Dependence on carbonated water: Clinical and policy implications

Directory of Open Access Journals (Sweden)

Sumit Kumar Gupta

2015-01-01

Full Text Available A case of caffeine dependence syndrome with preference for a specific brand of carbonated water (popularly known as soft drinks or colas is discussed to highlight the clinical and policy implications.

miRNAs in inflammatory skin diseases and their clinical implications

DEFF Research Database (Denmark)

Løvendorf, Marianne B; Skov, Lone

2015-01-01

biological processes. The clinical implications of miRNAs are intriguing, both from a diagnostic and a therapeutic perspective. Accordingly, there is emerging evidence for the clinical potential of miRNAs as both biomarkers and possible therapeutic targets in skin diseases. Future studies will hopefully...... incomplete; however, it is known that miRNAs are implicated in various cellular processes of both normal and diseased skin. Some miRNAs appear to be consistently deregulated in several different inflammatory skin diseases, including psoriasis and atopic dermatitis, indicating a common role in fundamental...

Risk prediction of emergency department revisit 30 days post discharge: a prospective study.

Directory of Open Access Journals (Sweden)

Shiying Hao

Full Text Available Among patients who are discharged from the Emergency Department (ED, about 3% return within 30 days. Revisits can be related to the nature of the disease, medical errors, and/or inadequate diagnoses and treatment during their initial ED visit. Identification of high-risk patient population can help device new strategies for improved ED care with reduced ED utilization.A decision tree based model with discriminant Electronic Medical Record (EMR features was developed and validated, estimating patient ED 30 day revisit risk. A retrospective cohort of 293,461 ED encounters from HealthInfoNet (HIN, Maine's Health Information Exchange (HIE, between January 1, 2012 and December 31, 2012, was assembled with the associated patients' demographic information and one-year clinical histories before the discharge date as the inputs. To validate, a prospective cohort of 193,886 encounters between January 1, 2013 and June 30, 2013 was constructed. The c-statistics for the retrospective and prospective predictions were 0.710 and 0.704 respectively. Clinical resource utilization, including ED use, was analyzed as a function of the ED risk score. Cluster analysis of high-risk patients identified discrete sub-populations with distinctive demographic, clinical and resource utilization patterns.Our ED 30-day revisit model was prospectively validated on the Maine State HIN secure statewide data system. Future integration of our ED predictive analytics into the ED care work flow may lead to increased opportunities for targeted care intervention to reduce ED resource burden and overall healthcare expense, and improve outcomes.

Post-Inflationary Gravitino Production Revisited

CERN Document Server

Ellis, John; Nanopoulos, Dimitri V.; Olive, Keith A.; Peloso, Marco

2016-01-01

We revisit gravitino production following inflation. As a first step, we review the standard calculation of gravitino production in the thermal plasma formed at the end of post-inflationary reheating when the inflaton has completely decayed. Next we consider gravitino production prior to the completion of reheating, assuming that the inflaton decay products thermalize instantaneously while they are still dilute. We then argue that instantaneous thermalization is in general a good approximation, and also show that the contribution of non-thermal gravitino production via the collisions of inflaton decay products prior to thermalization is relatively small. Our final estimate of the gravitino-to-entropy ratio is approximated well by a standard calculation of gravitino production in the post-inflationary thermal plasma assuming total instantaneous decay and thermalization at a time $t \\simeq 1.2/\\Gamma_\\phi$. Finally, in light of our calculations, we consider potential implications of upper limits on the gravitin...

HBV DNA Integration: Molecular Mechanisms and Clinical Implications

Science.gov (United States)

Tu, Thomas; Budzinska, Magdalena A.; Shackel, Nicholas A.; Urban, Stephan

2017-01-01

Chronic infection with the Hepatitis B Virus (HBV) is a major cause of liver-related morbidity and mortality. One peculiar observation in cells infected with HBV (or with closely‑related animal hepadnaviruses) is the presence of viral DNA integration in the host cell genome, despite this form being a replicative dead-end for the virus. The frequent finding of somatic integration of viral DNA suggests an evolutionary benefit for the virus; however, the mechanism of integration, its functions, and the clinical implications remain unknown. Here we review the current body of knowledge of HBV DNA integration, with particular focus on the molecular mechanisms and its clinical implications (including the possible consequences of replication-independent antigen expression and its possible role in hepatocellular carcinoma). HBV DNA integration is likely to influence HBV replication, persistence, and pathogenesis, and so deserves greater attention in future studies. PMID:28394272

DMPD: Innate immunity and toll-like receptors: clinical implications of basic scienceresearch. [Dynamic Macrophage Pathway CSML Database

Lifescience Database Archive (English)

Full Text Available 15069387 Innate immunity and toll-like receptors: clinical implications of basic science...te immunity and toll-like receptors: clinical implications of basic scienceresearch. PubmedID 15069387 Title... Innate immunity and toll-like receptors: clinical implications of basic sciencer

Periodic Epileptiform Discharges Clarified for the Nonneurologist Intensivist: Clinical Implications and Current Management.

Science.gov (United States)

Lahiri, Shouri; Boro, Alexis D; Shiloh, Ariel L; Milstein, Mark J; Savel, Richard H

2015-10-01

Periodic epileptiform discharges (PEDs) are frequently encountered during continuous electroencephalography monitoring in the intensive care unit. Their implications and management are variable and highly dependent on the clinical context. This article is intended for the nonneurologist intensivist, reviews basic terminology and clinical implications (including causes, prognosis, and association with seizures), and suggests an approach to management. Several case vignettes are included to illustrate the clinical variability associated with PEDs. © The Author(s) 2013.

Revisiting the 'paradigm shift' in opioid use: Developments and implications 10 years later.

Science.gov (United States)

Fischer, Benedikt; Rehm, Jürgen

2017-03-23

A decade ago, we queried the unfolding of a 'paradigm shift' in illicit opioid use in North America, specifically involving a shift away from heroin to prescription opioid (PO) use. Today, this situation is more acute than ever, with prescription opioid misuse, morbidity and mortality amounting to one of the most severe substance use-related public health crises ever, now even impacting life expectancy in key population segments. Despite medical system-based PO dispensing and practices being recognised as core drivers of the PO crisis, effective policy measures have been long absent or limited-including those to reduce medical PO use to levels supported by best evidence for pain care. At the same time, heroin use has been increasing again, now commonly tied into interdependent opioid use trajectories, initiated with POs yet shifting to heroin as influenced by economic or availability factors. For policy, there are now two major and urgent-yet partly conflicting-tasks: one is to reduce the determinants of PO misuse and harms by reducing medical prescribing to levels supported by good evidence, while the other is to effectively protect those many active problematic PO users from acute harms (including overdose mortality) by providing effective treatment and survival aids (e.g. naloxone). Surprisingly, it appears that a major 'homemade' and medical system-induced drug crisis has been at least as challenging for North American policy systems to address as other, more conventional illicit drug problems. Lessons for policy hence need to be urgently identified and applied for the future. [Fischer B, Rehm J. Revisiting the 'paradigm shift' in opioid use: Developments and implications 10 years later. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Implications of the Dynamics of the New Networked Economy for E-Business Start-Ups: The Case of Philips' Access Point.

Science.gov (United States)

Tovstiga, George; Fantner, Ernest J.

2000-01-01

Examines implications of the networked economy for e-commerce business start-ups. Revisits the notion of "value" and "value creation" in a network context. Examines "value" relative to technological innovation. Looks at implications of the network environment for the organization and transformation of the enterprise's…

Lakatos Revisited.

Science.gov (United States)

Court, Deborah

1999-01-01

Revisits and reviews Imre Lakatos' ideas on "Falsification and the Methodology of Scientific Research Programmes." Suggests that Lakatos' framework offers an insightful way of looking at the relationship between theory and research that is relevant not only for evaluating research programs in theoretical physics, but in the social…

Oxidative phosphorylation revisited

DEFF Research Database (Denmark)

Nath, Sunil; Villadsen, John

2015-01-01

The fundamentals of oxidative phosphorylation and photophosphorylation are revisited. New experimental data on the involvement of succinate and malate anions respectively in oxidative phosphorylation and photophosphorylation are presented. These new data offer a novel molecular mechanistic...

Supernatural impotence: historical review with anthropological and clinical implications.

Science.gov (United States)

Margolin, J; Witztum, E

1989-12-01

The historical and cultural background of the belief in supernatural impotence is presented, emphasizing its possible implications for clinical practice. A brief historical survey of the concept in Judaism and Christianity is followed by a short anthropological survey of supernatural impotence in different ethnic subcultures in Israel. A case demonstration exemplifies the connection between understanding the patient's cultural background and beliefs and the clinical competence of the therapist. The relationship between the clinical-therapeutic process in psychiatric practice and knowledge of the patient's cultural background and beliefs is stressed.

Clinical review: Ethnic differences in bone mass--clinical implications.

Science.gov (United States)

Leslie, William D

2012-12-01

Differences in bone mineral density (BMD) as assessed with dual-energy x-ray absorptiometry are observed between geographic and ethnic groups, with important implications in clinical practice. PubMed was employed to identify relevant studies. A review of the literature was conducted, and data were summarized and integrated. The available data highlight the complex ethnic variations in BMD, which only partially account for observed variations in fracture rates. Factors contributing to ethnic differences include genetics, skeletal size, body size and composition, lifestyle, and social determinants. Despite BMD differences, the gradient of risk for fracture from BMD and other clinical risk factors appears to be similar across ethnic groups. Furthermore, BMD variation is greater within an ethnic population than between ethnic populations. New imaging technologies have identified ethnic differences in bone geometry, volumetric density, microarchitecture, and estimated bone strength that may contribute to a better understanding of ethnic differences in fracture risk. Factors associated with ethnicity affect BMD and fracture risk through direct and indirect mechanisms.

Circular revisit orbits design for responsive mission over a single target

Science.gov (United States)

Li, Taibo; Xiang, Junhua; Wang, Zhaokui; Zhang, Yulin

2016-10-01

The responsive orbits play a key role in addressing the mission of Operationally Responsive Space (ORS) because of their capabilities. These capabilities are usually focused on supporting specific targets as opposed to providing global coverage. One subtype of responsive orbits is repeat coverage orbit which is nearly circular in most remote sensing applications. This paper deals with a special kind of repeating ground track orbit, referred to as circular revisit orbit. Different from traditional repeat coverage orbits, a satellite on circular revisit orbit can visit a target site at both the ascending and descending stages in one revisit cycle. This typology of trajectory allows a halving of the traditional revisit time and does a favor to get useful information for responsive applications. However the previous reported numerical methods in some references often cost lots of computation or fail to obtain such orbits. To overcome this difficulty, an analytical method to determine the existence conditions of the solutions to revisit orbits is presented in this paper. To this end, the mathematical model of circular revisit orbit is established under the central gravity model and the J2 perturbation. A constraint function of the circular revisit orbit is introduced, and the monotonicity of that function has been studied. The existent conditions and the number of such orbits are naturally worked out. Taking the launch cost into consideration, optimal design model of circular revisit orbit is established to achieve a best orbit which visits a target twice a day in the morning and in the afternoon respectively for several days. The result shows that it is effective to apply circular revisit orbits in responsive application such as reconnoiter of natural disaster.

Post-inflationary gravitino production revisited

Energy Technology Data Exchange (ETDEWEB)

Ellis, John [Theoretical Particle Physics and Cosmology Group, Department of Physics, King' s College London, London WC2R 2LS (United Kingdom); Garcia, Marcos A.G.; Olive, Keith A. [William I. Fine Theoretical Physics Institute, School of Physics and Astronomy, University of Minnesota, 116 Church Street SE, Minneapolis, MN 55455 (United States); Nanopoulos, Dimitri V. [George P. and Cynthia W. Mitchell Institute for Fundamental Physics and Astronomy, Texas A and M University, College Station, TX 77843 (United States); Peloso, Marco, E-mail: john.ellis@cern.ch, E-mail: garciagarcia@physics.umn.edu, E-mail: dimitri@physics.tamu.edu, E-mail: olive@physics.umn.edu, E-mail: peloso@physics.umn.edu [School of Physics and Astronomy and Minnesota Institute for Astrophysics, University of Minnesota, 116 Church Street SE, Minneapolis, MN 55455 (United States)

2016-03-01

We revisit gravitino production following inflation. As a first step, we review the standard calculation of gravitino production in the thermal plasma formed at the end of post-inflationary reheating when the inflaton has completely decayed. Next we consider gravitino production prior to the completion of reheating, assuming that the inflaton decay products thermalize instantaneously while they are still dilute. We then argue that instantaneous thermalization is in general a good approximation, and also show that the contribution of non-thermal gravitino production via the collisions of inflaton decay products prior to thermalization is relatively small. Our final estimate of the gravitino-to-entropy ratio is approximated well by a standard calculation of gravitino production in the post-inflationary thermal plasma assuming total instantaneous decay and thermalization at a time t ≅ 1.2/Γ{sub φ}. Finally, in light of our calculations, we consider potential implications of upper limits on the gravitino abundance for models of inflation, with particular attention to scenarios for inflaton decays in supersymmetric Starobinsky-like models.

Hypertensive response to exercise: mechanisms and clinical implication

OpenAIRE

Kim, Darae; Ha, Jong-Won

2016-01-01

A hypertensive response to exercise (HRE) is frequently observed in individuals without hypertension or other cardiovascular disease. However, mechanisms and clinical implication of HRE is not fully elucidated. Endothelial dysfunction and increased stiffness of large artery contribute to development of HRE. From neurohormonal aspects, excess stimulation of sympathetic nervous system and augmented rise of angiotensin II seems to be important mechanism in HRE. Increasing evidences indicates tha...

Revisiting Okun's Relationship

NARCIS (Netherlands)

Dixon, R.; Lim, G.C.; van Ours, Jan

2016-01-01

Our paper revisits Okun's relationship between observed unemployment rates and output gaps. We include in the relationship the effect of labour market institutions as well as age and gender effects. Our empirical analysis is based on 20 OECD countries over the period 1985-2013. We find that the

Implications of Nursing Clinical Practice to The Student’s Spiritual Health

Directory of Open Access Journals (Sweden)

Bhandesa Asthadi Mahendra

2018-01-01

Full Text Available This study aimed to clarify the implications of Nursing Clinical Practice (PLKK to the spiritual health of STIKES Bali students. This study employed purposive sampling method to determine the number of respondents. To conduct this study, the fourth grade of nursing students were recruited as the sample with total number 136 respondents. A questionnaire about spirituality from World Health Organization (WHO was used in this study as the instrument. In addition, the data were analysed by using quantitative descriptive technique. The result showed that 50.0% of students had a very good spiritual health, 42.6% had good spiritual health, 6.6% had moderate spiritual health, and 0.7 % had poor spiritual health. It can be interpreted that spiritual health of nursing students of STIKES Bali is good after conducting Nursing Clinical Practice. Thus, this study can be concluded that Nursing Clinical Practice has implication to the ability of students to love themselves and others meaningfully as the evidence of students’ spiritual health.

Tourists' perceptions and intention to revisit Norway

OpenAIRE

Lazar, Ana Florina; Komolikova-Blindheim, Galyna

2016-01-01

Purpose - The overall purpose of this study is to explore tourists' perceptions and their intention to revisit Norway. The aim is to find out what are the factors that drive the overall satisfaction, the willingness to recommend and the revisit intention of international tourists that spend their holiday in Norway. Design-Method-Approach - the Theory of Planned Behavior (Ajzen 1991), is used as a framework to investigate tourists' intention and behavior towards Norway as destination. The o...

Sensemaking Revisited

DEFF Research Database (Denmark)

Holt, Robin; Cornelissen, Joep

2014-01-01

We critique and extend theory on organizational sensemaking around three themes. First, we investigate sense arising non-productively and so beyond any instrumental relationship with things; second, we consider how sense is experienced through mood as well as our cognitive skills of manipulation ...... research by revisiting Weick’s seminal reading of Norman Maclean’s book surrounding the tragic events of a 1949 forest fire at Mann Gulch, USA....

REVISITING THE SCATTERING GREENHOUSE EFFECT OF CO2 ICE CLOUDS

International Nuclear Information System (INIS)

Kitzmann, D.

2016-01-01

Carbon dioxide ice clouds are thought to play an important role for cold terrestrial planets with thick CO 2 dominated atmospheres. Various previous studies showed that a scattering greenhouse effect by carbon dioxide ice clouds could result in a massive warming of the planetary surface. However, all of these studies only employed simplified two-stream radiative transfer schemes to describe the anisotropic scattering. Using accurate radiative transfer models with a general discrete ordinate method, this study revisits this important effect and shows that the positive climatic impact of carbon dioxide clouds was strongly overestimated in the past. The revised scattering greenhouse effect can have important implications for the early Mars, but also for planets like the early Earth or the position of the outer boundary of the habitable zone

Marginalization: A Revisitation With Integration of Scholarship on Globalization, Intersectionality, Privilege, Microaggressions, and Implicit Biases.

Science.gov (United States)

Hall, Joanne M; Carlson, Kelly

2016-01-01

In 1994, the concept of marginalization was explored in an article in Advances in Nursing Science. This is a revisitation of the concept incorporating new scholarship. This update is founded on feminism, postcolonialism, critical race theory, and discourse deconstruction, all viewpoints that have been explicated in nursing. The purpose of this analysis is to look at new scholarship and concepts useful to applying marginalization in nursing knowledge development from the standpoint of Bourdieu's macro, meso, and micro levels. New scholarship includes globalization, intersectionality, privilege, microaggressions, and implicit bias. Implications for decreasing health disparities through this new scholarship are discussed.

Pharmacokinetic drug-drug interaction and their implication in clinical management.

Science.gov (United States)

Palleria, Caterina; Di Paolo, Antonello; Giofrè, Chiara; Caglioti, Chiara; Leuzzi, Giacomo; Siniscalchi, Antonio; De Sarro, Giovambattista; Gallelli, Luca

2013-07-01

Drug-drug interactions (DDIs) are one of the commonest causes of medication error in developed countries, particularly in the elderly due to poly-therapy, with a prevalence of 20-40%. In particular, poly-therapy increases the complexity of therapeutic management and thereby the risk of clinically important DDIs, which can both induce the development of adverse drug reactions or reduce the clinical efficacy. DDIs can be classify into two main groups: pharmacokinetic and pharmacodynamic. In this review, using Medline, PubMed, Embase, Cochrane library and Reference lists we searched articles published until June 30 2012, and we described the mechanism of pharmacokinetic DDIs focusing the interest on their clinical implications.

Diet and Sleep Physiology: Public Health and Clinical Implications

Directory of Open Access Journals (Sweden)

Sarah Frank

2017-08-01

Full Text Available This mini-review examines the complex relationship between diet and sleep and explores the clinical and public health implications of the current evidence. Dietary quality and intake of specific nutrients can impact regulatory hormonal pathways to alter sleep quantity and quality. Sleep, in turn, affects the intake of total energy, as well as of specific foods and nutrients, through biological and behavioral mechanisms. Initial research in this field focused primarily on the effects of short sleep duration on nutritional quality. However, more recent studies have explored the dynamic relationship between long sleep duration and diet. Current evidence suggests that extremes of sleep duration alter sleep patterns, hormonal levels, and circadian rhythms, which contribute to weight-related outcomes and obesity, and other risk factors for the development of chronic disease such as type 2 diabetes and cardiovascular disease. These patterns may begin as early as childhood and have impacts throughout the life course. Given that non-communicable diseases are among the leading causes of death globally, deeper understanding of the interactions between sleep and nutrition has implications for both public health and clinical practice.

Brain microbleeds: Epidemiology and clinical implications.

Science.gov (United States)

Boyano, I; Bravo, N; Miranda, J; Gil-Gregorio, P; Olazarán, J

2016-06-22

Brain microbleeds (BMB) are haemosiderin deposits contained within macrophages, which are displayed as hypointense images in some T2-weighted magnetic resonance imaging sequences. There are still many questions to be answered about the pathophysiology and clinical relevance of BMB. We conducted a literature review of the main epidemiological, clinical, and anatomical pathology studies of BMB performed in the general population, in patients at risk of or already suffering from a vascular disease, and in patients with cognitive impairment. We analysed the prevalence of BMB, risk factors, and potential pathophysiological mechanisms and clinical implications. The prevalence of BMB is highly variable (3%-27% in the general population, 6%-80% in patients with vascular risk factors or vascular disease, and 16%-45% in patients with cognitive impairment). BMB are associated with ageing, Alzheimer disease (AD), and in particular haemorrhagic or ischaemic cerebrovascular disease. The pathological substrate of BMB is either lipohyalinosis (subcortical BMB) or cerebral amyloid angiopathy (lobar BMB). BMB exacerbate cognitive impairment, possibly through cortical-subcortical and intracortical disconnection, and increase the risk of death, mostly due to vascular causes. BMB also increase the risk of cerebral haemorrhage, particularly in patients with multiple lobar BMB (probable erebral amyloid angiopathy). Therefore, anticoagulant treatment may be contraindicated in these patients. In patients with lower risk of bleeding, the new oral anticoagulants and the combination of clinical and magnetic resonance imaging follow-up could be helpful in the decision-making process. Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

A Structural Equation Model of Risk Perception of Rockfall for Revisit Intention

OpenAIRE

Ya-Fen Lee; Yun-Yao Chi

2014-01-01

The study aims to explore the relationship between risk perception of rockfall and revisit intention using a Structural Equation Modeling (SEM) analysis. A total of 573 valid questionnaires are collected from travelers to Taroko National Park, Taiwan. The findings show the majority of travelers have the medium perception of rockfall risk, and are willing to revisit the Taroko National Park. The revisit intention to Taroko National Park is influenced by hazardous preferences, willingness-to-pa...

The Faraday effect revisited

DEFF Research Database (Denmark)

Cornean, Horia; Nenciu, Gheorghe

2009-01-01

This paper is the second in a series revisiting the (effect of) Faraday rotation. We formulate and prove the thermodynamic limit for the transverse electric conductivity of Bloch electrons, as well as for the Verdet constant. The main mathematical tool is a regularized magnetic and geometric...

Remembered Experiences and Revisit Intentions

DEFF Research Database (Denmark)

Barnes, Stuart; Mattsson, Jan; Sørensen, Flemming

2016-01-01

Tourism is an experience-intensive sector in which customers seek and pay for experiences above everything else. Remembering past tourism experiences is also crucial for an understanding of the present, including the predicted behaviours of visitors to tourist destinations. We adopt a longitudinal...... approach to memory data collection from psychological science, which has the potential to contribute to our understanding of tourist behaviour. In this study, we examine the impact of remembered tourist experiences in a safari park. In particular, using matched survey data collected longitudinally and PLS...... path modelling, we examine the impact of positive affect tourist experiences on the development of revisit intentions. We find that longer-term remembered experiences have the strongest impact on revisit intentions, more so than predicted or immediate memory after an event. We also find that remembered...

A neurophysiological approach to tinnitus: clinical implications.

Science.gov (United States)

Jastreboff, P J; Hazell, J W

1993-02-01

This paper presents a neurophysiological approach to tinnitus and discusses its clinical implications. A hypothesis of discordant damage of inner and outer hair cells systems in tinnitus generation is outlined. A recent animal model has facilitated the investigation of the mechanisms of tinnitus and has been further refined to allow for the measurement of tinnitus pitch and loudness. The analysis of the processes involved in tinnitus detection postulates the involvement of an abnormal increase of gain within the auditory system. Moreover, it provides a basis for treating patients with hyperacusis, which we are considering to be a pre-tinnitus state. Analysis of the process of tinnitus perception allows for the possibility of facilitating the process of tinnitus habituation for the purpose of its alleviation. The combining of theoretical analysis with clinical findings has resulted in the creation of a multidisciplinary Tinnitus Centre. The foundation of the Centre focuses on two goals: the clinical goal is to remove tinnitus perception from the patient's consciousness, while directing research toward finding a mechanism-based method for the suppression of tinnitus generators and processes responsible for enhancement of tinnitus-related neuronal activity.

Multidrug efflux pumps in Staphylococcus aureus and their clinical implications.

Science.gov (United States)

Jang, Soojin

2016-01-01

Antibiotic resistance is rapidly spreading among bacteria such as Staphylococcus aureus, an opportunistic bacterial pathogen that causes a variety of diseases in humans. For the last two decades, bacterial multidrug efflux pumps have drawn attention due to their potential association with clinical multidrug resistance. Numerous researchers have demonstrated efflux-mediated resistance in vitro and in vivo and found novel multidrug transporters using advanced genomic information about bacteria. This article aims to provide a concise summary of multidrug efflux pumps and their important clinical implications, focusing on recent findings concerning S. aureus efflux pumps.

Revisiting the Okun relationship

NARCIS (Netherlands)

Dixon, R. (Robert); Lim, G.C.; J.C. van Ours (Jan)

2017-01-01

textabstractOur article revisits the Okun relationship between observed unemployment rates and output gaps. We include in the relationship the effect of labour market institutions as well as age and gender effects. Our empirical analysis is based on 20 OECD countries over the period 1985–2013. We

Bounded Intention Planning Revisited

OpenAIRE

Sievers Silvan; Wehrle Martin; Helmert Malte

2014-01-01

Bounded intention planning provides a pruning technique for optimal planning that has been proposed several years ago. In addition partial order reduction techniques based on stubborn sets have recently been investigated for this purpose. In this paper we revisit bounded intention planning in the view of stubborn sets.

Exploring accountability of clinical ethics consultants: practice and training implications.

Science.gov (United States)

Weise, Kathryn L; Daly, Barbara J

2014-01-01

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

Pharmacokinetic drug-drug interaction and their implication in clinical management

Directory of Open Access Journals (Sweden)

Palleria Caterina

2013-01-01

Full Text Available Drug-drug interactions (DDIs are one of the commonest causes of medication error in developed countries, particularly in the elderly due to poly-therapy, with a prevalence of 20-40%. In particular, poly-therapy increases the complexity of therapeutic management and thereby the risk of clinically important DDIs, which can both induce the development of adverse drug reactions or reduce the clinical efficacy. DDIs can be classify into two main groups: pharmacokinetic and pharmacodynamic. In this review, using Medline, PubMed, Embase, Cochrane library and Reference lists we searched articles published until June 30 2012, and we described the mechanism of pharmacokinetic DDIs focusing the interest on their clinical implications.

REVISITING THE SCATTERING GREENHOUSE EFFECT OF CO{sub 2} ICE CLOUDS

Energy Technology Data Exchange (ETDEWEB)

Kitzmann, D., E-mail: daniel.kitzmann@csh.unibe.ch [Center for Space and Habitability, University of Bern, Sidlerstr. 5, 3012 Bern (Switzerland)

2016-02-01

Carbon dioxide ice clouds are thought to play an important role for cold terrestrial planets with thick CO{sub 2} dominated atmospheres. Various previous studies showed that a scattering greenhouse effect by carbon dioxide ice clouds could result in a massive warming of the planetary surface. However, all of these studies only employed simplified two-stream radiative transfer schemes to describe the anisotropic scattering. Using accurate radiative transfer models with a general discrete ordinate method, this study revisits this important effect and shows that the positive climatic impact of carbon dioxide clouds was strongly overestimated in the past. The revised scattering greenhouse effect can have important implications for the early Mars, but also for planets like the early Earth or the position of the outer boundary of the habitable zone.

The state of the art in organizational cognitive neuroscience: the therapeutic gap and possible implications for clinical practice.

Science.gov (United States)

Senior, Carl; Lee, Nick

2013-01-01

In the last decade, researchers in the social sciences have increasingly adopted neuroscientific techniques, with the consequent rise of research inspired by neuroscience in disciplines such as economics, marketing, decision sciences, and leadership. In 2007, we introduced the term organizational cognitive neuroscience (OCN), in an attempt to clearly demarcate research carried out in these many areas, and provide an overarching paradigm for research utilizing cognitive neuroscientific methods, theories, and concepts, within the organizational and business research fields. Here we will revisit and further refine the OCN paradigm, and define an approach where we feel the marriage of organizational theory and neuroscience will return even greater dividends in the future and that is within the field of clinical practice.

Revisiting Nursing Research in Nigeria

African Journals Online (AJOL)

2016-08-18

Aug 18, 2016 ... health care research, it is therefore pertinent to revisit the state of nursing research in the country. .... platforms, updated libraries with electronic resource ... benchmarks for developing countries of 26%, [17] the amount is still ...

Time functions revisited

Science.gov (United States)

Fathi, Albert

2015-07-01

In this paper we revisit our joint work with Antonio Siconolfi on time functions. We will give a brief introduction to the subject. We will then show how to construct a Lipschitz time function in a simplified setting. We will end with a new result showing that the Aubry set is not an artifact of our proof of existence of time functions for stably causal manifolds.

'Counterfeit deviance' revisited.

Science.gov (United States)

Griffiths, Dorothy; Hingsburger, Dave; Hoath, Jordan; Ioannou, Stephanie

2013-09-01

The field has seen a renewed interest in exploring the theory of 'counterfeit deviance' for persons with intellectual disability who sexually offend. The term was first presented in 1991 by Hingsburger, Griffiths and Quinsey as a means to differentiate in clinical assessment a subgroup of persons with intellectual disability whose behaviours appeared like paraphilia but served a function that was not related to paraphilia sexual urges or fantasies. Case observations were put forward to provide differential diagnosis of paraphilia in persons with intellectual disabilities compared to those with counterfeit deviance. The brief paper was published in a journal that is no longer available and as such much of what is currently written on the topic is based on secondary sources. The current paper presents a theoretical piece to revisit the original counterfeit deviance theory to clarify the myths and misconceptions that have arisen and evaluate the theory based on additional research and clinical findings. The authors also propose areas where there may be a basis for expansion of the theory. The theory of counterfeit deviance still has relevance as a consideration for clinicians when assessing the nature of a sexual offence committed by a person with an intellectual disability. Clinical differentiation of paraphilia from counterfeit deviance provides a foundation for intervention that is designed to specifically treat the underlying factors that contributed to the offence for a given individual. Counterfeit deviance is a concept that continues to provide areas for consideration for clinicians regarding the assessment and treatment of an individual with an intellectual disability who has sexually offended. It is not and never was an explanation for all sexually offending behavior among persons with intellectual disabilities. © 2013 John Wiley & Sons Ltd.

Ethical, legal, and social implications (ELSI) of microdose clinical trials.

Science.gov (United States)

Kurihara, Chieko

2011-06-19

A "microdose clinical trial" (microdosing) is one kind of early phase exploratory clinical trial, administering the compound at doses estimated to have no pharmacological or toxicological effects, aimed at screening candidates for further clinical development. This article's objective is to clarify the ethical, legal, and social implications (ELSI) of such an exploratory minimum-risk human trial. The definition and non-clinical study requirements for microdosing have been harmonized among the European Union (EU), United States (US), and Japan. Being conducted according to these regulations, microdosing seems to be ethically well justified in terms of respect for persons, beneficence, justice, human dignity, and animal welfare. Three big projects have been demonstrating the predictability of therapeutic dose pharmacokinetics from microdosing. The article offers suggestions as how microdosing can become a more useful and socially accepted strategy. Copyright © 2011 Elsevier B.V. All rights reserved.

The pathophysiology of the trigeminal autonomic cephalalgias, with clinical implications

DEFF Research Database (Denmark)

Barloese, Mads C J

2018-01-01

, it is obvious that this brainstem reflex is regulated by higher centers that seemingly play a pivotal role in the attacks and the wide range of other symptoms indicating a homeostatic disturbance. These symptoms, as well as a number of well-validated findings, implicate the hypothalamus in the pathophysiology....... over the course of the past 2-3 decades, novel therapies and technological advances have helped increase our knowledge of these clinical syndromes, and will likely continue to do so in the coming years as we witness the arrival of new drugs and neurostimulation options. In this review, the clinical...

Terror management theory applied clinically: implications for existential-integrative psychotherapy.

Science.gov (United States)

Lewis, Adam M

2014-01-01

Existential psychotherapy and Terror Management Theory (TMT) offer explanations for the potential psychological effects of death awareness, although their respective literatures bases differ in clarity, research, and implications for treating psychopathology. Existential therapy is often opaque to many therapists, in part due to the lack of consensus on what constitutes its practice, limited published practical examples, and few empirical studies examining its efficacy. By contrast, TMT has an extensive empirical literature base, both within social psychology and spanning multiple disciplines, although previously unexplored within clinical and counseling psychology. This article explores the implications of a proposed TMT integrated existential therapy (TIE), bridging the gap between disciplines in order to meet the needs of the aging population and current challenges facing existential therapists.

Portfolio assessment and evaluation: implications and guidelines for clinical nursing education.

Science.gov (United States)

Chabeli, M M

2002-08-01

With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and alternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional) methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described. In view of the qualitative, descriptive and exploratory nature of the study, a focus group interview with twenty students following a post-basic degree at a university in Gauteng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing education was used. A descriptive method of qualitative data analysis of open coding in accordance with Tesch's protocol (in Creswell 1994:155) was used. Resultant implications and guidelines were conceptualised and described within the existing theoretical framework. Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327). Ethical considerations were in accordance with DENOSA's standards of research (1998:7).

Revisiting Inter-Genre Similarity

DEFF Research Database (Denmark)

Sturm, Bob L.; Gouyon, Fabien

2013-01-01

We revisit the idea of ``inter-genre similarity'' (IGS) for machine learning in general, and music genre recognition in particular. We show analytically that the probability of error for IGS is higher than naive Bayes classification with zero-one loss (NB). We show empirically that IGS does...... not perform well, even for data that satisfies all its assumptions....

A Hydrostatic Paradox Revisited

Science.gov (United States)

Ganci, Salvatore

2012-01-01

This paper revisits a well-known hydrostatic paradox, observed when turning upside down a glass partially filled with water and covered with a sheet of light material. The phenomenon is studied in its most general form by including the mass of the cover. A historical survey of this experiment shows that a common misunderstanding of the phenomenon…

What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited.

Science.gov (United States)

Hartwig, Jochen

2008-05-01

The share of health care expenditure in GDP rises rapidly in virtually all OECD countries, causing increasing concern among politicians and the general public. Yet, economists have to date failed to reach an agreement on what the main determinants of this development are. This paper revisits Baumol's [Baumol, W.J., 1967. Macroeconomics of unbalanced growth: the anatomy of urban crisis. American Economic Review 57 (3), 415-426] model of 'unbalanced growth', showing that the latter offers a ready explanation for the observed inexorable rise in health care expenditure. The main implication of Baumol's model in this context is that health care expenditure is driven by wage increases in excess of productivity growth. This hypothesis is tested empirically using data from a panel of 19 OECD countries. Our tests yield robust evidence in favor of Baumol's theory.

The state of the art in organisational cognitive neuroscience: The therapeutic gap and possible implications for clinical practice

Directory of Open Access Journals (Sweden)

Carl eSenior

2013-12-01

Full Text Available In the last decade, researchers in the social sciences have increasingly adopted neuroscientific techniques, with the consequent rise of research inspired by neuroscience in disciplines such as economics, marketing, decision sciences, and leadership. In 2007, we introduced the term organizational cognitive neuroscience (OCN, in an attempt to clearly demarcate research carried out in these many areas, and provide an overarching paradigm for research utilising cognitive neuroscientific methods, theories, and concepts, within the organizational and business research fields. Here we will revisit and further refine the OCN paradigm, and define an approach where we feel the marriage of organisational theory and neuroscience will return even greater dividends in the future and that is within the field of clinical practice.

THE INFLUENCE OF DESTINATION IMAGE AND TOURIST SATISFACTION TOWARD REVISIT INTENTION OF SETU BABAKAN BETAWI CULTURAL VILLAGE

OpenAIRE

Wibowo, Setyo Ferry; Sazali, Adnan; Kresnamurti R. P., Agung

2016-01-01

The purpose of this research are: 1) To find out the description of destination image, tourist satisfaction, and revisit intention of Betawi cultural village Setu Babakan, 2) test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan, 3) test empirically the influence of tourist satisfaction toward revisit intention of Betawi cultural village Setu Babakan, 4) test empirically the influence of destination image toward revisit intention ...

Seven Issues, Revisited

OpenAIRE

Whitehead, Jim; De Bra, Paul; Grønbæk, Kaj; Larsen, Deena; Legget, John; schraefel, monica m.c.

2002-01-01

It has been 15 years since the original presentation by Frank Halasz at Hypertext'87 on seven issues for the next generation of hypertext systems. These issues are: Search and Query Composites Virtual Structures Computation in/over hypertext network Versioning Collaborative Work Extensibility and Tailorability Since that time, these issues have formed the nucleus of multiple research agendas within the Hypertext community. Befitting this direction-setting role, the issues have been revisited ...

'Felson Signs' revisited

International Nuclear Information System (INIS)

George, Phiji P.; Irodi, Aparna; Keshava, Shyamkumar N.; Lamont, Anthony C.

2014-01-01

In this article we revisit, with the help of images, those classic signs in chest radiography described by Dr Benjamin Felson himself, or other illustrious radiologists of his time, cited and discussed in 'Chest Roentgenology'. We briefly describe the causes of the signs, their utility and the differential diagnosis to be considered when each sign is seen. Wherever possible, we use CT images to illustrate the basis of some of these classic radiographic signs.

THE INFLUENCE OF DESTINATION IMAGE AND TOURIST SATISFACTION TOWARD REVISIT INTENTION OF SETU BABAKAN BETAWI CULTURAL VILLAGE

Directory of Open Access Journals (Sweden)

Setyo Ferry Wibowo

2016-04-01

Full Text Available The purpose of this research are: 1 To find out the description of destination image, tourist satisfaction, and revisit intention of Betawi cultural village Setu Babakan, 2 test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan, 3 test empirically the influence of tourist satisfaction toward revisit intention of Betawi cultural village Setu Babakan, 4 test empirically the influence of destination image toward revisit intention of Betawi cultural village Setu Babakan. The object of this research was 200 respondents who have ever visit to Betawi cultural village Setu Babakan at one time. The results of descriptive test explained that the destination image provided is good according to the tourist, so that the tourist is satisfied and want to revisit intention of Betawi cultural village Setu Babakan. The hypothesis test shows: 1 the influence of destination image toward revisit intention by -30%, 2 the influence of tourist satisfaction toward revisit intention by 118%, 3 the influence of destination image toward tourist satisfaction by 92%.

Leadership and Management Theories Revisited

DEFF Research Database (Denmark)

Madsen, Mona Toft

2001-01-01

The goal of the paper is to revisit and analyze key contributions to the understanding of leadership and management. As a part of the discussion a role perspective that allows for additional and/or integrated leader dimensions, including a change-centered, will be outlined. Seemingly, a major...

Implications of Derived Rule Following of Roulette Gambling for Clinical Practice.

Science.gov (United States)

Wilson, Alyssa N; Grant, Tara

2015-05-01

Problem gambling is a global concern, and behavior analytic attention has increasingly focused on reasons for why problem gambling occurs and conditions under which it is maintained. However, limited knowledge currently exists on the process to which self-generated rules maintain gambling behaviors. Therefore, the current study assessed six recreational gamblers on a roulette game before and after discrimination training to establish a self-rule to wager on red or black. Following discrimination training, all six participants altered their response allocation among red or black and consistently responded according to the newly derived self-rule. Results maintained during 1-week follow-up sessions across all participants. Implications for clinical application of self-awareness and self-generated rule following are discussed. Implications for practice • Demonstration of how stimuli such as color can alter gambling behavior • Procedures to assist clients with changing self-rules about gambling behavior • Using self-generated rule formulation for more contextually appropriate target behaviors • Highlights how self-generated rules can be altered to change clinical target behaviors.

Schroedinger's variational method of quantization revisited

International Nuclear Information System (INIS)

Yasue, K.

1980-01-01

Schroedinger's original quantization procedure is revisited in the light of Nelson's stochastic framework of quantum mechanics. It is clarified why Schroedinger's proposal of a variational problem led us to a true description of quantum mechanics. (orig.)

Implications of caries diagnostic strategies for clinical management decisions

DEFF Research Database (Denmark)

Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann

2012-01-01

-specificity) were calculated for each diagnostic strategy. RESULTS: Visual-tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual-tactile and a radiographic examination using the lesion in dentin threshold......OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions...... and cavitated lesions while the radiographic examination determined lesion depth. Direct inspection of the surfaces following tooth separation for the presence of cavitated or noncavitated lesions was the validation method. The true-positive rate (i.e. the sensitivity) and the false-positive rate (i.e. 1...

Revisiting the Survival Mnemonic Effect in Children

Directory of Open Access Journals (Sweden)

Josefa N. S. Pand Eirada

2014-04-01

Full Text Available The survival processing paradigm is designed to explore the adaptive nature of memory functioning. The mnemonic advantage of processing information in fitness-relevant contexts, as has been demonstrated using this paradigm, is now well established, particularly in young adults; this phenomenon is often referred to as the “survival processing effect.” In the current experiment, we revisited the investigation of this effect in children and tested it in a new cultural group, using a procedure that differs from the existing studies with children. A group of 40 Portuguese children rated the relevance of unrelated words to a survival and a new moving scenario. This encoding task was followed by a surprise free-recall task. Akin to what is typically found, survival processing produced better memory performance than the control condition (moving. These data put on firmer ground the idea that a mnemonic tuning to fitness-relevant encodings is present early in development. The theoretical importance of this result to the adaptive memory literature is discussed, as well as potential practical implications of this kind of approach to the study of memory in children.

A practical method of predicting client revisit intention in a hospital setting.

Science.gov (United States)

Lee, Kyun Jick

2005-01-01

Data mining (DM) models are an alternative to traditional statistical methods for examining whether higher customer satisfaction leads to higher revisit intention. This study used a total of 906 outpatients' satisfaction data collected from a nationwide survey interviews conducted by professional interviewers on a face-to-face basis in South Korea, 1998. Analyses showed that the relationship between overall satisfaction with hospital services and outpatients' revisit intention, along with word-of-mouth recommendation as intermediate variables, developed into a nonlinear relationship. The five strongest predictors of revisit intention were overall satisfaction, intention to recommend to others, awareness of hospital promotion, satisfaction with physician's kindness, and satisfaction with treatment level.

Pathophysiology and clinical implications of peroperative fluid management in elective surgery

DEFF Research Database (Denmark)

Holte, Kathrine

2010-01-01

The purpose of this thesis was to describe pathophysiological aspects of perioperative fluid administration and create a rational background for future, clinical outcome studies. In laparoscopic cholecystectomy, we have found "liberal" crystalloid administration ( approximately 3 liters) to improve....... Based on the current evidence, administration of liters intravenous fluid without specific indication in major surgical procedures should be avoided, while administration of liters in patients with anastomoses may not be recommended, an issue needing clarification in large-scale clinical studies...... perioperative physiology and clinical outcome, which has implication for fluid management in other laparoscopic procedures such as laparoscopic fundoplication, laparoscopic repair of ventral hernia, hysterectomy etc., where 2-3 liters crystalloid should be administered based on the present evidence. That equal...

Clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy insertion.

Science.gov (United States)

Stewart, Jessica K; Smith, Tony P; Kim, Charles Y

To determine the clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy (PCN) insertion. Collecting system hematoma burden was retrospectively assessed for 694 PCN insertions in 502 patients. Pelvicaliceal hematoma formation occurred in 146 kidneys (21%) in 136 patients. Clinically significant blood loss occurred in 3 patients with hematomas within one week compared to 4 patients without hematomas (p=0.39). Twenty-four patients with hematomas underwent catheter exchange within one week, compared to 55 patients without hematomas (p=0.49). Pelvicaliceal hematoma formation after PCN insertion is not uncommon and is associated with very rare clinical sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

Spondylolysis and spondylolisthesis: prevalence of different forms of instability and clinical implications.

Science.gov (United States)

Niggemann, Pascal; Kuchta, Johannes; Beyer, Hans-Konrad; Grosskurth, D; Schulze, Thorsten; Delank, Karl-Stefan

2011-10-15

Imaging study with an evaluation of incidences and clinical correlation. To evaluate the incidence of 3 different types of instabilities in patients with spondylolysis or isthmic spondylolisthesis. Clinical findings are correlated with imaging findings, and the imaging findings are analyzed with regard to their clinical implications. Spondylolysis and isthmic spondylolisthesis are common disorders. An unstable slip is the most well-known form of instability, but other forms also exist. However, the incidence of these instabilities and their clinical implications are yet unclear. A total of 140 patients with 141 levels of spondylolysis identified by MRI (magnetic resonance imaging) were included in this study. Using positional MRI, the instability of the slip, an increased angular movement, and movement in the spondylolytic cleft were assessed. On the basis of clinical findings, the patients were classified as presenting with either radicular or nonradicular symptoms. The incidence of the instabilities was recorded and correlated with the incidence of radicular symptoms. Fifteen patients had an unstable slip (anterior instability); 35, an increased angular movement (angular instability); and 34 patients, a movement in the spondylolytic cleft (posterior instability). All forms of instability could be found together. No instability at all was found in 76 patients. Radicular symptoms were found significantly more often in patients with one or more of the described instabilities compared with patients without instability. All 3 described forms of instability are common in spondylolysis or isthmic spondylolisthesis and associated with radicular pain. This finding stresses the value of positional MRI in the evaluation of patients with spondylolysis and isthmic spondylolisthesis, especially if radicular symptoms are present.

Clinical Implications of Hedgehog Pathway Signaling in Prostate Cancer

Directory of Open Access Journals (Sweden)

Daniel L. Suzman

2015-09-01

Full Text Available Activity in the Hedgehog pathway, which regulates GLI-mediated transcription, is important in organogenesis and stem cell regulation in self-renewing organs, but is pathologically elevated in many human malignancies. Mutations leading to constitutive activation of the pathway have been implicated in medulloblastoma and basal cell carcinoma, and inhibition of the pathway has demonstrated clinical responses leading to the approval of the Smoothened inhibitor, vismodegib, for the treatment of advanced basal cell carcinoma. Aberrant Hedgehog pathway signaling has also been noted in prostate cancer with evidence suggesting that it may render prostate epithelial cells tumorigenic, drive the epithelial-to-mesenchymal transition, and contribute towards the development of castration-resistance through autocrine and paracrine signaling within the tumor microenvironment and cross-talk with the androgen pathway. In addition, there are emerging clinical data suggesting that inhibition of the Hedgehog pathway may be effective in the treatment of recurrent and metastatic prostate cancer. Here we will review these data and highlight areas of active clinical research as they relate to Hedgehog pathway inhibition in prostate cancer.

Implications of inaccurate clinical nodal staging in pancreatic adenocarcinoma.

Science.gov (United States)

Swords, Douglas S; Firpo, Matthew A; Johnson, Kirsten M; Boucher, Kenneth M; Scaife, Courtney L; Mulvihill, Sean J

2017-07-01

Many patients with stage I-II pancreatic adenocarcinoma do not undergo resection. We hypothesized that (1) clinical staging underestimates nodal involvement, causing stage IIB to have a greater percent of resected patients and (2) this stage-shift causes discrepancies in observed survival. The Surveillance, Epidemiology, and End Results (SEER) research database was used to evaluate cause-specific survival in patients with pancreatic adenocarcinoma from 2004-2012. Survival was compared using the log-rank test. Single-center data on 105 patients who underwent resection of pancreatic adenocarcinoma without neoadjuvant treatment were used to compare clinical and pathologic nodal staging. In SEER data, medium-term survival in stage IIB was superior to IB and IIA, with median cause-specific survival of 14, 9, and 11 months, respectively (P < .001). Seventy-two percent of stage IIB patients underwent resection vs 28% in IB and 36% in IIA (P < .001). In our institutional data, 12.4% of patients had clinical evidence of nodal involvement vs 69.5% by pathologic staging (P < .001). Among clinical stage IA-IIA patients, 71.6% had nodal involvement by pathologic staging. Both SEER and institutional data support substantial underestimation of nodal involvement by clinical staging. This finding has implications in decisions regarding neoadjuvant therapy and analysis of outcomes in the absence of pathologic staging. Copyright © 2017 Elsevier Inc. All rights reserved.

An updated concept of coagulation with clinical implications.

Science.gov (United States)

Romney, Gregory; Glick, Michael

2009-05-01

Over the past century, a series of models have been put forth to explain the coagulation mechanism. The coagulation cascade/waterfall model has gained the most widespread acceptance. This model, however, has problems when it is used in different clinical scenarios. A more recently proposed cell-based model better describes the coagulation process in vivo and provides oral health care professionals (OHCPs) with a better understanding of the clinical implications of providing dental care to patients with potentially increased bleeding tendencies. The authors conducted a literature search using the PubMed database. They searched for key words including "coagulation," "hemostasis," "bleeding," "coagulation factors," "models," "prothrombin time," "activated partial thromboplastin time," "international normalized ratio," "anticoagulation therapy" and "hemophilia" separately and in combination. The coagulation cascade/waterfall model is insufficient to explain coagulation in vivo, predict a patient's bleeding tendency, or correlate clinical outcomes with specific laboratory screening tests such as prothrombin time, activated partial thromboplastin time and international normalized ratio. However, the cell-based model of coagulation that reflects the in vivo process of coagulation provides insight into the clinical ramifications of treating dental patients with specific coagulation factor deficiencies. Understanding the in vivo coagulation process will help OHCPs better predict a patient's bleeding tendency. In addition, applying the theoretical concept of the cell-based model of coagulation to commonly used laboratory screening tests for coagulation and bleeding will result in safer and more appropriate dental care.

The Faraday effect revisited: General theory

DEFF Research Database (Denmark)

Cornean, Horia Decebal; Nenciu, Gheorghe; Pedersen, Thomas Garm

This paper is the first in a series revisiting the Faraday effect, or more generally, the theory of electronic quantum transport/optical response in bulk media in the presence of a constant magnetic field. The independent electron approximation is assumed. For free electrons, the transverse...

Typology of Internet gaming disorder and its clinical implications.

Science.gov (United States)

Lee, Seung-Yup; Lee, Hae Kook; Choo, Hyekyung

2017-07-01

Various perspectives exist regarding Internet gaming disorder. While the concept of behavioral addiction is gaining recognition, some view the phenomenon as merely excessive indulgence in online pastimes. Still, in recent years, complaints from patients or their family members about problems related to Internet use, particularly Internet gaming, have become more common. However, the clinical picture of Internet gaming disorder could be obscured by its heterogeneous manifestations with other intertwined factors, such as psychiatric comorbidities, neurodevelopmental factors, sociocultural factors, and game-related factors, which may influence the pathogenesis as well as the clinical course. To mitigate such problems, clinicians should be able to consider diverse aspects related to Internet gaming disorder. Classifying such a heterogeneous problem into subtypes that share a similar etiology or phenomenology may provide additional clues in the diagnostic process and allow us to designate available clinical resources for particularly vulnerable factors. In this review paper, we suggest a typology of 'impulsive/aggressive,' 'emotionally vulnerable,' 'socially conditioned,' and 'not otherwise specified' as subtypes of the heterogeneous phenomena of pathological Internet gaming. The implications of these subtypes for assessment and treatment planning will also be highlighted. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Revisited

DEFF Research Database (Denmark)

Tegtmeier, Silke; Meyer, Verena; Pakura, Stefanie

2017-01-01

were captured when they described entrepreneurs. Therefore, this paper aims to revisit gender role stereotypes among young adults. Design/methodology/approach: To measure stereotyping, participants were asked to describe entrepreneurs in general and either women or men in general. The Schein......Purpose: Entrepreneurship is shaped by a male norm, which has been widely demonstrated in qualitative studies. The authors strive to complement these methods by a quantitative approach. First, gender role stereotypes were measured in entrepreneurship. Second, the explicit notions of participants......: The images of men and entrepreneurs show a high and significant congruence (r = 0.803), mostly in those adjectives that are untypical for men and entrepreneurs. The congruence of women and entrepreneurs was low (r = 0.152) and insignificant. Contrary to the participants’ beliefs, their explicit notions did...

Who should do the dishes now? Revisiting gender and housework in contemporary urban South Wales

OpenAIRE

Mannay, Dawn

2016-01-01

This chapter revisits Jane Pilcher’s (1994) seminal work ‘Who should do the dishes? Three generations of Welsh women talking about men and housework’, which was originally published in Our Sister’s Land: the changing identities of women in Wales. As discussed in the introductory chapter, I began revisiting classic Welsh studies as part of my doctoral study Mothers and daughters on the margins: gender, generation and education (Mannay, 2012); this lead to the later publication of a revisiting ...

Revisiting Nature vs. Nurture: Implications for the Teaching/Learning Process.

Science.gov (United States)

French, Fred

2003-01-01

Child development theories conclude that nature and nurture interactively shape individual development. Implications for education are that children learn better when they feel wanted and are in a supportive environment. Teaching needs to go beyond pure content and focus on learning how to learn. Assessment should focus on the use of knowledge…

The Faraday effect revisited: General theory

DEFF Research Database (Denmark)

Cornean, Horia Decebal; Nenciu, Gheorghe; Pedersen, Thomas Garm

2006-01-01

This paper is the first in a series revisiting the Faraday effect, or more generally, the theory of electronic quantum transport/optical response in bulk media in the presence of a constant magnetic field. The independent electron approximation is assumed. At zero temperature and zero frequency...

UNMASKING MASKED HYPERTENSION: PREVALENCE, CLINICAL IMPLICATIONS, DIAGNOSIS, CORRELATES, AND FUTURE DIRECTIONS

Science.gov (United States)

Peacock, James; Diaz, Keith M.; Viera, Anthony J.; Schwartz, Joseph E.; Shimbo, Daichi

2014-01-01

‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared to sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment, and areas for future research. PMID:24573133

Revisiting Stock Market Integration Pre-Post Subprime Mortgage Crisis: Insight From BRIC Countries

Directory of Open Access Journals (Sweden)

Chin-Hong Puah

2015-07-01

Full Text Available This study revisits the long-run relationships and short-run dynamic causal linkages among BRIC stock market, with the particular attention to the 2008 subprime mortgage crisis. Extending related empirical studies, comparative analyses of pre-crisis, and post-crisis periods were conducted to comprehensively evaluate how stock market integration was affected by financial crises. In general, after employing cointegration test and VAR test, the results reveal the increase of stock market integration in BRICs after the subprime crisis. The evidence also found that China stock market is the most influential among the BRICs, in which China stock market has the ability to Granger cause the other three BRICs member countries. An important implication of our findings is that the degree of integration among countries tends to change over time, especially around periods marked by financial crises.

Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions.

Science.gov (United States)

Wong, Christopher X; Ganesan, Anand N; Selvanayagam, Joseph B

2017-05-01

Obesity is increasingly recognized as a major modifiable determinant of atrial fibrillation (AF). Although body mass index and other clinical measures are useful indications of general adiposity, much recent interest has focused on epicardial fat, a distinct adipose tissue depot that can be readily assessed using non-invasive imaging techniques. A growing body of data from epidemiological and clinical studies has demonstrated that epicardial fat is consistently associated with the presence, severity, and recurrence of AF across a range of clinical settings. Evidence from basic science and translational studies has also suggested that arrhythmogenic mechanisms may involve adipocyte infiltration, pro-fibrotic, and pro-inflammatory paracrine effects, oxidative stress, and other pathways. Despite these advances, however, significant uncertainty exists and many questions remain unanswered. In this article, we review our present understanding of epicardial fat, including its classification and quantification, existing evidence implicating its role in AF, potential mechanisms, implications for clinicians, and future directions for research. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Revisiting the use of sPLA2-sensitive liposomes in cancer therapy

DEFF Research Database (Denmark)

Pourhassan, Houman; Clergeaud Veiga, Gael; Hansen, Anders Elias

2017-01-01

The first developed secretory phospholipase A2 (sPLA2) sensitive liposomal cisplatin formulation (LiPlaCis®) is currently undergoing clinical evaluation. In the present study we revisit and evaluate critical preclinical parameters important for the therapeutic potential and safety of platinum drugs......, here oxaliplatin (L-OHP), formulated in sPLA2 sensitive liposomes. We show the mole percentage of negatively charged phospholipid needed to obtain enzyme-sensitivity for saturated systems is ≥ 25% for 16-carbon chain lipid membranes, and > 40% for 18-chain lipid membranes, which was surprising as 25......% is used clinically in LiPlaCis®. Efficient sPLA2-dependent growth inhibition of colorectal cancer cells was demonstrated in vitro, where cell membrane degradation and cytolysis depends on the sensitivity of the formulation towards the enzyme and is governed by the amount of lysolipids generated...

Critical Review of Data Evaluation in Teaching Clinics of Traditional Chinese Medicine Outside China: Implications for Education.

Science.gov (United States)

Jiang, Jian; Peng, Wenbo; Gu, Tieguang; King, Catherine; Yin, J Kevin

2016-01-01

The increasing acceptance of traditional Chinese medicine (TCM) worldwide has highlighted the importance of ensuring the provision of high-quality TCM clinical education. This clinical training should be partly guided by a robust assessment of patient data outcomes in TCM teaching clinics. We undertook a comprehensive literature review to examine the data evaluation in TCM teaching clinics outside China and its implications for TCM education. Literature was retrieved via MEDLINE (from 1946 to January 2015), EMBASE (from 1980 to February 2015), and Google Scholar for studies conducted outside China. The search was restricted to English articles reporting empirical findings related to the assessments of patient data in TCM teaching clinics, with implications for TCM education in countries other than China. Only seven articles from six studies met the inclusion criteria. The characteristics and main symptoms of patients who received any TCM treatment in the context of teaching clinics among all included studies were similar. Symptom relief as well as a high level of patient satisfaction with TCM treatment were found in TCM teaching clinics. Conventional healthcare providers and other complementary practitioners were not the main source of referral to TCM practitioners but rather patients׳ friends/relatives. Patients received acupuncture treatment more frequently than treatments utilizing Chinese herbal medicine in teaching clinics. A standardized and consistent framework for patient records within TCM teaching clinics is currently lacking. There was no robust study which "translated" TCM clinic data evaluation findings into implications for TCM education and clinical training. Recognizing that TCM evolves over time and its practice varies in different settings, there is an urgent need to conduct large-scale, rigorous evaluations of TCM clinic data to address the findings of our review, with the purpose of better informing TCM education and clinical training in

Deterministic Graphical Games Revisited

DEFF Research Database (Denmark)

Andersson, Daniel; Hansen, Kristoffer Arnsfelt; Miltersen, Peter Bro

2008-01-01

We revisit the deterministic graphical games of Washburn. A deterministic graphical game can be described as a simple stochastic game (a notion due to Anne Condon), except that we allow arbitrary real payoffs but disallow moves of chance. We study the complexity of solving deterministic graphical...... games and obtain an almost-linear time comparison-based algorithm for computing an equilibrium of such a game. The existence of a linear time comparison-based algorithm remains an open problem....

Sources of variation in primary care clinical workflow: implications for the design of cognitive support.

Science.gov (United States)

Militello, Laura G; Arbuckle, Nicole B; Saleem, Jason J; Patterson, Emily; Flanagan, Mindy; Haggstrom, David; Doebbeling, Bradley N

2014-03-01

This article identifies sources of variation in clinical workflow and implications for the design and implementation of electronic clinical decision support. Sources of variation in workflow were identified via rapid ethnographic observation, focus groups, and interviews across a total of eight medical centers in both the Veterans Health Administration and academic medical centers nationally regarded as leaders in developing and using clinical decision support. Data were reviewed for types of variability within the social and technical subsystems and the external environment as described in the sociotechnical systems theory. Two researchers independently identified examples of variation and their sources, and then met with each other to discuss them until consensus was reached. Sources of variation were categorized as environmental (clinic staffing and clinic pace), social (perception of health information technology and real-time use with patients), or technical (computer access and information access). Examples of sources of variation within each of the categories are described and discussed in terms of impact on clinical workflow. As technologies are implemented, barriers to use become visible over time as users struggle to adapt workflow and work practices to accommodate new technologies. Each source of variability identified has implications for the effective design and implementation of useful health information technology. Accommodating moderate variability in workflow is anticipated to avoid brittle and inflexible workflow designs, while also avoiding unnecessary complexity for implementers and users.

Revisiting Hansen Solubility Parameters by Including Thermodynamics

NARCIS (Netherlands)

Louwerse, Manuel J; Fernández-Maldonado, Ana María; Rousseau, Simon; Moreau-Masselon, Chloe; Roux, Bernard; Rothenberg, Gadi

2017-01-01

The Hansen solubility parameter approach is revisited by implementing the thermodynamics of dissolution and mixing. Hansen's pragmatic approach has earned its spurs in predicting solvents for polymer solutions, but for molecular solutes improvements are needed. By going into the details of entropy

Bottomonium spectrum revisited

CERN Document Server

Segovia, Jorge; Entem, David R.; Fernández, Francisco

2016-01-01

We revisit the bottomonium spectrum motivated by the recently exciting experimental progress in the observation of new bottomonium states, both conventional and unconventional. Our framework is a nonrelativistic constituent quark model which has been applied to a wide range of hadronic observables from the light to the heavy quark sector and thus the model parameters are completely constrained. Beyond the spectrum, we provide a large number of electromagnetic, strong and hadronic decays in order to discuss the quark content of the bottomonium states and give more insights about the better way to determine their properties experimentally.

Hospital revisit rate after a diagnosis of conversion disorder.

Science.gov (United States)

Merkler, Alexander E; Parikh, Neal S; Chaudhry, Simriti; Chait, Alanna; Allen, Nicole C; Navi, Babak B; Kamel, Hooman

2016-04-01

To estimate the hospital revisit rate of patients diagnosed with conversion disorder (CD). Using administrative data, we identified all patients discharged from California, Florida and New York emergency departments (EDs) and acute care hospitals between 2005 and 2011 with a primary discharge diagnosis of CD. Patients discharged with a primary diagnosis of seizure or transient global amnesia (TGA) served as control groups. Our primary outcome was the rate of repeat ED visits and hospital admissions after initial presentation. Poisson regression was used to compare rates between diagnosis groups while adjusting for demographic characteristics. We identified 7946 patients discharged with a primary diagnosis of CD. During a mean follow-up of 3.0 (±1.6) years, patients with CD had a median of three (IQR, 1-9) ED or inpatient revisits, compared with 0 (IQR, 0-2) in patients with TGA and 3 (IQR, 1-7) in those with seizures. Revisit rates were 18.25 (95% CI, 18.10 to 18.40) visits per 100 patients per month in those with CD, 3.90 (95% CI, 3.84 to 3.95) in those with TGA and 17.78 (95% CI, 17.75 to 17.81) in those with seizures. As compared to CD, the incidence rate ratio for repeat ED visits or hospitalisations was 0.89 (95% CI, 0.86 to 0.93) for seizure disorder and 0.32 (95% CI 0.31 to 0.34) for TGA. CD is associated with a substantial hospital revisit rate. Our findings suggest that CD is not an acute, time-limited response to stress, but rather that CD is a manifestation of a broader pattern of chronic neuropsychiatric disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Future of Engineering Education--Revisited

Science.gov (United States)

Wankat, Phillip C.; Bullard, Lisa G.

2016-01-01

This paper revisits the landmark CEE series, "The Future of Engineering Education," published in 2000 (available free in the CEE archives on the internet) to examine the predictions made in the original paper as well as the tools and approaches documented. Most of the advice offered in the original series remains current. Despite new…

Revisiting the returns-volume relationship: Time variation, alternative measures and the financial crisis

Science.gov (United States)

Cook, Steve; Watson, Duncan

2017-03-01

Following its introduction in the seminal study of Osborne (1959), a voluminous literature has emerged examining the returns-volume relationship for financial assets. The present paper revisits this relationship in an examination of the FTSE100 which extends the existing literature in two ways. First, alternative daily measures of the FTSE100 index are used to create differing returns and absolute returns series to employ in an examination of returns-volume causality. Second, rolling regression analysis is utilised to explore potential time variation in the returns-volume relationship. The findings obtained depict a hitherto unconsidered complexity in this relationship with the type of returns series considered and financial crisis found to be significant underlying factors. The implications of the newly derived results for both the understanding of the nature of the returns-volume relationship and the development of theories in connection to it are discussed.

Ethical implications for clinical practice and future research in "at risk" individuals.

Science.gov (United States)

Singh, Fiza; Mirzakhanian, Heline; Fusar-Poli, Paolo; de la Fuente-Sandoval, Camilo; Cadenhead, Kristin S

2012-01-01

The last 15 years have witnessed a shift in schizophrenia research with increasing interest in earlier stages of illness with the hope of early intervention and ultimately prevention of psychotic illness. Large-scale longitudinal studies have identified clinical and biological risk factors associated with increased risk of psychotic conversion, which together with symptomatic and demographic risk factors may improve the power of prediction algorithms for psychotic transition. Despite these advances, 45-70% of at risk subjects in most samples do not convert to frank psychosis, but continue to function well below their age matched counterparts. The issue is of utmost importance in light of the upcoming DSM-V and the possible inclusion of the attenuated psychotic symptoms syndrome (APSS) diagnosis, with clinical and ethical implications. Clinical considerations include feasibility of reliably diagnosing the at risk state in non-academic medical centers, variable psychotic conversion rates, a non-uniform definition of conversion and extensive debate about treatment for individuals with an ill-defined outcome. On the ethical side, diagnosing APSS could lead to unnecessary prescribing of antipsychotics with long-term deleterious consequences, slow research by providing a false sense of comfort in the diagnosis, and have psychosocial implications for those who receive a diagnosis. Thus it may be prudent to engage at risk populations early and to use broad-spectrum treatments with low risk benefit ratios to relieve functional impairments, while simultaneously studying all subsets of the at risk population.

Glutamate in schizophrenia: clinical and research implications.

Science.gov (United States)

Goff, D C; Wine, L

1997-10-30

The excitatory amino acids, glutamate and aspartate, are of interest to schizophrenia research because of their roles in neurodevelopment, neurotoxicity and neurotransmission. Recent evidence suggests that densities of glutamatergic receptors and the ratios of subunits composing these receptors may be altered in schizophrenia, although it is unclear whether these changes are primary or compensatory. Agents acting at the phencyclidine binding site of the NMDA receptor produce symptoms of schizophrenia in normal subjects, and precipitate relapse in patients with schizophrenia. The improvement of negative symptoms with agents acting at the glycine modulatory site of the NMDA receptor, as well as preliminary evidence that clozapine may differ from conventional neuroleptic agents in its effects on glutamatergic systems, suggest that clinical implications may follow from this model. While geriatric patients may be at increased risk for glutamate-mediated neurotoxicity, very little is known about the specific relevance of this model to geriatric patients with schizophrenia.

[Clinical implications of polycystic ovary syndrome].

Science.gov (United States)

Dravecká, Ingrid

Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications. Reproduction disorders include hyperthyroidism, menstruation cycle disorders, infertility and pregnancy complications as well as early abortions, gestational diabetes and pregnancy induced hypertension. Long-term metabolic risks of PCOS include type 2 diabetes mellitus, dyslipidemia, arterial hypertension and endothelial dysfunction. The available data confirms higher incidence of cardiovascular diseases in women with PCOS. In particular among obese women PCOS is more frequently associated with non-alcoholic hepatic steatosis, sleep apnoea syndrome and endometrial cancer. The literature includes some controversial data about the relationship between PCOS and autoimmunity. Women with PCOS are more prone to suffer from insufficient confidence with higher incidence of anxiety, depression, bipolar disorder and eating disorders. autoimmunity - diabetes mellitus - pregnancy - insulin resistance - metabolic syndrome - menstrual disorders - polycystic ovary syndrome.

Tourism impacts of Three Mile Island and other adverse events: implications for Lincoln County and other rural counties bisected by radioactive wastes intended for Yucca Mountain

International Nuclear Information System (INIS)

Himmelberger, J.J.; Baughman, M.; Ogneva-Himmelberger, Y.A.

1995-01-01

Whether the proposed Yucca Mountain nuclear waste repository system will adversely impact tourism in southern Nevada is an open question of particular importance to visitor-oriented rural counties bisected by planned waste transportation corridors (highway or rail). As part of one such county's repository impact assessment program, tourism implications of Three Mile Island (TMI) and other major hazard events have been revisited to inform ongoing county-wide socioeconomic assessments and contingency planning efforts. This paper summarizes key research implications of such research as applied to Lincoln County, Nevada. Implications for other rural counties are discussed in light of the research findings

Revisiting Weak Simulation for Substochastic Markov Chains

DEFF Research Database (Denmark)

Jansen, David N.; Song, Lei; Zhang, Lijun

2013-01-01

of the logic PCTL\\x, and its completeness was conjectured. We revisit this result and show that soundness does not hold in general, but only for Markov chains without divergence. It is refuted for some systems with substochastic distributions. Moreover, we provide a counterexample to completeness...

Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

Science.gov (United States)

Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

2010-01-01

Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

Revisiting the formal foundation of Probabilistic Databases

NARCIS (Netherlands)

Wanders, B.; van Keulen, Maurice

2015-01-01

One of the core problems in soft computing is dealing with uncertainty in data. In this paper, we revisit the formal foundation of a class of probabilistic databases with the purpose to (1) obtain data model independence, (2) separate metadata on uncertainty and probabilities from the raw data, (3)

Revisiting Mutual Fund Performance Evaluation

OpenAIRE

Angelidis, Timotheos; Giamouridis, Daniel; Tessaromatis, Nikolaos

2012-01-01

Mutual fund manager excess performance should be measured relative to their self-reported benchmark rather than the return of a passive portfolio with the same risk characteristics. Ignoring the self-reported benchmark introduces biases in the measurement of stock selection and timing components of excess performance. We revisit baseline empirical evidence in mutual fund performance evaluation utilizing stock selection and timing measures that address these biases. We introduce a new factor e...

Deterministic Graphical Games Revisited

DEFF Research Database (Denmark)

Andersson, Klas Olof Daniel; Hansen, Kristoffer Arnsfelt; Miltersen, Peter Bro

2012-01-01

Starting from Zermelo’s classical formal treatment of chess, we trace through history the analysis of two-player win/lose/draw games with perfect information and potentially infinite play. Such chess-like games have appeared in many different research communities, and methods for solving them......, such as retrograde analysis, have been rediscovered independently. We then revisit Washburn’s deterministic graphical games (DGGs), a natural generalization of chess-like games to arbitrary zero-sum payoffs. We study the complexity of solving DGGs and obtain an almost-linear time comparison-based algorithm...

Metamorphosis in Craniiformea revisited

DEFF Research Database (Denmark)

Altenburger, Andreas; Wanninger, Andreas; Holmer, Lars E.

2013-01-01

We revisited the brachiopod fold hypothesis and investigated metamorphosis in the craniiform brachiopod Novocrania anomala. Larval development is lecithotrophic and the dorsal (brachial) valve is secreted by dorsal epithelia. We found that the juvenile ventral valve, which consists only of a thin...... brachiopods during metamorphosis to cement their pedicle to the substrate. N. anomala is therefore not initially attached by a valve but by material corresponding to pedicle cuticle. This is different to previous descriptions, which had led to speculations about a folding event in the evolution of Brachiopoda...

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology

OpenAIRE

Daryoush Shahbazi-Gahrouei; Mohsen Saeb; Shahram Monadi; Iraj Jabbari

2017-01-01

Background: Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Materials and Methods: Nonhomogeneous phantom as quality dose veri...

Hydroxyurea revisited: a decade of clinical effects studies

International Nuclear Information System (INIS)

Sinclair, W.K.

1981-01-01

Over a decade ago hydroxyurea was shown to selectively kill cells in the S phase in a proliferating cell population and to block cells at the G 1 -S border. Consequently, blocked cells became sensitized to irradiation and were further sensitized when the drug was present after exposure. In the ensuing decade, many in vivo studies on hydroxyurea have confirmed that the main properties of hydroxyurea identified in the dish are also evident in vivo. During a period of about ten years, a considerable number of clinical studies have been performed, the results of which have been mixed, ranging from indeterminate to encouraging, depending to some extent on the site treated and whether careful randomized studies were done. The question arises whether the clinical studies have represented adequate tests, by laboratory standards, of the likely effectiveness of the drug in clinical circumstances. The clinical studies with hydroxyurea have been examined in this light, since the results might also bear on the use of many other such agents in combination therapy. This examination revealed that no attempts have been made to determine the concentration of hydroxyurea in the tumor and other relevant tissues as a function of time or to assess the cell kinetic features of the tumor and thus estimate the appropriate dose regimen. It would seem that a wide gap still exists between laboratory research and clinical application

Chromosomal Aberrations Associated with Clonal Evolution and Leukemic Transformation in Fanconi Anemia: Clinical and Biological Implications

Directory of Open Access Journals (Sweden)

Stefan Meyer

2012-01-01

Full Text Available Fanconi anaemia (FA is an inherited disease with congenital and developmental abnormalities, bone marrow failure, and extreme risk of leukemic transformation. Bone marrow surveillance is an important part of the clinical management of FA and often reveals cytogenetic aberrations. Here, we review bone marrow findings in FA and discuss the clinical and biological implications of chromosomal aberrations associated with leukemic transformation.

The hard-core model on random graphs revisited

International Nuclear Information System (INIS)

Barbier, Jean; Krzakala, Florent; Zhang, Pan; Zdeborová, Lenka

2013-01-01

We revisit the classical hard-core model, also known as independent set and dual to vertex cover problem, where one puts particles with a first-neighbor hard-core repulsion on the vertices of a random graph. Although the case of random graphs with small and very large average degrees respectively are quite well understood, they yield qualitatively different results and our aim here is to reconciliate these two cases. We revisit results that can be obtained using the (heuristic) cavity method and show that it provides a closed-form conjecture for the exact density of the densest packing on random regular graphs with degree K ≥ 20, and that for K > 16 the nature of the phase transition is the same as for large K. This also shows that the hard-code model is the simplest mean-field lattice model for structural glasses and jamming

Clinical implications of vitamin D deficiency

Directory of Open Access Journals (Sweden)

Beata Matyjaszek-Matuszek

2015-06-01

Full Text Available Vitamin D deficiency is a common medical problem worldwide and its prevalence rises along with latitude, obesity, sedentary lifestyle, limited sunlight exposure and aging. A great body of evidence has shown that patients with vitamin D deficiency have increased cardiovascular risks and total mortality. Conversely, the presence of comorbidities progressive with age such as abdominal obesity, insulin resistance, type 2 diabetes and hypertension places the patients at an increased risk of vitamin D deficiency. The multidirectional effect of vitamin D deficiency is present in different phases of the aging process. Based on the literature review, the risk factors for vitamin D insufficiency most often found in post-menopausal women include limited sun exposure and time spent outdoors, inadequate dietary vitamin D intake, winter season and increased age. Vitamin D supplementation in this group might offer prevention of falls and fractures and may be beneficial for cardiovascular health, what may be especially important in osteoporotic and elderly populations. Prevention and treatment processes involve education regarding sunlight exposure and pharmacological cholecalciferol supplementation according to the recommendations for Central Europe. This manuscript reviews the role of vitamin D and its deficiency and considers their clinical implications, with particular regard to peri- and postmenopausal women.

Intra-tumor heterogeneity in head and neck cancer and its clinical implications

Directory of Open Access Journals (Sweden)

Edmund A. Mroz

2016-06-01

Full Text Available The presence of heritable differences among cancer cells within a tumor, called intra-tumor genetic heterogeneity, has long been suspected of playing a role in poor responses to therapy. Research over the past decade has documented the existence of such heterogeneity within tumors of individual patients and documented its potential clinical significance. The research methods for identifying this heterogeneity were not, however, readily adaptable to widespread clinical application. After a brief review of this background, we describe the development of a measure of intra-tumor genetic heterogeneity, based on whole-exome sequencing of individual tumor samples, that could be applied to biopsy specimens in a clinical setting. This measure has now been used in head and neck squamous cell carcinoma (HNSCC to document, for the first time, a relation of high intra-tumor genetic heterogeneity to shorter overall survival in a large, multi-institutional study. The implications of heterogeneity for research and clinical care thus now need to be addressed. Keywords: Head and neck squamous cell carcinoma, Intra-tumor genetic heterogeneity, Next-generation sequencing, Targeted therapy

A combined third and fourth branchial arch anomaly: clinical and embryological implications.

Science.gov (United States)

Mehrzad, H; Georgalas, C; Huins, C; Tolley, N S

2007-08-01

Embryological abnormalities of the branchial apparatus present an interesting diagnostic and surgical challenge. Thymic cysts are a rare form of branchial apparatus anomaly, resulting from abnormal development of the third pharyngeal pouch. We present two cases of a thymic cyst coexisting with a non recurrent inferior laryngeal nerve (NRILN), two anomalies that to our knowledge have not been associated previously. A possible embryological explication for this double abnormality is discussed, while the clinical implications of this association are presented.

Tourism impacts of Three Mile Island and other adverse events: Implications for Lincoln County and other rural counties bisected by radioactive wastes intended for Yucca Mountain

Energy Technology Data Exchange (ETDEWEB)

Himmelberger, J.J.; Ogneva-Himmelberger, Y.A. [Clark Univ., Worcester, MA (United States); Baughman, M. [Interech Services Corporation, Carson City, NV (United States)

1995-11-01

Whether the proposed Yucca Mountain nuclear waste repository system will adversely impact tourism in southern Nevada is an open question of particular importance to visitor-oriented rural counties bisected by planned waste transportation corridors (highway or rail). As part of one such county`s repository impact assessment program, tourism implications of Three Mile Island (TMI) and other major hazard events have been revisited to inform ongoing county-wide socioeconomic assessments and contingency planning efforts. This paper summarizes key research implications of such research as applied to Lincoln County, Nevada. Implications for other rural counties are discussed in light of the research findings. 29 refs., 3 figs., 1 tab.

The Effects of Korean Medical Service Quality and Satisfaction on Revisit Intention of the United Arab Emirates Government Sponsored Patients.

Science.gov (United States)

Lee, Seoyoung; Kim, Eun-Kyung

2017-06-01

The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.

α-Synuclein oligomers and clinical implications for Parkinson disease

Science.gov (United States)

Kalia, Lorraine V.; Kalia, Suneil K.; McLean, Pamela J.; Lozano, Andres M.; Lang, Anthony E.

2012-01-01

Protein aggregation within the central nervous system has been recognized as a defining feature of neurodegenerative diseases since the early 20th century. Since that time, there has been a growing list of neurodegenerative disorders, including Parkinson disease, which are characterized by inclusions of specific pathogenic proteins. This has led to the long-held dogma that these characteristic protein inclusions, which are composed of large insoluble fibrillar protein aggregates and visible by light microscopy, are responsible for cell death in these diseases. However, the correlation between protein inclusion formation and cytotoxicity is inconsistent suggesting another form of the pathogenic proteins may be contributing to neurodegeneration. There is emerging evidence implicating soluble oligomers, smaller protein aggregates not detectable by conventional microscopy, as potential culprits in the pathogenesis of neurodegenerative diseases. The protein α-synuclein is well recognized to contribute to the pathogenesis of Parkinson disease and is the major component of Lewy bodies and Lewy neurites. However, α-synuclein also forms oligomeric species with certain conformations being toxic to cells. The mechanisms by which these α-synuclein oligomers cause cell death are being actively investigated as they may provide new strategies for diagnosis and treatment of Parkinson disease and related disorders. Here we review the possible role of α-synuclein oligomers in cell death in Parkinson disease and discuss the potential clinical implications. PMID:23225525

The first clinical liver transplantation of Brazil revisited.

Science.gov (United States)

Bacchella, T; Machado, M C C

2004-05-01

The first clinical orthotopic liver transplantation in Brazil was performed on August 5, 1968. The patient was awake after surgery and died on the seventh postoperative day due to subdural hematoma, bronchopneumonia, renal failure, and graft rejection. The report of this case is important to understand the evolution of clinical liver transplantation in Brazil, where this procedure is now routinely carried out in many medical centers.

Venous chest anatomy: clinical implications

International Nuclear Information System (INIS)

Chasen, M.H.; Charnsangavej, C.

1998-01-01

This article provides a practical approach to the clinical implications and importance of understanding the collateral venous anatomy of the thorax. Routine radiography, conventional venography, computed tomography (CT), and magnetic resonance (MR) imaging studies provide correlative anatomic models for the demonstration of how interconnecting collateral vascular networks within the thorax maintain venous stability at all times. Five major systems comprise the collateral venous network of the thorax ( Fig. 1 ). These include the paravertebral, azygos-hemiazygos, internal mammary, lateral thoracic, and anterior jugular venous systems (AJVS). The five systems are presented in the following sequence: (a) a brief introduction to the importance of catheter position and malposition in understanding access to the thoracic venous system, (b) the anatomy of the azygos-hemiazygos systems and their relationship with the paravertebral plexus, (c) the importance of the AJVS, (d) 'loop' concepts interconnecting the internal mammary and azygos-hemiazygos systems by means of the lateral thoracic and intercostal veins, and (e) the interconnecting venous networks on the thoracic side of the thoracoabdominal junction. Certain aspects of the venous anatomy of the thorax will not be discussed in this chapter and include (a) the intra-abdominal anastomoses between the superior and inferior vena cavae (IVC) via the internal mammary, lateral thoracic, and azygos-hemiazygos systems (beyond the scope of this article), (b) potential collateral vessels involving vertebral, parascapular, thyroidal, thymic, and other smaller veins that might anastomose with the major systems, and (c) anatomic variants and pitfalls that may mimic pathologic conditions (space limitations). (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

Coccolithophorids in polar waters: Wigwamma spp. revisited

DEFF Research Database (Denmark)

Thomsen, Helge Abildhauge; Østergaard, Jette B.; Heldal, Mikal

2013-01-01

A contingent of weakly calcified coccolithophorid genera and species were described from polar regions almost 40 years ago. In the interim period a few additional findings have been reported enlarging the realm of some of the species. The genus Wigwamma is revisited here with the purpose of provi...... appearance of the coccolith armour of the cell...

The biology, function and clinical implications of exosomes in lung cancer.

Science.gov (United States)

Zhou, Li; Lv, Tangfeng; Zhang, Qun; Zhu, Qingqing; Zhan, Ping; Zhu, Suhua; Zhang, Jianya; Song, Yong

2017-10-28

Exosomes are 30-100 nm small membrane vesicles of endocytic origin that are secreted by all types of cells, and can also be found in various body fluids. Increasing evidence implicates that exosomes confer stability and can deliver their cargos such as proteins and nucleic acids to specific cell types, which subsequently serve as important messengers and carriers in lung carcinogenesis. Here, we describe the biogenesis and components of exosomes mainly in lung cancer, we summarize their function in lung carcinogenesis (epithelial mesenchymal transition, oncogenic cell transformation, angiogenesis, metastasis and immune response in tumor microenvironment), and importantly we focus on the clinical potential of exosomes as biomarkers and therapeutics in lung cancer. In addition, we also discuss current challenges that might impede the clinical use of exosomes. Further studies on the functional roles of exosomes in lung cancer requires thorough research. Copyright © 2017 Elsevier B.V. All rights reserved.

The significance test controversy revisited the fiducial Bayesian alternative

CERN Document Server

Lecoutre, Bruno

2014-01-01

The purpose of this book is not only to revisit the “significance test controversy,”but also to provide a conceptually sounder alternative. As such, it presents a Bayesian framework for a new approach to analyzing and interpreting experimental data. It also prepares students and researchers for reporting on experimental results. Normative aspects: The main views of statistical tests are revisited and the philosophies of Fisher, Neyman-Pearson and Jeffrey are discussed in detail. Descriptive aspects: The misuses of Null Hypothesis Significance Tests are reconsidered in light of Jeffreys’ Bayesian conceptions concerning the role of statistical inference in experimental investigations. Prescriptive aspects: The current effect size and confidence interval reporting practices are presented and seriously questioned. Methodological aspects are carefully discussed and fiducial Bayesian methods are proposed as a more suitable alternative for reporting on experimental results. In closing, basic routine procedures...

Resource utilization implications of treatment were able to be assessed from appropriately reported clinical trial data

NARCIS (Netherlands)

Poole-Wilson, Philip A.; Kirwan, Bridget-Anne; Voko, Zoltan; de Brouwer, Sophie; Dunselman, Peter H. J. M.; van Dalen, Frederik J.; Lubsen, Jacobus

Background and Objective: Published clinical trial data rarely allow assessment of the health care resource utilization implications of treatment. We give an example of how these can be assessed given appropriate tabulation of data. Methods: Data from a trial comparing long-acting nifedipine

Satellite failures revisited

Science.gov (United States)

Balcerak, Ernie

2012-12-01

In January 1994, the two geostationary satellites known as Anik-E1 and Anik-E2, operated by Telesat Canada, failed one after the other within 9 hours, leaving many northern Canadian communities without television and data services. The outage, which shut down much of the country's broadcast television for hours and cost Telesat Canada more than $15 million, generated significant media attention. Lam et al. used publicly available records to revisit the event; they looked at failure details, media coverage, recovery effort, and cost. They also used satellite and ground data to determine the precise causes of those satellite failures. The researchers traced the entire space weather event from conditions on the Sun through the interplanetary medium to the particle environment in geostationary orbit.

Pockets of Participation: Revisiting Child-Centred Participation Research

Science.gov (United States)

Franks, Myfanwy

2011-01-01

This article revisits the theme of the clash of interests and power relations at work in participatory research which is prescribed from above. It offers a possible route toward solving conflict between adult-led research carried out by young researchers, funding requirements and organisational constraints. The article explores issues of…

Faraday effect revisited: sum rules and convergence issues

DEFF Research Database (Denmark)

Cornean, Horia; Nenciu, Gheorghe

2010-01-01

This is the third paper of a series revisiting the Faraday effect. The question of the absolute convergence of the sums over the band indices entering the Verdet constant is considered. In general, sum rules and traces per unit volume play an important role in solid-state physics, and they give...

A Rare Chromosome 3 Imbalance and Its Clinical Implications

Directory of Open Access Journals (Sweden)

Karen Sims

2012-01-01

Full Text Available The duplication of chromosome 3q is a rare disorder with varying chromosomal breakpoints and consequently symptoms. Even rarer is the unbalanced outcome from a parental inv(3 resulting in duplicated 3q and a deletion of 3p. Molecular karyotyping should aid in precisely determining the length and breakpoints of the 3q+/3p− so as to better understand a child’s future development and needs. We report a case of an infant male with a 57.5 Mb duplication from 3q23-qter. This patient also has an accompanying 1.7 Mb deletion of 3p26.3. The duplicated segment in this patient encompasses the known critical region of 3q26.3-q27, which is implicated in the previously reported 3q dup syndrome; however, the accompanying 3p26.3 deletion is smaller than the previously reported cases. The clinical phenotype of this patient relates to previously reported cases of 3q+ that may suggest that the accompanying 1.7 Mb heterozygous deletion is not clinically relevant. Taken together, our data has refined the location and extent of the chromosome 3 imbalance, which will aid in better understanding the molecular underpinning of the 3q syndrome.

Point-of-care testing for chlamydia and gonorrhoea: implications for clinical practice.

Directory of Open Access Journals (Sweden)

Lisa Natoli

Full Text Available Point-of-care (POC testing for chlamydia (CT and gonorrhoea (NG offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings.In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise.Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection.The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines.

Point-of-Care Testing for Chlamydia and Gonorrhoea: Implications for Clinical Practice

Science.gov (United States)

Natoli, Lisa; Maher, Lisa; Shephard, Mark; Hengel, Belinda; Tangey, Annie; Badman, Steven G.; Ward, James; Guy, Rebecca J.

2014-01-01

Objectives Point-of-care (POC) testing for chlamydia (CT) and gonorrhoea (NG) offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs) in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings. Methods In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise. Results Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection. Conclusions The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines. PMID:24956111

Clinical Implications of Changing Parameters on an Elliptical Trainer.

Science.gov (United States)

Kaplan, Yonatan; Nyska, Meir; Palmanovich, Ezequiel; Shanker, Rebecca

2014-06-01

Specific weightbearing instructions continue to be a part of routine orthopaedic clinical practice on an injured or postoperative extremity. Researchers and clinicians have struggled to define the best weightbearing strategies to maximize clinical outcomes. To investigate the average percentage body weight (APBW) values, weightbearing distribution percentages (WBDP), and cadence values on the entire foot, hindfoot, and forefoot during changing resistance and incline on an elliptical trainer, as well as to suggest clinical implications. Descriptive laboratory study. An original research study was performed consisting of 30 asymptomatic subjects (mean age, 29.54 ± 12.64 years; range, 21-69 years). The protocol included 3 consecutive tests of changing resistance and incline within a speed range of 70 to 95 steps/min. The SmartStep weightbearing gait analysis system was utilized to measure the values. The APBW values for the entire foot ranged between 70% and 81%, the hindfoot values were between 27% and 57%, and the forefoot values between 42% and 70%. With regard to WBDP, the forefoot remained planted on the pedal (stance phase) 2 to 3 times more as compared with the hindfoot raise in the swing phase. The study findings highlight the fact that elliptical training significantly reduces weightbearing in the hindfoot, forefoot, and entire foot even at higher levels of resistance and incline. Weightbearing on the hindfoot consistently displayed the lowest weightbearing values. Orthopaedic surgeons, now equipped with accurate weightbearing data, may recommend using the elliptical trainer as a weightbearing exercise early on following certain bony or soft tissue pathologies and lower limb surgical procedures.

Goltz-Gorlin Syndrome: Revisiting the Clinical Spectrum.

Science.gov (United States)

Yesodharan, Dhanya; Büschenfelde, Uta Meyer Zum; Kutsche, Kerstin; Mohandas Nair, K; Nampoothiri, Sheela

2018-01-31

To describe the varying phenotypic spectrum of Focal Dermal Hypoplasia (FDH) and to emphasize the need for identifying the condition in mildly affected females which is crucial for offering a prenatal diagnosis in subsequent pregnancy owing to the risk of having a severely affected baby. The phenotype-genotype correlation of 4 patients with FDH, over a period of 11 y from the genetic clinic in a tertiary care centre from Kerala, India was done. All four mutation proven patients were females (2 adults and 2 children). One of the adult female subjects were mildly affected, though she had a history of having a severely affected female child who expired on day six. Among the 2 affected children, one of them had an unaffected mother and the other had an affected mother. FDH has a wide clinical spectrum from very subtle findings to severe manifestations. The lethality of the condition in males and the disfigurement and multisystem involvement in females highlights the importance of confirmation of diagnosis by molecular analysis so that the family can be offered prenatal diagnosis in subsequent pregnancy.

Additively homomorphic encryption with a double decryption mechanism, revisited

NARCIS (Netherlands)

Peter, Andreas; Kronberg, M.; Trei, W.; Katzenbeisser, S.

We revisit the notion of additively homomorphic encryption with a double decryption mechanism (DD-PKE), which allows for additions in the encrypted domain while having a master decryption procedure that can decrypt all properly formed ciphertexts by using a special master secret. This type of

Moral Judgment Development across Cultures: Revisiting Kohlberg's Universality Claims

Science.gov (United States)

Gibbs, John C.; Basinger, Karen S.; Grime, Rebecca L.; Snarey, John R.

2007-01-01

This article revisits Kohlberg's cognitive developmental claims that stages of moral judgment, facilitative processes of social perspective-taking, and moral values are commonly identifiable across cultures. Snarey [Snarey, J. (1985). "The cross-cultural universality of social-moral development: A critical review of Kohlbergian research."…

The practice and clinical implications of tablet splitting in international health

Science.gov (United States)

Elliott, Ivo; Mayxay, Mayfong; Yeuichaixong, Sengchanh; Lee, Sue J; Newton, Paul N

2014-01-01

Objective Tablet splitting is frequently performed to facilitate correct dosing, but the practice and implications in low-income settings have rarely been discussed. Methods We selected eight drugs, with narrow therapeutic indices or critical dosages, frequently divided in the Lao PDR (Laos). These were split, by common techniques used in Laos, by four nurses and four laypersons. The mean percentage deviation from the theoretical expected weight and weight loss of divided tablets/capsules were recorded. Results Five of eight study drugs failed, on splitting, to meet European Pharmacopoeia recommendations for tablet weight deviation from the expected weight of tablet/capsule halves with 10% deviating by more than 25%. There was a significant difference in splitting accuracy between nurses and laypersons (P = 0.027). Coated and unscored tablets were less accurately split than uncoated (P = 0.03 and 0.0019 for each half) and scored (0.0001 for both halves) tablets. Conclusion These findings have potential clinical implications on treatment outcome and the development of antimicrobial resistance. Investment by drug companies in a wider range of dosage units, particularly for narrow therapeutic index and critical dosage medicines, is strongly recommended. PMID:24702766

Radiative corrections to double-Dalitz decays revisited

Science.gov (United States)

Kampf, Karol; Novotný, Jiři; Sanchez-Puertas, Pablo

2018-03-01

In this study, we revisit and complete the full next-to-leading order corrections to pseudoscalar double-Dalitz decays within the soft-photon approximation. Comparing to the previous study, we find small differences, which are nevertheless relevant for extracting information about the pseudoscalar transition form factors. Concerning the latter, these processes could offer the opportunity to test them—for the first time—in their double-virtual regime.

A Feminist Revisit to the First-Year Curriculum.

Science.gov (United States)

Bernstein, Anita

1996-01-01

A seminar at Chicago-Kent College of Law (Illinois) that reviews six first-year law school courses by focusing on feminist issues in course content and structure is described. The seminar functions as both a review and a shift in perspective. Courses revisited include civil procedure, contracts, criminal law, justice and the legal system,…

Quantum duel revisited

International Nuclear Information System (INIS)

Schmidt, Alexandre G M; Paiva, Milena M

2012-01-01

We revisit the quantum two-person duel. In this problem, both Alice and Bob each possess a spin-1/2 particle which models dead and alive states for each player. We review the Abbott and Flitney result—now considering non-zero α 1 and α 2 in order to decide if it is better for Alice to shoot or not the second time—and we also consider a duel where players do not necessarily start alive. This simple assumption allows us to explore several interesting special cases, namely how a dead player can win the duel shooting just once, or how can Bob revive Alice after one shot, and the better strategy for Alice—being either alive or in a superposition of alive and dead states—fighting a dead opponent. (paper)

The Importance of Being a Complement: CED Effects Revisited

Science.gov (United States)

Jurka, Johannes

2010-01-01

This dissertation revisits subject island effects (Ross 1967, Chomsky 1973) cross-linguistically. Controlled acceptability judgment studies in German, English, Japanese and Serbian show that extraction out of specifiers is consistently degraded compared to extraction out of complements, indicating that the Condition on Extraction domains (CED,…

Evans Blue Dye: A Revisit of Its Applications in Biomedicine.

Science.gov (United States)

Yao, Linpeng; Xue, Xing; Yu, Peipei; Ni, Yicheng; Chen, Feng

2018-01-01

Evans blue (EB) dye has owned a long history as a biological dye and diagnostic agent since its first staining application by Herbert McLean Evans in 1914. Due to its high water solubility and slow excretion, as well as its tight binding to serum albumin, EB has been widely used in biomedicine, including its use in estimating blood volume and vascular permeability, detecting lymph nodes, and localizing the tumor lesions. Recently, a series of EB derivatives have been labeled with PET isotopes and can be used as theranostics with a broad potential due to their improved half-life in the blood and reduced release. Some of EB derivatives have even been used in translational applications in clinics. In addition, a novel necrosis-avid feature of EB has recently been reported in some preclinical animal studies. Given all these interesting and important advances in EB study, a comprehensive revisiting of EB has been made in its biomedical applications in the review.

Genetic recombination of the hepatitis C virus: clinical implications.

Science.gov (United States)

Morel, V; Fournier, C; François, C; Brochot, E; Helle, F; Duverlie, G; Castelain, S

2011-02-01

Genetic recombination is a well-known feature of RNA viruses that plays a significant role in their evolution. Although recombination is well documented for Flaviviridae family viruses, the first natural recombinant strain of hepatitis C virus (HCV) was identified as recently as 2002. Since then, a few other natural inter-genotypic, intra-genotypic and intra-subtype recombinant HCV strains have been described. However, the frequency of recombination may have been underestimated because not all known HCV recombinants are screened for in routine practice. Furthermore, the choice of treatment regimen and its predictive outcome remain problematic as the therapeutic strategy for HCV infection is genotype dependent. HCV recombination also raises many questions concerning its mechanisms and effects on the epidemiological and physiopathological features of the virus. This review provides an update on recombinant HCV strains, the process that gives rise to recombinants and clinical implications of recombination. © 2010 Blackwell Publishing Ltd.

Hypertensive response to exercise: mechanisms and clinical implication.

Science.gov (United States)

Kim, Darae; Ha, Jong-Won

2016-01-01

A hypertensive response to exercise (HRE) is frequently observed in individuals without hypertension or other cardiovascular disease. However, mechanisms and clinical implication of HRE is not fully elucidated. Endothelial dysfunction and increased stiffness of large artery contribute to development of HRE. From neurohormonal aspects, excess stimulation of sympathetic nervous system and augmented rise of angiotensin II seems to be important mechanism in HRE. Increasing evidences indicates that a HRE is associated with functional and structural abnormalities of left ventricle, especially when accompanied by increased central blood pressure. A HRE harbors prognostic significance in future development of hypertension and increased cardiovascular events, particularly if a HRE is documented in moderate intensity of exercise. As supported by previous studies, a HRE is not a benign phenomenon, however, currently, whether to treat a HRE is controversial with uncertain treatment strategy. Considering underlying mechanisms, angiotensin receptor blockers and beta blockers can be suggested in individuals with HRE, however, evidences for efficacy and outcomes of treatment of HRE in individuals without hypertension is scarce and therefore warrants further studies.

Literary Origins of the Term "School Psychologist" Revisited

Science.gov (United States)

Fagan, Thomas K.

2005-01-01

Previous research on the literary origins of the term "school psychologist" is revisited, and conclusions are revised in light of new evidence. It appears that the origin of the term in the American literature occurred as early as 1898 in an article by Hugo Munsterberg, predating the usage by Wilhelm Stern in 1911. The early references to the…

A Multi-Level Model of Moral Functioning Revisited

Science.gov (United States)

Reed, Don Collins

2009-01-01

The model of moral functioning scaffolded in the 2008 "JME" Special Issue is here revisited in response to three papers criticising that volume. As guest editor of that Special Issue I have formulated the main body of this response, concerning the dynamic systems approach to moral development, the problem of moral relativism and the role of…

Revisiting the two formulations of Bianchi identities and their implications on moduli stabilization

Energy Technology Data Exchange (ETDEWEB)

Shukla, Pramod [ICTP - International Centre for Theoretical Physics,Strada Costiera 11, Trieste 34151 (Italy)

2016-08-24

In the context of non-geometric type II orientifold compactifications, there have been two formulations for representing the various NS-NS Bianchi-identities. In the first formulation, the standard three-form flux (H{sub 3}), the geometric flux (ω) and the non-geometric fluxes (Q and R) are expressed by using the real six-dimensional indices (e.g. H{sub ijk},ω{sub ij}{sup k},Q{sub i}{sup jk} and R{sup ijk}), and this formulation has been heavily utilized for simplifying the scalar potentials in toroidal-orientifolds. On the other hand, relevant for the studies beyond toroidal backgrounds, a second formulation is utilized in which all flux components are written in terms of various involutively even/odd (2,1)- and (1,1)-cohomologies of the complex threefold. In the lights of recent model building interests and some observations made in http://dx.doi.org/10.1088/1126-6708/2007/08/043, http://dx.doi.org/10.1088/1126-6708/2007/12/058, in this article, we revisit two most commonly studied toroidal examples in detail to illustrate that the present forms of these two formulations are not completely equivalent. To demonstrate the same, we translate all the identities of the first formulation into cohomology ingredients, and after a tedious reshuffling of the subsequent constraints, interestingly we find that all the identities of the second formulation are embedded into the first formulation which has some additional constraints. In addition, we look for the possible solutions of these Bianchi identities in a detailed analysis, and we find that some solutions can reduce the size of scalar potential very significantly, and in some cases are too strong to break the no-scale structure completely. Finally, we also comment on the influence of imposing some of the solutions of Bianchi identities in studying moduli stabilization.

Statin-associated immune-mediated myopathy: biology and clinical implications.

Science.gov (United States)

Christopher-Stine, Lisa; Basharat, Pari

2017-04-01

In the last 6 years, our understanding of statin-associated myopathy expanded to include not only a toxic myopathy with limited and reversible side-effects but also an autoimmune variety in which statins likely induce an autoimmune myopathy that is both associated with a specific autoantibody and responsive to immunosuppression and immune modulation. This review widens the reader's understanding of statin myopathy to include an autoimmune process. Statin-associated immune-mediated myopathy provides an example of an environmental trigger (statins) directly implicated in an autoimmune disease associated with a genetic predisposition as well as potential risk factors including concomitant diseases and specific statins. Given a median exposure to statins of 38 months, providers should be aware that anti-3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) myopathy may occur even after several years of statin exposure. It is important for the reader to understand the clinical presentation of statin-associated immune-mediated myopathy and the difference in its clinical presentation to that of statins as direct myotoxins. Prompt recognition of such an entity allows the clinician to immediately stop the offending agent if it has not already been discontinued as well as to recognize that statin rechallenge is not a likely option, and that prompt treatment with immunosuppression and/or immunomodulation is usually of enormous benefit to the patient in restoring muscle strength and physical function. VIDEO ABSTRACT.

Paradigm Shift or Annoying Distraction: Emerging Implications of Web 2.0 for Clinical Practice

OpenAIRE

Spallek, H.; O’Donnell, J.; Clayton, M.; Anderson, P.; Krueger, A.

2010-01-01

Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five developing trends are explored: information channels, augmented reality, location-based mobile social computing, virtual worlds and serious gaming, and collaborative research network...

Accessory muscle of the flexor digitorum superficialis and its clinical implications

Directory of Open Access Journals (Sweden)

Edie Benedito Caetano

Full Text Available ABSTRACT Anatomical variations of the flexor digitorum superficialis (FDS muscle and tendon unit are frequently reported by anatomists and clinicians. Anatomical muscle variations of the FDS and its tendons may include variations of muscle belly, presence of accessory or duplicate tendons, abnormal tendon connections, and absence of muscle or tendon components. Such variations may or may not have clinical implications. This report presents a case not described previously: a unilateral accessory muscle of the flexor digitorum superficialis which was connected by a thick tendon to the flexor digitorum superficialis muscle; it was directed proximally to the insertion of the medial epicondyle of the humerus, next to the superficialis head of the pronator teres muscle. The belly of the accessory muscle was positioned anterior to the median and anterior interosseous nerve. This anatomical variation is known as type V in the classification of Elliot et al. The knowledge of these anatomical variations helps hand surgeons interpret the clinical examination, particularly in the evaluation of patients who have suffered tendon injuries or show sign s of possible peripheral nerve entrapment.

Revisiting Jack Goody to Rethink Determinisms in Literacy Studies

Science.gov (United States)

Collin, Ross

2013-01-01

This article revisits Goody's arguments about literacy's influence on social arrangements, culture, cognition, economics, and other domains of existence. Whereas some of his arguments tend toward technological determinism (i.e., literacy causes change in the world), other of his arguments construe literacy as a force that shapes and is shaped by…

A control center design revisited: learning from users’ appropriation

DEFF Research Database (Denmark)

Souza da Conceição, Carolina; Cordeiro, Cláudia

2014-01-01

This paper aims to present the lessons learned during a control center design project by revisiting another control center from the same company designed two and a half years before by the same project team. In light of the experience with the first project and its analysis, the designers and res...

PENGARUH GUIDE PERFORMANCE DAN QUALITY TOURISM SERVICE TERHADAP REVISIT INTENTION DI KEBUN RAYA BOGOR

Directory of Open Access Journals (Sweden)

Rian Andriani

2016-11-01

ABSTRACT Bogor Botanical Gardens is one of tourist destination in Bogor City, West Java, which the geographical in a strategic location between two big cities, Jakarta and Bandung. This location factor is can become an opportunity for Bogor Botanical Gardens to become a favorite tourist destination in Bogor City. Guide Performance and Quality Tourism Service is one of part of the tourism, so the researcher focus to Guide Performance and Quality Tourism Service To Revisit Intention in Bogor Botanical Gardens. In this research, the researcher used quantitative methode with descriptive verificative. The researcher used 100 respondent for a sample. In this research, the researcher used multiple linier regresion analysis with hypotesis test used determination coefficient test and F test. The classical assumption of this research is used normality test, multicollinearity test, heteroskedastisitas test and auto correlation test. In this research, the Guide Performance and Quality Tourism Service factors has an influence 33,2% of Revisit Intention in Bogor Botanical Garden. Keywords: Guide Performance, Quality Tourism Service and Revisit Intention

Obesity Paradox in Lung Cancer Prognosis: Evolving Biological Insights and Clinical Implications.

Science.gov (United States)

Zhang, Xueli; Liu, Yamin; Shao, Hua; Zheng, Xiao

2017-10-01

The survival rate of lung cancer remains low despite the progress of surgery and chemotherapy. With the increasing comorbidity of obesity in patients with lung cancer, new challenges are emerging in the management of this patient population. A key issue of interest is the prognostic effect of obesity on surgical and chemotherapeutic outcomes in patients with lung cancer, which is fueled by the growing observation of survival benefits in overweight or obese patients. This unexpected inverse relationship between obesity and lung cancer mortality, called the obesity paradox, remains poorly understood. The evolving insights into the heterogeneity of obesity phenotypes and associated biological connections with lung cancer progression in recent years may help explain some of the seemingly paradoxical relationship, and well-designed clinical studies looking at the causal role of obesity-associated molecules are expected. Here, we examine potential biological mechanisms behind the protective effects of obesity in lung cancer. We highlight the need to clarify the clinical implications of this relationship toward an updated intervention strategy in the clinical care of patients with lung cancer and obesity. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Revisiting the Political Economy of Communication

Directory of Open Access Journals (Sweden)

Nicholas Garnham

2014-02-01

The task of the paper and the seminar was to revisit some of Nicholas Garnham’s ideas, writings and contributions to the study of the Political Economy of Communication and to reflect on the concepts, history, current status and perspectives of this field and the broader study of political economy today. The topics covered include Raymond Williams’ cultural materialism, Pierre Bourdieu’s sociology of culture, the debate between Political Economy and Cultural Studies, information society theory, Karl Marx’s theory and the critique of capitalism.

The vacuum structure, special relativity theory and quantum mechanics revisited: a field theory-no-geometry approach

International Nuclear Information System (INIS)

Bogolubov, N.N. Jr.; Prykarpatsky, A.K.; Ufuk Taneri

2008-07-01

The main fundamental principles characterizing the vacuum field structure are formulated and the modeling of the related vacuum medium and charged point particle dynamics by means of de- vised field theoretic tools are analyzed. The Maxwell electrodynamic theory is revisited and newly derived from the suggested vacuum field structure principles and the classical special relativity theory relationship between the energy and the corresponding point particle mass is revisited and newly obtained. The Lorentz force expression with respect to arbitrary non-inertial reference frames is revisited and discussed in detail, and some new interpretations of relations between the special relativity theory and quantum mechanics are presented. The famous quantum-mechanical Schroedinger type equations for a relativistic point particle in the external potential and magnetic fields within the quasiclassical approximation as the Planck constant (h/2π) → 0 and the light velocity c → ∞ are obtained. (author)

K Mbugua The Problem of Hell Revisited pp93-103

African Journals Online (AJOL)

K Mbugua

The Problem of Hell Revisited: Towards a Gentler Theology of Hell 93 ... One who, after He has killed, has authority to cast into hell; yes, I tell you, fear. Him! .... Suppose your spouse or parent or child goes to hell and you go to heaven.

What matters to infrequent customers: a pragmatic approach to understanding perceived value and intention to revisit trendy coffee café.

Science.gov (United States)

Ting, Hiram; Thurasamy, Ramayah

2016-01-01

Notwithstanding the rise of trendy coffee café, little is done to investigate revisit intention towards the café in the context of developing markets. In particular, there is a lack of study which provides theoretical and practical explanation to the perceptions and behaviours of infrequent customers. Hence, the study aims to look into the subject matter by using the theory of reasoned action and social exchange theory as the underpinning basis. The framework proposed by Pine and Gilmore (Strat Leadersh 28:18-23, 2000), which asserts the importance of product quality, service quality and experience quality in a progressive manner, is used to decompose perceived value in the model so as to determine their effects on intention to revisit the café. Given the importance to gain practical insights into revisit intention of infrequent customers, pragmatism stance is assumed. Explanatory sequential mixed-method design is thus adopted whereby qualitative approach is used to confirm and complement quantitative findings. Self-administered questionnaire-based survey is first administered before personal interview is carried out at various cafés. Partial least squares structural equation modelling and content analysis are appropriated successively. In the quantitative findings, although product quality, service quality and experience quality are found to have positive effect on perceived value and revisit intention towards trendy coffee café, experience quality is found to have the greater effect than the others among the infrequent customers. The qualitative findings not only confirm their importance, but most importantly explain the favourable impressions they have at trendy coffee café based on their last in-store experience. While product and service quality might not necessary stimulate them to revisit trendy coffee café, experience quality driven by purposes of visit would likely affect their intention to revisit. As retaining customers is of utmost importance to

Abnormal Default System Functioning in Depression: Implications for Emotion Regulation.

Science.gov (United States)

Messina, Irene; Bianco, Francesca; Cusinato, Maria; Calvo, Vincenzo; Sambin, Marco

2016-01-01

Depression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parietal executive areas, instead of responding automatically to emotional stimuli. According to such models, the weaker executive area activation observed in depressed patients is attributable to a lack of cognitive control over negative emotions. Going beyond the concept of cognitive control, psychodynamic models describe the development of individuals' capacity to regulate their emotional states in mother-infant interactions during childhood, through the construction of the representation of the self, others, and relationships. In this mini-review, we link these psychodynamic models with recent findings regarding the abnormal functioning of the default system in depression. Consistently with psychodynamic models, psychological functions associated with the default system include self-related processing, semantic processes, and implicit forms of emotion regulation. The abnormal activation of the default system observed in depression may explain the dysfunctional aspects of emotion regulation typical of the condition, such as an exaggerated negative self-focus and rumination on self-esteem issues. We also discuss the clinical implications of these findings with reference to the therapeutic relationship as a key tool for revisiting impaired or distorted representations of the self and relational objects.

Paradigm shift or annoying distraction: emerging implications of web 2.0 for clinical practice.

Science.gov (United States)

Spallek, H; O'Donnell, J; Clayton, M; Anderson, P; Krueger, A

2010-01-01

Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five developing trends are explored: information channels, augmented reality, location-based mobile social computing, virtual worlds and serious gaming, and collaborative research networks. Each trend is discussed based on their utilization and pattern of use by healthcare providers or healthcare organizations. In addition to explorative research for each trend, a vignette is presented which provides a future example of adoption. Lastly each trend lists several research challenge questions for applied clinical informatics.

Isolated persistent left superior vena cava: A case report and its clinical implications

Directory of Open Access Journals (Sweden)

Samarjit Bisoyi

2017-01-01

Full Text Available The venous anomaly of a persistent left superior vena cava (PLSVC affects 0.3%-0.5% of the general population. PLSVC with absent right superior vena cava, also termed as "isolated PLSVC," is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.

Whole Exome Sequencing in Pediatric Neurology Patients: Clinical Implications and Estimated Cost Analysis.

Science.gov (United States)

Nolan, Danielle; Carlson, Martha

2016-06-01

Genetic heterogeneity in neurologic disorders has been an obstacle to phenotype-based diagnostic testing. The authors hypothesized that information compiled via whole exome sequencing will improve clinical diagnosis and management of pediatric neurology patients. The authors performed a retrospective chart review of patients evaluated in the University of Michigan Pediatric Neurology clinic between 6/2011 and 6/2015. The authors recorded previous diagnostic testing, indications for whole exome sequencing, and whole exome sequencing results. Whole exome sequencing was recommended for 135 patients and obtained in 53 patients. Insurance barriers often precluded whole exome sequencing. The most common indication for whole exome sequencing was neurodevelopmental disorders. Whole exome sequencing improved the presumptive diagnostic rate in the patient cohort from 25% to 48%. Clinical implications included family planning, medication selection, and systemic investigation. Compared to current second tier testing, whole exome sequencing can result in lower long-term charges and more timely diagnosis. Overcoming barriers related to whole exome sequencing insurance authorization could allow for more efficient and fruitful diagnostic neurological evaluations. © The Author(s) 2016.

Radiative corrections to neutrino deep inelastic scattering revisited

International Nuclear Information System (INIS)

Arbuzov, Andrej B.; Bardin, Dmitry Yu.; Kalinovskaya, Lidia V.

2005-01-01

Radiative corrections to neutrino deep inelastic scattering are revisited. One-loop electroweak corrections are re-calculated within the automatic SANC system. Terms with mass singularities are treated including higher order leading logarithmic corrections. Scheme dependence of corrections due to weak interactions is investigated. The results are implemented into the data analysis of the NOMAD experiment. The present theoretical accuracy in description of the process is discussed

Doppler Processing with Ultra-Wideband (UWB) Radar Revisited

Science.gov (United States)

2018-01-01

REPORT TYPE Technical Note 3. DATES COVERED (From - To) December 2017 4. TITLE AND SUBTITLE Doppler Processing with Ultra-Wideband (UWB) Radar...unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT This technical note revisits previous work performed at the US Army Research Laboratory related to...target considered previously is proportional to a delayed version of the transmitted signal, up to a complex constant factor. We write the received

[Anaesthetic-induced myocardial preconditioning: fundamental basis and clinical implications].

Science.gov (United States)

Chiari, P; Bouvet, F; Piriou, V

2005-04-01

Volatile halogenated anaesthetics offer a myocardial protection when they are administrated before a myocardial ischaemia. Cellular mechanisms involved in anaesthetic preconditioning are now better understood. The objectives of this review are to understand the anaesthetic-induced preconditioning underlying mechanisms and to know the clinical implications. References were obtained from PubMed data bank (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) using the following keywords: volatile anaesthetic, isoflurane, halothane, sevoflurane, desflurane, preconditioning, protection, myocardium. Ischaemic preconditioning (PC) is a myocardial endogenous protection against ischaemia. It has been described as one or several short ischaemia before a sustained ischemia. These short ischaemia trigger a protective signal against this longer ischaemia. An ischemic organ is able to precondition a remote organ. It is possible to replace the short ischaemia by a preadministration of halogenated volatile anaesthetic with the same protective effect, this is called anaesthetic PC (APC). APC and ischaemic PC share similar underlying biochemical mechanisms including protein kinase C, tyrosine kinase activation and mitochondrial and sarcolemnal K(ATP) channels opening. All halogenated anaesthetics can produce an anaesthetic PC effect. Myocardial protection during reperfusion, after the long ischaemia, has been shown by successive short ischaemia or volatile anaesthetic administration, this is called postconditioning. Ischaemic PC has been described in humans in 1993. Clinical studies in human cardiac surgery have shown the possibility of anaesthetic PC with volatile anaesthetics. These studies have shown a decrease of postoperative troponin in patient receiving halogenated anaesthetics.

Dynamics of Shape Fluctuations of Quasi-spherical Vesicles Revisited

DEFF Research Database (Denmark)

Miao, L.; Lomholt, Michael Andersen; Kleis, J.

2002-01-01

In this paper, the dynamics of spontaneous shape fluctuations of a single, giant quasi-spherical vesicle formed from a single lipid species is revisited theoretically. A coherent physical theory for the dynamics is developed based on a number of fundamental principles and considerations, and a sy......In this paper, the dynamics of spontaneous shape fluctuations of a single, giant quasi-spherical vesicle formed from a single lipid species is revisited theoretically. A coherent physical theory for the dynamics is developed based on a number of fundamental principles and considerations...... of the phenomenological constants in a canonical continuum description of fluid lipid-bilayer membranes and shown the consequences of this new interpretation in terms of the characteristics of the dynamics of vesicle shape fluctuations. Moreover, we have used the systematic formulation of our theory as a framework...... against which we have discussed the previously existing theories and their discrepancies. Finally, we have made a systematic prediction about the system-dependent characteristics of the relaxation dynamics of shape fluctuations of quasi-spherical vesicles with a view of experimental studies...

Revisiting Constructivist Teaching Methods in Ontario Colleges Preparing for Accreditation

Science.gov (United States)

Schultz, Rachel A.

2015-01-01

At the time of writing, the first community colleges in Ontario were preparing for transition to an accreditation model from an audit system. This paper revisits constructivist literature, arguing that a more pragmatic definition of constructivism effectively blends positivist and interactionist philosophies to achieve both student centred…

Thorbecke Revisited : The Role of Doctrinaire Liberalism in Dutch Politics

NARCIS (Netherlands)

Drentje, Jan

2011-01-01

Thorbecke Revisited: The Role of Doctrinaire Liberalism in Dutch Politics In the political history of the nineteenth century Thorbecke played a crucial role. As the architect of the 1848 liberal constitutional reform he led three cabinets. In many ways he dominated the political discourse during the

Non-invasive prenatal diagnosis using cell-free fetal DNA technology: applications and implications.

Science.gov (United States)

Hall, Alison; Bostanci, A; Wright, C F

2010-01-01

Cell-free fetal DNA and RNA circulating in maternal blood can be used for the early non-invasive prenatal diagnosis (NIPD) of an increasing number of genetic conditions, both for pregnancy management and to aid reproductive decision-making. Here we present a brief review of the scientific and clinical status of the technology, and an overview of key ethical, legal and social issues raised by the analysis of cell-free fetal DNA for NIPD. We suggest that the less invasive nature of the technology brings some distinctive issues into focus, such as the possibility of broader uptake of prenatal diagnosis and access to the technology directly by the consumer via the internet, which have not been emphasised in previous work in this area. We also revisit significant issues that are familiar from previous debates about prenatal testing. Since the technology seems to transect existing distinctions between screening and diagnostic tests, there are important implications for the form and process involved in obtaining informed consent or choice. This analysis forms part of the work undertaken by a multidisciplinary group of experts which made recommendations about the implementation of this technology within the UK National Health Service. Copyright 2010 S. Karger AG, Basel.

Recommendations of the IOM clinical preventive services for women committee: implications for obstetricians and gynecologists.

Science.gov (United States)

Gee, Rebekah E; Brindis, Claire D; Diaz, Angela; Garcia, Francisco; Gregory, Kimberly; Peck, Magda G; Reece, E Albert

2011-12-01

In July 2011, in response to language in the Affordable Care Act (ACA) the Office of the Assistant Secretary for Planning and Evaluation of the US Department of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to develop a report on the clinical preventive services necessary for women. The committee proposed eight new clinical preventive service recommendations aimed at closing significant gaps in preventive healthcare. This article reviews the process, findings, and the implications for obstetrician gynecologists and other primary care clinicians. Obstetricians and gynecologists play a major role in delivering primary care to women and many of the services recommended by the Committee are part of the core set of obstetrics and gynecology services. The women's health amendment to the ACA (Federal Register, 2010) requires that new private health plans cover - with no cost-sharing requirements - preventive healthcare services for women. Congress requested that a review be conducted to ascertain whether there were any additional needed preventive services specific to women's health that should be included. The IOM Committee on Preventive Services for Women recommended eight clinical measures specific to women's health that should be considered for coverage without co-payment. The US Department of HHS reviewed and adopted these recommendations, and, as a result, new health plans will need to include these services as part of insurance policies with plan years beginning on or after 1 August 2012. The authors discuss the implications of the IOM recommendations on practicing clinicians and on their potential impact on women's health and well being.

"Research on Infertility: Definition Makes a Difference" Revisited.

Science.gov (United States)

Jacobson, Melanie H; Chin, Helen B; Mertens, Ann C; Spencer, Jessica B; Fothergill, Amy; Howards, Penelope P

2018-02-01

In a 1989 paper, Marchbanks et al. (Am J Epidemiol. 1989;130(2):259-267) noted inconsistent definitions of infertility across research and clinical practice and examined differences in prevalence estimates across definitions. Since their study, there have been substantial changes in society, technology, and clinical practice related to female reproductive health. In response, we revisited the original paper using data from a recent study among reproductive-aged women. Internal comparisons across various definitions of infertility were made by assessing how many and which women were classified as infertile, their age at infertility, and the probability of spontaneous pregnancy after infertility. Results were also compared with Marchbanks et al. Black women were more likely to be classified as infertile than white women based on the definition "12 months of unprotected intercourse" (40.1% vs. 33.7%) but less likely by "12 months of attempting pregnancy" (14.3% vs. 21.8%) and "visiting a doctor for help getting pregnant" (8.4% vs. 19.7%). After unprotected intercourse for 12 months, 36.1% of women who were attempting pregnancy spontaneously conceived by 6 months compared with 13.5% of women who were not attempting pregnancy. While our results for most infertility definitions were similar to those of Marchbanks et al., prevalence estimates continued to differ across demographic groups by definition. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

Directory of Open Access Journals (Sweden)

Chun Nok Lam

2016-09-01

Full Text Available Introduction: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This study assessed the impact of homelessness on 30-day ED revisits and hospital readmissions among patients presenting with mental health conditions in an urban, safety-net hospital. Methods: We conducted a secondary analysis of administrative data on all adult ED visits in 2012 in an urban safety-net hospital. Patient demographics, mental health status, homelessness, insurance coverage, level of acuity, and ED disposition per ED visit were analyzed using multilevel modeling to control for multiple visits nested within patients. We performed multivariate logistic regressions to evaluate if homelessness moderated the likelihood of mental health patients’ 30-day ED revisits and hospital readmissions. Results: Study included 139,414 adult ED visits from 92,307 unique patients (43.5±15.1 years, 51.3% male, 68.2% Hispanic/Latino. Nearly 8% of patients presented with mental health conditions, while 4.6% were homeless at any time during the study period. Among patients with mental health conditions, being homeless contributed to an additional 28.0% increase in likelihood (4.28 to 5.48 odds of 30-day ED revisits and 38.2% increase in likelihood (2.04 to 2.82 odds of hospital readmission, compared to non-homeless, non-mental health (NHNM patients as the base category. Adjusted predicted probabilities showed that homeless patients presenting with mental health conditions have a 31.1% chance of returning to the ED within 30-day post discharge and a 3

Impulse control disorders in Parkinson's disease: clinical characteristics and implications.

Science.gov (United States)

Leeman, Robert F; Potenza, Marc N

2011-04-01

Impulse control disorders (ICDs), specifically those related to excessive gambling, eating, sex and shopping, have been observed in a subset of people with Parkinson's disease (PD). Although some initial case reports claimed that dopamine replacement therapies, particularly dopamine agonists, cause ICDs, more recent, larger and better controlled studies indicate a more complicated picture. While dopamine replacement therapy use is related to ICDs, other vulnerabilities, some related to PD and/or its treatment directly and others seemingly unrelated to PD, have also been associated with ICDs in PD. This suggests a complex etiology with multiple contributing factors. As ICDs occur in a sizable minority of PD patients and can be associated with significant distress and impairment, further investigation is needed to identify factors that can predict who may be more likely to develop ICDs. Clinical implications are discussed and topics for future research are offered.

"Computers, The Internet, and Cheating Among Secondary School Students: Some Implications for Educators "

Directory of Open Access Journals (Sweden)

Stacey Conradson

2000-03-01

Full Text Available This article investigates in greater depth one particular aspect of cheating within secondary education and..some implications for measuring academic achievement. More specifically, it examines how secondary..students exploit the Internet for plagiarizing schoolwork, and looks at how a traditional method of..educational assessment, namely paper-based report and essay writing, has been impacted by the growth of..Internet usage and the proliferation of computer skills among secondary school students. One of the..conclusions is that students' technology fluency is forcing educators to revisit conventional assessment..methods. Different options for combating Internet plagiarism are presented, and some software tools as well..as non-technology solutions are evaluated in light of the problems brought about by - cyberplagiarism.-

Variation in clinical practice: forests and trees revisited.

Science.gov (United States)

Wallis, Christopher J D; Naylor, C David; Detsky, Allan S

2017-09-01

Variations in clinical practice are commonly viewed as a sign of uneven quality of care and attributed to provider self-interest. However, patient preferences, physician practice patterns, and diagnostic and therapeutic uncertainty also cause variations. Greater attention to both doctor-patient interactions and limits to the available evidence might enable more effective assessment and improvement of health-care quality.

Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications.

Science.gov (United States)

Uljarević, Mirko; Katsos, Napoleon; Hudry, Kristelle; Gibson, Jenny L

2016-11-01

Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications. We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals. Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has

Surface tension in soap films: revisiting a classic demonstration

International Nuclear Information System (INIS)

Behroozi, F

2010-01-01

We revisit a classic demonstration for surface tension in soap films and introduce a more striking variation of it. The demonstration shows how the film, pulling uniformly and normally on a loose string, transforms it into a circular arc under tension. The relationship between the surface tension and the string tension is analysed and presented in a useful graphical form. (letters and comments)

The Neutrosophic Logic View to Schrodinger's Cat Paradox, Revisited

Directory of Open Access Journals (Sweden)

Florentin Smarandache

2008-07-01

Full Text Available The present article discusses Neutrosophic logic view to Schrodinger's cat paradox. We argue that this paradox involves some degree of indeterminacy (unknown which Neutrosophic logic can take into consideration, whereas other methods including Fuzzy logic cannot. To make this proposition clear, we revisit our previous paper by offering an illustration using modified coin tossing problem, known as Parrondo's game.

Surface tension in soap films: revisiting a classic demonstration

Energy Technology Data Exchange (ETDEWEB)

Behroozi, F [Department of Physics, University of Northern Iowa, Cedar Falls, IA 50614 (United States)], E-mail: behroozi@uni.edu

2010-01-15

We revisit a classic demonstration for surface tension in soap films and introduce a more striking variation of it. The demonstration shows how the film, pulling uniformly and normally on a loose string, transforms it into a circular arc under tension. The relationship between the surface tension and the string tension is analysed and presented in a useful graphical form. (letters and comments)

Revisiting the quantum harmonic oscillator via unilateral Fourier transforms

International Nuclear Information System (INIS)

Nogueira, Pedro H F; Castro, Antonio S de

2016-01-01

The literature on the exponential Fourier approach to the one-dimensional quantum harmonic oscillator problem is revised and criticized. It is shown that the solution of this problem has been built on faulty premises. The problem is revisited via the Fourier sine and cosine transform method and the stationary states are properly determined by requiring definite parity and square-integrable eigenfunctions. (paper)

Transport benchmarks for one-dimensional binary Markovian mixtures revisited

International Nuclear Information System (INIS)

Malvagi, F.

2013-01-01

The classic benchmarks for transport through a binary Markovian mixture are revisited to look at the probability distribution function of the chosen 'results': reflection, transmission and scalar flux. We argue that the knowledge of the ensemble averaged results is not sufficient for reliable predictions: a measure of the dispersion must also be obtained. An algorithm to estimate this dispersion is tested. (author)

Prostate cancer epigenetics and its clinical implications.

Science.gov (United States)

Yegnasubramanian, Srinivasan

2016-01-01

Normal cells have a level of epigenetic programming that is superimposed on the genetic code to establish and maintain their cell identity and phenotypes. This epigenetic programming can be thought as the architecture, a sort of cityscape, that is built upon the underlying genetic landscape. The epigenetic programming is encoded by a complex set of chemical marks on DNA, on histone proteins in nucleosomes, and by numerous context-specific DNA, RNA, protein interactions that all regulate the structure, organization, and function of the genome in a given cell. It is becoming increasingly evident that abnormalities in both the genetic landscape and epigenetic cityscape can cooperate to drive carcinogenesis and disease progression. Large-scale cancer genome sequencing studies have revealed that mutations in genes encoding the enzymatic machinery for shaping the epigenetic cityscape are among the most common mutations observed in human cancers, including prostate cancer. Interestingly, although the constellation of genetic mutations in a given cancer can be quite heterogeneous from person to person, there are numerous epigenetic alterations that appear to be highly recurrent, and nearly universal in a given cancer type, including in prostate cancer. The highly recurrent nature of these alterations can be exploited for development of biomarkers for cancer detection and risk stratification and as targets for therapeutic intervention. Here, we explore the basic principles of epigenetic processes in normal cells and prostate cancer cells and discuss the potential clinical implications with regards to prostate cancer biomarker development and therapy.

Prostate cancer epigenetics and its clinical implications

Directory of Open Access Journals (Sweden)

Srinivasan Yegnasubramanian

2016-01-01

Full Text Available Normal cells have a level of epigenetic programming that is superimposed on the genetic code to establish and maintain their cell identity and phenotypes. This epigenetic programming can be thought as the architecture, a sort of cityscape, that is built upon the underlying genetic landscape. The epigenetic programming is encoded by a complex set of chemical marks on DNA, on histone proteins in nucleosomes, and by numerous context-specific DNA, RNA, protein interactions that all regulate the structure, organization, and function of the genome in a given cell. It is becoming increasingly evident that abnormalities in both the genetic landscape and epigenetic cityscape can cooperate to drive carcinogenesis and disease progression. Large-scale cancer genome sequencing studies have revealed that mutations in genes encoding the enzymatic machinery for shaping the epigenetic cityscape are among the most common mutations observed in human cancers, including prostate cancer. Interestingly, although the constellation of genetic mutations in a given cancer can be quite heterogeneous from person to person, there are numerous epigenetic alterations that appear to be highly recurrent, and nearly universal in a given cancer type, including in prostate cancer. The highly recurrent nature of these alterations can be exploited for development of biomarkers for cancer detection and risk stratification and as targets for therapeutic intervention. Here, we explore the basic principles of epigenetic processes in normal cells and prostate cancer cells and discuss the potential clinical implications with regards to prostate cancer biomarker development and therapy.

Resolution of Reflection Seismic Data Revisited

DEFF Research Database (Denmark)

Hansen, Thomas Mejer; Mosegaard, Klaus; Zunino, Andrea

The Rayleigh Principle states that the minimum separation between two reflectors that allows them to be visually separated is the separation where the wavelet maxima from the two superimposed reflections combine into one maximum. This happens around Δtres = λb/8, where λb is the predominant...... lower vertical resolution of reflection seismic data. In the following we will revisit think layer model and demonstrate that there is in practice no limit to the vertical resolution using the parameterization of Widess (1973), and that the vertical resolution is limited by the noise in the data...

Personal Narratives: Cultural Differences and Clinical Implications

Science.gov (United States)

Bliss, Lynn S.; McCabe, Allyssa

2008-01-01

A study was conducted to examine the misdiagnosis of cultural difference deficits and how mistaking deficits in narrative production for cultural differences can be avoided. Findings reveal the implications for intervention.

Sloan Digital Sky Survey Photometric Calibration Revisited

International Nuclear Information System (INIS)

Marriner, John

2012-01-01

The Sloan Digital Sky Survey calibration is revisited to obtain the most accurate photometric calibration. A small but significant error is found in the flat-fielding of the Photometric telescope used for calibration. Two SDSS star catalogs are compared and the average difference in magnitude as a function of right ascension and declination exhibits small systematic errors in relative calibration. The photometric transformation from the SDSS Photometric Telescope to the 2.5 m telescope is recomputed and compared to synthetic magnitudes computed from measured filter bandpasses.

REVISITING A CLASSIC: THE PARKER–MOFFATT PROBLEM

International Nuclear Information System (INIS)

Pezzi, O.; Servidio, S.; Valentini, F.; Malara, F.; Veltri, P.; Parashar, T. N.; Yang, Y.; Matthaeus, W. H.; Vásconez, C. L.

2017-01-01

The interaction of two colliding Alfvén wave packets is described here by means of magnetohydrodynamics (MHD) and hybrid kinetic numerical simulations. The MHD evolution revisits the theoretical insights described by Moffatt, Parker, Kraichnan, Chandrasekhar, and Elsässer in which the oppositely propagating large-amplitude wave packets interact for a finite time, initiating turbulence. However, the extension to include compressive and kinetic effects, while maintaining the gross characteristics of the simpler classic formulation, also reveals intriguing features that go beyond the pure MHD treatment.

REVISITING A CLASSIC: THE PARKER–MOFFATT PROBLEM

Energy Technology Data Exchange (ETDEWEB)

Pezzi, O.; Servidio, S.; Valentini, F.; Malara, F.; Veltri, P. [Dipartimento di Fisica, Università della Calabria, 87036 Rende (CS) (Italy); Parashar, T. N.; Yang, Y.; Matthaeus, W. H. [Department of Physics and Astronomy, University of Delaware, DE 19716 (United States); Vásconez, C. L. [Departamento de Física, Escuela Politécnica Nacional, Quito (Ecuador)

2017-01-10

The interaction of two colliding Alfvén wave packets is described here by means of magnetohydrodynamics (MHD) and hybrid kinetic numerical simulations. The MHD evolution revisits the theoretical insights described by Moffatt, Parker, Kraichnan, Chandrasekhar, and Elsässer in which the oppositely propagating large-amplitude wave packets interact for a finite time, initiating turbulence. However, the extension to include compressive and kinetic effects, while maintaining the gross characteristics of the simpler classic formulation, also reveals intriguing features that go beyond the pure MHD treatment.

Sloan Digital Sky Survey Photometric Calibration Revisited

Energy Technology Data Exchange (ETDEWEB)

Marriner, John; /Fermilab

2012-06-29

The Sloan Digital Sky Survey calibration is revisited to obtain the most accurate photometric calibration. A small but significant error is found in the flat-fielding of the Photometric telescope used for calibration. Two SDSS star catalogs are compared and the average difference in magnitude as a function of right ascension and declination exhibits small systematic errors in relative calibration. The photometric transformation from the SDSS Photometric Telescope to the 2.5 m telescope is recomputed and compared to synthetic magnitudes computed from measured filter bandpasses.

The clinical implications of immunogenomics in colorectal cancer: A path for precision medicine.

Science.gov (United States)

Riley, Jenny M; Cross, Ashley W; Paulos, Chrystal M; Rubinstein, Mark P; Wrangle, John; Camp, E Ramsay

2018-04-15

Colorectal cancer (CRC) remains the third most common malignancy and the second-leading cause of cancer-related deaths in the United States. Large multi-omic databases, such as The Cancer Genome Atlas and the International Colorectal Cancer Subtyping Consortium, have identified distinct molecular subtypes related to anatomy. The identification of genomic alterations in CRC is now critical because of the recent success and US Food and Drug Administration approval of pembrolizumab and nivolumab for microsatellite-instable tumors. In parallel, landmark studies have established the prognostic significance of the CRC tumor-infiltrating lymphocyte and the clinical impact of the tumor immune microenvironment. As a result, there is a growing appreciation for immunogenomics, the interconnected relation between tumor genomics and the immune microenvironment. The clinical implications of CRC immunogenomics continue to expand, and it will likely serve as a guide for next-generation immunotherapy strategies for improving outcomes for this disease. Cancer 2018;124:1650-9. © 2018 American Cancer Society. © 2018 American Cancer Society.

Central Hyperexcitability in Chronic Musculoskeletal Pain: A Conceptual Breakthrough with Multiple Clinical Implications

Directory of Open Access Journals (Sweden)

Jan Lidbeck

2002-01-01

Full Text Available Recent investigations of dysfunctional pain processing in the central nervous system have contributed much knowledge about the development of chronic musculoskeletal pain. Many common chronic musculoskeletal pain syndromes - including regional myofascial pain syndromes, whiplash pain syndromes, refractory work-related neck-shoulder pain, certain types of chronic low back pain, fibromyalgia and others - may essentially be explained by abnormalities in central pain modulation. The growing awareness of dysfunctional central pain modulation may be a conceptual breakthrough leading to a better understanding of common chronic pain disorders. A new paradigm will have multiple clinical implications, including re-evaluation of clinical practice routines and rehabilitation methods, and will focus on controversial issues of medicolegal concern. The concept of dysfunctional central pain processing will also necessitate a mechanism-based classification of pain for the selection of individual treatment and rehabilitation programs for subgroups of patients with chronic musculoskeletal pain due to different pathophysiological mechanisms.

Revisiting deforestation in Africa (1990–2010): One more lost ...

African Journals Online (AJOL)

This spotlight revisits the dynamics and prognosis outlined in the late 1980's published in Déforestation en Afrique. This book on deforestation in Africa utilized available statistical data from the 1980's and was a pioneering self - styled attempt to provide a holistic viewpoint of the ongoing trends pertaining to deforestation in ...

Revisiting Individual Creativity Assessment: Triangulation in Subjective and Objective Assessment Methods

Science.gov (United States)

Park, Namgyoo K.; Chun, Monica Youngshin; Lee, Jinju

2016-01-01

Compared to the significant development of creativity studies, individual creativity research has not reached a meaningful consensus regarding the most valid and reliable method for assessing individual creativity. This study revisited 2 of the most popular methods for assessing individual creativity: subjective and objective methods. This study…

Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

International Nuclear Information System (INIS)

Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M.

2016-01-01

Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE

Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

Energy Technology Data Exchange (ETDEWEB)

Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

2016-01-15

Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications.

Science.gov (United States)

Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

2016-01-01

Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

Life quality index revisited

DEFF Research Database (Denmark)

Ditlevsen, Ove Dalager

2004-01-01

The derivation of the life quality index (LQI) is revisited for a revision. This revision takes into account the unpaid but necessary work time needed to stay alive in clean and healthy conditions to be fit for effective wealth producing work and to enjoyable free time. Dimension analysis...... at birth should not vary between countries. Finally the distributional assumptions are relaxed as compared to the assumptions made in an earlier work by the author. These assumptions concern the calculation of the life expectancy change due to the removal of an accident source. Moreover a simple public...... consistency problems with the standard power function expression of the LQI are pointed out. It is emphasized that the combination coefficient in the convex differential combination between the relative differential of the gross domestic product per capita and the relative differential of the expected life...

Klein's double discontinuity revisited

DEFF Research Database (Denmark)

Winsløw, Carl; Grønbæk, Niels

2014-01-01

Much effort and research has been invested into understanding and bridging the ‘gaps’ which many students experience in terms of contents and expectations as they begin university studies with a heavy component of mathematics, typically in the form of calculus courses. We have several studies...... of bridging measures, success rates and many other aspects of these “entrance transition” problems. In this paper, we consider the inverse transition, experienced by university students as they revisit core parts of high school mathematics (in particular, calculus) after completing the undergraduate...... mathematics courses which are mandatory to become a high school teacher of mathematics. To what extent does the “advanced” experience enable them to approach the high school calculus in a deeper and more autonomous way ? To what extent can “capstone” courses support such an approach ? How could it be hindered...

Clinical errors and therapist discomfort with client disclosure of troublesome pornography use: Implications for clinical practice and error reduction.

Science.gov (United States)

Walters, Nathan T; Spengler, Paul M

2016-09-01

Mental health professionals are increasingly aware of the need for competence in the treatment of clients with pornography-related concerns. However, while researchers have recently sought to explore efficacious treatments for pornography-related concerns, few explorations of potential clinical judgment issues have occurred. Due to the sensitive, and at times uncomfortable, nature of client disclosures of sexual concerns within therapy, therapists are required to manage their own discomfort while retaining fidelity to treatment. The present paper explores clinician examples of judgment errors that may result from feelings of discomfort, and specifically from client use of pornography. Issues of potential bias, bias management techniques, and therapeutic implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Emerging roles of innate lymphoid cells in inflammatory diseases: Clinical implications.

Science.gov (United States)

Kortekaas Krohn, I; Shikhagaie, M M; Golebski, K; Bernink, J H; Breynaert, C; Creyns, B; Diamant, Z; Fokkens, W J; Gevaert, P; Hellings, P; Hendriks, R W; Klimek, L; Mjösberg, J; Morita, H; Ogg, G S; O'Mahony, L; Schwarze, J; Seys, S F; Shamji, M H; Bal, S M

2018-04-01

Innate lymphoid cells (ILC) represent a group of lymphocytes that lack specific antigen receptors and are relatively rare as compared to adaptive lymphocytes. ILCs play important roles in allergic and nonallergic inflammatory diseases due to their location at barrier surfaces within the airways, gut, and skin, and they respond to cytokines produced by activated cells in their local environment. Innate lymphoid cells contribute to the immune response by the release of cytokines and other mediators, forming a link between innate and adaptive immunity. In recent years, these cells have been extensively characterized and their role in animal models of disease has been investigated. Data to translate the relevance of ILCs in human pathology, and the potential role of ILCs in diagnosis, as biomarkers and/or as future treatment targets are also emerging. This review, produced by a task force of the Immunology Section of the European Academy of Allergy and Clinical Immunology (EAACI), encompassing clinicians and researchers, highlights the role of ILCs in human allergic and nonallergic diseases in the airways, gastrointestinal tract, and skin, with a focus on new insights into clinical implications, therapeutic options, and future research opportunities. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications

Science.gov (United States)

Santamaría-García, Hernando; Santangelo, Gabriella

2018-01-01

Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM), emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs), most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients' management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD), or may emerge during the disease course as critical aspects, such as for Parkinson's and Alzheimer's diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients' well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits. PMID:29854017

Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications

Directory of Open Access Journals (Sweden)

Foteini Christidi

2018-01-01

Full Text Available Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM, emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs, most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients’ management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD, or may emerge during the disease course as critical aspects, such as for Parkinson’s and Alzheimer’s diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients’ well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits.

Rereading Albert B. Lord's The Singer of Tales . Revisiting the ...

African Journals Online (AJOL)

Access to a fresh set of video-recordings of Sesotho praise-poetry made in the year 2000 enabled the author to revisit his adaptation of Albert Lord's definition of the formula as a dynamic compositional device that the oral poet utilizes during delivery. The basic adaptation made in 1983 pertains to heroic praises (dithoko tsa ...

Re-Visit to the School Nurse and Adolescents' Medicine Use

Science.gov (United States)

Borup, Ina K.; Andersen, Anette; Holstein, Bjorn E.

2011-01-01

Objective: To examine if students who re-visit the school nurse use medicines differently than other students when exposed to aches and psychological problems. Methods: The study includes all 11-, 13- and 15-year-old students from a random sample of schools in Denmark, response rate 87 per cent, n = 5,205. The data collection followed the…

An analytic algorithm for global coverage of the revisiting orbit and its application to the CFOSAT satellite

Science.gov (United States)

Xu, Ming; Huang, Li

2014-08-01

This paper addresses a new analytic algorithm for global coverage of the revisiting orbit and its application to the mission revisiting the Earth within long periods of time, such as Chinese-French Oceanic Satellite (abbr., CFOSAT). In the first, it is presented that the traditional design methodology of the revisiting orbit for some imaging satellites only on the single (ascending or descending) pass, and the repeating orbit is employed to perform the global coverage within short periods of time. However, the selection of the repeating orbit is essentially to yield the suboptimum from the rare measure of rational numbers of passes per day, which will lose lots of available revisiting orbits. Thus, an innovative design scheme is proposed to check both rational and irrational passes per day to acquire the relationship between the coverage percentage and the altitude. To improve the traditional imaging only on the single pass, the proposed algorithm is mapping every pass into its ascending and descending nodes on the specified latitude circle, and then is accumulating the projected width on the circle by the field of view of the satellite. The ergodic geometry of coverage percentage produced from the algorithm is affecting the final scheme, such as the optimal one owning the largest percentage, and the balance one possessing the less gradient in its vicinity, and is guiding to heuristic design for the station-keeping control strategies. The application of CFOSAT validates the feasibility of the algorithm.

Clinical neurofeedback: case studies, proposed mechanism, and implications for pediatric neurology practice.

Science.gov (United States)

Legarda, Stella B; McMahon, Doreen; Othmer, Siegfried; Othmer, Sue

2011-08-01

Trends in alternative medicine use by American health care consumers are rising substantially. Extensive literature exists reporting on the effectiveness of neurofeedback in the treatment of autism, closed head injury, insomnia, migraine, depression, attention deficit hyperactivity disorder, epilepsy, and posttraumatic stress disorder. We speculated that neurofeedback might serve as a therapeutic modality for patients with medically refractory neurological disorders and have begun referring patients to train with clinical neurofeedback practitioners. The modality is not always covered by insurance. Confident their child's medical and neurological needs would continue to be met, the parents of 3 children with epilepsy spectrum disorder decided to have their child train in the modality. The children's individual progress following neurofeedback are each presented here. A proposed mechanism and practice implications are discussed.

Clinical and public health implications of acute and early HIV detection and treatment: a scoping review.

Science.gov (United States)

Rutstein, Sarah E; Ananworanich, Jintanat; Fidler, Sarah; Johnson, Cheryl; Sanders, Eduard J; Sued, Omar; Saez-Cirion, Asier; Pilcher, Christopher D; Fraser, Christophe; Cohen, Myron S; Vitoria, Marco; Doherty, Meg; Tucker, Joseph D

2017-06-28

The unchanged global HIV incidence may be related to ignoring acute HIV infection (AHI). This scoping review examines diagnostic, clinical, and public health implications of identifying and treating persons with AHI. We searched PubMed, in addition to hand-review of key journals identifying research pertaining to AHI detection and treatment. We focused on the relative contribution of AHI to transmission and the diagnostic, clinical, and public health implications. We prioritized research from low- and middle-income countries (LMICs) published in the last fifteen years. Extensive AHI research and limited routine AHI detection and treatment have begun in LMIC. Diagnostic challenges include ease-of-use, suitability for application and distribution in LMIC, and throughput for high-volume testing. Risk score algorithms have been used in LMIC to screen for AHI among individuals with behavioural and clinical characteristics more often associated with AHI. However, algorithms have not been implemented outside research settings. From a clinical perspective, there are substantial immunological and virological benefits to identifying and treating persons with AHI - evading the irreversible damage to host immune systems and seeding of viral reservoirs that occurs during untreated acute infection. The therapeutic benefits require rapid initiation of antiretrovirals, a logistical challenge in the absence of point-of-care testing. From a public health perspective, AHI diagnosis and treatment is critical to: decrease transmission via viral load reduction and behavioural interventions; improve pre-exposure prophylaxis outcomes by avoiding treatment initiation for HIV-seronegative persons with AHI; and, enhance partner services via notification for persons recently exposed or likely transmitting. There are undeniable clinical and public health benefits to AHI detection and treatment, but also substantial diagnostic and logistical barriers to implementation and scale-up. Effective

Revisiting the incidence of Mg II absorbers along the blazar sightlines

Science.gov (United States)

Mishra, Sapna; Chand, Hum; Gopal-Krishna; Joshi, Ravi

2018-04-01

It is believed that the cool gas clouds traced by Mg II absorption, within a velocity offset of 5000 km/s from the background quasar, are associated with the quasar itself, whereas the absorbers seen at larger velocity offsets towards us are intervening systems and hence their existence is completely independent of the background quasar. Recent evidence by Bergeron et al. 2011 (hereafter BBM), however, seriously questions this canonical view, by showing that the number density of intervening Mg II absorbers along the sightlines towards 45 blazars is, on average, 2 times the expectation based on the Mg II absorption systems seen on the sightlines to normal QSOs. Given the serious implications of this finding, it becomes important to revisit this issue by enlarging the source sample and subjecting it to an independent analysis. Here, we first report our results based on a re-analysis of the spectroscopic data for the BBM sample; this has reproduced their factor 2 excess in dN/dz along blazar sightlines, vis-a-vis the normal QSOs. Next, we assemble a 6 times larger sample of blazar sightlines, albeit with lower SNR. Using this enlarged sample together with the BBM sample, our analysis shows that the dN/dz of Mg II absorbers statistically matches that known for normal QSO sightlines.

Neurobiology and clinical implications of lucid dreaming.

Science.gov (United States)

Mota-Rolim, Sérgio A; Araujo, John F

2013-11-01

Several lines of evidence converge to the idea that rapid eye movement sleep (REMS) is a good model to foster our understanding of psychosis. Both REMS and psychosis course with internally generated perceptions and lack of rational judgment, which is attributed to a hyperlimbic activity along with hypofrontality. Interestingly, some individuals can become aware of dreaming during REMS, a particular experience known as lucid dreaming (LD), whose neurobiological basis is still controversial. Since the frontal lobe plays a role in self-consciousness, working memory and attention, here we hypothesize that LD is associated with increased frontal activity during REMS. A possible way to test this hypothesis is to check whether transcranial magnetic or electric stimulation of the frontal region during REMS triggers LD. We further suggest that psychosis and LD are opposite phenomena: LD as a physiological awakening while dreaming due to frontal activity, and psychosis as a pathological intrusion of dream features during wake state due to hypofrontality. We further suggest that LD research may have three main clinical implications. First, LD could be important to the study of consciousness, including its pathologies and other altered states. Second, LD could be used as a therapy for recurrent nightmares, a common symptom of depression and post-traumatic stress disorder. Finally, LD may allow for motor imagery during dreaming with possible improvement of physical rehabilitation. In all, we believe that LD research may clarify multiple aspects of brain functioning in its physiological, altered and pathological states. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ecological caring-Revisiting the original ideas of caring science.

Science.gov (United States)

Dahlberg, Helena; Ranheim, Albertine; Dahlberg, Karin

2016-01-01

The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew . Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it.

Ecological caring—Revisiting the original ideas of caring science

Directory of Open Access Journals (Sweden)

Helena Dahlberg

2016-11-01

Full Text Available The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew. Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it.

Ecological caring—Revisiting the original ideas of caring science

Science.gov (United States)

Dahlberg, Helena; Ranheim, Albertine; Dahlberg, Karin

2016-01-01

The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew. Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it. PMID:27914196

The Peter Effect Revisited: Reading Habits and Attitudes of College Students

Science.gov (United States)

Applegate, Anthony J.; Applegate, Mary DeKonty; Mercantini, Martha A.; McGeehan, Catherine M.; Cobb, Jeanne B.; DeBoy, Joanne R.; Modla, Virginia B.; Lewinski, Kimberly E.

2014-01-01

Certainly a primary goal of literacy education is the creation of avid, enthusiastic, and highly motivated readers. However, in this article revisiting the Peter Effect (Applegate & Applegate, 2004), researchers surveyed more than 1,000 college sophomores and found strikingly low levels of enthusiasm for reading. Only 46.6% of surveyed…

[Network clusters of symptoms as elementary syndromes of psychopathology: implications for clinical practice].

Science.gov (United States)

Goekoop, R; Goekoop, J G

2016-01-01

In a recent publication we reported the existence of around 11 (to 15) 'elementary syndromes' that may combine in various ways, rather like 'building blocks', to explain the wide range of psychiatric symptoms. 'Bridge symptoms' seem to be responsible both for combining large sets of symptoms into elementary syndromes and for combining the various elementary syndromes to form one globally connected network structure. To discuss the implication of these findings for clinical practice. We performed a network analysis of symptom scores. Elementary syndromes provide a massive simplification of the description of psychiatric disease. Instead of the more than 300 categories in DSM-5, we now need to consider only a handful of elementary syndromes and personality domains. This modular representation of psychiatric illnesses allows us to make a complete, systematic and efficient assessment of patients and a systematic review of treatment options. Clinicians, patients, managerial staff and insurance companies can verify whether symptom reduction is taking place in the most important domains of psychopathology. Unlike classic multidimensional methods of disease description, network models of psychopathology can be used to explain comorbidity patterns, predict the clinical course of psychopathology and to designate primary targets for therapeutic interventions. A network view on psychopathology could significantly improve everyday clinical practice.

Ambulatory thyroidectomy: A multistate study of revisits and complications

OpenAIRE

Orosco, RK; Lin, HW; Bhattacharyya, N

2015-01-01

© 2015 American Academy of Otolaryngology - Head and Neck Surgery Foundation. Objective. Determine rates and reasons for revisits after ambulatory adult thyroidectomy. Study Design. Cross-sectional analysis of multistate ambulatory surgery and hospital databases. Setting. Ambulatory surgery data from the State Ambulatory Surgery Databases of California, Florida, Iowa, and New York for calendar years 2010 and 2011. Subjects and Methods. Ambulatory thyroidectomy cases were linked to state ambul...

Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

Directory of Open Access Journals (Sweden)

Eleni Theocharidou

2017-01-01

Full Text Available Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation. The latter has been implicated in the pathophysiology of hepatic encephalopathy and spontaneous bacterial peritonitis. Enhanced colonic motility is usually associated with the use of lactulose. Pharmacological interventions aiming to alter gastrointestinal motility in cirrhosis could potentially have a beneficial effect reducing the risk of hepatic decompensation and improving prognosis.

Taï chimpanzees anticipate revisiting high-valued fruit trees from further distances.

Science.gov (United States)

Ban, Simone D; Boesch, Christophe; Janmaat, Karline R L

2014-11-01

The use of spatio-temporal memory has been argued to increase food-finding efficiency in rainforest primates. However, the exact content of this memory is poorly known to date. This study investigated what specific information from previous feeding visits chimpanzees (Pan troglodytes verus), in Taï National Park, Côte d'Ivoire, take into account when they revisit the same feeding trees. By following five adult females for many consecutive days, we tested from what distance the females directed their travels towards previously visited feeding trees and how previous feeding experiences and fruit tree properties influenced this distance. To exclude the influence of sensory cues, the females' approach distance was measured from their last significant change in travel direction until the moment they entered the tree's maximum detection field. We found that chimpanzees travelled longer distances to trees at which they had previously made food grunts and had rejected fewer fruits compared to other trees. In addition, the results suggest that the chimpanzees were able to anticipate the amount of fruit that they would find in the trees. Overall, our findings are consistent with the hypothesis that chimpanzees act upon a retrieved memory of their last feeding experiences long before they revisit feeding trees, which would indicate a daily use of long-term prospective memory. Further, the results are consistent with the possibility that positive emotional experiences help to trigger prospective memory retrieval in forest areas that are further away and have fewer cues associated with revisited feeding trees.

Clinical implications of microRNAs in human glioblastoma

Directory of Open Access Journals (Sweden)

Masahiro eMizoguchi

2013-02-01

Full Text Available Glioblastoma (GBM is one of the most common and dismal brain tumors in adults. Further elucidation of the molecular pathogenesis of GBM is mandatory to improve the overall survival of patients. A novel small non-coding RNA molecule, microRNA (miRNA, appears to represent one of the most attractive target molecules contributing to the pathogenesis of various types of tumors. Recent global analyses have revealed that several miRNAs are clinically implicated in GBM, with some reports indicating the association of miRNA dysregulation with acquired temozolomide (TMZ resistance. More recent studies have revealed that miRNAs could play a role in cancer stem cell (CSC properties, contributing to treatment resistance. In addition, greater impact might be expected from miRNA-targeted therapies based on tumor-derived exosomes that contain numerous functional miRNAs, which could be transferred between tumor cells and surrounding structures. Tumor-derived miRNAs are now considered to be a novel molecular mechanism promoting the progression of GBM. Establishment of miRNA-targeted therapies based on miRNA dysregulation of CSCs could provide effective therapeutic strategies for TMZ-resistant GBM. Recent progress has revealed that miRNAs are not only putative biological markers for diagnosis, but also one of the most promising targets for GBM treatment. Herein, we summarize the translational aspects of miRNAs in the diagnosis and treatment of GBM.

The Lumbar Lordosis in Males and Females, Revisited.

Directory of Open Access Journals (Sweden)

Ori Hay

Full Text Available Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females.Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height.Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined.Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis. The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

The Lumbar Lordosis in Males and Females, Revisited.

Science.gov (United States)

Hay, Ori; Dar, Gali; Abbas, Janan; Stein, Dan; May, Hila; Masharawi, Youssef; Peled, Nathan; Hershkovitz, Israel

2015-01-01

Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females. Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height. Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined). Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis). The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

High precision mass measurements in Ψ and Υ families revisited

International Nuclear Information System (INIS)

Artamonov, A.S.; Baru, S.E.; Blinov, A.E.

2000-01-01

High precision mass measurements in Ψ and Υ families performed in 1980-1984 at the VEPP-4 collider with OLYA and MD-1 detectors are revisited. The corrections for the new value of the electron mass are presented. The effect of the updated radiative corrections has been calculated for the J/Ψ(1S) and Ψ(2S) mass measurements [ru

Continuing medical education revisited: theoretical assumptions and practical implications: a qualitative study.

Science.gov (United States)

Dionyssopoulos, Alexander; Karalis, Thanassis; Panitsides, Eugenia A

2014-12-31

Recent research has evidenced that although investment in Continuing Medical Education (CME), both in terms of participation as well as financial resources allocated to it, has been steadily increasing to catch up with accelerating advances in health information and technology, effectiveness of CME is reported to be rather limited. Poor and disproportional returns can be attributed to failure of CME courses to address and stimulate an adult audience. The present study initially drew on research findings and adult learning theories, providing the basis for comprehending adult learning, while entailing practical implications on fostering effectiveness in the design and delivery of CME. On a second level, a qualitative study was conducted with the aim to elucidate parameters accounting for effectiveness in educational interventions. Qualitative data was retrieved through 12 in-depth interviews, conducted with a random sample of participants in the 26th European Workshop of Advanced Plastic Surgery (EWAPS). The data underwent a three level qualitative analysis, following the "grounded theory" methodology, comprising 'open coding', 'axial coding' and 'selective coding'. Findings from the EWAPS study come in line with relevant literature, entailing significant implications for the necessity to apply a more effective and efficient paradigm in the design and delivery of educational interventions, advocating for implementing learner-centered schemata in CME and benefiting from a model that draws on the learning environment and social aspects of learning. What emerged as a pivotal parameter in designing educational interventions is to focus on small group educational events which could provide a supportive friendly context, enhance motivation through learner-centered approaches and allow interaction, experimentation and critical reflection. It should be outlined however that further research is required as the present study is limited in scope, having dealt with a limited

Octogenarians' post-acute care use after cardiac valve surgery and recovery: clinical implications.

Science.gov (United States)

Edmiston, Elizabeth; Dolansky, Mary A; Zullo, Melissa; Forman, Daniel E

2017-12-21

Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery. We propose expansion of the Geriatric Cardiac Care model to include broader clinical therapy dynamics. The sample (n = 10,062) included patients over 80 years discharged from acute care following valve surgery. Post-acute care services were used by 68% of octagarians following cardiac valve surgery (1% intermediate rehabilitation, 35% skilled nursing facility, 32% home health). The large percentage of octagarians using PAC point to the importance of integrating geriatric cardiac care into post-acute services to optimize recovery outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Commentary on "Distributed Revisiting: An Analytic for Retention of Coherent Science Learning"

Science.gov (United States)

Hewitt, Jim

2015-01-01

The article, "Distributed Revisiting: An Analytic for Retention of Coherent Science Learning" is an interesting study that operates at the intersection of learning theory and learning analytics. The authors observe that the relationship between learning theory and research in the learning analytics field is constrained by several…

Double digest revisited : Complexity and Approximability in the Presence of Noisy Data

NARCIS (Netherlands)

Cieliebak, Mark; Eidenbenz, Stephan; Woeginger, Gerhard; Warnow, Tandy; Zhu, Binhai

2003-01-01

We revisit the Double Digest problem, which occurs in sequencing of large DNA strings and consists of reconstructing the relative positions of cut sites from two different enzymes: we first show that Double Digest is strongly NP-complete, improving upon previous results that only showed weak

First-principles lattice-gas Hamiltonian revisited: O-Pd(100)

OpenAIRE

Kappus, Wolfgang

2016-01-01

The methodology of deriving an adatom lattice-gas Hamiltonian (LGH) from first principles (FP) calculations is revisited. Such LGH cluster expansions compute a large set of lateral pair-, trio-, quarto interactions by solving a set of linear equations modelling regular adatom configurations and their FP energies. The basic assumption of truncating interaction terms beyond fifth nearest neighbors does not hold when adatoms show longer range interactions, e.g. substrate mediated elastic interac...

Concordance: Design Ideal for Facilitating Situated Negotiations in Out-of-clinic Healthcare

DEFF Research Database (Denmark)

Bagalkot, Naveen L.; Gronvall, Erik; Sokoler, Tomas

2014-01-01

Healthcare HCI research has explored various designs that encourage people to follow prescribed treatments, mostly adopting compliance and adherence as design ideals. However, within the medical sciences the notion of concordance also exists. Concordance promotes negotiation between the patient...... and healthcare professional for forging a therapeutic alliance. However, the HCI community has still not adopted concordance as a design ideal. This paper revisits four old design-cases to explore the role of concordance in out-of-clinic healthcare. We argue that concordance, as a design ideal, can guide new...... designs that promote a more active patient-role both at the clinic and beyond....

Current computational modelling trends in craniomandibular biomechanics and their clinical implications.

Science.gov (United States)

Hannam, A G

2011-03-01

Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus. © 2010 Blackwell Publishing Ltd.

Analytical Methods for Quantification of Vitamin D and Implications for Research and Clinical Practice.

Science.gov (United States)

Stokes, Caroline S; Lammert, Frank; Volmer, Dietrich A

2018-02-01

A plethora of contradictory research surrounds vitamin D and its influence on health and disease. This may, in part, result from analytical difficulties with regard to measuring vitamin D metabolites in serum. Indeed, variation exists between analytical techniques and assays used for the determination of serum 25-hydroxyvitamin D. Research studies into the effects of vitamin D on clinical endpoints rely heavily on the accurate assessment of vitamin D status. This has important implications, as findings from vitamin D-related studies to date may potentially have been hampered by the quantification techniques used. Likewise, healthcare professionals are increasingly incorporating vitamin D testing and supplementation regimens into their practice, and measurement errors may be also confounding the clinical decisions. Importantly, the Vitamin D Standardisation Programme is an initiative that aims to standardise the measurement of vitamin D metabolites. Such a programme is anticipated to eliminate the inaccuracies surrounding vitamin D quantification. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

Directory of Open Access Journals (Sweden)

David Filgueiras-Rama

2013-01-01

Full Text Available Obstructive sleep apnea (OSA is a common disorder characterized by repetitive interruption of ventilation during sleep caused by recurrent upper airway collapse, which leads to intermittent hypoxia. The disorder is commonly undiagnosed despite its relationship with substantial cardiovascular morbidity and mortality. Moreover, the effects of the disorder appear to be particularly dangerous in young subjects. In the last decade, substantial clinical evidence has identified OSA as independent risk factor for both bradyarrhythmias and tachyarrhythmias. To date the mechanisms leading to such arrhythmias have not been completely understood. However, recent data from animal models and new molecular analyses have increased our knowledge of the field, which might lead to future improvement in current therapeutic strategies mainly based on continuous positive airway pressure. This paper aims at providing readers a brief and specific revision of current knowledge about the mechanisms underlying atrial arrhythmias in OSA and their clinical and therapeutic implications.

Advanced Change Theory Revisited: An Article Critique

Directory of Open Access Journals (Sweden)

R. Scott Pochron

2008-12-01

Full Text Available The complexity of life in 21st century society requires new models for leading and managing change. With that in mind, this paper revisits the model for Advanced Change Theory (ACT as presented by Quinn, Spreitzer, and Brown in their article, “Changing Others Through Changing Ourselves: The Transformation of Human Systems” (2000. The authors present ACT as a potential model for facilitating change in complex organizations. This paper presents a critique of the article and summarizes opportunities for further exploring the model in the light of current trends in developmental and integral theory.

Revisiting fifth forces in the Galileon model

Energy Technology Data Exchange (ETDEWEB)

Burrage, Clare [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Gruppe Theorie; Seery, David [Sussex Univ., Brighton (United Kingdom). Dept. of Physics and Astronomy

2010-05-15

A Galileon field is one which obeys a spacetime generalization of the non- relativistic Galilean invariance. Such a field may possess non-canonical kinetic terms, but ghost-free theories with a well-defined Cauchy problem exist, constructed using a finite number of relevant operators. The interactions of this scalar with matter are hidden by the Vainshtein effect, causing the Galileon to become weakly coupled near heavy sources. We revisit estimates of the fifth force mediated by a Galileon field, and show that the parameters of the model are less constrained by experiment than previously supposed. (orig.)

Large J expansion in ABJM theory revisited.

Science.gov (United States)

Dimov, H; Mladenov, S; Rashkov, R C

Recently there has been progress in the computation of the anomalous dimensions of gauge theory operators at strong coupling by making use of the AdS/CFT correspondence. On the string theory side they are given by dispersion relations in the semiclassical regime. We revisit the problem of a large-charge expansion of the dispersion relations for simple semiclassical strings in an [Formula: see text] background. We present the calculation of the corresponding anomalous dimensions of the gauge theory operators to an arbitrary order using three different methods. Although the results of the three methods look different, power series expansions show their consistency.

The power reinforcement framework revisited

DEFF Research Database (Denmark)

Nielsen, Jeppe; Andersen, Kim Normann; Danziger, James N.

2016-01-01

Whereas digital technologies are often depicted as being capable of disrupting long-standing power structures and facilitating new governance mechanisms, the power reinforcement framework suggests that information and communications technologies tend to strengthen existing power arrangements within...... public organizations. This article revisits the 30-yearold power reinforcement framework by means of an empirical analysis on the use of mobile technology in a large-scale programme in Danish public sector home care. It explores whether and to what extent administrative management has controlled decision......-making and gained most benefits from mobile technology use, relative to the effects of the technology on the street-level workers who deliver services. Current mobile technology-in-use might be less likely to be power reinforcing because it is far more decentralized and individualized than the mainly expert...

Revisiting the Master-Signifier, or, Mandela and Repression.

Science.gov (United States)

Hook, Derek; Vanheule, Stijn

2015-01-01

The concept of the master-signifier has been subject to a variety of applications in Lacanian forms of political discourse theory and ideology critique. While there is much to be commended in literature of this sort, it often neglects salient issues pertaining to the role of master signifiers in the clinical domain of (individual) psychical economy. The popularity of the concept of the master (or "empty") signifier in political discourse analysis has thus proved a double-edged sword. On the one hand it demonstrates how crucial psychical processes are performed via the operations of the signifier, extending thus the Lacanian thesis that identification is the outcome of linguistic and symbolic as opposed to merely psychological processes. On the other, the use of the master signifier concept within the political realm to track discursive formations tends to distance the term from the dynamics of the unconscious and operation of repression. Accordingly, this paper revisits the master signifier concept, and does so within the socio-political domain, yet while paying particular attention to the functioning of unconscious processes of fantasy and repression. More specifically, it investigates how Nelson Mandela operates as a master signifier in contemporary South Africa, as a vital means of knitting together diverse elements of post-apartheid society, enabling the fantasy of the post-apartheid nation, and holding at bay a whole series of repressed and negated undercurrents.

Clinical leadership in contemporary clinical practice: implications for nursing in Australia.

Science.gov (United States)

Davidson, P M; Elliott, D; Daly, J

2006-04-01

Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.

Effects of a Structured Discharge Planning Program on Perceived Functional Status, Cardiac Self-efficacy, Patient Satisfaction, and Unexpected Hospital Revisits Among Filipino Cardiac Patients: A Randomized Controlled Study.

Science.gov (United States)

Cajanding, Ruff Joseph

Cardiovascular diseases remain the leading cause of morbidity and mortality among Filipinos and are responsible for a very large number of hospital readmissions. Comprehensive discharge planning programs have demonstrated positive benefits among various populations of patients with cardiovascular disease, but the clinical and psychosocial effects of such intervention among Filipino patients with acute myocardial infarction (AMI) have not been studied. In this study we aimed to determine the effectiveness of a nurse-led structured discharge planning program on perceived functional status, cardiac self-efficacy, patient satisfaction, and unexpected hospital revisits among Filipino patients with AMI. A true experimental (randomized control) 2-group design with repeated measures and data collected before and after intervention and at 1-month follow-up was used in this study. Participants were assigned to either the control (n = 68) or the intervention group (n = 75). Intervention participants underwent a 3-day structured discharge planning program implemented by a cardiovascular nurse practitioner, which is comprised of a series of individualized lecture-discussion, provision of feedback, integrative problem solving, goal setting, and action planning. Control participants received standard routine care. Measures of functional status, cardiac self-efficacy, and patient satisfaction were measured at baseline; cardiac self-efficacy and patient satisfaction scores were measured prior to discharge, and perceived functional status and number of revisits were measured 1 month after discharge. Participants in the intervention group had significant improvement in functional status, cardiac self-efficacy, and patient satisfaction scores at baseline and at follow-up compared with the control participants. Furthermore, participants in the intervention group had significantly fewer hospital revisits compared with those who received only standard care. The results demonstrate that a

Revisit boundary conditions for the self-adjoint angular flux formulation

Energy Technology Data Exchange (ETDEWEB)

Wang, Yaqi [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick N. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-03-01

We revisit the boundary conditions for SAAF. We derived the equivalent parity variational form ready for coding up. The more rigorous approach of evaluating odd parity should be solving the odd parity equation coupled with the even parity. We proposed a symmetric reflecting boundary condition although neither positive definiteness nor even-odd decoupling is achieved. A simple numerical test verifies the validity of these boundary conditions.

Place attachment and social legitimacy: Revisiting the sustainable entrepreneurship journey

OpenAIRE

Kibler, E; Fink, M; Lang, R; Munoz, PA

2015-01-01

This paper revisits the sustainable entrepreneurship journey by introducing a ‘place- based’ sustainable venture path model. We suggest that distinguishing between emo- tional (‘caring about the place’) and instrumental (‘using the place’) place attachment of sustainable entrepreneurs deepens our understanding of how place-based challenges of sustainable venture legitimacy are managed over time. We conclude with avenues for future sustainable entrepreneurship research.

Teacher Communication Concerns Revisited: Calling into Question the Gnawing Pull towards Equilibrium

Science.gov (United States)

Dannels, Deanna P.

2015-01-01

This study revisits the long-standing teacher communication concerns framework originating over three decades ago. Analysis of 10 years of contemporary GTA teacher communication concerns reveals a typology of 10 concerns, which taken together construct teaching as a process of negotiating relationships, managing identities, and focusing attention.…

Revisiting Learning in Higher Education--Framing Notions Redefined through an Ecological Perspective

Science.gov (United States)

Damsa, Crina; Jornet, Alfredo

2016-01-01

This article employs an ecological perspective as a means of revisiting the notion of learning, with a particular focus on learning in higher education. Learning is reconceptualised as a process entailing mutually constitutive, epistemic, social and affective relations in which knowledge, identity and agency become collective achievements of whole…

NICE guidelines, clinical practice and antisocial personality disorder: the ethical implications of ontological uncertainty.

Science.gov (United States)

Pickersgill, M D

2009-11-01

The British National Institute for Health and Clinical Excellence (NICE) has recently (28 January 2009) released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder (ASPD). Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising uncertainty, NICE risks reifying a controversial category. This is particularly problematical given that the guidelines recommend the identification of individuals "at risk" of raising antisocial children. Although this paper does not argue that NICE is "wrong" in any of its recommendations, more emphasis should have been placed on discussions of the ethical implications of diagnosis and treatment, especially given the multiple uncertainties associated with ASPD. It is proposed that these important issues be examined in more detail in revisions of existing NICE recommendations, and be included in upcoming guidance. This paper thus raises key questions regarding the place and role of ethics within the current and future remit of NICE.

Lorentz violation naturalness revisited

Energy Technology Data Exchange (ETDEWEB)

Belenchia, Alessio; Gambassi, Andrea; Liberati, Stefano [SISSA - International School for Advanced Studies, via Bonomea 265, 34136 Trieste (Italy); INFN, Sezione di Trieste, via Valerio 2, 34127 Trieste (Italy)

2016-06-08

We revisit here the naturalness problem of Lorentz invariance violations on a simple toy model of a scalar field coupled to a fermion field via a Yukawa interaction. We first review some well-known results concerning the low-energy percolation of Lorentz violation from high energies, presenting some details of the analysis not explicitly discussed in the literature and discussing some previously unnoticed subtleties. We then show how a separation between the scale of validity of the effective field theory and that one of Lorentz invariance violations can hinder this low-energy percolation. While such protection mechanism was previously considered in the literature, we provide here a simple illustration of how it works and of its general features. Finally, we consider a case in which dissipation is present, showing that the dissipative behaviour does not percolate generically to lower mass dimension operators albeit dispersion does. Moreover, we show that a scale separation can protect from unsuppressed low-energy percolation also in this case.

What are the clinical implications of nodular gastritis? Clues from histopathology.

Science.gov (United States)

Sokmensuer, Cenk; Onal, Ibrahim Koral; Yeniova, Ozgur; Ersoy, Osman; Aydinli, Musa; Yonem, Ozlem; Harmanci, Ozgur; Onal, Eda Demir; Altinok, Gulcin; Batman, Figen; Bayraktar, Yusuf

2009-10-01

There is no widely accepted histopathological definition for nodular gastritis. In this study we aim to uncover the pathologic entity responsible for the nodular appearance and to find clues about the clinical implications of nodular gastritis. Antral biopsy specimens of 160 patients with nodular gastritis and 133 patients without nodular gastritis were examined by an experienced pathologist for dysplasia, foveolar hyperplasia, inflammatory activity, intraepithelial lymphocytosis, intestinal metaplasia, and lymphoid follicle/aggregate formation, and comparative analysis was performed between the two groups of patients. The presence of intraepithelial lymphocytosis was more frequent in patients with nodular gastritis (P < 0.05). There was no difference between the two groups regarding the other pathological features such as presence of dysplasia, inflammatory activity, intestinal metaplasia, lymphoid hyperplasia, and Helicobacter pylori (H. pylori) infection. Increase of intraepithelial lymphocytes may contribute to formation of macroscopical nodules in this peculiar type of gastritis. Nodular gastritis would not indicate a new therapeutic approach in addition to the current measures for Helicobacter pylori infection.

Revisiting photodynamic therapy dosimetry: reductionist & surrogate approaches to facilitate clinical success

Science.gov (United States)

Pogue, Brian W.; Elliott, Jonathan T.; Kanick, Stephen C.; Davis, Scott C.; Samkoe, Kimberley S.; Maytin, Edward V.; Pereira, Stephen P.; Hasan, Tayyaba

2016-04-01

Photodynamic therapy (PDT) can be a highly complex treatment, with many parameters influencing treatment efficacy. The extent to which dosimetry is used to monitor and standardize treatment delivery varies widely, ranging from measurement of a single surrogate marker to comprehensive approaches that aim to measure or estimate as many relevant parameters as possible. Today, most clinical PDT treatments are still administered with little more than application of a prescribed drug dose and timed light delivery, and thus the role of patient-specific dosimetry has not reached widespread clinical adoption. This disconnect is at least partly due to the inherent conflict between the need to measure and understand multiple parameters in vivo in order to optimize treatment, and the need for expedience in the clinic and in the regulatory and commercialization process. Thus, a methodical approach to selecting primary dosimetry metrics is required at each stage of translation of a treatment procedure, moving from complex measurements to understand PDT mechanisms in pre-clinical and early phase I trials, towards the identification and application of essential dose-limiting and/or surrogate measurements in phase II/III trials. If successful, identifying the essential and/or reliable surrogate dosimetry measurements should help facilitate increased adoption of clinical PDT. In this paper, examples of essential dosimetry points and surrogate dosimetry tools that may be implemented in phase II/III trials are discussed. For example, the treatment efficacy as limited by light penetration in interstitial PDT may be predicted by the amount of contrast uptake in CT, and so this could be utilized as a surrogate dosimetry measurement to prescribe light doses based upon pre-treatment contrast. Success of clinical ALA-based skin lesion treatment is predicted almost uniquely by the explicit or implicit measurements of photosensitizer and photobleaching, yet the individualization of treatment

Quark matter revisited with non-extensive MIT bag model

Energy Technology Data Exchange (ETDEWEB)

Cardoso, Pedro H.G.; Nunes da Silva, Tiago; Menezes, Debora P. [Universidade Federal de Santa Catarina, Departamento de Fisica, CFM, Florianopolis (Brazil); Deppman, Airton [Instituto de Fisica da Universidade de Sao Paulo, Sao Paulo (Brazil)

2017-10-15

In this work we revisit the MIT bag model to describe quark matter within both the usual Fermi-Dirac and the Tsallis statistics. We verify the effects of the non-additivity of the latter by analysing two different pictures: the first order phase transition of the QCD phase diagram and stellar matter properties. While the QCD phase diagram is visually affected by the Tsallis statistics, the resulting effects on quark star macroscopic properties are barely noticed. (orig.)

My First CMC Article Revisited: A Window on Spanish L2 Interlanguage

Science.gov (United States)

Blake, Robert

2016-01-01

The computer-assisted language learning (CALL) field seems to change overnight with new technological affordances. Blake revisits his 2000 "LLT" article on computer-mediation communication (CMC) in order to reflect on how the field has examined this topic over the past decade or so. While the Interaction Hypothesis continues to guide…

The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications.

Science.gov (United States)

Lipski, M; Tomaszewska, I M; Lipska, W; Lis, G J; Tomaszewski, K A

2013-11-01

The aim of this paper is to summarise the knowledge about the anatomy, embryology and anthropology of the mandible and the mandibular foramen and also to highlight the most important clinical implications of the current studies regarding anaesthesia performed in the region of the mandible. An electronic journal search was undertaken to identify all the relevant studies published in English. The search included MEDLINE and EMBASE databases and years from 1950 to 2012. The subject search used a combination of controlled vocabulary and free text based on the search strategy for MEDLINE using key words: 'mandible', 'mandibular', 'foramen', 'anatomy', 'embryology', 'anthropology', and 'mental'. The reference lists of all the relevant studies and existing reviews were screened for additional relevant publications. Basing on relevant manuscripts, this short review about the anatomy, embryology and anthropology of the mandible and the mandibular foramen was written.

Gestational Diabetes Mellitus: a review of the diagnosis, clinical implications and management

Directory of Open Access Journals (Sweden)

Vincent Wing-Ming Wong

2013-04-01

Full Text Available Gestational diabetes mellitus (GDM is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies during pregnancy will be discussed. For years, insulin is the mainstay of treatment if medical nutrition therapy fails to maintain adequate glycaemic control, but use of other oral pharmacotherapy may gain greater acceptance in the future. Following delivery, ongoing follow-up of these women is worthwhile as early intervention through lifestyle or pharmacotherapy may prevent the development of diabetes.

The Best and the Rest: Revisiting the Norm of Normality of Individual Performance

Science.gov (United States)

O'Boyle, Ernest, Jr.; Aguinis, Herman

2012-01-01

We revisit a long-held assumption in human resource management, organizational behavior, and industrial and organizational psychology that individual performance follows a Gaussian (normal) distribution. We conducted 5 studies involving 198 samples including 633,263 researchers, entertainers, politicians, and amateur and professional athletes.…

The Levy sections theorem revisited

International Nuclear Information System (INIS)

Figueiredo, Annibal; Gleria, Iram; Matsushita, Raul; Silva, Sergio Da

2007-01-01

This paper revisits the Levy sections theorem. We extend the scope of the theorem to time series and apply it to historical daily returns of selected dollar exchange rates. The elevated kurtosis usually observed in such series is then explained by their volatility patterns. And the duration of exchange rate pegs explains the extra elevated kurtosis in the exchange rates of emerging markets. In the end, our extension of the theorem provides an approach that is simpler than the more common explicit modelling of fat tails and dependence. Our main purpose is to build up a technique based on the sections that allows one to artificially remove the fat tails and dependence present in a data set. By analysing data through the lenses of the Levy sections theorem one can find common patterns in otherwise very different data sets

The Levy sections theorem revisited

Science.gov (United States)

Figueiredo, Annibal; Gleria, Iram; Matsushita, Raul; Da Silva, Sergio

2007-06-01

This paper revisits the Levy sections theorem. We extend the scope of the theorem to time series and apply it to historical daily returns of selected dollar exchange rates. The elevated kurtosis usually observed in such series is then explained by their volatility patterns. And the duration of exchange rate pegs explains the extra elevated kurtosis in the exchange rates of emerging markets. In the end, our extension of the theorem provides an approach that is simpler than the more common explicit modelling of fat tails and dependence. Our main purpose is to build up a technique based on the sections that allows one to artificially remove the fat tails and dependence present in a data set. By analysing data through the lenses of the Levy sections theorem one can find common patterns in otherwise very different data sets.

"Rapid Revisit" Measurements of Sea Surface Winds Using CYGNSS

Science.gov (United States)

Park, J.; Johnson, J. T.

2017-12-01

The Cyclone Global Navigation Satellite System (CYGNSS) is a space-borne GNSS-R (GNSS-Reflectometry) mission that launched December 15, 2016 for ocean surface wind speed measurements. CYGNSS includes 8 small satellites in the same LEO orbit, so that the mission provides wind speed products having unprecedented coverage both in time and space to study multi-temporal behaviors of oceanic winds. The nature of CYGNSS coverage results in some locations on Earth experiencing multiple wind speed measurements within a short period of time (a "clump" of observations in time resulting in a "rapid revisit" series of measurements). Such observations could seemingly provide indications of regions experiencing rapid changes in wind speeds, and therefore be of scientific utility. Temporally "clumped" properties of CYGNSS measurements are investigated using early CYGNSS L1/L2 measurements, and the results show that clump durations and spacing vary with latitude. For example, the duration of a clump can extend as long as a few hours at higher latitudes, with gaps between clumps ranging from 6 to as high as 12 hours depending on latitude. Examples are provided to indicate the potential of changes within a clump to produce a "rapid revisit" product for detecting convective activity. Also, we investigate detector design for identifying convective activities. Results from analyses using recent CYGNSS L2 winds will be provided in the presentation.

Revisiting the phenotypic and genetic profiling of anergic T cells mediating long-term transplant tolerance.

Science.gov (United States)

You, Sylvaine; Chatenoud, Lucienne

2018-02-01

Herein our focus will be to revisit peripheral tolerance mechanisms and in particular 'active' or 'dominant' tolerance as originally defined and mediated by regulatory CD4FoxP3 T lymphocytes (Treg) and also T-cell anergy that appears as a major mainstay to support long-term allograft survival. It is at the same time interesting and rewarding that the tool that recently guided our efforts along this path is the in-vivo use of CD3 antibody, the first monoclonal introduced in the clinic (Orthoclone OKT3) about 35 years ago to treat and prevent rejection of renal allografts. Beyond their immunosuppressive activity, whenever administered judiciously, CD3 antibodies promote robust allograft tolerance through selective purging of alloreactive effectors, resetting Treg-mediated active tolerance and promoting a unique subset of anergic CD8 T cells. The new findings discussed open up new perspectives from both a fundamental and a clinical point of view. In basic research, concrete molecular signaling paths are now spotted to finely dissect the conditions that lead to the establishment and maintenance of robust T-lymphocyte anergy mediating allograft tolerance. In the clinic, this may rapidly translate into novel biomarkers to be used in parallel to the ones already available, to better adapt posttransplant immunotherapy and monitor for long-term allograft acceptance.

Re-visiting RHIC snakes: OPERA fields, n₀ dance

Energy Technology Data Exchange (ETDEWEB)

Meot, F. [Brookhaven National Lab. (BNL), Upton, NY (United States); Gupta, R. [Brookhaven National Lab. (BNL), Upton, NY (United States); Huang, H. [Brookhaven National Lab. (BNL), Upton, NY (United States); Ranjbar, V. [Brookhaven National Lab. (BNL), Upton, NY (United States); Robert-Demolaize, G. [Brookhaven National Lab. (BNL), Upton, NY (United States)

2017-09-22

In this Tech. Note RHIC snakes and stable spin direction $\\vector{n}$₀(s) are re-visited, based on OPERA-computed field maps of the former. The numerical simulations so undertaken provide various outcomes regarding RHIC optics and spin dynamics, in relation with orbital and focusing effects resulting from the use of this realistic 3-D representation of the snakes.

Variability of CSF Alzheimer's disease biomarkers: implications for clinical practice.

Directory of Open Access Journals (Sweden)

Stephanie J B Vos

Full Text Available BACKGROUND: Cerebrospinal fluid (CSF biomarkers are increasingly being used for diagnosis of Alzheimer's disease (AD. OBJECTIVE: We investigated the influence of CSF intralaboratory and interlaboratory variability on diagnostic CSF-based AD classification of subjects and identified causes of this variation. METHODS: We measured CSF amyloid-β (Aβ 1-42, total tau (t-tau, and phosphorylated tau (p-tau by INNOTEST enzyme-linked-immunosorbent assays (ELISA in a memory clinic population (n = 126. Samples were measured twice in a single or two laboratories that served as reference labs for CSF analyses in the Netherlands. Predefined cut-offs were used to classify CSF biomarkers as normal or abnormal/AD pattern. RESULTS: CSF intralaboratory variability was higher for Aβ1-42 than for t-tau and p-tau. Reanalysis led to a change in biomarker classification (normal vs. abnormal of 26% of the subjects based on Aβ1-42, 10% based on t-tau, and 29% based on p-tau. The changes in absolute biomarker concentrations were paralleled by a similar change in levels of internal control samples between different assay lots. CSF interlaboratory variability was higher for p-tau than for Aβ1-42 and t-tau, and reanalysis led to a change in biomarker classification of 12% of the subjects based on Aβ1-42, 1% based on t-tau, and 22% based on p-tau. CONCLUSIONS: Intralaboratory and interlaboratory CSF variability frequently led to change in diagnostic CSF-based AD classification for Aβ1-42 and p-tau. Lot-to-lot variation was a major cause of intralaboratory variability. This will have implications for the use of these biomarkers in clinical practice.

Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

DEFF Research Database (Denmark)

Martens, Pernille; Worm, Signe Westring; Lundgren, Bettina

2004-01-01

Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited.Martens P, Worm SW, Lundgren B, Konradsen HB, Benfield T. Department of Infectious Diseases 144, Hvidovre University Hospital, DK-2650 Hvidovre, Denmark. pernillemartens@yahoo.com BACKGROUND: Invasive infection...... with Streptococcus pneumoniae (pneumococci) causes significant morbidity and mortality. Case series and experimental data have shown that the capsular serotype is involved in the pathogenesis and a determinant of disease outcome. METHODS: Retrospective review of 464 cases of invasive disease among adults diagnosed...

Evidence behind FDA alerts for drugs with adverse cardiovascular effects: implications for clinical practice.

Science.gov (United States)

Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen

2014-01-01

The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications. © 2013 Pharmacotherapy Publications, Inc.

Clinical Implications of Associations between Headache and Gastrointestinal Disorders: A Study Using the Hallym Smart Clinical Data Warehouse.

Science.gov (United States)

Lee, Sang-Hwa; Lee, Jae-June; Kwon, Youngsuk; Kim, Jong-Ho; Sohn, Jong-Hee

2017-01-01

higher in patients with TTH compared with controls ( p  < 0.001). However, no differences were observed in the prevalence of HP infection between the groups. The observed association in this study may suggest that primary headache sufferers who experience migraines or TTH are more prone to GI disorders, which may have various clinical implications. Further research concerning the etiology of the association between headaches and GI disorders is warranted.

Rethinking dry eye disease: a perspective on clinical implications.

Science.gov (United States)

Bron, Anthony J; Tomlinson, Alan; Foulks, Gary N; Pepose, Jay S; Baudouin, Christophe; Geerling, Gerd; Nichols, Kelly K; Lemp, Michael A

2014-04-01

Publication of the DEWS report in 2007 established the state of the science of dry eye disease (DED). Since that time, new evidence suggests that a rethinking of traditional concepts of dry eye disease is in order. Specifically, new evidence on the epidemiology of the disease, as well as strategies for diagnosis, have changed the understanding of DED, which is a heterogeneous disease associated with considerable variability in presentation. These advances, along with implications for clinical care, are summarized herein. The most widely used signs of DED are poorly correlated with each other and with symptoms. While symptoms are thought to be characteristic of DED, recent studies have shown that less than 60% of subjects with other objective evidence of DED are symptomatic. Thus the use of symptoms alone in diagnosis will likely result in missing a significant percentage of DED patients, particularly with early/mild disease. This could have considerable impact in patients undergoing cataract or refractive surgery as patients with DED have less than optimal visual results. The most widely used objective signs for diagnosing DED all show greater variability between eyes and in the same eye over time compared with normal subjects. This variability is thought to be a manifestation of tear film instability which results in rapid breakup of the tearfilm between blinks and is an identifier of patients with DED. This feature emphasizes the bilateral nature of the disease in most subjects not suffering from unilateral lid or other unilateral destabilizing surface disorders. Instability of the composition of the tears also occurs in dry eye disease and shows the same variance between eyes. Finally, elevated tear osmolarity has been reported to be a global marker (present in both subtypes of the disease- aqueous-deficient dry eye and evaporative dry eye). Clinically, osmolarity has been shown to be the best single metric for diagnosis of DED and is directly related to

Revisiting Cotard’s Syndrome: Illustration of Two Psychiatric Clinical Cases

Directory of Open Access Journals (Sweden)

Lídia Sousa

2016-07-01

Full Text Available Background: Cotard’s Syndrome (CS is a rare and severe neuropsychiatric condition in which the central feature is the existence of nihilistic delusions. Controversy has ensued about the precise clinical picture Jules Cotard meant to describe and attempts have been made, more recently, not only to clarify the terminology, but also to define different types of this syndrome and explore its biological basis. Aims: We intend to briefly review the terminology, etiology, epidemiology and differential diagnosis of this syndrome, based on two clinical cases. Methods: Bibliographic search conducted through the electronic databases Medline and Gallica (French National Library, consultation of clinical records and direct interviews with the patients. Results and Conclusions: Typically the patients diagnosed with CS manifest the delusional idea that they are dying or already dead. However, it is also possible that they deny the existence of only some parts of their own body, or the functioning of some organs, and they may even sometimes deny the existence of the external world. We illustrate the case of a 66-year-old woman, diagnosed with bipolar affective disorder, admitted in the context of a severe depressive episode with psychotic symptoms, compatible with CS type II and the case of a young male aged 22, admitted due to a first  psychotic episode with schizophrenia like characteristics, presenting with nihilistic delusions compatible with CS type I.

The Assassination of John F. Kennedy: Revisiting the Medical Data

OpenAIRE

Rohrich, Rod J.; Nagarkar, Purushottam; Stokes, Mike; Weinstein, Aaron; Mantik, David W.; Jensen, J. Arthur

2014-01-01

Thank you for publishing "The Assassination of John F. Kennedy: Revisiting the Medical Data."1 The central conclusion of this study is that the assassination remains controversial and that some of the controversy must be attributable to the "reporting and handling of the medical evidence." With the greatest respect for you and Dr. Robert McClelland, let me argue that your text and on-line interviews perpetuate the central misunderstanding of the assassination and there...

Dispute Resolution and Technology: Revisiting the Justification of Conflict Management

OpenAIRE

Koulu, Riikka

2016-01-01

This study, Dispute Resolution and Technology: Revisiting the Justification of Conflict Management, belongs to the fields of procedural law, legal theory and law and technology studies. In this study the changes in dispute resolution caused by technology are evaluated. The overarching research question of this study is how does implementing technology to dispute resolution challenge the justification of law as a legitimised mode of violence? Before answering such an abstract research question...

Deja vu: The Unified Command Plan of the Future Revisited

Science.gov (United States)

2011-05-19

Approved for Public Release; Distribution is Unlimited Déjà vu : The Unified Command Plan of the Future Revisited A Monograph by Lieutenant...DD-MM-YYYY) 19-05-2011 2. REPORT TYPE Monograph 3. DATES COVERED (From - To) JUL 2010 – MAY 2011 4. TITLE AND SUBTITLE Déjà vu : The Unified...i SCHOOL OF ADVANCED MILITARY STUDIES MONOGRAPH APPROVAL Lieutenant Colonel Edward Francis Martignetti Title of Monograph: Déjà vu : The Unified

Interpretation of transport barriers and of subneoclassical transport in the framework of the revisited neoclassical theory

International Nuclear Information System (INIS)

Rogister, A.L.

1999-01-01

'Subneoclassical' heat fluxes are predicted in the high collisionality regime by the revisited neoclassical theory, which includes the roles of Finite Larmor Radius effects and Inertia, that we published earlier. Unlike conventional neoclassical theory, the revisited theory further provides a non degenerate ambipolarity constraint which defines unambiguously the radial electric field. Together with the parallel momentum equation, the ambipolarity constraint leads, under some conditions, to radial electric field profiles with high negative shear akin to those observed in spontaneous edge transport barriers. The predictions of the theory are outlined, with emphasis laid on the interpretation of experimental results such as magnitude of the jumps, width of the shear layer, local scaling laws. Extension of the theory to triggered transitions and cold pulse propagation studies is suggested. (author)

How does the Ambience of Cafe Affect the Revisit Intention Among its Patrons? A S on the Cafes in Ipoh, Perak

Directory of Open Access Journals (Sweden)

AbuThahir Sharmeela-Banu Syed

2018-01-01

Full Text Available Food service industry is growing rapidly as a result of the changing consumer lifestyle. The food service industry is highly competitive due to the increasing number of new entrants offering inventive food products and services. In order to be outstanding in such competitive industry, retailers nowadays opt to emphasize on their store environment. Past studies discovered that store environment stimulates emotions that significantly boost customer revisit intention. As a result, retailers attempt to differentiate their store by combining various environmental stimuli to create an attractive ambience that will in turn draw in the customers. Hence, this study attempts to investigate the impact of various café ambience factors on the patrons’ revisit intention. The patrons of cafes in Ipoh, Perak were selected using purposive sampling technique to be the respondents of this study. 250 questionnaires were collected and Partial Least Square technique was used to analyse the data collected. Findings show that all the five factors of café ambience namely lighting, music, decoration, cleanliness and layouts were significantly influencing the patrons’ revisit intention. Of these five factors, lighting was most influential while music was the least influential in affecting the patrons’ revisit intention. Accordingly, this study lists several recommendations for practitioners and academics with regards to the store environment and its impact on the repurchase intention.

Ocular gene transfer in the spotlight: implications of newspaper content for clinical communications.

Science.gov (United States)

Benjaminy, Shelly; Bubela, Tania

2014-07-16

Ocular gene transfer clinical trials are raising hopes for blindness treatments and attracting media attention. News media provide an accessible health information source for patients and the public, but are often criticized for overemphasizing benefits and underplaying risks of novel biomedical interventions. Overly optimistic portrayals of unproven interventions may influence public and patient expectations; the latter may cause patients to downplay risks and over-emphasize benefits, with implications for informed consent for clinical trials. We analyze the news media communications landscape about ocular gene transfer and make recommendations for improving communications between clinicians and potential trial participants in light of media coverage. We analyzed leading newspaper articles about ocular gene transfer (1990-2012) from United States (n = 55), Canada (n = 26), and United Kingdom (n = 77) from Factiva and Canadian Newsstand databases using pre-defined coding categories. We evaluated the content of newspaper articles about ocular gene transfer for hereditary retinopathies, exploring representations of framing techniques, research design, risks/benefits, and translational timelines. The dominant frame in 61% of stories was a celebration of progress, followed by human-interest in 30% of stories. Missing from the positive frames were explanations of research design; articles conflated clinical research with treatment. Conflicts-of-interest and funding sources were similarly omitted. Attention was directed to the benefits of gene transfer, while risks were only reported in 43% of articles. A range of visual outcomes was described from slowing vision loss to cure, but the latter was the most frequently represented even though it is clinically infeasible. Despite the prominence of visual benefit portrayals, 87% of the articles failed to provide timelines for the commencement of clinical trials or for clinical implementation. Our analysis confirms

The development of human visual cortex and clinical implications

Directory of Open Access Journals (Sweden)

Siu CR

2018-04-01

Full Text Available Caitlin R Siu,1 Kathryn M Murphy1,2 1McMaster Integrative Neuroscience Discovery and Study (MiNDS Program, McMaster University, Hamilton, ON, Canada; 2Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada Abstract: The primary visual cortex (V1 is the first cortical area that processes visual information. Normal development of V1 depends on binocular vision during the critical period, and age-related losses of vision are linked with neurobiological changes in V1. Animal studies have provided important details about the neurobiological mechanisms in V1 that support normal vision or are changed by visual diseases. There is very little information, however, about those neurobiological mechanisms in human V1. That lack of information has hampered the translation of biologically inspired treatments from preclinical models to effective clinical treatments. We have studied human V1 to characterize the expression of neurobiological mechanisms that regulate visual perception and neuroplasticity. We have identified five stages of development for human V1 that start in infancy and continue across the life span. Here, we describe these stages, compare them with visual and anatomical milestones, and discuss implications for translating treatments for visual disorders that depend on neuroplasticity of V1 function. Keywords: development, human visual cortex, amblyopia, synaptic plasticity, glutamatergic, GABAergic, receptors

The frequencies and clinical implications of mutations in 33 kinase-related genes in locally advanced rectal cancer: a pilot study.

LENUS (Irish Health Repository)

Abdul-Jalil, Khairun I

2014-08-01

Locally advanced rectal cancer (LARC: T3\\/4 and\\/or node-positive) is treated with preoperative\\/neoadjuvant chemoradiotherapy (CRT), but responses are not uniform. The phosphatidylinositol 3-kinase (PI3K), MAP kinase (MAPK), and related pathways are implicated in rectal cancer tumorigenesis. Here, we investigated the association between genetic mutations in these pathways and LARC clinical outcomes.

Revisiting the master-signifier, or, Mandela and repression

Directory of Open Access Journals (Sweden)

Derek eHook

2016-01-01

Full Text Available The concept of the master-signifier has been subject to a variety of applications in Lacanian forms of political discourse theory and ideology critique. While there is much to be commended in literature of this sort, it often neglects salient issues pertaining to the role of master signifiers in the clinical domain of (individual psychical economy. The popularity of the concept of the master (or ‘empty’ signifier in political discourse analysis has thus proved a double-edged sword. On the one hand it demonstrates how crucial psychical processes are performed via the operations of the signifier, extending thus the Lacanian thesis that identification is as much the outcome of linguistic and symbolic as opposed to merely psychological processes. On the other, the use of the master signifier concept within the political realm to track discursive formations tends to distance the term from the dynamics of the unconscious and operation of repression. Accordingly, this paper revisits the master signifier concept, and does so within the socio-political domain, yet while paying particular attention to the functioning of unconscious processes of fantasy and repression. More specifically, it investigates how Nelson Mandela operates as a master signifier in contemporary South Africa, as a vital means of knitting together diverse elements of post-apartheid society, enabling the fantasy of the post-apartheid nation, and holding at bay a whole series of repressed and negated undercurrents.

Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study.

Science.gov (United States)

Freedman, Stephen B; Rodean, Jonathan; Hall, Matthew; Alpern, Elizabeth R; Aronson, Paul L; Simon, Harold K; Shah, Samir S; Marin, Jennifer R; Cohen, Eyal; Morse, Rustin B; Katsogridakis, Yiannis; Berry, Jay G; Neuman, Mark I

2017-07-01

The use of abdominal radiographs contributes to increased healthcare costs, radiation exposure, and potentially to misdiagnoses. We evaluated the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation. Retrospective cohort study of children aged constipation at one of 23 EDs from 2004 to 2015. The primary exposure was abdominal radiograph performance. The primary outcome was a 3-day ED revisit with a clinically important alternate diagnosis. RAND/University of California, Los Angeles methodology was used to define whether the revisit was related to the index visit and due to a clinically important condition other than constipation. Regression analysis was performed to identify exposures independently related to the primary outcome. A total of 65.7% (185 439/282 225) of children with constipation had an index ED visit abdominal radiograph performed. Three-day revisits occurred in 3.7% (10 566/282 225) of children, and 0.28% (784/282 225) returned with a clinically important alternate related diagnosis. Appendicitis was the most common such revisit, accounting for 34.1% of all 3-day clinically important related revisits. Children who had an abdominal radiograph performed were more likely to have a 3-day revisit with a clinically important alternate related diagnosis (0.33% vs 0.17%; difference 0.17%; 95% CI 0.13-0.20). Following adjustment for covariates, abdominal radiograph performance was associated with a 3-day revisit with a clinically important alternate diagnosis (aOR: 1.39; 95% CI 1.15-1.67). Additional characteristics associated with the primary outcome included narcotic (aOR: 2.63) and antiemetic (aOR: 2.35) administration and underlying comorbidities (aOR: 2.52). Among children diagnosed with constipation, abdominal radiograph performance is associated with an increased risk of a revisit with a clinically important alternate related diagnosis

Revisiting reflexology: Concept, evidence, current practice, and practitioner training

OpenAIRE

Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

2015-01-01

Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and th...

Revisiting the Metaphor of the Island: Challenging "World Culture" from an Island Misunderstood

Science.gov (United States)

Rappleye, Jeremy

2015-01-01

This article revisits the newly "discovered" island that world culture theorists have repeatedly utilised to explain their theoretical stance, conceptual preferences and methodological approach. Yet, it seeks to (re)connect world culture with the real world by replacing their imagined atoll with a real one--the island-nation of Japan. In…

Clinical inertia, uncertainty and individualized guidelines.

Science.gov (United States)

Reach, G

2014-09-01

Doctors often do not follow the guidelines of good practice based on evidence-based medicine, and this "clinical inertia" may represent an impediment to efficient care. The aims of this article are as follows: 1) to demonstrate that this phenomenon is often the consequence of a discrepancy between the technical rationality of evidence-based medicine and the modes of reasoning of physicians practiced in "real-life", which is marked by uncertainty and risk; 2) to investigate in this context the meaning of the recent, somewhat paradoxical, concept of "individualized guidelines"; and 3) to revisit the real, essentially pedagogical, place of guidelines in medical practice. Copyright © 2014. Published by Elsevier Masson SAS.

Bridging the reductive and the synthetic: some reflections on the clinical implications of synchronicity.

Science.gov (United States)

Connolly, Angela

2015-04-01

When Jung introduced the concepts of synchronicity and the psychoid unconscious, he expanded analytical psychology into decidedly uncanny territory. Despite the early interest shown by Freud, anomalous phenomena such as telepathy have become a taboo subject in psychoanalysis. Today, however, there is an increasing interest in thought transference and synchronicity, thus opening the way for a fruitful exchange between different psychoanalytical schools on their clinical implications. I propose to examine some of the ambiguities of Jung's thinking, to clarify how we define synchronicity, the relationship between synchronicities and parapsychological events, and their clinical significance. At the present moment, we are still unsure if such events should be considered as normal and a way of facilitating individuation, or as an indication of psychopathology in the patient or in the analyst, just as we are uncertain about the particular characteristics of the intersubjective field that can lead to synchronicities. Making use of the typology of mind-matter correlations presented by Atmanspacher and Fach, and the distinction they draw between acategorial and non-categorial states of mind, I will use two clinical vignettes to illustrate the different states of mind in analyst and analysand that can lead to synchronicities. In particular I will focus on the relationship between analytical reverie and synchronicity. © 2015, The Society of Analytical Psychology.

Revisiting R-invariant direct gauge mediation

Energy Technology Data Exchange (ETDEWEB)

Chiang, Cheng-Wei [Center for Mathematics and Theoretical Physics andDepartment of Physics, National Central University,Taoyuan, Taiwan 32001, R.O.C. (China); Institute of Physics, Academia Sinica,Taipei, Taiwan 11529, R.O.C. (China); Physics Division, National Center for Theoretical Sciences,Hsinchu, Taiwan 30013, R.O.C. (China); Kavli IPMU (WPI), UTIAS, University of Tokyo,Kashiwa, Chiba 277-8583 (Japan); Harigaya, Keisuke [Department of Physics, University of California,Berkeley, California 94720 (United States); Theoretical Physics Group, Lawrence Berkeley National Laboratory,Berkeley, California 94720 (United States); ICRR, University of Tokyo,Kashiwa, Chiba 277-8582 (Japan); Ibe, Masahiro [Kavli IPMU (WPI), UTIAS, University of Tokyo,Kashiwa, Chiba 277-8583 (Japan); ICRR, University of Tokyo,Kashiwa, Chiba 277-8582 (Japan); Yanagida, Tsutomu T. [Kavli IPMU (WPI), UTIAS, University of Tokyo,Kashiwa, Chiba 277-8583 (Japan)

2016-03-21

We revisit a special model of gauge mediated supersymmetry breaking, the “R-invariant direct gauge mediation.” We pay particular attention to whether the model is consistent with the minimal model of the μ-term, i.e., a simple mass term of the Higgs doublets in the superpotential. Although the incompatibility is highlighted in view of the current experimental constraints on the superparticle masses and the observed Higgs boson mass, the minimal μ-term can be consistent with the R-invariant gauge mediation model via a careful choice of model parameters. We derive an upper limit on the gluino mass from the observed Higgs boson mass. We also discuss whether the model can explain the 3σ excess of the Z+jets+E{sub T}{sup miss} events reported by the ATLAS collaboration.

Revisiting kaon physics in general Z scenario

Directory of Open Access Journals (Sweden)

Motoi Endo

2017-08-01

Full Text Available New physics contributions to the Z penguin are revisited in the light of the recently-reported discrepancy of the direct CP violation in K→ππ. Interference effects between the standard model and new physics contributions to ΔS=2 observables are taken into account. Although the effects are overlooked in the literature, they make experimental bounds significantly severer. It is shown that the new physics contributions must be tuned to enhance B(KL→π0νν¯, if the discrepancy of the direct CP violation is explained with satisfying the experimental constraints. The branching ratio can be as large as 6×10−10 when the contributions are tuned at the 10% level.

Left ventricular hypertrophy in valvular aortic stenosis: mechanisms and clinical implications.

Science.gov (United States)

Rader, Florian; Sachdev, Esha; Arsanjani, Reza; Siegel, Robert J

2015-04-01

Valvular aortic stenosis is the second most prevalent adult valve disease in the United States and causes progressive pressure overload, invariably leading to life-threatening complications. Surgical aortic valve replacement and, more recently, transcatheter aortic valve replacement effectively relieve the hemodynamic burden and improve the symptoms and survival of affected individuals. However, according to current American College of Cardiology/American Heart Association guidelines on the management of valvular heart disease, the indications for aortic valve replacement, including transcatheter aortic valve replacement, are based primarily on the development of clinical symptoms, because their presence indicates a dismal prognosis. Left ventricular hypertrophy develops in a sizeable proportion of patients before the onset of symptoms, and a growing body of literature demonstrates that regression of left ventricular hypertrophy resulting from aortic stenosis is incomplete after aortic valve replacement and associated with adverse early postoperative outcomes and worse long-term outcomes. Thus, reliance on the development of symptoms alone without consideration of structural abnormalities of the myocardium for optimal timing of aortic valve replacement potentially constitutes a missed opportunity to prevent postoperative morbidity and mortality from severe aortic stenosis, especially in the face of the quickly expanding indications of lower-risk transcatheter aortic valve replacement. The purpose of this review is to discuss the mechanisms and clinical implications of left ventricular hypertrophy in severe valvular aortic stenosis, which may eventually move to center stage as an indication for aortic valve replacement in the asymptomatic patient. Copyright © 2015 Elsevier Inc. All rights reserved.

Revisiting the Decision of Death in Hurst v. Florida.

Science.gov (United States)

Cooke, Brian K; Ginory, Almari; Zedalis, Jennifer

2016-12-01

The United States Supreme Court has considered the question of whether a judge or a jury must make the findings necessary to support imposition of the death penalty in several notable cases, including Spaziano v. Florida (1984), Hildwin v. Florida (1989), and Ring v. Arizona (2002). In 2016, the U.S. Supreme Court revisited the subject in Hurst v. Florida Florida Statute § 921.141 allows the judge, after weighing aggravating and mitigating circumstances, to enter a sentence of life imprisonment or death. Before Hurst, Florida's bifurcated sentencing proceedings included an advisory sentence from jurors and a separate judicial hearing without juror involvement. In Hurst, the Court revisited the question of whether Florida's capital sentencing scheme violates the Sixth Amendment, which requires a jury, not a judge, to find each fact necessary to impose a sentence of death in light of Ring In an eight-to-one decision, the Court reversed the judgment of the Florida Supreme Court, holding that the Sixth Amendment requires a jury to find the aggravating factors necessary for imposing the death penalty. The role of Florida juries in capital sentencing proceedings was thereby elevated from advisory to determinative. We examine the Court's decision and offer commentary regarding this shift from judge to jury in the final imposition of the death penalty and the overall effect of this landmark case. © 2016 American Academy of Psychiatry and the Law.

Revisiting Ecosystem Services: Assessment and Valuation as Starting Points for Environmental Politics

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Adam Jadhav

2017-09-01

Full Text Available The paradigm of ecosystem services (ES and the methods of monetary valuation have become boundary objects, spanning disciplines and earning particular purchase in policy circles. However, the notion of ES and ES valuation have also been subjected to multiple critiques, ranging from their varying precision to the potential for neoliberalization of nature. This paper does not attempt to refute such critiques but rather revisits the potentials of the ES paradigm and the specific method of benefit transfer valuation for their utility as a form of environmental politics and sustainability practice. We find they have particular relevance in contexts where “data” are not readily available or are not legible to policy makers as well as where the imperative of “development” remains ideological. We argue for ES assessment and, specifically, rapid ES valuation as a first-pass tactic to inform evaluation of potentially environmentally degrading projects or environmental management. We demonstrate this using a simple benefit transfer analysis to offer an initial evaluation of (wet landscape ES in a lightly touched estuary in Karnataka, India, where a state-backed proposal to develop an industrial shipping port is gathering steam. While we recognize and do not categorically reject critiques of the ES paradigm, we nonetheless argue for valuation as a starting point for politics that highlight and make visible ES benefits and users implicated by “development” and other kinds of environmental change.

Roles of Ubiquitination and SUMOylation on Prostate Cancer: Mechanisms and Clinical Implications

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Zhenbang Chen

2015-02-01

Full Text Available The initiation and progression of human prostate cancer are highly associated with aberrant dysregulations of tumor suppressors and proto-oncogenes. Despite that deletions and mutations of tumor suppressors and aberrant elevations of oncogenes at the genetic level are reported to cause cancers, emerging evidence has revealed that cancer progression is largely regulated by posttranslational modifications (PTMs and epigenetic alterations. PTMs play critical roles in gene regulation, cellular functions, tissue development, diseases, malignant progression and drug resistance. Recent discoveries demonstrate that ubiquitination and SUMOylation are complicated but highly-regulated PTMs, and make essential contributions to diseases and cancers by regulation of key factors and signaling pathways. Ubiquitination and SUMOylation pathways can be differentially modulated under various stimuli or stresses in order to produce the sustained oncogenic potentials. In this review, we discuss some new insights about molecular mechanisms on ubiquitination and SUMOylation, their associations with diseases, oncogenic impact on prostate cancer (PCa and clinical implications for PCa treatment.

Clinical trials in "emerging markets": regulatory considerations and other factors.

Science.gov (United States)

Singh, Romi; Wang, Ouhong

2013-11-01

Clinical studies are being placed in emerging markets as part of global drug development programs to access large pool of eligible patients and to benefit from a cost effective structure. However, over the last few years, the definition of "emerging markets" is being revisited, especially from a regulatory perspective. For purposes of this article, countries outside US, EU and the traditional "western countries" are discussed. Multiple factors are considered for placement of clinical studies such as adherence to Good Clinical Practice (GCP), medical infrastructure & standard of care, number of eligible patients, etc. This article also discusses other quantitative factors such as country's GDP, patent applications, healthcare expenditure, healthcare infrastructure, corruption, innovation, etc. These different factors and indexes are correlated to the number of clinical studies ongoing in the "emerging markets". R&D, healthcare expenditure, technology infrastructure, transparency, and level of innovation, show a significant correlation with the number of clinical trials being conducted in these countries. This is the first analysis of its kind to evaluate and correlate the various other factors to the number of clinical studies in a country. © 2013.

Magnetic moments revisited

International Nuclear Information System (INIS)

Towner, I.S.; Khanna, F.C.

1984-01-01

Consideration of core polarization, isobar currents and meson-exchange processes gives a satisfactory understanding of the ground-state magnetic moments in closed-shell-plus (or minus)-one nuclei, A = 3, 15, 17, 39 and 41. Ever since the earliest days of the nuclear shell model the understanding of magnetic moments of nuclear states of supposedly simple configurations, such as doubly closed LS shells +-1 nucleon, has been a challenge for theorists. The experimental moments, which in most cases are known with extraordinary precision, show a small yet significant departure from the single-particle Schmidt values. The departure, however, is difficult to evaluate precisely since, as will be seen, it results from a sensitive cancellation between several competing corrections each of which can be as large as the observed discrepancy. This, then, is the continuing fascination of magnetic moments. In this contribution, we revisit the subjet principally to identify the role played by isobar currents, which are of much concern at this conference. But in so doing we warn quite strongly of the dangers of considering just isobar currents in isolation; equal consideration must be given to competing processes which in this context are the mundane nuclear structure effects, such as core polarization, and the more popular meson-exchange currents

Growth of the firm and foreign trade: Adrian Wood's theory revisited

OpenAIRE

Catermol, Fabrício

2006-01-01

This paper analyzes the growth of the firm by foreign trade. The theory of Adrian Wood is revisited for the analysis of growth and profit trade-off and improved to cope with growth by exports. The main outcome of this paper is that low domestic demand can be a very important factor to firm choices growth by foreign market. However, the growth of domestic demand does not necessarily reduce exports.

Revisiting the description of Protein-Protein interfaces. Part II: Experimental study

OpenAIRE

Cazals , Frédéric; Proust , Flavien

2006-01-01

This paper provides a detailed experimental study of an interface model developed in the companion article F. Cazals and F. Proust, Revisiting the description of Protein-Protein interfaces. Part I: algorithms. Our experimental study is concerned with the usual database of protein-protein complexes, split into five families (Proteases, Immune system, Enzyme Complexes, Signal transduction, Misc.) Our findings, which bear some contradictions with usual statements are the following: (i)Connectivi...

Small-angle scattering theory revisited: Photocurrent and spatial localization

DEFF Research Database (Denmark)

Basse, N.P.; Zoletnik, S.; Michelsen, Poul

2005-01-01

In this paper theory on collective scattering measurements of electron density fluctuations in fusion plasmas is revisited. We present the first full derivation of the expression for the photocurrent beginning at the basic scattering concepts. Thereafter we derive detailed expressions for the auto......- and crosspower spectra obtained from measurements. These are discussed and simple simulations made to elucidate the physical meaning of the findings. In this context, the known methods of obtaining spatial localization are discussed and appraised. Where actual numbers are applied, we utilize quantities from two...

Article Review: Advanced Change Theory Revisited: An Article Critique

Directory of Open Access Journals (Sweden)

R. Scott Pochron

2008-12-01

Full Text Available The complexity of life in 21st century society requires new models for leadingand managing change. With that in mind, this paper revisits the model for AdvancedChange Theory (ACT as presented by Quinn, Spreitzer, and Brown in their article,“Changing Others Through Changing Ourselves: The Transformation of HumanSystems” (2000. The authors present ACT as a potential model for facilitating change incomplex organizations. This paper presents a critique of the article and summarizesopportunities for further exploring the model in the light of current trends indevelopmental and integral theory.

The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

Science.gov (United States)

Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

2016-03-02

Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

Science.gov (United States)

Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

2016-01-01

Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

Creative Experience and Revisit Intention of Handmade Oriental Parasol Umbrella in Kaohsiung

OpenAIRE

Yi-Ju Lee

2015-01-01

This study identified the hypothesised relationship between creative experience, and revisit intention of handmade oriental parasol umbrella in Kaohsiung, Taiwan. A face-to-face questionnaire survey was administered in Meinong town, Kaohsiung. The components of creative experience were found as "sense of achievement", "unique learning" and "interaction with instructors" in creative tourism. The result also revealed significant positive relationships between creative exper...

Mammary Stem Cells and Breast Cancer Stem Cells: Molecular Connections and Clinical Implications.

Science.gov (United States)

Celià-Terrassa, Toni

2018-05-04

Cancer arises from subpopulations of transformed cells with high tumor initiation and repopulation ability, known as cancer stem cells (CSCs), which share many similarities with their normal counterparts. In the mammary gland, several studies have shown common molecular regulators between adult mammary stem cells (MaSCs) and breast cancer stem cells (bCSCs). Cell plasticity and self-renewal are essential abilities for MaSCs to maintain tissue homeostasis and regenerate the gland after pregnancy. Intriguingly, these properties are similarly executed in breast cancer stem cells to drive tumor initiation, tumor heterogeneity and recurrence after chemotherapy. In addition, both stem cell phenotypes are strongly influenced by external signals from the microenvironment, immune cells and supportive specific niches. This review focuses on the intrinsic and extrinsic connections of MaSC and bCSCs with clinical implications for breast cancer progression and their possible therapeutic applications.

Characteristics of revisits of children at risk for serious infections in pediatric emergency care

NARCIS (Netherlands)

E. De Vos-Kerkhof (Evelien); D.H.F. Geurts (Dorien); E.W. Steyerberg (Ewout); M. Lakhanpaul (Monica); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

2018-01-01

textabstractIn this study, we aimed to identify characteristics of (unscheduled) revisits and its optimal time frame after Emergency Department (ED) discharge. Children with fever, dyspnea, or vomiting/diarrhea (1 month–16 years) who attended the ED of Erasmus MC-Sophia, Rotterdam (2010–2013), the

Some technical implications of Klein's concept of 'premature ego development'.

Science.gov (United States)

Mitrani, Judith L

2007-08-01

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.

HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression.

Science.gov (United States)

Blanco, Madeline; Machado, Liuber Y; Díaz, Héctor; Ruiz, Nancy; Romay, Dania; Silva, Eladio

2015-10-01

INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with several coinciding routes of infection and other epidemiologic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVE Study genetic variability for the HIV-1 env, gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical disease progression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host characteristics, and patients' clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, transmission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes classified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombinant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No association was found between subtypes and

The image schema and innate archetypes: theoretical and clinical implications.

Science.gov (United States)

Merchant, John

2016-02-01

Based in contemporary neuroscience, Jean Knox's 2004 JAP paper 'From archetypes to reflective function' honed her position on image schemas, thereby introducing a model for archetypes which sees them as 'reliably repeated early developmental achievements' and not as genetically inherited, innate psychic structures. The image schema model is used to illustrate how the analyst worked with a patient who began life as an unwanted pregnancy, was adopted at birth and as an adult experienced profound synchronicities, paranormal/telepathic phenomena and visions. The classical approach to such phenomena would see the intense affectivity arising out of a ruptured symbiotic mother-infant relationship constellating certain archetypes which set up the patient's visions. This view is contrasted with Knox's model which sees the archetype an sich as a developmentally produced image schema underpinning the emergence of later imagery. The patient's visions can then be understood to arise from his psychoid body memory related to his traumatic conception and birth. The contemporary neuroscience which supports this view is outlined and a subsequent image schema explanation is presented. Clinically, the case material suggests that a pre-birth perspective needs to be explored in all analytic work. Other implications of Knox's image schema model are summarized. © 2016, The Society of Analytical Psychology.

Associated factors and clinical implications of serum aminotransferase elevation in scrub typhus.

Science.gov (United States)

Su, Tung-Hung; Liu, Chun-Jen; Shu, Pei-Yun; Fu, Yang-Hsien; Chang, Chi-Hsien; Jao, Ping; Kao, Jia-Horng

2016-12-01

Timely diagnosis and prompt treatment can reduce the complications of scrub typhus. It is thus important to find easy laboratory tests to help in the diagnosis, especially in patients without eschar at initial presentation. Because serum aminotransferase elevation is common in scrub typhus, its associated factors and clinical implications need further investigations. We conducted a retrospective study in Kinmen, Taiwan, to collect clinically suspected scrub typhus patients notified to Taiwan Centers for Disease Control for confirmation during 2005-2010. Scrub typhus was diagnosed and Orientia tsutsugamushi was genotyped by serological or molecular assays. The laboratory data and clinical information were recorded for analysis. Overall, 344 suspected scrub typhus patients were reported to Taiwan Centers for Disease Control and 288 of them were certified scrub typhus. Scrub typhus patients had significantly more thrombocytopenia, serum aminotransferase elevation (76% vs. 54%, p = 0.001), higher frequency of fever, eschar, and lymphadenopathy, compared with nontyphus patients. Hepatic dysfunction in scrub typhus was associated with older age, longer fever duration, and absence of lymphadenopathy, but seemed to be unrelated to the rickettsial genotypes. Multivariate analysis showed that serum aminotransferase elevation (odds ratio: 3.75; p = 0.003; 95% confidence interval: 1.56-9.01) independently predicted scrub typhus. Furthermore, in suspected scrub typhus patients without eschar, 92% of true typhus patients had serum aminotransferase elevation compared with the nontyphus ones (odds ratio: 6.47; p = 0.028, 95% confidence interval: 1.23-34.11). Hepatic dysfunction in scrub typhus patients is associated with older age, longer fever duration, and absence of lymphadenopathy. Serum aminotransferase elevation can aid in the diagnosis of scrub typhus, especially in suspected patients without eschar. Copyright © 2014. Published by Elsevier B.V.

Revisiting photodynamic therapy dosimetry: reductionist and surrogate approaches to facilitate clinical success

International Nuclear Information System (INIS)

Pogue, Brian W; Elliott, Jonathan T; Kanick, Stephen C; Davis, Scott C; Samkoe, Kimberley S; Maytin, Edward V; Pereira, Stephen P; Hasan, Tayyaba

2016-01-01

Photodynamic therapy (PDT) can be a highly complex treatment, with many parameters influencing treatment efficacy. The extent to which dosimetry is used to monitor and standardize treatment delivery varies widely, ranging from measurement of a single surrogate marker to comprehensive approaches that aim to measure or estimate as many relevant parameters as possible. Today, most clinical PDT treatments are still administered with little more than application of a prescribed drug dose and timed light delivery, and thus the role of patient-specific dosimetry has not reached widespread clinical adoption. This disconnect is at least partly due to the inherent conflict between the need to measure and understand multiple parameters in vivo in order to optimize treatment, and the need for expedience in the clinic and in the regulatory and commercialization process. Thus, a methodical approach to selecting primary dosimetry metrics is required at each stage of translation of a treatment procedure, moving from complex measurements to understand PDT mechanisms in pre-clinical and early phase I trials, towards the identification and application of essential dose-limiting and/or surrogate measurements in phase II/III trials. If successful, identifying the essential and/or reliable surrogate dosimetry measurements should help facilitate increased adoption of clinical PDT. In this paper, examples of essential dosimetry points and surrogate dosimetry tools that may be implemented in phase II/III trials are discussed. For example, the treatment efficacy as limited by light penetration in interstitial PDT may be predicted by the amount of contrast uptake in CT, and so this could be utilized as a surrogate dosimetry measurement to prescribe light doses based upon pre-treatment contrast. Success of clinical ALA-based skin lesion treatment is predicted almost uniquely by the explicit or implicit measurements of photosensitizer and photobleaching, yet the individualization of treatment

Revisiting the Gun Ownership and Violence Link; a multi- level analysis of victimisation survey data.

NARCIS (Netherlands)

van Kesteren, J.N.

2014-01-01

The link between gun ownership victimisation by violent crime remains one of the most contested issues in criminology. Some authors claim that high gun availability facilitates serious violence. Others claim that gun ownership prevents crime. This article revisits these issues using individual and

Psychosocial student functioning in comprehensive dental clinic education: A qualitative study

DEFF Research Database (Denmark)

Moore, Rod

2018-01-01

also rated their perceived stress using a 0-10 scale, where 0 is no stress, and 10 is highest stress. Qualitative analyses involved searching for recurring themes and discovery of categories of clinical and social functioning. All 8 students were revisited as dentists after 8 years and filled out a 15...... expectations and worries about how others perceived them. Dys-Grp experienced higher negative stress and maladaptive perfectionism and described crying behaviours, withdrawal and unwillingness to cooperate with others. In contrast, students in F+Grp provided rich content about mutual cooperation related...... to social networking and positive support. The 8 subjects exhibited high internal consistency (α = .98) in their responses to the follow-up survey about their first year of clinic. Conclusions: The comprehensive care teaching clinic environment with students working in groups appeared to provide...

NP-hardness of the cluster minimization problem revisited

Science.gov (United States)

Adib, Artur B.

2005-10-01

The computational complexity of the 'cluster minimization problem' is revisited (Wille and Vennik 1985 J. Phys. A: Math. Gen. 18 L419). It is argued that the original NP-hardness proof does not apply to pairwise potentials of physical interest, such as those that depend on the geometric distance between the particles. A geometric analogue of the original problem is formulated, and a new proof for such potentials is provided by polynomial time transformation from the independent set problem for unit disk graphs. Limitations of this formulation are pointed out, and new subproblems that bear more direct consequences to the numerical study of clusters are suggested.

NP-hardness of the cluster minimization problem revisited

International Nuclear Information System (INIS)

Adib, Artur B

2005-01-01

The computational complexity of the 'cluster minimization problem' is revisited (Wille and Vennik 1985 J. Phys. A: Math. Gen. 18 L419). It is argued that the original NP-hardness proof does not apply to pairwise potentials of physical interest, such as those that depend on the geometric distance between the particles. A geometric analogue of the original problem is formulated, and a new proof for such potentials is provided by polynomial time transformation from the independent set problem for unit disk graphs. Limitations of this formulation are pointed out, and new subproblems that bear more direct consequences to the numerical study of clusters are suggested

NP-hardness of the cluster minimization problem revisited

Energy Technology Data Exchange (ETDEWEB)

Adib, Artur B [Physics Department, Brown University, Providence, RI 02912 (United States)

2005-10-07

The computational complexity of the 'cluster minimization problem' is revisited (Wille and Vennik 1985 J. Phys. A: Math. Gen. 18 L419). It is argued that the original NP-hardness proof does not apply to pairwise potentials of physical interest, such as those that depend on the geometric distance between the particles. A geometric analogue of the original problem is formulated, and a new proof for such potentials is provided by polynomial time transformation from the independent set problem for unit disk graphs. Limitations of this formulation are pointed out, and new subproblems that bear more direct consequences to the numerical study of clusters are suggested.

Rural-Nonrural Disparities in Postsecondary Educational Attainment Revisited

Science.gov (United States)

Byun, Soo-yong; Meece, Judith L.; Irvin, Matthew J.

2013-01-01

Using data from the National Educational Longitudinal Study, this study revisited rural-nonrural disparities in educational attainment by considering a comprehensive set of factors that constrain and support youth's college enrollment and degree completion. Results showed that rural students were more advantaged in community social resources compared to nonrural students, and these resources were associated with a significant increase in the likelihood of bachelor's degree attainment. Yet results confirmed that rural students lagged behind nonrural students in attaining a bachelor's degree largely due to their lower socioeconomic background. The findings present a more comprehensive picture of the complexity of geographic residence in shaping college enrollment and degree attainment. PMID:24285873

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Directory of Open Access Journals (Sweden)

José Roberto Lambertucci

2014-05-01

Full Text Available Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fibrosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fibrosis was made by abdominal palpation and the finding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US has become the best imaging technique to evaluate liver fibrosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI findings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count, biomarkers for liver fibrosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

An Improvement on LSB Matching and LSB Matching Revisited Steganography Methods

OpenAIRE

Qazanfari, Kazem; Safabakhsh, Reza

2017-01-01

The aim of the steganography methods is to communicate securely in a completely undetectable manner. LSB Matching and LSB Matching Revisited steganography methods are two general and esiest methods to achieve this aim. Being secured against first order steganalysis methods is the most important feature of these methods. On the other hand, these methods don't consider inter pixel dependency. Therefore, recently, several steganalysis methods are proposed that by using co-occurrence matrix detec...

Dual beta-lactam therapy for serious Gram-negative infections: is it time to revisit?

Science.gov (United States)

Rahme, Christine; Butterfield, Jill M; Nicasio, Anthony M; Lodise, Thomas P

2014-12-01

We are rapidly approaching a crisis in antibiotic resistance, particularly among Gram-negative pathogens. This, coupled with the slow development of novel antimicrobial agents, underscores the exigency of redeploying existing antimicrobial agents in innovative ways. One therapeutic approach that was heavily studied in the 1980s but abandoned over time is dual beta-lactam therapy. This article reviews the evidence for combination beta-lactam therapy. Overall, in vitro, animal and clinical data are positive and suggest that beta-lactam combinations produce a synergistic effect against Gram-negative pathogens that rivals that of beta-lactam-aminoglycoside or beta-lactam-fluoroquinolone combination therapy. Although the precise mechanism of improved activity is not completely understood, it is likely attributable to an enhanced affinity to the diverse penicillin-binding proteins found among Gram negatives. The collective data indicate that dual beta-lactam therapy should be revisited for serious Gram-negative infections, especially in light of the near availability of potent beta-lactamase inhibitors, which neutralize the effect of problematic beta-lactamases. Copyright © 2014 Elsevier Inc. All rights reserved.

Forecasting of Satisfaction and Revisit Intention of Indonesia Shoppers in Shopping Malls

OpenAIRE

Ayuni, Risca Fitri

2017-01-01

. Due to tight competition, changing value proposition of customer and shiftingof mall functions become center for leisure purposes, shopping mall developer mustfocus on create shopper satisfaction to influence their post-transaction behaviors. Thisstudy investigates the relationship between mall personality, self-congruity, perceivedquality, shopping value, shopper satisfaction and revisit intention. Two hundredrespondents participated in this study. In order to achieve the aim of this study...

Sparse random matrices: The eigenvalue spectrum revisited

International Nuclear Information System (INIS)

Semerjian, Guilhem; Cugliandolo, Leticia F.

2003-08-01

We revisit the derivation of the density of states of sparse random matrices. We derive a recursion relation that allows one to compute the spectrum of the matrix of incidence for finite trees that determines completely the low concentration limit. Using the iterative scheme introduced by Biroli and Monasson [J. Phys. A 32, L255 (1999)] we find an approximate expression for the density of states expected to hold exactly in the opposite limit of large but finite concentration. The combination of the two methods yields a very simple geometric interpretation of the tails of the spectrum. We test the analytic results with numerical simulations and we suggest an indirect numerical method to explore the tails of the spectrum. (author)

Highway 61 Revisited: Bob Dilan i francuski poststrukturalizam / Highway 61 Revisited: Bob Dilan and French Poststructuralism

Directory of Open Access Journals (Sweden)

Nikola Dedić

2013-06-01

Full Text Available The main aim of this text is to show parallels between rock music and poststructuralist philosophy. As a case study one of the most celebrated rock albums of all times – Bob Dylan’s Highway 61 Revisited from 1965 is taken. It is one of the crucial albums in the history of popular culture which influenced further development of rock music within American counter culture of the 60s. Dylan’s turn from the politics of American New Left and folk movement, his relation towards the notions of the author and intertextuality, and his connection with experimental usage of language in the manner of avant-garde and neoavant-garde poetry, are juxtaposed with the main philosophical standpoints of Jean-François Lyotard, Jean Baudrillard, Roland Barthes and Julia Kristeva which historically and chronologically coincide with the appearance of Dylan’s album.

Structuralism's Relevance in a Post-Structural Era: Re-Visiting Research on Multicultural Curricular Studies

Science.gov (United States)

Shim, Jenna Min

2011-01-01

At the current historical juncture in which differences and inequalities are surfacing greater than ever in the world, societies, and schools, the main goal of this essay is to revisit the aspects of structuralism that can potentially contribute productively to understanding the invisible structures and forces that everyone carries (mostly…

The skeptical green consumer revisited: testing the relationship between green consumerism and skepticism toward advertising

NARCIS (Netherlands)

Matthes, J.; Wonneberger, A.

2014-01-01

This article revisits the widely believed notion of the skeptical green consumer, in other words, that green consumers tend to distrust green advertising. Study 1, a survey of U.S. consumers, found no positive relationship between green consumerism and general ad skepticism. However, green

A Cooperative Search and Coverage Algorithm with Controllable Revisit and Connectivity Maintenance for Multiple Unmanned Aerial Vehicles

Directory of Open Access Journals (Sweden)

Zhong Liu

2018-05-01

Full Text Available In this paper, we mainly study a cooperative search and coverage algorithm for a given bounded rectangle region, which contains several unknown stationary targets, by a team of unmanned aerial vehicles (UAVs with non-ideal sensors and limited communication ranges. Our goal is to minimize the search time, while gathering more information about the environment and finding more targets. For this purpose, a novel cooperative search and coverage algorithm with controllable revisit mechanism is presented. Firstly, as the representation of the environment, the cognitive maps that included the target probability map (TPM, the uncertain map (UM, and the digital pheromone map (DPM are constituted. We also design a distributed update and fusion scheme for the cognitive map. This update and fusion scheme can guarantee that each one of the cognitive maps converges to the same one, which reflects the targets’ true existence or absence in each cell of the search region. Secondly, we develop a controllable revisit mechanism based on the DPM. This mechanism can concentrate the UAVs to revisit sub-areas that have a large target probability or high uncertainty. Thirdly, in the frame of distributed receding horizon optimizing, a path planning algorithm for the multi-UAVs cooperative search and coverage is designed. In the path planning algorithm, the movement of the UAVs is restricted by the potential fields to meet the requirements of avoiding collision and maintaining connectivity constraints. Moreover, using the minimum spanning tree (MST topology optimization strategy, we can obtain a tradeoff between the search coverage enhancement and the connectivity maintenance. The feasibility of the proposed algorithm is demonstrated by comparison simulations by way of analyzing the effects of the controllable revisit mechanism and the connectivity maintenance scheme. The Monte Carlo method is employed to validate the influence of the number of UAVs, the sensing radius

Clinical implications for Vascular Endothelial Growth Factor in the lung: friend or foe?

Directory of Open Access Journals (Sweden)

Gourgoulianis Konstantinos I

2006-10-01

Full Text Available Abstract Vascular endothelial growth factor (VEGF is a potent mediator of angiogenesis which has multiple effects in lung development and physiology. VEGF is expressed in several parts of the lung and the pleura while it has been shown that changes in its expression play a significant role in the pathophysiology of some of the most common respiratory disorders, such as acute lung injury, asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, idiopathic pulmonary fibrosis, pulmonary hypertension, pleural disease, and lung cancer. However, the exact role of VEGF in the lung is not clear yet, as there is contradictory evidence that suggests either a protective or a harmful role. VEGF seems to interfere in a different manner, depending on its amount, the location, and the underlying pathologic process in lung tissue. The lack of VEGF in some disease entities may provide implications for its substitution, whereas its overexpression in other lung disorders has led to interventions for the attenuation of its action. Many efforts have been made in order to regulate the expression of VEGF and anti-VEGF antibodies are already in use for the management of lung cancer. Further research is still needed for the complete understanding of the exact role of VEGF in health and disease, in order to take advantage of its benefits and avoid its adverse effects. The scope of the present review is to summarize from a clinical point of view the changes in VEGF expression in several disorders of the respiratory system and focus on its diagnostic and therapeutic implications.

The role of brand destination experience in determining revisit intention

DEFF Research Database (Denmark)

Mattsson, Jan; Barnes, Stuart; Sørensen, Flemming

Destination branding has developed considerably as a topic area in the last decade with numerous conceptualizations focusing on different aspects of the brand. However, a unified view has not yet emerged. This paper examines destination branding via a new conceptualization, brand destination...... experience, which provides a more holistic and unified view of the brand destination. The research uses a logistic regression model to determine the role of satisfaction and brand experience in determining revisit intentions. The study also examines differences among subgroups and four brand experience sub...

Klein, Ferenczi and the clinical diary.

Science.gov (United States)

Hernandez-Halton, Isabel

2015-03-01

The aim of this article is to revisit Ferenczi's Clinical Diary (1932) to investigate the influence he had on Melanie Klein's work. It starts from the position that insufficient recognition has been given to Ferenczi's contribution to Klein's body of work and her professional development. Her analysis with Ferenczi lasted 5 years, a relatively long analysis for the period. It explores his influence in three specific areas: the importance of raw and early emotion in the maternal bond, the importance of freedom and authenticity in the analytic relationship, and finally the use of transference and countertransference feelings. Ferenczi's ill-fated experiment with mutual analysis will be discussed as it opened up a route to explore the analytic relationship, with important consequences for the future development of psychoanalysis.

Clinical implications of The Red Book.

Science.gov (United States)

Culliford, Penny

2012-09-01

This presentation stresses the uniqueness of both the therapist's and patient's personal experience in clinical work and relates this to the significance of The Red Book as Jung's personal odyssey and for me personally as an analyst. I consider The Red Book's enduring relevance alongside recent psychological theories, neuroscience and early mystical writings, and conclude with a clinical vignette of a patient's response to a piece of choral music and subsequent use of active imagination. © 2012, The Society of Analytical Psychology.

The Stroop revisited: a meta-analysis of interference control in AD/HD

NARCIS (Netherlands)

van Mourik, R.; Oosterlaan, J.; Sergeant, J.A.

2005-01-01

Background: An inhibition deficit, including poor interference control, has been implicated as one of the core deficits in AD/HD. Interference control is clinically measured by the Stroop Colour-Word Task. The aim of this meta-analysis was to investigate the strength of an interference deficit in

Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations.

Science.gov (United States)

de Pablo, Oliver Valencia; Estevez, Roberto; Heilborn, Carlos; Cohenca, Nestor

2012-01-01

Root canal anatomy may present clinicians with a complex clinical challenge that requires diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. This article discusses the clinical implications of endodontic therapy on permanent mandibular first molars. The number of roots on the mandibular first molar is directly related to ethnicity. Canal morphology has a significant effect on treatment protocol: Mesial roots present two canals on a regular basis, adopting 2-2 and 2-1 as the most common configurations. A third canal is present in 2.6% of the population. The most common configuration in the distal root is type I (62.7%), followed by type II (14.5%) and type IV (12.4%). Diagnosis and treatment of complex root canal systems often require specialized training that may be beyond the scope of the average general practitioner. Access modifications are required to find extra roots and/or canals. The instrumentation of the third root requires a different access and small, flexible instruments, given the curvature that is usually present buccally in the apical third. The incidence of isthmuses is 55% in the mesial root and 20% in the distal root. This anatomical configuration should be taken into consideration during endodontic treatment as well as during periapical surgery.

Explaining tourists satisfaction and intention to revisit Nha Trang, Viet Nam

OpenAIRE

Tran, Thi Ai Cam

2011-01-01

The first purpose of the thesis is to find how visitors evaluate the quality of different facets or attributes of a destination image of Nha Trang, how satisfied they are with Nha Trang, loyalty intention to revisit and willingness to recommend Nha Trang to others. The second is to investigate what “image” is most important to explain global satisfaction with visiting Nha Trang. The third is to investigate how perceived quality, satisfaction and other motivational or dismotivational factors ...

The emerging molecular architecture of schizophrenia, polygenic risk scores and the clinical implications for GxE research.

Science.gov (United States)

Iyegbe, Conrad; Campbell, Desmond; Butler, Amy; Ajnakina, Olesya; Sham, Pak

2014-02-01

Schizophrenia is a devastating mental disorder. The level of risk in the general population is sustained by the persistence of social, environmental and biological factors, as well as their interactions. Socio-environmental risk factors for schizophrenia are well established and robust. The same can belatedly be said of genetic risk factors for the disorder. Recent progress in schizophrenia genetics is primarily fuelled by genome-wide association, which is able to leverage substantial proportions of additional explained variance previously classified as 'missing'. Here, we provide an outline of the emerging genetic landscape of schizophrenia and demonstrate how this knowledge can be turned into a simple empirical measure of genetic risk, known as a polygenic risk score. We highlight the statistical framework used to assess the clinical potential of the new score and finally, draw relevance to and discuss the clinical implications for the study of gene-environment interaction.

Epidemiological and radio-biological studies in high background radiation areas of Kerala coast: implications in radiation protection science and human health

International Nuclear Information System (INIS)

Das, Birajalaxmi

2018-01-01

Till date, Linear No Threshold hypothesis (LNT) is well accepted in radiation protection science in spite of its limitations. However, dose response studies using multiple biological end points from high-background radiation areas have challenged the linearity. Radio-biological and epidemiological studies from high level natural radiation areas of Kerala coast showed non-linearity as well as efficient repair of DNA damage in HLNRA indicating that dose limits for public exposure needs to be revisited which may have implications in radiation protection science, human health and low dose radiation biology. However, further studies using high throughput approach is required to identify chronic radiation signatures in human population exposed to elevated level of natural background radiation

Revisiting Organizational Credibility and Organizational Reputation – A Situational Crisis Communication Approach

OpenAIRE

Jamal Jamilah; Abu Bakar Hassan

2017-01-01

Organizational credibility, the extent of which an organization as the source of messages is perceived as trustworthy and reliable, is one important aspect to determine organization’s survival. The perceived credibility of the messages will either strengthen or worsen an organization reputation. The primary objective of this paper is to revisit the concept of organizational credibility and its interaction with organizational outcomes such as organizational reputation. Based on the situational...

What matters in the patients' decision to revisit the same primary care physician?

Science.gov (United States)

Antoun, Jumana M; Hamadeh, Ghassan N; Adib, Salim M

2014-01-01

To assess the priority of various aspects of the patient-primary care physician relationship in the decision to visit again that same physician. STUDY SETTINGS: A total of 400 community residents in Ras Beirut, Lebanon. A cross-sectional community based study sampled by a nonrandom sex-education quota-based procedure. Participants were asked to fill a survey where they indicated the ranking of nine items by importance in their decision to revisit the same physician. The nine items were chosen from three categories of factors: professional expertise of the physician; characteristics of the patient-physician relationship, office organization. Having a physician that gives the patient adequate time for discussion prevailed as rank 1 and luxurious clinic ranked as 9th. Affordability was one of the main concerns among men, those with poor health and those of lower socioeconomic status. Accessibility of the physician's phone was considered highly important among women and those of lesser education status. This study emphasizes the importance of adequate time with the patient, accessibility and affordability of the physician in maintaining continuity of care and patient satisfaction, beyond mere medical expertise.

Service-Learning in Crisis Communication Education: Revisiting Coombs' Objectives for the Crisis Communication Course

Science.gov (United States)

Maresh-Fuehrer, Michelle M.

2015-01-01

The purpose of this study was to revisit Coombs' suggestions for teaching the crisis communication course using service-learning as a framework. The author sought to assess the effectiveness of using this method in terms of the benefits to both students and the partnering organization and students' perceptions of whether they met the learning…

Revisiting coupled Shukla-Varma and convective cell mode in classical and quantum dusty magnetoplasmas

Science.gov (United States)

Masood, W.; Mirza, Arshad M.; Nargis, Shahida

2010-08-01

The coupled Shukla-Varma (SV) and convective cell mode is revisited in classical and quantum dusty magnetoplasmas. It is shown that the inclusion of electron thermal effects modifies the original coupled SV and convective cell mode. It is also discussed how the quantum effects can be incorporated in the coupled SV and convective cell mode.

The Faraday effect revisited General theory

CERN Document Server

Cornean, H D; Pedersen, T G

2005-01-01

This paper is the first in a series revisiting the Faraday effect, or more generally, the theory of electronic quantum transport/optical response in bulk media in the presence of a constant magnetic field. The independent electron approximation is assumed. For free electrons, the transverse conductivity can be explicitly computed and coincides with the classical result. In the general case, using magnetic perturbation theory, the conductivity tensor is expanded in powers of the strength of the magnetic field $B$. Then the linear term in $B$ of this expansion is written down in terms of the zero magnetic field Green function and the zero field current operator. In the periodic case, the linear term in $B$ of the conductivity tensor is expressed in terms of zero magnetic field Bloch functions and energies. No derivatives with respect to the quasimomentum appear and thereby all ambiguities are removed, in contrast to earlier work.

Re-visiting the electrophysiology of language.

Science.gov (United States)

Obleser, Jonas

2015-09-01

This editorial accompanies a special issue of Brain and Language re-visiting old themes and new leads in the electrophysiology of language. The event-related potential (ERP) as a series of characteristic deflections ("components") over time and their distribution on the scalp has been exploited by speech and language researchers over decades to find support for diverse psycholinguistic models. Fortunately, methodological and statistical advances have allowed human neuroscience to move beyond some of the limitations imposed when looking at the ERP only. Most importantly, we currently witness a refined and refreshed look at "event-related" (in the literal sense) brain activity that relates itself more closely to the actual neurobiology of speech and language processes. It is this imminent change in handling and interpreting electrophysiological data of speech and language experiments that this special issue intends to capture. Copyright © 2015 Elsevier Inc. All rights reserved.

Revisiting the Performance of MACD and RSI Oscillators

Directory of Open Access Journals (Sweden)

Terence Tai-Leung Chong

2014-02-01

Full Text Available Chong and Ng (2008 find that the Moving Average Convergence–Divergence (MACD and Relative Strength Index (RSI rules can generate excess return in the London Stock Exchange. This paper revisits the performance of the two trading rules in the stock markets of five other OECD countries. It is found that the MACD(12,26,0 and RSI(21,50 rules consistently generate significant abnormal returns in the Milan Comit General and the S&P/TSX Composite Index. In addition, the RSI(14,30/70 rule is also profitable in the Dow Jones Industrials Index. The results shed some light on investors’ belief in these two technical indicators in different developed markets.

Revisiting the level scheme of the proton emitter 151Lu

International Nuclear Information System (INIS)

Wang, F.; Sun, B.H.; Liu, Z.; Scholey, C.; Eeckhaudt, S.; Grahn, T.; Greenlees, P.T.; Jones, P.; Julin, R.; Juutinen, S.; Kettelhut, S.; Leino, M.; Nyman, M.; Rahkila, P.; Saren, J.; Sorri, J.; Uusitalo, J.; Ashley, S.F.; Cullen, I.J.; Garnsworthy, A.B.; Gelletly, W.; Jones, G.A.; Pietri, S.; Podolyak, Z.; Steer, S.; Thompson, N.J.; Walker, P.M.; Williams, S.; Bianco, L.; Darby, I.G.; Joss, D.T.; Page, R.D.; Pakarinen, J.; Rigby, S.; Cullen, D.M.; Khan, S.; Kishada, A.; Gomez-Hornillos, M.B.; Simpson, J.; Jenkins, D.G.; Niikura, M.; Seweryniak, D.; Shizuma, Toshiyuki

2015-01-01

An experiment aiming to search for new isomers in the region of proton emitter 151 Lu was performed at the Accelerator Laboratory of the University of Jyväskylä (JYFL), by combining the high resolution γ-ray array JUROGAM, gas-filled RITU separator and GREAT detectors with the triggerless total data readout acquisition (TDR) system. In this proceeding, we revisit the level scheme of 151 Lu by using the proton-tagging technique. A level scheme consistent with the latest experimental results is obtained, and 3 additional levels are identified at high excitation energies. (author)

The importance of jet bending in gamma-ray AGNs—revisited

Energy Technology Data Exchange (ETDEWEB)

Graham, P. J. [School of Physics, University of New South Wales, Sydney, NSW 2052 (Australia); Tingay, S. J. [International Centre for Radio Astronomy Research, Curtin University, Bentley, WA (Australia)

2014-04-01

We investigate the hypothesis that γ-ray-quiet active galactic nuclei (AGNs) have a greater tendency for jet bending than γ-ray-loud AGNs, revisiting the analysis of Tingay et al. We perform a statistical analysis using a large sample of 351 radio-loud AGNs along with γ-ray identifications from the Fermi Large Area Telescope (LAT). Our results show no statistically significant differences in jet-bending properties between γ-ray-loud and γ-ray-quiet populations, indicating that jet bending is not a significant factor for γ-ray detection in AGNs.

Silent cries, dancing tears: the metapsychology of art revisited/revised.

Science.gov (United States)

Aragno, Anna

2011-04-01

Against the backdrop of a broad survey of the literature on applied psychoanalysis, a number of concepts underpinning the metapsychology of art are revisited and revised: sublimation; interrelationships between primary and secondary processes; symbolization; "fantasy"; and "cathexis." Concepts embedded in dichotomous or drive/energic contexts are examined and reformulated in terms of a continuum of semiotic processes. Freudian dream structure is viewed as a biological/natural template for nonrepressive artistic forms of sublimation. The synthesis presented proposes a model of continuous rather than discontinuous processes, in a nonenergic, biosemiotic metatheoretical framework.

Implications for new physics from fine-tuning arguments 1. Application to SUSY and seesaw cases

International Nuclear Information System (INIS)

Alberto Casas, J.; Hidalgo, Irene; Espinosa, Jose R.

2004-01-01

We revisit the standard argument to estimate the scale of new physics (NP) beyond the SM, based on the sensitivity of the Higgs mass to quadratic divergences. Although this argument is arguably naive, the corresponding estimate, Λ SM SM . One can obtain more precise implications from fine-tuning arguments in specific examples of NP. Here we consider SUSY and right-handed (seesaw) neutrinos. SUSY is a typical example for which the previous general estimate is indeed conservative: the MSSM is fine-tuned a few %, even for soft masses of a few hundred GeV. In contrast, other SUSY scenarios, in particular those with low-scale SUSY breaking, can easily saturate the general bound on Λ SM . The seesaw mechanism requires large fine-tuning if M R > or approx.10 7 GeV, unless there is additional NP (SUSY being a favourite option). (author)

"Suffering" in palliative sedation: Conceptual Analysis and Implications for Decision-Making in Clinical Practice.

Science.gov (United States)

Bozzaro, Claudia; Schildmann, Jan

2018-04-21

Palliative sedation is an increasingly used and, simultaneously, challenging practice at the end of life. Many controversies associated with this therapy are rooted in implicit differences regarding the understanding of "suffering" as prerequisite for palliative sedation. The aim of this paper is to inform the current debates by a conceptual analysis of two different philosophical accounts of suffering, (1) the subjective and holistic concept and (2) the objective and gradual concept and by a clinical-ethical analysis of the implications of each account for decisions about palliative sedation. We will show that while the subjective and holistic account of suffering fits well with the holistic approach of palliative care, there are considerable challenges to justify limits to requests for palliative sedation. By contrast, the objective and gradual account fits well with the need for an objective basis for clinical decisions in the context of palliative sedation, but runs the risk of falling short when considering the individual and subjective experience of suffering at the end of life. We will conclude with a plea for the necessity of further combined conceptual and empirical research to develop a sound and feasible understanding of suffering which can contribute to consistent decision-making about palliative sedation. Copyright © 2018. Published by Elsevier Inc.

Simulation of Two-Way Pushdown Automata Revisited

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Robert Glück

2013-09-01

Full Text Available The linear-time simulation of 2-way deterministic pushdown automata (2DPDA by the Cook and Jones constructions is revisited. Following the semantics-based approach by Jones, an interpreter is given which, when extended with random-access memory, performs a linear-time simulation of 2DPDA. The recursive interpreter works without the dump list of the original constructions, which makes Cook's insight into linear-time simulation of exponential-time automata more intuitive and the complexity argument clearer. The simulation is then extended to 2-way nondeterministic pushdown automata (2NPDA to provide for a cubic-time recognition of context-free languages. The time required to run the final construction depends on the degree of nondeterminism. The key mechanism that enables the polynomial-time simulations is the sharing of computations by memoization.

Distractor dwelling, skipping, and revisiting determine target absent performance in difficult visual search

Directory of Open Access Journals (Sweden)

Gernot Horstmann

2016-08-01

Full Text Available Some targets in visual search are more difficult to find than others. In particular, a target that is similar to the distractors is more difficult to find than a target that is dissimilar to the distractors. Efficiency differences between easy and difficult searches are manifest not only in target-present trials but also in target-absent trials. In fact, even physically identical displays are searched through with different efficiency depending on the searched-for target. Here, we monitored eye movements in search for a target similar to the distractors (difficult search versus a target dissimilar to the distractors (easy search. We aimed to examine three hypotheses concerning the causes of differential search efficiencies in target-absent trials: (a distractor dwelling (b distractor skipping, and (c distractor revisiting. Reaction times increased with target similarity which is consistent with existing theories and replicates earlier results. Eye movement data indicated guidance in target trials, even though search was very slow. Dwelling, skipping, and revisiting contributed to low search efficiency in difficult search, with dwelling being the strongest factor. It is argued that differences in dwell time account for a large amount of total search time differences.

Distractor Dwelling, Skipping, and Revisiting Determine Target Absent Performance in Difficult Visual Search

Science.gov (United States)

Horstmann, Gernot; Herwig, Arvid; Becker, Stefanie I.

2016-01-01

Some targets in visual search are more difficult to find than others. In particular, a target that is similar to the distractors is more difficult to find than a target that is dissimilar to the distractors. Efficiency differences between easy and difficult searches are manifest not only in target-present trials but also in target-absent trials. In fact, even physically identical displays are searched through with different efficiency depending on the searched-for target. Here, we monitored eye movements in search for a target similar to the distractors (difficult search) versus a target dissimilar to the distractors (easy search). We aimed to examine three hypotheses concerning the causes of differential search efficiencies in target-absent trials: (a) distractor dwelling (b) distractor skipping, and (c) distractor revisiting. Reaction times increased with target similarity which is consistent with existing theories and replicates earlier results. Eye movement data indicated guidance in target trials, even though search was very slow. Dwelling, skipping, and revisiting contributed to low search efficiency in difficult search, with dwelling being the strongest factor. It is argued that differences in dwell time account for a large amount of total search time differences. PMID:27574510

Clinical and functional implications of a history of childhood ADHD in first-episode psychosis.

Science.gov (United States)

Rho, Aldanie; Traicu, Alexandru; Lepage, Martin; Iyer, Srividya N; Malla, Ashok; Joober, Ridha

2015-07-01

There is mounting evidence indicating that a childhood history of attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for psychotic disorders, including schizophrenia. However, the implications of such a history on the symptomatic and functional outcomes of patients with psychotic disorders are still not well documented. This study examined the prevalence of childhood ADHD in patients with first episode psychosis (FEP) consecutively admitted to a specialized early intervention clinic covering a well-defined catchment area, and compared patients with and without a history of childhood ADHD on socio-demographic, clinical, and functional outcomes over a six to twelve months period. Out of 179 patients with FEP, 27 (15%) were treated for ADHD during childhood, consistent with previous literature indicating an association between childhood ADHD and psychosis. FEP patients with childhood history of ADHD had lower academic achievement, earlier onset of psychosis, and higher rates of childhood conduct and learning disorder. While the two groups had similar scores on psychopathology and functioning at baseline, patients with childhood ADHD showed significantly less improvement in positive and negative symptoms, as well as social and occupational functioning. These results strongly indicate that a history of childhood ADHD in FEP is more frequent than that reported in the general population and predictive of poorer clinical response to treatment. This emphasizes the need for actively screening for a history of ADHD in FEP patients and for treatments that are tailored for these patients. Copyright © 2015 Elsevier B.V. All rights reserved.

The Super-GUT CMSSM Revisited

CERN Document Server

Ellis, John

2016-01-01

We revisit minimal supersymmetric SU(5) grand unification (GUT) models in which the soft supersymmetry-breaking parameters of the minimal supersymmetric Standard Model (MSSM) are universal at some input scale, $M_{in}$, above the supersymmetric gauge coupling unification scale, $M_{GUT}$. As in the constrained MSSM (CMSSM), we assume that the scalar masses and gaugino masses have common values, $m_0$ and $m_{1/2}$ respectively, at $M_{in}$, as do the trilinear soft supersymmetry-breaking parameters $A_0$. Going beyond previous studies of such a super-GUT CMSSM scenario, we explore the constraints imposed by the lower limit on the proton lifetime and the LHC measurement of the Higgs mass, $m_h$. We find regions of $m_0$, $m_{1/2}$, $A_0$ and the parameters of the SU(5) superpotential that are compatible with these and other phenomenological constraints such as the density of cold dark matter, which we assume to be provided by the lightest neutralino. Typically, these allowed regions appear for $m_0$ and $m_{1/...

Critical boundary sine-Gordon revisited

International Nuclear Information System (INIS)

Hasselfield, M.; Lee, Taejin; Semenoff, G.W.; Stamp, P.C.E.

2006-01-01

We revisit the exact solution of the two space-time dimensional quantum field theory of a free massless boson with a periodic boundary interaction and self-dual period. We analyze the model by using a mapping to free fermions with a boundary mass term originally suggested in Ref. [J. Polchinski, L. Thorlacius, Phys. Rev. D 50 (1994) 622]. We find that the entire SL (2, C) family of boundary states of a single boson are boundary sine-Gordon states and we derive a simple explicit expression for the boundary state in fermion variables and as a function of sine-Gordon coupling constants. We use this expression to compute the partition function. We observe that the solution of the model has a strong-weak coupling generalization of T-duality. We then examine a class of recently discovered conformal boundary states for compact bosons with radii which are rational numbers times the self-dual radius. These have simple expression in fermion variables. We postulate sine-Gordon-like field theories with discrete gauge symmetries for which they are the appropriate boundary states

Investigating predictors of visiting, using, and revisiting an online health-communication program: a longitudinal study.

Science.gov (United States)

Van 't Riet, Jonathan; Crutzen, Rik; De Vries, Hein

2010-09-02

Online health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions. In the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population. A webpage was created providing the public with information about health and healthy behavior. The website included a "physical activity check," which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed. Analyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants (odds ratio [OR] = 2.81, 95% confidence interval [CI] = 1.16-6.81, P = .02) and participants with a strong motivation to be healthy (OR = 1.46, CI = 1

Operator entanglement of two-qubit joint unitary operations revisited: Schmidt number approach

Energy Technology Data Exchange (ETDEWEB)

Xia, Hui-Zhi; Li, Chao; Yang, Qing; Yang, Ming, E-mail: mingyang@ahu.edu.cn [Key Laboratory of Opto-electronic Information Acquisition and Manipulation, Ministry of Education, School of Physics and Material Science, Anhui University Hefei (China); Cao, Zhuo-Liang [School of Electronic Information Engineering, Hefei Normal University (China)

2012-08-15

The operator entanglement of two-qubit joint unitary operations is revisited. The Schmidt number, an important attribute of a two-qubit unitary operation, may have connection with the entanglement measure of the unitary operator. We find that the entanglement measure of a two-qubit unitary operators is classified by the Schmidt number of the unitary operators. We also discuss the exact relation between the operator entanglement and the parameters of the unitary operator. (author)

Revisit the spin-FET: Multiple reflection, inelastic scattering, and lateral size effects

OpenAIRE

Xu, Luting; Li, Xin-Qi; Sun, Qing-feng

2014-01-01

We revisit the spin-injected field effect transistor (spin-FET) by simulating a lattice model based on recursive lattice Green's function approach. In the one-dimensional case and coherent regime, the simulated results reveal noticeable differences from the celebrated Datta-Das model, which motivate thus an improved treatment and lead to analytic and generalized result. The simulation also allows us to address inelastic scattering (using B\\"uttiker's fictitious reservoir approach) and lateral...

Physiotherapy clinical education at a South African university

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V Chetty

2018-04-01

Full Text Available Background. Clinical education for physiotherapists forms a vital part of undergraduate programmes and equips students with competencies to practise autonomously as qualified health practitioners. However, disparities are evident in approaches to clinical education.Objective. To explore the perceptions of physiotherapy students, community-service physiotherapists and physiotherapy clinical supervisors regarding the clinical education framework at a tertiary institution in South Africa in order to understand preparedness of students for practice.Methods. A case study approach with two focus group discussions with students and interviews with community physiotherapists and clinical supervisors was employed. Data were analysed and categorised into key themes and sub-themes.Results. Five themes emerged from triangulation of data from the three groups: preparedness for professional practice, institutional barriers, curriculum disputes, personal factors and recommendations for physiotherapy clinical education. Students felt inadequately prepared owing to a perceived lack of exposure to certain aspects of physiotherapy, while community therapists believed that reflection on the undergraduate programme after qualifying contributed to their adequate preparation. Clinical supervisors supposed that students would benefit from actively engaging with teaching and learning opportunities, and clinical personnel collaboration was seen as key to facilitate a continuum in clinical education from classroom to healthcare setting.Conclusion. Participants reported that the existing curriculum structure may need to be revisited to address various issues, while holistic collaboration between students, supervisors and clinical personnel is imperative to create a cohesive learning environment.

Developments in our understanding of the effects of growth hormone on white adipose tissue from mice: implications to the clinic.

Science.gov (United States)

Berryman, Darlene E; Henry, Brooke; Hjortebjerg, Rikke; List, Edward O; Kopchick, John J

2016-01-01

Adipose tissue (AT) is a well-established target of growth hormone (GH) and is altered in clinical conditions associated with excess, deficiency and absence of GH action. Due to the difficulty in collecting AT from clinical populations, genetically modified mice have been useful in better understanding how GH affects this tissue. Recent findings in mice would suggest that the impact of GH on AT is beyond alterations of lipolysis, lipogenesis or proliferation/ differentiation. AT depot-specific alterations in immune cells, extracellular matrix, adipokines, and senescence indicate an expanded role for GH in AT physiology. This mouse data will guide additional studies necessary to evaluate the therapeutic potential and safety of GH for conditions associated with altering AT, such as obesity. In this review, we introduce several relatively new intricacies of GH's effect on AT, focusing on recent studies in mice. Finally, we summarize the clinical implications of these findings.

Entropy of measurement and erasure: Szilard's membrane model revisited

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Leff, Harvey S.; Rex, Andrew F.

1994-11-01

It is widely believed that measurement is accompanied by irreversible entropy increase. This conventional wisdom is based in part on Szilard's 1929 study of entropy decrease in a thermodynamic system by intelligent intervention (i.e., a Maxwell's demon) and Brillouin's association of entropy with information. Bennett subsequently argued that information acquisition is not necessarily irreversible, but information erasure must be dissipative (Landauer's principle). Inspired by the ensuing debate, we revisit the membrane model introduced by Szilard and find that it can illustrate and clarify (1) reversible measurement, (2) information storage, (3) decoupling of the memory from the system being measured, and (4) entropy increase associated with memory erasure and resetting.

The clinical implications and biologic relevance of neurofilament expression in gastroenteropancreatic neuroendocrine neoplasms.

Science.gov (United States)

Schimmack, Simon; Lawrence, Ben; Svejda, Bernhard; Alaimo, Daniele; Schmitz-Winnenthal, Hubertus; Fischer, Lars; Büchler, Markus W; Kidd, Mark; Modlin, Irvin

2012-05-15

Although gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) exhibit widely divergent behavior, limited biologic information (apart from Ki-67) is available to characterize malignancy. Therefore, the identification of alternative biomarkers is a key unmet need. Given the role of internexin alpha (INA) in neuronal development, the authors assessed its function in neuroendocrine cell systems and the clinical implications of its expression as a GEP-NEN biomarker. Functional assays were undertaken to investigate the mechanistic role of INA in the pancreatic BON cell line. Expression levels of INA were investigated in 50 pancreatic NENs (43 primaries, 7 metastases), 43 small intestinal NENs (25 primaries, 18 metastases), normal pancreas (n = 10), small intestinal mucosa (n = 16), normal enterochromaffin (EC) cells (n = 9), mouse xenografts (n = 4) and NEN cell lines (n = 6) using quantitative polymerase chain reaction, Western blot, and immunostaining analyses. In BON cells, decreased levels of INA messenger RNA and protein were associated with the inhibition of both proliferation and mitogen-activated protein kinase (MAPK) signaling. INA was not expressed in normal neuroendocrine cells but was overexpressed (from 2-fold to 42-fold) in NEN cell lines and murine xenografts. In pancreatic NENs, INA was overexpressed compared with pancreatic adenocarcinomas and normal pancreas (27-fold [P = .0001], and 9-fold [P = .02], respectively). INA transcripts were correlated positively with Ki-67 (correlation coefficient [r] = 0.5; P biologic information relevant to delineation of both pancreatic NEN tumor phenotypes and clinical behavior. Copyright © 2011 American Cancer Society.

Sexual Objectification of Women: Clinical Implications and Training Considerations

Science.gov (United States)

Szymanski, Dawn M.; Carr, Erika R.; Moffitt, Lauren B.

2011-01-01

This article focuses on the implications of theory and empirical research on the sexual objectification of women. Drawing largely from the American Psychological Association's 2007 "Guidelines for Psychological Practice With Girls and Women," the 2007 "Report of the American Psychological Association's Task Force on the Sexualization of Girls,"…

Revisit to diffraction anomalous fine structure

International Nuclear Information System (INIS)

Kawaguchi, T.; Fukuda, K.; Tokuda, K.; Shimada, K.; Ichitsubo, T.; Oishi, M.; Mizuki, J.; Matsubara, E.

2014-01-01

The diffraction anomalous fine structure method has been revisited by applying this measurement technique to polycrystalline samples and using an analytical method with the logarithmic dispersion relation. The diffraction anomalous fine structure (DAFS) method that is a spectroscopic analysis combined with resonant X-ray diffraction enables the determination of the valence state and local structure of a selected element at a specific crystalline site and/or phase. This method has been improved by using a polycrystalline sample, channel-cut monochromator optics with an undulator synchrotron radiation source, an area detector and direct determination of resonant terms with a logarithmic dispersion relation. This study makes the DAFS method more convenient and saves a large amount of measurement time in comparison with the conventional DAFS method with a single crystal. The improved DAFS method has been applied to some model samples, Ni foil and Fe 3 O 4 powder, to demonstrate the validity of the measurement and the analysis of the present DAFS method

The critical catastrophe revisited

International Nuclear Information System (INIS)

De Mulatier, Clélia; Rosso, Alberto; Dumonteil, Eric; Zoia, Andrea

2015-01-01

The neutron population in a prototype model of nuclear reactor can be described in terms of a collection of particles confined in a box and undergoing three key random mechanisms: diffusion, reproduction due to fissions, and death due to absorption events. When the reactor is operated at the critical point, and fissions are exactly compensated by absorptions, the whole neutron population might in principle go to extinction because of the wild fluctuations induced by births and deaths. This phenomenon, which has been named critical catastrophe, is nonetheless never observed in practice: feedback mechanisms acting on the total population, such as human intervention, have a stabilizing effect. In this work, we revisit the critical catastrophe by investigating the spatial behaviour of the fluctuations in a confined geometry. When the system is free to evolve, the neutrons may display a wild patchiness (clustering). On the contrary, imposing a population control on the total population acts also against the local fluctuations, and may thus inhibit the spatial clustering. The effectiveness of population control in quenching spatial fluctuations will be shown to depend on the competition between the mixing time of the neutrons (i.e. the average time taken for a particle to explore the finite viable space) and the extinction time

Gene therapy in dentistry: tool of genetic engineering. Revisited.

Science.gov (United States)

Gupta, Khushboo; Singh, Saurabh; Garg, Kavita Nitish

2015-03-01

Advances in biotechnology have brought gene therapy to the forefront of medical research. The concept of transferring genes to tissues for clinical applications has been discussed nearly half a century, but the ability to manipulate genetic material via recombinant DNA technology has brought this goal to reality. The feasibility of gene transfer was first demonstrated using tumour viruses. This led to development of viral and nonviral methods for the genetic modification of somatic cells. Applications of gene therapy to dental and oral problems illustrate the potential impact of this technology on dentistry. Preclinical trial results regarding the same have been very promising. In this review we will discuss methods, vectors involved, clinical implication in dentistry and scientific issues associated with gene therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

ESWT for tendinopathy: technology and clinical implications.

Science.gov (United States)

van der Worp, Henk; van den Akker-Scheek, Inge; van Schie, Hans; Zwerver, Johannes

2013-06-01

The general consensus that tendinopathy, at least in the chronic stage, is mainly a degenerative condition and inflammation plays a minor role has led to a shift from treatments that target inflammation towards treatment options that promote regeneration. One of these treatments is extracorporeal shockwave therapy (ESWT), a physical therapy modality that uses pressure waves to treat tendinopathy. This review was undertaken to give an overview of the literature concerning this treatment, and special attention is given to the differences between focused and radial ESWT. A narrative description of wave characteristics, generation methods and in vitro effects of ESWT is given. The literature on ESWT as a treatment for one common tendinopathy, patellar tendinopathy, was systematically reviewed. Waves that are generated for focused and radial ESWT have very different physical characteristics. It is unclear how these characteristics are related to clinical effectiveness. Studies into the biological effects of ESWT have mainly used focused shockwave therapy, showing a number of effects of shockwaves on biological tissue. The systematic review of studies into the clinical effects of ESWT for patellar tendinopathy showed conflicting evidence for its effectiveness. Physical characteristics of focused and radial waves differ substantially, but effect on clinical effectiveness is unclear. Whereas in vitro studies often show the effects of ESWT on tendon tissue, results of clinical studies are inconsistent. Based on the review of the literature, suggestions are given for the use of ESWT in clinical practice regarding timing and treatment parameters.

SUSY S4×SU(5) revisited

International Nuclear Information System (INIS)

Hagedorn, Claudia; King, Stephen F.; Luhn, Christoph

2012-01-01

Following the recent results from Daya Bay and RENO, which measure the lepton mixing angle θ 13 l ≈0.15, we revisit a supersymmetric (SUSY) S 4 ×SU(5) model, which predicts tri-bimaximal (TB) mixing in the neutrino sector with θ 13 l being too small in its original version. We show that introducing one additional S 4 singlet flavon into the model gives rise to a sizable θ 13 l via an operator which leads to the breaking of one of the two Z 2 symmetries preserved in the neutrino sector at leading order (LO). The results of the original model for fermion masses, quark mixing and the solar mixing angle are maintained to good precision. The atmospheric and solar mixing angle deviations from TB mixing are subject to simple sum rule bounds.

Neutrino dark energy. Revisiting the stability issue

Energy Technology Data Exchange (ETDEWEB)

Eggers Bjaelde, O.; Hannestad, S. [Aarhus Univ. (Denmark). Dept. of Physics and Astronomy; Brookfield, A.W. [Sheffield Univ. (United Kingdom). Dept. of Applied Mathematics and Dept. of Physics, Astro-Particle Theory and Cosmology Group; Van de Bruck, C. [Sheffield Univ. (United Kingdom). Dept. of Applied Mathematics, Astro-Particle Theory and Cosmology Group; Mota, D.F. [Heidelberg Univ. (Germany). Inst. fuer Theoretische Physik]|[Institute of Theoretical Astrophysics, Oslo (Norway); Schrempp, L. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Tocchini-Valentini, D. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Physics and Astronomy

2007-05-15

A coupling between a light scalar field and neutrinos has been widely discussed as a mechanism for linking (time varying) neutrino masses and the present energy density and equation of state of dark energy. However, it has been pointed out that the viability of this scenario in the non-relativistic neutrino regime is threatened by the strong growth of hydrodynamic perturbations associated with a negative adiabatic sound speed squared. In this paper we revisit the stability issue in the framework of linear perturbation theory in a model independent way. The criterion for the stability of a model is translated into a constraint on the scalar-neutrino coupling, which depends on the ratio of the energy densities in neutrinos and cold dark matter. We illustrate our results by providing meaningful examples both for stable and unstable models. (orig.)

Proprioception: where are we now? A commentary on clinical assessment, changes across the life course, functional implications and future interventions.

Science.gov (United States)

Suetterlin, Karen Joan; Sayer, Avan Aihie

2014-05-01

Proprioception, the sense of where one is in space, is essential for effective interaction with the environment. A lack of or reduction in proprioceptive acuity has been directly correlated with falls and with reduced functional independence in older people. Proprioceptive losses have also been shown to negatively correlate with functional recovery post stroke and play a significant role in other conditions such as Parkinson's disease. However, despite its central importance to many geriatric syndromes, the clinical assessment of proprioception has remained remarkably static. We look at approaches to the clinical assessment of proprioception, changes in proprioception across the life course, functional implications of proprioception in health and disease and the potential for targeted interventions in the future such as joint taping, and proprioception-specific rehabilitation and footwear.

Experiments on the Divergence between Willingness to Pay and Willingness to Accept: The Issue Revisited

OpenAIRE

Rodolfo M. Nayga, Jr.; Wipon Aiew; Richard Woodward

2005-01-01

Many empirical studies have discovered large discrepancies between willingness to pay (WTP) and willingness to accept (WTA) measures. This paper revisits the WTP and WTA divergence issue using a non-hypothetical market experiment, actual products, cash, and exchange in a market setting. We find WTA/WTP ratios that are significantly lower than most such studies.

Using destination image to predict visitors' intention to revisit three Hudson River Valley, New York, communities

Science.gov (United States)

Rudy M. Schuster; Laura Sullivan; Duarte Morais; Diane Kuehn

2009-01-01

This analysis explores the differences in Affective and Cognitive Destination Image among three Hudson River Valley (New York) tourism communities. Multiple regressions were used with six dimensions of visitors' images to predict future intention to revisit. Two of the three regression models were significant. The only significantly contributing independent...

The Stroop Revisited: A Meta-Analysis of Interference Control in AD/HD

Science.gov (United States)

Van Mourik, Rosa; Oosterlaan, Jaap; Sergeant, Joseph A.

2005-01-01

Background: An inhibition deficit, including poor interference control, has been implicated as one of the core deficits in AD/HD. Interference control is clinically measured by the Stroop Colour-Word Task. The aim of this meta-analysis was to investigate the strength of an interference deficit in AD/HD as measured by the Stroop Colour-Word Task…

A rare variant of the ulnar artery with important clinical implications: a case report

Directory of Open Access Journals (Sweden)

Casal Diogo

2012-11-01

Full Text Available Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elbow, crossed superficial to the muscles that originated from the medial epicondyle, and ran over the pronator teres muscle in a doubling of the antebrachial fascia. It then dipped into the forearm fascia, in the gap between the flexor carpi radialis and the palmaris longus. Subsequently, it ran deep to the palmaris longus muscle belly, and superficially to the flexor digitorum superficialis muscle, reaching the gap between the latter and the flexor carpi ulnaris muscle, where it assumed is usual position lateral to the ulnar nerve. Conclusion As far as the authors could determine, this variant of the superficial brachioulnar artery has only been described twice before in the literature. The existence of such a variant is of particular clinical significance, as these arteries are more susceptible to trauma, and can be easily confused with superficial veins during medical and surgical procedures, potentially leading to iatrogenic distal limb ischemia.

Revisiting the roles and responsibilities of speech-language therapists in South African schools.

Science.gov (United States)

Wium, A M; Louw, B

2013-12-01

The role of speech-language therapists (SLTs) in schools in South Africa needs to be revisited based on the changing educational needs in the country. This article builds on a paper by Kathard et al. (2011), which discussed the changing needs of the country with regard to the role of SLTs working in schools. South African policy changes indicated a shift from supporting the child to supporting the teacher, but also place more emphasis on the support of all learners in literacy in an effort to address past inequities. This paper addresses several of the questions that emerged from Kathard et al. and explores the collaborative roles played by SLTs on four levels in the education context. Collaboration at the learner level (level 1) focuses on prevention and support, whereas collaboration at the teacher level (level 2) is described in terms of training, mentoring, monitoring and consultation. Collaboration can also occur at the district level (level 3), where the focus is mainly on the development and implementation of support programmes for teachers in areas of literacy and numeracy. Collaboration at the level of national and provincial education (level 4) is key to all other roles, as it impacts on policy. This last level is the platform to advocate for the employment of SLTs in schools. Such new roles and responsibilities have important implications for the preparation of future SLTs. Suggestions for curricular review and professional development are discussed. It is proposed that SASLHA responds to the changes by developing a position statement on the roles and responsibilities of SLTs in schools.

Asian Lifelong Learning in the Context of a Global Knowledge Economy: A Task Re-Visited

Science.gov (United States)

Han, Soonghee

2007-01-01

This article revisits and reinterprets my previous paper. It is a snapshot of the lifelong learning system building in selected Asian countries, reflected in the mirror of the Asian Financial Crisis in the 1997s and the aftermath of that event. I reconsidered the arguments (1) the economic recession had delivered a global dimension of lifelong…

Revisiting "Kindergarten as Academic Boot Camp": A Nationwide Study of Ability Grouping and Psycho-Social Development

Science.gov (United States)

Catsambis, Sophia; Buttaro, Anthony, Jr.

2012-01-01

We revisit Harry L. Gracey's perspective of kindergarten as academic boot camp where, at school entry, children acquire the student role through a structured program of activities. We provide further insights into the crucial mechanisms of socialization that occur in U.S. kindergartens by examining the relationship between within-class ability…

Vestindien Revisited: I kølvandet på kuldampere og cruiseturister

DEFF Research Database (Denmark)

Brichet, Nathalia Sofie; Hastrup, Frida; Ørstedholm, Maroe

2017-01-01

What traces did Denmark officially leave behind when the West Indies were sold to the United States in 1917? And how are the islands still affected today by Denmark’s presence on the islands? The M/S Maritime Museum tries to answer these questions in its special new exhibition, ‘U.S. VIRGIN ISLAN...... special exhibition “U.S. VIRGIN ISLANDS REVISITED – in the wake of colliers and cruise tourists,” to commemorate the centennial anniversary of selling the West Indies to the United States of America....

The Tension between the Decision and Control Perspectives of Accounting Revisited

DEFF Research Database (Denmark)

Christensen, John

2009-01-01

to use different accounting systems for different purposes. That is not the norm. The tensions are managed within a single accounting system and that leads to trade-offs in the accounting system. I will revisit these conflicts of uses of accounting systems using product costing, transfer pricing and fair......The accounting system is a carefully managed information system which is used for multiple purposes. Traditionally, the uses are categorized using the main headings of decision and control. Numerous conflicts are the consequence of the multi-purpose accounting system. The easy way out is apparently...

[Radiation-induced bystander effect: the important part of ionizing radiation response. Potential clinical implications].

Science.gov (United States)

Wideł, Maria; Przybyszewski, Waldemar; Rzeszowska-Wolny, Joanna

2009-08-18

It has long been a central radiobiological dogma that the damaging effects of ionizing radiation, such as cell death, cytogenetic changes, apoptosis, mutagenesis, and carcinogenesis, are the results of the direct ionization of cell structures, particularly DNA, or indirect damage via water radiolysis products. However, several years ago attention turned to a third mechanism of radiation, termed the "bystander effect" or "radiation-induced bystander effect" (RIBE). This is induced by agents and signals emitted by directly irradiated cells and manifests as a lowering of survival, cytogenetic damage, apoptosis enhancement, and biochemical changes in neighboring non-irradiated cells. The bystander effect is mainly observed in in vitro experiments using very low doses of alpha particles (range; mGy, cGy), but also after conventional irradiation (X-rays, gamma rays) at low as well as conventional doses. The mechanisms responsible for the bystander effect are complex and still poorly understood. It is believed that molecular signals released from irradiated cells induce different signaling ways in non-irradiated neighboring cells, leading to the observed events. The molecular signals may be transmitted through gap junction intercellular communication and through a medium transfer mechanism. The nature of these transmitted factors are diverse, and still not definitely established. It seems that RIBE may have important clinical implications for health risk associated with radiation exposure. Potentially, this effect may have important implications in the creation of whole-body or localized side effects in tissues beyond the irradiation field and also in low-dose radiological and radioisotope diagnostics. Factors emitted by irradiated cells may result in the risk of genetic instability, mutations, and second primary cancer induction. They might also have their own part in inducing and extending post-radiation side effects in normal tissue. The bystander effect may be a

Radiation-induced bystander effect: The important part of ionizing radiation response. Potential clinical implications

Directory of Open Access Journals (Sweden)

Maria Wideł

2009-08-01

Full Text Available It has long been a central radiobiological dogma that the damaging effects of ionizing radiation, such as cell death, cytogenetic changes, apoptosis, mutagenesis, and carcinogenesis, are the results of the direct ionization of cell structures, particularly DNA, or indirect damage via water radiolysis products. However, several years ago attention turned to a third mechanism of radiation, termed the “bystander effect” or “radiation-induced bystander effect” (RIBE. This is induced by agents and signals emitted by directly irradiated cells and manifests as a lowering of survival, cytogenetic damage, apoptosis enhancement, and biochemical changes in neighboring non-irradiated cells. The bystander effect is mainly observed in in vitro experiments using very low doses of alpha particles (range; mGy, cGy, but also after conventional irradiation (X-rays, gamma rays at low as well as conventional doses. The mechanisms responsible for the bystander effect are complex and still poorly understood. It is believed that molecular signals released from irradiated cells induce different signaling ways in non-irradiated neighboring cells, leading to the observed events. The molecular signals may be transmitted through gap junction intercellular communication and through a medium transfer mechanism. The nature of these transmitted factors are diverse, and still not defi nitely established. It seems that RIBE may have important clinical implications for health risk associated with radiation exposure. Potentially, this effectmay have important implications in the creation of whole-body or localized side effects in tissues beyond the irradiation fi eld and also in low-dose radiological and radioisotope diagnostics. Factors emitted by irradiated cells may result in the risk of genetic instability, mutations, and second primary cancer induction. They might also have their own part in inducing and extending post-radiation side effects in normal tissue. The

[Association of Schizophrenia and its Clinical Implications with the NOS1AP Gene in the Colombian Population].

Science.gov (United States)

Valencia, Jenny García; Duarte, Ana Victoria Valencia; Vila, Ana Lucía Páez; Kremeyer, Bárbara; Montoya, María Patricia Arbeláez; Linares, Andrés Ruiz; Acosta, Carlos Alberto Palacio; Duque, Jorge Ospina; Berrío, Gabriel Bedoya

2012-06-01

The nitric oxide synthase 1 adaptor protein (NOS1AP) gene is possibly implicated in schizophrenia etiopathogenesis. To determine the association of NOS1AP gene variants with schizophrenia and the relationship of variants with the clinical dimensions of the disorder in the Colombian population. It is a case-control study with 255 subjects per group. Markers within the NOS1AP gene were typified as well as other informative material of genetic origin so as to adjust by population stratification. A factorial analysis of the main components for each item in the Scales for Evaluating Negative Symptoms (SENS) together with the Scales for Evaluating Positive Symptoms (SEPS) to determine clinical dimensions. Association between the C/C genotype of the rs945713 marker with schizophrenia (OR = 1.79, 95% CI: 1.13 - 2.84) was found. The C/C genotype of the rs945713 was related to higher scores in the "affective flattening and alogia" dimension; and the A/A genotype of the rs4657181 marker was associated to lower scores in the same dimension. Significant associations of markers inside the NOS1AP gene with schizophrenia and the "affective flattening and alogia" clinical dimension were found. These results are consistent with previous studies and support the possibility that NOS1AP influences schizophrenia susceptibility. Furthermore, NOS1AP might be a modifier of schizophrenia clinical characteristics. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

A comparative study of patients' and nurses' perceptions of the quality of nursing services, satisfaction and intent to revisit the hospital: a questionnaire survey.

Science.gov (United States)

Lee, Mi Aie; Yom, Young-Hee

2007-05-01

Although it is very important to clarify the factors influencing the patients' and nurses' satisfaction with nursing services, very little research has been performed in this area. The purpose of this study was to compare the nursing service quality, satisfaction and intent to revisit the hospital perceived by hospitalized patients and nurses in Korea. SERVQUAL scale, an overall satisfaction and intent to revisit the hospital questionnaires were used. The sample consisted of 272 patients and 282 nurses. The data were collected using paper and pencil self-rating questionnaires and analyzed using frequency, %, mean, standard deviation, t-test and Pearson correlation coefficient. Overall, nurses' expectations and performance were higher than those of patients, while patients' overall satisfaction with nursing and medical care was higher than that of nurses. There was a strong positive relationship between satisfaction with nursing and medical care and intent to revisit the hospital for both groups. The performance was relatively lower than expectations, resulting in poor nursing care quality. Differences between expectations and performance for both patients and nurses need to be further reduced.

Absence of the musculocutaneous nerve: a rare anatomical variation with possible clinical-surgical implications

Directory of Open Access Journals (Sweden)

José Humberto Tavares Guerreiro Fregnani

Full Text Available CONTEXT: The musculocutaneous nerve is one of the terminal branches of the lateral fasciculus of the brachial plexus, and is responsible for innervation of the flexor musculature of the elbow and for skin sensitivity on the lateral surface of the forearm. Its absence has been described previously, but its real prevalence is unknown. CASE REPORT: A case of absence of the musculocutaneous nerve that was observed during the dissection of the right arm of a male cadaver is described. The area of innervation was supplied by the median nerve. From this, three branches emerged: one to the coracobrachialis muscle, another to the biceps brachii muscle and the third to the brachialis muscle. This last branch continued as a lateral antebrachial cutaneous nerve. This is an anatomical variation that has clinical-surgical implications, considering that injury to the median nerve in this case would have caused unexpected paralysis of the flexor musculature of the elbow and hypoesthesia of the lateral surface of the forearm.

Beat-to-beat variability of cardiac action potential duration: underlying mechanism and clinical implications.

Science.gov (United States)

Nánási, Péter P; Magyar, János; Varró, András; Ördög, Balázs

2017-10-01

Beat-to-beat variability of cardiac action potential duration (short-term variability, SV) is a common feature of various cardiac preparations, including the human heart. Although it is believed to be one of the best arrhythmia predictors, the underlying mechanisms are not fully understood at present. The magnitude of SV is basically determined by the intensity of cell-to-cell coupling in multicellular preparations and by the duration of the action potential (APD). To compensate for the APD-dependent nature of SV, the concept of relative SV (RSV) has been introduced by normalizing the changes of SV to the concomitant changes in APD. RSV is reduced by I Ca , I Kr , and I Ks while increased by I Na , suggesting that ion currents involved in the negative feedback regulation of APD tend to keep RSV at a low level. RSV is also influenced by intracellular calcium concentration and tissue redox potential. The clinical implications of APD variability is discussed in detail.

Revisiting ovarian hyper stimulation syndrome: Towards OHSS free clinic

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Manish Banker

2015-01-01

Full Text Available A rapid development and application of assisted reproductive technologies (ARTs and ovulation-induction drugs may lead to ovarian hyper stimulation syndrome (OHSS. Young age, low body mass index (BMI, polycystic ovarian syndrome (PCOS, previous OHSS, high follicle count, and elevated serum estradiol (E2 are the certain factors that predispose women to OHSS. Many strategies have been used to reduce or avoid OHSS. Use of human chorionic gonadotropin (hCG increases ovarian vascular permeability and is responsible for activating the vascular endothelial growth factors (VEGF pathway and thus the entire cascade, leading to symptomatic OHSS. Gonadotropin-releasing hormone (GnRH agonists are used as a replacement for hCG for final oocyte maturation in antagonist cycles. Reducing or eliminating the use of hCG and use of GnRH agonist triggered GnRH antagonist cycles and cryopreservation of oocytes or embryos is the most promising approach in making OHSS free clinic a reality.

Leukemia and ionizing radiation revisited

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Cuttler, J.M. [Cuttler & Associates Inc., Vaughan, Ontario (Canada); Welsh, J.S. [Loyola University-Chicago, Dept. or Radiation Oncology, Stritch School of Medicine, Maywood, Illinois (United States)

2016-03-15

A world-wide radiation health scare was created in the late 19508 to stop the testing of atomic bombs and block the development of nuclear energy. In spite of the large amount of evidence that contradicts the cancer predictions, this fear continues. It impairs the use of low radiation doses in medical diagnostic imaging and radiation therapy. This brief article revisits the second of two key studies, which revolutionized radiation protection, and identifies a serious error that was missed. This error in analyzing the leukemia incidence among the 195,000 survivors, in the combined exposed populations of Hiroshima and Nagasaki, invalidates use of the LNT model for assessing the risk of cancer from ionizing radiation. The threshold acute dose for radiation-induced leukemia, based on about 96,800 humans, is identified to be about 50 rem, or 0.5 Sv. It is reasonable to expect that the thresholds for other cancer types are higher than this level. No predictions or hints of excess cancer risk (or any other health risk) should be made for an acute exposure below this value until there is scientific evidence to support the LNT hypothesis. (author)

Clinical implications of the recent homeopathic medicine and its application to oriental medicine

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Ok-Byung,Choi

2007-02-01

Full Text Available Objectives : The purpose of this study is to analyze the practical implications of homeopathic medicines, their status, their preparation systems and registration rules, recognized by the European Union and other countries. Contents : This paper covers the background of homeopathic medical principle, homeopathy throughout the world, the medicine status and clinical research, increases of the drug potency, the practical regulation of treatment, preparation techniques of homeopathic drugs and registration rules and the clinical practice. Homeopathy has been currently practised in over eighty countries throughout the world, especially in Europe. It had attracted considerable attentions in South and North America (notably in USA, Brazil, and Argentina, India and Pakistan. Although it is not dominantly popular in North America, constant growth has been nevertheless noted. Over the last thirty years, homeopathy has also developed or appeared in South Africa, Tunisia, Morocco, Venezuela, Israel, and Australia, etc. Result & suggestion : As over 300 million patients have put their trust in homeopathy, the study of the integration of homeopathy to oriental medicine, its development and feasibility in Korea are urgently needed. The products, substances, compositions of Homeopathic drugs are very similar to those of oriental medicine theory. Therefore their preparations and applications should prescribed and practised exclusively by oriental doctors. Applying the homeopathic theory and its preparation techniques to oriental medicine, the herbal acupuncture preparation should be modernized and various oriental products are to be developed. To this end, government and herbal acupuncture society need to interact each other for the development of oriental medicine.

An Examination of the Relationship between Rural Tourists’ Satisfaction, Revisitation and Information Preferences: A Korean Case Study

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Hee-Sun Cho

2014-09-01

Full Text Available To encourage the sustainability of rural tourism and to achieve success in the tourist industry, an understanding of the factors by which tourists are motivated to visit rural areas is required. This study aims to measure factors affecting rural tourists’ satisfaction in relation to different aspects of a destination and to increase the likelihood of revisitation and recommendation. This study also attempts to examine differences in relation to satisfaction depending on the information source preference. Overall satisfaction was influenced by physical infrastructure, service quality and satisfaction level with tour programs. However, the quality of services was more related to tourists’ intentions to revisit and recommend, suggesting that its qualitative improvement can contribute to vitalizing stagnant domestic tourism. The findings revealed that tourists’ satisfaction was high when people mainly gained tourist information through formal government sources, word-of-mouth and Internet advertising, suggesting that the positive correlation between tourists’ satisfaction and information sources reflects the reliability and credibility of those sources.

Clinical Implications of Intestinal Stem Cell Markers in Colorectal Cancer

DEFF Research Database (Denmark)

Espersen, Maiken Lise Marcker; Olsen, Jesper; Linnemann, Dorte

2015-01-01

Colorectal cancer (CRC) still has one of the highest incidence and mortality rate among cancers. Therefore, improved differential diagnostics and personalized treatment are still needed. Several intestinal stem cell markers have been found to be associated with CRC and might have a prognostic...... and predictive significance in CRC patients. This review provides an overview of the intestinal stem cell markers leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5), B cell–specific Moloney murine leukemia virus insertion site 1 (BMI1), Musashi1 (MSI1), and sex-determining region y-box 9 (SOX9......) and their implications in human CRC. The exact roles of the intestinal stem cell markers in CRC development and progression remain unclear; however, high expression of these stem cell markers have a potential prognostic significance and might be implicated in chemotherapy resistance...

Adrenal Disorders and the Paediatric Brain: Pathophysiological Considerations and Clinical Implications

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Vincenzo Salpietro

2014-01-01

Full Text Available Various neurological and psychiatric manifestations have been recorded in children with adrenal disorders. Based on literature review and on personal case-studies and case-series we focused on the pathophysiological and clinical implications of glucocorticoid-related, mineralcorticoid-related, and catecholamine-related paediatric nervous system involvement. Childhood Cushing syndrome can be associated with long-lasting cognitive deficits and abnormal behaviour, even after resolution of the hypercortisolism. Exposure to excessive replacement of exogenous glucocorticoids in the paediatric age group (e.g., during treatments for adrenal insufficiency has been reported with neurological and magnetic resonance imaging (MRI abnormalities (e.g., delayed myelination and brain atrophy due to potential corticosteroid-related myelin damage in the developing brain and the possible impairment of limbic system ontogenesis. Idiopathic intracranial hypertension (IIH, a disorder of unclear pathophysiology characterised by increased cerebrospinal fluid (CSF pressure, has been described in children with hypercortisolism, adrenal insufficiency, and hyperaldosteronism, reflecting the potential underlying involvement of the adrenal-brain axis in the regulation of CSF pressure homeostasis. Arterial hypertension caused by paediatric adenomas or tumours of the adrenal cortex or medulla has been associated with various hypertension-related neurological manifestations. The development and maturation of the central nervous system (CNS through childhood is tightly regulated by intrinsic, paracrine, endocrine, and external modulators, and perturbations in any of these factors, including those related to adrenal hormone imbalance, could result in consequences that affect the structure and function of the paediatric brain. Animal experiments and clinical studies demonstrated that the developing (i.e., paediatric CNS seems to be particularly vulnerable to alterations induced by

The random field Blume-Capel model revisited

Science.gov (United States)

Santos, P. V.; da Costa, F. A.; de Araújo, J. M.

2018-04-01

We have revisited the mean-field treatment for the Blume-Capel model under the presence of a discrete random magnetic field as introduced by Kaufman and Kanner (1990). The magnetic field (H) versus temperature (T) phase diagrams for given values of the crystal field D were recovered in accordance to Kaufman and Kanner original work. However, our main goal in the present work was to investigate the distinct structures of the crystal field versus temperature phase diagrams as the random magnetic field is varied because similar models have presented reentrant phenomenon due to randomness. Following previous works we have classified the distinct phase diagrams according to five different topologies. The topological structure of the phase diagrams is maintained for both H - T and D - T cases. Although the phase diagrams exhibit a richness of multicritical phenomena we did not found any reentrant effect as have been seen in similar models.

Metabolic fuel and clinical implications for female reproduction.

Science.gov (United States)

Mircea, Carmen N; Lujan, Marla E; Pierson, Roger A

2007-11-01

Reproduction is a physiologically costly process that consumes significant amounts of energy. The physiological mechanisms controlling energy balance are closely linked to fertility. This close relationship ensures that pregnancy and lactation occur only in favourable conditions with respect to energy. The primary metabolic cue that modulates reproduction is the availability of oxidizable fuel. An organism's metabolic status is transmitted to the brain through metabolic fuel detectors. There are many of these detectors at both the peripheral (e.g., leptin, insulin, ghrelin) and central (e.g., neuropeptide Y, melanocortin, orexins) levels. When oxidizable fuel is scarce, the detectors function to inhibit the release of gonadotropin-releasing hormone and luteinizing hormone, thereby altering steroidogenesis, reproductive cyclicity, and sexual behaviour. Infertility can also result when resources are abundant but food intake fails to compensate for increased energy demands. Examples of these conditions in women include anorexia nervosa and exercise-induced amenorrhea. Infertility associated with obesity appears to be less related to an effect of oxidizable fuel on the hypothalamic-pituitary-ovarian axis. Impaired insulin sensitivity may play a role in the etiology of these conditions, but their specific etiology remains unresolved. Research into the metabolic regulation of reproductive function has implications for elucidating mechanisms of impaired pubertal development, nutritional amenorrhea, and obesity-related infertility. A better understanding of these etiologies has far-reaching implications for the prevention and management of reproductive dysfunction and its associated comorbidities.

Antibiotic cross-resistance in the lab and resistance co-occurrence in the clinic: Discrepancies and implications in E.coli.

Science.gov (United States)

Obolski, Uri; Dellus-Gur, Eynat; Stein, Gideon Y; Hadany, Lilach

2016-06-01

Antibiotic resistance is an important public health issue, and vast resources are invested in researching new ways to fight it. Recent experimental works have shown that resistance to some antibiotics can result in increased susceptibility to others, namely induce cross-sensitivity. This phenomenon could be utilized to increase efficiency of antibiotic treatment strategies that minimize resistance. However, as conditions in experimental settings and in the clinic may differ substantially, the implications of cross-sensitivity for clinical settings are not guaranteed and should be examined. In this work we analyzed data of Escherichia coli isolates from patients' blood, sampled in Rabin Medical Center, Israel, to examine co-occurrence of resistance to antibiotics in the clinic. We compared the co-occurrence patterns with cross-sensitivity patterns observed in the lab. Our data showed only positively associated occurrence of resistance, even with antibiotics that were shown to induce cross-sensitivity in laboratory conditions. We used a mathematical model to examine the potential effects of cross-sensitivity versus co-occurrence on the spread of drug resistance. We conclude that resistance frequencies in the clinic can have a substantial effect on the success of treatment strategies, and should be considered alongside experimental evidence of cross-sensitivity. Copyright © 2016. Published by Elsevier B.V.

The changing face of Usher syndrome: clinical implications.

Science.gov (United States)

Cohen, Mazal; Bitner-Glindzicz, Maria; Luxon, Linda

2007-02-01

Usher syndrome is both genetically and phenotypically heterogeneous. Traditionally, the condition has been classified into three clinical types, differentiated by the severity and progression of the hearing impairment and by the presence or absence of vestibular symptoms. Recent advances in molecular genetics have enabled researchers to study the phenotypic expression in confirmed molecular groups of Usher. In response to the expansion of clinical and genetic information on Usher, we report an up to date review of the different clinical forms of Usher in known molecular groups and use the emerging evidence to appraise the diagnostic utility of the traditional classification of Usher. Our findings undermine the traditional view that the clinical types of Usher have distinct genetic causes. The pleiotropic effects of some of the major causes of Usher lead to considerable overlap between the different clinical types, with very little evidence for phenotypic-genotypic correlations. The novel synthesis emerging from this review suggests more productive approaches to the diagnosis of Usher in hearing-impaired children which would provide more accurate prognostic information to families.

Pattern of leisure-lifestyles among Indian school adolescents: Contextual influences and implications for emerging health concerns

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Arun Pratap Singh

2015-12-01

Full Text Available In view of a rampant increase in availability of and access to many health-compromising leisure choices and opportunities in India during the last few decades, this study examines the pattern of leisure practices in a sample of school-going adolescents from rural, urban, and metro regions of North India (n = 1,500. Data were collected through an anonymous leisure survey from consenting students. Results show a greater prevalence of the use of electronic media and telecommunication gadgets, reflecting a larger engagement in sedentary activities than in cultural, community, and physically demanding leisure activities. In particular, the students from metro and urban areas reported greater involvement in multiple sedentary activities, while rural adolescents reported greater engagement with watching television, listening to fast music and religious leisure. The results implicate an urgent need for revisiting adolescent health policy and promoting positive leisure education in schools.

Clinical research informatics

CERN Document Server

Richesson, Rachel L

2012-01-01

This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are

Revisited neoclassical transport theory for steep, collisional plasma edge profiles

International Nuclear Information System (INIS)

Rogister, A.L.

1994-01-01

Published neoclassical results are misleading as concerns the plasma edge for they do not adequately take the peculiar local conditions into account, in particular the fact that the density and temperature variation length-scales are quite small. Coupled novel neoclassical equations obtain, not only for the evolution of the density and temperatures, but also for the radial electric field and the evolution of the parallel ion momentum: gyro-stresses and inertia indeed upset the otherwise de facto ambipolarity of particle transport and a radial electric field necessarily builds up. The increased nonlinear character of these revisited neoclassical equations widens the realm of possible plasma behaviors. (author)

Grammatical Relations and Grammatical Categories in Malay; the Indonesian Prefix MeN- Revisited

OpenAIRE

Tjia, Johnny

2015-01-01

The lexical roots of Malay are flexible with regard to their grammatical categories, which presents a problem in providing grammatical evidence for their category determination. This paper attempts to propose the use of affixes as one way to deal with the issue. Data from Indonesian and Ambon (Malay) language are among others given for clarification. The grammatical evidence from Indonesian active meN-, together with other affixes, are revisited as they can contribute to our understanding of ...

Subchondral Bone and the Osteochondral Unit: Basic Science and Clinical Implications in Sports Medicine.

Science.gov (United States)

Saltzman, Bryan M; Riboh, Jonathan C

2018-06-01

Articular cartilage injuries and early osteoarthritis are among the most common conditions seen by sports medicine physicians. Nonetheless, treatment options for articular degeneration are limited once the osteoarthritic cascade has started. Intense research is focused on the use of biologics, cartilage regeneration, and transplantation to help maintain and improve cartilage health. An underappreciated component of joint health is the subchondral bone. A comprehensive, nonsystematic review of the published literature was completed via a PubMed/MEDLINE search of the keywords "subchondral" AND "bone" from database inception through December 1, 2016. Clinical review. Level 4. Articles collected via the database search were assessed for the association of bone marrow lesions and osteoarthritis, cartilage regeneration, and ligamentous and meniscal injury; the clinical disorder known as painful bone marrow edema syndrome; and the subchondral bone as a target for medical and surgical intervention. A complex interplay exists between the articular cartilage of the knee and its underlying subchondral bone. The role of subchondral bone in the knee is intimately related to the outcomes from cartilage restoration procedures, ligamentous injury, meniscal pathology, and osteoarthritis. However, subchondral bone is often neglected when it should be viewed as a critical element of the osteochondral unit and a key player in joint health. Continued explorations into the intricacies of subchondral bone marrow abnormalities and implications for the advent of procedures such as subchondroplasty will inform further research efforts on how interventions aimed at the subchondral bone may provide durable options for knee joint preservation.

Revisit complexation between DNA and polyethylenimine — Effect of length of free polycationic chains on gene transfection

DEFF Research Database (Denmark)

Yue, Yanan; Jin, Fan; Deng, Rui

2011-01-01

Our revisit of the complexation between DNA and polyethylenimine (PEI) by using a combination of laser light scattering and gel electrophoresis confirms that nearly all the DNA chains are complexed with PEI to form polyplexes when the molar ratio of nitrogen from PEI to phosphate from DNA (N:P) r...

Multi-national knowledge strategies, policy and the upgrading process of regions: Revisiting the automotive industry in Ostrava and Shanghai

NARCIS (Netherlands)

Tuijl, E. van; Carvalho, L.; Winden, W. van; Jacobs, W.A.A.

2012-01-01

This paper revisits how and why new multinational knowledge-based strategies and multi-level governmental policies influence the upgrading process of regions in developing economies. Automotive multinationals traditionally exploited local asset conditions, but it is shown that they have also been

Osteoarthritis subpopulations and implications for clinical trial design

NARCIS (Netherlands)

S.M. Bierma-Zeinstra (Sita); A.P. Verhagen (Arianne)

2011-01-01

textabstractTreatment guidelines for osteoarthritis have stressed the need for research on clinical predictors of response to different treatments. However, identifying such clinical predictors of response is less easy than it seems, and there is not a given classification of osteoarthritis

Revisiting Johnson and Jackson boundary conditions for granular flows

Energy Technology Data Exchange (ETDEWEB)

Li, Tingwen; Benyahia, Sofiane

2012-07-01

In this article, we revisit Johnson and Jackson boundary conditions for granular flows. The oblique collision between a particle and a flat wall is analyzed by adopting the classic rigid-body theory and a more realistic semianalytical model. Based on the kinetic granular theory, the input parameter for the partial-slip boundary conditions, specularity coefficient, which is not measurable in experiments, is then interpreted as a function of the particle-wall restitution coefficient, the frictional coefficient, and the normalized slip velocity at the wall. An analytical expression for the specularity coefficient is suggested for a flat, frictional surface with a low frictional coefficient. The procedure for determining the specularity coefficient for a more general problem is outlined, and a working approximation is provided.

Objective and quantitative equilibriometric evaluation of individual locomotor behaviour in schizophrenia: Translational and clinical implications.

Science.gov (United States)

Haralanov, Svetlozar; Haralanova, Evelina; Milushev, Emil; Shkodrova, Diana; Claussen, Claus-Frenz

2018-04-17

translational and clinical implications of the new approach and its future perspectives. © 2018 John Wiley & Sons, Ltd.

Financial and clinical governance implications of clinical coding accuracy in neurosurgery: a multidisciplinary audit.

Science.gov (United States)

Haliasos, N; Rezajooi, K; O'neill, K S; Van Dellen, J; Hudovsky, Anita; Nouraei, Sar

2010-04-01

Clinical coding is the translation of documented clinical activities during an admission to a codified language. Healthcare Resource Groupings (HRGs) are derived from coding data and are used to calculate payment to hospitals in England, Wales and Scotland and to conduct national audit and benchmarking exercises. Coding is an error-prone process and an understanding of its accuracy within neurosurgery is critical for financial, organizational and clinical governance purposes. We undertook a multidisciplinary audit of neurosurgical clinical coding accuracy. Neurosurgeons trained in coding assessed the accuracy of 386 patient episodes. Where clinicians felt a coding error was present, the case was discussed with an experienced clinical coder. Concordance between the initial coder-only clinical coding and the final clinician-coder multidisciplinary coding was assessed. At least one coding error occurred in 71/386 patients (18.4%). There were 36 diagnosis and 93 procedure errors and in 40 cases, the initial HRG changed (10.4%). Financially, this translated to pound111 revenue-loss per patient episode and projected to pound171,452 of annual loss to the department. 85% of all coding errors were due to accumulation of coding changes that occurred only once in the whole data set. Neurosurgical clinical coding is error-prone. This is financially disadvantageous and with the coding data being the source of comparisons within and between departments, coding inaccuracies paint a distorted picture of departmental activity and subspecialism in audit and benchmarking. Clinical engagement improves accuracy and is encouraged within a clinical governance framework.

Revisiting the melting temperature of NpO2 and the challenges associated with high temperature actinide compound measurements

NARCIS (Netherlands)

Böhler, R.; Welland, M.J.; De Bruycker, F.; Boboridis, K.; Janssen, A.; Eloirdi, R.; Konings, R.J.M.; Manara, D.

2012-01-01

This work revisits the melting behaviour of neptunium dioxide, an actinide compound which can be produced in the nuclear fuel during operation, and which has an important impact on the nuclear fuel and waste radioactivity especially on the very long term. The present experimental approach employs

Revisiting instanton corrections to the Konishi multiplet

Energy Technology Data Exchange (ETDEWEB)

Alday, Luis F. [Mathematical Institute, University of Oxford,Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG (United Kingdom); Korchemsky, Gregory P. [Institut de Physique Théorique, Université Paris Saclay, CNRS, CEA,F-91191 Gif-sur-Yvette (France)

2016-12-01

We revisit the calculation of instanton effects in correlation functions in N=4 SYM involving the Konishi operator and operators of twist two. Previous studies revealed that the scaling dimensions and the OPE coefficients of these operators do not receive instanton corrections in the semiclassical approximation. We go beyond this approximation and demonstrate that, while operators belonging to the same N=4 supermultiplet ought to have the same conformal data, the evaluation of quantum instanton corrections for one operator can be mapped into a semiclassical computation for another operator in the same supermultiplet. This observation allows us to compute explicitly the leading instanton correction to the scaling dimension of operators in the Konishi supermultiplet as well as to their structure constants in the OPE of two half-BPS scalar operators. We then use these results, together with crossing symmetry, to determine instanton corrections to scaling dimensions of twist-four operators with large spin.

PERCEPTION OF JUSTICE, POST SERVICE RECOVERY SATISFACTION, INTENTION TO REVISIT AND WOM RECOMMENDATIONS OF FOREIGN TOURISTS VISITING BALI

Directory of Open Access Journals (Sweden)

I Nyoman Sudiarta

2014-03-01

Full Text Available This study aimed to determine the effect of perceptions of distributive, procedural and interactional justice on post-service recovery satisfaction and post-service recovery satisfaction effect on the intention to revisit and WOM recommendations of foreign tourists to Bali. The respondents of this study were foreign tourists who visited Bali and ever experienced complaint. The number of eligible samples was 100 respondents. The questionnaire was given to tourists visiting tourist attractions of Tanah Lot, Kintamani and Besakih. Data were analyzed using multivariate statistical analysis, namely structural equation modeling (SEM. The results of this study indicated that the perception of distributive justice, procedural and interactional had a positive and significant effect on the post-service recovery satisfaction of foreign tourists who visited Bali. The study also found a positive and significant effect of post-service recovery satisfaction on the intention to revisit and the intention of recommending positive WOM of foreign tourists who visited Bali.

A gene expression signature for RSV: clinical implications and limitations.

Directory of Open Access Journals (Sweden)

Peter J M Openshaw

2013-11-01

Full Text Available Peter Openshaw discusses the challenges in advancing respiratory syncytial virus (RSV treatments and the implications of a study by Mejias and colleagues using a newly identified gene signature for diagnosis and prediction of RSV severity. Please see later in the article for the Editors' Summary.

Ethical Implications of an Experiment in Artificial Intelligence.

Science.gov (United States)

Levinson, Stephen E.

2003-01-01

Revisits the classic debate on whether there can be an artificial creation that behaves and uses language with intelligence and agency. Argues that many moral and spiritual objections to this notion are not grounded either ethically or empirically. (Author/VWL)

Bystander effects and their implications for clinical radiotherapy

International Nuclear Information System (INIS)

Munro, Alastair J

2009-01-01

Radiation-induced bystander effects are defined as those biological effects expressed, after irradiation, by cells whose nuclei have not been directly irradiated. Radiation oncologists are only gradually beginning to appreciate the clinical relevance of radiation-induced bystander effects and associated phenomena: adaptive responses, genomic instability and abscopal effects. Incorporating bystander effects into the science underpinning clinical radiotherapy will involve moving beyond simple mechanistic models and towards a more systems-based approach. It is, given the protean nature of bystander effects, difficult to devise a coherent research strategy to investigate the clinical impact and relevance of bystander phenomena. Epidemiological approaches will be required, the traditional research models based on randomised controlled trials are unlikely to be adequate for the task. Any consideration of bystander effects challenges not only clinicians' preconceptions concerning the effects of radiation on tumours and normal tissues but also their ingenuity. This review covers, from a clinical perspective, the issues and problems associated with radiation-induced bystander effects.

Cue-induced craving in pathological buying: empirical evidence and clinical implications.

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Trotzke, Patrick; Starcke, Katrin; Pedersen, Anya; Brand, Matthias

2014-01-01

Pathological buying is associated with marked distress and impaired functioning in important life domains. It is currently under debate whether pathological buying can be considered a behavioral addiction. In analogy to results reported in addicted individuals, craving reactions elicited by addiction-related cues might be an underlying mechanism for the etiology and pathogenesis of pathological buying. In the present study, 30 pathological buyers and 30 matched control participants were examined with a cue-reactivity paradigm consisting of shopping and control cues. Skin conductance responses, as well as subjective ratings for arousal, valence, and urge to buy, were assessed. Subjective craving reactions were measured before and after the cue-reactivity paradigm. On a physiological level, skin conductance responses toward shopping cues were higher in pathological buyers (mean [M; standard deviation {SD}] = 0.26 [0.13]) compared with control participants (M [SD] = 0.19 [0.09]; t(58) = 2.29, p = .025, d = 0.60). On a behavioral level, the individuals with pathological buying rated the shopping cues as more arousing and more positive, and reported a greater urge to buy compared with control participants and with control cues. An increase in subjective craving after completing the cue-reactivity paradigm was observed only in the pathological buyers (Mpre [SD] = 1.95 [1.47], Mpost [SD] = 2.87 [1.79]; t(29) = 5.07, p buying. The results demonstrate similarities between pathological buying and substance or behavioral addictions and provide implications for clinical treatment.

Personality traits in patients with Parkinson's disease: assessment and clinical implications.

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Poletti, Michele; Bonuccelli, Ubaldo

2012-06-01

This study reviews empirical evidence on the association between personality traits and Parkinson's disease (PD), with a twofold aim. First, to better identify non-motor symptoms, such as affective symptoms and personality changes, that could help to define the pre-motor phase of PD; second, to better understand the neurobiological bases of personality traits, a goal that is not fully accomplished by a purely anatomical approach. A literature review was performed on studies of personality traits in PD patients, in electronic databases ISI Web of Knowledge, Medline and PsychInfo, conducted in July 2011. We found evidence that the existence of a characteristic premorbid personality profile of PD patients is not actually sustained by robust empirical evidence, mainly due to the methodological bias of the retrospective assessment of personality; PD patients present a personality profile of low novelty seeking and high harm avoidance. We concluded that the definition of a pre-motor phase of PD, based on non-motor symptoms, should search for the presence of concomitant affective disorders and for a positive psychiatric history for affective disorders rather than for a typical personality profile or personality changes. The low novelty seeking profile is probably related to the dopaminergic deficit, while the high harm avoidance profile is probably associated with the presence of affective disorders. Clinical implications of these findings, in regard to personality assessment and pharmacological treatments in PD, are also discussed.

A study of pathogenesis of Acanthosis nigricans and its clinical implications

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Neerja Puri

2011-01-01

Full Text Available Background: Acanthosis nigricans (AN is a dermatosis characterized by thickened, hyperpigmented plaques, typically on the intertriginous surfaces and neck. Common in some populations, its prevalence depends on race. Clinicians should recognize AN; it heralds disorders ranging from endocrinologic disturbances to malignancy. In this review, we discuss the pathogenesis of AN and its clinical implications and management. Materials and Methods: We selected 30 patients for the study. Diagnosis of associated disorders was established by history, physical examination, body mass index (BMI, hormone measurements by radioimmunoassays of thyroidnfunction tests, free testosterone, 17 (OH progesterone, dehydroepiandrosterone sulfate (DHEAS, cortisol, gonadotropins, prolactin, immunoreactive insulin, and C-peptide levels. Results and Discussion: In our study, the flexural involvement (flexures of groins, knees and elbows was seen in 40% patients, lip involvement was seen in 6.6% patients, and dorsal involvement was seen in 3.3% patients each. Increased serum testosterone levels were seen in 13.3% patients and increased DHEAS levels were seen in 20% patients. Regarding the types of AN, obesity induced AN or pseudo-AN was seen 70% patients, syndromic AN was seen in 23.35% patients and malignant AN was seen in 6.6% patients. The commonest histopathological feature of patients with AN was hyperkeratosis, seen in 100% patients, papillomatosis was seen in 90% patients, dermal infiltrate of lymphocytes and plasma cells was seen in 60% patients, horn pseudocysts were seen in 30% patients, and irregular acanthosis was seen in 26.6% patients.

Anatomical Variations of Brachial Artery - Its Morphology, Embryogenesis and Clinical Implications

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KS, Siddaraju; Venumadhav, Nelluri; Sharma, Ashish; Kumar, Neeraj

2014-01-01

Background: Accurate knowledge of variation pattern of the major arteries of upper limb is of considerable practical importance in the conduct of reparative surgery in the arm, forearm and hand however brachial artery and its terminal branches variations are less common. Aim: Accordingly the present study was designed to evaluate the anatomical variations of the brachial artery and its morphology, embryogenesis and clinical implications. Materials and Methods: In an anatomical study 140 upper limb specimens of 70 cadavers (35 males and 35 females) were used and anatomical variations of the brachial artery have been documented. Results: Accessory brachial artery was noted in eight female cadavers (11.43%). Out of eight cadavers in three cadavers (4.29%) an unusual bilateral accessory brachial artery arising from the axillary artery and it is continuing in the forearm as superficial accessory ulnar artery was noted. Rare unusual variant unilateral accessory brachial artery and its reunion with the main brachial artery in the cubital fossa and its variable course in relation to the musculocutaneous nerve and median nerve were also noted in five cadavers (7.14%). Conclusion: As per our knowledge such anatomical variations of brachial artery and its terminal branches with their relation to the surrounding structures are not reported in the modern medical literature. An awareness of such a presence is valuable for the surgeons and radiologists in evaluation of angiographic images, vascular and re-constructive surgery or appropriate treatment for compressive neuropathies. PMID:25653931

Grammatical relations and grammatical categories in Malay; The Indonesian prefix meN- revisited

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Johnny Tjia

2015-04-01

Full Text Available The lexical roots of Malay are flexible with regard to their grammatical categories, which presents a problem in providing grammatical evidence for their category determination. This paper attempts to propose the use of affixes as one way to deal with the issue. Data from Indonesian and Ambon (Malay language are among others given for clarification. The grammatical evidence from Indonesian active meN-, together with other affixes, are revisited as they can contribute to our understanding of the matter.

Incidence, Risk Factors, and Clinical Implications of Pneumonia Following Total Hip and Knee Arthroplasty.

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Bohl, Daniel D; Saltzman, Bryan M; Sershon, Robert A; Darrith, Brian; Okroj, Kamil T; Della Valle, Craig J

2017-06-01

The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia following total joint arthroplasty (TJA). The American College of Surgeons National Surgical Quality Improvement Program was used to conduct a retrospective cohort study of patients undergoing TJA. Independent risk factors for the development of pneumonia within 30 days of TJA were identified using multivariate regression. Mortality and readmission rates were compared between patients who did and did not develop pneumonia. Multivariate regression was used to adjust for all demographic, comorbidity, and procedural characteristics. In total, 171,200 patients met inclusion criteria, of whom 66,493 (38.8%) underwent THA and 104,707 (61.2%) underwent TKA. Of the 171,200 patients, 590 developed pneumonia, yielding a rate of 0.34% (95% confidence interval = 0.32%-0.37%). Independent risk factors for pneumonia were chronic obstructive pulmonary disease, diabetes mellitus, greater age (most notably ≥80 years), dyspnea on exertion, dependent functional status, lower body mass index, hypertension, current smoker status, and male sex. The subset of patients who developed pneumonia following discharge had a higher readmission rate (82.1% vs 3.4%, adjusted relative risk [RR] = 16.6, P pneumonia. Pneumonia is a serious complication following TJA that occurs in approximately 1 in 300 patients. Approximately 4 in 5 patients who develop pneumonia are subsequently readmitted, and approximately 1 in 25 die. Given the serious implications of this complication, evidence-based pneumonia prevention programs including oral hygiene with chlorhexidine, sitting upright for meals, elevation of the head of the bed to at least 30°, aggressive incentive spirometry, and early ambulation should be considered for patients at greatest risk. Copyright © 2017 Elsevier Inc. All rights reserved.

Implications of SNOMED CT versioning

NARCIS (Netherlands)

Lee, Dennis; Cornet, Ronald; Lau, Francis

2011-01-01

To determine the changes each Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) release undergoes and the implications of those changes. (1) We reviewed the SNOMED CT Component History documentation and analyzed the Component History table in detail. (2) We outlined a list of semantic

The implication of transcultural psychiatry for clinical practice.

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Moldavsky, Daniel

2003-01-01

This article deals with the main concepts of Transcultural Psychiatry and their applications to everyday psychiatric practice. Transcultural psychiatry has undergone a conceptual reformulation in the last two decades. Having started with a comparative approach, which focused on the diverse manifestations of mental disorders among different societies, it broadened its scope, aiming at present to incorporate social and cultural aspects of illness into the clinical framework. Therefore, transcultural psychiatry now focuses more on what is called the illness experience than on the disease process, the latter understood as illness as it is viewed by health practitioners. Western medicine, of which psychiatry is a part, is grounded in positivist epistemological principles that stress the biological processes of disease. The intention of the paper is to develop an interest in alternative but also complementary ways of thinking. Modern transcultural psychiatry interprets some epidemiological and clinical aspects of major mental disorders (such as schizophrenia and depression) in a different light. However, it also distances itself from the absolute relativism of antipsychiatry, centering on clinical facts and helping clinicians in their primary task of alleviating suffering. An important contribution in addressing this task is the formulation of a cultural axis within the DSM model of multiaxial evaluation. A clinical vignette of a cultural formulation applied to a clinical discussion of a case is described.

Early-Transition Output Decline Revisited

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Crt Kostevc

2016-05-01

Full Text Available In this paper we revisit the issue of aggregate output decline that took place in the early transition period. We propose an alternative explanation of output decline that is applicable to Central- and Eastern-European countries. In the first part of the paper we develop a simple dynamic general equilibrium model that builds on work by Gomulka and Lane (2001. In particular, we consider price liberalization, interpreted as elimination of distortionary taxation, as a trigger of the output decline. We show that price liberalization in interaction with heterogeneous adjustment costs and non-employment benefits lead to aggregate output decline and surge in wage inequality. While these patterns are consistent with actual dynamics in CEE countries, this model cannot generate output decline in all sectors. Instead sectors that were initially taxed even exhibit output growth. Thus, in the second part we consider an alternative general equilibrium model with only one production sector and two types of labor and distortion in a form of wage compression during the socialist era. The trigger for labor mobility and consequently output decline is wage liberalization. Assuming heterogeneity of workers in terms of adjustment costs and non-employment benefits can explain output decline in all industries.

Neutrino assisted GUT baryogenesis revisited

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Huang, Wei-Chih; Päs, Heinrich; Zeißner, Sinan

2018-03-01

Many grand unified theory (GUT) models conserve the difference between the baryon and lepton number, B -L . These models can create baryon and lepton asymmetries from heavy Higgs or gauge boson decays with B +L ≠0 but with B -L =0 . Since the sphaleron processes violate B +L , such GUT-generated asymmetries will finally be washed out completely, making GUT baryogenesis scenarios incapable of reproducing the observed baryon asymmetry of the Universe. In this work, we revisit the idea to revive GUT baryogenesis, proposed by Fukugita and Yanagida, where right-handed neutrinos erase the lepton asymmetry before the sphaleron processes can significantly wash out the original B +L asymmetry, and in this way one can prevent a total washout of the initial baryon asymmetry. By solving the Boltzmann equations numerically for baryon and lepton asymmetries in a simplified 1 +1 flavor scenario, we can confirm the results of the original work. We further generalize the analysis to a more realistic scenario of three active and two right-handed neutrinos to highlight flavor effects of the right-handed neutrinos. Large regions in the parameter space of the Yukawa coupling and the right-handed neutrino mass featuring successful baryogenesis are identified.

Multi-method laboratory user evaluation of an actionable clinical performance information system: Implications for usability and patient safety.

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Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

2018-01-01

Electronic audit and feedback (e-A&F) systems are used worldwide for care quality improvement. They measure health professionals' performance against clinical guidelines, and some systems suggest improvement actions. However, little is known about optimal interface designs for e-A&F, in particular how to present suggested actions for improvement. We developed a novel theory-informed system for primary care (the Performance Improvement plaN GeneratoR; PINGR) that covers the four principal interface components: clinical performance summaries; patient lists; detailed patient-level information; and suggested actions. As far as we are aware, this is the first report of an e-A&F system with all four interface components. (1) Use a combination of quantitative and qualitative methods to evaluate the usability of PINGR with target end-users; (2) refine existing design recommendations for e-A&F systems; (3) determine the implications of these recommendations for patient safety. We recruited seven primary care physicians to perform seven tasks with PINGR, during which we measured on-screen behaviour and eye movements. Participants subsequently completed usability questionnaires, and were interviewed in-depth. Data were integrated to: gain a more complete understanding of usability issues; enhance and explain each other's findings; and triangulate results to increase validity. Participants committed a median of 10 errors (range 8-21) when using PINGR's interface, and completed a median of five out of seven tasks (range 4-7). Errors violated six usability heuristics: clear response options; perceptual grouping and data relationships; representational formats; unambiguous description; visually distinct screens for confusable items; and workflow integration. Eye movement analysis revealed the integration of components largely supported effective user workflow, although the modular design of clinical performance summaries unnecessarily increased cognitive load. Interviews and

The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

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Bhatnagar, D

1997-01-01

Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

PPP-RTK by means of S-system theory: revisiting the undifferenced, uncombined network model and a case study

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Zhang, Baocheng; Yuan, Yunbin

2017-04-01

A synthesis of two prevailing Global Navigation Satellite System (GNSS) positioning technologies, namely the precise point positioning (PPP) and the network-based real-time kinematic (NRTK), results in the emergence of the PPP-RTK. This new concept preferably integrates the typical advantage of PPP (e.g. flexibility) and that of NRTK (e.g. efficiency), such that it enables single-receiver users to achieve high positioning accuracy with reasonable timeliness through integer ambiguity resolution (IAR). The realization of PPP-RTK needs to accomplish two sequential tasks. The first task is to determine a class of corrections including, necessarily, the satellite orbits, the satellite clocks and the satellite phase (and code, in case of more than two frequencies) biases at the network level. With these corrections, the second task, then, is capable of solving for the ambiguity-fixed, absolute position(s) at the user level. In this contribution, we revisit three variants (geometry-free, geometry-fixed, and geometry- and satellite-clock-fixed) of undifferenced, uncombined PPP-RTK network model and discuss their implications for practical use. We carry out a case study using multi-day, dual-frequency GPS data from the Crustal Movement Observation Network of China (CMONOC), aiming to assess the (static and kinematic) positioning performance (in terms of time-to-first-fix and accuracy) that is achievable by PPP-RTK users across China.

Clinical and prognostic implications of Roundabout 4 (robo4 in adult patients with acute myeloid leukemia.

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Yin-Kai Chen

Full Text Available Robo4 is involved in hematopoietic stem/progenitor cell homeostasis and essential for tumor angiogenesis. Expression of Robo4 was recently found in solid tumors and leukemia stem cells. However, the clinical implications of Robo4 expression in patients with acute myeloid leukemia (AML remain unclear.We investigated the clinical and prognostic relevance of mRNA expression of Robo4 in bone marrow (BM mononuclear cells from 218 adult patients with de novo AML. We also performed immunohistochemical staining to assess the Robo4 protein expression in the BM biopsy specimens from 30 selected AML patients in the cohort.Higher Robo4 expression was closely associated with lower white blood cell counts, expression of HLA-DR, CD13, CD34 and CD56 on leukemia cells, t(8;21 and ASXL1 mutation, but negatively correlated with t(15;17 and CEBPA mutation. Compared to patients with lower Robo4 expression, those with higher expression had significantly shorter disease-free survival (DFS and overall survival (OS. This result was confirmed in an independent validation cohort. Furthermore, multivariate analyses showed that higher Robo4 expression was an independent poor prognostic factor for DFS and OS in total cohort and patients with intermediate-risk cytogenetics, irrespective of age, WBC count, karyotype, and mutation status of NPM1/FLT3-ITD, and CEBPA.BM Robo4 expression can serve as a new biomarker to predict clinical outcomes in AML patients and Robo4 may serve as a potential therapeutic target in patients with higher Robo4 expression.

Copper and Anesthesia: Clinical Relevance and Management of Copper Related Disorders

OpenAIRE

Langley, Adrian; Dameron, Charles T.

2013-01-01

Recent research has implicated abnormal copper homeostasis in the underlying pathophysiology of several clinically important disorders, some of which may be encountered by the anesthetist in daily clinical practice. The purpose of this narrative review is to summarize the physiology and pharmacology of copper, the clinical implications of abnormal copper metabolism, and the subsequent influence of altered copper homeostasis on anesthetic management.

Evaluating the effect of clinical decision units on patient flow in seven Canadian emergency departments.

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Schull, Michael J; Vermeulen, Marian J; Stukel, Therese A; Guttmann, Astrid; Leaver, Chad A; Rowe, Brian H; Sales, Anne

2012-07-01

To evaluate the effect of emergency department (ED) clinical decision units (CDUs) on overall ED patient flow in a pilot project funded in 2008 by the Ontario Ministry of Health and Long-Term Care (MOHLTC). A retrospective analysis of unscheduled ED visits at seven CDU pilot and nine control sites was conducted using administrative data. The authors examined trends in CDU utilization and compared outcomes between pilot-CDU and control sites 1 year prior to implementation, with the first 18 months of CDU operation. Sites that were unsuccessful in their applications for CDU program funding served as controls. Outcomes included ED length of stay (LOS), admission rates, and ED revisit rates. At CDU sites, roughly 4% of ED patients were admitted to CDUs. The presence of a pilot-CDU was independently associated with a small reduction in ED LOS for all low-acuity patients (-0.14 hour, 95% confidence interval [CI]=-0.22 to -0.07) and nonadmitted patients (-0.11 hour, 95% CI=-0.16 to -0.07). A small independent effect on absolute hospital admission rate for all high-acuity patients (-0.8%, 95% CI=-1.5% to -0.03%) and moderate-acuity patients (-0.6%, 95% CI=-1.1% to -0.2%) was also observed. Pilot-CDUs were not associated with changes in ED revisit rates. With only 4% of ED patients admitted to CDUs, the potential for efficiency gains in these EDs was limited. Nonetheless, these findings suggest small improvements in the operation of the ED through CDU implementation. Although marginal, the observed effects of CDU operation were in the desired direction of reduced ED LOS, reduced admission rate, and no increase in ED revisit rate. © 2012 by the Society for Academic Emergency Medicine.

The clinical phenotype of hereditary versus sporadic prostate cancer: HPC definition revisited

NARCIS (Netherlands)

Cremers, R.G.H.M.; Aben, K.K.H.; Oort, I.M. van; Sedelaar, J.P.M.; Vasen, H.F.A.; Vermeulen, S.H.; Kiemeney, L.A.L.M.

2016-01-01

BACKGROUND: The definition of hereditary prostate cancer (HPC) is based on family history and age at onset. Intuitively, HPC is a serious subtype of prostate cancer but there are only limited data on the clinical phenotype of HPC. Here, we aimed to compare the prognosis of HPC to the sporadic form

Viral asthma: implications for clinical practice

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Roger Menendez

2010-07-01

Full Text Available Roger Menendez1, Michael D Goldman21Allergy and Asthma Center of El Paso, El Paso, TX, USA; 2Pulmonary Division, UCLA Gaffen School of Medicine, Los Angeles, CA, USAAbstract: The natural history of asthma appears to be driven primarily by the timing and duration of viral respiratory infections. From the very high rate of infections in childhood, to the more sporadic pattern seen in adults, the cycle of acute injury followed by an inefficient repair process helps explain the clinical patterns of asthma severity currently recognized by asthma guidelines. Why the asthmatic host responds to viral injury in a particular way is largely a mystery and the subject of intense investigation. The role of viruses in asthma extends not just to intermittent but to persistent disease, and to both the atopic as well as nonatopic phenotypes. Future therapeutic strategies should include primary prevention via the development of antiviral innate immunity-enhancing vaccines, as well as secondary prevention via the use of antiviral agents, or immunomodulators designed to boost the antiviral response or interrupt the proinflammatory cascade.Keywords: asthma, rhinoviruses, exacerbations, epidemiology, phenotypes, clinical trials

PDGFRα/β and VEGFR2 polymorphisms in colorectal cancer: incidence and implications in clinical outcome

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Estevez-Garcia Purificacion

2012-11-01

Full Text Available Abstract Background Angiogenesis plays an essential role in tumor growth and metastasis, and is a major target in cancer therapy. VEGFR and PDGFR are key players involved in this process. The purpose of this study was to assess the incidence of genetic variants in these receptors and its potential clinical implications in colorectal cancer (CRC. Methods VEGFR2, PDGFRα and PDGFRβ mutations were evaluated by sequencing their tyrosine kinase domains in 8 CRC cell lines and in 92 samples of patients with CRC. Correlations with clinicopathological features and survival were analyzed. Results Four SNPs were identified, three in PDGFRα [exon 12 (A12: c.1701A>G; exon 13 (A13: c.1809G>A; and exon 17 (A17: c.2439+58C>A] and one in PDGFRβ [exon 19 (B19: c.2601A>G]. SNP B19, identified in 58% of tumor samples and in 4 cell lines (LS174T, LS180, SW48, COLO205, was associated with higher PDGFR and pPDGFR protein levels. Consistent with this observation, 5-year survival was greater for patients with PDGFR B19 wild type tumors (AA than for those harboring the G-allele genotype (GA or GG (51% vs 17%; p=0.073. Multivariate analysis confirmed SNP B19 (p=0.029 was a significant prognostic factor for survival, independent of age (p=0.060 or TNM stage (p Conclusions PDGFRβ exon 19 c.2601A>G SNP is commonly encountered in CRC patients and is associated with increased pathway activation and poorer survival. Implications regarding its potential influence in response to PDGFR-targeted agents remain to be elucidated.

Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: Incidence, predictive factors, and clinical implications.

Science.gov (United States)

Jesel, Laurence; Berthon, Charlotte; Messas, Nathan; Lim, Han S; Girardey, Mélanie; Marzak, Halim; Marchandot, Benjamin; Trinh, Annie; Ohlmann, Patrick; Morel, Olivier

2018-04-06

Takotsubo cardiomyopathy (TTC) is a stress-related transient cardiomyopathy. Life-threatening arrhythmias (LTA) can occur and worsen prognosis. The purpose of this study was to assess the incidence and outcome of LTA in TTC, as well as its predictive factors and clinical implications. We studied 214 consecutive cases of TTC over 8 years. The study cohort was divided into 2 groups: those with LTA (LTA group) and those without (non-LTA group). LTA was defined as ventricular tachycardia, ventricular fibrillation, or cardiac arrest. LTA occurred in 10.7% of patients mainly in the first 24 hours of hospitalization: ventricular tachycardia (n = 2), ventricular fibrillation (n = 11), cardiac arrest (n = 10: 5 asystole, 3 complete heart block, and 2 sinoatrial block). LTA were associated with lower left ventricular ejection fraction (LVEF) and a high rate of conduction disturbances. In-hospital (39.1% vs 8.9%; P 105 ms were independent predictors of LTA. In cases where a device was implanted, conduction disturbances persisted after the index event despite complete recovery of LVEF. There was no ventricular arrhythmia recurrence during follow-up. LTA occur early in patients presenting with TTC and is associated with significantly worse short- and long-term prognosis. Left ventricular impairment and QRS duration >105 ms are independent predictors of LTA. Ventricular arrhythmias occurred in the acute phase without further recurrence recorded in hospital survivors, whereas severe conduction disorders persisted during long-term follow-up. These findings may have implications on the choice of device therapy for this specific patient subgroup. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

PDGFRα/β and VEGFR2 polymorphisms in colorectal cancer: incidence and implications in clinical outcome

International Nuclear Information System (INIS)

Estevez-Garcia, Purificacion; Carnero, Amancio; Paz-Ares, Luis; Garcia-Carbonero, Rocio; Castaño, Angel; Martin, Ana C; Lopez-Rios, Fernando; Iglesias, Joaquin; Muñoz-Galván, Sandra; Lopez-Calderero, Iker; Molina-Pinelo, Sonia; Pastor, Maria D

2012-01-01

Angiogenesis plays an essential role in tumor growth and metastasis, and is a major target in cancer therapy. VEGFR and PDGFR are key players involved in this process. The purpose of this study was to assess the incidence of genetic variants in these receptors and its potential clinical implications in colorectal cancer (CRC). VEGFR2, PDGFRα and PDGFRβ mutations were evaluated by sequencing their tyrosine kinase domains in 8 CRC cell lines and in 92 samples of patients with CRC. Correlations with clinicopathological features and survival were analyzed. Four SNPs were identified, three in PDGFRα [exon 12 (A12): c.1701A>G; exon 13 (A13): c.1809G>A; and exon 17 (A17): c.2439+58C>A] and one in PDGFRβ [exon 19 (B19): c.2601A>G]. SNP B19, identified in 58% of tumor samples and in 4 cell lines (LS174T, LS180, SW48, COLO205), was associated with higher PDGFR and pPDGFR protein levels. Consistent with this observation, 5-year survival was greater for patients with PDGFR B19 wild type tumors (AA) than for those harboring the G-allele genotype (GA or GG) (51% vs 17%; p=0.073). Multivariate analysis confirmed SNP B19 (p=0.029) was a significant prognostic factor for survival, independent of age (p=0.060) or TNM stage (p<0.001). PDGFRβ exon 19 c.2601A>G SNP is commonly encountered in CRC patients and is associated with increased pathway activation and poorer survival. Implications regarding its potential influence in response to PDGFR-targeted agents remain to be elucidated

Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice.

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Basedow, Martin; Runciman, William B; Lipworth, Wendy; Esterman, Adrian

2016-11-01

Clinical practice guidelines (CPGs) have been shown to improve processes of care and health outcomes, but there is often a discrepancy between recommendations for care and clinical practice. This study sought to explore general practitioner (GP) attitudes towards CPGs, in general and specifically for osteoarthritis (OA), with the implications for translating OA care into practice. A self-administered questionnaire was conducted in January 2013 with a sample of 228 GPs in New South Wales and South Australia. Seventy-nine GPs returned questionnaires (response rate 35%). Nearly all GPs considered that CPGs support decision-making in practice (94%) and medical education (92%). Very few respondents regarded CPGs as a threat to clinical autonomy, and most recognised that individual patient circumstances must be taken into account. Shorter CPG formats were preferred over longer and more comprehensive formats, with preferences being evenly divided among respondents for short, 2-3-page summaries, flowcharts or algorithms and single page checklists. GPs considered accessibility to CPGs to be important, and electronic formats were popular. Familiarity and use of The Royal Australian College of General Practitioners OA Guideline was poor, with most respondents either not aware of it (30%; 95% confidence interval (CI) 27 - 41%), had never used it (19%; 95% CI 12 - 29%) or rarely used it (34%; 95% CI 25-45%). If CPGs are to assist with the translation of evidence into practice, they must be easily accessible and in a format that encourages use.

Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder.

Science.gov (United States)

Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

2016-01-01

Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry "A. Fiorini" Hospital, Terracina (Latina, Italy), was performed. The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium-high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications.

Clinical Implication of Anti-Angiogenic Effect of Regorafenib in Metastatic Colorectal Cancer.

Directory of Open Access Journals (Sweden)

Yoojoo Lim

Full Text Available Regorafenib induces distinct radiological changes that represent its anti-angiogenic effect. However, clinical implication of the changes is unclear.Tumor attenuation as measured by Hounsfield units (HU in contrast-enhanced computed tomography (CT and cavitary changes of lung metastases were analyzed in association with treatment outcome of metastatic colorectal cancer patients (N = 80 treated with regorafenib in a prospective study.141 lesions in 72 patients were analyzed with HU. After 2 cycles of regorafenib, 87.5% of patients showed decrease of HU (Median change -23.9%, range -61.5%-20.7%. Lesional attenuation change was modestly associated with metabolic changes of 18-fluoro-deoxyglucose positron emission tomography-CT (Pearson's r = 0.37, p = 0.002. Among 53 patients with lung metastases, 17 (32.1% developed cavitary changes. There were no differences in disease control rate, progression-free survival, or overall survival according to the radiological changes. At the time of progressive disease (PD according to RECIST 1.1, HU was lower than baseline in 86.0% (43/50 and cavitary change of lung metastasis persisted without refilling in 84.6% (11/13.Regorafenib showed prominent anti-angiogenic effect in colorectal cancer, but the changes were not associated with treatment outcome. However, the anti-angiogenic effects persisted at the time of PD, which suggests that we may need to develop new treatment strategies.

Clinical Implication of Anti-Angiogenic Effect of Regorafenib in Metastatic Colorectal Cancer

Science.gov (United States)

Yoon, Jeong Hee; Lee, Jeong Min; Lee, Jung Min; Paeng, Jin Chul; Won, Jae-Kyung; Kang, Gyeong Hoon; Jeong, Seung-Yong; Park, Kyu Joo; Lee, Kyung-Hun; Kim, Jee Hyun; Kim, Tae-You

2015-01-01

Background Regorafenib induces distinct radiological changes that represent its anti-angiogenic effect. However, clinical implication of the changes is unclear. Methods Tumor attenuation as measured by Hounsfield units (HU) in contrast-enhanced computed tomography (CT) and cavitary changes of lung metastases were analyzed in association with treatment outcome of metastatic colorectal cancer patients (N = 80) treated with regorafenib in a prospective study. Results 141 lesions in 72 patients were analyzed with HU. After 2 cycles of regorafenib, 87.5% of patients showed decrease of HU (Median change -23.9%, range -61.5%–20.7%). Lesional attenuation change was modestly associated with metabolic changes of 18-fluoro-deoxyglucose positron emission tomography-CT (Pearson’s r = 0.37, p = 0.002). Among 53 patients with lung metastases, 17 (32.1%) developed cavitary changes. There were no differences in disease control rate, progression-free survival, or overall survival according to the radiological changes. At the time of progressive disease (PD) according to RECIST 1.1, HU was lower than baseline in 86.0% (43/50) and cavitary change of lung metastasis persisted without refilling in 84.6% (11/13). Conclusion Regorafenib showed prominent anti-angiogenic effect in colorectal cancer, but the changes were not associated with treatment outcome. However, the anti-angiogenic effects persisted at the time of PD, which suggests that we may need to develop new treatment strategies. PMID:26671465

A rare case of persistent metopic suture in an elderly individual: Incidental autopsy finding with clinical implications

Directory of Open Access Journals (Sweden)

S Vikram

2014-01-01

Full Text Available Metopic suture is a dense fibrous joint extending from the nasion to the bregma. Normally, closure of this suture takes place between 1-8 years of age. Failure of this closure beyond 8 years leads to persistent metopic suture. A rare case of persistent metopic suture in a 60-year-old male is documented, who committed suicide by alleged consumption of organophosphorous compound at District Govt. Wenlock Hospital, Mangalore, Karnataka, India. Metopic suture may mimic skull fracture and may mislead an inexperienced forensic expert. Neurosurgeon should also be aware of this anatomical variation while performing frontal craniotomy, as the persistent metopic suture may mimic vertical fracture of the skull. Hence, in this case report, the clinical and medico-legal implications of the persistent metopic sutures have been discussed.

Response variance in functional maps: neural darwinism revisited.

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Hirokazu Takahashi

Full Text Available The mechanisms by which functional maps and map plasticity contribute to cortical computation remain controversial. Recent studies have revisited the theory of neural Darwinism to interpret the learning-induced map plasticity and neuronal heterogeneity observed in the cortex. Here, we hypothesize that the Darwinian principle provides a substrate to explain the relationship between neuron heterogeneity and cortical functional maps. We demonstrate in the rat auditory cortex that the degree of response variance is closely correlated with the size of its representational area. Further, we show that the response variance within a given population is altered through training. These results suggest that larger representational areas may help to accommodate heterogeneous populations of neurons. Thus, functional maps and map plasticity are likely to play essential roles in Darwinian computation, serving as effective, but not absolutely necessary, structures to generate diverse response properties within a neural population.

Response variance in functional maps: neural darwinism revisited.

Science.gov (United States)

Takahashi, Hirokazu; Yokota, Ryo; Kanzaki, Ryohei

2013-01-01

The mechanisms by which functional maps and map plasticity contribute to cortical computation remain controversial. Recent studies have revisited the theory of neural Darwinism to interpret the learning-induced map plasticity and neuronal heterogeneity observed in the cortex. Here, we hypothesize that the Darwinian principle provides a substrate to explain the relationship between neuron heterogeneity and cortical functional maps. We demonstrate in the rat auditory cortex that the degree of response variance is closely correlated with the size of its representational area. Further, we show that the response variance within a given population is altered through training. These results suggest that larger representational areas may help to accommodate heterogeneous populations of neurons. Thus, functional maps and map plasticity are likely to play essential roles in Darwinian computation, serving as effective, but not absolutely necessary, structures to generate diverse response properties within a neural population.

Prevention of thrombosis in pregnancy: how practical are consensus derived clinical practice guidelines?

LENUS (Irish Health Repository)

Hayes-Ryan, D

2012-11-01

Thromboembolic disease (TED) has, for many years, consistently been identified as one of the leading causes of direct maternal mortality. In November 2009, the RCOG published a guideline on the prevention of TED that has been rapidly adopted by hospital trusts in the UK. The aim of our study was to determine the number and profile of women in our population that would require treatment with low molecular weight heparin (LMWH) and the cost implications of such treatment if these guidelines were implemented. A retrospective review of the first 100 women who delivered at the Coombe Women & Infants University Hospital (CWIUH) in 2010 was conducted and risk stratification applied at the relevant time points. A total of 51% were deemed to be at intermediate or high risk of TED at some point during pregnancy. In 35 of the 51 women (70%), this risk was attributable to factors such as age>35 years, parity≥3, BMI>30 kg\\/m2 or cigarette smoking. In our obstetric population, the percentage of women with these risk factors was: 25.5%, 8.5%, 19% and 16.7%, respectively. Implementation of this guideline would increase the hospital annual expenditure on LMWH by a factor of 17. The strategy of attributing risk by accumulating factors that individually have a low risk of TED and are prevalent in the population needs to be re-visited. The cost of implementation of these guidelines is not inconsiderable in the absence of data to indicate that clinical outcome is improved with their implementation.

Biological behaviour and clinical implications of micrometastases.

LENUS (Irish Health Repository)

Kell, M R

2012-02-03

BACKGROUND: The most important prognostic determinant in cancer is the identification of disseminated tumour burden (metastases). Micrometastases are microscopic (smaller than 2 mm) deposits of malignant cells that are segregated spatially from the primary tumour and depend on neovascular formation (angiogenesis) to propagate. METHODS: The electronic literature (1966 to present) on micrometastases and their implications in malignant melanoma and epithelial cancers was reviewed. RESULTS: Immunohistochemical techniques combined with serial sectioning offer the best accuracy for detection of nodal micrometastases. Molecular techniques should be reserved for blood samples or bone marrow aspirates. Detection of micrometastases in regional lymph nodes and\\/or bone marrow confers a poor prognosis in epithelial cancers. The concept of sentinel node biopsy combined with serial sectioning and dedicated screening for micrometastases may improve staging procedures. Strategies against angiogenesis may provide novel therapies to induce and maintain micrometastatic dormancy. CONCLUSION: The concept of micrometastases has resulted in a paradigm shift in the staging of epithelial tumours and our overall understanding of malignant processes.

Myasthenia gravis and pregnancy: clinical implications and neonatal outcome

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Estanol Bruno

2004-11-01

Full Text Available Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasthenia gravis. Retrospective chart review of pregnant patients with myasthenia gravis, followed at the National Institute of Perinatology in Mexico City over an 8-year period. Data was abstracted from the medical records on the clinical course during pregnancy, delivery and neonatal outcome. Results From January 1, 1996 to December 31, 2003 18 patients with myasthenia gravis were identified and included in the study. The mean ± SD maternal age was 27.4 ± 4.0 years. During pregnancy 2 women (11% had an improvement in the clinical symptoms of myasthenia gravis, 7 women (39% had clinical worsening of the condition of 9 other patients (50% remained clinically unchanged. Nine patients delivered vaginally, 8 delivered by cesarean section and 1 pregnancy ended in fetal loss. Seventeen infants were born at mean ± SD gestational age of 37.5 ± 3.0 weeks and a mean birth weight of 2710 ± 73 g. Only one infant presented with transient neonatal myasthenia gravis. No congenital anomalies were identified in any of the newborns. Conclusions The clinical course of myasthenia gravis during pregnancy is variable, with a significant proportion of patients experiencing worsening of the clinical symptoms. However, neonatal transient myasthenia was uncommon in our patient population.

Conservation laws for steady flow and solitons in a multifluid plasma revisited

International Nuclear Information System (INIS)

Mace, R. L.; McKenzie, J. F.; Webb, G. M.

2007-01-01

The conservation laws used in constructing the governing equations for planar solitons in multifluid plasmas are revisited. In particular, the concept of generalized vorticity facilitates the derivation of some general ''Bernoulli theorems,'' which reduce, in specific instances, to conservation laws previously deduced by other means. These theorems clarify the underlying physical principles that give rise to the conserved quantities. As an example of the usefulness of the techniques, even for relatively simple flows and progressive waves, the equations governing stationary nonlinear whistler waves propagating parallel to an ambient magnetic field are derived using generalized vorticity concepts

Gaussian entanglement revisited

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Lami, Ludovico; Serafini, Alessio; Adesso, Gerardo

2018-02-01

We present a novel approach to the separability problem for Gaussian quantum states of bosonic continuous variable systems. We derive a simplified necessary and sufficient separability criterion for arbitrary Gaussian states of m versus n modes, which relies on convex optimisation over marginal covariance matrices on one subsystem only. We further revisit the currently known results stating the equivalence between separability and positive partial transposition (PPT) for specific classes of Gaussian states. Using techniques based on matrix analysis, such as Schur complements and matrix means, we then provide a unified treatment and compact proofs of all these results. In particular, we recover the PPT-separability equivalence for: (i) Gaussian states of 1 versus n modes; and (ii) isotropic Gaussian states. In passing, we also retrieve (iii) the recently established equivalence between separability of a Gaussian state and and its complete Gaussian extendability. Our techniques are then applied to progress beyond the state of the art. We prove that: (iv) Gaussian states that are invariant under partial transposition are necessarily separable; (v) the PPT criterion is necessary and sufficient for separability for Gaussian states of m versus n modes that are symmetric under the exchange of any two modes belonging to one of the parties; and (vi) Gaussian states which remain PPT under passive optical operations can not be entangled by them either. This is not a foregone conclusion per se (since Gaussian bound entangled states do exist) and settles a question that had been left unanswered in the existing literature on the subject. This paper, enjoyable by both the quantum optics and the matrix analysis communities, overall delivers technical and conceptual advances which are likely to be useful for further applications in continuous variable quantum information theory, beyond the separability problem.

Urodilatin, a natriuretic peptide with clinical implications.

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Meyer, M; Richter, R; Forssmann, W G

1998-02-21

Natriuretic peptides (NP) constitute hormonal systems of great clinical impact. This report deals with Urodilatin (URO), a renal natriuretic peptide type A. From the gene of NP type A, a message for the preprohormone is transcribed in heart and kidney. The cardiac prohormone CDD/ANP-1-126 is synthesized in the heart atrium and processed during exocytosis forming the circulating hormone CDD/ANP-99-126. URO (CDD/ANP 95-126) is a product from the same gene, but differentially processed in the kidney and detected only in urine. Physiologically, URO acts in a paracrine fashion. After release from distal tubular kidney cells into the tubular lumen, URO binds to luminal receptors (NPR-A) in the collecting duct resulting in a cGMP-dependent signal transduction. cGMP generation is followed by an interaction with the amiloriode-sensitive sodium channel which induces diuresis and natriuresis. In this way, URO physiologically regulates fluid balance and sodium homeostasis. Moreover, URO excretion and natriuresis are in turn dependent on several physiological states, such as directly by sodium homeostasis. Pharmacologically, URO at low dose administered intravenously shows a strong diuretic and natriuretic effect and a low hypotensive effect. Renal, pulmonary, and cardiovascular effects evoked by pharmacological doses indicate that URO is a putative drug for several related diseases. Clinical trials show promising results for various clinical indications. However, the reduction in hemodialysis/hemofiltration in patients suffering from ARF following heart and liver transplantation, derived from preliminary trials recruiting a small number of patients, was not confirmed by a multicenter phase II study. In contrast, data for the prophylactic use of URO in this clinical setting suggest a better outcome for the patients. Furthermore, treatment of asthmatic patients showed a convincingly beneficial effect of URO on pulmonary function. Patients with congestive heart failure may also

Destination Brand Equity, Satisfaction And Revisit Intention: An Application In TRNC As a Tourism Destination

OpenAIRE

Sarvari, Neda Gholizadeh

2012-01-01

ABSTRACT: This study revisits the previous studies carried out by several researchers on Customer – Based Brand Equity with an intension to further investigate the applications and testing of the Customer-Based Brand Equity (CBBE) model in relation to destination branding. The study specifically examines the effects of Brand Equity Dimensions (Brand Awareness, Brand Loyalty, Brand Value, Brand Quality and Brand Image) on Tourists Satisfaction and ultimately on Future Behaviours that result i...

The Allolobophora sturanyi species group revisited: Integrated taxonomy and new taxa (Clitellata: Megadrili

Directory of Open Access Journals (Sweden)

Szederjesi, T.

2016-04-01

Full Text Available The Allolobophora sturanyi Rosa, 1895 species group is revisited using DNA barcoding and morphology. Barcoding results corroborated the previous treatment of the Allolobophora sturanyi subspecies and furthermore proved that the morphologically similar Allolobophora gestroides Zicsi, 1970 species belong to this species group. Elaboration of new samples from the Apuseni Mts resulted in discovery of a new subspecies A. sturanyi biharica ssp. nov. from the summit of the Bihor range, and a new species A. zicsica from the Vladeasa range similar to A. gestroides described from Northern Hungary.

Rivastigmine for Alzheimer's disease: Canadian interpretation of intermediate outcome measures and cost implications.

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Baladi, J F; Bailey, P A; Black, S; Bouchard, R W; Farcnik, K D; Gauthier, S; Kertesz, A; Mohr, E; Robillard, A

2000-12-01

Clinical studies have shown that patients with Alzheimer's disease (AD) who are treated with rivastigmine have statistically significantly better scores on 5 scales used to assess AD than control patients receiving placebo. However, the clinical meaning and cost implications of these differences are not clear. The purpose of this study was to assess the clinical meaning and cost implications of statistically significant results obtained in clinical trials of rivastigmine for the treatment of AD. Potential cost implications for the health care system, caregivers, and society are considered. Data on clinical effects of rivastigmine were obtained from published North American and European clinical studies of patients with mild to moderately severe AD receiving rivastigmine 6 to 12 mg/d (n = 828) or placebo (n = 647). Differences in scores on the Alzheimer's Disease Assessment Scale-Cognitive Function, Clinician's Interview-Based Impression of Change with both clinical and caregiver information considered, Progressive Deterioration Scale, Mini-Mental State Examination (MMSE), and Global Deterioration Scale were assessed. A convenience panel of 9 Canadian specialists experienced in the treatment of AD provided their opinions on the clinical importance of the trial results. Chart review was performed to identify specific behaviors that improved, and cost implications of improvements were assessed. The panel determined that statistically significant differences in scores on all scales except the MMSE were likely associated with functional or cognitive differences that were clinically relevant for patients, reflecting stabilization that would have beneficial consequences for caregivers and health care resource use. Subsequent chart review showed that improvement on specific scale items confirmed the physician panel's opinion. Analysis of possible cost implications to society indicated that medication expenditures would be offset largely by delays in the need for paid home

Thermal ignition revisited with two-dimensional molecular dynamics: role of fluctuations in activated collisions

OpenAIRE

Sirmas, Nick; Radulescu, Matei I.

2016-01-01

The problem of thermal ignition in a homogeneous gas is revisited from a molecular dynamics perspective. A two-dimensional model is adopted, which assumes reactive disks of type A and B in a fixed area that react to form type C products if an activation threshold for impact is surpassed. Such a reaction liberates kinetic energy to the product particles, representative of the heat release. The results for the ignition delay are compared with those obtained from the continuum description assumi...

Revisiting the dilatation operator of the Wilson-Fisher fixed point

Energy Technology Data Exchange (ETDEWEB)

Liendo, Pedro [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Theory Group

2017-01-15

We revisit the order ε dilatation operator of the Wilson-Fisher fixed point obtained by Kehrein, Pismak, and Wegner in light of recent results in conformal field theory. Our approach is algebraic and based only on symmetry principles. The starting point of our analysis is that the first correction to the dilatation operator is a conformal invariant, which implies that its form is fixed up to an infinite set of coefficients associated with the scaling dimensions of higher-spin currents. These coefficients can be fixed using well-known perturbative results, however, they were recently re-obtained using CFT arguments without relying on perturbation theory. Our analysis then implies that all order-ε scaling dimensions of the Wilson-Fisher fixed point can be fixed by symmetry.

Carbon emission from global hydroelectric reservoirs revisited.

Science.gov (United States)

Li, Siyue; Zhang, Quanfa

2014-12-01

Substantial greenhouse gas (GHG) emissions from hydropower reservoirs have been of great concerns recently, yet the significant carbon emitters of drawdown area and reservoir downstream (including spillways and turbines as well as river reaches below dams) have not been included in global carbon budget. Here, we revisit GHG emission from hydropower reservoirs by considering reservoir surface area, drawdown zone and reservoir downstream. Our estimates demonstrate around 301.3 Tg carbon dioxide (CO2)/year and 18.7 Tg methane (CH4)/year from global hydroelectric reservoirs, which are much higher than recent observations. The sum of drawdown and downstream emission, which is generally overlooked, represents 42 % CO2 and 67 % CH4 of the total emissions from hydropower reservoirs. Accordingly, the global average emissions from hydropower are estimated to be 92 g CO2/kWh and 5.7 g CH4/kWh. Nonetheless, global hydroelectricity could currently reduce approximate 2,351 Tg CO2eq/year with respect to fuel fossil plant alternative. The new findings show a substantial revision of carbon emission from the global hydropower reservoirs.

Evidenced-based review of clinical studies on periodontics.

Science.gov (United States)

2009-08-01

Periodontal diseases have several implications for the practice of endodontics. First, advanced periodontitis often has direct implications for the long-term prognosis of the case and requires careful evaluation and coordinated treatment of both the periodontic and endodontic diseases. Second, the potential for functional interactions between odontogenic pathoses and marginal periodontitis requires careful collection of clinical observations and monitoring the outcome of various treatments. In this section, we provide an analysis of recent clinical studies in this area.

Population-based analysis of patients with COPD in Catalonia: a cohort study with implications for clinical management

Science.gov (United States)

Vela, Emili; Tényi, Ákos; Cano, Isaac; Monterde, David; Cleries, Montserrat; Garcia-Altes, Anna; Hernandez, Carme; Escarrabill, Joan; Roca, Josep

2018-01-01

Background Clinical management of patients with chronic obstructive pulmonary disease (COPD) shows potential for improvement provided that patients’ heterogeneities are better understood. The study addresses the impact of comorbidities and its role in health risk assessment. Objective To explore the potential of health registry information to enhance clinical risk assessment and stratification. Design Fixed cohort study including all registered patients with COPD in Catalonia (Spain) (7.5 million citizens) at 31 December 2014 with 1-year (2015) follow-up. Methods A total of 264 830 patients with COPD diagnosis, based on the International Classification of Diseases (Ninth Revision) coding, were assessed. Performance of multiple logistic regression models for the six main dependent variables of the study: mortality, hospitalisations (patients with one or more admissions; all cases and COPD-related), multiple hospitalisations (patients with at least two admissions; all causes and COPD-related) and users with high healthcare costs. Neither clinical nor forced spirometry data were available. Results Multimorbidity, assessed with the adjusted morbidity grouper, was the covariate with the highest impact in the predictive models, which in turn showed high performance measured by the C-statistics: (1) mortality (0.83), (2 and 3) hospitalisations (all causes: 0.77; COPD-related: 0.81), (4 and 5) multiple hospitalisations (all causes: 0.80; COPD-related: 0.87) and (6) users with high healthcare costs (0.76). Fifteen per cent of individuals with highest healthcare costs to year ratio represented 59% of the overall costs of patients with COPD. Conclusions The results stress the impact of assessing multimorbidity with the adjusted morbidity grouper on considered health indicators, which has implications for enhanced COPD staging and clinical management. Trial registration number NCT02956395. PMID:29511004

Women's perceptions of polycystic ovary syndrome following participation in a clinical research study: implications for knowledge, feelings, and daily health practices.

Science.gov (United States)

Colwell, Katie; Lujan, Marla E; Lawson, Karen L; Pierson, Roger A; Chizen, Donna R

2010-05-01

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects 6% to 10% of reproductive aged women. It is a poorly understood and often undiagnosed condition that has implications for the health of affected women. We assessed changes in knowledge, feelings, and daily health practices related to PCOS in clinical research study participants. Sixty-eight women who had received counselling and education about PCOS while participating in a clinical research study were invited to complete an online survey that assessed levels of concern, knowledge, healthy dieting, active living, and health care satisfaction before and after the study. Differences and associations between scores were analyzed by paired t tests and Pearson correlation. Forty-three women (63%) completed the survey. After taking part in a clinical research study, participants believed they had increased knowledge of (P better lifestyle practices (P women felt empowered to participate in the management of their condition and communicate with their primary care providers. Women with PCOS felt that they had more knowledge and motivation to implement preventive health strategies after participating in a clinical research study. Education about how PCOS affects their immediate and long-term health enabled women with PCOS to feel physical and psychological benefits and to engage more with their health care providers.

MERRF Classification: Implications for Diagnosis and Clinical Trials.

Science.gov (United States)

Finsterer, Josef; Zarrouk-Mahjoub, Sinda; Shoffner, John M

2018-03-01

Given the etiologic heterogeneity of disease classification using clinical phenomenology, we employed contemporary criteria to classify variants associated with myoclonic epilepsy with ragged-red fibers (MERRF) syndrome and to assess the strength of evidence of gene-disease associations. Standardized approaches are used to clarify the definition of MERRF, which is essential for patient diagnosis, patient classification, and clinical trial design. Systematic literature and database search with application of standardized assessment of gene-disease relationships using modified Smith criteria and of variants reported to be associated with MERRF using modified Yarham criteria. Review of available evidence supports a gene-disease association for two MT-tRNAs and for POLG. Using modified Smith criteria, definitive evidence of a MERRF gene-disease association is identified for MT-TK. Strong gene-disease evidence is present for MT-TL1 and POLG. Functional assays that directly associate variants with oxidative phosphorylation impairment were critical to mtDNA variant classification. In silico analysis was of limited utility to the assessment of individual MT-tRNA variants. With the use of contemporary classification criteria, several mtDNA variants previously reported as pathogenic or possibly pathogenic are reclassified as neutral variants. MERRF is primarily an MT-TK disease, with pathogenic variants in this gene accounting for ~90% of MERRF patients. Although MERRF is phenotypically and genotypically heterogeneous, myoclonic epilepsy is the clinical feature that distinguishes MERRF from other categories of mitochondrial disorders. Given its low frequency in mitochondrial disorders, myoclonic epilepsy is not explained simply by an impairment of cellular energetics. Although MERRF phenocopies can occur in other genes, additional data are needed to establish a MERRF disease-gene association. This approach to MERRF emphasizes standardized classification rather than clinical

Searle's"Dualism Revisited"

Energy Technology Data Exchange (ETDEWEB)

P., Henry

2008-11-20

A recent article in which John Searle claims to refute dualism is examined from a scientific perspective. John Searle begins his recent article 'Dualism Revisited' by stating his belief that the philosophical problem of consciousness has a scientific solution. He then claims to refute dualism. It is therefore appropriate to examine his arguments against dualism from a scientific perspective. Scientific physical theories contain two kinds of descriptions: (1) Descriptions of our empirical findings, expressed in an every-day language that allows us communicate to each other our sensory experiences pertaining to what we have done and what we have learned; and (2) Descriptions of a theoretical model, expressed in a mathematical language that allows us to communicate to each other certain ideas that exist in our mathematical imaginations, and that are believed to represent, within our streams of consciousness, certain aspects of reality that we deem to exist independently of their being perceived by any human observer. These two parts of our scientific description correspond to the two aspects of our general contemporary dualistic understanding of the total reality in which we are imbedded, namely the empirical-mental aspect and the theoretical-physical aspect. The duality question is whether this general dualistic understanding of ourselves should be regarded as false in some important philosophical or scientific sense.

Individualist Biocentrism vs. Holism Revisited

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Katie McShane

2014-06-01

Full Text Available While holist views such as ecocentrism have considerable intuitive appeal, arguing for the moral considerability of ecological wholes such as ecosystems has turned out to be a very difficult task. In the environmental ethics literature, individualist biocentrists have persuasively argued that individual organisms—but not ecological wholes—are properly regarded as having a good of their own . In this paper, I revisit those arguments and contend that they are fatally flawed. The paper proceeds in five parts. First, I consider some problems brought about by climate change for environmental conservation strategies and argue that these problems give us good pragmatic reasons to want a better account of the welfare of ecological wholes. Second, I describe the theoretical assumptions from normative ethics that form the background of the arguments against holism. Third, I review the arguments given by individualist biocentrists in favour of individualism over holism. Fourth, I review recent work in the philosophy of biology on the units of selection problem, work in medicine on the human biome, and work in evolutionary biology on epigenetics and endogenous viral elements. I show how these developments undermine both the individualist arguments described above as well as the distinction between individuals and wholes as it has been understood by individualists. Finally, I consider five possible theoretical responses to these problems.

Long-acting family planning method switching among revisit clients of public health facilities in Dire Dawa, Ethiopia.

Science.gov (United States)

Atnafe, Meselu; Assefa, Nega; Alemayehu, Tadesse

2016-01-01

"Contraceptive switching" from one method to another is a common phenomenon. Switching from a more effective long-acting method to a less effective method exposes women for unplanned pregnancy. The aim of this study was to assess the level and factors associated with long-acting family planning method switching to other methods. A facility-based cross-sectional study was conducted from January to March 2013 on 634 women attending public health facilities in Dire Dawa City Administration, Ethiopia. Participants of the study were revisit clients of family planning service and were interviewed as they appear in the clinics. Data were analyzed using crude and adjusted logistic regression, and results were reported using OR and corresponding 95 % CI. Long-acting family planning method switching among revisit clients was 40.4 %; switching from implant was 29.8 % and from IUCD, it was 10.6 %. The main reasons for methods switching were side effects of the methods such as bleeding, weight loss, and feeling of arm numbness. The tendency of switching was less among married women (AOR = 2.41, 95 % CI: 1.01, 5.74), women who had 2-4 and 5 and more children (AOR 3.00, 95 % CI: 1.59, 5.67) and (AOR 2.07, 95 % CI: 1.17, 3.66), respectively. It was also less among women who want to stop birth (AOR 5.11, 95 % CI: 1.15, 24.8), among those who mentioned health care providers as source of information for family planning (AOR 1.88, 95 % CI: 1.18, 3.01), and among women whose husbands were aware of their use of the methods (AOR 3.05, 95 % CI: 1.88, 4.94). Method switching from long-acting contraceptives to less effective methods is high. Method switching was significant among unmarried women, who had one child, plan to postpone fertility, and whose husbands were not aware of their wive's use of the method. In the provision of family planning service, the health care providers should give adequate information about each method and risks of method switching. Appropriate family

Potentially malignant disorders of the oral cavity: a clinical study.

Science.gov (United States)

Shukla, Anirudh

2014-01-01

Oral cancers in India, unlike in the West are the most common cancers encountered, be it a primary or a tertiary referral practice. This makes the study and management of these cancers an important issue especially for the otolaryngologist. It is well known that the most common variant of oral cancers is the squamous cell carcinoma. Also the etiology is well established; with tobacco use in both smoking and smokeless forms, alcohol, betel nut and recently the Human Papilloma virus infection being implicated. Certain conditions which definitely increase the probability of getting oral cancers are known and this study aims in revisiting these aspects of pre-malignancy. The progression from a pre-cancerous lesion/condition to frank cancer is well established across many studies and many specialties. Also timely recognizing these pre-cancerous conditions and administration of proper treatment will greatly help in reducing the morbidity and mortality from subsequent much advanced and dangerous oral cancer. Keeping these facts in mind this study was planned to study the established pre-cancerous lesions which are known to progress to oral cancers.

Theory of magnetohydrodynamic waves: The WKB approximation revisited

International Nuclear Information System (INIS)

Barnes, A.

1992-01-01

Past treatments of the eikonal or WKB theory of the propagation of magnetohydrodynamics waves have assumed a strictly isentropic background. IF in fact there is a gradient in the background entropy, then in second order in the WKB ordering, adiabatic fluctuations (in the Lagrangian sense) are not strictly isentropic in the Eulerian sense. This means that in the second order of the WKB expansion, which determines the variation of wave amplitude along rays, the violation of isentropy must be accounted for. The present paper revisits the derivation of the WKB approximation for small-amplitude magnetohydrodynamic waves, allowing for possible spatial variation of the background entropy. The equation of variation of wave amplitude is rederived; it is a bilinear equation which, it turns out, can be recast in the action conservation form. It is shown that this action conservation equation is in fact equivalent to the action conservation law obtained from Lagrangian treatments

Revisitation: a trans phenomenology of the media image

Directory of Open Access Journals (Sweden)

Cael M Keegan

2016-12-01

Full Text Available How might certain moving images move us into transgender becoming? The recent proliferation of transgender images in the media of the Global North has been widely regarded as supporting transgender political and social equality. But do these images do justice to the complexity of transgender lives? Who are images of transgender identity made for, and whose interests do they serve? Instead of discussing media that produce a transgender object for public consumption, this essay’s author is interested in theorizing a trans point of media reception for the popular image. This essay illustrates how transgender subjects might fashion their own archives of becoming through encounters with media that unintentionally support transgender embodiment as a possibility in the world. Revisiting his phenomenological encounters with the film Under the Skin and the “Milk: It Does a Body Good” ad campaign, the author analyzes how certain media objects have the unexpected power to “move” the transgender subject into becoming.

PENGARUH PERCEIVED JUSTICE TERHADAP WORD OF MOUTH, TRUST DAN REVISIT INTENTION YANG DIMEDIASI OLEH RECOVERY SATISFACTION

OpenAIRE

Sembodo Herry C

2008-01-01

The purpose: of this study is to assess the relative influences of distributive (DJ), procedural (PJ), and interactional (Li) justice on customer satisfaction on service recovery and to examine the relationship between recovery satisfaction and subsequent customer relationships: trust, word-of-riwuth (WOM), and revisit intention. Methodology: On-site surveys were administered to collect data from insurance customer who bought, and experienced a service failure. Findings: The effect of D...

Tumor suppressive effect of PARP1 and FOXO3A in gastric cancers and its clinical implications

Science.gov (United States)

Yoon, Sarah; Jo, Yuna; Kwon, So Mee; Kim, Kyoung Min; Kwon, Keun Sang; Kim, Chan Young; Woo, Hyun Goo

2015-01-01

Poly (ADP-ribose) polymerase1 (PARP1) has been reported as a possible target for chemotherapy in many cancer types. However, its action mechanisms and clinical implications for gastric cancer survival are not yet fully understood. Here, we investigated the effect of PARP1 inhibition in the growth of gastric cancer cells. PARP1 inhibition by Olaparib or PARP1 siRNA could significantly attenuate growth and colony formation of gastric cancer cells, and which were mediated through induction of G2/M cell cycle arrest but not apoptosis. FOXO3A expression was induced by PARP1 inhibition, suggesting that FOXO3A might be one of downstream target of the PARP1 effect on gastric cancer cell growth. In addition, by performing tissue microarrays on the 166 cases of gastric cancer patients, we could observe that the expression status of PARP1 and FOXO3A were significantly associated with overall survival (OS) and relapse-free survival (RFS). Strikingly, combined expression status of PARP1 and FOXO3A showed better prediction for patient's clinical outcomes. The patient group with PARP1+/FOXO3A− expression had the worst prognosis while the patient group with PARP1−/FOXO3A+ had the most favorable prognosis (OS: P = 6.0 × 10−9, RFS: P = 2.2 × 10−8). In conclusion, we suggest that PARP1 and FOXO3A play critical roles in gastric cancer progression, and might have therapeutic and/or diagnostic potential in clinic. PMID:26540566

Clinical implications for substandard, nonproprietary medicines in multiple sclerosis: focus on fingolimod

Directory of Open Access Journals (Sweden)

Correale J

2016-06-01

each ingredient in each capsule/tablet and lower quality. Substandard, nonproprietary copies of medicines that are immunomodulatory or immunosuppressive are of concern to patients due to their possible untoward safety and lack of efficacy events. This article reviews the potential risks associated with nonproprietary medicines that do not meet the regulatory requirements of the United States Food and Drug Administration, the European Medicines Agency, or the World Health Organization. The clinical implications for patients are described. This article focuses on nonproprietary medicines for multiple sclerosis, particularly fingolimod, that are not identical to proprietary versions and could thus fail to meet efficacy expectations or have different impact on the safety of patients with multiple sclerosis.Keywords: bioequivalence, fingolimod, multiple sclerosis, proprietary, substandard copies, toxicity

Need for revisiting the role of sexually transmitted disease clinics in government hospitals in India

Directory of Open Access Journals (Sweden)

Madhulekha Bhattacharya

2017-01-01

Full Text Available Introduction: The Government of India provides treatment for sexually transmitted infections (STIs through government's sexually transmitted disease (STD clinics with the mandate of providing curative and preventive services for clients in the context of STIs. However, besides the patients suffering from STDs, other clients with problems related to reproductive and sexual health also attend these clinics. This study aimed to assess the profile and treatment-seeking behavior of clients attending STD clinics in government hospitals in India. Materials and Methods: This multicentric, cross-sectional study with 5098 participants was conducted over 2 months in identified 19 Indian states. Chi–square test was used for statistical analysis. Results: The percentage with STDs (62.98% was nearly double than those with non-STDs (37.1%. Around 8.2% of patients had an STD and were also HIV positive. Compared to the total STD cases, only 9% of the partners had turned up for screening. Of significance were the non-STD cases who presented with both physical and psychological symptoms including infertility. Among males, it was mainly sexual dysfunction and balanoposthitis, and in females, lower abdominal pain and bacterial vaginosis. Only 27.3% reported that they had come directly to the government facility/clinic. Nearly 38% of males and 30% of females had tried home remedies before coming to the government clinic. Majority (77.9% of the clients reported that they had never been counseled on any aspect of STD or HIV. Conclusion: The profile of clients in the various clinics across the country indicates that the name “STD Clinic” is a misnomer since the presenting complaints of clients are varied, and related not only to STDs but also to other reproductive tract problems. Furthermore, the average new patient load observed in our study is low and this was attributed to the name “STDs” given to these clinics. Renaming them as “Reproductive Health

Is a clinical sociolinguistics possible?

Science.gov (United States)

Ball, M J

1992-01-01

This paper considers the idea of developing a clinical sociolinguistics. Various areas of the field are examined, and the importance of the 'core' area of the correlation of non-linguistic variables with linguistic variables stressed. Issues concerning language and class, region, sex, age and context of utterance are investigated, together with the implications for clinical linguistics. Finally, the difficulty of integrating such issues into clinical assessment is explored, and a tentative step forward suggested along the lines of a 'clinical sociolinguistic checklist'.

Clinical implications for substandard, nonproprietary medicines in multiple sclerosis: focus on fingolimod

Science.gov (United States)

Correale, Jorge; Chiquete, Erwin; Boyko, Alexey; Beran, Roy G; Strauch, Jorge Barahona; Milojevic, Snezana; Frider, Nadina

2016-01-01

Both proprietary and nonproprietary medicines are expected to undergo rigorous preapproval testing and both should meet stringent health authority regulatory requirements related to quality to obtain approval. Nonproprietary (also known as copy, or generic) medicines, which base their authorization and use on the proprietary documentation and label, are often viewed as a means to help lower the cost and, thus, increase patient access. If these medicines fail to meet quality standards, such as good manufacturing practice and bioequivalence (in humans), they are then defined as substandard copies and can pose serious risks to patients in terms of safety and efficacy. Potentially noncontrolled or different manufacturing process and excipients in nonproprietary medicines may result in poor batch-to-batch reproducibility (accurate and consistent quantity of each ingredient in each capsule/tablet) and lower quality. Substandard, nonproprietary copies of medicines that are immunomodulatory or immunosuppressive are of concern to patients due to their possible untoward safety and lack of efficacy events. This article reviews the potential risks associated with nonproprietary medicines that do not meet the regulatory requirements of the United States Food and Drug Administration, the European Medicines Agency, or the World Health Organization. The clinical implications for patients are described. This article focuses on nonproprietary medicines for multiple sclerosis, particularly fingolimod, that are not identical to proprietary versions and could thus fail to meet efficacy expectations or have different impact on the safety of patients with multiple sclerosis. PMID:27418809

Changes in composition, ecology and structure of high-mountain vegetation: a re-visitation study over 42 years.

Science.gov (United States)

Evangelista, Alberto; Frate, Ludovico; Carranza, Maria Laura; Attorre, Fabio; Pelino, Giovanni; Stanisci, Angela

2016-01-27

High-mountain ecosystems are increasingly threatened by climate change, causing biodiversity loss, habitat degradation and landscape modifications. However, very few detailed studies have focussed on plant biodiversity in the high mountains of the Mediterranean. In this study, we investigated the long-term changes that have occurred in the composition, structure and ecology of high-mountain vegetation in the central Apennines (Majella) over the last 42 years. We performed a re-visitation study, using historical and newly collected vegetation data to explore which ecological and structural features have been the most successful in coping with climatic changes. Vegetation changes were analysed by comparing geo-referenced phytosociological relevés collected in high-mountain habitats (dolines, gentle slopes and ridges) on the Majella massif in 1972 and in 2014. Composition analysis was performed by detrended correspondence analysis, followed by an analysis of similarities for statistical significance assessment and by similarity percentage procedure (SIMPER) for identifying which species indicate temporal changes. Changes in ecological and structural indicators were analysed by a permutational multivariate analysis of variance, followed by a post hoc comparison. Over the last 42 years, clear floristic changes and significant ecological and structural variations occurred. We observed a significant increase in the thermophilic and mesonitrophilic plant species and an increment in the frequencies of hemicryptophytes. This re-visitation study in the Apennines agrees with observations in other alpine ecosystems, providing new insights for a better understanding of the effects of global change on Mediterranean high-mountain biodiversity. The observed changes in floristic composition, the thermophilization process and the shift towards a more nutrient-demanding vegetation are likely attributable to the combined effect of higher temperatures and the increase in soil nutrients

Clinical and nutritional implications of radiation enteritis

Energy Technology Data Exchange (ETDEWEB)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.

Clinical and nutritional implications of radiation enteritis

International Nuclear Information System (INIS)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value

The "medication interest model": an integrative clinical interviewing approach for improving medication adherence-part 2: implications for teaching and research.

Science.gov (United States)

Shea, Shawn Christopher

2009-01-01

Over the past several decades, exciting advances have been made in the art and science of teaching clinical interviewing, which are supported by an ever-growing evidence base documenting their effectiveness. In this second article in a 2-part series, the training and research implications of an innovative approach to improving medication adherence based on these educational advances--the medication interest model (MIM)--are described. The objective is to provide an "insider's view" of how to creatively teach the MIM to case managers, as well as design state-of-the-art courses and research platforms dedicated to improving medication adherence through improved clinical interviewing skills in both nursing and medical student education. The teaching and research design concepts are applicable to all primary care settings as well as specialty areas from endocrinology and cardiology to psychiatry. Evidence-based advances in the teaching of clinical interviewing skills such as response-mode research, facilic supervision, microtraining, and macrotraining lend a distinctive quality and integrative power to the MIM. The model delineates several new platforms for training and research regarding the enhancement of medication adherence including an approach for collecting individual interviewing techniques into manageable "learning modules" amenable to competency evaluation and potential certification.

Revisiting the argument from fetal potential

Directory of Open Access Journals (Sweden)

Manninen Bertha

2007-05-01

Full Text Available Abstract One of the most famous, and most derided, arguments against the morality of abortion is the argument from potential, which maintains that the fetus' potential to become a person and enjoy the valuable life common to persons, entails that its destruction is prima facie morally impermissible. In this paper, I will revisit and offer a defense of the argument from potential. First, I will criticize the classical arguments proffered against the importance of fetal potential, specifically the arguments put forth by philosophers Peter Singer and David Boonin, by carefully unpacking the claims made in these arguments and illustrating why they are flawed. Secondly, I will maintain that fetal potential is morally relevant when it comes to the morality of abortion, but that it must be accorded a proper place in the argument. This proper place, however, cannot be found until we first answer a very important and complex question: we must first address the issue of personal identity, and when the fetus becomes the type of being who is relevantly identical to a future person. I will illustrate why the question of fetal potential can only be meaningfully addressed after we have first answered the question of personal identity and how it relates to the human fetus.

PNH revisited: Clinical profile, laboratory diagnosis and follow-up

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Gupta P

2009-01-01

Full Text Available Background: Paroxysmal nocturnal hemoglobinuria (PNH is characterized by intravascular hemolysis, marrow failure, nocturnal hemoglobinuria and thrombophila. This acquired disease caused by a deficiency of glycosylphosphatidylinositol (GPI anchored proteins on the hematopoietic cells is uncommon in the Indian population. Materials and Methods: Data of patients diagnosed with PNH in the past 1 year were collected. Clinical data (age, gender, various presenting symptoms, treatment information and follow-up data were collected from medical records. Results of relevant diagnostic tests were documented i.e., urine analysis, Ham′s test, sucrose lysis test and sephacryl gel card test (GCT for CD55 and CD59. Results: A total of 5 patients were diagnosed with PNH in the past 1 year. Presenting symptoms were hemolytic anemia (n=4 and bone marrow failure (n=1. A GCT detected CD59 deficiency in all erythrocytes in 4 patients and CD55 deficiency in 2 patients. A weak positive PNH test for CD59 was seen in 1 patient and a weak positive PNH test for CD55 was seen in 3 patients. All patients were negative by sucrose lysis test. Ham′s test was positive in two cases. Patients were treated with prednisolone and/or androgen and 1 patient with aplastic anemia was also given antithymocyte globulin. A total of 4 patients responded with a partial recovery of hematopoiesis and 1 patient showed no recovery. None of the patients received a bone marrow transplant. Conclusion: The study highlights the diagnostic methods and treatment protocols undertaken to evaluate the PNH clone in a developing country where advanced methods like flowcytometry immunophenotyping (FCMI and bone marrow transplants are not routinely available.

Governing Education: a revisiting of ‘Political Power beyond the State’ 25 years on

DEFF Research Database (Denmark)

Lim, Miguel Antonio

2016-01-01

that are used in classrooms, management offices, and policy setting agencies. Each of these instruments and calculative devices is pregnant with interest. They bridge the gap between everyday practices and larger governance goals. Yet as the technical sophistication of these instruments increases......This article revisits Political Power Beyond the State: Problematics of Government by sociologist Nikolas Rose and critical accounting scholar Peter Miller. The reach of this influential critique of the nature of power and its exercise ‘beyond the state’ continues to this day, 25 years after...

Agglomeration externalities, market structure and employment growth in high-tech industries: Revisiting the evidence

Directory of Open Access Journals (Sweden)

Cieślik Andrzej

2015-09-01

Full Text Available In this paper we revisit the existing empirical evidence on the effects of various agglomeration externalities and the market structure on employment growth in the high-tech industries of the European Economic Area (EEA. Our study is based on the dynamic panel dataset of two-digit NACE rev 1.1. industries in 285 regions of the European Economic Area for the period 1995-2007. We find that employment growth is negatively related to competition, while localization and urbanization externalities do not seem to affect growth.

NRASQ61K mutated primary leptomeningeal melanoma in a child: case presentation and discussion on clinical and diagnostic implications

International Nuclear Information System (INIS)

Angelino, Giulia; De Pasquale, Maria Debora; De Sio, Luigi; Serra, Annalisa; Massimi, Luca; De Vito, Rita; Marrazzo, Antonio; Lancella, Laura; Carai, Andrea; Antonelli, Manila; Giangaspero, Felice; Gessi, Marco; Menchini, Laura; Scarciolla, Laura; Longo, Daniela; Mastronuzzi, Angela

2016-01-01

Primary melanocytic neoplasms are rare in the pediatric age. Among them, the pattern of neoplastic meningitis represents a peculiar diagnostic challenge since neuroradiological features may be subtle and cerebrospinal fluid analysis may not be informative. Clinical misdiagnosis of neoplastic meningitis with tuberculous meningitis has been described in few pediatric cases, leading to a significant delay in appropriate management of patients. We describe the case of a child with primary leptomeningeal melanoma (LMM) that was initially misdiagnosed with tuberculous meningitis. We review the clinical and molecular aspects of LMM and discuss on clinical and diagnostic implications. A 27-month-old girl with a 1-week history of vomiting with mild intermittent strabismus underwent Magnetic Resonance Imaging, showing diffuse brainstem and spinal leptomeningeal enhancement. Cerebrospinal fluid analysis was unremarkable. Antitubercular treatment was started without any improvement. A spinal intradural biopsy was suggestive for primary leptomeningeal melanomatosis. Chemotherapy was started, but general clinical conditions progressively worsened and patient died 11 months after diagnosis. Molecular investigations were performed post-mortem on tumor tissue and revealed absence of BRAF V600E , GNAQ Q209 and GNA11 Q209 mutations but the presence of a NRAS Q61K mutation. Our case adds some information to the limited experience of the literature, confirming the presence of the NRAS Q61K mutation in children with melanomatosis. To our knowledge, this is the first case of leptomeningeal melanocytic neoplasms (LMN) without associated skin lesions to harbor this mutation. Isolated LMN presentation might be insidious, mimicking tuberculous meningitis, and should be suspected if no definite diagnosis is possible or if antitubercular treatment does not result in dramatic clinical improvement. Leptomeningeal biopsy should be considered, not only to confirm diagnosis of LMN but also to study

Assessment of activities performed by clinical nurse practitioners and implications for staffing and patient care at primary health care level in South Africa

Directory of Open Access Journals (Sweden)

Jude Igumbor

2016-03-01

Full Text Available Background: The shortage of nurses in public healthcare facilities in South Africa is well documented; finding creative solutions to this problem remains a priority. Objective: This study sought to establish the amount of time that clinical nurse practitioners (CNPs in one district of the Western Cape spend on clinical services and the implications for staffing and skills mix in order to deliver quality patient care. Methods: A descriptive cross-sectional study was conducted across 15 purposively selected clinics providing primary health services in 5 sub-districts. The frequency of activities and time CNPs spent on each activity in fixed and mobile clinics were recorded. Time spent on activities and health facility staff profiles were correlated and predictors of the total time spent by CNPs with patients were identified. Results: The time spent on clinical activities was associated with the number of CNPs in the facilities. CNPs in fixed clinics spent a median time of about 13 minutes with each patient whereas CNPs in mobile clinics spent 3 minutes. Fixed-clinic CNPs also spent more time on their non-core functions than their core functions, more time with patients, and saw fewer patients compared to mobile-clinic CNPs. Conclusions: The findings give insight into the time CNPs in rural fixed and mobile clinics spend with their patients, and how patient caseload may affect consultation times. Two promising strategies were identified – task shifting and adjustments in health workerd eployment – as ways to address staffing and skills mix, which skills mix creates the potential for using healthcare workers fully whilst enhancing the long-term health of these rural communities.

Tick-borne encephalitis: Pathogenesis and clinical implications

Czech Academy of Sciences Publication Activity Database

Růžek, Daniel; Dobler, G.; Mantke, O. D.

2010-01-01

Roč. 8, č. 4 (2010), s. 223-232 ISSN 1477-8939 R&D Projects: GA ČR GPP302/10/P438; GA MŠk(CZ) LC06009 Institutional research plan: CEZ:AV0Z60220518 Keywords : Tick-borne encephalitis * Tick-borne encephalitis virus * Pathogenesis * Clinical data Subject RIV: EE - Microbiology, Virology

The Kickstart of the Age of the Earth Race: Revisiting the Experiment of the Comte de Buffon at School

Science.gov (United States)

Pincelli, M. M.; Prat, M. R.; Lescano, G. M.; Formichella, M. del C.; Brustle, M.; Otranto, S.

2018-01-01

In this work, the first experiment ever done to determine the age of the Earth is revisited. The benefits of its application at primary and secondary school levels are presented and discussed. In particular, emphasis is placed on the advantage of facing students with the challenges that scientists have had to overcome during the past three…

Anosognosia as motivated unawareness: the 'defence' hypothesis revisited.

Science.gov (United States)

Turnbull, Oliver H; Fotopoulou, Aikaterini; Solms, Mark

2014-12-01

Anosognosia for hemiplegia has seen a century of almost continuous research, yet a definitive understanding of its mechanism remains elusive. Essentially, anosognosic patients hold quasi-delusional beliefs about their paralysed limbs, in spite of all the contrary evidence, repeated questioning, and logical argument. We review a range of findings suggesting that emotion and motivation play an important role in anosognosia. We conclude that anosognosia involves (amongst other things) a process of psychological defence. This conclusion stems from a wide variety of clinical and experimental investigations, including data on implicit awareness of deficit, fluctuations in awareness over time, and dramatic effects upon awareness of psychological interventions such as psychotherapy, reframing of the emotional consequences of the paralysis, and first versus third person perspectival manipulations. In addition, we review and refute the (eight) arguments historically raised against the 'defence' hypothesis, including the claim that a defence-based account cannot explain the lateralised nature of the disorder. We argue that damage to a well-established right-lateralised emotion regulation system, with links to psychological processes that appear to underpin allocentric spatial cognition, plays a key role in anosognosia (at least in some patients). We conclude with a discussion of implications for clinical practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Revisiting the safety of aspartame.

Science.gov (United States)

Choudhary, Arbind Kumar; Pretorius, Etheresia

2017-09-01

Aspartame is a synthetic dipeptide artificial sweetener, frequently used in foods, medications, and beverages, notably carbonated and powdered soft drinks. Since 1981, when aspartame was first approved by the US Food and Drug Administration, researchers have debated both its recommended safe dosage (40 mg/kg/d) and its general safety to organ systems. This review examines papers published between 2000 and 2016 on both the safe dosage and higher-than-recommended dosages and presents a concise synthesis of current trends. Data on the safe aspartame dosage are controversial, and the literature suggests there are potential side effects associated with aspartame consumption. Since aspartame consumption is on the rise, the safety of this sweetener should be revisited. Most of the literature available on the safety of aspartame is included in this review. Safety studies are based primarily on animal models, as data from human studies are limited. The existing animal studies and the limited human studies suggest that aspartame and its metabolites, whether consumed in quantities significantly higher than the recommended safe dosage or within recommended safe levels, may disrupt the oxidant/antioxidant balance, induce oxidative stress, and damage cell membrane integrity, potentially affecting a variety of cells and tissues and causing a deregulation of cellular function, ultimately leading to systemic inflammation. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Zika virus: A review with oral health implications

Directory of Open Access Journals (Sweden)

Ruchika Khanna

2017-01-01

Full Text Available Zika virus was first isolated in the year 1947 from the blood of sentinel rhesus macaque of Uganda. The virus was introduced in Brazil from Pacific Islands and thereon spread rapidly. It was considered the first infectious disease to have birth defects. This review highlights the transmission, clinical aspects, clinical features, diagnosis, and possible implications of the virus for the dental team.

Psychosocial stress and cardiovascular disease. Part 3: Clinical and policy implications of research on the transcendental meditation program.

Science.gov (United States)

Walton, Kenneth G; Schneider, Robert H; Salerno, John W; Nidich, Sanford I

2005-01-01

Cardiovascular disease (CVD) remains the leading cause of death in the United States today and a major contributor to total health care costs. Psychosocial stress has been implicated in CVD, and psychosocial approaches to primary and secondary prevention are gaining research support. This third article in the series on psychosocial stress and CVD continues the evaluation of one such approach, the Maharishi Transcendental Meditation program, a psychophysiological approach from the Vedic tradition that is systematically taught by qualified teachers throughout the world. Evidence suggests not only that this program can provide benefits in prevention but also that it may reduce CVD-related and other health care expenses. On the basis of data from the studies available to date, the Transcendental Meditation program may be responsible for reductions of 80% or greater in medical insurance claims and payments to physicians. This article evaluates the implications of research on the Transcendental Meditation program for health care policy and for large-scale clinical implementation of the program. The Transcendental Meditation program can be used by individuals of any ethnic or cultural background, and compliance with the practice regimen is generally high. The main steps necessary for wider adoption appear to be: (1) educating health care providers and patients about the nature and expected benefits of the program, and (2) adjustments in public policies at the state and national levels to allow this program to be included in private and public health insurance plans.

On the Froehlich decomposition and the condensate fraction in He II

International Nuclear Information System (INIS)

Ghassib, H.B.; Sridhar, R.

1983-09-01

The method of extracting the Bose-Einstein condensate fraction in He II within the Froehlich decomposition scheme is revisited. A new simple formula for determining this fraction is derived. Possible experimental and theoretical implications are discussed. (author)

A COMPARATIVE ANALYSIS OF DIET QUALITY IN URBAN AND ...

African Journals Online (AJOL)

thinkexploitsint'l

The objectives of this study are to determine the level of protein intake, ..... Tantalizer, Mr. Biggs, Nestles, Cadbury etc for healthy living should be part of the corporate ... “Economic implication of malnutrition”: the dismal science revisited.

Pair Production Constraints on Superluminal Neutrinos Revisited

International Nuclear Information System (INIS)

Brodsky, Stanley

2012-01-01

We revisit the pair creation constraint on superluminal neutrinos considered by Cohen and Glashow in order to clarify which types of superluminal models are constrained. We show that a model in which the superluminal neutrino is effectively light-like can evade the Cohen-Glashow constraint. In summary, any model for which the CG pair production process operates is excluded because such timelike neutrinos would not be detected by OPERA or other experiments. However, a superluminal neutrino which is effectively lightlike with fixed p 2 can evade the Cohen-Glashow constraint because of energy-momentum conservation. The coincidence involved in explaining the SN1987A constraint certainly makes such a picture improbable - but it is still intrinsically possible. The lightlike model is appealing in that it does not violate Lorentz symmetry in particle interactions, although one would expect Hughes-Drever tests to turn up a violation eventually. Other evasions of the CG constraints are also possible; perhaps, e.g., the neutrino takes a 'short cut' through extra dimensions or suffers anomalous acceleration in matter. Irrespective of the OPERA result, Lorentz-violating interactions remain possible, and ongoing experimental investigation of such possibilities should continue.

Izmit Foreshocks Revisited

Science.gov (United States)

Ellsworth, W. L.; Bulut, F.

2016-12-01

Much of what we know about the initiation of earthquakes comes from the temporal and spatial relationship of foreshocks to the initiation point of the mainshock. The 1999 Mw 7.6 Izmit, Turkey, earthquake was preceded by a 44 minute-long foreshock sequence. Bouchon et al. (Science, 2011) analyzed the foreshocks using a single seismic station, UCG, located to the north of the east-west fault, and concluded on the basis of waveform similarity that the foreshocks repeatedly re-ruptured the same fault patch, driven by slow slip at the base of the crust. We revisit the foreshock sequence using seismograms from 9 additional stations that recorded the four largest foreshocks (Mw 2.0 to 2.8) to better characterize spatial and temporal evolution of the foreshock sequence and their relationship to the mainshock hypocenter. Cross-correlation timing and hypocentroid location with hypoDD reveals a systematic west-to-east propagation of the four largest foreshocks toward the mainshock hypocenter. Foreshock rupture dimensions estimated using spectral ratios imply no major overlap for the first three foreshocks. The centroid of 4th and largest foreshock continues the eastward migration, but lies within the circular source area of the 3rd. The 3rd, however, has a low stress drop and strong directivity to the west . The mainshock hypocenter locates on the eastern edge of foreshock 4. We also re-analyzed waveform similarity of all 18 foreshocks recorded at UCG by removing the common mode signal and clustering the residual seismogram using the correlation coefficient as the distance metric. The smaller foreshocks cluster with the larger events in time order, sometimes as foreshocks and more commonly as aftershocks. These observations show that the Izmit foreshock sequence is consistent with a stress-transfer driven cascade, moving systematically to the east along the fault and that there is no observational requirement for creep as a driving mechanism.

A revisited Johnson-Mehl-Avrami-Kolmogorov model and the evolution of grain-size distributions in steel

OpenAIRE

Hömberg, D.; Patacchini, F. S.; Sakamoto, K.; Zimmer, J.

2016-01-01

The classical Johnson-Mehl-Avrami-Kolmogorov approach for nucleation and growth models of diffusive phase transitions is revisited and applied to model the growth of ferrite in multiphase steels. For the prediction of mechanical properties of such steels, a deeper knowledge of the grain structure is essential. To this end, a Fokker-Planck evolution law for the volume distribution of ferrite grains is developed and shown to exhibit a log-normally distributed solution. Numerical parameter studi...

Revisit to Grad's Closure and Development of Physically Motivated Closure for Phenomenological High-Order Moment Model

International Nuclear Information System (INIS)

Myong, R. S.; Nagdewe, S. P.

2011-01-01

The Grad's closure for the high-order moment equation is revisited and, by extending his theory, a physically motivated closure is developed for the one-dimensional velocity shear gas flow. The closure is based on the physical argument of the relative importance of various terms appearing in the moment equation. Also, the closure is derived such that the resulting theory may be inclusive of the well established linear theory (Navier-Stokes-Fourier) as limiting case near local thermal equilibrium.

Nursing informatics, ethics and decisions: implications for translational research

DEFF Research Database (Denmark)

Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Dowie, Jack

Nursing informatics, ethics and decisions: implications for translational research Objective: To introduce, in the multi-disciplinary contexts of clinical decision making and policy formation, a theory-based decision-analytic framework for the transparent forward translation of research......-calculation with evidence-based ratings for option performance on those criteria to produce a preference-sensitive assessment or opinion. Results: The first example shows the framework connecting nursing informatics and nursing ethics in the clinical context of a nurse’s decision to disclose or not disclose information......, satisfaction, Quality of Life), organization-related (staff and work environment, internal and external communication and relationships) and economics-related (start-up costs, financial implications and externalities)). Conclusion: Web-based decision support can provide nursing with a template, technique...

Investigating the micromorphological differences of the implant-abutment junction and their clinical implications: a pilot study.

Science.gov (United States)

Mattheos, Nikos; Li, Xiaona; Zampelis, Antonios; Ma, Li; Janda, Martin

2016-11-01

The aim of this pilot study was to investigate the morphological micro-features of three commercially available implant-abutment joints, using compatible and original prosthetic components. Furthermore, possible correlations between the micromorphology and potential functional complications were investigated with the use of finite element analysis. Three abutments (one original and two compatibles) were torqued on original Straumann RN implants, as according to each of the manufacturer's instructions. The implant-abutment units were sliced in the microtome and photographed under different magnifications (10×-500×) through a scanning electron microscope. Finite element analysis models were reconstructed for each of the implant-abutment units using the precise measurements from the SEM. Differences in stress, strain and deformation for the three different abutments were then calculated using ANSYS Workbench v13. Major dimensional differences were identified between all studied contact areas of the three units. The tight contact in the implant shoulder was similar in all three units, but engagement of the internal connection and, in particular, the anti-rotation elements was seriously compromised in the compatible abutments. One compatible abutment demonstrated compromised engagement of the abutment screw as well. Equivalent stress and strain in the FEA were much higher for the compatible abutments. An evaluation of the sequence of preload application revealed differences in the pattern of deformation between the original and compatible abutments, which can have serious clinical implications. Compatible abutments can present critical morphological differences from the original ones. The differences in the cross-sectional geometry result in large differences in the overall contact areas, both in terms of quality and quantity which could have serious implications for the long-term stability of the prosthesis. © 2015 John Wiley & Sons A/S. Published by John Wiley

Tensions of Reimagining Our Roles as Teacher Educators in a Third Space: Revisiting a Co/Autoethnography through a Faculty Lens

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Taylor, Monica; Klein, Emily J.; Abrams, Linda

2014-01-01

This co/autoethnography uses our lens as university faculty to examine how engaging in a year-long self-study with mentors nurtured a complicated third space where we could together begin to reimagine our roles as teacher educators. Two secondary faculty members and a doctoral assistant used co/autoethnography to revisit a collaborative self-study…

Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

Science.gov (United States)

Johnston, Rory; Crooks, Valorie A; Ormond, Meghann

2015-07-04

Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua's framework to identify overlapping and divergent issues. Many of the issues identified in Pocock and Phua's policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework. The framework

Running spectral index from large-field inflation with modulations revisited

Energy Technology Data Exchange (ETDEWEB)

Czerny, Michael, E-mail: mczerny@tuhep.phys.tohoku.ac.jp [Department of Physics, Tohoku University, Sendai 980-8578 (Japan); Kobayashi, Takeshi, E-mail: takeshi@cita.utoronto.ca [Canadian Institute for Theoretical Astrophysics, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 3H8 (Canada); Perimeter Institute for Theoretical Physics, 31 Caroline Street North, Waterloo, Ontario N2L 2Y5 (Canada); Takahashi, Fuminobu, E-mail: fumi@tuhep.phys.tohoku.ac.jp [Department of Physics, Tohoku University, Sendai 980-8578 (Japan); Kavli IPMU, TODIAS, University of Tokyo, Kashiwa 277-8583 (Japan)

2014-07-30

We revisit large field inflation models with modulations in light of the recent discovery of the primordial B-mode polarization by the BICEP2 experiment, which, when combined with the Planck+WP+highL data, gives a strong hint for additional suppression of the CMB temperature fluctuations at small scales. Such a suppression can be explained by a running spectral index. In fact, it was pointed out by two of the present authors (TK and FT) that the existence of both tensor mode perturbations and a sizable running of the spectral index is a natural outcome of large inflation models with modulations such as axion monodromy inflation. We find that this holds also in the recently proposed multi-natural inflation, in which the inflaton potential consists of multiple sinusoidal functions and therefore the modulations are a built-in feature.

Revisiting of Stommel's model for the understanding of the abrupt climate change

International Nuclear Information System (INIS)

Scatamacchia, R.; Purini, R.; Rafanelli, C.

2010-01-01

Despite the enormous number of papers devoted to modelling climate changes, the pionieristic Stommel paper (1961) remains a still valid tool for the understanding of the basic mechanism that governs the abrupt climate change, i.e. the existence of multipla equilibria in the governing non-linear equations. Using non-dimensional quantities, Stommel did not provide any explicit information about the temporal scale affecting the process under examination when the control parameters are varied. On the basis of this consideration, the present paper revisits the Stommel theory putting some emphasis on the quantitative estimate of how the variations of the control system parameters system modify the fundamental motor of the climate change, i.e. the thermohaline circulation.

Micrometastatic cancer cells in lymph nodes, bone marrow, and blood: Clinical significance and biologic implications.

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Leong, Stanley P L; Tseng, William W

2014-01-01

Cancer metastasis may be regarded as a progressive process from its inception in the primary tumor microenvironment to distant sites by way of the lymphovascular system. Although this type of tumor dissemination often occurs in an orderly fashion via the sentinel lymph node (SLN), acting as a possible gateway to the regional lymph nodes, bone marrow, and peripheral blood and ultimately to distant metastatic sites, this is not a general rule as tumor cells may enter the blood and spread to distant sites, bypassing the SLN. Methods of detecting micrometastatic cancer cells in the SLN, bone marrow, and peripheral blood of patients have been established. Patients with cancer cells in their SLN, bone marrow, or peripheral blood have worse clinical outcomes than patients with no evidence of spread to these compartments. The presence of these cells also has important biologic implications for disease progression and the clinician's understanding of the process of cancer metastasis. Further characterization of these micrometastatic cancer cells at each stage and site of metastasis is needed to design novel selective therapies for a more "personalized" treatment. © 2014 American Cancer Society, Inc.

Feasibility, Acceptability, and Clinical Trends of a Mindfulness-Informed Child Welfare Intervention: Implications for Trauma-Focused Practice

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Samantha M. Brown

2017-09-01

Full Text Available Exposure to stress and early life trauma have been linked to child maltreatment and parental substance misuse. These issues often co-occur, yet few child welfare services target their shared underlying causes in a single intervention. Teaching mindfulness-informed strategies to substance-misusing families in the child welfare system may be one promising trauma-informed approach. As part of a larger pilot study testing the initial efficacy of a mindfulness-informed intervention for parents in public child welfare, this study explored the feasibility, acceptability, and clinical trends of the intervention using weekly reports of stress, coping, and mindfulness. Findings show support for the feasibility and acceptability of the intervention as well as positive responses to the intervention on measures of stress and mindfulness. However, the impact of the intervention varied with regard to improving weekly coping among participants. Implications for the integration of mindfulness into child welfare practice as a trauma-informed approach are discussed.

The importance of least restrictive care: the clinical implications of a recent High Court decision on negligence.

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Ryan, Christopher James; Callaghan, Sascha; Large, Matthew

2015-08-01

This paper aims to explain the meaning and implications for practice of the High Court of Australia's finding in the negligence case, Hunter and New England Local Health District v McKenna [2014] HCA 44. The facts of the case and the law of negligence are reviewed before reporting the Court's decision. The High Court found that the obligation upon doctors to provide the least restrictive option for care that was imposed by the, then applicable, Mental Health Act 1990 (NSW) was inconsistent with an obligation that might otherwise be imposed by a common law duty to have regard to the interests of those with whom a psychiatric patient may come into contact if not detained. The Court's finding underlines the importance of clinicians documenting their clinical reasoning around why their negotiated management plan was the option least restrictive of the patient's freedom and most protective of his or her human rights. © The Royal Australian and New Zealand College of Psychiatrists 2015.

arXiv Uncertainties in WIMP Dark Matter Scattering Revisited

CERN Document Server

Ellis, John; Olive, Keith A.

We revisit the uncertainties in the calculation of spin-independent scattering matrix elements for the scattering of WIMP dark matter particles on nuclear matter. In addition to discussing the uncertainties due to limitations in our knowledge of the nucleonic matrix elements of the light quark scalar densities , we also discuss the importances of heavy quark scalar densities , and comment on uncertainties in quark mass ratios. We analyze estimates of the light-quark densities made over the past decade using lattice calculations and/or phenomenological inputs. We find an uncertainty in the combination that is larger than has been assumed in some phenomenological analyses, and a range of that is smaller but compatible with earlier estimates. We also analyze the importance of the {\\cal O}(\\alpha_s^3) calculations of the heavy-quark matrix elements that are now available, which provide an important refinement of the calculation of the spin-independent scattering cross section. We use for illustration a benchmar...

Revisiting Cross-Channel Information Transfer for Chromatic Aberration Correction

KAUST Repository

Sun, Tiancheng; Peng, Yifan; Heidrich, Wolfgang

2017-01-01

Image aberrations can cause severe degradation in image quality for consumer-level cameras, especially under the current tendency to reduce the complexity of lens designs in order to shrink the overall size of modules. In simplified optical designs, chromatic aberration can be one of the most significant causes for degraded image quality, and it can be quite difficult to remove in post-processing, since it results in strong blurs in at least some of the color channels. In this work, we revisit the pixel-wise similarity between different color channels of the image and accordingly propose a novel algorithm for correcting chromatic aberration based on this cross-channel correlation. In contrast to recent weak prior-based models, ours uses strong pixel-wise fitting and transfer, which lead to significant quality improvements for large chromatic aberrations. Experimental results on both synthetic and real world images captured by different optical systems demonstrate that the chromatic aberration can be significantly reduced using our approach.

Revisiting Cross-Channel Information Transfer for Chromatic Aberration Correction

KAUST Repository

Sun, Tiancheng

2017-12-25

Image aberrations can cause severe degradation in image quality for consumer-level cameras, especially under the current tendency to reduce the complexity of lens designs in order to shrink the overall size of modules. In simplified optical designs, chromatic aberration can be one of the most significant causes for degraded image quality, and it can be quite difficult to remove in post-processing, since it results in strong blurs in at least some of the color channels. In this work, we revisit the pixel-wise similarity between different color channels of the image and accordingly propose a novel algorithm for correcting chromatic aberration based on this cross-channel correlation. In contrast to recent weak prior-based models, ours uses strong pixel-wise fitting and transfer, which lead to significant quality improvements for large chromatic aberrations. Experimental results on both synthetic and real world images captured by different optical systems demonstrate that the chromatic aberration can be significantly reduced using our approach.

HOXA genes cluster: clinical implications of the smallest deletion

OpenAIRE

Pezzani, Lidia; Milani, Donatella; Manzoni, Francesca; Baccarin, Marco; Silipigni, Rosamaria; Guerneri, Silvana; Esposito, Susanna

2015-01-01

Background HOXA genes cluster plays a fundamental role in embryologic development. Deletion of the entire cluster is known to cause a clinically recognizable syndrome with mild developmental delay, characteristic facies, small feet with unusually short and big halluces, abnormal thumbs, and urogenital malformations. The clinical manifestations may vary with different ranges of deletions of HOXA cluster and flanking regions. Case presentation We report a girl with the smallest deletion reporte...

Nothing New (Ethically Under the Sun: Policy & Clinical Implications of Nanomedicine

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MacDonald, Chris

2012-06-01

Full Text Available Nanotechnology research is beginning to see widespread coverage in the media and popular science literatures, but discussions of hopes and fears about nanotechnology have already become polarised into utopian and dystopian visions. More moderate discussions focus on the near-term applications of nanotechnologies, and on potential benefits and harms. However, in exploring the social and ethical implications of nanotechnology (or nanomedicine, the focus of this paper, important lessons should be learned from experiences in other fields. In particular, studies of the ethical, legal, and social issues (ELSI of genetics research have successfully mapped out many of the issues (and social and political responses that arise when new technologies are deployed. It is our contention that, for the most part, the ethical and social issues arising in nanomedicine are not altogether new, and thus do not require novel ethical principles or frameworks, nor a massive investment in ‘NELSI’ research. Instead, what is needed is support for the development of a culture of ethics amongst scientists and clinicians, basic scientific and medical knowledge for bioethicists, and a social competency for citizens to participate actively in debates about the implications of new technologies in general.

The role of glycans in immune evasion: the human fetoembryonic defence system hypothesis revisited.

Science.gov (United States)

Clark, Gary F

2014-03-01

Emerging data suggest that mechanisms to evade the human immune system may be shared by the conceptus, tumour cells, persistent pathogens and viruses. It is therefore timely to revisit the human fetoembryonic defense system (Hu-FEDS) hypothesis that was proposed in two papers in the 1990s. The initial paper suggested that glycoconjugates expressed in the human reproductive system inhibited immune responses directed against gametes and the developing human by employing their carbohydrate sequences as functional groups. These glycoconjugates were proposed to block specific binding interactions and interact with lectins linked to signal transduction pathways that modulated immune cell functions. The second article suggested that aggressive tumour cells and persistent pathogens (HIV, H. pylori, schistosomes) either mimicked or acquired the same carbohydrate functional groups employed in this system to evade immune responses. This subterfuge enabled these pathogens and tumour cells to couple their survival to the human reproductive imperative. The Hu-FEDS model has been repeatedly tested since its inception. Data relevant to this model have also been obtained in other studies. Herein, the Hu-FEDS hypothesis is revisited in the context of these more recent findings. Far more supportive evidence for this model now exists than when it was first proposed, and many of the original predictions have been validated. This type of subterfuge by pathogens and tumour cells likely applies to all sexually reproducing metazoans that must protect their gametes from immune responses. Intervention in these pathological states will likely remain problematic until this system of immune evasion is fully understood and appreciated.

Regulating clinical trials in India: the economics of ethics.

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Porter, Gerard

2017-07-09

The relationship between the ethical standards for the governance of clinical trials and market forces can be complex and problematic. This article uses India as a case study to explore this nexus. From the mid-2000s, India became a popular destination for foreign-sponsored clinical trials. The Indian government had sought to both attract clinical trials and ensure these would be run in line with internationally accepted ethical norms. Reports of controversial medical research, however, triggered debate about the robustness and suitability of India's regulatory system. In response to civil society pressure and interventions by the Supreme Court, the Indian government proposed additional measures aimed at strengthening protections for clinical trial participants. Whilst the reforms can be seen as a victory for human rights activists, they have also been criticised as being overly burdensome for sponsors. Indeed, their announcement prompted an exodus of clinical trials from India. Fearful of losing business to 'rival' countries, the Indian government is revisiting some of its proposals. The Indian example suggests that research ethics frameworks and national policies for economic development are increasingly intertwined. Host countries are in theory free to improve the lot of research participants, but doing so may make them appear less attractive to foreign sponsors, who can simply shift their activities to more industry-friendly jurisdictions. Although these economic pressures are unlikely to lead to a regulatory 'race to the bottom', they may limit host countries' ability to enact socially desirable reforms. © 2017 John Wiley & Sons Ltd.

Implications of Clinical Trial Design on Sample Size Requirements

OpenAIRE

Leon, Andrew C.

2008-01-01

The primary goal in designing a randomized controlled clinical trial (RCT) is to minimize bias in the estimate of treatment effect. Randomized group assignment, double-blinded assessments, and control or comparison groups reduce the risk of bias. The design must also provide sufficient statistical power to detect a clinically meaningful treatment effect and maintain a nominal level of type I error. An attempt to integrate neurocognitive science into an RCT poses additional challenges. Two par...

The Vicious Cycle of Myostatin Signaling in Sarcopenic Obesity: Myostatin Role in Skeletal Muscle Growth, Insulin Signaling and Implications for Clinical Trials.

Science.gov (United States)

Consitt, L A; Clark, B C

2018-01-01

The age-related loss of skeletal muscle (sarcopenia) is a major health concern as it is associated with physical disability, metabolic impairments, and increased mortality. The coexistence of sarcopenia with obesity, termed 'sarcopenic obesity', contributes to skeletal muscle insulin resistance and the development of type 2 diabetes, a disease prevalent with advancing age. Despite this knowledge, the mechanisms contributing to sarcopenic obesity remain poorly understood, preventing the development of targeted therapeutics. This article will discuss the clinical and physiological consequences of sarcopenic obesity and propose myostatin as a potential candidate contributing to this condition. A special emphasis will be placed on examining the role of myostatin signaling in impairing both skeletal muscle growth and insulin signaling. In addition, the role of myostatin in regulating muscle-to fat cross talk, further exacerbating metabolic dysfunction in the elderly, will be highlighted. Lastly, we discuss how this knowledge has implications for the design of myostatin-inhibitor clinical trials.

Physician-assisted suicide: a review of the literature concerning practical and clinical implications for UK doctors

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Hicks Madelyn

2006-06-01

Full Text Available Abstract Background A bill to legalize physician-assisted suicide in the UK recently made significant progress in the British House of Lords and will be reintroduced in the future. Until now there has been little discussion of the clinical implications of physician-assisted suicide for the UK. This paper describes problematical issues that became apparent from a review of the medical and psychiatric literature as to the potential effects of legalized physician-assisted suicide. Discussion Most deaths by physician-assisted suicide are likely to occur for the illness of cancer and in the elderly. GPs will deal with most requests for assisted suicide. The UK is likely to have proportionately more PAS deaths than Oregon due to the bill's wider application to individuals with more severe physical disabilities. Evidence from other countries has shown that coercion and unconscious motivations on the part of patients and doctors in the form of transference and countertransference contribute to the misapplication of physician-assisted suicide. Depression influences requests for hastened death in terminally ill patients, but is often under-recognized or dismissed by doctors, some of whom proceed with assisted death anyway. Psychiatric evaluations, though helpful, do not solve these problems. Safeguards that are incorporated into physician-assisted suicide criteria probably decrease but do not prevent its misapplication. Summary The UK is likely to face significant clinical problems arising from physician-assisted suicide if it is legalized. Terminally ill patients with mental illness, especially depression, are particularly vulnerable to the misapplication of physician-assisted suicide despite guidelines and safeguards.

The odd one out: Revisiting and investigating the gender imbalance in ICT study choices

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Scott Morton

Full Text Available For the past two decades there has been an imbalance between male and female students entering the Bachelor of Information Technology degree from high schools. The literature suggests that only one in six students entering higher education to study computer related degrees are female. It also suggests that occupational stereotyping can be linked to the decline in the number of females entering computing degree courses. This research is proposing to revisit and investigate why this is still prevalent in today\\'s society that has been brought up on technology and can see the benefits of good careers and good jobs.

Revisiting top-bottom-tau Yukawa unification in supersymmetric grand unified theories

International Nuclear Information System (INIS)

Tobe, Kazuhiro; Wells, James D.

2003-01-01

Third family Yukawa unification, as suggested by minimal SO(10) unification, is revisited in light of recent experimental measurements and theoretical progress. We characterize unification in a semi-model-independent fashion, and conclude that finite b quark mass corrections from superpartners must be non-zero, but much smaller than naively would be expected. We show that a solution that does not require cancellations of dangerously large tanβ effects in observables implies that scalar superpartner masses should be substantially heavier than the Z scale, and perhaps inaccessible to all currently approved colliders. On the other hand, gauginos must be significantly lighter than the scalars. We demonstrate that a spectrum of anomaly-mediated gaugino masses and heavy scalars works well as a theory compatible with third family Yukawa unification and dark matter observations

Genetic and epigenetic regulatory mechanisms of the oxytocin receptor gene (OXTR) and the (clinical) implications for social behavior.

Science.gov (United States)

Tops, Sanne; Habel, Ute; Radke, Sina

2018-03-12

Oxytocin and the oxytocin receptor (OXTR) play an important role in a large variety of social behaviors. The oxytocinergic system interacts with environmental cues and is highly dependent on interindividual factors. Deficits in this system have been linked to mental disorders associated with social impairments, such as autism spectrum disorder (ASD). This review focuses on the modulation of social behavior by alterations in two domains of the oxytocinergic system. We discuss genetic and epigenetic regulatory mechanisms and alterations in these mechanisms that were found to have clinical implications for ASD. We propose possible explanations how these alterations affect the biological pathways underlying the aberrant social behavior and point out avenues for future research. We advocate the need for integration studies that combine multiple measures covering a broad range of social behaviors and link these to genetic and epigenetic profiles. Copyright © 2018. Published by Elsevier Inc.

Implications of the behavioral approach to hypnosis.

Science.gov (United States)

Starker, S

1975-07-01

The findings of behaviorally oriented research regarding the importance of cognitive-motivational variables in hypnosis are examined and some clinical and theoretical implications are explored. Hypnosis seems usefully conceptualized as a complex configuration or gestalt of interacting variables on several different levels, for example, cognitive, motivational, social, physiologic.

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology.

Science.gov (United States)

Shahbazi-Gahrouei, Daryoush; Saeb, Mohsen; Monadi, Shahram; Jabbari, Iraj

2017-01-01

Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany). Seven test cases were performed using semi CIRS phantom. In homogeneous regions and simple plans for both energies, there was a good agreement between measured and treatment planning system calculated dose. Their relative error was found to be between 0.8% and 3% which is acceptable for audit, but in nonhomogeneous organs, such as lung, a few errors were observed. In complex treatment plans, when wedge or shield in the way of energy is used, the error was in the accepted criteria. In complex beam plans, the difference between measured and calculated dose was found to be 2%-3%. All differences were obtained between 0.4% and 1%. A good consistency was observed for the same type of energy in the homogeneous and nonhomogeneous phantom for the three-dimensional conformal field with a wedge, shield, asymmetric using the TiGRT treatment planning software in studied center. The results revealed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy was globally within acceptable standards with no major causes for concern.

Serum N-terminal-pro-brain natriuretic peptide level and its clinical implications in patients with atrial fibrillation.

Science.gov (United States)

Bai, Mei; Yang, Jiefu; Li, Yingying

2009-12-01

Brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not been determined. This study investigates serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its clinical implications in patients with AF. Serum NT-proBNP levels were measured by enzyme-linked immunosorbent assay (ELISA) and transthoracic echocardiography was performed in 136 subjects (90 cases with AF and 46 cases with sinus rhythm [SR]). Subjects were excluded if they had a history of myocardial infarction, cardiomyopathy, rheumatic heart disease, or hyperthyroidism that preceded the onset of AF. Controls (n = 30) were from a healthy outpatient primary care population. Potential determinants of serum NT-proBNP levels were identified by univariate and multivariate analyses. Individuals with AF had higher serum NT-proBNP levels (689.56 +/- 251.87 fmol/ml) than those with SR (456.11 +/- 148.14 fmol/ml, P NT-proBNP levels (P > 0.05). The regression model of serum NT-proBNP levels and clinical predictors showed that presence of AF, older age, and larger right atrial diameter were independently predictive of higher serum NT-proBNP values. Patients with AF were associated with increased serum NT-proBNP levels. Examining the change of serum NT-proBNP levels is helpful to evaluate the cardiac function in patients with AF. Copyright 2009 Wiley Periodicals, Inc.