adult APA.

  16. Nonpharmacologic treatment of functional abdominal pain disorders: a systematic review.

    Science.gov (United States)

    Rutten, Juliette M T M; Korterink, Judith J; Venmans, Leonie M A J; Benninga, Marc A; Tabbers, Merit M

    2015-03-01

    Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine. Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach. Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P pediatric AP-FGIDs. Data on fiber supplements are inconclusive. Copyright © 2015 by the American Academy of Pediatrics.

  17. Treatment of Leukocytospermia in Male Infertility: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jae Hung Jung

    2016-12-01

    Full Text Available Male factors account for 20% to 50% of infertility cases, and infection in the genitourinary tract may play a contributing role in up to 15% of male infertility. Leukocytospermia is a well-known indicator of infection or inflammation in the male sex glands and the urogenital tract. Although great deal of effort has been expended to elucidate definite management strategies in infertile men with leukocytospermia, the gold standard of treatment remains unclear. Until recently, broad spectrum antibiotics and antioxidants have been used in the treatment of leukocytospermia for male infertility to eliminate infection and reduce reactive oxygen free radicals produced inside cellular mitochondria as a result of inflammation. The present review reveals that antibiotics might improve sperm parameters, the rate of resolution of leukocytospermia, the bacteriologic cure rate, and even the pregnancy rate, although some reports conflict. Antioxidants might also have clinical benefits for sperm function as shown by in vitro studies. However, the data are insufficient to conclude whether antibiotics and antioxidants for the treatment of infertile men with leukocytospermia are effective or not. Better designed investigations into leukocytospermia are needed.

  18. Botulinum toxin treatment for facial palsy: A systematic review.

    Science.gov (United States)

    Cooper, Lilli; Lui, Michael; Nduka, Charles

    2017-06-01

    Facial palsy may be complicated by ipsilateral synkinesis or contralateral hyperkinesis. Botulinum toxin is increasingly used in the management of facial palsy; however, the optimum dose, treatment interval, adjunct therapy and performance as compared with alternative treatments have not been well established. This study aimed to systematically review the evidence for the use of botulinum toxin in facial palsy. The Cochrane central register of controlled trials (CENTRAL), MEDLINE(R) (1946 to September 2015) and Embase Classic + Embase (1947 to September 2015) were searched for randomised studies using botulinum toxin in facial palsy. Forty-seven studies were identified, and three included. Their physical and patient-reported outcomes are described, and observations and cautions are discussed. Facial asymmetry has a strong correlation to subjective domains such as impairment in social interaction and perception of self-image and appearance. Botulinum toxin injections represent a minimally invasive technique that is helpful in restoring facial symmetry at rest and during movement in chronic, and potentially acute, facial palsy. Botulinum toxin in combination with physical therapy may be particularly helpful. Currently, there is a paucity of data; areas for further research are suggested. A strong body of evidence may allow botulinum toxin treatment to be nationally standardised and recommended in the management of facial palsy. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Peginterferon Treatment In Children: A Review Of Chronic Hepatitis B And Chronic Hepatitis C Treatment

    Directory of Open Access Journals (Sweden)

    Makbule EREN

    2009-11-01

    Full Text Available Despite of extensive blood product screening and national immunization programs, chronic hepatitis B and C infections continues to be a global problem with high mortality, morbidity and economic impact. Even though acquisition of these infections mostly occurs in childhood, major problems appear in adulthood. Cirrhosis and HCC are two major expected late events related to chronic hepatitis B and C infections. Rarely, children may also face these complications. To avoid these complications and increase the life expectancy in adults treatment of these two type infections should be started in childhood with appropriate patient selection. In contrast to children, adults are luckier in terms of treatment alternatives. They have the chance to use more potent antivirals with higher genetic barrier and pegylated form of interferons. Recently, the use of pegylated interferon and ribavirin combinations has been approved in children in Chronic HCV infection. However, chronic hepatitis B treatment in children is still dependent on the use of one type antiviral drug and conventional interferon. Treatment in early ages with an antiviral agent that has limited genetic barrier may block the chance of treatment or reduce the response rate in adulthood in chronic hepatitis B infection. This burden indicates the necessity of new therapeutic modalities in children. In this term pegylated interferons may be one of the optiones. In this article we aimed to reviewe the efficacy and safety of conventional and pegylated interferons, for the treatment of Hepatitis C and B infections in children.

  20. Mini implants for definitive prosthodontic treatment: a systematic review.

    Science.gov (United States)

    Bidra, Avinash S; Almas, Khalid

    2013-03-01

    Mini implants are commonly used in orthodontics and for interim prosthodontic treatment, but evidence for their use in definitive prosthodontic treatment is not clear. This systematic review evaluated the mini-implant literature to analyze short-term (1 to 5 years), medium-term (5 to 10 years), and long-term (beyond 10 years) survival rates when used for definitive prosthodontic treatment. An electronic search of the English language literature for articles published between January 1974 and May 2012 was performed by using PubMed and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were mini dental implants, narrow diameter implants, reduced diameter implants, small diameter implants, transitional implants, interim implants, and provisional implants. After a systematic filtering process, the selected articles were subjected to a detailed review, and the data collected were used to calculate the 1-year interval survival rate (ISR) and the cumulative survival rate (CSR). The electronic database search yielded 1807 titles. By scrutinizing the titles and abstracts with inclusion and exclusion criteria, the researchers identified 9 studies of mini implants for definitive prosthodontic treatment. Of the studies identified, 1 was a randomized controlled trial, 2 were prospective studies, and 6 were retrospective studies. The majority of mini implants were placed by using a flapless surgical technique in the mandibular anterior region to support an overdenture. The 1st year ISR was 94.7% and the CSR over a 9-year period, primarily attributed to data from 1 study, was 92.2%. Most implants were immediately loaded and almost all implant failures occurred during the first year after implant placement. For short-term survival, the first year ISR of 94.7% of mini dental implants appears encouraging, but the true 1-year survival rate is unknown, as the minimum follow-up period reported for several implants was less than a year

  1. Glycyrrhizic Acid in the Treatment of Liver Diseases: Literature Review

    Directory of Open Access Journals (Sweden)

    Jian-yuan Li

    2014-01-01

    Full Text Available Glycyrrhizic acid (GA is a triterpene glycoside found in the roots of licorice plants (Glycyrrhiza glabra. GA is the most important active ingredient in the licorice root, and possesses a wide range of pharmacological and biological activities. GA coupled with glycyrrhetinic acid and 18-beta-glycyrrhetic acid was developed in China or Japan as an anti-inflammatory, antiviral, and antiallergic drug for liver disease. This review summarizes the current biological activities of GA and its medical applications in liver diseases. The pharmacological actions of GA include inhibition of hepatic apoptosis and necrosis; anti-inflammatory and immune regulatory actions; antiviral effects; and antitumor effects. This paper will be a useful reference for physicians and biologists researching GA and will open the door to novel agents in drug discovery and development from Chinese herbs. With additional research, GA may be more widely used in the treatment of liver diseases or other conditions.

  2. Breast Cancer After Treatment of Hodgkin's Lymphoma: General Review

    International Nuclear Information System (INIS)

    Alm El-Din, Mohamed A.; El-Badawy, Samy A.; Taghian, Alphonse G.

    2008-01-01

    The improved survival rates among patients with Hodgkin's lymphoma over the past few decades have come with increased incidence of second malignancies. One of the major concerns among female survivors is the significantly elevated risk of breast cancer that appears with extended follow-up. In this review, we include the published literature regarding the risk of breast cancer after irradiation for Hodgkin's lymphoma. We also present the possible long-term surveillance strategies and the optimal time to start screening these women. This could potentially help in early detection of secondary breast cancers and consequently improve outcomes. Furthermore, because of prior radiotherapy, the management of the breast cancer among this unique population has been controversial. We discuss the characteristics of breast cancer that occurs after Hodgkin's lymphoma and also treatment options that could be implemented

  3. Pseudofolliculitis barbae: review and update on new treatment modalities.

    Science.gov (United States)

    Garcia-Zuazaga, Jorge

    2003-07-01

    Pseudofolliculits barbae, PFB, is a common cutaneous disease encountered frequently in medical practice. PFB represents a chronic inflammatory condition of the hair follicle caused by ingrown hairs producing an inflammatory foreign body reaction. The pathogenesis of PFB is multifactorial. Factors such as hair type and direction of hair growth play a role in the initial inflammatory reaction. In the armed forces, PFB represents a real challenge for both the physician and the patient. The combat environment, with the recent threat of biological and chemical weapons, requires the servicemen to be clean-shaven for appropriate gas mask fitting around the face. This article will review the etiology, pathogenesis, classification, and newer treatment modalities in the management of PFB.

  4. Electron beam treatment planning: A review of dose computation methods

    International Nuclear Information System (INIS)

    Mohan, R.; Riley, R.; Laughlin, J.S.

    1983-01-01

    Various methods of dose computations are reviewed. The equivalent path length methods used to account for body curvature and internal structure are not adequate because they ignore the lateral diffusion of electrons. The Monte Carlo method for the broad field three-dimensional situation in treatment planning is impractical because of the enormous computer time required. The pencil beam technique may represent a suitable compromise. The behavior of a pencil beam may be described by the multiple scattering theory or, alternatively, generated using the Monte Carlo method. Although nearly two orders of magnitude slower than the equivalent path length technique, the pencil beam method improves accuracy sufficiently to justify its use. It applies very well when accounting for the effect of surface irregularities; the formulation for handling inhomogeneous internal structure is yet to be developed

  5. The mechanisms of heavy metal immobilization by cementitious material treatments and thermal treatments: A review.

    Science.gov (United States)

    Guo, Bin; Liu, Bo; Yang, Jian; Zhang, Shengen

    2017-05-15

    Safe disposal of solid wastes containing heavy metals is a significant task for environment protection. Immobilization treatment is an effective technology to achieve this task. Cementitious material treatments and thermal treatments are two types of attractive immobilization treatments due to that the heavy metals could be encapsulated in their dense and durable wasteforms. This paper discusses the heavy metal immobilization mechanisms of these methods in detail. Physical encapsulation and chemical stabilization are two fundamental mechanisms that occur simultaneously during the immobilization processes. After immobilization treatments, the wasteforms build up a low permeable barrier for the contaminations. This reduces the exposed surface of wastes. Chemical stabilization occurs when the heavy metals transform into more stable and less soluble metal bearing phases. The heavy metal bearing phases in the wasteforms are also reviewed in this paper. If the heavy metals are incorporated into more stable and less soluble metal bearing phases, the potential hazards of heavy metals will be lower. Thus, converting heavy metals into more stable phases during immobilization processes should be a common way to enhance the immobilization effect of these immobilization methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. New antibacterials for the treatment of toxoplasmosis; a patent review.

    Science.gov (United States)

    Rodriguez, Juan Bautista; Szajnman, Sergio Hernán

    2012-03-01

    Toxoplasma gondii is an opportunistic protozoan parasite responsible for toxoplasmosis. T. gondii is able to infect a wide range of hosts, particularly humans and warm-blooded animals. Toxoplasmosis can be considered as one of the most prevalent parasitic diseases affecting close to one billion people worldwide, but its current chemotherapy is still deficient and is only effective in the acute phase of the disease. This review covers different approaches to toxoplasmosis chemotherapy focused on the metabolic differences between the host and the parasite. Selective action on different targets such as the isoprenoid pathway, dihydrofolate reductase, T. gondii adenosine kinase, different antibacterials, T. gondii histone deacetylase and calcium-dependent protein kinases is discussed. A new and safe chemotherapy is needed, as T. gondii causes serious morbidity and mortality in pregnant women and immunodeficient patients undergoing chemotherapy. A particular drawback of the available treatments is the lack of efficacy against the tissue cyst of the parasite. During this review a broad scope of several attractive targets for drug design have been presented. In this context, the isoprenoid pathway, dihydrofolate reductase, T. gondii histone deacetylase are promising molecular targets.

  7. Review of Natural Compounds for Potential Skin Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Tawona N. Chinembiri

    2014-08-01

    Full Text Available Most anti-cancer drugs are derived from natural resources such as marine, microbial and botanical sources. Cutaneous malignant melanoma is the most aggressive form of skin cancer, with a high mortality rate. Various treatments for malignant melanoma are available, but due to the development of multi-drug resistance, current or emerging chemotherapies have a relatively low success rates. This emphasizes the importance of discovering new compounds that are both safe and effective against melanoma. In vitro testing of melanoma cell lines and murine melanoma models offers the opportunity for identifying mechanisms of action of plant derived compounds and extracts. Common anti-melanoma effects of natural compounds include potentiating apoptosis, inhibiting cell proliferation and inhibiting metastasis. There are different mechanisms and pathways responsible for anti-melanoma actions of medicinal compounds such as promotion of caspase activity, inhibition of angiogenesis and inhibition of the effects of tumor promoting proteins such as PI3-K, Bcl-2, STAT3 and MMPs. This review thus aims at providing an overview of anti-cancer compounds, derived from natural sources, that are currently used in cancer chemotherapies, or that have been reported to show anti-melanoma, or anti-skin cancer activities. Phytochemicals that are discussed in this review include flavonoids, carotenoids, terpenoids, vitamins, sulforaphane, some polyphenols and crude plant extracts.

  8. Research Review: Gender identity in youth: treatment paradigms and controversies.

    Science.gov (United States)

    Turban, Jack L; Ehrensaft, Diane

    2017-10-26

    Pediatric gender identity has gained increased attention over the past several years in the popular media, political arena, and medical literature. This article reviews terminology in this evolving field, traditional models of gender identity development and their limitations, epidemiology and natural history of cross-gender identification among children and adolescents, co-occurring conditions and behaviors, research into the biological and psychosocial determinants of cross-gender identification, and research into the options regarding and benefits of clinical approaches to gender incongruent youth. Based on a critical review of the extant literature, both theoretical and empirical, that addresses the issue of pediatric gender identity, the authors synthesized what is presently known and what is in need of further research in order to elucidate the developmental trajectory and clinical needs of gender diverse youth. The field of pediatric gender identity has evolved substantially over the past several years. New research suggests that cross-gender identification is prevalent (approximately 1% of youth). These youth suffer disproportionately high rates of anxiety, depression, and suicidality. Although research into the etiology of cross-gender identification is limited, emerging data have shown that affirmative treatment protocols may improve the high rates of mental health difficulties seen among these patients. The field of pediatric gender identity has evolved dramatically. Emerging data suggest that these patients' high rates of anxiety, depression, and suicidality appear to be improved with affirmative protocols, although future longitudinal data are needed. © 2017 Association for Child and Adolescent Mental Health.

  9. Photobiomodulation for the treatment of retinal diseases: a review

    Directory of Open Access Journals (Sweden)

    Ivayla I. Geneva

    2016-01-01

    Full Text Available Photobiomodulation (PBM, also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber’s hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: “photobiomodulation AND retina”, “low level light therapy AND retina”, “low level laser therapy AND retina”, and “FR/NIR therapy AND retina”. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.

  10. Exploring treatment by covariate interactions using subgroup analysis and meta-regression in cochrane reviews: a review of recent practice.

    Directory of Open Access Journals (Sweden)

    Sarah Donegan

    Full Text Available Treatment by covariate interactions can be explored in reviews using interaction analyses (e.g., subgroup analysis. Such analyses can provide information on how the covariate modifies the treatment effect and is an important methodological approach for personalising medicine. Guidance exists regarding how to apply such analyses but little is known about whether authors follow the guidance.Using published recommendations, we developed criteria to assess how well interaction analyses were designed, applied, interpreted, and reported. The Cochrane Database of Systematic Reviews was searched (8th August 2013. We applied the criteria to the most recently published review, with an accessible protocol, for each Cochrane Review Group. We excluded review updates, diagnostic test accuracy reviews, withdrawn reviews, and overviews of reviews. Data were summarised regarding reviews, covariates, and analyses.Each of the 52 included reviews planned or did interaction analyses; 51 reviews (98% planned analyses and 33 reviews (63% applied analyses. The type of analysis planned and the type subsequently applied (e.g., sensitivity or subgroup analysis was discrepant in 24 reviews (46%. No review reported how or why each covariate had been chosen; 22 reviews (42% did state each covariate a priori in the protocol but no review identified each post-hoc covariate as such. Eleven reviews (21% mentioned five covariates or less. One review reported planning to use a method to detect interactions (i.e., interaction test for each covariate; another review reported applying the method for each covariate. Regarding interpretation, only one review reported whether an interaction was detected for each covariate and no review discussed the importance, or plausibility, of the results, or the possibility of confounding for each covariate.Interaction analyses in Cochrane Reviews can be substantially improved. The proposed criteria can be used to help guide the reporting and

  11. Membranous nephropathy: A review on the pathogenesis, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Wei Ling Lai

    2015-02-01

    Full Text Available In adults, membranous nephropathy (MN is a major cause of nephrotic syndrome. However, the etiology of approximately 75% of MN cases is idiopathic. Secondary causes of MN are autoimmune diseases, infection, drugs, and malignancy. The pathogenesis of MN involves formation of immune complex in subepithelial sites, but the definite mechanism is still unknown. There are three hypotheses about the formation of immune complex, including preformed immune complex, in situ immune-complex formation, and autoantibody against podocyte membrane antigen. The formation of immune complex initiates complement activation, which subsequently leads to glomerular damage. Recently, the antiphospholipase A2 receptor antibody was found to be associated with idiopathic MN. This finding may be useful in the diagnosis and prognosis of MN. The current treatment includes best supportive care, which consists of the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, lipid-lowering agents, and optimal control of blood pressure. Immunosuppressive agents should be used for patients who suffer from refractory proteinuria or complications associated with nephrotic syndrome. Existing evidence supports the use of a combination of steroid and alkylating agents. This article reviews the epidemiology, pathogenesis, diagnosis, and the treatment of MN.

  12. Treatment of Men for "Low Testosterone": A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Samantha Huo

    Full Text Available Testosterone products are recommended by some prescribers in response to a diagnosis or presumption of "low testosterone" (low-T for cardiovascular health, sexual function, muscle weakness or wasting, mood and behavior, and cognition. We performed a systematic review of 156 eligible randomized controlled trials in which testosterone was compared to placebo for one or more of these conditions. We included studies in bibliographic databases between January 1, 1950 and April 9, 2016, and excluded studies involving bodybuilding, contraceptive effectiveness, or treatment of any condition in women or children. Studies with multiple relevant endpoints were included in all relevant tables. Testosterone supplementation did not show consistent benefit for cardiovascular risk, sexual function, mood and behavior, or cognition. Studies that examined clinical cardiovascular endpoints have not favored testosterone therapy over placebo. Testosterone is ineffective in treating erectile dysfunction and controlled trials did not show a consistent effect on libido. Testosterone supplementation consistently increased muscle strength but did not have beneficial effects on physical function. Most studies on mood-related endpoints found no beneficial effect of testosterone treatment on personality, psychological well-being, or mood. The prescription of testosterone supplementation for low-T for cardiovascular health, sexual function, physical function, mood, or cognitive function is without support from randomized clinical trials.

  13. Reviewing the options for local estrogen treatment of vaginal atrophy

    Directory of Open Access Journals (Sweden)

    Lindahl SH

    2014-03-01

    Full Text Available Sarah H Lindahl Sutter East Bay Medical Foundation, SEBMF – Diablo Division, Castro Valley, CA, USA Background: Vaginal atrophy is a chronic condition with symptoms that include vaginal dryness, pain during sex, itching, irritation, burning, and discharge, as well as various urinary problems. Up to 45% of postmenopausal women may be affected, but it often remains underreported and undertreated. This article aims to review the current recommendations for treatment of vaginal atrophy, and current data on the effectiveness and safety of local vaginal estrogen therapies. Methods: Literature regarding vaginal atrophy (2007–2012 was retrieved from PubMed and summarized, with emphasis on data related to the treatment of vaginal atrophy with local vaginal estrogen therapy. Results: Published data support the effectiveness and endometrial safety of low-dose local estrogen therapies. These results further support the general recommendation by the North American Menopause Society that a progestogen is not needed for endometrial protection in patients using low-dose local vaginal estrogen. Benefits of long-term therapy for vaginal atrophy include sustained relief of symptoms as well as physiological improvements (eg, decreased vaginal pH and increased blood flow, epithelial thickness, secretions. Conclusion: Currently available local vaginal estrogen therapies are well tolerated and effective in relieving symptoms of vaginal atrophy. Recent data support the endometrial safety of low-dose regimens for up to 1 year. Keywords: menopause, estrogen, local estrogen therapy, vaginal atrophy

  14. Review of drug treatment of oral submucous fibrosis.

    Science.gov (United States)

    Chole, Revant H; Gondivkar, Shailesh M; Gadbail, Amol R; Balsaraf, Swati; Chaudhary, Sudesh; Dhore, Snehal V; Ghonmode, Sumeet; Balwani, Satish; Mankar, Mugdha; Tiwari, Manish; Parikh, Rima V

    2012-05-01

    This study undertook a review of the literature on drug treatment of oral submucous fibrosis. An electronic search was carried out for articles published between January 1960 to November 2011. Studies with high level of evidence were included. The levels of evidence of the articles were classified after the guidelines of the Oxford Centre for Evidence-Based Medicine. The main outcome measures used were improvement in oral ulceration, burning sensation, blanching and trismus. Only 13 publications showed a high level of evidence (3 randomized controlled trials and 10 clinical trials/controlled clinical trials), with a total of 1157 patients. Drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene, have been used. Only systemic agents were associated with few adverse effects like gastritis, gastric irritation and peripheral flushing with pentoxifylline, and flushingly warm skin with nylidrin hydrochloride; all other side-effects were mild and mainly local. Few studies with high levels of evidence were found. The drug treatment that is currently available for oral submucous fibrosis is clearly inadequate. There is a need for high-quality randomized controlled trials with carefully selected and standardized outcome measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. A critical review on textile wastewater treatments: Possible approaches.

    Science.gov (United States)

    Holkar, Chandrakant R; Jadhav, Ananda J; Pinjari, Dipak V; Mahamuni, Naresh M; Pandit, Aniruddha B

    2016-11-01

    Waste water is a major environmental impediment for the growth of the textile industry besides the other minor issues like solid waste and resource waste management. Textile industry uses many kinds of synthetic dyes and discharge large amounts of highly colored wastewater as the uptake of these dyes by fabrics is very poor. This highly colored textile wastewater severely affects photosynthetic function in plant. It also has an impact on aquatic life due to low light penetration and oxygen consumption. It may also be lethal to certain forms of marine life due to the occurrence of component metals and chlorine present in the synthetic dyes. So, this textile wastewater must be treated before their discharge. In this article, different treatment methods to treat the textile wastewater have been presented along with cost per unit volume of treated water. Treatment methods discussed in this paper involve oxidation methods (cavitation, photocatalytic oxidation, ozone, H2O2, fentons process), physical methods (adsorption and filtration), biological methods (fungi, algae, bacteria, microbial fuel cell). This review article will also recommend the possible remedial measures to treat different types of effluent generated from each textile operation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Handling and Treatment of Poultry Hatchery Waste: A Review

    Directory of Open Access Journals (Sweden)

    Belinda Rodda

    2011-01-01

    Full Text Available A literature review was undertaken to identify methods being used to handle and treat hatchery waste. Hatchery waste can be separated into solid waste and liquid waste by centrifuging or by using screens. Potential methods for treating hatchery waste on site include use of a furnace to heat the waste to produce steam to run a turbine generator or to use an in line composter to stabilise the waste. There is also potential to use anaerobic digestion at hatcheries to produce methane and fertilisers. Hatcheries disposing wastewater into lagoons could establish a series of ponds where algae, zooplankton and fish utilise the nutrients using integrated aquaculture which cleans the water making it more suitable for irrigation. The ideal system to establish in a hatchery would be to incorporate separation and handling equipment to separate waste into its various components for further treatment. This would save disposal costs, produce biogas to reduce power costs at plants and produce a range of value added products. However the scale of operations at many hatcheries is too small and development of treatment systems may not be viable.

  17. Herbal treatments for alleviating premenstrual symptoms: a systematic review.

    Science.gov (United States)

    Dante, Giulia; Facchinetti, Fabio

    2011-03-01

    Premenstrual syndrome (PMS) is a condition of cyclical and recurrent physical and psychological discomfort occurring 1 to 2 weeks before menstrual period. More severe psychological symptoms have been described for the premenstrual dysphoric disorder (PMDD). No single treatment is universally recognised as effective and many patients often turn to therapeutic approaches outside of conventional medicine. This systematic review is aimed at analysing the effects of herb remedies in the above conditions. Systematic literature searches were performed in electronic databases, covering the period January 1980 to September 2010. Randomised controlled clinical trials (RCTs) were included. Papers quality was evaluated with the Jadad' scale. A further evaluation of PMS/PMDD diagnostic criteria was also done. Of 102 articles identified, 17 RCTs were eligible and 10 of them were included. The heterogeneity of population included, study design and outcome presentation refrained from a meta-analysis. Vitex agnus castus was the more investigated remedy (four trials, about 500 women), and it was reported to consistently ameliorate PMS better than placebo. Single trials also support the use of either Gingko biloba or Crocus sativus. On the contrary, neither evening primrose oil nor St. John's Wort show an effect different than placebo. None of the herbs was associated with major health risks, although the reduced number of tested patients does not allow definitive conclusions on safety. Some herb remedies seem useful for the treatment of PMS. However, more RCTs are required to account for the heterogeneity of the syndrome.

  18. Literature Review: Herbal Medicine Treatment after Large-Scale Disasters.

    Science.gov (United States)

    Takayama, Shin; Kaneko, Soichiro; Numata, Takehiro; Kamiya, Tetsuharu; Arita, Ryutaro; Saito, Natsumi; Kikuchi, Akiko; Ohsawa, Minoru; Kohayagawa, Yoshitaka; Ishii, Tadashi

    2017-01-01

    Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation's experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords "disaster" and "herbal medicine" were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.

  19. New Topical Treatment Options for Actinic Keratosis: A Systematic Review.

    Science.gov (United States)

    Stockfleth, Eggert; Sibbring, Gillian C; Alarcon, Ivette

    2016-01-01

    This systematic review compared the relative efficacy of 5-fluorouracil 0.5% in salicylic acid 10% (5-FU/SA), ingenol mebutate (IMB) and imiquimod 2.5%/3.75% (IMI) for actinic keratosis on the face, forehead or scalp. Only 11 publications, relating to 7 randomised controlled trials, met inclusion criteria and it was only possible to compare the effect of all 3 treatments on complete clinical clearance, and the effect of 5-FU/SA and IMB on actinic keratosis recurrence rate. Despite a higher vehicle response rate for 5-FU/SA, complete clinical clearance was higher than IMB and IMI (55.4, 42.2, and 25.0-30.6/34.0-35.6%, [corrected] respectively). 5-FU/SA was also associated with lower actinic keratosis recurrence rate than IMB at 12 months post-treatment (32.7 vs. 53.9%). Although qualitative assessment suggested a numerical advantage of 5-FU/SA over IMB and IMI in terms of complete clinical clearance and sustained clearance, clinical data from longer term trials, with comparable outcome measures, are required to corroborate these findings.

  20. Epidemiology, treatment and prevention of herpes zoster: A comprehensive review.

    Science.gov (United States)

    Koshy, Elsam; Mengting, Lu; Kumar, Hanasha; Jianbo, Wu

    2018-01-01

    Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised status, and those on immunosuppressant drugs. It is caused by a reactivation of varicella zoster virus infection. Cell-mediated immunity plays a role in this reactivation. Fever, pain, and itch are common symptoms before the onset of rash. Post-herpetic neuralgia is the most common complication associated with herpes zoster. Risk factors and complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Routine vaccination for individuals over 60 years has shown considerable effect in terms of reducing the incidence of herpes zoster and post-herpetic neuralgia. Treatment with antiviral drugs and analgesics within 72 hours of rash onset has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia. This study mainly focuses on herpes zoster using articles and reviews from PubMed, Embase, Cochrane library, and a manual search from Google Scholar. We cover the incidence of herpes zoster, gender distribution, seasonal and regional distribution of herpes zoster, incidence of herpes zoster among immunocompromised individuals, incidence of post-herpetic neuralgia following a zoster infection, complications, management, and prevention of herpes zoster and post-herpetic neuralgia.

  1. Stenting in the treatment of acute ischemic stroke: literature review.

    Directory of Open Access Journals (Sweden)

    Edgar A Samaniego

    2011-12-01

    Full Text Available Recanalization of acute large artery occlusions is a strong predictor of good outcome. The development of thrombectomy devices resulted in a significant improvement in recanalization rates compared to thrombolytics alone. However, clinical trials and registries with these thrombectomy devices in acute ischemic stroke (AIS have shown recanalization rates in the range of 40-81%. The last decade has seen the development of nickel titanium self-expandable stents (SES. These stents, in contrast to balloon-mounted stents, allow better navigability and deployment in tortuous vessels and therefore are optimal for the cerebral circulation. SES were initially used for stent-assisted coil embolization of intracranial aneurysms and for treatment of intracranial stenosis. However, a few authors have recently reported feasibility of deployment of SES in AIS. The use of these devices yielded higher recanalization rates compared to traditional thrombectomy devices. Encouraged by these results, retrievable SES systems have been recently used in AIS. These devices offer the advantage of resheathing and retrieving of the stent even after full deployment. Some of these stents can also be detached in case permanent stent placement is needed. Retrievable SES are being used in Europe and currently tested in clinical trials in the United States. We review the recent literature in the use of stents for the treatment of AIS secondary to large vessel occlusion.

  2. Giving Student Groups a Stronger Voice: Using Participatory Research and Action (PRA) to Initiate Change to a Curriculum

    Science.gov (United States)

    O'Neill, Geraldine; McMahon, Sinead

    2012-01-01

    Traditional student feedback mechanisms have been criticised for being teacher-centred in design and, in particular, for their absence of transparent follow-up actions. In contrast, this study describes the process and the evaluation of a participatory research and action (PRA) approach used in an undergraduate physiotherapy degree. This approach…

  3. Loss of coolant accident (LOCA) analysis for McMaster Nuclear Reactor through probabilistic risk assessment (PRA)

    Energy Technology Data Exchange (ETDEWEB)

    Ha, T.; Garland, W.J. [McMaster Univ., Dept. of Engineering Physics, Hamilton, Ontario (Canada)]. E-mail: hats@mcmaster.ca

    2006-07-01

    A probabilistic risk assessment (PRA) was conducted for the loss of coolant accident (LOCA) sequence in the McMaster Nuclear Reactor (MNR). A level 1 PRA was completed including event sequence modeling, system modeling, and quantification. To support the quantification of the accident sequence identified, data analysis using the Bayesian method and human reliability analysis (HRA) using the ASEP approach were performed. Since human performance in research reactors is significantly different from that in power reactors, a different time-oriented HRA model was proposed and applied for the estimation of the human error probability (HEP) of core relocation. This HEP estimate was less than that by the ASEP approach by a factor of about 2. These two HEP estimates were used for sensitivity analysis, and modeling uncertainty in the PRA models was quantified. This showed the necessity of appropriate human reliability models in PRA for research reactors. This method could be implemented for the operators' actions which require extensive manual execution with little cognitive load, as might be the case for some maintenance operations in power reactors. (author)

  4. A systematic review of natural health product treatment for vitiligo

    Directory of Open Access Journals (Sweden)

    Boon Heather S

    2008-05-01

    Full Text Available Abstract Background Vitiligo is a hypopigmentation disorder affecting 1 to 4% of the world population. Fifty percent of cases appear before the age of 20 years old, and the disfigurement results in psychiatric morbidity in 16 to 35% of those affected. Methods Our objective was to complete a comprehensive, systematic review of the published scientific literature to identify natural health products (NHP such as vitamins, herbs and other supplements that may have efficacy in the treatment of vitiligo. We searched eight databases including MEDLINE and EMBASE for vitiligo, leucoderma, and various NHP terms. Prospective controlled clinical human trials were identified and assessed for quality. Results Fifteen clinical trials were identified, and organized into four categories based on the NHP used for treatment. 1 L-phenylalanine monotherapy was assessed in one trial, and as an adjuvant to phototherapy in three trials. All reported beneficial effects. 2 Three clinical trials utilized different traditional Chinese medicine products. Although each traditional Chinese medicine trial reported benefit in the active groups, the quality of the trials was poor. 3 Six trials investigated the use of plants in the treatment of vitiligo, four using plants as photosensitizing agents. The studies provide weak evidence that photosensitizing plants can be effective in conjunction with phototherapy, and moderate evidence that Ginkgo biloba monotherapy can be useful for vitiligo. 4 Two clinical trials investigated the use of vitamins in the therapy of vitiligo. One tested oral cobalamin with folic acid, and found no significant improvement over control. Another trial combined vitamin E with phototherapy and reported significantly better repigmentation over phototherapy only. It was not possible to pool the data from any studies for meta-analytic purposes due to the wide difference in outcome measures and poor quality ofreporting. Conclusion Reports investigating the

  5. Doxapram Treatment for Apnea of Prematurity: A Systematic Review.

    Science.gov (United States)

    Vliegenthart, Roseanne J S; Ten Hove, Christine H; Onland, Wes; van Kaam, Anton H L C

    2017-01-01

    Apnea of prematurity (AOP) is a common complication of preterm birth, for which caffeine is the first treatment of choice. In case of persistent AOP, doxapram has been advocated as an additional therapy. To identify and appraise all existing evidence regarding efficacy and safety of doxapram use for AOP in infants born before 34 weeks of gestational age. All studies reporting on doxapram use for AOP were identified by searching electronic databases, references from relevant studies, and abstracts from the Societies for Pediatric Research. Two reviewers independently assessed study eligibility and quality, and extracted data on study design, patient characteristics, efficacy and safety outcomes. The randomized controlled trials showed less apnea during doxapram treatment when compared to placebo, but no difference in treatment effect when compared to theophylline. No serious adverse effects were reported. We identified 28 observational studies consisting mainly of cohort studies and case series (n = 1,994). There was considerable heterogeneity in study design and quality. Most studies reported a positive effect of doxapram on apnea rate. A few studies reported on long-term outcomes with conflicting results. A range of possible doxapram-related short-term adverse effects were reported, sometimes associated with the use of higher doses. Based on the limited number of studies and level of evidence, no firm conclusions on the efficacy and safety of doxapram in preterm infants can be drawn. For this reason, routine use cannot be recommended. A large multicenter randomized controlled trial is urgently needed to provide more conclusive evidence. © 2016 The Author(s) Published by S. Karger AG, Basel.

  6. "VEM PRA RUA": THE POLITICAL AND THE POLITICS ON THE WEB

    Directory of Open Access Journals (Sweden)

    Benedito Fernando Pereira

    2014-12-01

    Full Text Available Considering the political and the social division of senses, this paper seeks to check how is the process of signification in a society increasingly challenged by electronic discourse and the ways in which political and policy find themselves affected by it. In order do that, we make the analysis of discursive statements “vem pra rua” and “somos a rede social” that were present in banners and posters in street protests in Brazil in 2013, which were organized and delivered, in large part, by virtual means. We observed that such utterances go through a process of appropriation and re-signification, with shifting meanings that run of market logic, go to the social politics and go back to the market logic. We had also observed how the urban environment is affected by the electronic discourse that now constitutes the ways it makes sense.

  7. Elastin and Mechanics of Pig Pericardial Resistance Arteries (pPRA)

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Leurgans, Thomas; Rosenstand, Kristoffer

    Resistance arteries are remodeled in hypertension and diabetes. Elastin was reported to play a role herein. The parietal pericardium is opened during cardio-thoracic surgeries and might be a valuable biopsy for research in cardio-vascular diseases. We tested the hypothesis that resistance arteries...... can be isolated from the pericardium to study the micro-architecture of elastin and vascular wall mechanics. The pericardium of pigs served to test the hypothesis. pPRAs were microdissected. Their structure was examined using multiphoton excitation fluorescence microscopy. Diameter......-tension and pressure-diameter-length relationships were recorded in myographs. Findings are compared to rodent mesenteric resistance arteries and –basilar arteries (rMRA, rBA) with comparable lumen diameter (±300µm at 100mmHg). pPRA have no clear external elastic lamina (present in rMRA, but not rBA), scant elastin...

  8. Validation needs of seismic probabilistic risk assessment (PRA) methods applied to nuclear power plants

    International Nuclear Information System (INIS)

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J.

    1985-01-01

    An effort to validate seismic PRA methods is in progress. The work concentrates on the validation of plant response and fragility estimates through the use of test data and information from actual earthquake experience. Validation needs have been identified in the areas of soil-structure interaction, structural response and capacity, and equipment fragility. Of particular concern is the adequacy of linear methodology to predict nonlinear behavior. While many questions can be resolved through the judicious use of dynamic test data, other aspects can only be validated by means of input and response measurements during actual earthquakes. A number of past, ongoing, and planned testing programs which can provide useful validation data have been identified, and validation approaches for specific problems are being formulated

  9. Diagnosis and Treatment of Bipolar Disorders in Adults: A Review of the Evidence on Pharmacologic Treatments

    Science.gov (United States)

    Jann, Michael W.

    2014-01-01

    Background Patients with bipolar disorder are exceptionally challenging to manage because of the dynamic, chronic, and fluctuating nature of their disease. Typically, the symptoms of bipolar disorder first appear in adolescence or early adulthood, and are repeated over the patient's lifetime, expressed as unpredictable recurrences of hypomanic/manic or depressive episodes. The lifetime prevalence of bipolar disorder in adults is reported to be approximately 4%, and its management was estimated to cost the US healthcare system in 2009 $150 billion in combined direct and indirect costs. Objective To review the published literature and describe the personal and societal burdens associated with bipolar disorder, the impact of delays in accurate diagnosis, and the evidence for the clinical effectiveness of available pharmacologic therapies. Methods The studies in this comprehensive review were selected for inclusion based on clinical relevance, importance, and robustness of data related to diagnosis and treatment of bipolar disorder. The search terms that were initially used on MEDLINE/PubMed and Google Scholar were restricted to 1994 through 2014 and included “bipolar disorder,” “mania,” “bipolar depression,” “mood stabilizer,” “atypical antipsychotics,” and “antidepressants.” High-quality, recent reviews of major relevant topics were included to supplement the primary studies. Discussion Substantial challenges facing patients with bipolar disorder, in addition to their severe mood symptoms, include frequent incidence of psychiatric (eg, anxiety disorders, alcohol or drug dependence) and general medical comorbidities (eg, diabetes, cardiovascular disease, obesity, migraine, and hepatitis C virus infection). It has been reported that more than 75% of patients take their medication less than 75% of the time, and the rate of suicide (0.4%) among patients with bipolar disorder is more than 20 times greater than in the general US population. Mood

  10. Use of PRA techniques to optimize the design of the IRIS nuclear power plant

    International Nuclear Information System (INIS)

    Muhlheim, M.D.; Cletcher, J.W. II

    2003-01-01

    True design optimization of a plants inherent safety and performance characteristics results when a probabilistic risk assessment (PRA) is integrated with the plant-level design process. This is the approach being used throughout the design of the International Reactor Innovative and Secure (IRIS) nuclear power plant to maximize safety. A risk-based design optimization tool employing a 'one-button' architecture is being developed by the Oak Ridge National Laboratory to evaluate design changes; new modeling approaches, methods, or theories modeling uncertainties and completeness; physical assumptions; and data changes on component, cabinet, train, and system bases. Unlike current PRAs, the one-button architecture allows components, modules, and data to be interchanged at will with the probabilistic effect immediately apparent. Because all of the current and previous design, and data sets are available via the one-button architecture, the safety ramifications of design options are evaluated, feedback on design alternatives is immediate, and true optimization and understanding can be achieved. Thus, for the first time, PRA analysts and designers can easily determine the probabilistic implications of different design configurations and operating conditions in various combinations for the entire range of initiating events. The power of the one-button architecture becomes evident by the number of design alternatives that can be evaluated C11 component choices yielded 160 design alternatives. Surprisingly, the lessons learned can be counter-intuitive and significant. For example, one of the alternative designs for IRIS evaluated via this architecture revealed that because of common-cause failure probabilities, using the most reliable components actually decreased systems' reliability. (author)

  11. Treatment of Hyperthyroidism in Down Syndrome: Case Report and Review of Literature.

    Science.gov (United States)

    Ali, Fawzi E.; Al-Busairi, Waleed A.; Al-Mulla, Fatema A.

    1999-01-01

    A case of an institutionalized adult male with Down syndrome and hyperthyroidism is reported. After treatment with radioactive iodine, he was found to be markedly hypothyroid when he was reviewed 11 weeks later. Three treatment options for hyperthyroidism in Down syndrome are reviewed: surgery, medical treatments, and radiotherapy. (Author/CR)

  12. 76 FR 2754 - Agency Information Collection (Matured Endowment Notification) Activity Under OMB Review

    Science.gov (United States)

    2011-01-14

    ... Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the... receive the proceeds in monthly installment or in a combination of cash and monthly installment and to...

  13. Parent-professional alliance and outcomes of child, parent, and family treatment: A systematic review

    NARCIS (Netherlands)

    Greef, M. de; Pijnenburg, H.M.P.H.M.; Hattum, M.J.C. van; McLeod, B.D.; Scholte, R.H.J.

    2017-01-01

    This review systematically explored research examining the relation between parent-professional alliance and outcomes of psychosocial treatments provided to children, and their parents and families. Study findings and methodological characteristics were reviewed to investigate the evidence linking

  14. Pharmacologic treatment in pediatric functional abdominal pain disorders: a systematic review

    NARCIS (Netherlands)

    Korterink, Judith J.; Rutten, Juliette M. T. M.; Venmans, Leonie; Benninga, Marc A.; Tabbers, Merit M.

    2015-01-01

    To systematically review literature assessing efficacy and safety of pharmacologic treatments in children with abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). MEDLINE and Cochrane Database were searched for systematic reviews and randomized controlled trials investigating

  15. New therapeutic approaches for treatment of tularaemia: a review

    Directory of Open Access Journals (Sweden)

    Sandrine eBOISSET

    2014-03-01

    Full Text Available Antibiotic treatment of tularaemia is based on a few drugs, including the fluoroquinolones, the tetracyclines and the aminoglycosides. Because no effective and safe vaccine is currently available, tularaemia prophylaxis following proven exposure to F. tularensis also relies on administration of antibiotics. A number of reasons make it necessary to search for new therapeutic alternatives: the potential toxicity of first-line drugs, especially in children and pregnant women; a high rate of treatment relapses and failures, especially for severe and/or suppurated forms of the disease; and the possible use of antibiotic-resistant strains in the context of a biological threat. This review presents novel therapeutic approaches that have been explored in recent years to improve tularaemia patients’ management and prognosis. First, the activities of newly available antibiotic compounds were evaluated against F. tularensis, including tigecycline (a glycylcycline, ketolides (telithromycin and cethromycin and fluoroquinolones (moxifloxacin, gatifloxacin, trovafloxacin and grepafloxacin. The liposome delivery of some antibiotics was evaluated. The effect of antimicrobial peptides against F. tularensis was also considered. Other drugs were evaluated for their ability to suppress the intracellular multiplication of F. tularensis. The effects of the modulation of the innate immune response (especially via TLR receptors on the course of F. tularensis infection were characterized. Another approach was the administration of specific antibodies to induce passive resistance to F. tularensis infection. All of these studies highlight the need to develop new therapeutic strategies to improve the management of patients with tularaemia. Many possibilities exist, some unexplored. Moreover, it is likely that new therapeutic alternatives that are effective against this intracellular pathogen could be, at least partially, extrapolated to other human pathogens.

  16. Functional Food and Cardiovascular Disease Prevention and Treatment: A Review.

    Science.gov (United States)

    Asgary, Sedigheh; Rastqar, Ali; Keshvari, Mahtab

    2018-03-12

    Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Lifestyle factors, including nutrition, play an important role in the etiology and treatment of CVD. Functional foods based on their basic nutritional functions can decrease the risk of many chronic diseases and have some physiological benefits. They contain physiologically active components either from plant or animal sources, marketed with the claim of their ability to reduce heart disease risk, focusing primarily on established risk factors, which are hyperlipidemia, diabetes, metabolic syndrome, obesity/overweight, elevated lipoprotein A level, small dense low-density lipoprotein cholesterol (LDL-C), and elevated inflammatory marker levels. Functional foods are suspected to exert their cardioprotective effects mainly through blood lipid profile level and improve hypertension control, endothelial function, platelet aggregation, and antioxidant actions. Clinical and epidemiological observations indicate that vegetable and fruit fiber, nuts and seeds, sea foods, coffee, tea, and dark chocolate have cardioprotective potential in humans, as well whole-grain products containing intact grain kernels rich in fiber and trace nutrients. They are nutritionally more important because they contain phytoprotective substances that might work synergistically to reduce cardiovascular risk. This review will focus on the reciprocal interaction between functional foods and the potential link to cardiovascular health and the possible mechanisms of action.

  17. Phytochemicals in Skin Cancer Prevention and Treatment: An Updated Review

    Directory of Open Access Journals (Sweden)

    Chau Yee Ng

    2018-03-01

    Full Text Available Skin is the largest human organ, our protection against various environmental assaults and noxious agents. Accumulation of these stress events may lead to the formation of skin cancers, including both melanoma and non-melanoma skin cancers. Although modern targeted therapies have ameliorated the management of cutaneous malignancies, a safer, more affordable, and more effective strategy for chemoprevention and treatment is clearly needed for the improvement of skin cancer care. Phytochemicals are biologically active compounds derived from plants and herbal products. These agents appear to be beneficial in the battle against cancer as they exert anti-carcinogenic effects and are widely available, highly tolerated, and cost-effective. Evidence has indicated that the anti-carcinogenic properties of phytochemicals are due to their anti-oxidative, anti-inflammatory, anti-proliferative, and anti-angiogenic effects. In this review, we discuss the preventive potential, therapeutic effects, bioavailability, and structure–activity relationship of these selected phytochemicals for the management of skin cancers. The knowledge compiled here will provide clues for future investigations on novel oncostatic phytochemicals and additional anti-skin cancer mechanisms.

  18. Clinical pharmacology review of escitalopram for the treatment of depression.

    Science.gov (United States)

    Pastoor, Devin; Gobburu, Joga

    2014-01-01

    Depression is a serious and debilitating psychiatric condition with serious societal health and economic implications. Escitalopram , the S-enantiomer of racemic citalopram, is an effective treatment for major depressive disorder. This review covers the clinical pharmacology of escitalopram, with emphasis on regulatory approval. Its pharmacokinetics, pharmacodynamics and clinical efficacy for major depressive disorder are evaluated, along with data regarding safety and tolerability. Drug development of escitalopram was heavily guided by prior approval of citalopram. Select safety and efficacy studies for escitalopram in combination with supportive evidence from the results of prior citalopram studies allowed for regulatory approval for acute and maintenance claims in both adults and adolescents, while minimizing burden on the sponsor. Escitalopram has been shown to have better efficacy and safety profile than other selective serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor drugs, including racemic citalopram. The first generic escitalopram was approved in 2012, along with Abbreviated New Drug Applications. The associated cost savings have helped reduce the burden of weighing the benefits of escitalopram over less-expensive alternatives.

  19. Treatment of bruxism in children: a systematic review.

    Science.gov (United States)

    Restrepo, Claudia; Gómez, Sandra; Manrique, Ruben

    2009-01-01

    To conduct a systematic review to assess and analyze the scientific evidence about the available therapies for bruxism in children. The literature was searched using Medline, PubMed, Ovid, Biomed Central, EBSCOhost, ISI, Cochrane Library, Embase, LILACS, Scielo, Scirus, the Internet at large, and databases of universities from March 1985 to the end of September 2007. Studies had to be intervention studies for bruxism in children, and the children included in the studies had to be 3 to 10 years old. From 52 records found, 2 fulfilled the inclusion criteria. In 1 study, bruxism was treated by widening the upper airway through adenoidectomy, and the other study proposed to treat bruxism in children with psychologic techniques. When analyzed, the 2 considered studies did not fully accomplish the requirements to treat the etiology of bruxism in children. The available literature does not provide adequate support to treat bruxism in children, as the diagnosis methods in the studies are insufficient and are not comparable to confirm the presence of bruxism. Very few studies about therapies for bruxism in children meet the quality criteria required for the evidence-based practice. Treatment for bruxism in children requires further study.

  20. Melatonin as a treatment for mood disorders: a systematic review.

    Science.gov (United States)

    De Crescenzo, F; Lennox, A; Gibson, J C; Cordey, J H; Stockton, S; Cowen, P J; Quested, D J

    2017-12-01

    Melatonin has been widely studied in the treatment of sleep disorders and evidence is accumulating on a possible role for melatonin influencing mood. Our aim was to determine the efficacy and acceptability of melatonin for mood disorders. We conducted a comprehensive systematic review of randomized clinical trials on patients with mood disorders, comparing melatonin to placebo. Eight clinical trials were included; one study in bipolar, three in unipolar depression and four in seasonal affective disorder. We have only a small study on patients with bipolar disorder, while we have more studies testing melatonin as an augmentation strategy for depressive episodes in major depressive disorder and seasonal affective disorder. The acceptability and tolerability were good. We analyzed data from three trials on depressive episodes and found that the evidence for an effect of melatonin in improving mood symptoms is not significant (SMD = 0.37; 95% CI [-0.05, 0.37]; P = 0.09). The small sample size and the differences in methodology of the trials suggest that our results are based on data deriving from investigations occurring early in this field of study. There is no evidence for an effect of melatonin on mood disorders, but the results are not conclusive and justify further research. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Treatments for chronic myeloid leukemia: a qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Ferdin

    2012-08-01

    Full Text Available Roxanne Ferdinand,1 Stephen A Mitchell,2 Sarah Batson,2 Indra Tumur11Pfizer, Tadworth, UK; 2Abacus International, Bicester, UKBackground: Chronic myeloid leukemia (CML is a myeloproliferative disorder of blood stem cells. The tyrosine kinase inhibitor (TKI imatinib was the first targeted therapy licensed for patients with chronic-phase CML, and its introduction was associated with substantial improvements in response and survival compared with previous therapies. Clinical trial data are now available for the second-generation TKIs (nilotinib, dasatinib, and bosutinib in the first-, second-, and third-line settings. A qualitative systematic review was conducted to qualitatively compare the clinical effectiveness, safety, and effect on quality of life of TKIs for the management of chronic-, accelerated-, or blast-phase CML patients.Methods: Included studies were identified through a search of electronic databases in September 2011, relevant conference proceedings and the grey literature.Results: In the first-line setting, the long-term efficacy (up to 8 years of imatinib has been confirmed in a single randomized controlled trial (International Randomized Study of Interferon [IRIS]. All second-generation TKIs reported lower rates of transformation, and comparable or superior complete cytogenetic response (CCyR, major molecular response (MMR, and complete molecular response rates compared with imatinib by 2-year follow-up. Each of the second-generation TKIs was associated with a distinct adverse-event profile. Bosutinib was the only second-generation TKI to report quality-of-life data (no significant difference compared with imatinib treatment. Data in the second- and third-line setting confirmed the efficacy of the second-generation TKIs in either imatinib-resistant or -intolerant patients, as measured by CCyR and MMR rates.Conclusion: Data from first-line randomized controlled trials reporting up to 2-year follow-up indicate superior response

  2. Review insights on the probabilistic risk assessment for the Limerick Generating Station

    International Nuclear Information System (INIS)

    1984-08-01

    In recognition of the high population density around the Limerick Generating Station site and the proposed power level, the Philadelphia Electric Company, in response to NRC staff requests, conducted and submitted between March 1981 and November 1983 a probabilistic risk assessment (PRA) on internal event contributors and a severe accident risk assessment on external event contributors to assess risks posed by operation of the plant. The applicant has developed perspectives using PRA models on the safety profile of the Limerick plant and has altered the plant design to reduce accident vulnerabilities identified in these PRAs. The staff's review of the Limerick PRA has particularly emphasized the dominant accident sequences and the resulting insights into demonstration of compliance with regulatory requirments, unique design features and major plant vulnerabilities to assess the need for any additional measures to further improve the safety of the LGS. The staff's review insights and PRA safety review conclusions are presented in this report

  3. Treatment and disposal of tyres: Two EU approaches. A review.

    Science.gov (United States)

    Torretta, Vincenzo; Rada, Elena Cristina; Ragazzi, Marco; Trulli, Ettore; Istrate, Irina Aura; Cioca, Lucian Ionel

    2015-11-01

    The treatment and disposal of tyres from vehicles has long been of considerable environmental importance. The main problem lies in the mixed composition of the tyres. Studies have been undertaken to modify the structure of the tyres, especially with reference to the percentage of granulated rubber incorporated, in order to improve their performance, and also to reduce their environmental impact during normal functioning (noise, particulates, etc.) and facilitate recycling and final disposal. The aim of the present study is to review and compare how used tyres are treated and disposed of in two different EU countries. The first is Italy, which has been part of the European Union since its inception, and has important industrial traditions. The second is Romania, an emerging country which recently became part of the EU, and whose economic and industrial development has had a major boost in recent years, with a strong growth in waste production, together with consumption in urban areas. The occasion was useful to consider the situation concerning the evolution of the different aspects related to the management of the end-of-life tyres. In particular, the paper considers the properties of tyre waste and their potential reuse, the enhancement of end-of-life tires and the various types of recovery, such as the reconstruction of tyres and the material recovery. The aspects related to the energy recovery and the use of the life cycle analysis, as a tool to support the choices of the best management system, were also taken into consideration, not forgetting that an adequate end-of-life planning is important when developing a sustainable product, since it can affect considerably its overall life cycle. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Treatment of depressive disorders in primary care - protocol of a multiple treatment systematic review of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Linde Klaus

    2011-11-01

    Full Text Available Abstract Background Several systematic reviews have summarized the evidence for specific treatments of primary care patients suffering from depression. However, it is not possible to answer the question how the available treatment options compare with each other as review methods differ. We aim to systematically review and compare the available evidence for the effectiveness of pharmacological, psychological, and combined treatments for patients with depressive disorders in primary care. Methods/Design To be included, studies have to be randomized trials comparing antidepressant medication (tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs, hypericum extracts, other agents and/or psychological therapies (e.g. interpersonal psychotherapy, cognitive therapy, behavioural therapy, short dynamically-oriented psychotherapy with another active therapy, placebo or sham intervention, routine care or no treatment in primary care patients in the acute phase of a depressive episode. Main outcome measure is response after completion of acute phase treatment. Eligible studies will be identified from available systematic reviews, from searches in electronic databases (Medline, Embase and Central, trial registers, and citation tracking. Two reviewers will independently extract study data and assess the risk of bias using the Cochrane Collaboration's corresponding tool. Meta-analyses (random effects model, inverse variance weighting will be performed for direct comparisons of single interventions and for groups of similar interventions (e.g. SSRIs vs. tricyclics and defined time-windows (up to 3 months and above. If possible, a global analysis of the relative effectiveness of treatments will be estimated from all available direct and indirect evidence that is present in a network of treatments and comparisons. Discussion Practitioners do not only want to know whether there is evidence that a specific treatment is more effective than

  5. Evaluation of safety issues on newly regulated nuclear power plant by tsunami-level 1 PRA

    International Nuclear Information System (INIS)

    Tsuji, Yutaro; Miwa, Shuichiro; Mori, Michitsugu

    2014-01-01

    The tsunami caused by the Great East Japan Earthquake triggered severe accidents involving the units 1 to 4 at the Fukushima Dai-ichi nuclear power station (NPS). In order to re-operate existing nuclear power plants it should be necessary to reduce the core damage frequency on risk by tsunami. In this work, effects of the off-site power supply installation on resuming operation of nuclear power plants were investigated by utilizing the Tsunami-Level 1 Probability Risk Assessment (PRA). Unit 2 of the Onagawa nuclear power station, which resembled units 2 and 3 of Fukushima Dai-ichi, was selected for PRA. First, event-tree was created for the units of the Onagawa nuclear power station with the safety systems such as Emergency Core Cooling System (ECCS), investigating the plant situation at the time of the earthquake and tsunami occurrences. It was assumed that the magnitude of the tsunami was equivalent to the Great East Japan Earthquake. The accident-analytical progression-time was 36 hours, determined from the core-damage occurrence of the unit 3 of Fukushima Dai-ichi nuclear power station. Failure probabilities were calculated by the fault tree, which was created from the elements listed in the event tree. For the calculation, failure rates reported by the NUCIA (NUClear Information Archives) were primarily utilized. Then, obtained failure probabilities were embedded to the event tree. Core damage probabilities were evaluated by calculating success and failure rates for each accidental progression and scenarios. Restoration of the failed equipment and machineries was not considered in the analysis. Installation of the power supply vehicles at the nuclear power plant site reduced the core damage probability from 2.58×10 -6 to 8.56×10 -7 . However, continued addition of the power supply vehicles could not lower the core damage probability further more. In the case of Unit 2 of Onagawa nuclear power station, there could be a limit to lower the core damage

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

    Science.gov (United States)

    Bagal, Manisha V; Gogate, Parag R

    2014-01-01

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

  7. Treatment of extra-articular proximal and middle phalangeal fractures of the hand: a systematic review

    NARCIS (Netherlands)

    D. Verver (Daniëlle); L. Timmermans (Lucas); Klaassen, R.A.; C.H. van der Vlies (Cornelis); D.I. Vos (Dagmar); N.W.L. Schep (Niels)

    2017-01-01

    textabstractThe aim of the study was to systematically review the patient reported and functional outcomes of treatment for extra-articular proximal or middle phalangeal fractures of the hand in order to determine the best treatment options. The review methodology was registered with PROSPERO. A

  8. 76 FR 56503 - Agency Information Collection (Report of Treatment in Hospital) Activity Under OMB Review

    Science.gov (United States)

    2011-09-13

    ... of Treatment in Hospital) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below... Treatment in Hospital, VA FL 29-551. OMB Control Number: 2900-0119. Type of Review: Extension of a currently...

  9. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  10. Practitioner Review: Treatments for Tourette syndrome in children and young people - a systematic review.

    Science.gov (United States)

    Whittington, Craig; Pennant, Mary; Kendall, Tim; Glazebrook, Cristine; Trayner, Penny; Groom, Madeleine; Hedderly, Tammy; Heyman, Isobel; Jackson, Georgina; Jackson, Stephen; Murphy, Tara; Rickards, Hugh; Robertson, Mary; Stern, Jeremy; Hollis, Chris

    2016-09-01

    Tourette syndrome (TS) and chronic tic disorder (CTD) affect 1-2% of children and young people, but the most effective treatment is unclear. To establish the current evidence base, we conducted a systematic review of interventions for children and young people. Databases were searched from inception to 1 October 2014 for placebo-controlled trials of pharmacological, behavioural, physical or alternative interventions for tics in children and young people with TS or CTD. Certainty in the evidence was assessed with the GRADE approach. Forty trials were included [pharmacological (32), behavioural (5), physical (2), dietary (1)]. For tics/global score there was evidence favouring the intervention from four trials of α2-adrenergic receptor agonists [clonidine and guanfacine, standardised mean difference (SMD) = -0.71; 95% CI -1.03, -0.40; N = 164] and two trials of habit reversal training (HRT)/comprehensive behavioural intervention (CBIT) (SMD = -0.64; 95% CI -0.99, -0.29; N = 133). Certainty in the effect estimates was moderate. A post hoc analysis combining oral clonidine/guanfacine trials with a clonidine patch trial continued to demonstrate benefit (SMD = -0.54; 95% CI -0.92, -0.16), but statistical heterogeneity was high. Evidence from four trials suggested that antipsychotic drugs improved tic scores (SMD = -0.74; 95% CI -1.08, -0.40; N = 76), but certainty in the effect estimate was low. The evidence for other interventions was categorised as low or very low quality, or showed no conclusive benefit. When medication is considered appropriate for the treatment of tics, the balance of clinical benefits to harm favours α2-adrenergic receptor agonists (clonidine and guanfacine) as first-line agents. Antipsychotics are likely to be useful but carry the risk of harm and so should be reserved for when α2-adrenergic receptor agonists are either ineffective or poorly tolerated. There is evidence that HRT/CBIT is effective, but there is no evidence for HRT

  11. REVIEW ON NATURAL METHODS FOR WASTE WATER TREATMENT

    Directory of Open Access Journals (Sweden)

    Ashwani Kumar Dubey

    2014-01-01

    Full Text Available In Ethiopia, the most common method of disposal of waste water is by land spreading. This treatment method has numerous problems, namely high labor requirements and the potential for eutrophication of surface an d ground waters. Constructed wetlands are commonl y used for treatment of seconda ry municipal wastewaters and they have been gaining popularity for treatment of agricultural wastewaters in Ethiopia. Intermittent sand filtration may offer an alternative to traditional treatment methods. As well as providing comparable treatment performance, they also have a smaller footprint, due to the substantially higher organic loading rates that may be applied to their surfaces. Th is paper discusses the performance and design criteria of constructed wetlands for the treatment of domestic and agricultural wastewater, and sand filters for the treatment of domestic wastewater. It also proposes sand filtration as an alt ernative treatment mechanism for agricultural wa stewater and suggests design guide lines.

  12. Results and insights of a level-1 internal event PRA of a PWR during mid-loop operations

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1993-01-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analysis that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. The objective of this paper is to present the approach utilized in the level-1 PRA for the Surry plant, and discuss the results obtained. A comparison of the results with those of other shutdown studies is provided. Relevant safety issues such as plant and hardware configurations, operator training, and instrumentation and control is discussed

  13. Chronic orchialgia: Review of treatments old and new

    Directory of Open Access Journals (Sweden)

    Bayo Tojuola

    2016-01-01

    Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options.

  14. Review: Drug and nondrug treatment in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient...

  15. Automated system for review of radiotherapy treatment sheets

    International Nuclear Information System (INIS)

    Collado Chamorro, P.; Sanz Freire, C. J.; Vazquez Galinanes, A.; Diaz Pascual, V.; Gomez amez, J.; Martinez Sanchez, S.; Ossola Lentati, G. A.

    2011-01-01

    In many modern radiotherapy services begins to leaf treatment implemented in electronic form. In our department has developed an automated reporting system, that check the following parameters: treatment completed correctly, number of sessions and cumulative dose administered. Likewise treatments are verified in the allocated separate unit, and over-writing table parameters.

  16. Analysis of climate and anthropogenic impacts on runoff in the Lower Pra River Basin of Ghana.

    Science.gov (United States)

    Awotwi, Alfred; Anornu, Geophrey Kwame; Quaye-Ballard, Jonathan; Annor, Thompson; Forkuo, Eric Kwabena

    2017-12-01

    The Lower Pra River Basin (LPRB), located in the forest zone of southern Ghana has experienced changes due to variability in precipitation and diverse anthropogenic activities. Therefore, to maintain the functions of the ecosystem for water resources management, planning and sustainable development, it is important to differentiate the impacts of precipitation variability and anthropogenic activities on stream flow changes. We investigated the variability in runoff and quantified the contributions of precipitation and anthropogenic activities on runoff at the LPRB. Analysis of the precipitation-runoff for the period 1970-2010 revealed breakpoints in 1986, 2000, 2004 and 2010 in the LPRB. The periods influenced by anthropogenic activities were categorized into three periods 1987-2000, 2001-2004 and 2005-2010, revealing a decrease in runoff during 1987-2000 and an increase in runoff during 2001-2004 and 2005-2010. Assessment of monthly, seasonal and annual runoff depicted a significant increasing trend in the runoff time series during the dry season. Generally, runoff increased at a rate of 9.98 × 10 7 m 3 yr -1 , with precipitation variability and human activities contributing 17.4% and 82.3% respectively. The dominant small scale alluvial gold mining activity significantly contributes to the net runoff variability in LPRB.

  17. Application of FIVE methodology in probabilistic risk assessment (PRA) of fire events

    International Nuclear Information System (INIS)

    Lopez Garcia, F.J.; Suarez Alonso, J.; Fiolamengual, M.J.

    1993-01-01

    This paper reflects the experience acquired during the process of evaluation and updating of the fire analysis within the Cofrentes NPP PRA. It determines which points are the least precise, either because of their greater uncertainty or because of their excessive conservatism, as well as the subtasks which have involved a larger work load and could be simplified. These aspects are compared with the steps followed in methodology FIVE (Fire Vulnerability Evaluation Methodology) to assess whether application of this methodology would optimize the task, by making it more systematic and realistic and reducing uncertainties. On the one hand, the FIVE methodology does not have the scope sufficient to carry out a quantitative risk evaluation, but it can easily be complemented -without detriment to its systematic nature- by quantifying core damage in significant areas. On the other hand, certain issues such as definition of the fire growth software program which has to be used, are still not fully closed. Nevertheless, the conclusions derived from this assessment are satisfactory, since it is considered that this methodology would serve to unify the criteria and data of the analysis of fire-induced risks, providing a progressive screening method which would considerably simplify the task. (author)

  18. Value impact analysis utilizing PRA techniques combined with a hybrid plant model

    International Nuclear Information System (INIS)

    Edson, J.L.; Stillwell, D.W.

    1989-01-01

    A value impact analysis (VIA) has been performed by the INEL to support a NRC Regulatory Analysis for resolution of Generic Issue (GI) 29, Bolting Degradation or Failure in Nuclear Power Plants. A VIA for replacing the reactor coolant pressure boundary (RCPB) bolts of BWRs and PWRs was previously prepared by Pacific Northwest Laboratories in 1985 under instructions limiting the VIA to the potential for failure of primary pressure boundary bolting. Subsequently the INEL was requested to perform a VIA that included non primary systems and component support bolts to be compatible with the resolution of the broader issue. Because the initial list of systems and bolting applications that could be included in the VIA was very large, including them all in the VIA would likely result in analyzing some that have little if any effect on public risk. This paper discusses how PRA techniques combined with a hybrid plant model were used to determine which bolts have the potential to be significant contributors to public risk if they were to fail, and therefore were included in the VIA

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

    OpenAIRE

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

    2015-01-01

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

  20. PRA Procedures Guide: a guide to the performance of probabilistic risk assessments for nuclear power plants. Final report, Volume 1 - Chapters 1-8

    International Nuclear Information System (INIS)

    1983-01-01

    This document, the Probabilistic Risk Assessment (PRA) Procedures Guide, is intended to provide an overview of the risk-assessment field as it exists today and to identify acceptable techniques for the systematic assessment of the risk from nuclear power plants. Topics discussed include: organization of PRA; accident-sequence definition and system modeling; human-reliability analysis; data-base development; accident-sequence quantification; physical processes of core-melt accidents; and radionuclide release and transport

  1. Results and insights of a level-1 internal event PRA of a PWR during mid-loop operations

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J.; Wong, S.M.; Holmes, B.; Su, R.F.; Dang, V.; Siu, N.; Bley, D.; Johnson, D.; Lin, J.

    1994-01-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analysis that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by BNL and SNL. Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The scope of the program includes that of a level-3 PRA. The objective of this paper is to present the approach utilized in the level-1 PRA for the Surry plant, and discuss the results obtained. A comparison of the results with those of other shutdown studies is provided. Relevant safety issues such as plant and hardware configurations, operator training, and instrumentation and control is discussed

  2. Development of margin assessment methodology of decay heat removal function against external hazards. (2) Tornado PRA methodology

    International Nuclear Information System (INIS)

    Nishino, Hiroyuki; Kurisaka, Kenichi; Yamano, Hidemasa

    2014-01-01

    Probabilistic Risk Assessment (PRA) for external events has been recognized as an important safety assessment method after the TEPCO's Fukushima Daiichi nuclear power station accident. The PRA should be performed not only for earthquake and tsunami which are especially key events in Japan, but also the PRA methodology should be developed for the other external hazards (e.g. tornado). In this study, the methodology was developed for Sodium-cooled Fast Reactors paying attention to that the ambient air is their final heat sink for removing decay heat under accident conditions. First, tornado hazard curve was estimated by using data recorded in Japan. Second, important structures and components for decay heat removal were identified and an event tree resulting in core damage was developed in terms of wind load and missiles (i.e. steel pipes, boards and cars) caused by a tornado. Main damage cause for important structures and components is the missiles and the tornado missiles that can reach those components and structures placed on high elevations were identified, and the failure probabilities of the components and structures against the tornado missiles were calculated as a product of two probabilities: i.e., a probability for the missiles to enter the intake or outtake in the decay heat removal system, and a probability of failure caused by the missile impacts. Finally, the event tree was quantified. As a result, the core damage frequency was enough lower than 10 -10 /ry. (author)

  3. Peracids in water treatment:a critical review

    OpenAIRE

    Luukkonen, T. (Tero); Pehkonen, S. O. (Simo O.)

    2017-01-01

    Abstract Peracids have gained interest in the water treatment over the last few decades. Peracetic acid (CH₃CO₃H) has already become an accepted alternative disinfectant in wastewater disinfection whereas performic acid (CHO₃H) has been studied much less, although it is also already commercially available. Additionally, peracids have been studied for drinking water disinfection, oxidation of aqueous (micro)pollutants, sludge treatment, and ballast water treatment, to name just a few exampl...

  4. Novel and emerging treatments for autism spectrum disorders: a systematic review.

    Science.gov (United States)

    Rossignol, Daniel A

    2009-01-01

    Currently, only one medication (risperidone) is FDA-approved for the treatment of autism spectrum disorders (ASD). Perhaps for this reason, the use of novel, unconventional, and off-label treatments for ASD is common, with up to 74% of children with ASD using these treatments; however, treating physicians are often unaware of this usage. A systematic literature search of electronic scientific databases was performed to identify studies of novel and emerging treatments for ASD, including nutritional supplements, diets, medications, and nonbiological treatments. A grade of recommendation ("Grade") was then assigned to each treatment using a validated evidence-based guideline as outlined in this review: A: Supported by at least 2 prospective randomized controlled trials (RCTs) or 1 systematic review. B: Supported by at least 1 prospective RCT or 2 nonrandomized controlled trials. C: Supported by at least 1 nonrandomized controlled trial or 2 case series. D: Troublingly inconsistent or inconclusive studies or studies reporting no improvements. Potential adverse effects for each treatment were also reviewed. Grade A treatments for ASD include melatonin, acetylcholinesterase inhibitors, naltrexone, and music therapy. Grade B treatments include carnitine, tetrahydrobiopterin, vitamin C, alpha-2 adrenergic agonists, hyperbaric oxygen treatment, immunomodulation and anti-inflammatory treatments, oxytocin, and vision therapy. Grade C treatments for ASD include carnosine, multivitamin/mineral complex, piracetam, polyunsaturated fatty acids, vitamin B6/magnesium, elimination diets, chelation, cyproheptadine, famotidine, glutamate antagonists, acupuncture, auditory integration training, massage, and neurofeedback. The reviewed treatments for ASD are commonly used, and some are supported by prospective RCTs. Promising treatments include melatonin, antioxidants, acetylcholinesterase inhibitors, naltrexone, and music therapy. All of the reviewed treatments are currently considered

  5. A review of the regenerative endodontic treatment procedure

    Directory of Open Access Journals (Sweden)

    Bin-Na Lee,

    2015-08-01

    Full Text Available Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

  6. Assessing Side Effects of Pharmacotherapy Treatment of Bipolar Disorder: A 20-Year Review of the Literature

    Science.gov (United States)

    Matson, Johnny L.; Gonzalez, Melissa L.; Smith, Kimberly R.; Terlonge, Cindy; Thorson, Ryan T.; Dixon, Dennis R.

    2006-01-01

    A substantial literature on the effective treatment of bipolar disorder has begun to appear, particularly in the last 20 years.The majority of treatments studied have employed medications, particularly mood stabilizers, a typical antipsychotics and antidepressants. Most treatments produce side effects and medications are no exception. A review of…

  7. Bleeding in cancer patients and its treatment: a review.

    Science.gov (United States)

    Johnstone, Candice; Rich, Shayna E

    2017-12-18

    Bleeding is a common problem in cancer patients, related to local tumor invasion, tumor angiogenesis, systemic effects of the cancer, or anti-cancer treatments. Existing bleeds can also be exacerbated by medications such as bevacizumab, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants. Patients may develop acute catastrophic bleeding, episodic major bleeding, or low-volume oozing. Bleeding may present as bruising, petechiae, epistaxis, hemoptysis, hematemesis, hematochezia, melena, hematuria, or vaginal bleeding. Therapeutic intervention for bleeding should start by establishing goals of care, and treatment choice should be guided by life expectancy and quality of life. Careful thought should be given to discontinuation of medications and reversal of anticoagulation. Interventions to stop or slow bleeding may include systemic agents or transfusion of blood products. Noninvasive local treatment options include applied pressure, dressings, packing, and radiation therapy. Invasive local treatments include percutaneous embolization, endoscopic procedures, and surgical treatment.

  8. Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions.

    Science.gov (United States)

    Hawk, Cheryl; Minkalis, Amy L; Khorsan, Raheleh; Daniels, Clinton J; Homack, Dennis; Gliedt, Jordan A; Hartman, Julie A; Bhalerao, Shireesh

    2017-06-01

    The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low- to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions. Copyright © 2017. Published by Elsevier Inc.

  9. Pharmacological and non- pharmacological treatment of hypertension: A review article

    Directory of Open Access Journals (Sweden)

    Marjan Seyedmazhari

    2013-01-01

    Full Text Available BACKGROUND: Hypertension is a worldwide epidemic disease. It is more common and more severe in elderly persons. Various studies however have estimated 41.9 million men and 27.8 million women to have prehypertension. Diagnosis and early treatment of prehypertension are of utmost importance. Although hypertension is usually divided into 2 general categories of essential (primary and secondary hypertension, the initial treatment for hypertension often depends on its stage which is determined by systolic and diastolic blood pressure. Lifestyle modification is the first step in treating stage one hypertension. Pharmaceutical treatments including diuretics, angiotensin converting enzyme (ACE inhibitors, calcium blockers, beta blockers, and angiotensin receptor blockers will be recommended if lifestyle modification fails to control blood pressure.    METHODS: The PubMed database was searched by a number of keywords including hypertension, pharmaceutical treatment, and non-pharmaceutical treatment. The results were limited by determining a date range of 2008-11.    RESULTS: High blood pressure causes major health problems for many people around the world. It should be controlled because of its high mortality and morbidity. However, in order to select an appropriate treatment modality, it is initially important to diagnose the kinds and stages of hypertension. Pharmaceutical or non-pharmaceutical treatments can then be employed to control this serious disease.    CONCLUSION: Treating hypertension depends on the kinds and stages of this disease. Several tips should be considered when selecting a method of treatment.       Keywords: Hypertension, Pharmacological treatment, Non-pharmacological treatment

  10. A methodology for reviewing Probabilistic Risk Assessments

    International Nuclear Information System (INIS)

    Derby, S.L.

    1983-01-01

    The starting point for peer review of a Probabilistic Risk Assessment (PRA) is a clear understanding of how the risk estimate was prepared and of what contributions dominate the calculation. The problem facing the reviewers is how to cut through the complex details of a PRA to gain this understanding. This paper presents a structured, analytical procedure that solves this problem. The effectiveness of this solution is demonstrated by an application on the Zion Probabilistic Safety Study. The procedure found the three dominant initiating events and provided a simplified reconstruction of the calculation of the risk estimate. Significant assessments of uncertainty were also identified. If peer review disputes the accuracy of these judgments, then the revised risk estimate could significantly increase. The value of this procedure comes from having a systematic framework for the PRA review. Practical constraints limit the time and qualified people needed for an adequate review. Having the established framework from this procedure as a starting point, reviewers can focus most of their attention on the accuracy and the completeness of the calculation. Time wasted at the start of the review is reduced by first using this procedure to sort through the technical details of the PRA and to reconstruct the risk estimate from dominant contributions

  11. 75 FR 27558 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Extension

    Science.gov (United States)

    2010-05-17

    ...The information collection requirements described below will be submitted to the Office of Management and Budget (``OMB'') for review, as required by the Paperwork Reduction Act (``PRA''). The FTC is seeking public comments on its proposal to extend through May 31, 2013, the current PRA clearance for information collection requirements contained its Antitrust Improvements Act Rules (``HSR Rules'') and corresponding Notification and Report Form for Certain Mergers and Acquisitions (``Notification and Report Form''). That clearance expires on May 31, 2010.

  12. 75 FR 20427 - Agency Information Collection (Rehabilitation Needs Inventory) Activity Under OMB Review

    Science.gov (United States)

    2010-04-19

    ...In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.

  13. 77 FR 47705 - Agency Information Collection (Rehabilitation Needs Inventory) Activity Under OMB Review

    Science.gov (United States)

    2012-08-09

    ...In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.

  14. Ramadan fasting and dental treatment considerations: a review.

    Science.gov (United States)

    Shaeesta, Khaleelahmed Bhavikatti; Prabhuji, M Lv; Shruthi, J R

    2015-01-01

    During the sacred month of Ramadan, Muslims abstain from the consumption of food from dawn until dusk. Extended fasting hours produce changes in the body's metabolism during this period. A majority of the population who fast also restrict themselves from undergoing dental treatments due to a fear of breaking the fast. Even among health professionals, a certain amount of uncertainty prevails about the implications of treating a patient who is fasting. To help clinicians carry out safe and effective treatment without hampering a patient's religious beliefs, the present article focuses on the effect of Ramadan fasting on the body's metabolism and the ramifications for treatment aspects, including medications and dental procedures.

  15. Breast cancer treatment: historical review and current approaches

    International Nuclear Information System (INIS)

    Kulakowski, A.

    1994-01-01

    The evolution and development of opinions on the diagnosis and treatment of breast cancer since Galen to present time is presented. The concept of breast cancer as a local disease has been replaced by the understanding of its systemic character. On this background described are the methods of surgical treatment beginning from early - supraradical, to present -conservative approaches. The ''milestones'' in diagnosis and treatment of breast cancer of the last 40 years are presented. Current methods of breast cancer management include correct diagnosis (clinical examination, mammography, ultrasound, fine needle aspiration biopsy), TNM staging, adequate loco-regional therapy, systemic therapy, rehabilitation, reconstruction and careful follow-up. (author)

  16. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment

    Directory of Open Access Journals (Sweden)

    Wong AWY

    2014-05-01

    Full Text Available Amy WY Wong, Chengfei Zhang, Chun-hung Chu Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China Abstract: Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy AND (single-visit OR one-visit OR 1-visit. Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of

  17. Impact of Gold mining activities on the water quality of the lower pra river

    International Nuclear Information System (INIS)

    Dwamena, Offei Samuel K.

    2013-07-01

    This study was conducted to assess the extent of Mercury (THg) contamination at four locations within the Shama-Mporhor Wassa catchment area of the Lower Pra River. Water, fish and sediment samples were taken twice with the longitudinal transect method at Daboase, Beposo, Bokorkope and Shama during the minor rainy season in October and at the apex of the dry season in March. Careful investigation of the Shama-Mporhor Wassa catchment area revealed that two of the locations Daboase and Beposo had been continuously impacted by the activities of Artisanal Gold miners (AGM). From the study, Total Mercury (THg) levels were found to have persisted in River water several kilometers downstream the second Artisanal Gold mining (AGM) location at Shama estuary for both seasons. Ten trace elements Mercury (Hg), Selenium (Se), Copper (Cu), Chromium (Cr), Lead (Pb), Iron (Fe), Manganese (Mn), Nickel (Ni), Zinc (Zn) and Cadmium (Cd) were determined in water, fish and sediment samples using the Atomic Absorption Spectroscopy (AAS) equipped with both Hydride Generation (HGAAS) for Selenium (Se) and Cold Vapour (CVAAS) for Total Mercury (THg). The levels of Total Mercury (THg) were largely above the WHO and USEPA guidelines for drinking water (1μg/L) and sediments (200 μg/Kg) respectively for the four locations investigated. Total Mercury (THg) exceeded the WHO, 2011 guideline value of 0.5 mg/Kg for fish species Clarias submarginatus but was below the guideline value for Xenomystus nigri. Mean concentration of Cd and Fe exceeded the WHO, 2011 guideline values for drinking water for the wet season. The other trace elements Zn, Ni, Cu, Cr, Se, Mn, and Pb had their mean concentration below the WHO, 2011 guideline values for drinking water. Apart from the mean concentration of Cd that exceeded the Canadian Interim Sediment Quality (ISQG) guideline value of 0.6 mg/Kg for the wet season, Cr, Cu, Zn, Ni and Pb were below their respective guideline values for both seasons. Statistical

  18. Why do ineffective treatments seem helpful? A brief review

    Directory of Open Access Journals (Sweden)

    Hartman Steve E

    2009-10-01

    Full Text Available Abstract After any therapy, when symptoms improve, healthcare providers (and patients are tempted to award credit to treatment. Over time, a particular treatment can seem so undeniably helpful that scientific verification of efficacy is judged an inconvenient waste of time and resources. Unfortunately, practitioners' accumulated, day-to-day, informal impressions of diagnostic reliability and clinical efficacy are of limited value. To help clarify why even treatments entirely lacking in direct effect can seem helpful, I will explain why real signs and symptoms often improve, independent of treatment. Then, I will detail quirks of human perception, interpretation, and memory that often make symptoms seem improved, when they are not. I conclude that healthcare will grow to full potential only when judgments of clinical efficacy routinely are based in properly scientific, placebo-controlled, outcome analysis.

  19. Treatment for Negative Symptoms in Schizophrenia: A Comprehensive Review

    NARCIS (Netherlands)

    Veerman, Selene R. T.; Schulte, Peter F. J.; de Haan, Lieuwe

    2017-01-01

    Negative symptoms (such as amotivation and diminished expression) associated with schizophrenia are a major health concern. Adequate treatment would mean important progress with respect to quality of life and participation in society. Distinguishing primary from secondary negative symptoms may

  20. Application of multivariate statistical technique for hydrogeochemical assessment of groundwater within the Lower Pra Basin, Ghana

    Science.gov (United States)

    Tay, C. K.; Hayford, E. K.; Hodgson, I. O. A.

    2017-06-01

    Multivariate statistical technique and hydrogeochemical approach were employed for groundwater assessment within the Lower Pra Basin. The main objective was to delineate the main processes that are responsible for the water chemistry and pollution of groundwater within the basin. Fifty-four (54) (No) boreholes were sampled in January 2012 for quality assessment. PCA using Varimax with Kaiser Normalization method of extraction for both rotated space and component matrix have been applied to the data. Results show that Spearman's correlation matrix of major ions revealed expected process-based relationships derived mainly from the geochemical processes, such as ion-exchange and silicate/aluminosilicate weathering within the aquifer. Three main principal components influence the water chemistry and pollution of groundwater within the basin. The three principal components have accounted for approximately 79% of the total variance in the hydrochemical data. Component 1 delineates the main natural processes (water-soil-rock interactions) through which groundwater within the basin acquires its chemical characteristics, Component 2 delineates the incongruent dissolution of silicate/aluminosilicates, while Component 3 delineates the prevalence of pollution principally from agricultural input as well as trace metal mobilization in groundwater within the basin. The loadings and score plots of the first two PCs show grouping pattern which indicates the strength of the mutual relation among the hydrochemical variables. In terms of proper management and development of groundwater within the basin, communities, where intense agriculture is taking place, should be monitored and protected from agricultural activities. especially where inorganic fertilizers are used by creating buffer zones. Monitoring of the water quality especially the water pH is recommended to ensure the acid neutralizing potential of groundwater within the basin thereby, curtailing further trace metal

  1. Neurofeedback for Tinnitus TreatmentReview and Current Concepts

    OpenAIRE

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily ...

  2. Karakteristik Reverse Transcriptase Gen Polymerase Virus Hepatitis B Pada Penderita Hepatitis B Kronis Asimptomatik Pra-Pengobatan

    Directory of Open Access Journals (Sweden)

    Turyadi Turyadi

    2018-01-01

    Full Text Available Abstrak Antiviral nucleos(tide analogue (NUCs merupakan pengobatan utama pada hepatitis B kronis (HBK. Pemberian jangka panjang dinilai cukup efektif menekan progresivitas penyakit, namun dapat menimbulkan mutasi resisten. Studi ini melihat karakteristik gen polimerase yang berkaitan dengan resistensi NUCs pada penderita HBK asimptomatik pra-pengobatan. Penelitian dilakukan di Laboratorium Hepatitis, Lembaga Biologi Molekuler Eijkman, Jakarta. Sebanyak 38 sampel individu dengan hepatitis B surface antigen (HBsAg positif dikarakterisasi dengan PCR-sekuensing. Genotipe dan subtipe ditentukan berdasarkan sekuens HBsAg. Sebanyak 37 (97,4% sampel menunjukkan mutasi rtQ238H/N dan satu sampel wildtype. Sebanyak 23 (62,2% memiliki mutasi rtQ238H, 10 (27,0% rtQ238N, dan empat (10,8% dengan mutasi ganda rtA194T dan rtQ238H. Genotipe B ditemukan pada 26 (68,4% sampel, genotipe C pada 11 (28,9%, dan genotipe D pada satu (2,6% sampel. Secara statistik, mutasi rtQ238H berasosiasi dengan genotipe B (p<0,001 dan mutasi rtQ238N dengan genotipe C (p<0,001. Subtipe ayw ditemukan pada 25 (65,8% sampel, adr pada 11 (28,9%, dan adw pada dua (5,3% sampel. Sebagian besar sampel tidak menunjukkan mutasi yang berkaitan dengan resistensi NUCs, sehingga pemberian NUCs masih. Mutasi rtQ238H merupakan varian yang berkaitan dengan genotipe B dan rtQ238N dengan genotipe C. Kata kunci: virus hepatitis B; mutasi; pengobatan; polymerase.   Reverse-Transcriptase Characteristics of Hepatitis B Virus Polymerase Gene in Treatment-Naïve Asymptomatic Chronic Hepatitis B Individuals Abstract Nucleos(tide analogues (NUCs remain the main treatment for chronic hepatitis B (CHB. Long-term use of NUCs significantly reduces disease progression; however, it might lead to resistance-associated mutations. We studied characteristics of polymerase gene related to NUCs resistance in naïve hepatitis B surface antigen (HBsAg-positive individuals. The research was done at Laboratory of Hepatitis

  3. Novel treatment technologies for PFAS compounds: A critical review.

    Science.gov (United States)

    Kucharzyk, Katarzyna H; Darlington, Ramona; Benotti, Mark; Deeb, Rula; Hawley, Elisabeth

    2017-12-15

    Perfluorinated compounds such as perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) have recently drawn great attention due to their wide distribution in aquatic environments. The understanding of the physicochemical properties and fate and transport of PFAs in groundwater is still limited. Preliminary studies indicate that these compounds can readily bioaccumulate and pose human and animal health concerns. Due to their physicochemical properties, PFOS and PFOA are water soluble, nonvolatile and persistent in the environment, which is a cause of concern related to their treatment with conventional remediation technologies. Extraction with inefficient carbon adsorption is one of the most common treatment technologies for remediation of PFOS- or PFOA-impacted groundwater. Several other innovative and promising technologies, including sonochemistry, bioremediation and photolysis, have been tested for their effectiveness in removal of perfluorinated compounds. This paper provides a baseline for understanding research needs to better develop treatment technologies for PFOA and PFOS in groundwater. Frontiers for improving the state of practice for PFOA and PFOS treatment include the development of more cost-effective ex situ treatment methods and the development and demonstration of promising in situ treatment technologies at the pilot and full scale. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Tamoxifen treatment and gynecologic side effects : A review

    NARCIS (Netherlands)

    Mourits, MJE; De Vries, EGE; Willemse, PHB; Ten Hoor, KA; Hollema, H; Van der Zee, AGJ

    Objective: To review the literature on tamoxifen side effects on the female genital tract and psychosexual function in premenopausal and postmenopausal women. Data Sources: We used the English-language literature in MEDLINE and reference lists from selected articles. Search terms included:

  5. Behavioral Treatment of Children's Fears and Phobias: A Review.

    Science.gov (United States)

    Morris, Richard J.; Kratochwill, Thomas R.

    1985-01-01

    An overview of the behaviorally-oriented fear reduction methods for children is presented. Systematic desensitization and related procedures, flooding-related therapies, contingency management approaches, modeling procedures, and self-control methods are discussed after reviewing normative and prevalence data regarding children's fears. Research…

  6. Candida Prosthetic Joint Infection. A Review of Treatment Methods.

    Science.gov (United States)

    Cobo, Fernando; Rodríguez-Granger, Javier; Sampedro, Antonio; Aliaga-Martínez, Luis; Navarro-Marí, José María

    2017-01-01

    Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to Candida albicans in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to S. epidermidis occurred several months ago. Moreover, the treatment in 76 cases of Candida prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients. Infection site was the knee in 38 patients and hip in 36; pain was present in 44 patients and swelling in 24. The most frequent species was C. albicans , followed by C. parapsilosis . Eleven patients were only treated with antifungal drugs being the outcome favourable in all of them. Two-stage exchange arthroplasty was performed in 30 patients, and resection arthroplasty in other 30; in three patients one-stage exchange arthroplasty was done. A favourable outcome was found in 58 patients after antifungal plus surgical treatment, in 11 after antifungal treatment alone and in one after surgery alone. The type of treatment is still not clearly defined and an algorithm for treatment in fungal PJI should be established, but various types of surgical procedures may be applied.

  7. Behavioral treatments for children and adults who stutter: a review

    Directory of Open Access Journals (Sweden)

    Blomgren M

    2013-06-01

    Full Text Available Michael Blomgren Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT, USA Abstract: This paper provides a brief overview of stuttering followed by a synopsis of current approaches to treat stuttering in children and adults. Treatment is discussed in terms of multifactorial, operant, speech restructuring, and anxiolytic approaches. Multifactorial and operant treatments are designed for young children who stutter. Both of these approaches involve parent training and differ primarily in their focus on reducing demands on the child (multifactorial or in their use of response contingent stimulation (operant conditioning. Speech restructuring and anxiolytic approaches are used with adults who stutter. Speech restructuring approaches focus on the mechanics of speech production, and anxiolytic treatments tend to focus on the symptoms and social and vocational challenges of stuttering. The evidence base for these different approaches is outlined. Response contingent therapy (for children and speech restructuring therapy (for adults have the most robust empirical evidence base. Multifactorial treatments for children and stuttering management approaches for adults are popular but are based on theoretical models of stuttering; the evidence base is not robust and tends to be inferred from work in areas such as cognitive behavior therapy and desensitization. Comprehensive, or holistic, approaches to treating stuttering are also discussed. Comprehensive approaches for treating stuttering in adults address both improved speech fluency and stuttering management. Keywords: stuttering, treatment, stuttering management, speech restructuring, cognitive restructuring

  8. A meta-analytic review of psychological treatments for tinnitus.

    Science.gov (United States)

    Andersson, G; Lyttkens, L

    1999-08-01

    Meta-analysis is a technique of combining results from different trials in order to obtain estimates of effects across studies. Meta-analysis has, as yet, rarely been used in audiological research. The aim of this paper was to conduct a meta-analysis on psychological treatment of tinnitus. The outcomes of 18 studies, including a total of 24 samples and up to 700 subjects, were included and coded. Included were studies on cognitive/cognitive-behavioural treatment, relaxation, hypnosis, biofeedback, educational sessions and problem-solving. Effect sizes for perceived tinnitus loudness, annoyance, negative affect (e.g. depression) and sleep problems were calculated for randomized controlled studies, pre-post-treatment design studies and follow-up results. Results showed strong to moderate effects on tinnitus annoyance for controlled studies (d = 0.86), pre-post designs (d = 0.5) and at follow-up (d = 0.48). Results on tinnitus loudness were weaker and disappeared at follow-up. Lower effect sizes were also obtained for measures of negative affect and sleep problems. Exploratory analyses revealed that cognitive-behavioural treatments were more effective on ratings of annoyance in the controlled studies. It is concluded that psychological treatment for tinnitus is effective, but that aspects such as depression and sleep problems may need to be targeted in future studies.

  9. Review of the treatment of actinides-bearing radioactive wastes

    International Nuclear Information System (INIS)

    Krause, H.

    1983-01-01

    Actinides bearing wastes are produced above all in the course of irradiated nuclear fuel reprocessing and during fabrication of mixed oxide fuel elements. Particular attention in research and development work must be paid to this type of waste, mainly on account of its longevity. In practical application, the specific character of the actinides bearing wastes has been largely recognized. Nevertheless, definitions and methods of treatment generally accepted worldwide are still missing today. This has no bearing as yet on present day treatment of radioactive wastes. But by the time of application of the breeder technology at the latest a special treatment concept should be available which complies with the high actinide contents and short precooling periods of the wastes

  10. Ionizing radiation quarantine treatments against tephritid fruit flies: a review

    Energy Technology Data Exchange (ETDEWEB)

    Hallman, G. J. [USDA-ARS, Weslaco, TX (United States)

    1999-06-15

    Fruit flies of the family Tephritidae are considered the most important insect pest risk carried by exported fruits worldwide. Fruits suspected of harboring fruit fly eggs and larvae must be treated to control virtually 100% of any tephritids present. Irradiation is unique among quarantine treatments in that it is the only treatment used which does not cause acute mortality; instead, insects are prevented from maturing or are sterilized. Tephritids have been the most studied group of quarantined pests as far as irradiation; minimum absorbed doses confirmed with large-scale testing to provide control to the probit 9 level (99.9968%) have ranged from 50 to 250 Gy. Considerable work has been done with the Mediterranean fruit fly, Ceratitis capitata (Wiedemann), one of the most important quarantined pests worldwide, and doses suggested to provide quarantine security have varied widely. The fact that insects are still alive for some time after irradiation has been one of the major obstacles to its use. Irradiation may be the most widely applicable quarantine treatment from the standpoint of fruit quality. However, some important fruits shipped across quarantine barriers (mangoes, Mangifera indica L., and citrus) may suffer from doses as low as 150 Gy when applied on a commercial scale where much of the fruit load may receive 300 Gy. Fortunately, some of the important tephritids attacking these fruits, such as Anastrepha spp., can be controlled with lower doses. Mainland USA has begun to use irradiation as a quarantine treatment for some fruits imported from Hawaii since April 1995 and remains the only country using irradiation as a quarantine treatment, although on a very limited basis. Irradiation offers some additional risk abatement advantages over other quarantine treatments. © 1999 Published by Elsevier Science B.V. All rights reserved. (author)

  11. Ionizing radiation quarantine treatments against tephritid fruit flies: a review

    International Nuclear Information System (INIS)

    Hallman, G.J.

    1999-01-01

    Fruit flies of the family Tephritidae are considered the most important insect pest risk carried by exported fruits worldwide. Fruits suspected of harboring fruit fly eggs and larvae must be treated to control virtually 100% of any tephritids present. Irradiation is unique among quarantine treatments in that it is the only treatment used which does not cause acute mortality; instead, insects are prevented from maturing or are sterilized. Tephritids have been the most studied group of quarantined pests as far as irradiation; minimum absorbed doses confirmed with large-scale testing to provide control to the probit 9 level (99.9968%) have ranged from 50 to 250 Gy. Considerable work has been done with the Mediterranean fruit fly, Ceratitis capitata (Wiedemann), one of the most important quarantined pests worldwide, and doses suggested to provide quarantine security have varied widely. The fact that insects are still alive for some time after irradiation has been one of the major obstacles to its use. Irradiation may be the most widely applicable quarantine treatment from the standpoint of fruit quality. However, some important fruits shipped across quarantine barriers (mangoes, Mangifera indica L., and citrus) may suffer from doses as low as 150 Gy when applied on a commercial scale where much of the fruit load may receive 300 Gy. Fortunately, some of the important tephritids attacking these fruits, such as Anastrepha spp., can be controlled with lower doses. Mainland USA has begun to use irradiation as a quarantine treatment for some fruits imported from Hawaii since April 1995 and remains the only country using irradiation as a quarantine treatment, although on a very limited basis. Irradiation offers some additional risk abatement advantages over other quarantine treatments. © 1999 Published by Elsevier Science B.V. All rights reserved. (author)

  12. Polycystic ovary syndrome: a review for dermatologists: Part II. Treatment.

    Science.gov (United States)

    Buzney, Elizabeth; Sheu, Johanna; Buzney, Catherine; Reynolds, Rachel V

    2014-11-01

    Dermatologists are in a key position to treat the manifestations of polycystic ovary syndrome (PCOS). The management of PCOS should be tailored to each woman's specific goals, reproductive interests, and particular constellation of symptoms. Therefore, a multidisciplinary approach is recommended. In part II of this continuing medical education article, we present the available safety and efficacy data regarding treatments for women with acne, hirsutism, and androgenetic alopecia. Therapies discussed include lifestyle modification, topical therapies, combined oral contraceptives, antiandrogen agents, and insulin-sensitizing drugs. Treatment recommendations are made based on the current available evidence. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. REVIEW OF EXISTING LCA STUDIES ON WASTE WATER TREATMENT TECHNOLOGIES

    DEFF Research Database (Denmark)

    Larsen, Henrik Fred; Hauschild, Michael Zwicky

    The EU research project “NEPTUNE” is related to the EU Water Framework Directive and focused on the development of new waste water treatment technologies (WWTT) for municipal waste water. The sustainability of these WWTTs is going to be assessed by the use of life cycle assessment (LCA). New life...... importance of the different life cycle stages and the individual impact categories in the total impact from the waste water treatment, and the degree to which micropollutants, pathogens and whole effluent toxicity have been included in earlier studies. The results show that more than 30 different WWTT (and...

  14. Predictors of adherence to exercise interventions during and after cancer treatment : A systematic review

    NARCIS (Netherlands)

    Ormel, H L; van der Schoot, G G F; Sluiter, W J; Jalving, M; Gietema, J A; Walenkamp, A M E

    Objective: Exercise interventions benefit cancer patients. However, only low numbers of patients adhere to these interventions. This review aimed to identify predictors of exercise intervention adherence in patients with cancer, during and after multimodality cancer treatment. Methods: A literature

  15. The effects of psychological treatments for adult depression on physical activity: A systematic review.

    NARCIS (Netherlands)

    Cuijpers, P.; de Wit, L.M.; Taylor, A.

    2014-01-01

    Objectives Physical activity and depression have been consistently shown to be inversely associated in epidemiological surveys. It is not clear, however, whether successful treatment of depression results in increases in physical activity. Method Systematic review of randomized trials examining

  16. Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class

    NARCIS (Netherlands)

    Jansen, T.T.G.; Timmers, H.J.L.M.; Marres, H.A.M.; Kaanders, J.H.A.M.; Kunst, H.P.M.

    2018-01-01

    OBJECTIVE: Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities

  17. Surgical treatment of brain metastases - a review. Part 2. Results of treatment

    International Nuclear Information System (INIS)

    Wronski, M.; Czernicki, Z.

    1994-01-01

    Results of treatment of most frequent brain metastases from nonsmall cell lung cancer, breast cancer, malignant melanoma and kidney tumors are discussed. Also efficacy of surgical treatment, chemotherapy, radiotherapy and radiosurgery is analyzed

  18. Treatment decision-making processes in the systemic treatment of ovarian cancer: review of the scientific evidence.

    Science.gov (United States)

    Luketina, Hrvoje; Fotopoulou, Christina; Luketina, Ruzica-Rosalia; Pilger, Adak; Sehouli, Jalid

    2012-09-01

    The systemic treatment of epithelial ovarian cancer (OC) is one of the cornerstones in the multimodal management of advanced OC in both primary and recurrent stages of this disease. In most situations various treatment options are available but only few data exists about the treatment decision-making process. Therefore, we conducted a review of the current literature regarding the decision-making process concerning the systemic therapy in patients with advanced ovarian cancer. The electronic database MEDLINE (PubMed) was systematically reviewed for studies that evaluate the treatment decision-making processes in patients with advanced OC. The PubMed database was searched in detail for all titles and abstracts of potentially relevant studies published between 1995 and 2011. An initial search identified 15 potentially relevant studies, but only seven met all inclusion criteria. Factors that influence treatment decisions in patients with OC include not only rational arguments and medical reasons, but also individual attitudes, fears, existential questions, various projections resulting from the physician patient relationship and the social environment. The physician's personal experience with OC treatment seems to be an important factor, followed by previous personal experience with medical issues, and the fear of side-effects and future metastases. Family and self-support organisations also seem to play a significant role in the treatment decision-making process. This review underlines the need for more research activities to explore the treatment decision-making process to enable the best individual support for patients in treatment decision-making. It is a challenge for clinicians to determine the individual information needs of women with OC and to involve them during the decision-making process to the extent they wish.

  19. Constructed wetlands for saline wastewater treatment: A review

    Science.gov (United States)

    Saline wastewater originating from sources such as agriculture, aquaculture, and many industrial sectors usually contains high levels of salts and other contaminants, which can adversely affect both aquatic and terrestrial ecosystems. Therefore, the treatment of saline wastewater (removal of both sa...

  20. Rehabilitation Treatment In Aphasia Caused By Stroke(Review

    Directory of Open Access Journals (Sweden)

    Parvane Rahimifar

    2017-02-01

    Full Text Available Aphasia is a relatively common language disorder, occurring in about 25% of all stroke patients. The ultimate aim of aphasia treatment is to improve patients oral and written language abilities and to facilitate their participation in everyday communication. Over the last decades, a range of approaches in aphasia therapy have been introduced, based on cognitive neuropsychological models, psycholinguistic theories, and socio-pragmatic approaches. In view of the range of different approaches and findings of therapy studies, the challenge for therapists is to decide which approach is the most appropriate one for an aphasic individual at a specific stage of recovery. The Findings showed that, therapy plan for aphasic individuals involves selecting the therapeutic approach most appropriate for dealing with a particular type of disorder, degree of severity, stage of recovery and the extent of the patient's participation in social life. A framework of aphasia treatment is outlined which considers the rehabilitation process at the various stages of recovery, and Different approaches are combined into a comprehensive treatment regimen which differentiates three stages of recovery: the acute, post-acute, and chronic stage. Also ,The intensive therapy in the treatment of language disorders have a great effect, and Brain imaging studies have shown that the linguistic reorganization of a damaged brain is aided by intensive speech therapy even in the chronic phase.

  1. review of compliance to anti tuberculosis treatment and risk factors ...

    African Journals Online (AJOL)

    Background: The aim of this study is to assess anti TB treatment compliance and the factors predictive for poor adherence in Sub-Saharan Africa in the last 10 years. Methods: We searched Medline for articles written in English using the terms: "Patient Compliance"[Mesh] OR "Medication Adherence"[Mesh])) AND ...

  2. Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

    NARCIS (Netherlands)

    Rutten, Juliette M. T. M.; Korterink, Judith J.; Venmans, Leonie M. A. J.; Benninga, Marc A.; Tabbers, Merit M.

    2015-01-01

    BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for

  3. SURGICAL TREATMENT OF HALLUX VALGUS AND ITS POSSIBLE COMPLICATIONS (REVIEW

    Directory of Open Access Journals (Sweden)

    E. P. Sorokin

    2011-01-01

    Full Text Available Hallux valgus surgery remains the most important direction of modern orthopedics. In this article authors analyzed the history of Hallux valgus surgical treatment development observing the details of different types of methods directing on various pathogenic parts of pathology as well as complications occurring with different types of methods. Main tendencies of development and improvements of hallux valgus surgery are described.

  4. [Conservative treatment of deciduous teeth--a review].

    Science.gov (United States)

    Magnusson, B

    1976-06-01

    In all countries with a lack of manpower in dentistry, there is an unfortunate tendency to leave the primary teeth without proper conservative treatment. In addition to toothaches and poor esthetics, a neglected care of the primary dentition may result in several other untoward effects. Decayed deciduous teeth may cause such a discomfort during tooth-brushing that the child is prevented from learning good oral hygiene habits. With bad primary molars the child cannot chew properly, and may have to choose soft and often cariogenic food. When the permanent teeth erupt among the decayed deciduous teeth, there will be a greater chance for them to have carious attacks as well. Premature loss of primary molars may lead to malocclusion. It must also be kept in mind that the treatment of badly decayed teeth, including necessary extractions, may be difficult. This may cause fear of dental treatment. On the basis of current Swedish philosophies of treatment the author surveys various conservative procedures for deciduous teeth-amalgam therapy, stainless steel crowns, composites and disking.

  5. Cervical Cancer: A Review of the Psychosocial Factors Following Treatment.

    Science.gov (United States)

    Gilliland, Kevin Clark

    Cervical cancer is a diagnosis that has a profound psychosocial impact, constituting a physical and emotional crisis for patients as well as family. In general, research indicates that the choice of treatment and the stage of the disease are instrumental in determining the psychosocial adjustment. Disruptions are likely to occur in self-esteem,…

  6. Hydroponic root mats for wastewater treatment-a review.

    Science.gov (United States)

    Chen, Zhongbing; Cuervo, Diego Paredes; Müller, Jochen A; Wiessner, Arndt; Köser, Heinz; Vymazal, Jan; Kästner, Matthias; Kuschk, Peter

    2016-08-01

    Hydroponic root mats (HRMs) are ecotechnological wastewater treatment systems where aquatic vegetation forms buoyant filters by their dense interwoven roots and rhizomes, sometimes supported by rafts or other floating materials. A preferential hydraulic flow is created in the water zone between the plant root mat and the bottom of the treatment system. When the mat touches the bottom of the water body, such systems can also function as HRM filter; i.e. the hydraulic flow passes directly through the root zone. HRMs have been used for the treatment of various types of polluted water, including domestic wastewater; agricultural effluents; and polluted river, lake, stormwater and groundwater and even acid mine drainage. This article provides an overview on the concept of applying floating HRM and non-floating HRM filters for wastewater treatment. Exemplary performance data are presented, and the advantages and disadvantages of this technology are discussed in comparison to those of ponds, free-floating plant and soil-based constructed wetlands. Finally, suggestions are provided on the preferred scope of application of HRMs.

  7. Telemedicine and Pediatric Obesity Treatment: Review of the literature and lessons learned

    OpenAIRE

    Cohen, Gail M.; Irby, Megan B.; Boles, Katie; Jordan, Christine; Skelton, Joseph A.

    2012-01-01

    Pediatric obesity is more prevalent in rural areas, yet rural families may not have access to pediatric obesity treatment programs. Use of new technologies, particularly telemedicine, has proven effective in other behavioral fields, such as psychiatry. This paper reviews the literature on the use of telemedicine in pediatric obesity treatment, and describes one tertiary-care pediatric obesity telemedicine program. We performed a systematic review of the literature from 1990–2011 using the fol...

  8. An exploration of the feasibility of radiation therapist participation in treatment reviews

    Energy Technology Data Exchange (ETDEWEB)

    Monk, Clare Maree; Wrightson, Stephanie Jane [Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales (Australia); Smith, Tony Neil [Department of Rural Health, University of Newcastle, Taree, New South Wales (Australia); Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales (Australia)

    2013-09-15

    As radiation oncologists' (ROs') workload has increased over time, treatment review clinics have become recognized as an area of RO practice into which radiation therapist (RT) practice could extend. There has been limited utilization of RTs in this role in Australia and a paucity of data on the acceptability and opinions regarding RTs practising in this role in an Australian context. The purpose of this audit was to investigate the feasibility of RT participation in review clinics at Calvary Mater Newcastle. Feasibility was determined by two methods: an audit of 200 treatment reviews to determine medical intervention (MI) levels required and a survey of 80 clinical staff to explore attitudes towards RT participation in clinics. Medical intervention was required in 59% (n = 118) of observed reviews, with the lowest being for breast (33%) and prostate (28%) cancers. MI peaked at 73% between fractions 16–20 and was lowest early and late in the treatment period at 48%. There were 60 responses to the staff survey. All but one respondent agreed that RTs would be willing to participate in treatment review clinics, but all five consultant ROs indicated they would not be willing to delegate reviews to RTs. Neither feasibility measure reached acceptable levels to recommend RT participation in treatment review clinics. Further investigation and RT education are required to help meet the future RO workforce shortfall. As MI rates are lowest for breast and prostate cancer RT participation could be targeted to these clinics.

  9. An exploration of the feasibility of radiation therapist participation in treatment reviews

    International Nuclear Information System (INIS)

    Monk, Clare Maree; Wrightson, Stephanie Jane; Smith, Tony Neil

    2013-01-01

    As radiation oncologists' (ROs') workload has increased over time, treatment review clinics have become recognized as an area of RO practice into which radiation therapist (RT) practice could extend. There has been limited utilization of RTs in this role in Australia and a paucity of data on the acceptability and opinions regarding RTs practising in this role in an Australian context. The purpose of this audit was to investigate the feasibility of RT participation in review clinics at Calvary Mater Newcastle. Feasibility was determined by two methods: an audit of 200 treatment reviews to determine medical intervention (MI) levels required and a survey of 80 clinical staff to explore attitudes towards RT participation in clinics. Medical intervention was required in 59% (n = 118) of observed reviews, with the lowest being for breast (33%) and prostate (28%) cancers. MI peaked at 73% between fractions 16–20 and was lowest early and late in the treatment period at 48%. There were 60 responses to the staff survey. All but one respondent agreed that RTs would be willing to participate in treatment review clinics, but all five consultant ROs indicated they would not be willing to delegate reviews to RTs. Neither feasibility measure reached acceptable levels to recommend RT participation in treatment review clinics. Further investigation and RT education are required to help meet the future RO workforce shortfall. As MI rates are lowest for breast and prostate cancer RT participation could be targeted to these clinics

  10. Functional Family Therapy for Young People in Treatment for Nonopioid Drug Use: A Systematic Review

    Science.gov (United States)

    Filges, Trine; Andersen, Ditte; Jørgensen, Anne-Marie Klint

    2018-01-01

    Objectives: This review evaluates the evidence on the effects of functional family therapy (FFT) on drug abuse reduction for young people in treatment for nonopioid drug use. Data and Analysis: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized trials. Results: The search yielded two…

  11. Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

    Directory of Open Access Journals (Sweden)

    Uhlmann Carmen

    2016-12-01

    Full Text Available Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.

  12. The use of electrical devices for the treatment of bladder dysfunction: a review of methods.

    NARCIS (Netherlands)

    Balken, M.R. van; Vergunst, H.; Bemelmans, B.L.H.

    2004-01-01

    PURPOSE: We reviewed the literature on the application of various devices and techniques for the electrical stimulation treatment of lower urinary tract dysfunction with respect to mechanism of action and clinical outcome. MATERIALS AND METHODS: A systematic review was done in PubMed of publications

  13. Fearing Fat: A Literature Review of Family Systems Understandings and Treatments of Anorexia and Bulimia.

    Science.gov (United States)

    Killian, Kyle D.

    1994-01-01

    Reviews literature examining family variables associated with anorexia nervosa and bulimia nervosa and family systems treatments for these eating disorders. Presents definitions of and diagnostic criteria for anorexia and bulimia, and discusses prevalence of these disorders. Reviews role played by psychopathological, sociological, and…

  14. Psychological Treatments for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Lackner, Jeffrey M.; Mesmer, Christina; Morley, Stephen; Dowzer, Clare; Hamilton, Simon

    2004-01-01

    This study conducted a systematic review to assess the quality of existing literature on psychological treatments for irritable bowel syndrome and to quantify the evidence for their efficacy. Three independent reviewers (2 from England, 1 from the United States) coded the quality of 32 studies, 17 of which provided data suitable for meta-analysis.…

  15. Practitioner Review: Psychological treatments for children and adolescents with conduct disorder problems - a systematic review and meta-analysis

    NARCIS (Netherlands)

    Bakker-Huvenaars, M.J.; Greven, C.U.; Buitelaar, J.K.; Glennon, J.C.

    2017-01-01

    BACKGROUND: This meta-analysis evaluates the efficacy of nonpharmacological treatments for conduct disorder (CD) problems in children and adolescents, based on child, parent and teacher report. METHODS: PubMed, PsycINFO and EMBASE were searched for peer-reviewed articles published between January

  16. Invited review: A systematic review and qualitative analysis of treatments other than conventional antimicrobials for clinical mastitis in dairy cows.

    Science.gov (United States)

    Francoz, D; Wellemans, V; Dupré, J P; Roy, J P; Labelle, F; Lacasse, P; Dufour, S

    2017-10-01

    Clinical mastitis is an important disease in dairies. Its treatment is mainly based on the use of antimicrobial drugs. Numerous non-antimicrobial drugs and treatment strategies have already been reported for clinical mastitis treatment, but data on their efficacy have never been collated in a systematic way. The objective of this systematic review was to identify treatments other than conventional antimicrobials for the treatment of clinical mastitis in lactating dairy cows. A systematic review was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science from January 1970 to June 2014. Controlled clinical trials, observational studies, and experimental challenges were retained. Lactating dairy cows with clinical mastitis were the participant of interest. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included. Outcomes evaluated were clinical and bacteriological cure rates and milk production. Selection of the study, data extraction, and assessment of risk of bias was performed by 3 reviewers. Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions. A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and 1 was an observational study. The treatments evaluated were conventional anti-inflammatory drugs (n = 14), oxytocin with or without frequent milk out (n = 5), biologics (n = 9), homeopathy (n = 5), botanicals (n = 4), probiotics (n = 2), and other alternative products (n = 2). All trials had at least one unclear or high risk of bias. Most trials (n = 13) did not observe significant differences in clinical or bacteriological cure rates in comparison with negative

  17. BJR supplements and radiotherapy treatment planning data - a review

    International Nuclear Information System (INIS)

    Agrawal, M.S.

    2000-01-01

    Scientific community has depended on the BJR Supplements on central axis depth dose data published from time to time. There have been five supplements since 1953 when Supplement No. 5 was first published on the subject. The frequent revisions, addition of new data and updating with the technological advancements are special features of these supplements. The most recent supplement is numbered 25 and has been brought out in 1996. A review of the data in respect of cobalt-60, MV X-rays and electron beams as described in the supplements is the subject matter of this write-up. (author)

  18. Endoscopic treatment of colorectal perforations – a systematic review

    DEFF Research Database (Denmark)

    Hassan, Mohamed Ali; Thomsen, Christian Øystein; Vilmann, Peter

    2016-01-01

    invasive therapy. The aim of this systematic review was to assess the existing evidence in this field. METHODS: Literature was searched on PubMed, Embase and the Cochrane databases. Papers found were reported according to the PRISMA guidelines. Trials on animals were excluded. RESULTS: A total of 32...... success rate of 87.8% (standard deviation: ± 13.0%) on average and a median of 92.3% (range: 58.6-100%). The total number of patients needing surgery after attempted clip closure was 30 (14.7%); another four were found to have sealed perforations during surgery. One patient died after clip failure (0...

  19. Endoscopic treatment of colorectal perforations--a systematic review

    DEFF Research Database (Denmark)

    Hassan, Mohamed Ali; Thomsen, Christian Øystein; Vilmann, Peter

    2016-01-01

    invasive therapy. The aim of this systematic review was to assess the existing evidence in this field. METHODS: Literature was searched on PubMed, Embase and the Cochrane databases. Papers found were reported according to the PRISMA guidelines. Trials on animals were excluded. RESULTS: A total of 32...... success rate of 87.8% (standard deviation: ± 13.0%) on average and a median of 92.3% (range: 58.6-100%). The total number of patients needing surgery after attempted clip closure was 30 (14.7%); another four were found to have sealed perforations during surgery. One patient died after clip failure (0...

  20. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review.

    Science.gov (United States)

    Lopatiene, Kristina; Borisovaite, Marija; Lapenaite, Egle

    2016-01-01

    The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances. Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding. 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15). Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs) (P < 0.05); fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05). Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

  1. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Kristina Lopatiene

    2016-06-01

    Full Text Available Objectives: The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances. Material and Methods: Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding. Results: 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15. Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs (P < 0.05; fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05. Conclusions: Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

  2. Thermal treatment of solid residues from WtE units: A review

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Daniel, E-mail: daniel.lindberg@abo.fi; Molin, Camilla, E-mail: camilla.molin@abo.fi; Hupa, Mikko, E-mail: mikko.hupa@abo.fi

    2015-03-15

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field.

  3. Thermal treatment of solid residues from WtE units: A review

    International Nuclear Information System (INIS)

    Lindberg, Daniel; Molin, Camilla; Hupa, Mikko

    2015-01-01

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field

  4. LITERATURE REVIEW ON STEM CELL TREATMENT & ORAL SUBMUCOUS FIBROSIS (OSMF)

    OpenAIRE

    Prathipaty James; Kameswararao

    2015-01-01

    Stem cell therapy is a part of regenerative medicine that involves the use of undifferentiated cells in order to cure the disease. Stem cell - based therapies are being investigated for the treatment of many conditions, including neurodegenerative conditions such as Parkinson's disease, cardiovascular disease, liver disease, diabetes, autoimmune diseases and for nerve regeneration. (1) In orofacial region these therapies are being used for tooth and periodonta...

  5. Review of virtual reality treatment for mental health.

    Science.gov (United States)

    Gourlay, D; Lun, K C; Liya, G

    2001-01-01

    This paper describes recent research that proposes virtual reality techniques as a therapy for patients with cognitive and psychological problems. Specifically this applies to victims of conditions such as traumatic brain injury, Alzheimers and Parkinsons. Additionally virtual reality therapy offers an alternative to current desensitization techniques for the treatment of phobias Some important issues are examined including means of user interaction, skills transfer to the real world, and side-effects of virtual reality exposure.

  6. Bacterial resistance and impetigo treatment trends: a review.

    Science.gov (United States)

    Bangert, Scott; Levy, Moise; Hebert, Adelaide A

    2012-01-01

    Impetigo is a common cutaneous infection that is especially prevalent in children. The prevalence of colonization and infection with resistant strains is continually increasing, forcing clinicians to reevaluate treatment strategies. Newer topical agents are effective in treating infections with resistant strains and may help minimize resistance and adverse effects from systemic agents. Use of topical disinfectants to decrease colonization is an important adjunctive measure. Physicians should be aware of local resistance patterns in impetigo to help guide therapy. © 2012 Wiley Periodicals, Inc.

  7. Application of nanotechnology in treatment of leishmaniasis: A Review.

    Science.gov (United States)

    Akbari, Maryam; Oryan, Ahmad; Hatam, Gholamreza

    2017-08-01

    Leishmaniasis is a neglected tropical disease caused by a protozoan species of the genus Leishmania affecting mostly the developing countries. The disease with current mortality rate of 50,000 deaths per year threatens approximately 350 million people in more than 90 countries all over the world. Cutaneous, mucocutaneous and visceral leishmaniasis are the most frequent forms of the disease. Chemotherapy still relies on the use of pentavalent antimonials, amphotericin B, liposomal amphotericin B and miltefosin. Treatment of leishmaniasis has remained insufficient since the current antileishmanial agents have several limitations including low efficacy, toxicity, adverse side effects, drug-resistance, length of treatment and cost lines. Consequently, there is an immediate requirement to search for new antileishmanial compounds. New drug delivery devices transport antileishmanial drug to the target cell specifically with minimizing the toxic effects to normal cells. This study attempts to present a comprehensive overview of different approaches of nanotechnology in treatment of leishmaniasis. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Emerging desalination technologies for water treatment: a critical review.

    Science.gov (United States)

    Subramani, Arun; Jacangelo, Joseph G

    2015-05-15

    In this paper, a review of emerging desalination technologies is presented. Several technologies for desalination of municipal and industrial wastewater have been proposed and evaluated, but only certain technologies have been commercialized or are close to commercialization. This review consists of membrane-based, thermal-based and alternative technologies. Membranes based on incorporation of nanoparticles, carbon nanotubes or graphene-based ones show promise as innovative desalination technologies with superior performance in terms of water permeability and salt rejection. However, only nanocomposite membranes have been commercialized while others are still under fundamental developmental stages. Among the thermal-based technologies, membrane distillation and adsorption desalination show the most promise for enhanced performance with the availability of a waste heat source. Several alternative technologies have also been developed recently; those based on capacitive deionization have shown considerable improvements in their salt removal capacity and feed water recovery. In the same category, microbial desalination cells have been shown to desalinate high salinity water without any external energy source, but to date, scale up of the process has not been methodically evaluated. In this paper, advantages and drawbacks of each technology is discussed along with a comparison of performance, water quality and energy consumption. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. An overview of insights gained and lessons learned from U.S. plant-specific PRA studies

    International Nuclear Information System (INIS)

    Joksimovich, V.

    1985-01-01

    Probabilistic Risk Assessment (PRA) has been under development for over twenty years, but it has reached the level of widespread use only in the aftermath of the TMI accident. Over thirty PRAs have now been completed in the U.S. PRAs have been in the mainstream of many licensing decisions because the NRC recognizes that they provide independent and comprehensive plant safety audit. Some difficulties have been experienced leading to interpretive and intercomparison studies. Numerous global and plant-specific insights have been derived. A new application termed risk management is clearly emerging. (orig./HP)

  10. Devonian conodonts from the Foča–Prača Paleozoic complex (Durmitor Nappe, southeastern Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Bogdan Jurkovšek

    2011-06-01

    Full Text Available Conodont study of the Crna Rijeka borehole CR-17, positioned in the frontal part of the Durmitor Nappe (Foča – Prača Paleozoic complex, SE Bosnia and Herzegovina is presented. The obtained fauna indicates an Early-Middle Devonian age and due to poor preservation an identification at a generic level is possible only. The recovered conodont elements have a high Color Alteration Index (CAI = 6,5–7 indicating a degree of metamorphism corresponding to a temperature interval from 440 °C to 720 °C.

  11. Recovery actions in PRA [probabilistic risk assessment] for the Risk Methods Integration and Evaluation Program (RMIEP): Volume 1, Development of the data-based method

    International Nuclear Information System (INIS)

    Weston, L.M.; Whitehead, D.W.; Graves, N.L.

    1987-06-01

    In a probabilistic risk assessment (PRA) for a nuclear power plant, the analyst identifies a set of potential core damage events consisting of equipment failures and human errors and their estimated probabilities of occurrence. If operator recovery from an event within some specified time is considered, then the probability of this recovery can be included in the PRA. This report provides PRA analysts with an improved methodology for including recovery actions in a PRA. A recovery action can be divided into two distinct phases: a Diagnosis Phase (realizing that there is a problem with a critical parameter and deciding upon the correct course of action) and an Action Phase (physically accomplishing the required action). In this methodology, simulator data are used to estimate recovery probabilities for the diagnosis phase. Different time-reliability curves showing the probability of failure of diagnosis as a function of time from the compelling cue for the event are presented. These curves are based on simulator exercises, and the actions are grouped based upon their operational similarities. This is an improvement over existing diagnosis models that rely greatly upon subjective judgment to obtain such estimates. The action phase is modeled using estimates from available sources. The methodology also includes a recommendation on where and when to apply the recovery action in the PRA process

  12. Exercise program for children and adolescents with leukemia and lymphoma during treatment: A comprehensive review.

    Science.gov (United States)

    Zucchetti, Giulia; Rossi, Francesca; Chamorro Vina, Carolina; Bertorello, Nicoletta; Fagioli, Franca

    2018-05-01

    An exercise program (EP) during cancer treatment seems to be a valid strategy against physiological and quality-of-life impairments, but scientific evidence of benefits among pediatric patients is still limited. This review summarizes the literature focused on randomized controlled trials of EP offered to patients during leukemia and lymphoma treatment. Studies published up to June 2017 were selected from multiple databases and assessed by three independent reviewers for methodological validity. The review identified eight studies, but several types of bias have to be avoided to provide evidence-based recommendations accessible to patients, families, and professionals. © 2018 Wiley Periodicals, Inc.

  13. Treatment of autoinflammatory diseases: results from the Eurofever Registry and a literature review

    NARCIS (Netherlands)

    Haar, N. Ter; Lachmann, H.; Ozen, S.; Woo, P.; Uziel, Y.; Modesto, C.; Kone-Paut, I.; Cantarini, L.; Insalaco, A.; Neven, B.; Hofer, M.; Rigante, D.; Al-Mayouf, S.; Touitou, I.; Gallizzi, R.; Papadopoulou-Alataki, E.; Martino, S.; Kuemmerle-Deschner, J.; Obici, L.; Iagaru, N.; Simon, A.; Nielsen, S.; Martini, A.; Ruperto, N.; Gattorno, M.; Frenkel, J.; et al.,

    2013-01-01

    OBJECTIVE: To evaluate the response to treatment of autoinflammatory diseases from an international registry and an up-to-date literature review. METHODS: The response to treatment was studied in a web-based registry in which clinical information on anonymised patients with autoinflammatory diseases

  14. Cognitive-behavioral treatments for tinnitus: a review of the literature.

    Science.gov (United States)

    Cima, Rilana F F; Andersson, Gerhard; Schmidt, Caroline J; Henry, James A

    2014-01-01

    Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound. The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches. Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch. A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice. Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level. American Academy of Audiology.

  15. Pharmacologic Treatments for Pediatric Bipolar Disorder: A Review and Meta-Analysis

    Science.gov (United States)

    Liu, Howard Y.; Potter, Mona P.; Woodworth, K. Yvonne; Yorks, Dayna M.; Petty, Carter R.; Wozniak, Janet R.; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: A growing body of literature has documented pediatric bipolar disorder to be a severely impairing form of psychopathology. However, concerns remain as to the inadequacy of the extant literature on its pharmacotherapy. Furthermore, treatment studies have not been systematically reviewed for treatment effects on core and associated…

  16. [Endodontic treatment in one or several sessions? Review of the literature].

    Science.gov (United States)

    Darbinyan, M; Bogaerts, P; Van Nieuwenhuysen, J P

    2005-01-01

    This literature review compares the endodontic treatment in one or more appointments on the healing of periapical lesions and the occurrence of postoperative pain and flare-ups. It turns out that the root canal treatment completed in one session has many advantages and may he considered the prime option in the majority of clinical cases.

  17. Sexual, Psychological, and Relational Functioning in Women after Surgical Treatment for Vulvar Malignancy: A Literature Review

    NARCIS (Netherlands)

    Aerts, Leen; Enzlin, Paul; Vergote, Ignace; Verhaeghe, Johan; Poppe, Willy; Amant, Frederic

    2012-01-01

    Introduction. Vulvectomy is an intrusive treatment option for women with vulvar malignancy that theoretically may affect sexual function. Aim. This study aims to provide a comprehensive review of the literature on the impact of surgical treatment for vulvar malignancy on sexual functioning, overall

  18. Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

    Directory of Open Access Journals (Sweden)

    Giuliano de Oliveira Freitas

    2013-12-01

    Full Text Available Preexisting corneal astigmatism, present at the time of cataract surgery, is reviewed in detail throughout this article on its most important aspects such as occurrence rates, clinical relevance and current treatment options. Special emphasis is given to the latter aspect. Each method's rationale, advantage and limitation ishigh lightened. Comparisons between treatment options, whenever possible, are also provided.

  19. An Evidence-Based Systematic Review on Communication Treatments for Individuals with Right Hemisphere Brain Damage

    Science.gov (United States)

    Blake, Margaret Lehman; Frymark, Tobi; Venedictov, Rebecca

    2013-01-01

    Purpose: The purpose of this review is to evaluate and summarize the research evidence related to the treatment of individuals with right hemisphere communication disorders. Method: A comprehensive search of the literature using key words related to right hemisphere brain damage and communication treatment was conducted in 27 databases (e.g.,…

  20. A Review Of Traditional Plants Used In The Treatment Of Epilepsy ...

    African Journals Online (AJOL)

    Five prescriptions used in the treatment of epilepsy amongst the Hausa/Fulani tribe of Northern Nigeria were collected from traditional healers. The five prescriptions containing eight plants were reviewed as in literature to ascertain scientific basis of their use in treatment of epilepsy. Securidaca longipedunculata (family ...

  1. Systematic Review of Treatment Outcome Measures for Vulvodynia.

    Science.gov (United States)

    Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

    2018-07-01

    To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

  2. Fournier's Gangrene Complicating Hematologic Malignancies: Literature Review and Treatment Suggestions

    Directory of Open Access Journals (Sweden)

    Giovanni D'Arena

    2013-11-01

    Full Text Available Fournier’s gangrene (FG is a rare but severe necrotizing fasciitis of the external genitalia that may complicate the clinical course of hematologic malignancies and sometimes may be the first sign of the disease. The clinical course of FG is very aggressive and the mortality is still high despite the improvement in its management. Early recognition of FG and prompt appropriate treatment with surgical debridement and administration of antibiotics are the cornerstone of the management of this very severe disease.

  3. Treatment of morphea or localized scleroderma: review of the literature.

    Science.gov (United States)

    Vilela, Fernanda Aguiar Santos; Carneiro, Sueli; Ramos-e-Silva, Marcia

    2010-10-01

    Scleroderma is a disease that affects the microvasculature and the connective tissue. These alterations produce fibrosis and blood vessel occlusion. Its cause is still unknown, although the exaggerated synthesis of collagens I and IV, detected in skin and vessels, may be related to genetic, immunologic and, less frequently, exogenous factors as inhalation of silica and polyvinyl chloride. There is a localized and a systemic form, which affects both adults and children. The treatment of the localized form, also called morphea, is still controversial, and, in this article, the authors will discuss the main agents that were found to improve the lesions and symptoms.

  4. Interventional radiological treatment of renal transplant complications: A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Lezzi, Roberto; La, Torre Michele fabio; Santoro, Marco; Dattesi, Robrta; Nestola, Massimiliano; Posa, Alessandro; Romagnoli, Jacopo; CItterio, Franco; Bonomo, Lorenzo [' A. Gemelli' Hospital - Catholic University, Rome (Italy)

    2015-06-15

    Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.

  5. Marketing and Testosterone Treatment in the USA: A Systematic Review.

    Science.gov (United States)

    Bandari, Jathin; Ayyash, Omar M; Emery, Sherry L; Wessel, Charles B; Davies, Benjamin J

    2017-10-01

    Testosterone replacement therapy (TRT) is currently approved by the Food and Drug Administration only for classic hypogonadism, although off-label indications have resulted in a dramatic expansion in prescriptions in the USA. Marketing may significantly affect prescriber behavior. To systematically review all available evidence on marketing and TRT in the USA. PubMed, Embase, and Scopus were searched up to July 2017 for all relevant publications reporting on assessments of the TRT market size, economic costs associated with hypogonadism, trends in TRT prescriptions, drug discontinuation rates, and advertising and sales efforts in the USA. Twenty retrospective studies were included in the final analysis. The market size for hypogonadism constitutes 5.6-76.8% of men in the USA, with the lower end of the range representing the strictest criteria for diagnosis. Men with a diagnosis of hypogonadism consume $14 118 in direct and indirect costs to the payer. Over the last 2 decades, TRT prescriptions have increased between 1.8- and 4-fold. After 1 yr, 80-85% of men discontinue TRT. There is an association between direct-to-consumer advertising and testosterone testing, TRT prescriptions, and TRT without testosterone testing. There is a high prevalence of misinformation on Internet advertising. Off-label indications have driven the dramatic expansion of TRT prescriptions over the last 2 decades. Direct-to-consumer advertising poses a unique challenge in the USA. Overtreatment can be avoided by applying strict diagnostic criteria for hypogonadism, which limits the addressable market for TRT. In this report, we reviewed the relationship between marketing and testosterone therapy in the USA. We found that many patients are prescribed testosterone without an appropriate diagnosis of hypogonadism, which may be related to the marketing efforts for off-label prescribing. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  6. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Kumar S

    2013-09-01

    effective treatment option when compared to placebo and some active treatment options (such as relaxation, especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as mobilization, standard medical care, and acupuncture. Conclusion: There is an emerging body of evidence, albeit small, that supports the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. Due to common methodological flaws in the primary research, which informed the systematic reviews, recommendations arising from this evidence base should be interpreted with caution. Keywords: massage therapy, systematic review, evidence-based practice, complementary and alternative medicine

  7. Pharmacotherapy of pathological gambling: review of new treatment modalities.

    Science.gov (United States)

    Lowengrub, Katherine; Iancu, Iulian; Aizer, Anat; Kotler, Moshe; Dannon, Pinhas N

    2006-12-01

    Pathological gambling is classified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition as an impulse-control disorder. In the International Classification of Diseases of the WHO, pathological gambling is coded under the heading of 'Habit and Impulse Disorders'. Pathological gambling is a chronic, progressive disorder, which has a prevalence of 1-3.4% among western civilizations. The enormous personal and social consequences of this disorder include a high rate of suicide attempts, job loss, marital and family problems, legal problems, and criminal behavior. Recent studies have demonstrated that pathological gambling patients respond well to treatment with selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. These findings support the idea that pathological gambling and other disorders of impulse control may be conceptualized as part of the obsessive-compulsive spectrum disorders or addictive disorders. This article will discuss possible treatment strategies according to different behavior patterns in pathological gambling and also remind the physicians who intend to treat this disorder of the possible diagnosis of pathological gambling.

  8. Gastroparesis: a review of current and emerging treatment options

    Directory of Open Access Journals (Sweden)

    Enweluzo C

    2013-09-01

    Full Text Available Chijioke Enweluzo, Fahad AzizHospital Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USAAbstract: Gastroparesis is a motility disorder of the stomach causing delay in food emptying from the stomach without any evidence of mechanical obstruction. The majority of cases are idiopathic. Patients need to be diagnosed properly by formal testing, and the evaluation of the severity of the gastroparesis may assist in guiding therapy. Initially, dietary modifications are encouraged, which include frequent and small semisolid-based meals. Promotility medications, like erythromycin, and antiemetics, like prochlorperazine, are offered for symptom relief. In patients who are refractory to pharmacologic treatment, more invasive options, such as intrapyloric botulinum toxin injections, placement of a jejunostomy tube, or implantation of a gastric stimulator, can be considered. Hemin therapy and gastric electric stimulation are emerging treatment options that are still at different stages of research. Regenerative medicine and stem cell-based therapies also hold promise for gastroparesis in the near future.Keywords: Gastroparesis, gastric emptying, gastric electrical stimulation, hemin

  9. Selective mutism: a review of etiology, comorbidities, and treatment.

    Science.gov (United States)

    Wong, Priscilla

    2010-03-01

    Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.Comorbidities and treatment. Selective mutism can present a variety of comorbidities including enuresis, encopresis, obsessive-compulsive disorder, depression, premorbid speech and language abnormalities, developmental delay, and Asperger's disorders. The specific manifestations and severity of these comorbidities vary based on the individual. Given the multidimensional manifestations of selective mutism, treatment options are similarly diverse. They include individual behavioral therapy, family therapy, and psychotherapy with antidepressants and anti-anxiety medications.Future directions. While studies have helped to elucidate the phenomenology of selective mutism, limitations and gaps in knowledge still persist. In particular, the literature on selective mutism consists primarily of small sample populations and case reports. Future research aims to develop an increasingly integrated, multidimensional framework for evaluating and treating children with selective mutism.

  10. Treatment of neuromyelitis optica: an evidence based review

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2012-01-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS, and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

  11. Virtual reality in the psychological treatment for mental health problems: An systematic review of recent evidence.

    Science.gov (United States)

    Valmaggia, Lucia R; Latif, Leila; Kempton, Matthew J; Rus-Calafell, Maria

    2016-02-28

    The aim of this paper is to provide a review of controlled studies of the use of Virtual Reality in psychological treatment (VRT). Medline, PsychInfo, Embase and Web of Science were searched. Only studies comparing immersive virtual reality to a control condition were included. The search resulted in 1180 articles published between 2012 and 2015, of these, 24 were controlled studies. The reviewed studies confirm the effectiveness of VRT compared to treatment as usual, and show similar effectiveness when VRT is compared to conventional treatments. Current developments and future research are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Does comorbidity predict poorer treatment outcome in pediatric anxiety disorders? An updated 10-year review

    DEFF Research Database (Denmark)

    Walczak, Monika Anna; Ollendick, Thomas H; Ryan, Sarah

    2018-01-01

    The aim of the present review was to provide an updated investigation of literature from the past ten years that examined the effects of comorbid problems on treatment outcomes, and/or explored if cognitive behavioral treatments (CBT) targeting anxiety disorders also affected comorbid disorders...... diagnoses, rather than grouping them together. Overall, our findings suggest that comorbid disorders may have a more negative impact on treatment outcomes than proposed in previous reviews, particularly in the cases of comorbid social anxiety and mood disorders. Furthermore, CBT for anxiety disorders...

  13. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  14. 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.

  15. One-Session Treatment of Specific Phobias: A Detailed Description and Review of Treatment Efficacy

    Science.gov (United States)

    Zlomke, Kimberly; Davis, Thompson E., III

    2008-01-01

    One-Session Treatment (OST) is a form of massed exposure therapy for the treatment of specific phobias. OST combines exposure, participant modeling, cognitive challenges, and reinforcement in a single session, maximized to three hours. Clients are gradually exposed to steps of their fear hierarchy using therapist-directed behavioral experiments.…

  16. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review.

    Science.gov (United States)

    Fogarty, Sarah; Smith, Caroline A; Hay, Phillipa

    2016-04-01

    This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The Impact of Colleague Peer Review on the Radiotherapy Treatment Planning Process in the Radical Treatment of Lung Cancer.

    Science.gov (United States)

    Rooney, K P; McAleese, J; Crockett, C; Harney, J; Eakin, R L; Young, V A L; Dunn, M A; Johnston, R E; Hanna, G G

    2015-09-01

    Modern radiotherapy uses techniques to reliably identify tumour and reduce target volume margins. However, this can potentially lead to an increased risk of geographic miss. One source of error is the accuracy of target volume delineation (TVD). Colleague peer review (CPR) of all curative-intent lung cancer plans has been mandatory in our institution since May 2013. At least two clinical oncologists review plans, checking treatment paradigm, TVD, prescription dose tumour and critical organ tolerances. We report the impact of CPR in our institution. Radiotherapy treatment plans of all patients receiving radical radiotherapy were presented at weekly CPR meetings after their target volumes were reviewed and signed off by the treating consultant. All cases and any resultant change to TVD (including organs at risk) or treatment intent were recorded in our prospective CPR database. The impact of CPR over a 13 month period from May 2013 to June 2014 is reported. One hundred and twenty-two patients (63% non-small cell lung carcinoma, 17% small cell lung carcinoma and 20% 'clinical diagnosis') were analysed. On average, 3.2 cases were discussed per meeting (range 1-8). CPR resulted in a change in treatment paradigm in 3% (one patient proceeded to induction chemotherapy, two patients had high-dose palliative radiotherapy). Twenty-one (17%) had a change in TVD and one (1%) patient had a change in dose prescription. In total, 6% of patients had plan adjustment after review of dose volume histogram. The introduction of CPR in our centre has resulted in a change in a component of the treatment plan for 27% of patients receiving curative-intent lung radiotherapy. We recommend CPR as a mandatory quality assurance step in the planning process of all radical lung plans. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  18. A clinical review of the treatment of catatonia

    Directory of Open Access Journals (Sweden)

    Pascal eSienaert

    2014-12-01

    Full Text Available Catatonia is a severe motor syndrome with an estimated prevalence among psychiatric inpatients of about 10%. At times, it is life-threatening especially in its malignant form when complicated by fever and autonomic disturbances. Catatonia can accompany many different psychiatric illnesses and somatic diseases. In order to recognize the catatonic syndrome, apart from thorough and repeated observation, a clinical examination is needed. A screening instrument, such as the Bush-Francis Catatonia Rating Scale, can guide the clinician through the neuropsychiatric examination. Although severe and life-threatening, catatonia has a good prognosis. Research on the treatment of catatonia is scarce, but there is overwhelming clinical evidence of the efficacy of benzodiazepines, such as lorazepam, and electroconvulsive therapy.

  19. [The treatment of binge eating disorder - a review].

    Science.gov (United States)

    Papp, Ildikó; Szumska, Irena; Túry, Ferenc

    2015-01-01

    The binge eating disorder is a relatively new type of eating disorders, which was first described in 1992, and became a distinct nosological entity in the system of DSM-5 in 2013. Its central symptom is the binge, which is not followed by compensatory behaviours as in bulimia nervosa. Therefore, the patients are generally obese. The prevalence of the disorder is 1-3% in the general population, but much higher in help-seeking obese subjects. The two main goals of the therapy is body weight reduction, and the cessation of binges. In the pharmacotherapy of binge eating disorder the antidepressants are recommended mainly in the case of unsuccessful psychotherapy, and in treating comorbid depression. In the field of psychotherapy data are available mainly on the effectiveness of cognitive behavioural therapy, dialectic behaviour therapy, behavioural weight loss, and interpersonal therapy. Effectivity studies on new therapeutic methods and treatment combinations are needed as well as long term follow-up studies.

  20. Review of biotechnology applications to nuclear waste treatment

    International Nuclear Information System (INIS)

    Ashley, N.V.; Roach, D.J.W.

    1990-01-01

    This paper gives an overview of the feasibility of the application of biotechnology to nuclear waste treatment. Many living and dead organisms accumulate heavy metals and radionuclides. The controlled use of this phenomenon forms the basis for the application of biotechnology to the removal of radionuclides from nuclear waste streams. An overview of biotechnology areas, namely the use of biopolymers and biosorption using biomass applicable to the removal of radionuclides from industrial nuclear effluents is given. The potential of biomagnetic separation technology, genetic engineering and monoclonal antibody technology is also to be examined. The most appropriate technologies to develop for radionuclide removal in the short term appear to be those based on biosorption of radionuclides by biomass and the use of modified and unmodified biopolymers in the medium term. (author)

  1. Surgical Treatment with Locoregional Flaps for the Eyelid: A Review

    Directory of Open Access Journals (Sweden)

    Federico Lo Torto

    2017-01-01

    Full Text Available Reconstruction of the eyelids after skin cancer excision can be challenging. Surgical treatment options are multiple; deep anatomy knowledge of lamellar components is mandatory to choose the most adequate surgical planning. Eyelids’ role in vision and social relationship is critical; both function and aesthetics are tough to restore. Using a flap provides a satisfying texture and colour match with adjacent tissues and ensures short contraction during healing; furthermore, grafts are sometimes necessary to achieve pleasing results. Hundreds of surgical techniques have been described aiming for eyelid reconstruction; in our paper, we want to provide for our audience the most reliable and useful procedures for subtotal and total eyelid reconstruction following NMSC full-thickness excision.

  2. Bicipitoradial Bursitis: A Review of Clinical Presentation and Treatment

    Directory of Open Access Journals (Sweden)

    Tsz-Lung Choi

    2014-06-01

    Full Text Available The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis and most often results from repetitive mechanical trauma or overuse. Other causes include tuberculosis, immunological complications of rheumatological disease and synovial chondromatosis. Accurate diagnosis requires imaging studies and sometimes histological study. It can be treated conservatively with aspiration and steroid injection. Surgical excision of the bursa is indicated in the case of infection cause, failed conservative treatment with recurrence of the enlarged bursa and pain after aspiration, presence of nerve compression with neurological impairment, mechanical limitation to flexion, and extension of the elbow or biceps tendon degeneration and/or functional impairment.

  3. Characteristics and performance of anaerobic wastewater treatment (a review)

    International Nuclear Information System (INIS)

    Zeb, B.S.; Mahmood, Q.; Pervez, A.

    2013-01-01

    Summary: Pakistan's current population of 180 million is expected to grow to about 221 million by the year 2025. In developing countries such as Pakistan water pollution is a major threat to the livelihood of people. Pakistan is also currently experiencing profound demographic, economic changes and energy crisis that have major implications for water management. The contamination of aquatic and terrestrial ecosystems with heavy metals is a major environmental problem. Each pollution problem calls for specific optimal and cost effective solution so if one technology proves less or ineffective other takes its place. Every day the vast amounts of the municipal, industrial and agricultural wastes are released in to the environment and create serious problems. Anaerobic digestion is very attractive and cost-effective option and technology for the highly loaded waste water treatment and energy conversion. The anaerobic process is in many ways ideal for waste treatment. It has several significant advantages over other available methods. In this process organic matter is utilized as source of electron donor to reduce carbon dioxide to produce methane gas. It involves three bacterial groups namely: hydrolytic, acetogenic and methanogenic bacteria that work optimally at pH and temperature ranges of 6.8 to 7.5 and 30-35 degree C, respectively. The residence time in a digester varies with the amount and type of feed material, the configuration of the digestion system, and whether it be one-stage or two-stage. It is ideal for all kinds of wastewaters. Currently anaerobic technology is being operated at full scale in many industrialized nations. (author)

  4. Fexofenadine hydrochloride in the treatment of allergic disease: a review

    Directory of Open Access Journals (Sweden)

    David Axelrod

    2008-09-01

    Full Text Available David Axelrod1, Leonard Bielory2Division of Allergy, Immunology and Rheumatology, UMDNJ-New Jersey Medical School, 1Department of Medicine, 2Departments of Medicine, Pediatrics, Ophthalmology and Visual Sciences, Newark, New Jersey, USAAbstract: Fexofenadine is a selective, non-sedating H1 receptor antagonist, marketed in the United States since 2000. The FDA approved an oral suspension in 2006, for the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria in children. The tablet, capsule, and oral suspension are bioequivalent. Although fexofenadine does not use P450 CYP 3A4 it does interact with a number of drugs at P-glycoprotein and organic anion transporter polypeptides. The risk of toxicity from other drugs may increase with the administration of fexofenadine. Orange and grapefruit juices reduce the bioavailability of fexofenadine. Fexofenadine has been shown to have an impact on inflammatory mediators, other than histamine, such as decreasing the production of LTC4, LTD4, LTE4, PGE2, and PGF2α; inhibiting cyclo-oxygenase 2, thromboxane; limiting iNOS generation of NO; decreasing cytokine levels (ICAM-1, ELAM-1, VCAM-1, RANTES, I-TAC, MDC, TARC, MMP-2, MMP-9, tryptase; and diminishing eosinophil adherence, chemotaxis, and opsonization of particles. These effects may provide benefit to some of the inflammatory responses of an acute allergic reaction and provide a basis for future development of H1 antagonists with stronger anti-inflammatory effects. These studies also support the contention that fexofenadine is effective for the treatment of allergic rhinits and chronic idiopathic urticaria.Keywords: fexofenadine, allergy, oral suspension, formulations, pharmacology

  5. 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.

  6. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.

    Science.gov (United States)

    Kumar, Saravana; Beaton, Kate; Hughes, Tricia

    2013-09-04

    The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as

  7. Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review.

    Science.gov (United States)

    Rozeboom, A V J; Dubois, L; Bos, R R M; Spijker, R; de Lange, J

    2017-04-01

    Of all mandibular fractures, 25-35% are condylar. Many studies have focused on whether to treat such fractures via open or closed modalities. A uniform protocol for closed treatment is lacking, but such a protocol could ensure good clinical practice. The aims of this systematic review were to provide an overview of the published studies exclusively pertaining to closed treatment and to summarize the existing modalities for closed treatment and their clinical outcomes. Sixteen studies were selected for detailed analysis. The treatments given were highly variable, ranging from doing nothing to applying maxillomandibular fixation with stainless steel wires. The results of the different studies and the treatment modalities used were difficult to interpret; however no clear differences in the outcome measures were seen between the treatment modalities applied. Complications encountered after closed treatment included malocclusion, limited mouth opening, reduced range of motion, and persistent pain. Due to the heterogeneity between groups, high loss-to-follow-up, poor descriptions of the treatments given, and variability in outcome measurement methods, no clear associations between adverse outcomes and the treatments applied could be determined. This review suggests that due to the high level of methodological variability in the relevant studies published to date, there are currently no uniform standards for the closed treatment of condylar fractures that can be expected to yield good clinical results. The establishment of such standards could potentially improve treatment outcomes. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Nasal PCR assay for the detection of Mycobacterium leprae pra gene to study subclinical infection in a community.

    Science.gov (United States)

    Arunagiri, Kamalanathan; Sangeetha, Gopalakrishnan; Sugashini, Padmavathy Krishnan; Balaraman, Sekar; Showkath Ali, M K

    2017-03-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Identification of Mycobacterium leprae is difficult in part due to the inability of the leprosy bacillus to grow in vitro. A number of diagnostic methods for leprosy diagnosis have been proposed. Both serological tests and molecular probes have shown certain potential for detection and identification of Mycobacterium leprae in patients. In this study, we have investigated whether Mycobacterium leprae DNA from the nasal secretion of healthy household contacts and the non contacts could be detected through PCR amplification as a method to study the sub clinical infection in a community. A total of 200 samples, 100 each from contacts and non contacts representing all age groups and sex were included in this study. The M. leprae specific primer (proline-rich region) of pra gene was selected and PCR was performed using extracted DNA from the sample. A total of 13 samples were found to be positive for nasal PCR for pra gene among the male and female contacts out of which 7% were males and 6% were females. Even though several diagnostic tools are available to detect the cases of leprosy, they lack the specificity and sensitivity. PCR technology has demonstrated the improved diagnostic accuracy for epidemiological studies and requires minimal time. Although nasal PCR studies have been reported from many countries it is not usually recommended due to the high percentage of negative results in the contact. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Physical Review: a family of journals

    Science.gov (United States)

    Sprouse, Gene

    2013-03-01

    The expansion of research in physics in the last 100 years has been reflected in the expansion of the Physical Review(PR). Reviews of Modern Physics was the first ``new'' journal, starting in 1929. Physical Review Letters commenced in 1958, and was the first ``letters'' type of journal for important new results in all fields. By 1970 the Physical Review itself had grown so large that it was necessary to separate it by field into manageable volumes: PRA, PRB, PRC and PRD, and subsequently PRE, which was split off from PRA. More recently, two Special Topics journals for accelerator physics and physics education were pioneers of the open access business model, and the newest member of the family, Physical Review X, continues this trend. PRX is broad scope and very selective, setting it well above many of the new open access journals with a review standard of ``not incorrect.'' Some possible future directions for the Physical Review journals will be discussed.

  10. The prevention, detection and management of cancer treatment-induced cardiotoxicity: a meta-review

    International Nuclear Information System (INIS)

    Conway, Aaron; McCarthy, Alexandra L; Lawrence, Petra; Clark, Robyn A

    2015-01-01

    The benefits associated with some cancer treatments do not come without risk. A serious side effect of some common cancer treatments is cardiotoxicity. Increased recognition of the public health implications of cancer treatment-induced cardiotoxicity has resulted in a proliferation of systematic reviews in this field to guide practice. Quality appraisal of these reviews is likely to limit the influence of biased conclusions from systematic reviews that have used poor methodology related to clinical decision-making. The aim of this meta-review is to appraise and synthesise evidence from only high quality systematic reviews focused on the prevention, detection or management of cancer treatment-induced cardiotoxicity. Using Cochrane methodology, we searched databases, citations and hand-searched bibliographies. Two reviewers independently appraised reviews and extracted findings. A total of 18 high quality systematic reviews were subsequently analysed, 67 % (n = 12) of these comprised meta-analyses. One systematic review concluded that there is insufficient evidence regarding the utility of cardiac biomarkers for the detection of cardiotoxicity. The following strategies might reduce the risk of cardiotoxicity: 1) The concomitant administration of dexrazoxane with anthracylines; 2) The avoidance of anthracyclines where possible; 3) The continuous administration of anthracyclines (>6 h) rather than bolus dosing; and 4) The administration of anthracycline derivatives such as epirubicin or liposomal-encapsulated doxorubicin instead of doxorubicin. In terms of management, one review focused on medical interventions for treating anthracycline-induced cardiotoxicity during or after treatment of childhood cancer. Neither intervention (enalapril and phosphocreatine) was associated with statistically significant improvement in ejection fraction or mortality. This review highlights the lack of high level evidence to guide clinical decision-making with respect to the detection

  11. A comparative review of the options for treatment of erectile dysfunction: which treatment for which patient?

    Science.gov (United States)

    Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios G

    2005-01-01

    The field of erectile dysfunction (ED) has been revolutionised over the last two decades. Several treatment options are available today, most of which are associated with high efficacy rates and favourable safety profiles. A MEDLINE search was undertaken in order to evaluate all currently available data on treatment modalities for ED. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first-choice of most physicians and patients for the treatment of ED. PDE5 inhibitors have differences in their pharmacological profiles, the most obvious being the long duration of action of tadalafil, but there are no data supporting superiority for any one of them in terms of efficacy or safety. Sublingual apomorphine has limited efficacy compared with the PDE5 inhibitors, and its use is limited to patients with mild ED. Treatment failures with oral drugs may be due to medication, clinician and patient issues. The physician needs to address all of these issues in order to identify true treatment failures. Patients who are truly unresponsive to oral drugs may be offered other treatment options.Intracavernous injections of alprostadil alone, or in combination with other vasoactive agents (papaverine and phentolamine), remain an excellent treatment option, with proven efficacy and safety over time. Topical pharmacotherapy is appealing in nature, but currently available formulations have limited efficacy. Vacuum constriction devices may be offered mainly to elderly patients with occasional intercourse attempts, as younger patients show limited preference because of the unnatural erection that is associated with this treatment modality. Penile prostheses are generally the last treatment option offered, because of invasiveness, cost and non-reversibility; however, they are associated with high satisfaction rates in properly selected patients. All treatment options are associated with particular strengths and weaknesses. A patient

  12. Sequence variations and protein expression levels of the two immune evasion proteins Gpm1 and Pra1 influence virulence of clinical Candida albicans isolates.

    Science.gov (United States)

    Luo, Shanshan; Hipler, Uta-Christina; Münzberg, Christin; Skerka, Christine; Zipfel, Peter F

    2015-01-01

    Candida albicans, the important human fungal pathogen uses multiple evasion strategies to control, modulate and inhibit host complement and innate immune attack. Clinical C. albicans strains vary in pathogenicity and in serum resistance, in this work we analyzed sequence polymorphisms and variations in the expression levels of two central fungal complement evasion proteins, Gpm1 (phosphoglycerate mutase 1) and Pra1 (pH-regulated antigen 1) in thirteen clinical C. albicans isolates. Four nucleotide (nt) exchanges, all representing synonymous exchanges, were identified within the 747-nt long GPM1 gene. For the 900-nt long PRA1 gene, sixteen nucleotide exchanges were identified, which represented synonymous, as well as non-synonymous exchanges. All thirteen clinical isolates had a homozygous exchange (A to G) at position 73 of the PRA1 gene. Surface levels of Gpm1 varied by 8.2, and Pra1 levels by 3.3 fold in thirteen tested isolates and these differences influenced fungal immune fitness. The high Gpm1/Pra1 expressing candida strains bound the three human immune regulators more efficiently, than the low expression strains. The difference was 44% for Factor H binding, 51% for C4BP binding and 23% for plasminogen binding. This higher Gpm1/Pra1 expressing strains result in enhanced survival upon challenge with complement active, Factor H depleted human serum (difference 40%). In addition adhesion to and infection of human endothelial cells was increased (difference 60%), and C3b surface deposition was less effective (difference 27%). Thus, variable expression levels of central immune evasion protein influences immune fitness of the human fungal pathogen C. albicans and thus contribute to fungal virulence.

  13. A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments.

    Science.gov (United States)

    Stirnemann, Jérôme; Belmatoug, Nadia; Camou, Fabrice; Serratrice, Christine; Froissart, Roseline; Caillaud, Catherine; Levade, Thierry; Astudillo, Leonardo; Serratrice, Jacques; Brassier, Anaïs; Rose, Christian; Billette de Villemeur, Thierry; Berger, Marc G

    2017-02-17

    Gaucher disease (GD, ORPHA355) is a rare, autosomal recessive genetic disorder. It is caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, which leads to an accumulation of its substrate, glucosylceramide, in macrophages. In the general population, its incidence is approximately 1/40,000 to 1/60,000 births, rising to 1/800 in Ashkenazi Jews. The main cause of the cytopenia, splenomegaly, hepatomegaly, and bone lesions associated with the disease is considered to be the infiltration of the bone marrow, spleen, and liver by Gaucher cells. Type-1 Gaucher disease, which affects the majority of patients (90% in Europe and USA, but less in other regions), is characterized by effects on the viscera, whereas types 2 and 3 are also associated with neurological impairment, either severe in type 2 or variable in type 3. A diagnosis of GD can be confirmed by demonstrating the deficiency of acid glucocerebrosidase activity in leukocytes. Mutations in the GBA1 gene should be identified as they may be of prognostic value in some cases. Patients with type-1 GD-but also carriers of GBA1 mutation-have been found to be predisposed to developing Parkinson's disease, and the risk of neoplasia associated with the disease is still subject to discussion. Disease-specific treatment consists of intravenous enzyme replacement therapy (ERT) using one of the currently available molecules (imiglucerase, velaglucerase, or taliglucerase). Orally administered inhibitors of glucosylceramide biosynthesis can also be used (miglustat or eliglustat).

  14. A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments

    Directory of Open Access Journals (Sweden)

    Jérôme Stirnemann

    2017-02-01

    Full Text Available Gaucher disease (GD, ORPHA355 is a rare, autosomal recessive genetic disorder. It is caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, which leads to an accumulation of its substrate, glucosylceramide, in macrophages. In the general population, its incidence is approximately 1/40,000 to 1/60,000 births, rising to 1/800 in Ashkenazi Jews. The main cause of the cytopenia, splenomegaly, hepatomegaly, and bone lesions associated with the disease is considered to be the infiltration of the bone marrow, spleen, and liver by Gaucher cells. Type-1 Gaucher disease, which affects the majority of patients (90% in Europe and USA, but less in other regions, is characterized by effects on the viscera, whereas types 2 and 3 are also associated with neurological impairment, either severe in type 2 or variable in type 3. A diagnosis of GD can be confirmed by demonstrating the deficiency of acid glucocerebrosidase activity in leukocytes. Mutations in the GBA1 gene should be identified as they may be of prognostic value in some cases. Patients with type-1 GD—but also carriers of GBA1 mutation—have been found to be predisposed to developing Parkinson’s disease, and the risk of neoplasia associated with the disease is still subject to discussion. Disease-specific treatment consists of intravenous enzyme replacement therapy (ERT using one of the currently available molecules (imiglucerase, velaglucerase, or taliglucerase. Orally administered inhibitors of glucosylceramide biosynthesis can also be used (miglustat or eliglustat.

  15. Review on the refractive treatment methods of aphakia

    Directory of Open Access Journals (Sweden)

    Xiao-Yan Deng

    2015-06-01

    Full Text Available The refractive treatment methods of aphakia include corrective glasses, contact lens correction and intraocular lens(IOLimplantation. It magnifies images highly and limits vision field with corrective glasses. For infant aphakia corrective glasses are more likely to be chosen because their eyes are still unable to tolerate IOL implantation in the developmental stage. With low magnification of images, contact lens includes soft contact lens and rigid contact lens. The former is rarely used because it is prone to ocular lesions due to its poor oxygen permeability. The latter is widely used due to its good oxygen permeability especially suitable for the eyes of irregular astigmatism or iris missing due to trauma. At present, the most commonly used in clinical work is IOL implantation. The eye of IOL may avoid anisometropia, aberrations and so on because of more physiological anatomy. According to the IOL implantation site, it is divided into the anterior chamber IOL implantation and the posterior chamber IOL implantation. The anterior chamber IOL implantation is divided into angle fixed IOL implantation and iris fixed IOL implantation. The posterior chamber IOL implantation is divided into secondary in-the-bag IOL implantation, the ciliary sulcus IOL implantation and transscleral suture fixed IOL implantation.

  16. The diagnosis and treatment of paradoxical embolism: a systematic review

    Directory of Open Access Journals (Sweden)

    Atooshe Rohani

    2016-11-01

    Full Text Available One in five adults has patent foramen ovale (PFO, which is typically without symptoms. Because of the low pressure in both atria and the anatomical position of the septum secundum, there is no left-to-right shunting and little right-to-left shunting in the general condition; however, when the right atrial pressure increases, this slit-like flap separates and allows right-to-left shunting. According to the Johnson criteria, simultaneous occurrences of arterial emboli, such as those caused by cerebrovascular accident or pulmonary embolism, demonstrate the presence of paradoxical embolism through a PFO. When a patient presents with multivascular arterial embolism, the clinician should perform a contrast transthoracic echo, a transesophageal (TEE, a real-time three-dimensional TEE, and even an intracardiac echocardiography (ICE in order to differentiate between PFO, flat atrial septal defect (ASD and hybrid defects. The randomized trials that have assessed therapeutic interventions for paradoxical embolism have not produced any clear guidelines as to how best to treat this condition. The classic treatment is surgical embolectomy with exploration of the right chambers and the pulmonary arteries under full cardiopulmonary bypass. Patients with a history of ≥1 paradoxical embolism may be indicated for device PFO closure.

  17. Keratosis lichenoides chronica: Case-based review of treatment options.

    Science.gov (United States)

    Pistoni, Federica; Peroni, Anna; Colato, Chiara; Schena, Donatella; Girolomoni, Giampiero

    2016-08-01

    Keratosis lichenoides chronica (KLC) is a rare dermatological condition characterized by keratotic papules arranged in a parallel linear or reticular pattern and facial lesions resembling seborrheic dermatitis or rosacea. The clinical, histological and therapeutic information on 71 patients with KLC retrieved through a PubMed search plus one our new case were analyzed. KLC affects patients of all ages, with a modest male predominance. Pediatric cases represent about one quarter of patients. Diagnosis is usually delayed and histologically confirmed. All patients have thick, rough and scaly papules and plaques arranged in a linear or reticular pattern, on limbs (>80%) and trunk (about 60%). Face involvement is described in two-thirds of patients. Lesions are usually asymptomatic or mildly pruritic. Other manifestations, such as palmoplantar keratoderma, mucosal involvement, ocular manifestations, nail dystrophy, are reported in 20-30% of patients. Children present more frequently alopecia. No controlled trials are available. Results from small case series or single case reports show that the best treatment options are phototherapy and systemic retinoids, alone or in combination, with nearly half of patients reaching complete remission. Systemic corticosteroids as well as antibiotics and antimalarials are not effective.

  18. Improving Treatment Adherence in Bipolar Disorder: A Review of Current Psychosocial Treatment Efficacy and Recommendations for Future Treatment Development

    Science.gov (United States)

    Gaudiano, Brandon A.; Weinstock, Lauren M.; Miller, Ivan W.

    2008-01-01

    Treatment adherence is a frequent problem in bipolar disorder, with research showing that more than 60% of bipolar patients are at least partially nonadherent to medications. Treatment nonadherence is consistently predictive of a number of negative outcomes in bipolar samples, and the discontinuation of mood stabilizers places these patients at…

  19. Review of the integrated thermal and nonthermal treatment system studies. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  20. Review of the integrated thermal and nonthermal treatment system studies. Final report

    International Nuclear Information System (INIS)

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering